Medicine and Health Sciences Commons^™

P. Falciparum And P. Vivax Epitope-Focused Vlps Elicit Sterile Immunity To Blood Stage Infections, David C. Whitacre, Diego A. Espinosa, Cory J. Peters, Joyce E. Jones, Amy E. Tucker, Darrell L. Peterson, Fidel P. Zavala, David R. Milich

Biochemistry and Molecular Biology Publications

In order to design P. falciparum preerythrocytic vaccine candidates, a library of circumsporozoite (CS) T and B cell epitopes displayed on the woodchuck hepatitis virus core antigen (WHcAg) VLP platform was produced. To test the protective efficacy of the WHcAg-CS VLPs, hybrid CS P. berghei/P. falciparum (Pb/Pf) sporozoites were used to challenge immunized mice. VLPs carrying 1 or 2 different CS repeat B cell epitopes and 3 VLPs carrying different CS non-repeat B cell epitopes elicited high levels of anti-insert antibodies (Abs). Whereas, VLPs carrying CS repeat B cell epitopes conferred 98% protection of the liver against …

Increased Eicosanoid Levels In The Sugen/Chronic Hypoxia Model Of Severe Pulmonary Hypertension, Aysar Al-Husseini, Dayanjan S. Wijesinghe, Laszlo Farkas, Donatas Kraskauskas, Jennifer I. Drake, Ben Van Tassel, Antonio Abbate, Charles E. Chalfant, Norbert F. Voelkel

Biochemistry and Molecular Biology Publications

Inflammation and altered immunity are recognized components of severe pulmonary arterial hypertension in human patients and in animal models of PAH. While eicosanoid metabolites of cyclooxygenase and lipoxygenase pathways have been identified in the lungs from pulmonary hypertensive animals their role in the pathogenesis of severe angioobliterative PAH has not been examined. Here we investigated whether a cyclooxygenase-2 (COX-2) inhibitor or diethylcarbamazine (DEC), that is known for its 5-lipoxygenase inhibiting and antioxidant actions, modify the development of PAH in the Sugen 5416/hypoxia (SuHx) rat model. The COX-2 inhibitor SC-58125 had little effect on the right ventricular pressure and did not …

A Comparison Of A Multistate Inpatient Ehr Database To The Hcup Nationwide Inpatient Sample, Jonathan P. Deshazo, Mark A. Hoffman

Health Administration Publications

Background

The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data.

Methods

In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010.

Results

The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent …

A Comparison Of A Multistate Inpatient Ehr Database To The Hcup Nationwide Inpatient Sample, Jonathan P. Deshazo, Mark A. Hoffman

Health Administration Publications

Background

The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data.

Methods

In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010.

Results

The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent …

Right Atrial Metastatic Melanoma With Unknown Primaries, Robin Kuriakose, Rakhi Melvani, Venkataramanan Gangadharan, Michael Cowley

Neurosurgery Publications

A 54-year-old male with history of anemia and rheumatoid arthritis presented with a three-month history of dyspnea on exertion and lower extremity edema. Patient was referred for a transthoracic echocardiogram that revealed a large right atrial mass with reduced ejection fraction of 40% and an incidental large liver mass. Subsequent cardiac MRI revealed a lobulated right atrial mass measuring 5.4 cm * 5.3 cm with inferior vena cava compression and adjacent multiple large liver lesions confirmed to be malignant melanoma through biopsy. Interestingly, no primaries were found in the patient. PET/CT imaging displayed hypermetabolic masses within the right atrium and …

Green Tea Inhibited The Elimination Of Nephro-Cardiovascular Toxins And Deteriorated The Renal Function In Rats With Renal Failure, Yu-Hsuan Peng, Douglas H. Sweet, Shiuan-Pey Lin, Chung-Ping Yu, Pei-Dawn Lee Chao, Yu-Chi Hou

