Acute myocarditis in dengue hemorrhagic fever: a case report and review of cardiac complications in dengue-affected patients

SummaryWe report a case of dengue hemorrhagic fever (DHF) complicated by acute myocarditis and review the literature. A 65-year-old woman experienced DHF due to dengue virus serotype 3, complicated with acute myocarditis and acute pulmonary edema. Clinically this masqueraded as acute myocardial infarction, with an electrocardiographically depressed ST segment in precordial leads and elevated serum cardiac-specific troponin I level. Under supportive management, the patient recovered 3 days later. A total of 18 pertinent articles involving 339 dengue-affected patients with cardiac complications were found by PubMed search. Clinical manifestations of cardiac complications varied considerably, from self-limiting tachy–brady arrhythmia to severe myocardial damage, leading to hypotension and pulmonary edema. Although rare, a fatal outcome was reported in some cases of dengue with cardiac complications. To avoid otherwise preventable morbidity and mortality, physicians should have a high index of suspicion for cardiac complications in patients with dengue illness and should manage this accordingly

XRCC1, but not APE1 and hOGG1 gene polymorphisms is a risk factor for pterygium.

PurposeEpidemiological evidence suggests that UV irradiation plays an important role in pterygium pathogenesis. UV irradiation can produce a wide range of DNA damage. The base excision repair (BER) pathway is considered the most important pathway involved in the repair of radiation-induced DNA damage. Based on previous studies, single-nucleotide polymorphisms (SNPs) in 8-oxoguanine glycosylase-1 (OGG1), X-ray repair cross-complementing-1 (XRCC1), and AP-endonuclease-1 (APE1) genes in the BER pathway have been found to affect the individual sensitivity to radiation exposure and induction of DNA damage. Therefore, we hypothesize that the genetic polymorphisms of these repair genes increase the risk of pterygium.MethodsXRCC1, APE1, and hOGG1 polymorphisms were studied using fluorescence-labeled Taq Man probes on 83 pterygial specimens and 206 normal controls.ResultsThere was a significant difference between the case and control groups in the XRCC1 genotype (p=0.038) but not in hOGG1 (p=0.383) and APE1 (p=0.898). The odds ratio of the XRCC1 A/G polymorphism was 2.592 (95% CI=1.225-5.484, p=0.013) and the G/G polymorphism was 1.212 (95% CI=0.914-1.607), compared to the A/A wild-type genotype. Moreover, individuals who carried at least one C-allele (A/G and G/G) had a 1.710 fold increased risk of developing pterygium compared to those who carried the A/A wild type genotype (OR=1.710; 95% CI: 1.015-2.882, p=0.044). The hOGG1 and APE1 polymorphisms did not have an increased odds ratio compared with the wild type.ConclusionsXRCC1 (Arg399 Glu) is correlated with pterygium and might become a potential marker for the prediction of pterygium susceptibility

Aqueous Extract from Hibiscus sabdariffa Linnaeus Ameliorate Diabetic Nephropathy via Regulating Oxidative Status and Akt/Bad/14-3-3γ in an Experimental Animal Model

Several studies point out that oxidative stress maybe a major culprit in diabetic nephropathy. Aqueous extract of Hibiscus sabdariffa L. (HSE) has been demonstrated as having beneficial effects on anti-oxidation and lipid-lowering in experimental studies. This study aimed at investigating the effects of Hibiscus sabdariffa L. on diabetic nephropathy in streptozotocin induced type 1 diabetic rats. Our results show that HSE is capable of reducing lipid peroxidation, increasing catalase and glutathione activities significantly in diabetic kidney, and decreasing the plasma levels of triglyceride, low-density lipoprotein (LDL) and increasing high-density lipoprotein (HDL) value. In histological examination, HSE improves hyperglycemia-caused osmotic diuresis in renal proximal convoluted tubules (defined as hydropic change) in diabetic rats. The study also reveals that up-regulation of Akt/Bad/14-3-3γ and NF-κB-mediated transcription might be involved. In conclusion, our results show that HSE possesses the potential effects to ameliorate diabetic nephropathy via improving oxidative status and regulating Akt/Bad/14-3-3γ signaling

Nonsteroidal Anti-Inflammatory Drugs for Wounds: Pain Relief or Excessive Scar Formation?

