Oxidative stress and diabetes: Glucose response in the cROSsfire

In this review, Suurvali et al. [16] discuss the roles and properties of the purinergic P2X4 receptor. P2X4 is one of several receptors that recognizes extracellular ATP, but has been less widely studied than another receptor of this family: P2X7. Suurvali and colleagues present several convincing arguments for why this receptor should not be overlooked: it is 1000 times more sensitive than P2X7, it mediates neuropathic pain in a gender-specific manner, and through its ability to promote inflammation, it is linked to several diseases. The Chang Gung Research Database (CGRD) is a de-identified database of medical records collected from the Chang Gung Memorial Hospital, the largest hospital system in Taiwan. With more than 280,000 patients admitted to the hospital system every year, the database is a gem for big data mining and has been used in around 1800 studies. However, the characteristics and coverage of the database with respect to the general population of Taiwan have never been studied before. Based on their analysis of nearly one million medical records from the CGRD, Tsai et al. [17] report that the severity of co-morbidities and the prevalence of certain diseases were higher in the CGRD than in the Taiwanese National Health Insurance Research Database. Thus, the CRGD could provide additional statistical power when studying complicated or rare diseases. Over the past decade, Lactobacillus bacteria has gained much recognition for its reputed benefit for gastrointestinal health [18] . This has led to a boom in the food industry of products containing Lactobacillus, which are frequently labelled “probiotic”. Lactobacillus are a natural component of the microbiota of humans and animals and are particularly enriched in dairy products. In an attempt to identify new Lactobacillus strains with probiotic activity, Prabhurajeshwar et al. [19] isolated Lactobacillus from local homemade and commercially available dairy products and tested their in vitro antimicrobial activities against pathogens. Their work identifies three promising strains of probiotic bacteria for validation in vivo . India has the highest burden of tuberculosis (TB) worldwide, accounting for 2.2 million of the 9.6 million cases reported globally in 2015 [20] . Fortunately, both the overall rate of and mortality from tuberculosis in India are declining, but in some regions there is relatively scarce information on the occurrence of TB lymphadenitis, a chronic granulomatous inflammation of the lymph node that is commonly associated with the disease. Dasgupta et al. [21] investigate trends of TB lymphadenitis in Eastern India and report encouragingly that the occurrence of TB lymphadenitis has decreased over the past ten years in the region. The past few decades have seen significant improvement to equipment, techniques and pre- and post-operative care. Despite the continuing introduction of such improvements, clinical audits to assess mortality rates over time remain an essential tool for a functioning health care system. In this retrospective study, Kumar et al. [22] carry out the equivalent of assess 5-year trend in the mortality rate in the otorhinolaryngology ward of a tertiary care centre in urban India, to identify trends in mortality and serve as the basis for improving patient care even further.

The author declares no conflicts of interest.

Endometriosis is a common cause of infertility, and women treated for the condition and wanting biological children must, in most cases, undergo in vitro fertilisation (IVF). In this issue of the Biomedical Journal , Yu et al. [11] report promising news for women with bilateral ovarian endometriosis and treated by laproscopic surgery: when it comes to pregnancy outcome after IVF, two ovaries affected is no worse than one. Around 10–20% of women of reproductive age have endometriosis [12] , a condition in which tissues that normally line the uterus grow outside of it. In around one third of these cases, uterine tissues grow on one or both of the ovaries, giving rise to endometriotic cysts that can be removed by surgery. Laparoscopic surgery is today the preferred method for the removal of endometriotic cysts, because it is minimally invasive and quicker than the open abdominal surgery. However, it requires a high level of training and skill on the part of the surgeon, who has the difficult challenge of distinguishing effectively between the cyst and normal ovarian tissue. With one study reporting that more than half of laproscopic cystectomies lead to loss of normal ovarian tissue [13] , it follows that the success of subsequent IVF may be lower in women with two affected ovaries (bilateral endometrioma) than in those with only one affected ovary (unilateral endometrioma). To investigate this question, Yu et al. [11] identified retrospectively 148 cycles of IVF performed in infertile women who had undergone laproscopic cystectomy for bilateral or unilateral endometrioma and compared ovarian response and pregnancy outcome between the two groups. Controlling for various parameters such as age, BMI and duration of infertility, Yu and colleagues report that the number of oocytes retrieved and ultimately embryos transferred was lower in the bilateral group than in the unilateral group. However, these differences did not translate into differences in outcome, with the two groups showing similar rates of implantation, pregnancy and birth. These findings are encouraging for women with bilateral endometrioma and are consistent with other reports in the literature showing that ultimately undergoing a bilateral cystectomy is no worse than undergoing a unilateral cystectomy in terms of pregnancy outcome [14] . Nonetheless, the experience of the surgeon cannot be overstated, with Yu and colleagues reporting previously that the experience of the surgeon who performed the laproscopic surgery influences ovarian reserve and subsequent birth rate after IVF [15] . Inexperienced surgeons have a greater risk of removing normal ovarian tissue. Thus, these current findings must await validation in a larger prospective study taking the experience of the surgeon into account.