bluuebunny/crossref_metadata_2025 huggingface dataset:
Foi, é e será? Usos da fórmula da eternidade para falar do tempo na filosofia pré-socrática
Authors: Vieira Celso
Published: June 2015

The so called Eternity Formula is found both in Homer and Hesiod. The speeches of a seer and of the muses are said to inform the things “that are, will be and were”. Versions of this formula were also used by presocratic philosophers to describe the temporal aspect of central concepts within their cosmologies. Generally, they use it to convey the eternity of an entity by the affirmation of its existence throughout past, present and future. That is the case of fire in Heraclitus’ linear and reciprocal conception of time, of hate and love in the cyclical time of Empedocles, of the intelligence living in an eternal now in Anaxagoras’ cosmos, and of the eternal being in Melissus and Parmenides. Nonetheless, each use of the formula has its own peculiarities. The aim of this article is to make a comparative analysis of them, both within the thought of each philosopher as in face of one another. At the end I will propose a general formula of eternity in the presocratic philosophy that points towards an absolute conception of time. Furthermore, I hope to show that such an absolute treatment of time ends up by denying it implicitly or explicitly in a particular type of eternal present.
As obras e os dias, de Hesíodo, por João Felix Pereira
Authors: Moura Alessandro Rolim
Published: June 2015

This article republishes and briefly discusses the work of João Félix Pereira on Hesiod: the Portuguese translation of passages from the Works & Days with introduction and Greek text (Lisbon, 1876).
Um projeto de tradução expressiva: Édipo e Fenícias, de Sêneca
Authors: Sanches Cíntia Martins
Published: June 2015

This article deals with procedures for expressive translation of Seneca’s tragedies, Oedipus and Phoenissae. The research is part of a project of study on expressiveness in such tragedies, defining the stylistic idiom used by the author in both plays, so that those expressiveness’ marks from source texts can be valued and transferred into target texts. Thus, besides the translation project itself, the expressive effects on a small part of Phoenissae (654-659) are presented and, finally, the verses are translated into Brazilian Portuguese.
De re rustica de Columela e Geórgicas IV de Virgílio: estudo crítico-comparativo
Authors: Santos Gilson José
Published: June 2015

In the study we analyse comparatively selected fragments from Georgics IV and De re rustica (Book IX) in order to understand a little better the linguistic-literary treatment due to the distinct generic orientations the authors deliver to their works. The dominating compounding and stylistic characteristics in the texts are studied and are used as instruments to analyse (a) the constitutive particularities of the genders, didactic poetry and technical treatise (in prose), and (b) the aspects related to the construction of the particular meanings in the works. The theoretical reference marks for the text studies are: the literary genders theory, literary stylistic (referring to the Roman agrarian literature) and the history of Roman literature.
Antígona, o fruto de uma cepa deformada Hélia Correia, Perdição
Authors: Silva Maria de Fátima
Published: June 2015

This Portuguese Antigone, inspired by the Sophoclean play, puts the accent on different topics. Following Antigone’s behaviour from her childhood, it creates a group of female characters around the heroine and aims at her development as someone growing up from a disturbed family. Her irreverency is not put in service of any ideal, it is the consequence of her desadaptation.
Safo – Fr. 1 e Fr. 31
Authors: Antunes Leonardo
Published: June 2015

In this article, we analyse the structure of two poems by Sappho (Fr. 1 and Fr. 31), for which we present a poetic translation. It is followed by a commentary on stylistic aspects of the poems and the way they were recreated (or not) in the translation.
Alegoria e (anti)bucolismo: da clivagem entre a poesia pastoral greco-latina e as pastorelas alegóricas médio-latinas
Authors: Samyn Henrique Marques
Published: June 2015

In this article, we attempt to analyse the medieval Latin pastourelles in contrast with the pastoral poetry of the bucolic tradition. We analyse three pastourelles of the Carmina Burana, which in our interpretation have an allegorical meaning: Estivali sub fervore (CB 79), Lucis ordo sidere (CB 157) and Vere dulci mediante (CB 158); we argue that the concept of counter-pastoral as defined by Raymond Williams can be useful to understand the representation of the country in medieval Latin pastourelles, though some reevaluation is necessary. Our conclusion is that the absence of the real social conditions of country life in medieval Latin pastourelles is deeply related to its allegorical content.
El monstruo: Lo otro del Hombre. Un abordaje arqueológico de la monstruosidad en Hesíodo
Authors: Colombani María Cecília
Published: June 2015

O objetivo do presente artigo consiste em pensar a figura do monstro no âmbito geral do universo mítico grego, como modo de tensionar a dicotomia Mesmidade e Alteridade.
O fragmento de Galo
Authors: Carolli Fábio Paifer
Published: June 2015

ABSTRACT: The few remaining fragments from the works of the Latin poet Cornelius Gallus (c. 70-26 BC), discovered in Egypt in 1978, are presented, translated and analyzed in this paper. The role of these works among the books dated from the time of the poet, as well as some critical appreciation left by poets that lived during the Augustan reign and elected Cornelius Gallus as a model, are also brought into discussion. In addition, a poetic translation is also suggested.

