Glucose is the primary energy source for the brain, and exposure to both high and low levels of glucose has been associated with numerous adverse central nervous system (CNS) outcomes. While a large body of work has highlighted the impact of hyperglycemia on peripheral and central measures of oxidative stress, cognitive deficits, and vascular complications in Type 1 and Type 2 diabetes, there is growing evidence that glycemic variability significantly drives increased oxidative stress, leading to neuroinflammation and cognitive dysfunction. In this review, the latest data on the impact of glycemic variability on brain function and neuroinflammation will be presented. Because high levels of oxidative stress have been linked to dysfunction of the blood–brain barrier (BBB), special emphasis will be placed on studies investigating the impact of glycemic variability on endothelial and vascular inflammation. The latest clinical and preclinical/in vitro data will be reviewed, and clinical/therapeutic implications will be discussed.
This is retrospective report of 107 cases of poisonous snakebites treated in south Georgia and north Florida. Sixty-seven percent of the cases required intensive treatment. Intravenous antivenin therapy, if indicated, should be given early and over a short time. Steroids are of use primarily for allergic phenomena. Fasciotomies were not necessary unless cooling or inadequate antivenin had been administered. A grading system that matches the species of snake with the severity of the bite was used to classify the cases.
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