Pharmaceutics Publications

Chronic kidney disease (CKD) is a major health problem worldwide. Indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are highly protein-bound nephro-cardiovascular toxins, which are not efficiently removed through hemodialysis. The renal excretions of IS and PCS were mediated by organic anion transporters (OATs) such as OAT1 and OAT3. Green tea (GT) is a popular beverage containing plenty of catechins. Previous pharmacokinetic studies of teas have shown that the major molecules present in the bloodstream are the glucuronides/sulfates of tea catechins, which are putative substrates of OATs. Here we demonstrated that GT ingestion significantly elevated the systemic exposures of endogenous …

Il-4 Inhibits Il-1Β-Induced Depressive-Like Behavior And Central Neurotransmitter Alterations, Hyun-Jung Park, Hyun-Soo Shim, Kyungeh An, Angela Starkweather, Kyung Soo Kim, Insop Shim

School of Nursing Publications

It has been known that activation of the central innate immune system or exposure to stress can disrupt balance of anti-/proinflammatory cytokines. The aim of the present study was to investigate the role of pro- and anti-inflammatory cytokines in the modulation of depressive-like behaviors, the hormonal and neurotransmitter systems in rats. We investigated whether centrally administered IL-1β is associated with activation of CNS inflammatory pathways and behavioral changes and whether treatment with IL-4 could modulate IL-1β-induced depressive-like behaviors and central neurotransmitter systems. Infusion of IL-4 significantly decreased IL-1β-induced anhedonic responses and increased social exploration and …

Randomized Sham Controlled Trial Of Cranial Microcurrent Stimulation For Symptoms Of Depression, Anxiety, Pain, Fatigue And Sleep Disturbances In Women Receiving Chemotherapy For Early-Stage Breast Cancer, Debra Lyon, Debra Kelley, Jeanne M. Walter, Harry Bear, Leroy R. Thacker, R.K. Elswick

School of Nursing Publications

Purpose

Women with breast cancer may experience symptoms of depression, anxiety, pain, fatigue and sleep disturbances during chemotherapy. However, there are few modalities that address multiple, commonly occurring symptoms that may occur in individuals receiving cancer treatment. Cranial electrical stimulation (CES) is a treatment that is FDA cleared for depression, anxiety and insomnia. CES is applied via electrodes placed on the ear that deliver pulsed, low amplitude electrical current to the head.

Methods

This phase III randomized, sham-controlled study aimed to examine the effects of cranial microcurrent stimulation on symptoms of depression, anxiety, pain, fatigue, and sleep disturbances in women …

Virginia Commonwealth University Volunteer Doula Program Training Manual, Kathleen M. Bell, Susan L. Linder

School of Nursing Publications

A birth doula is a specially trained birth assistant who provides emotional, psychological and physical support and care to a pregnant and/or laboring woman. In providing this care, the doula helps the laboring woman and her support person achieve their most optimal birth experience. This is typically an unmedicated birth; however, doulas may attend any birth and be of profound assistance and comfort.

This curriculum was written specifically for nursing students who are being trained as lay doulas. Unique in its approach and delivery, the curriculum is written with the nursing student in mind; particularly a student who has already …

Geriatric Telemedicine: Background And Evidence For Telemedicine As A Way To Address The Challenges Of Geriatrics, Ronald C. Merrell

Surgery Publications

Objectives

The global population of elderly people is increasing at a remarkable rate, which may be expected to continue for some time. Older patients require more care, and with the current model of care delivery, the costs may be expected to rise, although higher cost is unsustainable. For this reason, a new pattern of practice is needed. Telemedicine will be presented as a highly effective and necessary tool in geriatrics.