KEYWORDS: Cornelius Gallus (c. 70-26 BC); epigram; elegy; poetic translation; elegiac couplet.
Literatura Comparada e Estudos Clássicos: um diálogo interdisciplinar
Authors: Rodrigues Thiago De Souza Bittencourt
Published: June 2015

ABSTRACT: The aim of such investigation is to discuss, firstly, the issue of the “Greek miracle” in the light of an interdisciplinary dialogue between Comparative Literature and Classical Studies; secondly, to establish, from such discussion, its role in the process of the

constitution of the “western tradition”.

KEYWORDS: literary studies; classical studies; comparative literature; “Greek miracle”.
 
Violência na tragédia grega: infanticídios e parricídios
Authors: Barbosa Tereza Virgínia Ribeiro
Published: June 2015

This article deals with different manifestations of violence, including the distortions and mistakes that maternal or other kind of love can produce on the object of its affections. In order to reflect about this theme, we focus on some ancients sources, such as Plutarch’s Of the affection towards offspring, mythological narratives and excerpts of Greek

tragedies. To understand some aspects of the dynamics of good and evil, we recur to the thought of the French philosopher Paul Ricoeur.
Comentário à Pítica VIII 1-60
Authors: Frade Gustavo Henrique Montes
Published: June 2015

A commentary on the first three triads of Pindar’s Pythian VIII. In the first triad, the poet uses the divine Hesykhía to relate sports, war and politics; he also indicates the dependence of the human excelence on divine action and uses the presence of gods to praise the champion. In the second triad, Pindar praises the champion’s homeland and shows the relation between the athlete and the poet, a brief remark on poetry and its social function. The third triad is dedicated to the mythical speech of Amphiaraus about luck and the oscillations between winning and losing in human life.

 

 
A má política em cena
Authors: Silva Maria de Fátima
Published: June 2015

Les Chevaliers d’Aristophane ont représenté, dans la carrière de son auteur, un moment particulier. Quand Aristophane présentait, pour la première fois, une pièce sous son propre nom il obtenait aussi un premier prix. Ce que le poète faisait, à ce moment, privilégiait La satire politique, suivant l’exemple d’un prédecesseur distingué, Cratinus. L’humour et La vibration des Chevaliers rivalisaient avec la vigueur de son modèle de l’ancienne génération.
Cícero e a obra filosófica em latim como munus rei publicae
Authors: Lima Sidney Calheiros de
Published: June 2015

Dans les préambules de quelques unes de ses oeuvres philosophiques, surtout de celles publiées à partir de 45 avant J.C., Cicéron justifie son activité d’écrivain de philosophieen latin en caractérisant son travail comme un munus rei publicae. Dans ce texte, nous proposons que ce genre d’argumentation n’est pas seulement une stratégie rhétorique qui aurait en vue tout simplement la sympathie des lecteurs romains; il s’agit aussi d’une déclaration d’un grand projet d’éducation philosophique des hommes publiques romains, plusieurs fois évoqué dans l’oeuvre cicéronienne et qui se trouve en parfaite harmonie avec les aspects les plus profonds de la pensée de cet auteur.
O que é “ontologia do presente”?
Authors: Adverse Helton
Published: June 2015

ABSTRACT: This paper’s aim is to elucidate the meaning of theparadoxical expression “ontology of the present”, utilized by Foucaultin his latest works. To achieve this goal, I adopted a twofold strategy:on the one hand, it was useful to recall that this was not the first timeFoucault used a deranging expression. In the 1960’s, in the period hedeveloped his “archeology of knowledge”, we can find in some ofhis major works the husserlian term “historical a priori”. On theother hand, I had to analyze some aspects of his interpretation of themodernity that we can find in his last articles, interviews and lessonsin the Collège de France. In these occasions, Kant’s philosophy wasthe main theoretical influence.

KEYWORDS: Foucault; historical a priori; ontology of the present;modernity; Kant.
Michel Foucault: el giro griego. Una genealogía del sujeto del deseo
Authors: Colombani María Cecilia
Published: June 2015

O presente trabalho mostra como Foucault transita pela cultura grega destacando a preocupação pelo uso dos prazeres nosdistintos tópoi que tocam; não se trata de uma preocupação etnológica,mas de uma preocupação estético-política do tópico. A vida mesmase constitui em obra de arte a partir da tarefa subjetivante de tornarseum homem autônomo e é esta poíesis subjetivante que determina aconsolidação de um modelo étnico-antropológico a tocar a totalidadedo bíos.
A narrativa da morte: Platão e a morte filosófica
Authors: Poddis José Gonçalves
Published: June 2015

This paper is a brief commentary on the narrative of Socrates’ death in the Phaedon. The aim is to perceive the textualelements used and possible impacts of that construction.
Amor erótico e castidade no Hipólito de Eurípides
Authors: Oliveira Flávio Ribeiro de
Published: June 2015

Dans cet article, j’analyse comment, dans l’Hippolyte d’Euripide, la notion de passion érotique est conçue comme une maladie et quelles sont ses relations avec la notion de chasteté.
Heróis, oráculos e reis: a construção de genealogias ilustres e imaginárias nas literaturas da Antiguidade ao Renascimento
Authors: Barcellos Raphael Dias
Published: June 2015

