Coronavirus disease-2019 is the infectious disease caused by the recently discovered coronavirus SARS-CoV-2. The first case of COVID-19 was reported to the World Health Organization (WHO) by Chinese authorities on December 31st 2019 as a result of a patient suffering pneumonia in Wuhan City, Hubei Province, China. Following a rapid spread in China, new outbreaks occurred in northern Italy and in several European countries. On March 12th 2020 WHO announced COVID-19 outbreak a pandemic.COVID-19 results in a respiratory infection characterized by mild to severe symptoms such as dry cough, fever and difficulty breathing which can appear up to about 14 days after exposure to the virus. According to National Center for Immunization and Respiratory Diseases (NCIRD) high-risk categories for severe illness from COVID-19 are people aged 65 years and older, who live in a nursing home or long-term
Hypokalemia is a common electrolyte disturbance, especially in hospitalized patients. It can have various causes, including endocrine ones. Sometimes, hypokalemia requires urgent medical attention. The aim of this review is to present updated information regarding: (1) the definition and prevalence of hypokalemia, (2) the physiology of potassium homeostasis, (3) the various causes leading to hypokalemia, (4) the diagnostic steps for the assessment of hypokalemia and (5) the appropriate treatment of hypokalemia depending on the cause. Practical algorithms for the optimal diagnostic, treatment and follow-up strategy are presented, while an individualized approach is emphasized.
Hepatic insulin resistance is a driving force in the pathogenesis of type 2 diabetes mellitus (T2DM) and is tightly coupled with excessive storage of fat and the ensuing inflammation within the liver. There is compelling evidence that activation of the transcription factor nuclear factor-κB (NF-κB) and downstream inflammatory signaling pathways systemically and in the liver are key events in the etiology of hepatic insulin resistance and β-cell dysfunction, although the molecular mechanisms involved are incompletely understood. We here test the hypothesis that receptor activator of NF-κB ligand (RANKL), a prototypic activator of NF-κB, contributes to this process using both an epidemiological and experimental approach. In the prospective population-based Bruneck Study, a high serum concentration of soluble RANKL emerged as a significant (P<0.001) and independent risk predictor of T2DM manifestation. In close agreement, systemic or hepatic blockage of RANKL signaling in genetic and nutritional mouse models of T2DM resulted in a marked improvement of hepatic insulin sensitivity and amelioration or even normalization of plasma glucose concentrations and glucose tolerance. Overall, this study provides evidence for a role of RANKL signaling in the pathogenesis of T2DM. If so, translation to the clinic may be feasible given current pharmacological strategies to lower RANKL activity to treat osteoporosis.
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