Analysis of serum inflammatory mediators identifies unique dynamic networks associated with death and spontaneous survival in pediatric acute liver failure

Background: Tools to predict death or spontaneous survival are necessary to inform liver transplantation (LTx) decisions in pediatric acute liver failure (PALF), but such tools are not available. Recent data suggest that immune/inflammatory dysregulation occurs in the setting of acute liver failure. We hypothesized that specific, dynamic, and measurable patterns of immune/inflammatory dysregulation will correlate with outcomes in PALF. Methods: We assayed 26 inflammatory mediators on stored serum samples obtained from a convenience sample of 49 children in the PALF study group (PALFSG) collected within 7 days after enrollment. Outcomes were assessed within 21 days of enrollment consisting of spontaneous survivors, non-survivors, and LTx recipients. Data were subjected to statistical analysis, patient-specific Principal Component Analysis (PCA), and Dynamic Bayesian Network (DBN) inference. Findings: Raw inflammatory mediator levels assessed over time did not distinguish among PALF outcomes. However, DBN analysis did reveal distinct interferon-gamma-related networks that distinguished spontaneous survivors from those who died. The network identified in LTx patients pre-transplant was more like that seen in spontaneous survivors than in those who died, a finding supported by PCA. Interpretation: The application of DBN analysis of inflammatory mediators in this small patient sample appears to differentiate survivors from non-survivors in PALF. Patterns associated with LTx pre-transplant were more like those seen in spontaneous survivors than in those who died. DBN-based analyses might lead to a better prediction of outcome in PALF, and could also have more general utility in other complex diseases with an inflammatory etiology. Copyright: © 2013 Azhar et al

Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

From farm to fork: lipid oxidation in fish products. A review

Lipid oxidation is a very complex and important event threatening the quality of foods especially of those containing highly unsaturated fats. Fish are the main source of polyunsaturated fatty acids that, unfortunately, are highly susceptible to degradation process, such as oxidation. Fish supply chain generally involves many steps and each of them together with their interaction might play a central role in muscle quality maintenance. From this review emerged that antioxidants supplementation diet can play a central role to limit the detrimental effects of stress (pre-slaughter or at killing) and storage. In this sense, lycopene shows the best antioxidant activity during stressful conditions while α-tocopherol acts preferentially in long-term frozen storage. Stress just before or at slaughter can greatly threaten flesh quality both immediately and after storage by inducing numerous metabolic pathways, that often involve the production of very reactive molecular species, such as hydroperoxides. A common operation such as bleeding can significantly reduce both reactive molecules and haemoglobin (Hb), which is recognised as a great pro-oxidant. Temperature and duration are two critical points of storage phase which has to be considered even by consumers. Frozen storage at very low temperatures (−30 °C, −40 °C) confirms to be the best storage practise. Finally, cooking can compromise aromatic profile of cooking fillets. Thus, feeding antioxidant, reducing stress both during pre-slaughter practise and at killing, good storage practises, if associated with an appropriate cooking method (low temperature, short time) seems to be the clues for preserving the fragile lipid fraction from farm to fork

Tackling dengue fever: Current status and challenges

International audienceAccording to recent statistics, 96 million apparent dengue infections were estimated worldwide in 2010. This figure is by far greater than the WHO prediction which indicates the rapid spread of this disease posing a growing threat to the economy and a major challenge to clinicians and health care services across the globe particularly in the affected areas. This article aims at bringing to light the current epidemiological and clinical status of the dengue fever. The relationship between genetic mutations, single nucleotide polymorphism (SNP) and the pathophysiology of disease progression will be put into perspective. It will also highlight the recent advances in dengue vaccine development. Thus far, a significant progress has been made in unraveling the risk factors and understanding the molecularpathogenesis associated with the disease. However, further insights in molecular features of the disease and the development of animal models will enormously help improving the therapeutic interventions and potentially contribute to finding new preventive measures for population at risk