Pendant l’Antiquité Classique, le Moyen Âge et la Renaissance les dynasties ou les familles nobles avaient coutume de se forger une ascendance imaginaire parfois liée à des personnages littéraires fabuleux. Dans cette tentative destinée à se légitimer politiquement et idéologiquement, il faut retenir le rôle important joué par des personnages comme Énée et Arthur. Ce travail présentera et commentera quelques exemples de cette ressource employée par les diverses littératures anciennes et modernes, comme c’est le cas dans l’Énéide de Virgile, les Livres de Lignages portugais, certains récits de chevalerie et poèmes épiques de la Renaissance italienne et anglaise.
Infidelidades veladas: Ulisses entre Circe e Calipso na Odisseia
Authors: Assunção Teodoro Rennó
Published: June 2015

Cet article veut commenter ponctuellement les rapportssexuels d’Ulysse avec les déesses-nymphes Circé et Calypso dansl’Odyssée, en essayant de discuter, dans le cadre majeur de son mariageavec Pénélope, la pertinence d’une perception de ces deux rapportshors mariage comme des “infidélités”. L’ordre de présentation deces deux épisodes suit l’ordre chronologique interne de l’histoire etnon pas celui du récit direct de l’Odyssée, en raison de la priorité deCircé comme modèle caractériel et narratif. Le commentaire essaied’être bien attentif à la manière (quelquefois elliptique) deprésentation de ces rapports sexuels, en dégageant les hypothèsesd’interprétation possibles, et ensuite, dans une brève conclusion, ilessaie de les caractériser et penser dans l’ensemble du poème.
Muito prazer, anfitrião!
Authors: Costa Lilian Nunes da
Published: June 2015

An approach to the theme of pleasure could not beavoided in Plautus’ Amphitruo, inasmuch as the prologue states(104 f.) that the great Jupiter spares no effort to get the women hedesires. Notwithstanding, Plautine craftsmanship disguises the themein this play with irony, ambiguity and euphemism. It’s a curious fact,for instance, that four out of the seven times the word uoluptas occursin the play are within the song (633-653) of the (self proclaimed)virtuous Alcmena, a passage whose value as a serious testimony, or asparody of lyric, is disputed. The dimension assumed by the topic ofpleasure in this comedy (as well as its contribution to the generationof poetic effects, the humorous ones among them) is the subjectmatterof this paper.
A Olímpica 12 de Píndaro: tradução e comentário
Authors: Frade Gustavo Henrique Montes
Published: June 2015

Abstract: This study proposes an interpretation of Pindar’s Olympian 12 with particular attention to the theme of contingency (according to Aristotle, “that which may be otherwise”) in relation to human action. As the course of the athlete’s life and of the political history of Himera, the poem and its water images move through uncertainties and reach the accomplishment. Although Pindar recognizes the risks of hope, he shows how the constant variations of human life and the impossibility of knowing the future can result in a positive reversion of conditions in which an adverse situation leads to achievement, even when it is unlikely.
Mito y rito dionisíaco en Bacantes de Eurípides: sobre el origen ritual del teatro
Authors: Nápoli Juan Tobías
Published: June 2015

Resumo: No párodo de As Bacantes, de Eurípides, obra que tem sido descrita por unanimidade como a melhor representação do dionisismo grego e, por isso, do rito em cuja celebração se teria originado a tragédia clássica, o coro de mulheres asiáticas explica o que é o fundamento mítico de suas crenças e, ao mesmo tempo, descreve o tipo de rituais que praticam. A partir dessa dupla explicação, procuraremos analisar a passagem com duplo referencial, quanto à consideração desses rituais como um exemplo dos cultos que deram origem ao teatro clássico e quanto à interpretação geral da tragédia como uma reflexão sobre o fazer teatral por parte de seu autor.
CURADO, Ana Lúcia. Mulheres em Atenas: as mulheres legítimas e as outras. Lisboa: Sá da Costa Editora, 2008. (551 p.) ISBN 9789725623688
Authors: Leite Priscilla Gontijo
Published: June 2015

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Ars Rhetorica: Petrônio, Satyricon, 5
Authors: Gouvêa Júnior Márcio Meirelles
Published: June 2015

The twenty-two verses that make up Chapter 5 of Satyricon describe the guidelines of the formation of perfectus orator, as defined by Cato, Tacitus and Quintilian. However, the function of the poem in the assembly of this Latin novel is to accentuate the gap between educational theory during the early empire and the practice of an effective teaching of oratory – a practice deemed decadent since the final years of the republic. The poem, therefore, satirizes the educational processes at the time, serving as an object of sarcasm to the readers of ancient Rome
Luciano y las lenguas
Authors: Mestre Francesca
Published: June 2015

A leitura da obra de Luciano mostra a preocupação pelo uso correto da língua. Mas de que língua? O ático, responder-se-ia quase que automaticamente. Na verdade, Luciano é um exemplo de aticismo e, portanto, o uso adequado desse ático antigo, de prestígio e de bom tom, que os homens da segunda sofística usam como um traço que os caracteriza, é, para ele, obviamente, uma das suas principais preocupações. De origem síria, semita e, portanto, de língua aramaica, sua formação foi em grego e na cultura grega. Luciano parece estar muito preocupado com a pureza da língua, ele quer uma língua pura, mas sem exageros e sem artificialidade excessiva. Pureza ática da linguagem que, contudo, não o impede de considerar outros dialetos gregos, como o jônico, por exemplo, em algumas de suas obras. Por outro lado, é bom lembrar o contexto bilíngue (greco-latino) em que Luciano se move, especialmente considerando os pontos de contato entre ele e o mundo romano. O meu objetivo neste artigo é abordar alguns desses aspectos marcantes do uso da língua em Luciano, não só do ponto de vista do uso estritamente linguístico da língua grega, como também a partir de um ponto de vista sociolinguístico: Luciano tem uma ideia do grego que vai além da língua grega, expressando antes uma maneira de compreender o mundo. Luciano é um caso único: a sua análise da língua constitui uma visão particular de seu pensamento e da sua posição no mundo em que vive.
Eurípides: Suplicantes (1-41)
Authors: Salvador Evandro Luis
Published: June 2015

