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We summarize the existing literature data concerning the involvement of skeletal muscle (SM) in whole body glucose homeostasis and the contribution of SM insulin resistance (IR) to the metabolic derangements observed in several endocrine disorders, including polycystic ovary syndrome (PCOS), adrenal disorders and thyroid function abnormalities. IR in PCOS is associated with a unique postbinding defect in insulin receptor signaling in general and in SM in particular, due to a complex interaction between genetic and environmental factors. Adrenal hormone excess is also associated with disrupted insulin action in peripheral tissues, such as SM. Furthermore, both hyper- and hypothyroidism are thought to be insulin resistant states, due to insulin receptor and postreceptor defects. Further studies are definitely needed in order to unravel the underlying pathogenetic mechanisms. In summary, the principal mechanisms involved in muscle IR in the endocrine diseases reviewed herein include abnormal phosphorylation of insulin signaling proteins, altered muscle fiber composition, reduced transcapillary insulin delivery, decreased glycogen synthesis, and impaired mitochondrial oxidative metabolism.

Wetting experiments, by the sessile drop technique, were carried out at 37 degrees C in air to determine the surface and interfacial interactions that take place in various solid bioceramics based on Al2O3, ZrO2(YPZ), SiO2, and TiO2 in contact with water, Ringer solution, artificial synovial fluid, calf serum, human plasma, and whole blood (+ EDTA). The surface energy of the liquids was measured by the ring method. The calculated values of the energy of interaction (work of adhesion) reveal that intermolecular forces act across the solid-liquid interfaces. The contribution of the dispersion and polar interactions to the surface energy of the polar liquids and the pure or mixed oxides was determined assuming that in the system of Mn-steel-liquids only dispersion forces act at the interface. It was found that the contribution of the polar interactions to the energy of interaction at the solid-liquid interface increases with the glassy phase content of the oxide that causes reduction of the measured contact angle.

OBJECTIVES To assess the effect of bladder instillations of hyaluronic acid (HA) on the rate of recurrence of urinary tract infection (UTI). PATIENTS AND METHODS Forty women (mean age 35 years) with a history of recurrent UTI received intravesical instillations of HA (40 mg in 50 mL phosphate‐buffered saline) once weekly for 4 weeks then once monthly for 4 months. The UTI status was assessed over a prospective follow‐up of 12.4 months and compared with the rates of UTI before instillation, determined by a retrospective review of patient charts covering 15.8 months. RESULTS After HA treatment no patients had a UTI during the 5‐month treatment phase and 28 (70%) were recurrence‐free at the end of the follow‐up. The mean (sd) rate of UTI per patient‐year was 4.3 (1.55) before treatment and 0.3 (0.55) afterward (P < 0.001). The median time to recurrence after HA treatment was 498 days, compared with 96 days beforehand (P < 0.001). The tolerability was excellent, as side‐effects were limited to nine patients who reported mild bladder irritation; no patient interrupted the treatment. CONCLUSIONS In this preliminary study, bladder instillations of HA had a significant effect on the rate of UTI in women with a history of recurrent UTIs. The bladder instillation of HA is an acceptable and promising therapeutic alternative in patients with recurrent UTI. Expanded placebo controlled clinical trials examining this application of HA are currently underway.

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