Paroxysmal atrial fibrillation presenting as anterior wall STEMI in an elderly woman

A 77-year-old woman without traditional risk factors for coronary artery disease (CAD) underwent coronary CT-angiography for evaluation of palpitations after negative Holter monitoring and non-diagnostic ECG exercise stress test. Coronary artery calcium score was reported zero; 1 day later, she was admitted with anterior-wall ST elevation myocardial infarction. Acute left anterior descending artery thrombus was treated with mechanical thrombectomy and Percutaneous Coronary Intervention (PCI). Interestingly, the coronary arteries were angiographically normal. During hospitalisation, paroxysmal atrial fibrillation was noted followed by initiation of anticoagulation. Echocardiogram did not show thrombus or atrial shunt. Cardioversion with Sotalol was successful. Myocardial infraction was most likely cardioembolic secondary to paroxysmal atrial fibrillation-consistent with longstanding history of palpitations. Accounting for 3% of acute coronary syndromes, coronary embolism is treated with therapeutic anticoagulation for at least 3 months irrespective of cause and carries a higher risk of adverse cardiovascular events

Transcatheter Therapies for Aortic Regurgitation: Where Are We in 2023?

Aortic regurgitation (AR) is retrograde flow across the aortic valve in diastole and is classified from stage A to D based on severity and symptoms. Severe symptomatic AR (stage D) is a class I indication for surgical aortic valve replacement per the 2020 American College of Cardiology/American Heart Association guidelines. Though off-label, patients with prohibitive surgical risk may benefit from transcatheter aortic valve replacement (TAVR) in appropriately selected patients. However, TAVR is challenging in AR due to a lack of leaflet and annular calcification and dilation of the perivalvular apparatus, compromising the optimal anchorage of the bioprosthesis with a risk of prosthetic valve leak and embolization. Valve oversizing by 10–15% is frequently required, with caution not to oversize beyond 20%. Multimodality imaging, including echocardiography, magnetic resonance imaging, and computerized tomography, is essential for procedural planning. Registry data shows acceptable results for off-label TAVR with newer generation valves such as Medtronic Evolut and Edwards Sapien 3 for native AR. The JenaValve designed especially for TAVR for native AR is currently undergoing clinical trial. Until the results of randomized clinical trials are available, careful selection of native AR patients for TAVR is paramount to procedural and clinical success

Utilization of indigenously isolated single strain starter cultures for the production of sourdough bread

Sourdoughs were prepared with Saccharomyces cerevisiae (T0) and indigenously isolated starter cultures i.e Lactobacillus brevis (T1), Lactobacillus fermentum (T2) and Lactobacillus plantarum (T3). Breads were prepared from all sourdoughs samples in triplicate and analyzed for pH, Total Titratable Acidity (TTA), loaf volume, microbial characteristics (total plate count and fungal count) and sensory profile (internal and external) in triplicate. The breads prepared from Saccharomyces cerevisiae (T0) exhibited the highest pH with the lowest TTA while T1 showed the lowest pH with the highest TTA. The T0 breads got the highest values for loaf volume followed by T1. The breads produced with the addition of hetero-fermentative starter cultures (T1 and T2) showed resistance against the growth of the contaminating microorganisms. In the sensory evaluation, the breads produced with T1 ranked the best for color (crust and crumb), taste, aroma, texture and overall acceptability by the panelists.Â

Genotypic response of chickpea (Cicer arietinum L.) for resistance against gram pod borer (Helicoverpa armigera)