This text presents a free verse translation of the prologue (1-41) to The Suppliants, by Euripides. It is followed by a panoramic introduction highlighting the religious background that underpins this tragedy in order to better set the context in which Aethra enters onto the stage.
International Diabetes Federation –Putting Women and Diabetes on the Global Agenda
Authors: Keeling Ann , Dain Katie ,   Chief Executive Officer,   Advocacy and Programme Development Co-ordinator, International Diabetes Federation
Published: June 2015

Eighty per cent of the 300 million people with diabetes live in low- and middle-income countries and women represent half of this worldwide diabetes community. Gender roles and power dynamics shape vulnerability to diabetes, affect women’s health-seeking behaviour, access to health services and influence the impact of diabetes on women’s health. This creates a set of concerns that are specific to women. In addition, as the prevalence of type 2 diabetes in women of reproductive age has increased, so has the prevalence of gestational diabetes mellitus (GDM), a form of diabetes with onset or that is first recognised during pregnancy. GDM is a major cause of maternal and infant morbidity and mortality and a major factor in the intergenerational transmission of diabetes. The International Diabetes Federation (IDF) is responding to this aspect of the global diabetes epidemic by launching a new programme on women and diabetes. This programme will build the evidence base, promote awareness and political commitment, support gender-responsive health systems and empower women to take a leading role in diabetes prevention.
Clinical Aspects of Continuous Glucose Monitoring
Authors: Verheyen Nina , Gios Jens , Block Christophe De ,   Department of Endocrinology–Diabetology, Antwerp University Hospital, Antwerp University,   Department of Endocrinology–Diabetology, Antwerp University Hospital, Antwerp University,   Department of Endocrinology–Diabetology, Antwerp University Hospital, Antwerp University
Published: June 2015

In patients with diabetes, strict glycaemic control is warranted to achieve an improvement in metabolic outcome. When performing self-monitoring of blood glucose, hypo- and hyperglycaemic excursions can be missed. Continuous glucose monitoring (CGM) provides a complete picture of the patient’s glucose levels throughout the day. CGM may also warn against impending glycaemic excursions, thereby reducing the fear of hypoglycaemia and improving the patient’s quality of life. Patients with brittle diabetes, hypoglycaemia unawareness or gastroparesis, pregnant women with diabetes and those who are critically ill may particularly benefit from CGM. Patients and care-givers must be highly motivated, technologically adept and aware of the limitations of CGM devices to successfully use this type of monitoring in daily practice. The impact of CGM on metabolic control, incidence of hypoglycaemia, chronic complications and quality of life needs further investigation.
The Challenge of Managing Hypertension in Patients with Diabetes or Other Endocrine Disorders
Authors: Rosei Enrico Agabiti , Castellano Maurizio ,   Professor of Internal Medicine, and Director, Department of Medical and Surgical Sciences and Post-graduate School of Internal Medicine,   Professor of Internal Medicine, and Director, Post-graduate School of Endocrinology, Brescia University Medical School
Published: June 2015

Arterial hypertension is a frequent condition in the general population, but its prevalence increases in association with several endocrine diseases. Up to three-quarters of patients with diabetes are also hypertensive, and this association poses specific problems in the management of both conditions. Hypertension is a relevant condition in several other endocrinopathies and in some cases it is the main reason prompting patients to seek medical advice. Some of these endocrine diseases are frequent (primary aldosteronism) or may produce major complications (pheochromocytoma), and in any case require specific diagnostic work-ups and treatment.
Emerging Aspects of Turner Syndrome
Authors: Gravholt Claus H , Stochholm Kirstine , Cleemann Line , Mortensen Kristian Havmand ,   Consultant, and Senior Researcher, Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus Sygehus NBG, Aarhus University Hospital,   Endocrinologist, Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus Sygehus NBG, Aarhus University Hospital,   Paediatrician, Department of Paediatrics, Hillerød Hospital,   Clinical Research Fellow, Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus Sygehus NBG, Aarhus University Hospital
Published: June 2015

Turner syndrome is a genetic disorder caused by abnormalities of the X chromosome. It occurs in 50 in 100,000 live-born girls. Turner syndrome is associated with reduced adult height, gonadal dysgenesis and insufficient circulating levels of female sex steroids, leading to premature ovarian failure and infertility. Average intellectual performance is within the normal range. Treatment with growth hormone during childhood and adolescence allows a considerable gain in adult height. Short stature homeobox (SHOX) deficiency explains some of the phenotypic characteristics of Turner syndrome, principally short stature. Puberty has to be induced in most cases, and female sex hormone replacement therapy is given during adulthood. Morbidity and mortality are increased throughout life, in particular as a result of congenital and acquired cardiovascular disease, type 2 diabetes, osteoporosis and thyroid disease. In summary, Turner syndrome is a condition associated with a number of diseases and conditions that calls for the attention of a multidisciplinary team.
Glucagon Testing in Adult Growth Hormone Deficiency – Current Status and Future Perspectives
Authors: Yuen Kevin C J ,   Assistant Professor in Endocrinology, Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University
Published: June 2015