Methods

This review will present some of the background and evidence for telemedicine as a way to address the challenges of geriatrics through geriatric telemedicine. Some of the evidence for …

Addition Of Interleukin-21 For Expansion Of T-Cells For Adoptive Immunotherapy Of Murine Melanoma, Christine Kathryn Zoon, Wen Wan, Laura Graham, Harry D. Bear

Surgery Publications

We previously demonstrated that interleukin (IL)-7/15 was superior to IL-2 for expansion of T cells in vitro for adoptive immunotherapy. We sought to ascertain whether IL-21 would further improve yield and therapeutic efficacy of T cells in culture. Naïve T cell receptor (TcR) transgenic splenocytes or antigen-sensitized lymph node cells were harvested from PMEL-1 mice and exposed to bryostatin-1 and ionomycin (B/I) for 18 h. Cells were then cultured in IL-2, IL-21, IL-7/15 or IL-7/15/21 for six days. Harvested cells were analyzed by flow cytometry and used to treat C57Bl/6 mice injected intravenously with B16 melanoma. Lungs were harvested and …

An Unusual Case Of Bony Styloid Processes That Extend To The Hyoid Bone, Shekhar K. Gadkaree, Christopher G. Hyppolite, Aisha Harun, Ryan H. Sobel, Young Kim

Surgery Publications

The embryological origin of the hyoid bone is a point of uncertainty, with controversy surrounding the relative contribution of the second pharyngeal arch to hyoid development. We encountered a 52-year-old male with bilateral bony styloid extension to the lesser cornu of the hyoid bone during the workup of a patient with laryngeal cancer. This embryological malformation clearly supports the hypothesis that the second pharyngeal arch gives rise to the lesser cornu and demonstrates an unusual clinical finding that may be encountered by otolaryngologists. We demonstrate the imaging findings and surgical management of this unusual anatomical variant and review the embryological …

Penetrating Cardiac Trauma And The Use Of Emergent Extracorporeal Membrane Oxygenation And Therapeutic Hypothermia: When Cooler Heads Prevail, Nathaniel Lee, Daniel Tang, Sudha Jayaraman

Surgery Publications

This is a case of penetrating chest trauma with traumatic arrest from cardiac tamponade, right and left ventriculotomies, mitral valve injury and ventricular septal defect. Patient underwent resuscitative thoracotomy converted to clamshell thoracotomy for haemorrhage control. Ventriculotomies were repaired on initial damage control operation. Extracorporeal membrane oxygenation cannulation and therapeutic cooling bridged to definitive cardiac repair several days later. Patient was discharged to an inpatient rehabilitation facility in 16 days.

Wses Guidelines For Management Of Clostridium Difficile Infection In Surgical Patients, Massimo Sartelli, Mark A. Malangoni, Fikri M. Abu-Zidan, Ewen A. Griffiths, Stefano Di Bella, Lynne V. Mcfarland, Ian Eltringham, Vishal G. Shelat, George C. Velmahos, Ciarán P. Kelly, Sahil Khanna, Zaid M. Abdelsattar, Layan Alrahmani, Luca Ansaloni, Goran Augustin, Miklosh Bala, Frédéric Barbut, Offir Ben-Ishay, Aneel Bhangu, Walter L. Biffl, Stephen M. Brecher, Adrián Camacho-Ortiz, Miguel A. Caínzos, Laura A. Canterbury, Fausto Catena, Shirley Chan, Jill R. Cherry-Bukowiec, Jesse Clanton, Federico Coccolini, Maria Elena Cocuz, Raul Coimbra, Charles H. Cook, Yunfeng Cui, Jacek Czepiel, Koray Das, Zaza Demetrashvili, Isidoro Di Carlo, Salomone Di Saverio, Irina Magdalena Dumitru, Catherine Eckert, Christian Eckmann, Edward H. Eiland, Mushira Abdulaziz Enani, Mario Faro, Paula Ferrada, Joseph Derek Forrester, Gustavo P. Fraga, Jean Louis Frossard, Rita Galeiras, Wagih Ghnnam, Carlos Augusto Gomes, Venkata Gorrepati, Mohamed Hassan Ahmed, Torsten Herzog, Felicia Humphrey, Jae Il Kim, Arda Isik, Rao Ivatury, Yeong Yeh Lee, Paul Juang, Luis Furuya-Kanamori, Aleksandar Karamarkovic, Peter K. Kim, Yoram Kluger, Wen Chien Ko, Francis D. Labarbera, Jae Gil Lee, Ari Leppaniemi, Varut Lohsiriwat, Sanjay Marwah, John E. Mazuski, Gokhan Metan, Ernest E. Moore, Frederick Alan Moore, Carl Erik Nord, Carlos A. Ordoñez, Gerson Alves Pereira Júnior, Nicola Petrosillo, Francisco Portella, Basant K. Puri, Arnab Ray, Mansoor Raza, Miran Rems, Boris E. Sakakushev, Gabriele Sganga, Patrizia Spigaglia, David B. Stewart, Pierre Tattevin, Jean Francois Timsit, Kathleen B. To, Cristian Tranà, Waldemar Uhl, Libor Urbánek, Harry Van Goor, Angela Vassallo, Jean Ralph Zahar, Emanuele Caproli, Pierluigi Viale

