bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic Antipsoriatic Combination Therapy with Fumaric Acid Esters for Plaque-Type Psoriasis: Report on 17 Cases
Authors: Wilsmann-Theis Dagmar , Frambach Yvonne , Philipp Sandra , Weyergraf Ansgar J. , Jacobi Arnd , Mössner Rotraut , Gerdes Sascha
Published: February 2015

Background: In the literature as well as in existing psoriasis guidelines, only little evidence is available on combination regimens with systemic antipsoriatic agents. However, if systemic monotherapy is not efficacious enough to control the disease, a combination therapy might be necessary. Objective: To evaluate the use of fumaric acid esters (FAEs) in combination with other antipsoriatic agents in 6 specialized dermatological departments in Germany. Methods: A systematic retrospective chart review of patients receiving FAEs was performed. Results: A total of 17 cases of patients receiving FAEs combined with at least one other systemic therapy (methotrexate, acitretin, etanercept, cyclosporine, leflunomide and infliximab) to treat psoriasis or psoriatic arthritis were identified. Conclusion: FAEs can be combined in an off-label setting with conventional as well as biological agents to treat recalcitrant psoriasis or psoriatic arthritis. Safety monitoring should be taken seriously as no controlled data for these combination regimens exist.
Caregiver's Education Level and Child's Dental Caries in African Americans: A Path Analytic Study
Authors: Heima Masahiro , Lee Wonik , Milgrom Peter , Nelson Suchita
Published: February 2015

The objective of this study was to investigate the influence of caregiver education level on children's dental caries mediated by both caregiver and child oral health behaviors. Participants were 423 low-income African American kindergarteners and their caregivers who were part of a school-based randomized clinical trial. Path analysis tested the hypothesis that caregiver education level affected untreated dental caries and cumulative overall caries experience (decayed or filled teeth) through the mediating influence of frequency of dental visits, use of routine care, and frequency of toothbrushing for both the caregiver and the child. The results supported the hypothesis: caregivers who completed high school were 1.76 times more likely to visit dentists compared with those who did not complete high school (e0.56 = 1.76, 95% CI: 1.03-2.99), which in turn was associated with 5.78 times greater odds of dental visits among their children (e1.76 = 5.78, 95% CI: 3.53-9.48). Children's dental visits, subsequently, were associated with 26% fewer untreated decayed teeth compared with children without dental visits (e-0.31 = 0.74, 95% CI: 0.60-0.91). However, this path was not present in the model with overall caries experience. Additionally, caregiver education level was directly associated with 34% less untreated decayed teeth (e-0.42 = 0.66, 95% CI: 0.54-0.79) and 28% less decayed or filled teeth (e-0.32 = 0.72, 95% CI: 0.60-0.88) among the children. This study overcomes important conceptual and analytic limitations in the existing literature. The findings confirm the role of caregiver education in child dental caries and indicate that caregiver's behavioral factors are important mediators of child oral health.
Dynamic Cerebral Autoregulation Is Transiently Impaired for One Week after Large-Vessel Acute Ischemic Stroke
Authors: Petersen Nils H. , Ortega-Gutierrez Santiago , Reccius Andrés , Masurkar Arjun , Huang Amy , Marshall Randolph S.
Published: February 2015

Background: Dynamic cerebral autoregulation (DCA) is the continuous counterregulation of cerebral blood flow to fluctuations in blood pressure. DCA can become impaired after acute stroke, but it remains unclear to what extent and over what interval this occurs. Methods: We included 28 patients (NIHSS = 12 ± 6.5, age = 68.4 ± 17.1, 16F) with acute large-vessel ischemic stroke in the middle cerebral artery territory and 29 healthy controls (mean age 54.9 ± 9, 16F). DCA was assessed by simultaneous measurement of blood pressure together with blood flow velocities using finger plethysmography/arterial catheter and transcranial Doppler over three 10-minute recordings on days 0-2, 3-6 and ≥7 days after stroke. Transfer function analysis was applied to calculate average phase shift (PS) in the low frequency range (0.06-0.12 Hz). Less PS indicated poorer autoregulation. The affected side was compared with the unaffected side and controls. Univariate comparisons of data were performed using t tests at single time points, and generalized estimating equations with an exchangeable correlation matrix to examine the change in PS over time. Results: At mean 1.3 ± 0.5 days after stroke the average PS in the affected hemisphere was 29.6 ± 10.5 vs. 42.5 ± 13 degrees in the unaffected hemisphere (p = 0.004). At 4.1 ± 1 days, the PS in affected and unaffected hemisphere was 23.2 ± 19.1 vs. 41.7 ± 18.5 degrees, respectively (p = 0.003). At mean 9.75 ± 2.2 days stroke there was no difference between the affected and the unaffected hemisphere (53.2 ± 28.2 vs. 50.7 ± 29.2 degrees, p = 0.69). Control subjects had an average PS = 47.9 ± 16.8, significantly different from patients' affected hemisphere at the first two measurements (p = 0.001), but not the third (p = 0.37). The PS in controls remained unchanged on repeat testing after an average 19.1 days (48.4 ± 17.1, p = 0.61). Using the last recording as the reference, the average PS in the affected hemisphere was -23.54 (-44.1, -3) degrees lower on recording one (p = 0.025), and -31.6 (-56.1, -7.1) degrees lower on recording two (p < 0.011). Changes in the unaffected hemisphere over time were nonsignificant. Discussion: These data suggest that dynamic cerebral autoregulation is impaired in the affected hemisphere throughout the first week after large-vessel ischemic stroke, and then normalizes by week two. These findings may have important implications for acute blood pressure management after stroke.
The Effect of Carvedilol on B-Type Natriuretic Peptide and Cardiac Function in Patients with Heart Failure and Persistent Atrial Fibrillation
Authors: Khand Aleem U. , Chew Pei G. , Douglas Homeyra , Jones Julia , Jan Aftab , Cleland J.G.F.
Published: February 2015

