Introduction
The effects of incretin-based drugs, such as receptor agonists of glucagon-like peptide-1 and inhibitors of dipeptidyl peptidase-4, on bone metabolism are not completely clear yet. The aim of this study is to compare the effects of glucagon-like peptide-1 and inhibitors of dipeptidyl peptidase-4 on the bone to see how different elements of the incretin pathway affect bone quality in terms of biomechanical properties, bone turnover, and mineral properties.
Materials and methods
Forty 10-week-old Wistar rats were divided into four groups: a control group, a control diabetic group, a diabetic group treated with sitagliptin, and a diabetic group treated with exenatide. Type 2 diabetes was simulated by dietary manipulation in addition to low-dose streptozotocin, and then two different incretin-based drugs were administered. The rats were sacrificed after five weeks of therapeutic treatment. Their serum was analyzed with the enzyme-linked immunosorbent assay (ELISA) method for basic bone turnover markers, and their right femur was subjected to a three-point bending test. Finally, Hematoxylin & Eosin staining, in addition to Raman spectroscopy, were employed to access the collagen and mineral properties of the bone.
Results
Both incretin-based drugs reduced osteoclast function; however, they were not able to restore osteoblastic function to normal. The net effect on bone strength was surprising: bone elasticity was restored by the antidiabetic treatment, but bone strength deteriorated. Exenatide had a slightly more pronounced effect, which, although not significant, points to the direction that dipeptidyl peptidase-4 (DPP4) may be a linking factor between reduced osteoclastic function and reduced bone formation, as suggested by the literature.
Conclusion
DPP4 receptors seem to be one of the links between reduced osteoclast function and reduced bone remodeling, so DPP4 inhibition can be more detrimental to the bone than glucagon-like peptide-1 (GLP-1) receptor agonists.
Aim of the present study is to expand our knowledge of the anatomy of the 11th cranial nerve and discuss the clinical importance and literature pertaining to accessory nerve duplication. We present one case of duplicated spinal accessory nerve in a patient undergoing neck dissection for oral cavity cancer. The literature review confirms the extremely rare diagnosis of a duplicated accessory nerve. Its clinical implication is of great importance. From this finding, a further extension to our knowledge of the existing anatomy is proposed.
Infected coronary artery aneurysms present high mortality and surgical
management is the treatment of choice in most cases. We present a case
of a giant infected aneurysm of the mid right coronary artery
complicated with purulent pericarditis in an 83-year-old male patient.
It is unknown whether the aneurysm or purulent pericarditis preceded.
The patient underwent urgent aneurysm resection and coronary artery
distal bypass grafting. He died 24 hours after the operation. When
purulent pericarditis and ICAA co-exist the riddle of the chicken and
the egg becomes apparent.
Ameloblastoma is a rare, benign (99%) or malignant (1%) tumour, which has derived from dental mesenchyme. We present a case of a patient mainly complaining about obstruction on the right nasal cavity. Endoscopy and computed tomography revealed a soft tissue mass occupying the maxillary sinus to the middle meatus causing complete obstruction of the right nasal cavity. Endoscopic en block removal of the lesion and biopsy confirmed follicular ameloblastoma. Literature review confirms the extremely rare frequency of ameloblastoma. The aim of the present study is to expand on our knowledge of a rare pathological entity that can frequently be misdiagnosed.
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