Surgery Publications

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficileinfection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.

Pulmonary Hypertension Is A Manifestation Of Congestive Heart Failure And Left Ventricular Diastolic Dysfunction In Octogenarians With Severe Aortic Stenosis, Amresh Raina, Zachary M. Gertz, William T. O'Donnell, Howard C. Herrmann, Paul R. Forfia

Internal Medicine Publications

Previous studies have suggested that pulmonary hypertension (PH) in severe aortic stenosis (AS) is a risk factor for operative mortality with aortic valve replacement (AVR). Conversely, others have shown that patients with AS and PH extract a large symptomatic and survival benefit from AVR compared with those patients not treated surgically. We sought to evaluate the prevalence, severity, and mechanism of PH in an elderly patient cohort with severe AS. We prospectively evaluated 41 patients aged ≥80 years with severe AS. All patients underwent cardiac catheterization and transthoracic echocardiography within 24 hours. We found that PH was common in this …

Peritoneal Mesothelioma: An Unusual Cause Of High-Protein Ascites, Matthew Kaspar

Internal Medicine Publications

We present a case illustrating the workup and diagnosis of peritoneal sarcomatous mesothelioma as an unusual etiology of intestinal obstruction and high-protein ascites in an otherwise healthy man. This rare disorder is diagnosed based on immunohistochemistry, which is necessary to differentiate it from other rare sarcomatous carcinomas. In many cases, localized disease can be treated to cure with surgery and intraperitoneal chemotherapy. Advanced disease is often treated for palliation of symptoms.

Metabolic Effects Of Fgf-21: Thermoregulation And Beyond, Bin Ni, Jared S. Farrar, Janina A. Vaitkus, Francesco S. Celi

Internal Medicine Publications

Fibroblast growth factor (FGF)-21, a member of the FGF family, is a novel hormone involved in the control of metabolism by modulating glucose homeostasis, insulin sensitivity, ketogenesis, and promoting adipose tissue “browning.” Recent studies demonstrated that brown adipose tissue is not only a target for FGF-21, but is also a potentially important source of systemic FGF-21. These findings support the hypothesis that FGF-21 plays a physiologic role in thermogenesis and thermogenic recruitment of white adipose tissue by an autocrine–paracrine axis. This review examines the role of FGF-21 in thermogenesis from the perspective of cell-based, animal model, and human studies. We …

Meta-Analysis Of Microrna-146a Rs2910164 G>C Polymorphism Association With Autoimmune Diseases Susceptibility, An Update Based On 24 Studies, Changzheng Li, Weijun Fu, Yu Zhang, Liang Zhou, Zhi Mao, Weiran Lv, Juan Li, Ye Zhou

Internal Medicine Publications

Background

Published data showed that the susceptibility of autoimmune diseases (ADs) was associated with the polymorphism rs2910164 in microRNA-146a (miR-146a). However, the results remain controversial so far. Two meta-analyses published in 2013 and 2014 came to opposite conclusions. In order to derive a more precise estimation of the relationship, we performed this meta-analysis.