Objectives: We sought to determine the relationship between changes in natriuretic peptides and symptoms as a consequence of introducing beta-blocker therapy, in patients with chronic heart failure (CHF) and persistent atrial fibrillation (AF). Methods: In a randomised, double-blind, placebo-controlled study involving 47 patients with CHF and persistent AF (mean age 68 years and 62% men), we analysed the individual change (Δ) in B-type natriuretic peptide (BNP) level to the introduction of carvedilol (titrated to a target dose of 25 mg twice daily, group A) or placebo (group B) in addition to background treatment with digoxin. Symptoms score, 6-min walk distance, New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), heart rate (24-hour ECG) and BNP were measured at baseline and at 4 months. Results: LVEF (Δ median +5 vs. +0.4, p = 0.048), symptoms score (Δ median -4 vs. 0, p = 0.04), NYHA class (Δ median -33% vs. +3% in NYHA class 3-4, p = 0.046) and heart rate [Δ median 24-hour ventricular rate (VR) -19 vs. -2, p < 0.0001] improved with combination therapy of digoxin and carvedilol compared to digoxin alone, but BNP (Δ median +28 vs. -6 , p = 0.11) trended in the opposite direction. There was no relationship between the degree of symptomatic improvement or VR control and BNP response. Conclusion: After the introduction of carvedilol, clinical outcome appears unrelated to BNP changes in patients with CHF and AF. Changes in BNP cannot be used as a marker of clinical response in terms of symptoms or cardiac function in this setting.
Cerebral Peduncle Tumor Ablated by Novel 3-mm Laser Tip
Authors: Xu David S. , Rosenfeld Amy , Ponce Francisco A. , Nakaji Peter , Bhardwaj Ratan D.
Published: February 2015

Background/Objective: Decisions to use open surgery or radiotherapy in pediatric patients with familial neoplastic syndromes must consider not only the symptomatic benefits of treatment, but also future limitations these treatments may impose. Specifically, open surgical resection of noncurable tumors may preclude or encumber future lesion resections, while radiotherapy has detrimental effects on pediatric cognitive development and increases the risk of future malignancy development. We provide the first report of using a novel 3.0-mm diffusing laser tip with laser-induced thermal therapy (LiTT) to treat a pediatric patient with neurofibromatosis type 1 (NF-1). Methods: A 12-year-old boy with NF-1 presented with a progressively enlarging lesion in the right midbrain. A stereotactic biopsy was performed, followed by LiTT with a novel 3.0-mm laser applicator. Results: MRI 1 week after LiTT showed stable gross total ablation of the lesion with reduction in fluid-attenuated inversion recovery signal. The patient remained neurologically intact 6 months after his procedure, and follow-up MRI showed no evidence of recurrence. Conclusion: LiTT is a powerful adjunct to conventional open surgical and radiotherapy modalities in the treatment of patients with familial neoplastic syndromes or incurable lesions. The novel laser applicator tip described expands the treatment scope of this technique.
Association between Coeliac Disease and Psoriasis: Italian Primary Care Multicentre Study
Authors: De Bastiani Rudi , Gabrielli Maurizio , Lora Liliana , Napoli Luigi , Tosetti Cesare , Pirrotta Enzo , Ubaldi Enzo , Bertolusso Luciano , Zamparella Maria , De Polo Manuela , Nebiacolombo Cristina , Bortot Mario , Mancuso Maurizio , Bacchin Paolo , Marsala Valerio , Pinna Roberto , Tursi Antonio , Benedetto Edoardo , Cuffari Alfredo , Pati Antonino , Di Caro Simona , Perenzin Gastone , Sala Raffaella , Calzavara Pinton Giacomo , Gasbarrini Antonio
Published: February 2015

Background: Studies assessing the association between coeliac disease (CD) and psoriasis show conflicting results. Objective: To assess in the primary care setting the prevalence of CD in patients with psoriasis and the response to a gluten-free diet (GFD) in subjects with psoriasis and CD. Methods: We enrolled 218 patients with psoriasis and 264 controls. Coeliac screening was carried out in all subjects (Eurospital, Trieste, Italy). In subjects with a positive serology, the diagnosis of CD was confirmed histologically. Results: Nine (4.1%) psoriatic patients had positive anti-tissue transglutaminase antibodies compared to only 1 among controls (0.4%, p < 0.05; OR 2.03, 95% CI 1.42-90.11). The diagnosis of CD was confirmed histologically in all 10 subjects. At 6 months GFD was associated with a great improvement of skin lesions in 7 out of 8 patients with psoriasis. Conclusion: Our multicentre primary care study showed an high prevalence of CD in psoriasis and an improvement of skin lesions in CD under GFD.
In situ Localization of (GATA)n and (TTAGGG)n Repeated DNAs and W Sex Chromosome Differentiation in Parodontidae (Actinopterygii: Characiformes)
Authors: Ziemniczak Kaline , Traldi Josiane B. , Nogaroto Viviane , Almeida Mara C. , Artoni Roberto F. , Moreira-Filho Orlando , Vicari Marcelo R.
Published: February 2015

