Subclinical VZV reactivation in immunocompetent children hospitalized in the ICU associated with prolonged fever duration*

AbstractA prospective observational study was conducted to examine whether asymptomatic VZV reactivation occurs in immunocompetent children hospitalized in an ICU and its impact on clinical outcome. A secondary aim was to test the hypothesis that vaccinated children have a lower risk of reactivation than naturally infected children. Forty immunocompetent paediatric ICU patients and healthy controls were enrolled. Patients were prospectively followed for 28 days. Clinical data were collected and varicella exposure was recorded. Admission serum levels of TNF-a, cortisol and VZV-IgG were measured. Blood and saliva samples were collected for VZV-DNA detection via real-time PCR. As a comparison, the detection of HSV-DNA was also examined. Healthy children matched for age and varicella exposure type (infection or vaccination) were also included. VZV reactivation was observed in 17% (7/39) of children. Children with VZV reactivation had extended duration of fever (OR = 1.17; 95% CI, 1.02–1.34). None of the varicella-vaccinated children or healthy controls had detectable VZV-DNA in any blood or saliva samples examined. HSV-DNA was detected in saliva from 33% of ICU children and 2.6% of healthy controls. Among children with viral reactivation, typing revealed wild-type VZV and HSV-1. In conclusion, VZV reactivation occurs in immunocompetent children under severe stress and is associated with prolonged duration of fever

Intensity of Resistance Exercise Determines Adipokine and Resting Energy Expenditure Responses in Overweight Elderly Individuals

OBJECTIVE - To evaluate the time course of leptin, adiponectin, and testing energy expenditure (REE) responses in overweight elderly mates after acute resistance exercise protocols of various intensity configurations. RESEARCH DESIGN AND METHODS - Forty inactive men (65-82 years) were randomly assigned to one of four groups (n = 10/group): control, low-intensity resistance exercise, moderate-intensity resistance exercise, and high-intensity resistance exercise. Exercise energy cost, REE, leptin, adiponectin, cortisol, insulin, lactate, glucose, nonesterified fatty acids (NEFAs), and glycerol were determined at baseline, immediately after exercise, and during a 72-h recovery period. RESULTS - Exercise energy cost was lower in high-intensity than in low-intensity and moderate-intensity groups (221.6 +/- 8.8 vs. 295.6 +/- 10.7 and 281.6 +/- 9.8 kcal, P < 0.001). Lactate, glucose, NEFAs, and glycerol concentrations increased (P < 0.001) after exercise and returned to baseline thereafter in all groups. REE increased (P < 0.001) in all groups at 12 h in an intensity-dependent manner (P < 0.05). REE reached baseline after 48 h in the low- and mode rate-intensity groups and after 72 h in the high-intensity group. Cortisol peaked in all active groups after exercise (P < 0.001) and remained elevated (P < 0.001) for 12 h. After adjustment for plasma volume shifts, leptin remained unaltered. Adiponectin concentration increased after 12 hand remained elevated for 24 h only in the high-intensity group (P < 0.001). CONCLUSIONS - Resistance exercise does not alter circulating leptin concentration but does increase REE and adiponectin in an intensity-dependent manner for as long as 48 and 24 h, respectively, in overweight elderly individuals. It appears that resistance exercise may represent an effective approach for weight management and metabolic control in overweight elderly individuals

The GPR55 agonist lysophosphatidylinositol acts as an intracellular messenger and bidirectionally modulates Ca2+-activated large-conductance K+ channels in endothelial cells