Methods

We searched the PubMed, OvidSP and CNKI databases (published prior to September 8th, 2014) and extracted data from eligible studies. The procedure of meta-analysis was performed by using the Stata 12.0 software. Random effect model or fixed effect model were chosen respectively, according to the between …

Increased Eicosanoid Levels In The Sugen/Chronic Hypoxia Model Of Severe Pulmonary Hypertension, Aysar A. Al-Husseini, Dayanjan S. Wijesinghe, Laszlo Farkas, Donatas Kraskauskas, Jennifer I. Drake, Ben Van Tassel, Antonio Abbate, Charles E. Chalfant, Norbert F. Voelkel

Internal Medicine Publications

Inflammation and altered immunity are recognized components of severe pulmonary arterial hypertension in human patients and in animal models of PAH. While eicosanoid metabolites of cyclooxygenase and lipoxygenase pathways have been identified in the lungs from pulmonary hypertensive animals their role in the pathogenesis of severe angioobliterative PAH has not been examined. Here we investigated whether a cyclooxygenase-2 (COX-2) inhibitor or diethylcarbamazine (DEC), that is known for its 5-lipoxygenase inhibiting and antioxidant actions, modify the development of PAH in the Sugen 5416/hypoxia (SuHx) rat model. The COX-2 inhibitor SC-58125 had little effect on the right ventricular pressure and did not …

Inhibition Of Bcl-2 Sensitizes Mitochondrial Permeability Transition Pore (Mptp) Opening In Ischemia-Damaged Mitochondria, Qun Chen, Haishan Xu, Aijun Xu, Thomas Ross, Elizabeth Bowler, Ying Hu, Edward J. Lesnefsky

Internal Medicine Publications

Background

Mitochondria are critical to cardiac injury during reperfusion as a result of damage sustained during ischemia, including the loss of bcl-2. We asked if bcl-2 depletion not only leads to selective permeation of the outer mitochondrial membrane (MOMP) favoring cytochrome crelease and programmed cell death, but also favors opening of the mitochondrial permeability transition pore (MPTP). An increase in MPTP susceptibility would support a role for bcl-2 depletion mediated cell death in the calcium overload setting of early reperfusion via MPTP as well as later in reperfusion via MOMP as myocardial calcium content normalizes.

Methods

Calcium retention capacity …

Correlation Between Mass And Volume Of Collected Blood With Positivity Of Blood Cultures, Lariessa Neves, Alexandre Rodrigues Marra, Thiago Zinsly Sampaio Camargo, Maura Cristina Dos Santos, Flávia Zulin, Patrícia Candido Da Silva, Natália Ariede De Moura, Elivane Da Silva Victor, Jacyr Pasternak, Oscar Fernando Pavão Dos Santos, Michael B. Edmond, Marines Dalla Valle Martino

Internal Medicine Publications

Background

The collection of blood cultures is an extremely important method in the management of patients with suspected infection. Microbiology laboratories should monitor blood culture collection.

Methods

Over an 8-month period we developed a prospective, observational study in an adult Intensive Care Unit (ICU). We correlated the mass contained in the blood vials with blood culture positivity and we also verified the relationship between the mass of blood and blood volume collected for the diagnosis of bloodstream infection (BSI), as well as we explored factors predicting positive blood cultures.

Results

We evaluated 345 patients with sepsis, severe sepsis or septic …

Dysregulated Hepatic Methionine Metabolism Drives Homocysteine Elevation In Diet-Induced Nonalcoholic Fatty Liver Disease, Tommy Pacana, Sophie Cazanave, Aurora Verdianelli, Vaishali Patel, Hae-Ki Min, Faridoddin Mirshahi, Eoin Quinlivan, Arun J. Sanyal