Background: Chickpea is an important pulse crop of Pakistan. The pod borer, Helicoverpa armigera (Hubner), is the major pest in most of the chickpea growing areas of the country. A field trial was carried out at Entomological Research Area, Ayub Agriculture Research Institute (AARI), Faisalabad, during growing season of 2012-13 to evaluate the resistance of chickpea genotypes against gram pod borer (Helicoverpa armigera).Methods: Experiments were conducted in randomized complete block design (RCBD) with four replications having plot size of 3 ft × 20 ft. Morphological characters of chickpea like pod trichome, pod wall thickness, pod length, pod breadth, pod area and number of pods per plant were measured. The pod borer larval population/pod infestation was recorded from fifteen randomly selected plants per plot after ten days interval.Results: It was found that the genotypes which had higher trichomes length and density and pod wall thickness were more resistant against Helicoverpa infestation. Significant genetic variation for resistance against Helicoverpa armigera attack was found in chickpea and variety K-70005 showed resistant behavior followed by K-08004 and K-60062.Conclusions: It was concluded from prescribed study that the most susceptible genotypes were K-70005, K-08004 and K-70008 for the attack of Helicoverpa armigera to reduce grain yield

Post radiation chylous ascites: a case report

We report a 64 years old gentleman with unresectable right-sided retroperitoneal liposarcoma, who underwent radiotherapy & subsequently developed chylous ascites. He failed conservative management of chylous ascites and this was successfully managed with a peritoneovenous shunt. The pathophysiology and management of post radiational chylous ascites is discussed

ECM microenvironment unlocks brown adipogenic potential of adult human bone marrow-derived MSCs

Key to realizing the diagnostic and therapeutic potential of human brown/brite adipocytes is the identification of a renewable, easily accessible and safe tissue source of progenitor cells, and an efficacious in vitro differentiation protocol. We show that macromolecular crowding (MMC) facilitates brown adipocyte differentiation in adult human bone marrow mesenchymal stem cells (bmMSCs), as evidenced by substantially upregulating uncoupling protein 1 (UCP1) and uncoupled respiration. Moreover, MMC also induced ‘browning’ in bmMSC-derived white adipocytes. Mechanistically, MMC creates a 3D extracellular matrix architecture enshrouding maturing adipocytes in a collagen IV cocoon that is engaged by paxillin-positive focal adhesions also at the apical side of cells, without contact to the stiff support structure. This leads to an enhanced matrix-cell signaling, reflected by increased phosphorylation of ATF2, a key transcription factor in UCP1 regulation. Thus, tuning the dimensionality of the microenvironment in vitro can unlock a strong brown potential dormant in bone marrow

SGBS cells as a model of human adipocyte browning: A comprehensive comparative study with primary human white subcutaneous adipocytes.

The Simpson Golabi Behmel Syndrome (SGBS) pre-adipocyte cell strain is widely considered to be a representative in vitro model of human white pre-adipocytes. A recent study suggested that SGBS adipocytes exhibit an unexpected transient brown phenotype. Here, we comprehensively examined key differences between SGBS adipocytes and primary human white subcutaneous (PHWSC) adipocytes. RNA-Seq analysis revealed that extracellular matrix (ECM)-receptor interaction and metabolic pathways were the top two KEGG pathways significantly enriched in SGBS adipocytes, which included positively enriched mitochondrial respiration and oxidation pathways. Compared to PHWSC adipocytes, SGBS adipocytes showed not only greater induction of adipogenic gene expression during differentiation but also increased levels of UCP1 mRNA and protein expression. Functionally, SGBS adipocytes displayed higher ISO-induced basal leak respiration and overall oxygen consumption rate, along with increased triglyceride accumulation and insulin-stimulated glucose uptake. In conclusion, we confirmed that SGBS adipocytes, which are considered of white adipose tissue origin can shift towards a brown/beige adipocyte phenotype. These differences indicate SGBS cells may help to identify mechanisms leading to browning, and inform our understanding for the use of SGBS vis-à-vis primary human subcutaneous adipocytes as a human white adipocyte model, guiding the selection of appropriate cell models in future metabolic research

The transcription factor SOX6 contributes to the developmental origins of obesity by promoting adipogenesis

10.1242/dev.131573Development (Cambridge, England)1436950-961GUSTO (Growing up towards Healthy Outcomes