Insulin Resistance and Cardiomyopathy

An interesting abstract was published in the recent issue of the Journal of the American College of Cardiology - Insulin-Resistant Cardiomyopathy, Clinical Evidence, Mechanisms, and Treatment Options.

Increasing evidence points to insulin resistance as a primary etiologic factor in the development of nonischemic heart failure (HF). The myocardium normally responds to injury by altering substrate metabolism to increase energy efficiency. Insulin resistance prevents this adaptive response and can lead to further injury by contributing to lipotoxicity, sympathetic up-regulation, inflammation, oxidative stress, and fibrosis.

Animal models have repeatedly demonstrated the existence of an insulin-resistant cardiomyopathy, one that is characterized by inefficient energy metabolism and is reversible by improving energy use. Clinical studies in humans strongly support the link between insulin resistance and nonischemic HF.

Insulin resistance is highly prevalent in the nonischemic HF population, predates the development of HF, independently defines a worse prognosis, and predicts response to antiadrenergic therapy.

Potential options for treatment include metabolic-modulating agents and antidiabetic drugs. This article reviews the basic science evidence, animal experiments, and human clinical data supporting the existence of an "insulin-resistant cardiomyopathy" and proposes specific potential therapeutic approaches.

-------------------------

Protein Provides Satiety Through PYY

In our strange world, we have researchers now promoting the idea that a pharmaceutical version of the gut hormone PYY may offer a solution to help individuals lose weight.

In the MSN article, Natural Gut Hormones May Provide a Treatment for Obesity, we learn that researchers are seeking to develop a pill to provide the satiety hormone PYY.

"The advantage of developing weight loss medications based on gut-derived satiety hormones is that they enhance a process that occurs naturally. It is expected, therefore, that side effects will be minimal," says Dr Sainsbury-Salis.

Folks, we're not PYY deficient; in fact, I'd argue we're not eating the foods that stimulate PYY to effectively sate appetite naturally.

As I noted in a previous blog post about research investigating PYY, "A high protein diet led to spontaneous calorie reduction as PYY increased. The phenomenon was consistent with both the animal model using mice and in human studies used to validate the mice model. Over a longer term, the higher protein diet stimulated weight loss and enhanced PYY synthesis and secretion in mice."

As I noted in that post, the study I wrote about included quite specific detail about how diet influences the release of PYY in humans - "The ready availability of carbohydrate-rich grains and cereals has been a recent development in human nutrition with the onset of organized agriculture. Many of the physiological systems that regulate food intake were probably established and may function better under lower-carbohydrate and higher-protein dietary conditions."

Those were not my words, but the words of the researchers!

And now we have researchers looking to design a pill to provide what we already have naturally - if we eat adequate protein and fat. But, let's not go there and discuss diet, let's just pop a pill and continue along with the supposed "healthy diet" that obviously is not sating out appetite!

The future of Oracle APEX - aka Oracle APEX 4.0

In case you haven't read it on Marc Sewtz blog or in the newest edition of the German Oracle APEX community newsletter, on Friday July 25th at 14:00 (German time) there will be a WebCast about the features the Oracle APEX team is currently working on for Oracle APEX 4.0! The WebCast will also cover some tips & tricks for APEX 3.1.1.

Get the details about how to join the WebCast at the German Oracle APEX Community web site.

Overlapping labels in an Oracle APEX pie chart

Ever had the problem of overlapping labels in a pie chart which you used in an Oracle Application Express (APEX) application? Have a look at Gary Myers excellent tip to avoid collisions by using analytic functions to sort the data. It's another great example of using the built-in power of the Oracle database.

Two new Oracle APEX whitepapers

Ok, they are not brand new anymore, they have already been released last month. But in case you are not reading David Peake's blog or checking regularly the Oracle APEX website on OTN, the APEX team has published the following two new whitepapers:

• NTLM Authentication (a PL/SQL only solution) and
• Oracle APEX with RAC (Real Application Cluster)

Oracle APEX team needs your help!

It's your chance to help the Oracle APEX team to spreading the word about Oracle APEX. They want to convince the Oracle eBusiness Suite/Oracle Applications team to formally legitimize the use of Oracle Application Express with the Oracle eBusiness Suite/Applications. I think that would be another huge step to get Oracle APEX into more companies if it can be officially used to write custom applications in that environment.

But they need your help! Check out David Peake's blog posting for more details.

What's next on the Oracle APEX roadmap? Oracle APEX 3.2!

Just read on David Peake's blog that he has updated the Statement of Direction for Oracle Application Express (APEX).

What has changed?

They are planing to release Oracle APEX 3.2, which will be Oracle APEX 3.1 + The Oracle Forms Migration Tool. If you are a Forms guru, they are looking for beta testers! Get the details at David's blog.

I think the Forms Migration Tool will be another major step for Oracle APEX to get the Forms developers into the APEX boat. These two tools have a lot of similarities (declarative, PL/SQL, ...) and the same kind of productivity to develop database driven applications. Forms developers can re-use their existing skills and companies protect there investment by using the same business logic (if written in database packages) as for there Forms applications. Compared to learning or migrating an application into a new language (eg. Java/.Net) this can be a huge time safer.