The inflammatory process has direct effects on normal and abnormal wound healing. Hypertrophic scar formation is an aberrant form of wound healing and is an indication of an exaggerated function of fibroblasts and excess accumulation of extracellular matrix during wound healing. Two cytokines—transforming growth factor-β (TGF-β) and prostaglandin E2 (PGE2)—are lipid mediators of inflammation involving wound healing. Overproduction of TGF-β and suppression of PGE2 are found in excessive wound scarring compared with normal wound healing. Nonsteroidal anti-inflammatory drugs (NSAIDs) or their selective cyclooxygenase-2 (COX-2) inhibitors are frequently used as a pain-killer. However, both NSAIDs and COX-2 inhibitors inhibit PGE2 production, which might exacerbate excessive scar formation, especially when used during the later proliferative phase. Therefore, a balance between cytokines and medication in the pathogenesis of wound healing is needed. This report is a literature review pertaining to wound healing and is focused on TGF-β and PGE2

Genetic copy number variants in sib pairs both affected with schizophrenia

<p>Abstract</p> <p>Background</p> <p>Schizophrenia is a complex disorder with involvement of multiple genes.</p> <p>Methods</p> <p>In this study, genome-wide screening for DNA copy-number variations (CNVs) was conducted for ten pairs, a total of 20 cases, of affected siblings using oligonucleotide array-based CGH.</p> <p>Results</p> <p>We found negative symptoms were significantly more severe (p < 0.05) in the subgroup that harbored more genetic imbalance (n ≧ 13, n = number of CNV-disrupted genes) as compared with the subgroup with fewer CNVs (n ≦ 6), indicating that the degree of genetic imbalance may influence the severity of the negative symptoms of schizophrenia. Four central nervous system (CNS) related genes including CCAAT/enhancer binding protein, delta (<it>CEBPD</it>, 8q11.21), retinoid × receptor, alpha (<it>RXRA</it>, 9q34.2), LIM homeobox protein 5 (<it>LHX5</it>, 12q24.13) and serine/threonine kinase 11 (<it>STK11</it>, 19p13.3) are recurrently (incidence ≧ 16.7%) disrupted by CNVs. Two genes, <it>PVR </it>(poliovirus receptor) and <it>BU678720</it>, are concordantly deleted in one and two, respectively, pairs of co-affected siblings. However, we did not find a significant association of this <it>BU678720 </it>deletion and schizophrenia in a large case-control sample.</p> <p>Conclusions</p> <p>We conclude that the high genetic loading of CNVs may be the underlying cause of negative symptoms of schizophrenia, and the CNS-related genes revealed by this study warrant further investigation.</p

Effects of detraining on functional fitness and lymphocyte subsets in postmenopausal females

