Relationship of serum bilirubin concentration to kidney function and 24-hour urine protein in Korean adults

<p>Abstract</p> <p>Background</p> <p>The relationships among serum bilirubin concentration, kidney function and proteinuria have yet to be fully elucidated, nor have these relationships been investigated in Korean adults.</p> <p>Method</p> <p>We retrospectively reviewed the medical records of Korean adults who were evaluated at Kosin University Gospel Hospital (Busan, Republic of Korea) during a five-year period from January 2005 to December 2009. We evaluated the relationships among serum bilirubin concentration, estimated glomerular filtration rate (eGFR) and 24-hour urinary protein excretion in a sample of 1363 Korean adults aged 18 years or older.</p> <p>Results</p> <p>The values of eGFR <60 mL/min/1.73 m²and 24-hour urine albumin ≥150 mg/day were observed in 26.1% (n = 356) and 40.5% (n = 553) of subjects, respectively. Fasting glucose levels ≥126 mg/dL were observed in 44.9% (n = 612) of the total sample. After adjustment for potential confounding factors including demographic characteristics, comorbidities and other laboratory measures, total serum bilirubin was positively associated with eGFR and negatively associated with proteinuria both in the whole cohort and in a subgroup of diabetic individuals.</p> <p>Conclusions</p> <p>To our knowledge, this is the first hospital-based study specifically aimed at examining the relationships among serum total bilirubin concentration, 24-hour urine protein and kidney function in Korean adults. We demonstrated that serum total bilirubin concentration was negatively correlated with 24-hour urine protein and positively correlated with eGFR in Korean non-diabetic and diabetic adults.</p

Promoter Nucleosome Organization Shapes the Evolution of Gene Expression

Understanding why genes evolve at different rates is fundamental to evolutionary thinking. In species of the budding yeast, the rate at which genes diverge in expression correlates with the organization of their promoter nucleosomes: genes lacking a nucleosome-free region (denoted OPN for “Occupied Proximal Nucleosomes”) vary widely between the species, while the expression of those containing NFR (denoted DPN for “Depleted Proximal Nucleosomes”) remains largely conserved. To examine if early evolutionary dynamics contributes to this difference in divergence, we artificially selected for high expression of GFP–fused proteins. Surprisingly, selection was equally successful for OPN and DPN genes, with ∼80% of genes in each group stably increasing in expression by a similar amount. Notably, the two groups adapted by distinct mechanisms: DPN–selected strains duplicated large genomic regions, while OPN–selected strains favored trans mutations not involving duplications. When selection was removed, DPN (but not OPN) genes reverted rapidly to wild-type expression levels, consistent with their lower diversity between species. Our results suggest that promoter organization constrains the early evolutionary dynamics and in this way biases the path of long-term evolution

Addressing vulnerability, building resilience:community-based adaptation to vector-borne diseases in the context of global change

Abstract Background The threat of a rapidly changing planet – of coupled social, environmental and climatic change – pose new conceptual and practical challenges in responding to vector-borne diseases. These include non-linear and uncertain spatial-temporal change dynamics associated with climate, animals, land, water, food, settlement, conflict, ecology and human socio-cultural, economic and political-institutional systems. To date, research efforts have been dominated by disease modeling, which has provided limited practical advice to policymakers and practitioners in developing policies and programmes on the ground. Main body In this paper, we provide an alternative biosocial perspective grounded in social science insights, drawing upon concepts of vulnerability, resilience, participation and community-based adaptation. Our analysis was informed by a realist review (provided in the Additional file 2) focused on seven major climate-sensitive vector-borne diseases: malaria, schistosomiasis, dengue, leishmaniasis, sleeping sickness, chagas disease, and rift valley fever. Here, we situate our analysis of existing community-based interventions within the context of global change processes and the wider social science literature. We identify and discuss best practices and conceptual principles that should guide future community-based efforts to mitigate human vulnerability to vector-borne diseases. We argue that more focused attention and investments are needed in meaningful public participation, appropriate technologies, the strengthening of health systems, sustainable development, wider institutional changes and attention to the social determinants of health, including the drivers of co-infection. Conclusion In order to respond effectively to uncertain future scenarios for vector-borne disease in a changing world, more attention needs to be given to building resilient and equitable systems in the present

Pseudoneoplastic lesions of the testis and paratesticular structures

Pseudotumors or tumor-like proliferations (non-neoplastic masses) and benign mimickers (non-neoplastic cellular proliferations) are rare in the testis and paratesticular structures. Clinically, these lesions (cysts, ectopic tissues, and vascular, inflammatory, or hyperplastic lesions) are of great interest for the reason that, because of the topography, they may be relevant as differential diagnoses. The purpose of this paper is to present an overview of the pseudoneoplasic entities arising in the testis and paratesticular structures; emphasis is placed on how the practicing pathologist may distinguish benign mimickers and pseudotumors from true neoplasia. These lesions can be classified as macroscopic or microscopic mimickers of neoplasia

Role of host genetics in fibrosis

Fibrosis can occur in tissues in response to a variety of stimuli. Following tissue injury, cells undergo transformation or activation from a quiescent to an activated state resulting in tissue remodelling. The fibrogenic process creates a tissue environment that allows inflammatory and matrix-producing cells to invade and proliferate. While this process is important for normal wound healing, chronicity can lead to impaired tissue structure and function

Cardiotoxicity of anthracycline agents for the treatment of cancer: systematic review and meta-analysis of randomised controlled trials