The family Parodontidae presents a conserved diploid number of 54 chromosomes and different stages associated with ZW sex chromosome differentiation. For the great majority of species in this family it was proposed that the karyotypic diversification is mostly due to repetitive DNA mobility and accumulation. In this study, 2 repetitive probes, (GATA)n and (TTAGGG)n, were used to assess probable mechanisms of chromosome diversification, especially those related to molecular differentiation of the W chromosome. Results showed that the (GATA)n sequence is involved in the differentiation of the W chromosome female-specific region of Parodontidae and that it is accumulated in diverse autosomes. The (TTAGGG)n repeat is part of the vertebrate telomere, and the presence of interstitial telomeric sites may help to identify chromosome rearrangements. However, in Parodontidae, no interstitial telomeric sites were detected. This study shows plasticity in the amount of the (GATA)n repeat in Parodontidae that may be involved in chromatin modifications and transcriptional control of the W chromosome, and the role of repetitive DNAs in genomic diversification in this fish family is discussed.
Clinically Relevant Depressive Symptoms in Young Stroke Patients - Results of the sifap1 Study
Authors: Tanislav Christian , Kropp Peter , Grittner Ulrike , Holzhausen Martin , Fazekas Franz , Jungehülsing Gerhard Jan , Tatlisumak Turgut , von Sarnowski Bettina , Putaala Jukka , Huber Roman , Thijs Vincent , Schmidt Reinhold , Kaps Manfred , Enzinger Christian , Dichgans Martin , Norrving Bo , Rolfs Arndt
Published: February 2015

Background: Although post-stroke depression is widely recognized, less is known about depressive symptoms in the acute stage of stroke and especially in young stroke patients. We thus investigated depressive symptoms and their determinants in such a cohort. Methods: The Stroke in Young Fabry Patients study (sifap1) prospectively recruited a large multinational European cohort (n = 5,023) of patients with a cerebrovascular event aged 18-55. For assessing clinically relevant depressive symptoms (CRDS, defined by a BDI-score ≥18) the self-reporting Beck Depression Inventory (BDI) was obtained on inclusion in the study. Associations with baseline parameters, stroke severity (National Institutes of Health Stroke Scale, NIHSS), and brain MRI findings were analyzed. Results: From the 2007 patients with BDI documentation, 202 (10.1%) had CRDS. CRDS were observed more frequently in women (12.6 vs. 8.2% in men, p < 0.001). Patients with CRDS more often had arterial hypertension, diabetes mellitus, and hyperlipidemia than patients without CRDS (hypertension: 58.0 vs. 47.1%, p = 0.017; diabetes mellitus: 17.9 vs. 8.9%, p < 0.001; hyperlipidemia: 40.5 vs. 32.3%, p = 0.012). In the subgroup of patients with ischemic stroke or TIA (n = 1,832) no significant associations between CRDS and cerebral MRI findings such as the presence of acute infarcts (68.1 vs. 65.8%, p = 0.666), old infarctions (63.4 vs. 62.1%, p = 0.725) or white matter hyper-intensities (51.6 vs. 53.7%, p = 0.520) were found. Conclusion: Depressive symptoms were present in 10.1% of young stroke patients in the acute phase, and were related to risk factors but not to imaging findings.
The Significance of Cortical Cerebellar Microbleeds and Microinfarcts in Neurodegenerative and Cerebrovascular Diseases
Authors: De Reuck Jacques L. , Deramecourt Vincent , Auger Florent , Durieux Nicolas , Cordonnier Charlotte , Devos David , Defebvre Luc , Moreau Caroline , Capparos-Lefebvre Dominique , Pasquier Florence , Leys Didier , Maurage Claude-Alain , Bordet Regis
Published: February 2015

Background: As cortical microbleeds and microinfarcts in neurodegenerative and cerebrovascular diseases have been studied predominantly at the level of the cerebral hemispheres and linked to the presence of cerebral amyloid angiopathy (CAA), we aimed at determining with 7.0-tesla magnetic resonance imaging (MRI) whether the causes and the frequency of cortical cerebellar microbleeds (CCeMBs) and microinfarcts (CCeMIs) are the same. Materials and Methods: Hundred and four postmortem brains, composed of 29 with pure Alzheimer's disease (AD), 9 with AD associated to CAA, 10 with frontotemporal lobar degeneration, 9 with amyotrophic lateral sclerosis, 10 with Lewy body disease, 12 with progressive supranuclear palsy, 9 with vascular dementia (VaD), and 16 controls, were examined. On a horizontal section of a cerebellar hemisphere examined with 7.0-tesla MRI, the number CCeMBs and CCeMIs were compared between the different disease groups and the control group. The MRI findings were also compared with the corresponding mean values observed on histological examination of a separate standard horizontal section of a cerebellar hemisphere, used for diagnostic purpose. Results: CCeMBs and CCeMIs were only significantly increased in the VaD group. When comparing the diseased patients with and without CAA mutually and with those with arterial hypertension and severe atherosclerotic cerebrovascular disease, only in the latter an increase of CCeMBs and CCeMIs was observed. There was an excellent correlation between the MRI and the neuropathological findings. Conclusions: CCeMBs and CCeMIs are mainly due to atherosclerotic cerebrovascular disease and not due to CAA. Their increased presence cannot be included to the Boston diagnostic criteria for CAA.
Treatment of a Fetal Tracheal Obstruction by Fetoscopy and Laser
Authors: Bel Sandra , Sananes Nicolas , Gaudineau Adrien , Akladios Cherif , Favre Romain
Published: February 2015