Internal Medicine Publications

Methionine metabolism plays a central role in methylation reactions, production of glutathione and methylarginines, and modulating homocysteine levels. The mechanisms by which these are affected in NAFLD are not fully understood. The aim is to perform a metabolomic, molecular and epigenetic analyses of hepatic methionine metabolism in diet-induced NAFLD. Female 129S1/SvlmJ;C57Bl/6J mice were fed a chow (n = 6) or high-fat high-cholesterol (HFHC) diet (n = 8) for 52 weeks. Metabolomic study, enzymatic expression and DNA methylation analyses were performed. HFHC diet led to weight gain, marked steatosis and extensive fibrosis. In the methionine cycle, hepatic methionine was depleted (30%, …

An International Survey On Taking Up A Career In Cardiovascular Research: Opportunities And Biases Toward Would-Be Physician-Scientists, Giuseppe Biondi-Zoccai, Enrico Cerrato, Mariangela Peruzzi, Fabrizio D'Ascenzo, Elena De Falco, Isotta Chimenti, Sebastiano Sciarretta, Antonio G. M. Marullo, Elena Cavarretta, Ernesto Greco, Umberto Benedetto, Giulio Pompilio, Javier Escaned, Antonio Abbate, Alain Carpentier, Juan Carlos Chachques, Giacomo Frati

Internal Medicine Publications

Background

Cardiovascular research is the main shaper of clinical evidence underpinning decision making, with its cyclic progression of junior researchers to mature faculty members. Despite efforts at improving cardiovascular research training, several unmet needs persist. We aimed to appraise current perceptions on cardiovascular research training with an international survey.

Methods and Results

We administered a 20-closed-question survey to mentors and mentees belonging to different international institutions. A total of 247 (12%) surveys were available (out of 2,000 invitations). Overall, mentees and mentors were reasonably satisfied with the educational and research resources. Significant differences were found analyzing results according to gender, …

Early Goal-Directed Resuscitation Of Patients With Septic Shock: Current Evidence And Future Directions, Ravi G. Gupta, Sarah M. Hartigan, Markos G. Kashiouris, Curtis N. Sessler, Gonzalo M. L. Bearman

Internal Medicine Publications

Severe sepsis and septic shock are among the leading causes of mortality in the intensive care unit. Over a decade ago, early goal-directed therapy (EGDT) emerged as a novel approach for reducing sepsis mortality and was incorporated into guidelines published by the international Surviving Sepsis Campaign. In addition to requiring early detection of sepsis and prompt initiation of antibiotics, the EGDT protocol requires invasive patient monitoring to guide resuscitation with intravenous fluids, vasopressors, red cell transfusions, and inotropes. The effect of these measures on patient outcomes, however, remains controversial. Recently, three large randomized trials were undertaken to re-examine the effect …

Thyroid Hormone Mediated Modulation Of Energy Expenditure, Janina A. Vaitkus, Jared S. Farrar, Francesco S. Celi

Internal Medicine Publications

Thyroid hormone (TH) has diverse effects on mitochondria and energy expenditure (EE), generating great interest and research effort into understanding and harnessing these actions for the amelioration and treatment of metabolic disorders, such as obesity and diabetes. Direct effects on ATP utilization are a result of TH’s actions on metabolic cycles and increased cell membrane ion permeability. However, the majority of TH induced EE is thought to be a result of indirect effects, which, in turn, increase capacity for EE. This review discusses the direct actions of TH on EE, and places special emphasis on the indirect actions of TH, …

Non-Alcoholic Steatohepatitis: Limited Available Treatment Options But Promising Drugs In Development And Recent Progress Towards A Regulatory Approval Pathway, Claudia Filozof, Barry J. Goldstein, Richard N. Williams, Arun Sanyal

Internal Medicine Publications

The prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) is increasing world-wide in parallel to the increase of the obesity epidemic. Insulin resistance (IR) and the accumulation of triglyceride-derived toxic lipid metabolites play a key role in its pathogenesis. Multiple biomarkers are being evaluated for the non-invasive diagnosis of NASH. However, a percutaneous liver biopsy is still the gold standard method; the minimal diagnostic criteria include the presence of >5 % macrovesicular steatosis, inflammation, and liver cell ballooning. Several pharmaceutical agents have been evaluated for the treatment of NASH; however, no single therapy has been approved so …