Introduction: Aging leads to declines of functional fitness and regular exercise has been recognized to be beneficial for keeping health and preventing degenerative diseases in older adults. Limited evidences connect the relationships among detraining, functional fitness, immunosenescence, and vascular integrity in aged individuals. Thus, the aims of this study was to inspect: How training and detraining influence functional fitness, mobilization of circulating leukocytes and lymphocyte subsets? Method: Twenty-two female volunteers aged 50 to 65 years were recruited as participants in this study. Participants were assigned into training group (TG, n=13) and control group (CG, n=9). The participants in TG were asked to attend exercise program, including aerobic exercise at 70% HRR for 60 min twice per week and resistance training at 60-70% 1RM, 3 sets and 9 exercises for 60 min per week for 16 weeks and subsequently avoid exercise for 6 weeks to investigate detraining effects. CG were asked to stay in their regular lifestyles. A six-items measurement of functional fitness and resting (at fasting status) venous blood samples were collected at before training program (Pre-training), 8th week of training (Mid-training), after training program (Post-training), and 6th week of detraining 6 weeks (Detraining). Blood cell counts (WBC, RBC, HCT, LYM) were measured using an automated cell counter and lymphocyte subsets (CD4, CD8, CD19, CD56) were analyzed by flow cytometry. Data were analyzed by descriptive statistic, mixed two-factors (time × group) measures ANOVA or ACOVA and the significance was set at pResult: Functional fitness of TG was not significantly improved following the training program although it was significantly better than CG in Pre-training. Blood cell counts were not changed and all in normal range. A significant difference in CD19 counts were observed between TG and CG (71.23±32.05 vs. 116.45±67.95 103/mL) in Post-training. CD19 counts in TG were increased at Detraining compared with Mid-training and Post-training (138.08±50.22 vs. 74.92±31.20, 71.23±32.05 103/mL). No alterations in quantity and percentage of CD4, CD8, and CD56 were observed in this study. Conclusion: Findings of this study suggest that both a 16-week moderate exercise program and a 6-week detraining did not significantly change the functional fitness and lymphocyte subsets in postmenopausal females

Pullout strength of pedicle screws with cement augmentation in severe osteoporosis: A comparative study between cannulated screws with cement injection and solid screws with cement pre-filling

<p>Abstract</p> <p>Background</p> <p>Pedicle screws with PMMA cement augmentation have been shown to significantly improve the fixation strength in a severely osteoporotic spine. However, the efficacy of screw fixation for different cement augmentation techniques, namely solid screws with retrograde cement pre-filling versus cannulated screws with cement injection through perforation, remains unknown. This study aimed to determine the difference in pullout strength between conical and cylindrical screws based on the aforementioned cement augmentation techniques. The potential loss of fixation upon partial screw removal after screw insertion was also examined.</p> <p>Method</p> <p>The Taguchi method with an L₈array was employed to determine the significance of design factors. Conical and cylindrical pedicle screws with solid or cannulated designs were installed using two different screw augmentation techniques: solid screws with retrograde cement pre-filling and cannulated screws with cement injection through perforation. Uniform synthetic bones (test block) simulating severe osteoporosis were used to provide a platform for each screw design and cement augmentation technique. Pedicle screws at full insertion and after a 360-degree back-out from full insertion were then tested for axial pullout failure using a mechanical testing machine.</p> <p>Results</p> <p>The results revealed the following 1) Regardless of the screw outer geometry (conical or cylindrical), solid screws with retrograde cement pre-filling exhibited significantly higher pullout strength than did cannulated screws with cement injection through perforation (<it>p </it>= 0.0129 for conical screws; <it>p </it>= 0.005 for cylindrical screws). 2) For a given cement augmentation technique (screws without cement augmentation, cannulated screws with cement injection or solid screws with cement pre-filling), no significant difference in pullout strength was found between conical and cylindrical screws (<it>p ></it>0.05). 3) Cement infiltration into the open cell of the test block led to the formation of a cement/bone composite structure. Observations of the failed specimens indicated that failure occurred at the composite/bone interface, whereas the composite remained well bonded to the screws. This result implies that the screw/composite interfacial strength was much higher than the composite/bone interfacial strength. 4) The back-out of the screw by 360 degrees from full insertion did not decrease the pullout strength in any of the studied cases. 5) Generally, larger standard deviations were found for the screw back-out cases, implying that the results of full insertion cases are more repeatable than those of the back-out cases.</p> <p>Conclusions</p> <p>Solid screws with retrograde cement pre-filling offer improved initial fixation strength when compared to that of cannulated screws with cement injection through perforation for both the conically and cylindrically shaped screw. Our results also suggest that the fixation screws can be backed out by 360 degrees for intra-operative adjustment without the loss of fixation strength.</p