Cholecalciferol supplementation and angiogenic markers in chronic kidney disease

Vitamin D plays an important role in proliferation and differentiation of cells and deficiency of vitamin D disturbs angiogenic balance. Previous studies in animal models have reported an association between serum levels of vitamin D and balance between pro- and anti-angiogenic factors. There is insufficient evidence about the effect of vitamin D on mediators of angiogenesis in patients with CKD. We investigated the effect of cholecalciferol supplementation on serum levels of angiogenic markers in non-diabetic patients with CKD stage 3-4. In this secondary analysis on stored samples of our previously published randomized, double-blind, placebo-controlled trial, stable patients of either sex, aged 18-70 years, with non-diabetic CKD stage 3-4 and vitamin D deficiency (serum 25-hydroxyvitamin D ≤20 ng/ml) were randomized to receive either two directly observed oral doses of cholecalciferol (300,000 IU) or matching placebo at baseline and 8 weeks. The primary outcome was change in brachial artery flow-mediated dilatation at 16 weeks. Changes in levels of serum angiogenesis markers (angiopoietin-1, angiopoietin-2, VEGF-A, VEGEF-R, and Tie-2) between groups over 16 weeks were compared. A total 120 patients were enrolled. Supplementation with cholecalciferol led to significant improvement in FMD. Serum 25(OH)D levels were similar in both groups at baseline (13.21±4.78 ng/ml and 13.40±4.42 ng/ml; p = 0.888). At 16 weeks, the serum 25(OH)D levels increased in the cholecalciferol group but not in the placebo group (between-group difference in mean change:23.40 ng/ml; 95% CI, 19.76 to 27.06; p<0.001). Serum levels of angiogenic markers were similar at baseline. At 16 weeks, angiopoietin-2 level decreased in cholecalciferol group (mean difference:-0.73 ng/ml, 95%CI, -1.25 to -0.20, p = 0.002) but not in placebo group (mean difference -0.46 ng/ml, 95%CI, -1.09 to 0.17, p = 0.154), however there was no between-group difference at 16 weeks (between-group difference in mean change: -0.27 ng/ml, 95%CI, -1.09 to 0.55, p = 0.624). Serum angiopoietin-1 level increased [mean change: 5.63 (0.51 to 10.75), p = 0.018] and VEGF-R level decreased [mean change: -87.16 (-131.89 to -42.44), p<0.001] in placebo group but did not show any change in cholecalciferol group. Our data shows the changes in Ang-1, Ang-2 and Ang-1/Ang-2 ratio after high dose oral cholecalciferol supplementation in patients with non-diabetic G3-4 CKD. The data suggests changes in circulating levels of angiogenic markers which needs to be confirmed through an adequately powered study

Clostridium difficile Infections amongst Patients with Haematological Malignancies: A Data Linkage Study

OBJECTIVES: Identify risk factors for Clostridium difficile infection (CDI) and assess CDI outcomes among Australian patients with a haematological malignancy. METHODS: A retrospective cohort study involving all patients admitted to hospitals in Western Australia with a haematological malignancy from July 2011 to June 2012. Hospital admission data were linked with all hospital investigated CDI case data. Potential risk factors were assessed by logistic regression. The risk of death within 60 and 90 days of CDI was assessed by Cox Proportional Hazards regression. RESULTS: There were 2085 patients of whom 65 had at least one CDI. Twenty percent of CDI cases were either community-acquired, indeterminate source or had only single-day admissions in the 28 days prior to CDI. Using logistic regression, having acute lymphocytic leukaemia, neutropenia and having had bacterial pneumonia or another bacterial infection were associated with CDI. CDI was associated with an increased risk of death within 60 and 90 days post CDI, but only two deaths had CDI recorded as an antecedent factor. Ribotyping information was available for 33 of the 65 CDIs. There were 19 different ribotypes identified. CONCLUSIONS: Neutropenia was strongly associated with CDI. While having CDI is a risk factor for death, in many cases it may not be a direct contributor to death but may reflect patients having higher morbidity. A wide variety of C. difficile ribotypes were found and community-acquired infection may be under-estimated in these patients

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency–Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research

Scientific Letter: Sodium valproate for the treatment of mania in a patient with Charcot-Marie-Tooth disease

No AbstractAfrican Journal of Psychiatry •  November 2013, 16(6

Not Available

Not AvailableABSTRACT India achieved food security and self sufficiency in 1970s through adoption of high yielding wheat and rice varieties on large area. The high yielding varieties were responsive to high inputs and were developed through genetic intervention. But in case of maize for the first time, the single cross hybrid technology revolution through genetic intervention happened in USA (1960-1990) and the productivity has increased from 3.5 t/ha to 7.5 t/ha. Whereas, in India maize production remained stagnant for the last five decades (1950-2000) mainly due to non-adoption of proven and established technology - single cross hybrid (SCH). However, in India with the introduction of SCH technology, the productivity has increased from 1.9 t/ha (2007-08) to 2.5 t/ha (2010-11) with average growth rate of more than 7 % in production, this is the highest growth rate among cereal crops. Further, it has registered more than 6 % in productivity @ 134 kg/ha/annum in India and transformed India as net maize exporter and stopped importing of maize. Even in USA the productivity remained around 7.5 to 8 t/ha for a decade (1990-1997) in spite of adoption of 100 % SCH technology with best practices and growing conditions. The further enhancement in yield was achieved by integration of SCH with novel tools and techniques in 1997. Since then the productivity of maize in USA has touched 8 to 10.1 (t/ha) during a span of 10-12 years (1997-2010). It is evident that it is not possible to increase the food by simple genetic manipulation and crop management practices alone under the scenario of shrinking land and other natural resources. Therefore genetic and biotechnological interventions in maize are one of the best solutions to ensure food security and national prosperity under changed climate scenarios.Not Availabl

Nonmedical factors and health-related quality of life in CKD in India

Background and objectives&nbsp;Patient-reported outcomes have gained prominence in the management of chronic noncommunicable diseases. Measurement of health-related quality of life is being increasingly incorporated into medical decision making and health care delivery processes. Design, setting, participants, &amp; measurements&nbsp;The Indian Chronic Kidney Disease Study is a prospective cohort of participants with mild to moderate CKD. Baseline health-related quality of life scores, determined by the standardized Kidney Disease Quality of Life 36 item instrument, are presented for the inception cohort (n=2919). Scores are presented on five subscales: mental component summary, physical component summary, burden, effect of kidney disease, and symptom and problems; each is scored 0&ndash;100. The associations of socioeconomic and clinical parameters with the five subscale scores and lower quality of life (defined as subscale score &lt;1 SD of the sample mean) were examined. The main socioeconomic factors studied were sex, education, occupation, and income. The key medical factors studied were age, eGFR, diabetes, hypertension, and albuminuria. Results&nbsp;The mean (SD) subscale scores were physical component summary score, 43&plusmn;9; mental component summary score, 48&plusmn;10; burden, 61&plusmn;33; effects, 87&plusmn;13; and symptoms, 90&plusmn;20. Among the socioeconomic variables, women, lower education, and lower income were negatively associated with reduced scores across all subscales. For instance, the respective&nbsp;&beta;-coefficients (SD) for association with the physical component summary subscale were &minus;2.6 (&minus;3.4 to &minus;1.8), &minus;1.5 (&minus;2.2 to &minus;0.7), and &minus;1.6 (&minus;2.7 to &minus;0.5). Medical factors had inconsistent or no association with subscale scores. The quality of life scores also displayed regional variations. Conclusions&nbsp;In this first of its kind analysis from India, predominantly socioeconomic factors were associated with quality of life scores in patients with CKD.</p