Background: We conducted a systematic review and meta-analysis to clarify the risk of early and late cardiotoxicity of anthracycline agents in patients treated for breast or ovarian cancer, lymphoma, myeloma or sarcoma.Methods: Randomized controlled trials were sought using comprehensive searches of electronic databases in June 2008. Reference lists of retrieved articles were also scanned for additional articles. Outcomes investigated were early or late clinical and sub-clinical cardiotoxicity. Trial quality was assessed, and data were pooled through meta-analysis where appropriate.Results: Fifty-five published RCTs were included; the majority were on women with advanced breast cancer. A significantly greater risk of clinical cardiotoxicity was found with anthracycline compared with non-anthracycline regimens (OR 5.43 95% confidence interval: 2.34, 12.62), anthracycline versus mitoxantrone (OR 2.88 95% confidence interval: 1.29, 6.44), and bolus versus continuous anthracycline infusions (OR 4.13 95% confidence interval: 1.75, 9.72). Risk of clinical cardiotoxicity was significantly lower with epirubicin versus doxorubicin (OR 0.39 95% confidence interval: 0.20, 0.78), liposomal versus non-liposomal doxorubicin (OR 0.18 95% confidence interval: 0.08, 0.38) and with a concomitant cardioprotective agent (OR 0.21 95% confidence interval: 0.13, 0.33). No statistical heterogeneity was found for these pooled analyses. A similar pattern of results were found for subclinical cardiotoxicity; with risk significantly greater with anthracycline containing regimens and bolus administration; and significantly lower risk with epirubicin, liposomal doxorubicin versus doxorubicin but not epirubicin, and with concomitant use of a cardioprotective agent. Low to moderate statistical heterogeneity was found for two of the five pooled analyses, perhaps due to the different criteria used for reduction in Left Ventricular Ejection Fraction. Meta-analyses of any cardiotoxicity (clinical and subclinical) showed moderate to high statistical heterogeneity for four of five pooled analyses; criteria for any cardiotoxic event differed between studies. Nonetheless the pattern of results was similar to those for clinical or subclinical cardiotoxicity described above.Conclusions: Evidence is not sufficiently robust to support clear evidence-based recommendations on different anthracycline treatment regimens, or for routine use of cardiac protective agents or liposomal formulations. There is a need to improve cardiac monitoring in oncology trials.<br/

Visioneering: an essential framework in sustainability science

The science of sustainability has inevitably emerged as a vibrant field of research and education that transcends disciplinary boundaries and focuses increasingly on understanding the dynamics of social-ecological systems (SES). Yet, sustainability remains an elusive concept, and its nature seems unclear for the most part. In order to truly mobilize people and nations towards sustainability, we place emphasis on the necessity of understanding the nature, cost and principles of `visioneering`aEuro"the engineering of a clear vision. In SES, purpose is the most important pillar, which gives birth to vision-the key to fulfilling the systems` mission. Such a systems perspective leads us to redefine resilience as jumping back to the original purpose, for which SES do not necessarily retain the same structures and functioning after disturbances. A sustainable future will require purpose-driven transformation of society at all scales, guided by the best foresight, with insight based on hindsight that science can provide. Visioneering with resilience-based systems thinking will provide communities with a logical framework for understanding their interconnections and purposes, envisioning a sustainable web of life, and eventually dancing with the systems.Wagener T, 2010, WATER RESOUR RES, V46, DOI 10.1029/2009WR008906LEVIN SA, 2010, 196 HARV U CTR INT DCHAPIN F, 2009, PRINCIPLES ECOSYSTEMMITCHELL M, 2009, COMPLEXITY GUIDED TORIFKIN J, 2009, EMPATHIC CIVILIZATIORockstrom J, 2009, ECOL SOC, V14Kajikawa Y, 2008, SUSTAIN SCI, V3, P215, DOI 10.1007/s11625-008-0053-1EHRENFELD J, 2008, SUSTAINABILITY DESIGHAHN T, 2008, COMPLEXITY THEORY SU, P119MASER C, 2008, UNDERSTANDING SUSTAIMEADOWS DH, 2008, THINKING SYSTEMS PRINORBERG J, 2008, COMPLEXITY THEORY SUKEMP R, 2007, SUSTAINABILITY SCI P, V3, P5LOORBACH D, 2007, SUSTAIN SCI PRACT PO, V3*RES ALL, 2007, ASS RES SOC EC SYSTSTANLEY A, 2007, MAKING VISION STICKMEADOWS DH, 2004, LIMITS GROWTH 30 YEACostanza R, 2003, FUTURES, V35, P651, DOI 10.1016/S0016-3287(02)00105-2BERKES F, 2003, NAVIGATING SOCIAL ECMUNROE M, 2003, PRINCIPLES POWER VISBARABASI A, 2002, LINKED NEW SCI NETWOCAPRA F, 2002, HIDDEN CONNECTIONS SGALLOPIN GC, 2002, PANARCHY UNDERSTANDI, P63GUNDERSON LH, 2002, PANARCHY UNDERSTANDIHOLLING CS, 2002, PANARCHY UNDERSTANDI, P25NOWOTNY H, 2001, RETHINKING SCI KNOWLMASER C, 1999, VISION LEADERSHIP SUSTANLEY A, 1999, VISIONEERING GODS BLMEADOWS D, 1996, INT S ECOL ECON SER, P117ANTHES RA, 1993, B AM METEOROL SOC, V74, P1121DALY HE, 1993, VALUING EARTH EC ECO, P267SENGE PM, 1990, 5 DISCIPLINE ART PRA*WCED, 1987, OUR COMM FUTHARDIN G, 1968, SCIENCE, V162, P1243KUHN TS, 1962, STRUCTURE SCI REVOLU