Nearly Fatal Case of Whipple's Disease in a Patient Mistakenly on Anti-TNF Therapy

Whipple's disease is a rare cause of chronic diarrhea and abdominal pain that may be confused with inflammatory bowel disease. We report a Whipple's case misdiagnosed as Crohn's disease in which treatment with anti-tumor necrosis factor (anti-TNF) therapy led to nearly fatal progression. Lymph node tissue obtained during laparotomy for suspected bowel necrosis stained dramatically with periodic acid-Schiff (PAS), and electron microscopy showed a bacterium consistent with Trophyrema whipplei. The patient made a remarkable recovery complicated only by cholestatic hepatitis, which was likely a treatment-associated inflammatory response. This case serves as a reminder that all granulomatous infections should be considered prior to initiation of anti-TNF therapies

Glucagon-like peptide-1 and the exenatide analogue AC3174 improve cardiac function, cardiac remodeling, and survival in rats with chronic heart failure

<p>Abstract</p> <p>Background</p> <p>Accumulating evidence suggests glucagon-like peptide-1 (GLP-1) exerts cardioprotective effects in animal models of myocardial infarction (MI). We hypothesized that chronic treatment with GLP-1 or the exenatide analog AC3174 would improve cardiac function, cardiac remodeling, insulin sensitivity, and exercise capacity (EC) in rats with MI-induced chronic heart failure (CHF) caused by coronary artery ligation.</p> <p>Methods</p> <p>Two weeks post-MI, male Sprague-Dawley rats were treated with GLP-1 (2.5 or 25 pmol/kg/min), AC3174 (1.7 or 5 pmol/kg/min) or vehicle via subcutaneous infusion for 11 weeks. Cardiac function and morphology were assessed by echocardiography during treatment. Metabolic, hemodynamic, exercise-capacity, and body composition measurements were made at study end.</p> <p>Results</p> <p>Compared with vehicle-treated rats with CHF, GLP-1 or AC3174 significantly improved cardiac function, including left ventricular (LV) ejection fraction, and end diastolic pressure. Cardiac dimensions also improved as evidenced by reduced LV end diastolic and systolic volumes and reduced left atrial volume. Vehicle-treated CHF rats exhibited fasting hyperglycemia and hyperinsulinemia. In contrast, GLP-1 or AC3174 normalized fasting plasma insulin and glucose levels. GLP-1 or AC3174 also significantly reduced body fat and fluid mass and improved exercise capacity and respiratory efficiency. Four of 16 vehicle control CHF rats died during the study compared with 1 of 44 rats treated with GLP-1 or AC3174. The cellular mechanism by which GLP-1 or AC3174 exert cardioprotective effects appears unrelated to changes in GLUT1 or GLUT4 translocation or expression.</p> <p>Conclusions</p> <p>Chronic treatment with either GLP-1 or AC3174 showed promising cardioprotective effects in a rat model of CHF. Hence, GLP-1 receptor agonists may represent a novel approach for the treatment of patients with CHF or cardiovascular disease associated with type 2 diabetes.</p

Spotlight on Re-Search: A New Beginning : Selected Proceedings of the 2008 Michigan Teachers of English to Speakers of Other Languages Conference

https://commons.emich.edu/mitesol/1004/thumbnail.jp

Dark costs, missing data: shedding some light on services trade

We develop a method to project missing sectoral services output and trade. For OECD countries, projected and observed output data match well. The basis is a structural gravity model to estimate barriers to services trade across sectors, countries and time. The model fits well and reveals key differences across service sectors. Border barriers fall over time but unevenly. Inferred border barriers are fitted to national geography, technology, income and endowments, and institutional determinants. The fitted model including fitted border barriers is used to project missing internal or bilateral trade flows, aggregating to projected output

The quantification of within week session intensity, duration and intensity distribution across a season in Australian Football using the session RPE method

Purpose: Training in team sports requires the daily manipulation of intensity, duration andfrequency with pre-season focusing on meeting the demands of in-season competition and inseason on recovery from competition. In order to provide information about daily training inAustralian Football (AF), this study aimed to quantify session duration, intensity anddistribution across a full season.Methods: Intensity (Ratings of Perceived Exertion, RPE) and duration were collected fromforty-five professional male AF for every training session and game. Each RPE wascategorized into the corresponding intensity zone; Low (Results: The distribution of the mean session intensity across the season was 29% low-, 57%moderate- and 14% high-intensity. While 96% of games were high-intensity, 44% and 49%of skills training sessions were low- and moderate-intensity, respectively. Running had thehighest proportion of high-intensity training sessions (27%). Pre-season displayed highertraining session intensity and duration, while in-season game intensity and duration werehigher.Conclusion: By using a cost-effective monitoring tool, this study provides information aboutthe intensity and duration of all training types across different phases of the season, thusallowing a greater understanding of the training and competition demands of AustralianFootballers

Cancellous bone and theropod dinosaur locomotion. Part II—a new approach to inferring posture and locomotor biomechanics in extinct tetrapod vertebrates

