VEGF is indirectly associated with NO production

Background? Increased levels of vascular endothelial growth factor (VEGF) have been observed in patients with metabolic syndrome (MetS). Nitric oxide (NO) formation is reduced in MetS, but its relationship to VEGF production remains poorly defined. We evaluated the association between VEGF/NO synthesis and insulin sensitivity in obese subjects and investigated the secretory response of VEGF to an acute elevation of glucose.Materials and methods? Seven healthy normal-weight subjects, seven obese subjects without MetS and seven obese subjects with MetS were recruited. Anthropometry, body composition and cardiometabolic functions (blood pressure, glucose, insulin, triglycerides, total cholesterol, HDL-C and VEGF) were measured, and a novel stable isotope method was used to assess in vivo rates of NO production. A frequent sampling intravenous glucose tolerance test was performed to study the dynamics of VEGF release.Results? Fasting VEGF levels were significantly higher in the two obese groups compared to the control group (P for trend = 0·02), but the difference was not significant after adjustment for age. Vascular endothelial growth factor levels were associated with systolic blood pressure (? = 0·54; P = 0·01) and NO production (? = ?0·44; P = 0·04). Vascular endothelial growth factor levels increased in response to acute hyperglycaemia in normal-weight and obese subjects (P < 0·001).Conclusions? Vascular endothelial growth factor levels rapidly increase during hyperglycaemia and are inversely related to NO production at steady state. The potential link between the acute secretion of VEGF and atherosclerotic risk in subjects with poorly controlled glycaemia as well as the potential of lowering elevated VEGF levels by increasing NO production and/or availability warrants further investigation

Sinking of Crude Oil Amended-Model Oil Mixtures Due to Evaporative or Dissolution Weathering on the Surface and Submerged in Water

Despite the popular belief that crude oil is a mixture of hydrocarbons that floats on the surface of water, tar balls continue to wash up on beaches from the sea floor years after the Deep Water Horizon oil spill. This is because of the rarely studied weathering effects that occur during deep sea spills. While the evaporative weathering process of oil at the water’s surface has been studied, no currently implemented models assess the weathering effects of dissolution within the water column. The evaporative effects at the sea surface and the dissolution of soluble components within droplets located in the water column leave a heavy fraction of oil that may sink. Laboratory experiments from previous work used hydrocarbon-like chemicals to form binary model oils. In contrast, experiments presented in this work use crude oil amended model oil (COA-MO) mixtures where the sinking of heavy fractions of crude oil does occur. The evaporative weathering binary model, when applied to COA-MO mixtures, was able to predict the sinking times of oil droplets using physical data of the three individual components of the mixture (crude oil, a light volatile, and heavy non-volatile chemical). The dissolution bonary model was able to predict the sinking times of COA-MO mixtures while submerged under water. A range of experimentally derived dissolution time constant, K, was obtained which could be applied to a broad spectrum of real world oils where the solubility of individual crude oil components varies greatly

Nurse Anesthetists' Perceptions and Use of Ultrasound for Epidural and Spinal Needle Placement in Obese Parturients

Purpose: The use of ultrasound scout scans and real-time ultrasound scanning for epidural/spinal needle placement is possible, but not prevalent in obstetric anesthesia practice. Ultrasound use in the obese parturient with impalpable landmarks can facilitate epidural/spinal needle placement. It is estimated that 50% of parturients are obese and eight percent of those are considered morbidly obese as defined by a BMI ≥ 40 kg/m2.6 A survey of Certified Registered Nurse Anesthetists (CRNAs) and Student Registered Nurse Anesthetists (SRNAs) was utilized to determine their knowledge of ultrasound for epidural/ spinal needle placement, the availability of ultrasound equipment, and barriers to ultrasound use in obstetric anesthesia practice. Previous studies have not included CRNAs. Methods: An online survey was distributed to 1,882 practicing CRNAs and SRNAs to determine their knowledge, access, and perceptions of ultrasound used for epidural and spinal needle placement in parturients with a BMI ≥ 35 kg/m2. Results: Of the109 respondents, 85% were involved in obstetric anesthesia services, and 76% were regularly involved in the care of parturients with a BMI ≥ 35 kg/m2. 57% of respondents had used ultrasound for a scout scan, and 29% used ultrasound in real-time needle placement. There was 100% agreement that ultrasound was helpful in needle placement when landmarks were indistinguishable. Barriers included a lack of knowledge, equipment, and privileges. Conclusion: Ultrasound for epidural and spinal needle placement is known by CRNAs and SRNAs and is considered useful for needle placement in a parturient with a BMI ≥ 35 kg/m2. The survey data showed that CRNAs who utilized ultrasound for epidural/spinal needle placement found it useful; however, they did not find it necessary in every case despite the parturients size. Because of the low response rate, further research is necessary. Data Sources: Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, Google Scholar, Medscape, PubMed.Doctor of Anesthesia Practice (DAP)Anesthesia PracticeUniversity of Michigan-Flinthttp://deepblue.lib.umich.edu/bitstream/2027.42/156390/1/Loebig2020.pdfDescription of Loebig2020.pdf : thesi