We report below a case of in utero tracheoscopy with laser collapse of a bronchogenic cyst obstructing the fetal trachea. The patient was referred for ultrasonography at 24 weeks of gestation because of fetal hydrops. Tracheoscopy was performed via fetoscopic approach using a single trocar under local anesthesia with lidocaine and ultrasound guidance. This revealed an image suggestive of a cyst obstructing the middle third at the anterior base of the trachea. Coagulation using a diode laser enabled us to collapse this fluid-filled cyst with three 10-watt bursts (3 times 3 s) and to visualize a completely unobstructed tracheobronchial tree with significant pulmonary fluid reflux on removal of the obstacle. The fetal condition improved markedly within 48 h after the procedure. To the best of our knowledge, this is the first described case of in utero treatment of a tracheal obstruction by tracheoscopy and laser. In severe cases of obstruction of the fetal airways, whether the obstacle is situated in a high or low position, fetal endoscopy is of diagnostic and potentially therapeutic utility.
Renal Function Decline in Recipients and Donors of Kidney Grafts: Role of Aortic Stiffness
Authors: Bahous Sola Aoun , Khairallah Maya , Al Danaf Jad , Halaby Rim , Korjian Serge , Daaboul Yazan , Salameh Pascale , Stephan Antoine , Blacher Jacques , Safar Michel E.
Published: February 2015

Background/Aims: Renal function decreases over time as a result of reduction in the number of functioning nephrons with age. In recipients and donors of kidney grafts, renal function decline may be linked differently to various parameters, namely arterial stiffness. Methods: We conducted a prospective cohort study including 101 recipients of kidney grafts and their donors aiming at determining the factors correlated to the renal function decline over time. Aortic stiffness was evaluated by the non-invasive measurement of aortic pulse wave velocity. The glomerular filtration rate was estimated using the Modification of Diet in Renal Disease (MDRD) equation and the annualized change was determined. Results: Decline in renal function was estimated at 1-year post-transplantation and annually thereafter (median follow-up 8 years, range 3.6-18.3), as the mean of the annualized decrease in the glomerular filtration rate. In recipients, filtration rate decreased by 4.8 ± 19.7 ml/min/1.73 m2 the first post-transplant year and at a yearly rate of 2.2 ± 3.8 ml/min/1.73 m2 thereafter. The first-year decline was related to smoking and acute rejection. Later decline was significantly associated with donor age and aortic stiffness. In living donors, renal function decline after the first year corresponded to 0.7 ml/min/1.73 m2, was significantly lower than that of recipients (p < 0.001), and was determined by donor age at nephrectomy. Conclusion: Recipients of kidney grafts show a glomerular filtration rate decline over time that is significantly associated with donor age and aortic stiffness after the first post-transplant year, while donors demonstrate a lower decline that is mostly determined by age at nephrectomy.
A Case of Contiguous Primary Hepatic Marginal Zone B-Cell Lymphoma and Hemangioma Ultimately Diagnosed Using Contrast-Enhanced Ultrasonography
Authors: Shiozawa Kazue , Watanabe Manabu , Ikehara Takashi , Matsukiyo Yasushi , Kikuchi Yoshinori , Kaneko Hironori , Okubo Yoichiro , Shibuya Kazutoshi , Igarashi Yoshinori , Sumino Yasukiyo
Published: February 2015

Primary hepatic marginal zone B-cell malignant lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is extremely rare. We present a case in which a lesion was diagnosed as 2 contiguous tumors (MALT lymphoma and hemangioma) using contrast-enhanced ultrasonography (US) with sonazoid. There has been no previous case of contiguous hepatic MALT lymphoma and hemangioma. The present case was a female with no medical history. We detected a snowman-like appearance, which was a tumor of 15 mm in diameter with hypo- and hyper-echogenicities in the lateral and medial parts, respectively, in the Couinaud's segment (S6) of the liver on US. The tumor appeared as a single lesion with a low-density area in the unenhanced phase and prolonged enhancement in the equilibrium phases on dynamic CT. On MRI, the whole lesion showed a low-intensity signal on T1-weighted imaging, but isointensity in the lateral part and high intensity in the medial part were seen on T2-weighted imaging. On contrast-enhanced US, the lateral hypoechoic region was homogenously hyperenhanced in the early vascular phase, and the contrast medium was washed out after about 30 s; in contrast, the medial hyperechoic region was gradually stained from the margin toward the central region. The tumor showed a defect in both hypo- and hyperechoic regions in the postvascular phase. Hemangioma was suspected for the medial part based on the typical image findings, but the lateral part was not given a diagnosis. Thus, surgical resection was performed. The medial part was a hemangioma, and the lateral part was a MALT lymphoma by histopathological findings.
Radiofrequency Catheter Ablation of Idiopathic Ventricular Arrhythmias Originating From Intramural Foci in the Left Ventricular Outflow Tract
Authors: Yamada Takumi , Maddox William R. , McElderry H. Thomas , Doppalapudi Harish , Plumb Vance J. , Kay G. Neal
Published: January 2015

Backgrounds—

Idiopathic ventricular arrhythmias (VAs) originating from the left ventricular outflow tract (LVOT) sometimes require catheter ablation from the endocardial and epicardial sides for their elimination, suggesting the presence of intramural VA foci. This study investigated the efficacy of sequential and simultaneous unipolar radiofrequency catheter ablation from the endocardial and epicardial sides in treating intramural LVOT VAs.

