Red Blood Cell Fatty Acid Patterns and Acute Coronary Syndrome

BACKGROUND:Assessment of coronary heart disease (CHD) risk is typically based on a weighted combination of standard risk factors. We sought to determine the extent to which a lipidomic approach based on red blood cell fatty acid (RBC-FA) profiles could discriminate acute coronary syndrome (ACS) cases from controls, and to compare RBC-FA discrimination with that based on standard risk factors. METHODOLOGY/PRINCIPAL FINDINGS:RBC-FA profiles were measured in 668 ACS cases and 680 age-, race- and gender-matched controls. Multivariable logistic regression models based on FA profiles (FA) and standard risk factors (SRF) were developed on a random 2/3(rds) derivation set and validated on the remaining 1/3(rd). The area under receiver operating characteristic (ROC) curves (c-statistics), misclassification rates, and model calibrations were used to evaluate the individual and combined models. The FA discriminated cases from controls better than the SRF (c = 0.85 vs. 0.77, p = 0.003) and the FA profile added significantly to the standard model (c = 0.88 vs. 0.77, p<0.0001). Hosmer-Lemeshow calibration was poor for the FA model alone (p = 0.01), but acceptable for both the SRF (p = 0.30) and combined models (p = 0.22). Misclassification rates were 23%, 29% and 20% for FA, the SRF, and the combined models, respectively. CONCLUSIONS/SIGNIFICANCE:RBC-FA profiles contribute significantly to the discrimination of ACS cases, especially when combined with standard risk factors. The utility of FA patterns in risk prediction warrants further investigation

Multi-minicore Disease

Multi-minicore Disease (MmD) is a recessively inherited neuromuscular disorder characterized by multiple cores on muscle biopsy and clinical features of a congenital myopathy. Prevalence is unknown. Marked clinical variability corresponds to genetic heterogeneity: the most instantly recognizable classic phenotype characterized by spinal rigidity, early scoliosis and respiratory impairment is due to recessive mutations in the selenoprotein N (SEPN1) gene, whereas recessive mutations in the skeletal muscle ryanodine receptor (RYR1) gene have been associated with a wider range of clinical features comprising external ophthalmoplegia, distal weakness and wasting or predominant hip girdle involvement resembling central core disease (CCD). In the latter forms, there may also be a histopathologic continuum with CCD due to dominant RYR1 mutations, reflecting the common genetic background. Pathogenetic mechanisms of RYR1-related MmD are currently not well understood, but likely to involve altered excitability and/or changes in calcium homeoestasis; calcium-binding motifs within the selenoprotein N protein also suggest a possible role in calcium handling. The diagnosis of MmD is based on the presence of suggestive clinical features and multiple cores on muscle biopsy; muscle MRI may aid genetic testing as patterns of selective muscle involvement are distinct depending on the genetic background. Mutational analysis of the RYR1 or the SEPN1 gene may provide genetic confirmation of the diagnosis. Management is mainly supportive and has to address the risk of marked respiratory impairment in SEPN1-related MmD and the possibility of malignant hyperthermia susceptibility in RYR1-related forms. In the majority of patients, weakness is static or only slowly progressive, with the degree of respiratory impairment being the most important prognostic factor

Membranous Nephropathy and Kimura\u27s Disease Manifesting a Hip Mass. A Case Report with Literature Review

We report a case of Kimura\u27s disease with membranous nephropathy. A 15-year-old Japanese boy was referred to our hospital with proteinuria and a subcutaneous mass in the hip. Renal biopsy demonstrated secondary membranous nephropathy (MN) with mild mesangial proliferation and some electron-dense deposits in the mesangium. Laboratory tests revealed eosinophilia and a high level of serum IgE, which are common findings in Kimura\u27s disease. A biopsy of the mass in the hip was performed and Kimura\u27s disease was diagnosed. Treatment with oral prednisolone resulted in a decrease of proteinuria and regression of the subcutaneous mass. Kimura\u27s disease should be included in the differential diagnosis of secondary MN

Anticipatory Cues Differentially Provoke In Vivo Peptidergic and Monoaminergic Release at the Medial Prefrontal Cortex

Like primary reinforcers, the anticipation of reward ought to affect neurochemical release in brain regions, such as the medial prefrontal cortex (mPFC), which are associated with appraisal processes. To assess the neurochemical changes associated with anticipation, rats were exposed to the pairing of auditory (60-dB white noise), visual, and olfactory cues with the daily presentation of a palatable snack (Cue Relevant group). Rats of a second group were similarly trained, but for a 2-week period, the snack was no longer provided following cue presentation (Extinction group). In the third condition, the presentation of the snack and cues was uncorrelated (Cue Irrelevant group). Analyses of dialysates collected in vivo from the mPFC revealed that release of corticotropin-releasing hormone (CRH), gastrin-releasing peptide (GRP), and the 5-HT catabolite, 5-hydroxyindole acetic acid (5-HIAA), had increased bilaterally in response to the anticipatory cues, whereas DA release increased only within the right mPFC. In the case of CRH and GRP, these increases were also apparent in the extinction condition, despite the fact that behavioral arousal to the anticipatory cues (increased exploration, rearing, grooming, and vigilance) was only evident in the Cue Relevant condition. In contrast, the elevated DA and 5-HIAA were apparent exclusively in the Cue Relevant condition. Thus, CRH and GRP systems may serve to allocate salience and/or incentive reward value to biologically significant stimuli or reflect the emotional response to the anticipatory stimulus. The activity of DA and 5-HT neurons, in contrast, is more closely aligned with the cognitive appraisal of predictor stimuli

A comparative study of the water budgets of lawns under three management scenarios

The fate of irrigation in urban ecosystems is highly uncertain, due to uncertainties in urban ecohydrology. We compared irrigation rates, soil moisture, evapotranspiration (ET), stomatal conductance, and water budgets of landscape ecosystems managed with different turfgrass species and irrigation technologies. The “Typical” landscape had a cool-season fescue and was irrigated by an automatic timer. The “Alternative1” landscape had a warm-season paspalum and a “smart” soil moisture sensor-based irrigation system. The “Alternative2” landscape had a cool-season native sedge and a “smart” weather station-based drip irrigation system. ET was measured with a portable closed chamber and modeled using a Penman-Monteith approach, and the two methods agreed well. The water applied to the Alternative1 was 54 % less than the water applied to the Typical landscape, and the water applied to the Alternative2 was 24 % less. Soil moisture was similar in the Typical and Alternative2, while Alternative1 was drier in spring. The stomatal conductance of sedge was lower than the other two species, but its ET was not lower due to higher leaf area. Irrigation efficiencies (ET/applied irrigation) were 57 - 58&nbsp;%, 86 – 97&nbsp;%, and 78 - 80&nbsp;% for the Typical, Alternative1, and Alternative2 landscapes, respectively. Runoff was less than 2&nbsp;% in each landscape, and excess irrigation primarily drained below the root zone. Differences in irrigation efficiency between landscapes were due mainly to irrigation application, which varied more than species water use. Smart irrigation systems provided substantial water savings relative to a timer-based system, and prevented significant drainage losses. The utilization of smart sensors was more important than the choice of turfgrass species for irrigation efficiency