Obesity, mainly characterized by the excess fat storage, is a global health problem resulting in serious morbidity and mortality. Identification of molecular mechanisms in adipogenic differentiation pathway might lead to development of new strategies for diagnosis, prevention and therapy of obesity and associated diseases. Discovery of new genes and proteins in the differentiation pathway could help to understand the key specific regulators of the adipogenesis. Cytoglobin (Cygb), identified as a new globin family member protein, is expressed in various tissues. Although its interaction with oxygen and nitric oxide indicates the potential role in antioxidant pathways, the exact role remains unclear. In the current study, expression level of Cygb was determined in proliferating and differentiating 3T3-F442A cells by gene expression and protein expression analysis. Results revealed that Cygb expression up-regulated in differentiated cells in parallel with adipogenic differentiation markers; PPARγ, CEBPα and FABP4 expressions. Besides, Cygb overexpression in preadipocytes contributed to the adipogenic differentiation as verified by detection of higher lipid droplets and increased PPARγ, CEBPα and FABP4 expressions with respect to control cells. These findings will shed light on the unknown roles of Cygb in adipogenesis and obesity.
In 2015 HMS DUNCAN was chosen as the intervention ship for an Institute of Naval Medicine (INM)-led project entitled Second Sea Lord (2SL)’s Feeding the Fleet Initiative. During her nine-month maiden deployment on Operation KIPION, a healthy lifestyle intervention was initiated, encompassing executive health, catering services, medical services and physical training. The key enabler of the success of the intervention was the formation of an effective Unit Health Committee. This article presents the lessons identified and provides useful examples from the intervention, which aimed to create a healthy lifestyle culture on board a deployed ship.
Prone position ventilation is a life-saving technique for the management of hypoxic respiratory failure in ventilated patients. It has particular application in the isolated Role 2 Afloat (R2A) environment where both human and material resources are limited. It can be achieved with minimal training. This article describes the rationale behind prone position ventilation and equips the reader with the knowledge base that will allow the technique to be instigated.
Background: Diabetes mellitus (DM) has historically been diagnosed by measurement of blood glucose concentrations. More recently, the use of glycated haemoglobin (HbA1c) has been advocated in the diagnosis of diabetes, complementing its existing role in the monitoring of glycaemic control. A recent study has shown that obesity is an important problem in the UK Armed Forces. Obese patients are at increased risk of diabetes and intermediate hyperglycaemia (pre-diabetes). It is unclear whether the application of diagnostic criteria based on HbA1c would produce different categorisation of obese patients compared with standard glucose-based criteria. In the current study, we compared HbA1c with fasting plasma glucose in the diagnosis of type 2 diabetes and intermediate hyperglycaemia in a cohort of obese patients.
Methods: Patients were recruited from the NHS Tayside Specialist Weight Management Service. They were classified into three categories (normoglycaemia, pre-diabetes, and diabetes) according to their fasting plasma glucose (FPG) and HbA1c. The diagnostic criteria of three organisations were applied: the World Health Organisation (WHO); the American Diabetes Association (ADA); and the International Expert Committee (IEC). Glucose, insulin, cholesterol, triglycerides, uric acid, liver function tests and sex hormone-binding globulin (SHBG) were measured.
Results: By WHO (fasting glucose) criteria, 102 subjects were classified as normal, 13 as having impaired fasting glycaemia (IFG) and 5 as having diabetes mellitus (DM). By IEC (HbA1c) criteria, 89 subjects were classified as normal, 21 as pre-diabetes and 7 as DM. By ADA (HbA1c) criteria, 69 subjects were classified as normal, 41 as pre-diabetes and 7 as DM. Alkaline phosphatase was significantly higher in hyperglycaemic states compared with normal subjects, with ANOVA F statistics of 9.45 for WHO (p < 0.001), 9.24 for IEC (p < 0.001), and 6.87 for ADA (p < 0.01).
Conclusion: Although the numbers were small, more obese patients were categorised as hyperglycaemic (pre-diabetes and diabetes) when HbA1c-based criteria were applied, compared with WHO (glucose-based) criteria. Further studies are required to confirm this preliminary observation.
In 1981, the description of symptoms widespread among his messmates by a Leading Seaman admitted to hospital with pneumonia led to an epidemiological and clinical investigation on board HMS SHEFFIELD, a Type 42 destroyer. It was concluded that all the members of one mess deck were affected by humidifier fever. Simple advice which was given to CINCFLEET staff to keep air conditioning systems running during refits and prolonged maintenance periods is believed to have prevented a recurrence on other ships.
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