Dysregulated Hepatic Methionine Metabolism Drives Homocysteine Elevation In Diet-Induced Nonalcoholic Fatty Liver Disease, Tommy Pacana, Sophie Cazanave, Aurora Verdianelli, Viashali Patel, Hae-Ki Min, Faridoddin Mirshahi, Eoin Quinlavin, Arun J. Sanyal

Internal Medicine Publications

Methionine metabolism plays a central role in methylation reactions, production of glutathione and methylarginines, and modulating homocysteine levels. The mechanisms by which these are affected in NAFLD are not fully understood. The aim is to perform a metabolomic, molecular and epigenetic analyses of hepatic methionine metabolism in diet-induced NAFLD. Female 129S1/SvlmJ;C57Bl/6J mice were fed a chow (n = 6) or high-fat high-cholesterol (HFHC) diet (n = 8) for 52 weeks. Metabolomic study, enzymatic expression and DNA methylation analyses were performed. HFHC diet led to weight gain, marked steatosis and extensive fibrosis. In the methionine cycle, hepatic methionine was depleted (30%, …

State Of The Art On The Evidence Base In Cardiac Regenerative Therapy: Overview Of 41 Systematic Reviews, Mariangela Peruzzi, Elena De Falco, Antonio Abbate, Giuseppe Biondi-Zoccai, Isotta Chementi, Marzia Lotrionte, Umberto Benedetto, Ronak Delewi, Antonino G. M. Marullo, Giacomo Frati

Internal Medicine Publications

Objectives. To provide a comprehensive appraisal of the evidence from secondary research on cardiac regenerative therapy. Study Design and Setting. Overview of systematic reviews of controlled clinical trials concerning stem cell administration or mobilization in patients with cardiovascular disease. Results. After a systematic database search, we short-listed 41 reviews (660 patients). Twenty-two (54%) reviews focused on acute myocardial infarction (AMI), 19 (46%) on chronic ischemic heart disease (IHD) or heart failure (HF), 29 (71%) on bone marrow-derived stem-cells (BMSC), and 36 (88%) to randomized trials only. Substantial variability among reviews was found for validity (AMSTAR score: median 9 [minimum …

Ascorbate-Dependent Vasopressor Synthesis: A Rationale For Vitamin C Administration In Severe Sepsis And Septic Shock?, Anitra C. Carr, Geoffrey M. Shaw, Alpha A. Fowler, Ramesh Natarajan

Internal Medicine Publications

Severe systemic inflammatory response to infection results in severe sepsis and septic shock, which are the leading causes of death in critically ill patients. Septic shock is characterised by refractory hypotension and is typically managed by fluid resuscitation and administration of catecholamine vasopressors such as norepinephrine. Vasopressin can also be administered to raise mean arterial pressure or decrease the norepinephrine dose. Endogenous norepinephrine and vasopressin are synthesised by the copper-containing enzymes dopamine β-hydroxylase and peptidylglycine α-amidating monooxygenase, respectively. Both of these enzymes require ascorbate as a cofactor for optimal activity. Patients with severe sepsis present with hypovitaminosis C, and pre-clinical …

Intermittent Hypoxia In Childhood: The Harmful Consequences Versus Potential Benefits Of Therapeutic Uses, Tatiana V. Serebrovskaya, Lei Xi

Internal Medicine Publications

Intermittent hypoxia (IH) often occurs in early infancy in both preterm and term infants and especially at 36–44 weeks postmenstrual age. These episodes of IH could result from sleep-disordered breathing or may be temporally unrelated to apnea or bradycardia events. There are numerous reports indicating adverse effects of IH on development, behavior, academic achievement, and cognition in children with sleep apnea syndrome. It remains uncertain about the exact causative relationship between the neurocognitive and behavioral morbidities and IH and/or its associated sleep fragmentation. On the other hand, well-controlled and moderate IH conditioning/training has been used in sick children for treating …