Methods and Results—

Fourteen consecutive LVOT VAs, which required sequential or simultaneous irrigated unipolar radiofrequency ablation from the endocardial and epicardial sides for their elimination, were studied. The first ablation was performed at the site with the earliest local ventricular activation and best pace map on the endocardial or epicardial side. When the first ablation was unsuccessful, the second ablation was delivered on the other surface. If this sequential unipolar ablation failed, simultaneous unipolar ablation from both sides was performed. The first ablation was performed on the epicardial side in 9 VAs and endocardial side in 5 VAs. The intramural LVOT VAs were successfully eliminated by the sequential (n=9) or simultaneous (n=5) unipolar catheter ablation. Simultaneous ablation was most likely to be required for the elimination of the VAs when the distance between the endocardial and epicardial ablation sites was >8 mm and the earliest local ventricular activation time relative to the QRS onset during the VAs of <–30 ms was recorded at those ablation sites.

Conclusions—

LVOT VAs originating from intramural foci could usually be eliminated by sequential unipolar radiofrequency ablation and sometimes required simultaneous ablation from both the endocardial and epicardial sides.
Percutaneous Epicardial Ablation of Ventricular Arrhythmias Arising From the Left Ventricular Summit
Authors: Santangeli Pasquale , Marchlinski Francis E. , Zado Erica S. , Benhayon Daniel , Hutchinson Mathew D. , Lin David , Frankel David S. , Riley Michael P. , Supple Gregory E. , Garcia Fermin C. , Bala Rupa , Desjardins Benoit , Callans David J. , Dixit Sanjay
Published: January 2015

Background—

Percutaneous epicardial ablation of ventricular arrhythmias arising from the left ventricular summit is limited by the presence of major coronary vessels and epicardial fat. We report the outcomes of percutaneous epicardial mapping and ablation of ventricular arrhythmias arising from the left ventricular summit and the ECG features associated with successful ablation.

Methods and Results—

Between January 2003 and December 2012, a total of 23 consecutive patients (49±14 years; 39% men) with ventricular arrhythmias arising from the left ventricular summit underwent percutaneous epicardial instrumentation for mapping and ablation because of unsuccessful ablation from the coronary venous system and multiple endocardial LV/right ventricular sites. Successful epicardial ablation was achieved in 5 (22%) patients. In the remaining 18 (78%) cases, ablation was aborted for either close proximity to major coronary arteries or poor energy delivery over epicardial fat. The Q-wave amplitude ratio in aVL/aVR was higher in the successful group, with a ratio of >1.85 present in 4 (80%) patients in the successful group versus 2 (11%) in the unsuccessful group (
P
=0.008). The ratio of R/S wave in V1 was greater in the successful group, with 4 (80%) patients in the successful group having a R/S ratio of >2 in V1 versus 5 (28%) in the unsuccessful group (
P
=0.056). None of the patients in the successful group had an initial q wave in lead V1, as opposed to 6 (33%) in the unsuccessful group. The presence of at least 2 of the 3 ECG criteria above predicted successful ablation with 100% sensitivity and 72% specificity.

Conclusions—

Epicardial instrumentation for mapping and ablation of ventricular arrhythmias arising from the left ventricular summit is successful only in a minority of patients because of close proximity to major coronary arteries and epicardial fat. A Q-wave ratio of >1.85 in aVL/aVR, a R/S ratio of >2 in V1, and absence of q waves in lead V1 help identify appropriate candidates for epicardial ablation.
Upregulation of MG53 Induces Diabetic Cardiomyopathy Through Transcriptional Activation of Peroxisome Proliferation-Activated Receptor α
Authors: Liu Fenghua , Song Ruisheng , Feng Yuanqing , Guo Jiaojiao , Chen Yanmin , Zhang Yong , Chen Tao , Wang Yanru , Huang Yanyi , Li Chuan-Yun , Cao Chunmei , Zhang Yan , Hu Xinli , Xiao Rui-ping
Published: January 2015

Background—

Diabetic cardiomyopathy, which contributes to >50% diabetic death, is featured by myocardial lipid accumulation, hypertrophy, fibrosis, and cardiac dysfunction. The mechanism underlying diabetic cardiomyopathy is poorly understood. Recent studies have shown that a striated muscle-specific E3 ligase Mitsugumin 53 (MG53, or TRIM72) constitutes a primary causal factor of systemic insulin resistance and metabolic disorders. Although it is most abundantly expressed in myocardium, the biological and pathological roles of MG53 in triggering cardiac metabolic disorders remain elusive.

Methods and Results—

Here we show that cardiac-specific transgenic expression of MG53 induces diabetic cardiomyopathy in mice. Specifically, MG53 transgenic mouse develops severe diabetic cardiomyopathy at 20 weeks of age, as manifested by insulin resistance, compromised glucose uptake, increased lipid accumulation, myocardial hypertrophy, fibrosis, and cardiac dysfunction. Overexpression of MG53 leads to insulin resistant via destabilizing insulin receptor and insulin receptor substrate 1. More importantly, we identified a novel role of MG53 in transcriptional upregulation of peroxisome proliferation-activated receptor alpha and its target genes, resulting in lipid accumulation and lipid toxicity, thereby contributing to diabetic cardiomyopathy.

Conclusions—

Our results suggest that overexpression of myocardial MG53 is sufficient to induce diabetic cardiomyopathy via dual mechanisms involving upregulation of peroxisome proliferation-activated receptor alpha and impairment of insulin signaling. These findings not only reveal a novel function of MG53 in regulating cardiac peroxisome proliferation-activated receptor alpha gene expression and lipid metabolism, but also underscore MG53 as an important therapeutic target for diabetes mellitus and associated cardiomyopathy.
Myocardial Stiffness in Patients With Heart Failure and a Preserved Ejection Fraction
Authors: Zile Michael R. , Baicu Catalin F. , S. Ikonomidis John , Stroud Robert E. , Nietert Paul J. , Bradshaw Amy D. , Slater Rebecca , Palmer Bradley M. , Van Buren Peter , Meyer Markus , M. Redfield Margaret , A. Bull David , L. Granzier Henk , LeWinter Martin M.
Published: January 2015

Background—

The purpose of this study was to determine whether patients with heart failure and a preserved ejection fraction (HFpEF) have an increase in passive myocardial stiffness and the extent to which discovered changes depend on changes in extracellular matrix fibrillar collagen and cardiomyocyte titin.

