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Limited data are available about the role of the serotonin 2B (5-HT2B) receptor in the function of human islets. This study aimed to test whether the 5-HT2B receptor contributes to glucose, insulin, and glucagon homeostasis in humans, utilizing a hereditary loss-of-function gene mutation in the receptor, which causes a 50% reduction in the production of the receptor protein in heterozygotes. This clinical study enrolled participants recruited by newspaper advertisements and from mental status examinations. A cohort of participants from a young Finnish founder population composed of 68 non-diabetic males with a mean age of 30 was divided into groups for comparison based on being a 5-HT2B receptor loss-of-function gene mutation (HTR2B Q20*) heterozygote carrier (n = 11) or not (n = 57). Serum levels of glucose, insulin, and glucagon were measured in a 5 h oral glucose tolerance test using a 75 g glucose challenge. Insulin resistance, insulin sensitivity, and beta cell activity were calculated using the homeostasis model assessment (HOMA2) and whole body insulin sensitivity index (WBISI), as well as the ratio of glucagon to insulin was noted. The areas under the curves (AUCs) were also determined. Concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) were measured in cerebrospinal fluid (CSF). Covariate adjusted mean score comparisons were applied. Lower glucagon secretion and decreased glucose excursion were observed among HTR2B Q20* carriers as compared with individuals who were homozygotes for the wild-type Q20 allele (controls). No differences in insulin secretion, beta cell activity, insulin resistance, or insulin sensitivity were observed. The glucagon to insulin ratio differed between the HTR2B Q20* carriers and controls. CSF levels of 5-HIAA were similar between groups. Our findings indicate that the 5-HT2B receptor may contribute to the regulation of human glucagon and glucose homeostasis and the interplay between glucagon and insulin secretion. [ABSTRACT FROM AUTHOR]

New approaches of analysis show that the public policies are the result of complex joints between diverse referential frames. Some investigations center his attention on the processes for which there develop the learnings, the convergences, the diffusion and the transfer in public policies. This article analyzes the diffusion of cash conditional transfer programs developed in Latin America and the Caribe. It shows the epicenters of the original ideas and the incident of the local epistemic communities as well as of the international organizations. The debate that these actors generated, contributed to the adoption of similar measures in the rest of the continent, by means of a movement of diffusion in the shape of wave. The adoption of the model happens in spite of the different socio-political situations between the countries recipients. The widespread adoption of the new model, re-defined the orientation of the policies of assistance in the S XXI

Forty one moderately impaired patients with clinically confirmed multiple sclerosis (MS) and a relapsing-remitting course were submitted to a neuropsychological battery and magnetic resonance imaging (MRI) to correlate the neuropsychological performances with the degree of cerebral demyelination. The neuropsychological results were indicative of a very mild overall impairment. The patients were subdivided into two groups (extensive periventricular demyelination or discrete lesions on MRI) and the results of neuropsychological tests compared. Patients with extensive periventricular demyelination had an inferior performance on concept formation, non-verbal reasoning and verbal memory tests. [ABSTRACT FROM AUTHOR]

Eculizumab (ECU) and Efgartigimod (EFGA) are approved for the treatment of generalized Myasthenia Gravis (gMG). Objective of our study is to describe their clinical response in a real-life setting. We included patients receiving either ECU or EFGA as part of our clinic practice and retrospectively collected data on the MG activities of daily living (MG-ADL), quantitative MG scale (QMG), MG deterioration/crises, adverse events, and prednisone use. We enrolled 63 patients, 32 treated with ECU and 31 with EFGA. Median follow-up was 253 days. Both treatments were well tolerated. Patients treated with EFGA were more likely to suspend treatment (HR 3.732; p=0.043). Main reasons were MG deterioration, patient choice, adverse event. ECU decreased the MG deterioration/crises rate more than EFGA (OR 0.545, p=0.043). Treatment did not impact on the MG-ADL reduction (F=1.3; p=0.237). Mean prednisone reduction at follow-up was -16.7 mg for ECU and -5.2 mg for EFGA (F=11.7; p=0.001). Eculizumab was superior to Efgartigimod in reducing the QMG score (F=4.9; p=0.003). By week 24, the QMG decreased by -7.8 for ECU and -2.8 for EFGA. Speed of CS reduction was superior in ECU treated patients compared to EFGA (-13.1 mg/month vs -3.2 mg/month; p=0.001). Eculizumab and Efgartigimod proved to be both effective treatments in a real-world setting. Both treatments reduced MG-ADL and QMG in difficult to treat gMG patients. Patients treated with ECU were less likely to suspend treatment or show a deterioration/crisis. Prednisone sparing effect and reduction speed was higher with Eculizumab. [ABSTRACT FROM AUTHOR]