Fiber Type-Specific Nitric Oxide Protects Oxidative Myofibers against Cachectic Stimuli

Oxidative skeletal muscles are more resistant than glycolytic muscles to cachexia caused by chronic heart failure and other chronic diseases. The molecular mechanism for the protection associated with oxidative phenotype remains elusive. We hypothesized that differences in reactive oxygen species (ROS) and nitric oxide (NO) determine the fiber type susceptibility. Here, we show that intraperitoneal injection of endotoxin (lipopolysaccharide, LPS) in mice resulted in higher level of ROS and greater expression of muscle-specific E3 ubiqitin ligases, muscle atrophy F-box (MAFbx)/atrogin-1 and muscle RING finger-1 (MuRF1), in glycolytic white vastus lateralis muscle than in oxidative soleus muscle. By contrast, NO production, inducible NO synthase (iNos) and antioxidant gene expression were greatly enhanced in oxidative, but not in glycolytic muscles, suggesting that NO mediates protection against muscle wasting. NO donors enhanced iNos and antioxidant gene expression and blocked cytokine/endotoxin-induced MAFbx/atrogin-1 expression in cultured myoblasts and in skeletal muscle in vivo. Our studies reveal a novel protective mechanism in oxidative myofibers mediated by enhanced iNos and antioxidant gene expression and suggest a significant value of enhanced NO signaling as a new therapeutic strategy for cachexia

ICAR: endoscopic skull‐base surgery

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Fusionless procedures for the management of early-onset spine deformities in 2011: what do we know?

While attempts to understand them better and treat them more effectively, early-onset deformities have gained great pace in the past few years. Large patient series with long follow-ups that would provide high levels of evidence are still almost non-existent. That there is no safe treatment algorithm defined and agreed upon for this patient population continues to pose a challenge for pediatric spine surgeons. In this review, authors who are well known for their research and experience in the treatment of early-onset scoliosis (EOS) have come together in order to answer those questions which are most frequently asked by other surgeons. The most basic eight questions in this field have been answered succinctly by these authors and a current overview is provided

Consumer Perceptions of Integrated Trauma-Informed Services among Women with Co-Occurring Disorders

As part of a national, multi-site treatment outcome study, an instrument was designed to assess consumers’ perceptions of key services integrating trauma, mental health, and substance abuse issues, the Consumer Perceptions of Care (CPC). This study evaluates the psychometric properties of this instrument and analyzes consumers’ perceptions of the services they received. The results suggest that the measure has four factors: services integration, choice in services, trauma-informed assessment, and respect for cultural identity. These factors demonstrated adequate reliability, and the overall results suggested that the measure is a reliable, sensitive, and valid reflection of consumers’ perceptions of their services and their providers for diverse racial and ethnic groups. Women in the intervention programs perceived their services as more highly integrated for trauma, mental health, and substance use than women in the services as usual or comparison programs, supporting its utility as a measure of programs designed to provide integrated services