Abdominal obesity exhibits distinct effect on inflammatory and anti-inflammatory proteins in apparently healthy Japanese men

<p>Abstract</p> <p>Background</p> <p>Since visceral fat tissue is known to release various inflammatory and anti-inflammatory cytokines, abdominal obesity may play a key role in the inflammation associated with metabolic syndrome (MetS). However, few studies have determined precise relationships of abdominal obesity with inflammatory markers in MetS. To clarify the importance of abdominal obesity in sub-clinical inflammation, we examined the changes of inflammatory markers in clustering of MetS components with or without abdominal obesity.</p> <p>Methods</p> <p>Subjects consisted of 326 apparently healthy Japanese men (age: 30 to 59 years) who underwent health examination in the Osaka University Health Care Center. MetS components were assessed and serum levels of high sensitive C-reactive protein (hs-CRP), interleukin (IL)-6 and adiponectin were examined in all subjects.</p> <p>Results</p> <p>Subjects with abdominal obesity (waist circumference ≥ 85 cm) showed higher serum hs-CRP and IL-6 levels and a lower adiponectin level than those without abdominal obesity. Serum levels of hs-CRP and IL-6 significantly increased in association with clustering of MetS components in the subjects with abdominal obesity, but not in those without abdominal obesity. On the other hand, serum adiponectin level exhibited a little change with clustering of MetS components in the subjects with abdominal obesity. Significant negative correlation between adiponectin and hs-CRP was observed in the subjects with abdominal obesity, however this correlation was not detected in obese subjects defined by body mass index ≥ 25.</p> <p>Conclusion</p> <p>Inflammatory status is not exaggerated by clustering of MetS components in the subjects without abdominal obesity. Abdominal obesity may exhibit distinct effect on inflammatory and anti-inflammatory proteins and modulate inflammatory network in MetS.</p

Effect of vasodilators in patient with pulmonary hypertension associated with hemolytic anemia

AbstractPulmonary arterial hypertension (PAH) has been described to associate with hemolytic anemia in updated clinical classification of pulmonary hypertension. A 56-year-old woman, diagnosed with warm antibody autoimmune hemolytic anemia (AIHA), was treated with oral corticosteroids at the Department of Hematology, Osaka University Hospital for 30 years. Her AIHA worsened 3 months before the admission, and she was treated with rituximab and cyclosporine in combination with prednisolone. Soon after she left the hospital, she developed dyspnea on effort and leg edema, therefore she was re-admitted to the Department of Cardiovascular Medicine. Echocardiogram and cardiac catheterization demonstrated PAH associated with AIHA. She was treated with three types of vasodilatory agents, resulting in an improvement in pulmonary arterial pressure and pulmonary vascular resistance after 6 weeks. A few weeks after she left the hospital, her hemolytic anemia became in remission without intensifying AIHA therapy, and did not worsen for a year of follow-up. Although corticosteroids are the first-line treatment for AIHA, medications for PAH should be considered when the first-line therapy for AIHA failed to improve PAH

Retrospective survey for clinical course and aggravating factors of adolescent atopic dermatitis in two years' cohort study on first‐year university students

Abstract Background Recent epidemiological studies have revealed increased numbers of adolescent subjects with atopic dermatitis, most of who experienced chronic symptoms since childhood. However, the complete clinical nature of atopic dermatitis in Japanese adolescents is poorly understood. We conducted this study to accumulate knowledge of factors contributing to protracted atopic dermatitis symptoms in adolescent subjects to avoid an unfavorable clinical outcome in these patients. Methods On 2013 and 2014, first‐year students at our university answered a retrospective self‐questionnaire about their demographic characteristics and past history of allergies. Answers from 6105 respondents were analyzed. Subjects with atopic dermatitis were divided into four groups according to their clinical courses, and factors potentially influencing their clinical courses were identified. Results Nearly 16% of the students had a history of diagnosed atopic dermatitis, many of who had experienced symptoms since childhood (protracted course). Other respondents had experienced remission (32%), adolescent onset (14%), or recurrence (6%). Logistic regression analysis found that psychological stress and air dryness were apparent exacerbating factors that increased the risk of the protracted, recurrent, and adolescence courses. Furthermore, sleep loss, house dust, pollen, high temperature, and sweat were the aggravating factors associated with the protracted course alone. Conclusions We found that a high proportion of Japanese adolescent subjects with atopic dermatitis had experienced protracted symptoms and further identified factors that may have led to this unfavorable course. We expect that limiting these factors in this population might alleviate the subjects' chronic symptoms