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Consumption of coffee is associated with reduced risk of Parkinson's disease (PD), an effect that has largely been attributed to caffeine. However, coffee contains numerous components that may also be neuroprotective. One of these compounds is eicosanoyl-5-hydroxytryptamide (EHT), which ameliorates the phenotype of α-synuclein transgenic mice associated with decreased protein aggregation and phosphorylation, improved neuronal integrity and reduced neuroinflammation. Here, we sought to investigate if EHT has an effect in the MPTP model of PD. Mice fed a diet containing EHT for four weeks exhibited dose-dependent preservation of nigral dopaminergic neurons following MPTP challenge compared to animals given control feed. Reductions in striatal dopamine and tyrosine hydroxylase content were also less pronounced with EHT treatment. The neuroinflammatory response to MPTP was markedly attenuated, and indices of oxidative stress and JNK activation were significantly prevented with EHT. In cultured primary microglia and astrocytes, EHT had a direct anti-inflammatory effect demonstrated by repression of lipopolysaccharide-induced NFκB activation, iNOS induction, and nitric oxide production. EHT also exhibited a robust anti-oxidant activity in vitro. Additionally, in SH-SY5Y cells, MPP(+)-induced demethylation of phosphoprotein phosphatase 2A (PP2A), the master regulator of the cellular phosphoregulatory network, and cytotoxicity were ameliorated by EHT. These findings indicate that the neuroprotective effect of EHT against MPTP is through several mechanisms including its anti-inflammatory and antioxidant activities as well as its ability to modulate the methylation and hence activity of PP2A. Our data, therefore, reveal a strong beneficial effect of a novel component of coffee in multiple endpoints relevant to PD. [ABSTRACT FROM AUTHOR]

Background: Despite the plethora of data in the critical care setting, there are few studies to guide clinicians in the hospitalwide care of patients with hyperglycemia., Methods: Patients 18 years of age and older who had a discharge diagnosis code for diabetes were admitted between January 1, 2005, and December 31, 2010, and received an insulin infusion for any reason were included in the analysis. Patients were receiving noncritical care or cardiac care (with interchangeable critical and noncritical care capacity). The effect of an insulin infusion guideline introduced in 2006 with a target glucose of 5.6-8.3 mmol/L was measured. Hyperglycemic (> 11.1 mmol/L) and hypoglycemic (< 3.9 or < 2.8 mmol/L) events were analyzed using multivariable models., Results: After adjusting for age, gender, race, and nutrition, there was a significant decrease in time to first glucose < 8.3 mmol/L in hours (T8.3; p = .01) and hyperglycemia (p < .0001) in the year following implementation of the guideline in cardiac but not noncritical beds, which persisted through 2010. There was a significant decrease in hypoglycemic events by Year 3 in cardiac beds and by Year 5 in noncritical beds. Compared with patients who received nothing by mouth, patients eating discrete meals had significantly longer T8.3, greater variability, and more hyperglycemic and hypoglycemic events in cardiac and noncritical beds., Conclusions: Following the hospitalwide implementation of a nursing-run insulin infusion guideline, rapid, stable reduction in hyperglycemia was achieved in cardiac beds (having interchangeable ICU and non-ICU status), and the frequency of hypoglycemia steadily decreased over time in both cardiac and noncardiac beds. Oral intake and enteral feeding were associated with worse glycemic control.

Maintaining sustainable practices will require a concert of efforts including industry-wide cooperation, governmental openness, and education reform.

Complete mastery of dermatology is difficult, if not impossible. However, for the open-minded, inquisitive dermatologist, there are many tangential areas that can be studied. This article presents some of the items that have been of interest to me. I hope it inspires others to search out sidelights that will be equally fascinating.