Methods and Results—

Seventy patients undergoing coronary artery bypass grafting underwent an echocardiogram, plasma biomarker determination, and intraoperative left ventricular epicardial anterior wall biopsy. Patients were divided into 3 groups: referent control (n=17, no hypertension or diabetes mellitus), hypertension (HTN) without (–) HFpEF (n=31), and HTN with (+) HFpEF (n=22). One or more of the following studies were performed on the biopsies: passive stiffness measurements to determine total, collagen-dependent and titin-dependent stiffness (differential extraction assay), collagen assays (biochemistry or histology), or titin isoform and phosphorylation assays. In comparison with controls, patients with HTN(–)HFpEF had no change in left ventricular end-diastolic pressure, myocardial passive stiffness, collagen, or titin phosphorylation but had an increase in biomarkers of inflammation (C-reactive protein, soluble ST2, tissue inhibitor of metalloproteinase 1). In comparison with both control and HTN(–)HFpEF, patients with HTN(+)HFpEF had increased left ventricular end-diastolic pressure, left atrial volume, N-terminal propeptide of brain natriuretic peptide, total, collagen-dependent, and titin-dependent stiffness, insoluble collagen, increased titin phosphorylation on PEVK S11878(S26), reduced phosphorylation on N2B S4185(S469), and increased biomarkers of inflammation.

Conclusions—

Hypertension in the absence of HFpEF did not alter passive myocardial stiffness. Patients with HTN(+)HFpEF had a significant increase in passive myocardial stiffness; collagen-dependent and titin-dependent stiffness were increased. These data suggest that the development of HFpEF depends on changes in both collagen and titin homeostasis.
Transcatheter Aortic Valve Implantation in the United Kingdom
Authors: Ludman Peter F. , Moat Neil , de Belder Mark A. , Blackman Daniel J. , Duncan Alison , Banya Winston , MacCarthy Philip A. , Cunningham David , Wendler Olaf , Marlee Damian , Hildick-Smith David , Young Christopher P. , Kovac Jan , Uren Neal G. , Spyt Tomasz , Trivedi Uday , Howell Jonathan , Gray Huon
Published: January 2015

Background—

We assessed trends in the performance of transcatheter aortic valve implantation in the United Kingdom from the first case in 2007 to the end of 2012. We analyzed changes in case mix, complications, outcomes to 6 years, and predictors of mortality.

Methods and Results—

Annual cohorts were examined. Mortality outcomes were analyzed in the 92% of patients from England and Wales for whom independent mortality tracking was available. A total of 3980 transcatheter aortic valve implantation procedures were performed. In successive years, there was an increase in frequency of impaired left ventricular function, but there was no change in Logistic EuroSCORE. Overall 30-day mortality was 6.3%; it was highest in the first cohort (2007–2008), after which there were no further significant changes. One-year survival was 81.7%, falling to 37.3% at 6 years. Discharge by day 5 rose from 16.7% in 2007 and 2008 to 28% in 2012. The only multivariate preprocedural predictor of 30-day mortality was Logistic EuroSCORE ≥40. During long-term follow-up, multivariate predictors of mortality were preprocedural atrial fibrillation, chronic obstructive pulmonary disease, creatinine >200 μmol/L, diabetes mellitus, and coronary artery disease. The strongest independent procedural predictor of long-term mortality was periprocedural stroke (hazard ratio=3.00;
P
<0.0001). Nonfemoral access and postprocedural aortic regurgitation were also significant predictors of adverse outcome.

Conclusions—

We analyzed transcatheter aortic valve implantation in an entire country, with follow-up over 6 years. Although clinical profiles of enrolled patients remained unchanged, longer-term outcomes improved, and patients were discharged earlier. Periprocedural stroke, nonfemoral access, and postprocedural aortic regurgitation are predictors of adverse outcome, along with intrinsic patient risk factors.
Matrix Metalloproteinase-2 Mediates a Mechanism of Metabolic Cardioprotection Consisting of Negative Regulation of the Sterol Regulatory Element–Binding Protein-2/3-Hydroxy-3-Methylglutaryl-CoA Reductase Pathway in the Heart
Authors: Wang Xiang , Berry Evan , Hernandez-Anzaldo Samuel , Takawale Abhijit , Kassiri Zamaneh , Fernandez-Patron Carlos
Published: February 2015