Growth hormone deficiency (GHD) in adults is a recognised clinical syndrome and its diagnosis is established through GH stimulation testing. The decision to perform GH stimulation testing should be based on clinical findings, medical history and using the appropriate GH stimulation test to obtain biochemical evidence. The insulin tolerance test (ITT) remains the diagnostic test of choice, but this test is labour intensive, contraindicated in the elderly and in adults with seizure disorders and ischaemic heart disease, can be unpleasant for the patient, and is potentially hazardous. The glucagon stimulation test (GST) in recent years has been increasingly used as the alternative test to the ITT in the US and Europe because of its availability, reproducibility, safety, lack of influence by gender and hypothalamic cause of GHD, and relatively few contraindications. In the article, we discuss our recommendations in performing this test, the potential drawbacks in conducting and caveats in interpreting this test, and its future perspectives.
The Role of Steroids in Endothelial Function in the Ageing Male
Authors: Aversa Antonio , Bruzziches Roberto , Francomano Davide , Greco Emanuela A , Migliaccio Silvia , Lenzi Andrea ,   Senior Lecturer,   Research Fellow, Department of Experimental Medicine, Medical Pathophysiology Section, ‘La Sapienza’ University of Rome,   Research Fellow, Department of Experimental Medicine, Medical Pathophysiology Section, ‘La Sapienza’ University of Rome,   Research Fellow, Department of Experimental Medicine, Medical Pathophysiology Section, ‘La Sapienza’ University of Rome,   Researcher, Department of Health Sciences, Endocrinology Unit, Foro Italico University of Rome,   Full Professor, Department of Experimental Medicine, Medical Pathophysiology Section, ‘La Sapienza’ University of Rome
Published: June 2015

Normal vascular endothelium is essential for the synthesis and release of substances affecting vascular tone, cell adhesion and the homoeostasis of clotting and fibrinolysis. The degeneration of endothelial integrity promotes adverse events leading to atherogenesis. Circulating levels of endogenous hormones decline during ageing and this may contribute to the occurrence of major adverse cardiovascular events, independently of gender differences. During the last decade more attention has been drawn to the importance of testosterone, oestradiol and adrenal androgens in the pathophysiology, prevention and treatment of male ageing-associated diseases. A considerable body of literature is available indicating that steroid hormones, particularly the sex steroids, are known to modulate endothelial function in all vascular beds and their deficiency may promote endothelial dysfunction. Testosterone decrease and increased mineralocorticoid activity in the ageing male are frequent and may yield endothelial dysfunction and increased cardiovascular burden; we recommend careful hormonal investigations in men who present comorbidities such as diabetes, hypertension and dyslipidaemia.
Switching to Biphasic Insulin Aspart 30 in Patients Uncontrolled on Human Premix Insulin
Authors: Christiansen Jens Sandahl ,   Professor, Department of Endocrinology and Diabetes, The University of Aarhus and Consultant, Department of Medicine (Endocrinology), Aarhus University Hospital
Published: June 2015

Two cases relating to switching from biphasic human insulin 30 (BHI 30) to biphasic insulin aspart 30 (BIAsp 30) are described. Case 1: switching from BHI 30 to BIAsp 30 due to inadequate glycosylated haemoglobin (HbA1c) control. Case 2: switching from BHI to BIAsp 30 due to nocturnal hypoglycaemia. Case 1: HbA1cfell from 7.9 % with BHI to 6.9 % with BIAsp 30 at the six-month follow-up. Postprandial glucose (PPG) fell from 12.6 mmol/l with BHI to 9.1 mmol/l with BIAsp 30. Case 2: a man who had experienced recurrent nocturnal hypoglycaemia with neutral protamine Hagedorn (NPH) or BHI was able to maintain his glycaemic control without severe nocturnal hypoglycaemia with BIAsp 30. BIAsp 30 offers advantages over BHI 30 in terms of faster absorption, higher peak concentrations, and a more rapid and pronounced prandial glucose-lowering effect, which means that BIAsp 30 can improve PPG control and reduce the risk of nocturnal and major hypoglycaemic episodes.
Hyponatraemia – Current Treatment Strategies and Perspectives for the Future
Authors: Hannon Mark J , Thompson Christopher J ,   Endocrinology Research Fellow,   Professor, Academic Department of Endocrinology, Beaumont Hospital and Royal College of Surgeons in Ireland Medical School
Published: June 2015

Hyponatraemia is the commonest electrolyte abnormality found in hospital inpatients and is associated with a greatly increased morbidity and mortality. The management of hyponatraemia is predicated on correct diagnosis of the underlying cause, which relies on accurate assessment of the patient’s volume status. The syndrome of inappropriate antidiuresis (SIAD) is the most common cause of hyponatraemia and current treatments for this syndrome are poorly effective. Hypervolaemic hyponatraemia is also difficult to manage. The emergence of a new class of medications – the selective vasopressin-2 receptor antagonists or vaptans – gives clinicians an opportunity to target the underlying pathophysiology of these conditions, and represents an exciting new development in the management of hyponatraemia. In this article we review the differential diagnosis of hyponatraemia, current treatment strategies and emerging management options.
The Challenge of Lipid Management in Patients with Diabetes or Other Endocrine Disorders
Authors: Catapano Alberico L , Grigore Liliana , Pirillo Angela ,   Professor of Pharmacology, Faculty of Pharmacy, Department of Pharmacological Sciences, University of Milan,   Professor of Pharmacology, Faculty of Pharmacy, Department of Pharmacological Sciences, University of Milan,   Professor of Pharmacology, Faculty of Pharmacy, Department of Pharmacological Sciences, University of Milan
Published: June 2015