Lysophospholipids are known to serve as intra- and extracellular messengers affecting many physiological processes. Lysophosphatidylinositol (LPI), which is produced in endothelial cells, acts as an endogenous agonist of the orphan receptor, G protein-coupled receptor 55 (GPR55). Stimulation of GPR55 by LPI evokes an intracellular Ca2+ rise in several cell types including endothelial cells. In this study, we investigated additional direct, receptor-independent effects of LPI on endothelial large-conductance Ca2+ and voltage-gated potassium (BKCa) channels. Electrophysiological experiments in the inside-out configuration revealed that LPI directly affects the BKCa channel gating properties. This effect of LPI strictly depended on the presence of Ca2+ and was concentration-dependent, reversible, and dual in nature. The modulating effects of LPI on endothelial BKCa channels correlated with their initial open probability (Po): stimulation at low Po (<0.3) and inhibition at high Po levels (>0.3). In the whole-cell configuration, LPI in the pipette facilitated membrane hyperpolarization in response to low (0.1–2 μM) histamine concentrations. In contrast, LPI counteracted membrane hyperpolarization in response to supramaximal cell stimulation with histamine. These results highlight a novel receptor-independent and direct bidirectional modulation of BKCa channels by LPI on endothelial cells. We conclude that LPI via this mechanism serves as an important modulator of endothelial electrical responses to cell stimulation

Low total antioxidant status is implicated with high 8-hydroxy-2-deoxyguanosine serum concentrations in phenylketonuria

Background: Phenylketonuria (PKU), an inborn error of metabolism, is treated with a low phenylalanine (Phe) lifelong diet, which can be characterized as vegetarian. 8-Hydroxy-2-deoxyguanosine (8-OHdG) is highly implicated in degenerative diseases. Objective: To evaluate the effect of plasma total antioxidant status (TAS) and Phe on the serum marker of DNA damage, 8-OHdG, in PKU. Methods: Twenty-four PKU patients on a strict diet (group A), 25 PKU patients on a “loose diet’ (group B), and 24 healthy children (controls) participated in this study. Plasma TAS was evaluated spectrophotometrically. 8-OHdG and Phe were measured in blood with immunoassays. Results: TAS levels were significantly higher (P &lt; 0.001) in group A (1458 140 mu mol/L) and controls (1452 +/- 235 mu mol/L) than those in group B (907 150 mu mol/L). In contrast, 8-OHdG serum levels were 2-fold higher in group B (0.22 +/- 0.03 ng/mL) as compared with those in group A (0.11 +/- 0.02 ng/mL) and 3-fold higher than those in controls (0.08 0.02 ng/mL) (P &lt; 0.001). As expected, Phe levels were also significantly higher in group B than those in the other study groups. Positive correlation coefficients were found between Phe and 8-OHdG levels, whereas negative correlations were evaluated between TAS and 8-OHdG in all groups. Conclusions: The high Phe and the low TAS plasma levels in PKU patients on a “loose diet” may induce DNA oxidation, as evidenced by the measured high 8-OHdG level in their sera. 8-OHdG evaluation may be a useful marker of increased risk for a neurodegenerative process. (C) 2004 The Canadian Society of Clinical Chemists. All rights reserved

A rare 33 bp in-frame deletion (alpha 63-74 or alpha 64-74 or alpha 65-75) in the alpha 1-globin gene causing alpha(+)-thalassemia: A second observation

The most frequent defects resulting in alpha-thalassemia (that) include large deletions that remove one or both of the duplicated alpha-globin genes on chromosome 16. Less commonly, alpha-thal Mutations involve single nucleotide substitutions or micro-deletions, leading either directly to decreased alpha-globin chain synthesis by the affected allele, or indirectly through production of hyperunstable variant alpha-globin chains. Here we describe the characterization of a 33 bp in-frame deletion within the alpha1-globin gene, in a woman with hematological findings consistent with an alpha-thal trait. The amino acids predicted to be missing as a result of the 33 bp deletion are at the end of the E helix and the EF corner of the alpha-globin protein chain, and are not normally involved in the heme contact, although it is presumed that alpha-globin chain folding and hemoglobin (Hb) formation will be disrupted. The observation of inclusion and Heinz bodies indicates the synthesis of some abnormal Hb (or globin chains). An identical mutation has been previously observed in a single case, a Canadian individual of Greek descent, indicating that it is a rare mutation, and probably of the same origin. Possible mechanisms underlying the mutation at the DNA level are discussed