Previously, we reported that cardiac matrix metalloproteinase (MMP)-2 is upregulated in hypertensive mice. How MMP-2 affects the development of cardiac disease is unclear. Here, we report that MMP-2 protects from hypertensive cardiac disease. In mice infused with angiotensin II, the lack of MMP-2 (
Mmp2
−/−
) did not affect the severity of the hypertension but caused cardiac hypertrophy to develop earlier and to a greater extent versus wild-type (
Mmp2
+/+
) mice, as measured by heart weight:body weight ratio and upregulation of hypertrophy and fibrosis markers. We further found numerous metabolic and inflammatory gene expression abnormalities in the left ventricle of
Mmp2
−/−
mice. Interestingly,
Mmp2
−/−
mice expressed greater amounts of sterol regulatory element–binding protein-2 and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (a target of sterol regulatory element–binding protein-2–mediated transcription and rate limiting enzyme in cholesterol and isoprenoids biosynthesis) in addition to markers of inflammation including chemokines of the C-C motif ligand family. We focused on the functionally related genes for sterol regulatory binding protein-2 and 3-hydroxy-3-methylglutaryl-coenzyme A reductase. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor, lovastatin, attenuated angiotensin II–induced cardiac hypertrophy and fibrosis in
Mmp2
−/−
and wild-type (
Mmp2
+/+
) mice, with
Mmp2
−/−
mice showing resistance to cardioprotection by lovastatin. MMP-2 deficiency predisposes to cardiac dysfunction as well as metabolic and inflammatory gene expression dysregulation. This complex phenotype is, at least in part, because of the cardiac sterol regulatory element–binding protein-2/3-hydroxy-3-methylglutaryl-coenzyme A reductase pathway being upregulated in MMP-2 deficiency.
Visual Information Shapes the Dynamics of Corticobasal Ganglia Pathways during Response Selection and Inhibition
Authors: Jahfari Sara , Waldorp Lourens , Ridderinkhof K. Richard , Scholte H. Steven
Published: February 2015

Action selection often requires the transformation of visual information into motor plans. Preventing premature responses may entail the suppression of visual input and/or of prepared muscle activity. This study examined how the quality of visual information affects frontobasal ganglia (BG) routes associated with response selection and inhibition. Human fMRI data were collected from a stop task with visually degraded or intact face stimuli. During go trials, degraded spatial frequency information reduced the speed of information accumulation and response cautiousness. Effective connectivity analysis of the fMRI data showed action selection to emerge through the classic direct and indirect BG pathways, with inputs deriving form both prefrontal and visual regions. When stimuli were degraded, visual and prefrontal regions processing the stimulus information increased connectivity strengths toward BG, whereas regions evaluating visual scene content or response strategies reduced connectivity toward BG. Response inhibition during stop trials recruited the indirect and hyperdirect BG pathways, with input from visual and prefrontal regions. Importantly, when stimuli were nondegraded and processed fast, the optimal stop model contained additional connections from prefrontal to visual cortex. Individual differences analysis revealed that stronger prefrontal-to-visual connectivity covaried with faster inhibition times. Therefore, prefrontal-to-visual cortex connections appear to suppress the fast flow of visual input for the go task, such that the inhibition process can finish before the selection process. These results indicate response selection and inhibition within the BG to emerge through the interplay of top–down adjustments from prefrontal and bottom–up input from sensory cortex.
Miconia valentinensis (Melastomataceae), a new species from Espírito Santo, Brazil
Authors: Bacci Lucas De Freitas , Goldenberg Renato
Published: February 2015

During the preparation of the monograph on Miconia for the Flora of Espírito Santo, Brazil, a new species was recognized and is described in this paper. Miconia valentin­ensis was found in Serra do Valentim, in Iúna Municipality. It has leaves with a slightly cordate base, 5+2 nerves (the inner pair strongly suprabasal, plus a basal median pair and a faint additional marginal pair), branches with strong longitudinal ridges, calyx early caducous, with the petals basally adhering to it, anthers dehiscing through a broad longitudinal slit, and with the ovary glabrous at the apex.
Rubus gayeri and Rubus slavonicus, two new species of Rubus ser. Micantes (Rosaceae) from Central and South-Eastern Europe
Authors: Király Gergely , Trávníček Bohumil , Žíla Vojtěch
Published: February 2015

Two new apomictic species of bramble occurring in Hungary and adjacent regions, Rubus gayeri and R. slavonicus, section Rubus, subsection Hiemales E. H. L. Krause, series Micantes Sudre, are described. Diagnostic features, pen drawings and photographs of both new species are presented; moreover, distribution maps, list of revised specimens and habitat characteristics are included as well. R. gayeri is a regional bramble species occurring on the eastern foothills of the Alps (W Hungary, SE Austria and N Slovenia); its range is of approximately 120 km diameter. Originally, it was connected with acidophilous oak-hornbeam and beech forests and forest fringes, expanding later (due to anthropogenic influences) to secondary coniferous woods of base-poor soils. R. slavonicus has a specific long-drawn range from the northwestern Balkans (Bosnia & Herzegovina) to the centre of the Pannonian Basin (Hungary) of approximately 250 km diameter. Throughout its range it typically occurs in pedunculate oak-hornbeam forests of lower altitudes with several sub-Mediterranean elements. In the northernmost isolated part of the range (N of Lake Balaton) it is found in extrazonal beech forests on basalt bedrock.
Zehntneriana serrata n. sp., a new species of pilumnid crab from southern Taiwan (Crustacea, Decapoda, Brachyura)
Authors: NG PETER K. L. , LIN CHIA-WEI
Published: February 2015

A new species of rhizopine crab, Zehntneriana serrata (Pilumnidae) is described from a coral reef in southern Taiwan. The new species differs from congeners by its smooth and glabrous carapace, prominently serrated anterolateral margins, elongated ambulatory legs with a serrated anterior margin of the merus, and the diagnostic morphology of the male first gonopod.
A review of the Palaearctic Heliocheilus translucens Felder & Rogenhofer, 1874 species-group with description of a new species from West Mongolia
(Lepidoptera, Noctuidae, Heliothinae)
Authors: VOLYNKIN ANTON V. , STÜNING DIETER , MATOV ALEXEJ YU.
Published: February 2015

Three Palaearctic species of the Heliocheilus translucens species-group are reviewed. One new species, H. tengri Volynkin & Matov, sp. n. is described from West Mongolia, southwestern part of Mongolian Altai Mts. The adults, male and female genitalia are illustrated.
Synopsis of the genus Eldarca Signoret, 1864 (Hemiptera: Heteroptera: Coreidae)
Authors: FAÚNDEZ EDUARDO I.
Published: February 2015