Diabetes increases the risk of developing cardiovascular disease (CVD), and several guidelines suggest that subjects with diabetes are at high risk of developing CVD. The increased risk can be attributed, at least in part, to associated risk factors, including hypertension and dyslipidaemia. The role of statins in primary and secondary prevention of CVD is well established, and the positive effect has been clearly demonstrated also in patients with type 2 diabetes. A number of studies have evaluated the effect of statin therapy on incident CVD and shown that statin therapy produces a great reduction in cardiovascular risk, but a recent meta-analysis revealed a slight increase in the risk of developing diabetes. Such risk is, however, low, especially when compared with the reduction in cardiovascular events and should not interfere with the choice of treating diabetic patients with a cholesterol-lowering therapy.
The Role of Visceral Adipose Tissue in the Pathogenesis of Non-alcoholic Fatty Liver Disease
Authors: Verrijken An , Francque Sven , Gaal Luc Van ,   Master of Science, Department of Endocrinology, Diabetology and Metabolism,   Hepatologist, Department of Gastroenterology and Hepatology,   Professor of Medicine and Head, Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp
Published: June 2015

Non-alcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in Western countries, comprises a disease spectrum ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), advanced fibrosis and cirrhosis. Fatty liver develops when fatty acid uptake and de novo fatty acid synthesis exceed fatty acid oxidation and export as very low-density lipoprotein/triglycerides. Because of its high prevalence and its association with obesity, metabolic syndrome, type 2 diabetes, dyslipidaemia and hypertension, NAFLD has become an important public health problem. The pathogenesis of NAFLD has to date not been completely clarified. Research has been conducted regarding the role of insulin resistance, lipotoxicity, oxidative stress and chronic inflammation. Visceral adipose tissue has increasingly been recognised as a biologically active organ contributing to the pathogenesis of NAFLD. Its role in the development of fatty liver might be situated at several levels: as a source of free fatty acids, by the production of adipocytokines, as a cause of insulin resistance and by inflammation.
In Pursuit of an Ideal – A Perspective on Non-Invasive Continuous Glucose Monitoring
Authors: English Lisa B ,   Director of Scientific and Technological Affairs, C8 MediSensors
Published: June 2015

Diabetes is one of the most common non-communicable diseases globally, and is the fourth or fifth leading cause of death in many countries. Medical technology for the management of diabetes has advanced steadily since the discovery of insulin in the early 20th century. Today, individuals with diabetes benefit from home-use blood glucose meters, continuous insulin pumps and, most recently, continuous glucose monitoring (CGM). Numerous studies have shown that frequent use of real-time CGM can improve glycaemic control with reduced risk of hypoglycaemia. However, current CGM devices have not been wholeheartedly embraced, limiting their potential. A CGM device that is accurate, non-invasive, pain-free and non-intrusive to daily activities could drive increased adoption and use of CGM, potentially improving health and quality of life for many individuals living with diabetes.
Blood Glucose Monitoring In Pediatric Patients—Looking Toward Better Diabetes Management and Perspectives for the Future
Authors: Clarke William L ,   Robert M Blizzard Professor of Pediatric Endocrinology and Chief of Pediatric Endocrinology, Department of Pediatrics, University of Virginia Health Sciences Center
Published: June 2015

Self-blood glucose monitoring (SBGM) is an important component of day-to-day diabetes management for children and their families. Despite some recent concerns in terms of its analytical accuracy, it has been used successfully to implement intensive glucose control in the Diabetes control and complications trial (DCCT), reduce glycated haemoglobin (HbA1c) levels, prevent acute complications, and make it possible for children to attend school and participate in sports activities safely. While still in its infancy, continuous glucose monitoring (CGM) has been shown to be useful in reducing the occurrence of nocturnal hypoglycaemia, lowering HbA1c levels and reducing glycaemic variability. Its analytical accuracy has prevented its approval as an alternative to SBGM for insulin decision-making. However, it has made possible the development and testing of closed-loop ‘artificial pancreas’ systems for controlling glucose levels in adults and adolescents.
Endothelin Receptor Antagonists in Diabetic Nephropathy
Authors: Wenzel René R , Ritz Eberhard , Wenzel Maximilian Q ,   Head, Department of Internal Medicine, Teaching Hospital, Zell am See,   Professor Emeritus, Ruperto Carola University Heidelberg,   Medical Student, University of Vienna
Published: June 2015