This paper is the second of a three-part series that investigates the architecture of cancellous bone in the main hindlimb bones of theropod dinosaurs, and uses cancellous bone architectural patterns to infer locomotor biomechanics in extinct non-avian species. Cancellous bone is widely known to be highly sensitive to its mechanical environment, and therefore has the potential to provide insight into locomotor biomechanics in extinct tetrapod vertebrates such as dinosaurs. Here in Part II, a new biomechanical modelling approach is outlined, one which mechanistically links cancellous bone architectural patterns with three-dimensional musculoskeletal and finite element modelling of the hindlimb. In particular, the architecture of cancellous bone is used to derive a single ‘characteristic posture’ for a given species—one in which bone continuum-level principal stresses best align with cancellous bone fabric—and thereby clarify hindlimb locomotor biomechanics. The quasi-static approach was validated for an extant theropod, the chicken, and is shown to provide a good estimate of limb posture at around mid-stance. It also provides reasonable predictions of bone loading mechanics, especially for the proximal hindlimb, and also provides a broadly accurate assessment of muscle recruitment insofar as limb stabilization is concerned. In addition to being useful for better understanding locomotor biomechanics in extant species, the approach hence provides a new avenue by which to analyse, test and refine palaeobiomechanical hypotheses, not just for extinct theropods, but potentially many other extinct tetrapod groups as well

Age-related macular degeneration in a randomized controlled trial of low-dose aspirin: Rationale and study design of the ASPREE-AMD study

Purpose: Although aspirin therapy is used widely in older adults for prevention of cardiovascular disease, its impact on the incidence, progression and severity of age-related macular degeneration (AMD) is uncertain. The effect of low-dose aspirin on the course of AMD will be evaluated in this clinical trial. Design: A sub-study of the ‘ASPirin in Reducing Events in the Elderly’ (ASPREE) trial, ASPREE-AMD is a 5-year follow-up double-blind, placebo-controlled, randomized trial of the effect of 100 mg daily aspirin on the course of AMD in 5000 subjects aged 70 years or older, with normal cognitive function and without cardiovascular disease at baseline. Non-mydriatic fundus photography will be performed at baseline, 3-year and 5-year follow-up to determine AMD status. Primary outcome measures: The incidence and progression of AMD. Exploratory analyses will determine whether aspirin affects the risk of retinal hemorrhage in late AMD, and whether other factors, such as genotype, systemic disease, inflammatory biomarkers, influence the effect of aspirin on AMD. Conclusion: The study findings will be of significant clinical and public interest due to a potential to identify a possible low cost therapy for preventing AMD worldwide and to determine risk/benefit balance of the aspirin usage by the AMD-affected elderly. The ASPREE-AMD study provides a unique opportunity to determine the effect of aspirin on AMD incidence and progression, by adding retinal imaging to an ongoing, large-scale primary prevention randomized clinical trial

Genetic and Environmental Drivers of Migratory Behavior in Western Burrowing Owls and Implications for Conservation and Management

Migration is driven by a combination of environmental and genetic factors, but many questions remain about those drivers. Potential interactions between genetic and environmental variants associated with different migratory phenotypes are rarely the focus of study. We pair low coverage whole genome resequencing with a de novo genome assembly to examine population structure, inbreeding, and the environmental factors associated with genetic differentiation between migratory and resident breeding phenotypes in a species of conservation concern, the western burrowing owl (Athene cunicularia hypugaea). Our analyses reveal a dichotomy in gene flow depending on whether the population is resident or migratory, with the former being genetically structured and the latter exhibiting no signs of structure. Among resident populations, we observed significantly higher genetic differentiation, significant isolation-by-distance, and significantly elevated inbreeding. Among migratory breeding groups, on the other hand, we observed lower genetic differentiation, no isolation-by-distance, and substantially lower inbreeding. Using genotype–environment association analysis, we find significant evidence for relationships between migratory phenotypes (i.e., migrant versus resident) and environmental variation associated with cold temperatures during the winter and barren, open habitats. In the regions of the genome most differentiated between migrants and residents, we find significant enrichment for genes associated with the metabolism of fats. This may be linked to the increased pressure on migrants to process and store fats more efficiently in preparation for and during migration. Our results provide a significant contribution toward understanding the evolution of migratory behavior and vital insight into ongoing conservation and management efforts for the western burrowing owl

Micro-CT based finite element models of cancellous bone predict accurately displacement once the boundary condition is well replicated: A validation study

Non-destructive 3D micro-computed tomography (microCT) based finite element (microFE) models are used to estimate bone mechanical properties at tissue level. However, their validation remains challenging. Recent improvements in the quantification of displacements in bone tissue biopsies subjected to staged compression, using refined Digital Volume Correlation (DVC) techniques, now provide a full field displacement information accurate enough to be used for microFE validation. In this study, three specimens (two humans and one bovine) were tested with two different experimental set-ups, and the resulting data processed with the same DVC algorithm. The resulting displacement vector field was compared to that predicted by microFE models solved with three different boundary conditions (BC): nominal force resultant, nominal displacement resultant, distributed displacement. The first two conditions were obtained directly from the measurements provided by the experimental jigs, whereas in the third case the displacement field measured by the DVC in the top and bottom layer of the specimen was applied. Results show excellent relationship between the numerical predictions (x) and the experiments (y) when using BC derived from the DVC measurements (UX: y=1.07x-0.002, RMSE: 0.001 mm; UY: y=1.03x-0.001, RMSE: 0.001 mm; UZ: y=x+0.0002, RMSE: 0.001 mm for bovine specimen), whereas only poor correlation was found using BCs according to experiment setups. In conclusion, microFE models were found to predict accurately the vectorial displacement field using interpolated displacement boundary condition from DVC measurement