A synopsis of the Coreid genus Eldarca Signoret, 1864 is presented. Full species status is given to Eldarca rufa Reed, 1899 n. stat. New distributional data are provided for Eldarca nigra Signoret, 1864. Eldarca haematoloma rufa Reed, 1899 n. stat. is considered as subspecies of E. haematomera. Eldarca nigroscutellata sp. nov. is described from southern Patagonia; which becomes also the southernmost record of Coreidae in South America. Differential diagnoses and figures for all the species of the genus are included. The distribution of the species is commented and a distribution map is provided. A key to the four known species of Eldarca is added.
Break of the Western North Pacific Summer Monsoon in Early August
Authors: Xu Ke , Lu Riyu
Published: February 2015

Although the monsoon break is a well-known phenomenon for the South Asian summer monsoon, it has not been well documented for the other monsoons, for instance, the western North Pacific (WNP) summer monsoon. This study identified a distinct monsoon break over the WNP by analyzing the subseasonal evolution of atmospheric convection and precipitation. This WNP monsoon break occurs climatologically in early August (3–8 August), but shows a strong variation, in either intensity or timing, from year to year. For about 30% of years, the rainfall amount reduces by more than 10 mm day−1 over the northeast WNP (10°–20°N, 140°–160°E) in early August, and is even less than that before the monsoon onset. However, for the other 30% of years, the subseasonal evolution of rainfall tends to be out of phase with the climatology, and rainfall reduction appears in mid-August. Furthermore, the 10–25-day oscillations, which originate at the equatorial western Pacific and propagate northwestward, are found to play a crucial role in forming the monsoon break. The 10–25-day oscillations exhibit a strong interannual variation, associated with the WNP monsoon trough during the period from late July to mid-August, and contribute greatly to the year-to-year variation in both the timing and intensity of the monsoon break. Considering the close link in subseasonal evolution between the WNP and East Asian monsoons, the present results indicate the necessity to investigate the possible role of the WNP monsoon break on the weather and climate over East Asia.
Acid-Suppressing Agents and Risk for Clostridium difficile Infection in Pediatric Patients
Authors: Brown Katelyn E. , Knoderer Chad A. , Nichols Kristen R. , Crumby Ashley S.
Published: February 2015

Background. Acid-suppressing agents have been associated with increased Clostridium difficile infection (CDI) in adults. The objective of this study was to evaluate the association of acid-suppressing therapy with the development of CDI in the pediatric population. Methods. This was a retrospective case-control study. Children aged 1 through 17 years with a positive C difficile polymerase chain reaction (PCR) result obtained between June 1, 2008, and June 1, 2012, were randomly matched to a control population selected from patients with negative PCR. Results. A total of 458 children were included. No difference was observed in acid-suppressive therapy prior to PCR in CDI-positive versus -negative patients (n = 131 [57.2%] vs n = 121 [52.8%], P = .348). Among patients receiving acid-suppressing therapy prior to obtaining a PCR, no difference was observed in proton pump inhibitor use (45% vs 46.3%, P = .843), but histamine-2 receptor antagonist (H2RA) use was greater in the CDI-positive patients (32.8% vs 14.9%, P = .001). Logistic regression analysis demonstrated that H2RA therapy at home (odds ratio = 4.6; 95% confidence interval = 1.5-14.5) was an independent CDI predictor. Conclusion. In this pediatric population, CDI risk in children receiving home acid-suppressive therapy with H2RAs is nearly 4.5 times greater than that of children not receiving H2RA therapy. These results suggest the need for continued monitoring and study of H2RA therapy in children.
Effects of a Brief Physical Activity Program on Young Students’ Physical Fitness
Authors: Hayes Rebecca M. , Thompson Lauren M. , Gress Todd , Cottrell Lesley , Pino Isabel , Gilkerson Christine L. , Flesher Susan L.
Published: February 2015

Background. Our objective was to test whether brief daily activity could increase young students’ physical fitness and compare different forms of intervention delivery. Methods. Two intervention groups were instructed to increase children’s activity by 6 minutes daily. The principal was responsible for the intervention in the first group while classroom teachers were responsible in the second. The third group was a control. Success was defined by changes in student fitness. Results. The principal-led group had a significant increase in the number of 75-foot laps completed after intervention (+0.61 laps) and a significant decrease in after-exercise heart rate (−37.4 beats per minute) as compared with the control group. The teacher-led group experienced no change in either outcome. Conclusions. Our findings demonstrate that a 6-minute increase in activity can produce a significant improvement in student fitness. Administrative support of school-based interventions can have a positive impact on program completion.
Race Differences in Drug Offending and Drug Distribution Arrests
Authors: Mitchell Ojmarrh , Caudy Michael S.
Published: January 2015

The War on Drugs’ emphasis on apprehending low-level drug offenders dramatically increased the number of arrests for drug distribution and exacerbated racial and ethnic disparities in such arrests. Although these disparities have been the topic of much discussion, they rarely have been the subject of multivariate empirical scrutiny. This research examines the degree to which race differences in drug offending, nondrug offending, and community context explain race differences in the likelihood of experiencing a drug distribution arrest in a longitudinal sample of youthful respondents (age 12-29). Our results indicate that in comparison with White drug offenders, Hispanic drug offenders’ greater likelihood of arrest is largely due to differences in community context; however, African Americans’ greater likelihood of arrest is not explained by differences in offending or community context. The policy implications of these findings are discussed.