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease and affects an estimated 150 million people worldwide. Despite optimal treatment, including glycaemic control and antihypertensive therapy (e.g., renin–angiotensin–aldosterone system [RAS] blockade), the disease progresses. A ‘late escape’ phenomenon has been described, where proteinuria reappears despite continued RAS blockade. The endothelin (ET) system is strongly involved in the pathophysiology of the disease and contributes to vasoconstriction, inflammation and proliferation. ET antagonists are promising drugs that potently slow down disease progression in animal models and have beneficial effects on cardiac structure, mitochondrial damage and microvascular architecture. However, the available ET antagonists, at least in higher doses, may also inhibit tubular endothelin receptors subtype B, which promote sodium and water excretion. The three clinical trials with avosentan and atrasentan published so far show the unique nephroprotective effects of these drugs, with a reduction of up to 45 % in albuminuria. However, fluid retention, oedema and, in higher stages of chronic kidney disease, heart failure limit their use. The reason may be that we have been using too high doses of these ET antagonists so far and they are inhibiting tubular sodium and water excretion. Thus, we will need to learn more about the role of ET and its antagonists in the tubular and collecting duct system, and on how to use these potent drugs in DN. ET antagonists are among the most promising molecules for the treatment of nephropathies. We should definitely not abandon these drugs because of the initial drawbacks in the first clinical trials.
Evidence for Anti-vascular Endothelial Growth Factor Treatment of Diabetic Macular Oedema
Authors: Bandello Francesco , Benedetto Umberto De , Knutsson Karl Anders , Parodi Maurizio Battaglia , Cascavilla Maria Lucia , Iacono Pierluigi ,   Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan,   Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan,   Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan,   Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan,   Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan,   GB Bietti Ophthalmology Foundation, Rome
Published: June 2015

Diabetic macular oedema (DME) represents the most common cause of vision loss in patients affected by diabetes mellitus. Diabetic retinopathy has a significant impact on public health and the quality of life of many patients and thus requires serious consideration. The first line of treatment remains the management of systemic risk factors but this is often insufficient in controlling DME and currently, laser retinal photocoagulation is considered the standard of care. However, laser treatment reduces the risk of moderate visual loss by approximately 50 % without guaranteeing remarkable effects on visual improvement. For these reasons, new approaches in the treatment of DME have been considered, in particular the employment of anti-vascular endothelial growth factor (VEGF) drugs. VEGF is a pluripotent growth factor that functions as a vasopermeability factor and an endothelial cell mitogen and thereby represents an appealing candidate as a therapeutic target for the treatment of DME. The goal of this article is to present the evidence behind the use of anti-VEGF drugs in the treatment of DME.
Triamcinolone Acetonide for the Treatment of Diabetic Macular Oedema
Authors: Sarao Valentina , Veritti Daniele , Lanzetta Paolo ,   Department of Ophthalmology, University of Udine,   Department of Ophthalmology, University of Udine,   Department of Ophthalmology, University of Udine
Published: June 2015

Diabetic macular oedema is a major cause of severe visual loss whose pathogenesis appears to be complex and multifactorial. For many years laser photocoagulation has been the standard of care for the treatment of this condition. Emerging pharmacologic approaches are being evaluated through randomised controlled trials. Triamcinolone acetonide has been proposed as a promising option, due to its well-known anti-inflammatory, anti-permeability and anti-angiogenic properties. Intravitreal delivery allows bypassing of the blood–retinal barrier to achieve a more concentrated dose of steroid in the vitreal cavity for a prolonged time. Intravitreal triamcinolone acetonide is effective in reducing central macular thickness and improving visual acuity, even if the duration of action is often provisional and requires repeated injections. Drug-related and injection-related side effects have been reported; the most common are induced cataract and increased intraocular pressure. To extend the duration of steroid effects and to minimise the risk of complications, alternative routes of administration and extend-release implants are being investigated.
Recent Management Controversies in Osteoporosis
Authors: DeLange Hudec Susan M , Camacho Pauline M ,   Endocrinology Fellow, Loyola University Medical Center,   Associate Professor of Medicine and Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Loyola University Medical Center
Published: June 2015

Osteoporosis is a important health concern that leads to significant morbidity for millions of Americans. Most recently, several areas of osteoporosis treatment have been debated, including calcium and vitamin D supplementation, duration of bisphosphonate therapy, and frequency of bone mineral density measurement. This article reviews the recent studies on these controversial topics and presents the current practice guidelines.
Are We Achieving Pharmacological Disease Control in Acromegaly?
Authors: Colao Annamaria ,   Professor of Endocrinology, Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University of Naples, Naples, Italy
Published: June 2015

Acromegaly is a rare endocrine disorder, associated with significant morbidity and mortality due to the harmful effects of prolonged exposure to increased levels of growth hormone (GH) and its effector, insulin-like growth factor-1 (IGF-1). The most common cause of acromegaly is a pituitary adenoma, for which surgical resection is usually the first choice treatment. In cases where surgical resection is not possible, or where the patient declines surgery, somatostatin analogues (SSAs) are used as first-line medical therapy. Other therapeutic options include dopamine antagonists and the GH receptor antagonist – pegvisomant. In addition, considerable current research is investigating the clinical utility of combined therapies. Disease control is defined in terms of reduction of GH and IGF-1 normalisation and reduction in mortality levels to those seen in the general population. Reported disease control rates of acromegaly are highly variable and it has been reported that treatment efficacy in clinical practice is considerably lower than the success rates reported by reference centres. There is therefore a substantial need for improved disease management strategies for acromegaly.
Temozolomide in the Treatment of Aggressive Pituitary Tumours – An Overview of Existing Knowledge and Future Perspectives
Authors: McCormack Ann ,   Staff Specialist Endocrinology, St Vincent’s Hospital and Garvan Institute of Medical Research, Sydney, Australia
Published: June 2015

