Effect of hypoxic conditions on skeletal myoblasts

Ischemic injury in skeletal muscle caused by hypoxic (low oxygen) conditions occurs in response to vascular and musculoskeletal traumas, diseases and following reconstructive surgeries. Thus, a thorough understanding of the effect of hypoxia on skeletal myoblasts is warranted to identify potential therapeutic targets. We have determined that treatment with cobalt chloride (to mimic hypoxic conditions) leads to decreased numbers of viable (attached) skeletal myoblast over time and an increase in the percentage of detached myoblasts. To determine the contribution of apoptosis (cell death) to this increase in detached myoblasts, we assessed PARP cleavage, a well- accepted marker for apoptosis. Consistent with cell death via the apoptotic process, PARP cleavage was detected following cobalt chloride treatment. We next assessed the effect of cobalt chloride on the expression of the pro-apoptotic Bcl2 family member PUMA. We determined that after three hours, cobalt chloride treated myoblasts possessed PUMA mRNA levels six times greater than untreated myoblasts. Further, this increase in PUMA mRNA resulted in a three-fold increase in PUMA protein. Future experiments will focus on determining the mechanism whereby cobalt chloride treatment results in increased PUMA levels.https://engagedscholarship.csuohio.edu/u_poster_2016/1013/thumbnail.jp

Effect of hypoxic conditions on skeletal myoblasts

Ischemic injury in skeletal muscle caused by hypoxic (low oxygen) conditions occurs in response to vascular and musculoskeletal traumas, diseases and following reconstructive surgeries. Thus, a thorough understanding of the effect of hypoxia on skeletal myoblasts is warranted to identify potential therapeutic targets. We have determined that treatment with cobalt chloride (to mimic hypoxic conditions) leads to decreased numbers of viable (attached) skeletal myoblast over time and an increase in the percentage of detached myoblasts. To determine the contribution of apoptosis (cell death) to this increase in detached myoblasts, we assessed PARP cleavage, a well- accepted marker for apoptosis. Consistent with cell death via the apoptotic process, PARP cleavage was detected following cobalt chloride treatment. We next assessed the effect of cobalt chloride on the expression of the pro-apoptotic Bcl2 family member PUMA. We determined that after three hours, cobalt chloride treated myoblasts possessed PUMA mRNA levels six times greater than untreated myoblasts. Further, this increase in PUMA mRNA resulted in a three-fold increase in PUMA protein. Future experiments will focus on determining the mechanism whereby cobalt chloride treatment results in increased PUMA levels.https://engagedscholarship.csuohio.edu/u_poster_2016/1013/thumbnail.jp

Necrotizing Pancreatitis: Current Management and Therapies

Acute necrotizing pancreatitis accounts for 10% of acute pancreatitis (AP) cases and is associated with a higher mortality and morbidity. Necrosis within the first 4 weeks of disease onset is defined as an acute necrotic collection (ANC), while walled off pancreatic necrosis (WOPN) develops after 4 weeks of disease onset. An infected or symptomatic WOPN requires drainage. The management of pancreatic necrosis has shifted away from open necrosectomy, as it is associated with a high morbidity, to less invasive techniques. In this review, we summarize the current management and therapies for acute necrotizing pancreatitis

Closing perforations and postperforation management in endoscopy: duodenal, biliary, and colorectal

Early recognition of adverse events arising from endoscopy is essential. In some cases the injury can be viewed clearly during the procedure, and immediate action should be taken to repair the defect endoscopically if feasible. If perforation is unclear, imaging can be used to confirm the diagnosis. Surgical intervention is not always necessary; however, a surgical consultation for backup is essential. Selective cases can be managed conservatively or endoscopically with successful outcomes. Early recognition and intervention, input from specialist colleagues, and communication with the patient and family are keys to successfully managing the event

Predictors of quality of life in patients with end-stage renal disease on hemodialysis

Marc M Saad,1 Youssef El Douaihy,1 Christine Boumitri,1 Chetana Rondla,2 Elias Moussaly,1 Magda Daoud,1 Suzanne E El Sayegh3 1Internal Medicine, Staten Island University Hospital, Staten Island, NY, 2Nephrology, Emory University Hospital, Atlanta, GA, 3Nephrology, Staten Island University Hospital, Staten Island, NY, USA Background: Assessment of quality of life (QOL) of end-stage renal disease (ESRD) patients (physical, mental, and social well-being) has become an essential tool to develop better plans of care. Objective of this study is to determine which demographic and biochemical parameters correlate with the QOL scores in patients with ESRD on hemodialysis (HD) using Kidney Disease QOL-36 surveys (KDQOL). Methods: A retrospective chart review of all ESRD patients who underwent HD at an outpatient center. The five components of the KDQOL were the primary end points of this study (burden of kidney disease, symptoms and problems, effects of kidney disease on daily life, mental component survey, and physical component survey). Scores were grouped into three categories (below average, average, and above average). In addition to demographics (age, sex, and race), the independent variables such as weight gain, number of years on dialysis, urea reduction ratio, calcium, phosphorus, parathyroid hormone, albumin, and hemoglobin in the serum were collected. Chi-square analysis for dependent variables and the nominal independent variables was used, and analysis of variance analysis was used for continuous independent variables. Ordinal regression using PLUM (polytomous universal model) method was used to weigh out possible effects of confounders. Results: The cohort size was 111 patients. Mean age was 61.8 (±15.5) years; there were more males than females (64.9% vs 35.1%), the mean time-on-dialysis at the time of the study was 4.3 (4.8) years. Approximately two-thirds of the responses on all five domains of the questionnaire ranked average when compared to the national numbers. The remainders were split between above average (20.6%) and below average (13.4%). In our cohort, no relationships were statistically significant between the five dependent variables of interest and the independent variables by chi-square- and t-test analyses. This was further confirmed by regression analysis. Of note, sex carried the strongest statistical significance (with a P-value of 0.16) as a predictor of “the burden of kidney disease on daily life” in ordinal regression. Conclusion: Prior studies have shown variables such as serum phosphate level, intradialytic weight gain, and dialysis adequacy are associated with lower KDQOL scores; however, this was not evident in our analysis likely due to smaller sample size. Larger size studies are required to better understand the predictors of QOL in ESRD patients on HD. Keywords: quality of life, end-stage renal disease, hemodialysis, metabolic profil