The management of aggressive pituitary tumours remains a challenge, however, the recent identification of temozolomide as a chemotherapeutic agent with significant efficacy against these tumours has heralded a new therapeutic era. There has been an exponential growth in the international experience with temozolomide over the past five years, now totalling 50 published cases. Overall, 67 % of cases demonstrated a response to temozolomide. Prolactin- and adrenocorticotrophic hormone (ACTH)-secreting tumours respond more frequently than non-functioning tumours. Response is typically evident in the first three months of treatment. Adverse effects occur in almost half of patients, although the majority are mild. The expression of a DNA repair enzyme, 06-methylguanine-DNA methyltransferase (MGMT), as determined by immunohistochemistry, appears to be the primary determinant of response to temozolomide in pituitary tumours. There is suggestion that MGMT may also play a role in pituitary tumorigenesis. Over the next few years we will see temozolomide used earlier in the treatment algorithm of aggressive pituitary tumours, making it imperative to collect global long-term data on its use.
Witnessing a New Era? – The Emerging Role of Targeted Drugs in the Medical Treatment of Advanced Medullary and Anaplastic Thyroid Cancer
Authors: Lorch Jochen , Voigt Wieland ,   Assistant Professor, Dana Farber Cancer Institute, Boston, Massachusetts, US,   Associate Professor, Department of Oncology/Haematology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
Published: June 2015

The treatment of advanced thyroid cancer is currently entering a new era due to the introduction of targeted therapy into modern cancer treatment. The growing insight into the molecular biology of thyroid cancer and on the development of numerous mainly multitargeted agents provide the basis for new treatment strategies. In particular, activation of mitogenic and angiogenic signalling pathways are suitable targets as preclinical and clinical data suggest. Several Phase II and a few Phase III studies were launched in thyroid cancer which included medullary thyroid cancer (MTC) and anaplastic thyroid cancer (ATC) but only a few focused specifically on theses subtypes. A number of smaller Phase II trials reported promising response rates and progression-free survival. Results from a randomised Phase III trial in MTC with vandetanib, a combined vascular endothelial growth factor receptor 2 + 3 (VEGF-R2+3) and RET multi tyrosine kinase inhibitor demonstrated significant clinical activity and resulted in the first approval of a kinase inhibitor for the treatment of MTC in 2011. Unlike in MTC, in ATC the prognosis is dismal due to the aggressive nature of the disease. Some mainly vascular targeting agents alone or in combination with chemotherapy have shown interesting activity in this disease and have raised new hope. Particularly the combination of fosbretabulin with a chemotherapy backbone of paclitaxel and carboplatin tripled the one-year survival rate in a recent Phase II trial which included 80 patients with ATC. In this review, we provide a brief overview of the general treatment concept of MTC and ATC and summarise the compiled evidence published on targeted agents in these rare thyroid cancer subtypes.
Incidence of Hypoglycaemia in Patients with Type 2 Diabetes – A Subgroup Analysis from the GINGER study
Authors: Fritsche Andreas , Hahn Almut , Landgraf Wolfgang , Häring Hans-Ulrich ,   Fourth Medical Department and Policlinic, University Tübingen,   CROMSOURCE GmbH, Aachen,   CROMSOURCE GmbH, Aachen,   Fourth Medical Department and Policlinic, University Tübingen
Published: June 2015

Introduction:The Glulisine in Combination with Insulin Glargine in an Intensified Insulin Regimen (GINGER) study compared insulin glargine plus insulin glulisine with premixed insulin in the treatment of patients with Type 2 diabetes mellitus (T2DM). This was a post-hoc analysis of hypoglycaemia rates in subgroups from the GINGER study.Methods:This analysis compared the once-daily glargine plus mealtime glulisine group (n=153, four injections/day) with the overall twice-daily premixed insulin group (n=157, two injections/day), which consisted of two subgroups receiving either neutral protamine Hagedorn (NPH) plus regular insulin (n=93) or biphasic insulin aspart 70/30 (n=63). Observed and predicted hypoglycaemia rates relative to endpoint HbA1cfor both the total population and those patients who experienced ≥1 episodes of any hypoglycaemia were estimated.Results:The overall hypoglycaemic event rate (episodes per patient-year) for patients receiving glargine plus glulisine was numerically but not significantly lower (–24.5 %) compared with the overall premixed insulin group (14.0±24.2 versus 18.5±36.9; p=0.12) and significantly lower (–43.3 %) compared with the biphasic insulin aspart 70/30 subgroup (24.7±48.5; p=0.02). In patients with ≥1 episode of hypoglycaemia during treatment, the overall hypoglycaemic event rate was significantly lower (–26.5 %) in patients receiving glargine plus glulisine versus overall premixed insulin (18.5±26.3 versus 25.1±41.1; p=0.044) and significantly lower (–40.7 %) than in patients receiving biphasic insulin aspart 70/30 (31.1±52.7; p=0.009). Glargine/glulisine treatment maintained a more consistent and numerically lower hypoglycaemia rate at all achieved HbA1cendpoints compared with premixed insulin treatment.Conclusion:This post-hoc analysis of the GINGER study showed that the frequency of hypoglycaemia in T2DM patients was lowered to a greater extent by insulin glargine plus insulin glulisine in a comparison with premixed biphasic insulin aspart 70/30 than was previously shown in a comparison with overall premixed insulin.Trial Identifier:NCT00174668