Evidence for a Relationship between VEGF and BMI Independent of Insulin Sensitivity by Glucose Clamp Procedure in a Homogenous Group Healthy Young Men

BACKGROUND: This is the first study to experimentally explore the direct relationship between circulating VEGF levels and body mass index (BMI) as well as to unravel the role of insulin sensitivity in this context under standardized glucose clamp conditions as the methodical gold-standard. In order to control for known influencing factors such as gender, medication, and arterial hypertension, we examined a highly homogeneous group of young male subjects. Moreover, to encompass also subjects beyond the normal BMI range, low weight and obese participants were additionally included and stress hormones as a main regulator of VEGF were assessed. METHODOLOGY/PRINCIPAL FINDINGS: Under euglycemic clamp conditions, VEGF was measured in 15 normal weight (BMI 20-25 kg/m(2)), 15 low weight (BMI<20 kg/m(2)), and 15 obese (BMI>30 kg/m(2)) male subjects aged 18-30 years and the insulin sensitivity index (ISI) was calculated. Since stress axis activation promotes VEGF secretion, concentrations of ACTH, cortisol, and catecholamines were monitored. Despite of comparable ACTH (P = 0.145), cortisol (P = 0.840), and norepinephrine (P = 0.065) levels, VEGF concentrations differed significantly between BMI-groups (P = 0.008) with higher concentrations in obese subjects as compared to normal weight (P = 0.061) and low weight subjects (P = 0.002). Pearson's correlation analysis revealed a positive relationship between BMI and VEGF levels (r = 0.407; P = 0.010) but no correlation of VEGF with ISI (r = 0.224; P = 0.175). CONCLUSIONS/SIGNIFICANCE: Our data demonstrate a positive correlation between concentrations of circulating VEGF levels and BMI in healthy male subjects under highly controlled conditions. This relationship which is apparently disconnected from insulin sensitivity may be part of some pathogenetic mechanisms underlying obesity and type 2 diabetes

Distinct Characteristics of Circulating Vascular Endothelial Growth Factor-A and C Levels in Human Subjects

The mechanisms that lead from obesity to atherosclerotic disease are not fully understood. Obesity involves angiogenesis in which vascular endothelial growth factor-A (VEGF-A) plays a key role. On the other hand, vascular endothelial growth factor-C (VEGF-C) plays a pivotal role in lymphangiogenesis. Circulating levels of VEGF-A and VEGF-C are elevated in sera from obese subjects. However, relationships of VEGF-C with atherosclerotic risk factors and atherosclerosis are unknown. We determined circulating levels of VEGF-A and VEGF-C in 423 consecutive subjects not receiving any drugs at the Health Evaluation Center. After adjusting for age and gender, VEGF-A levels were significantly and more strongly correlated with the body mass index (BMI) and waist circumference than VEGF-C. Conversely, VEGF-C levels were significantly and more closely correlated with metabolic (e.g., fasting plasma glucose, hemoglobin A1c, immunoreactive insulin, and the homeostasis model assessment of insulin resistance) and lipid parameters (e.g., triglycerides, total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), and non-high-density-lipoprotein cholesterol (non-HDL-C)) than VEGF-A. Stepwise regression analyses revealed that independent determinants of VEGF-A were the BMI and age, whereas strong independent determinants of VEGF-C were age, triglycerides, and non-HDL-C. In apolipoprotein E-deficient mice fed a high-fat-diet (HFD) or normal chow (NC) for 16 weeks, levels of VEGF-A were not significantly different between the two groups. However, levels of VEGF-C were significantly higher in HFD mice with advanced atherosclerosis and marked hypercholesterolemia than NC mice. Furthermore, immunohistochemistry revealed that the expression of VEGF-C in atheromatous plaque of the aortic sinus was significantly intensified by feeding HFD compared to NC, while that of VEGF-A was not. In conclusion, these findings demonstrate that VEGF-C, rather than VEGF-A, is closely related to dyslipidemia and atherosclerosis

Parents' psychological adjustment in families of children with Spina Bifida: a meta-analysis

BACKGROUND: Spina Bifida (SB) is the second most common birth defect worldwide. Since the chances of survival in children with severe SB-forms have increased, medical care has shifted its emphasis from life-saving interventions to fostering the quality of life for these children and their families. Little is known, however, about the impact of SB on family adjustment. Reviewers have struggled to synthesize the few contradictory studies available. In this systematic review a new attempt was made to summarize the findings by using meta-analysis and by delimiting the scope of review to one concept of family adjustment: Parents' psychological adjustment. The questions addressed were: (a) do parents of children with SB have more psychological distress than controls? (b) do mothers and fathers differ? and (c) which factors correlate with variations in psychological adjustment? METHODS: PsycInfo, Medline, and reference lists were scanned. Thirty-three relevant studies were identified of which 15 were eligible for meta-analysis. RESULTS: SB had a negative medium-large effect on parents' psychological adjustment. The effect was more heterogeneous for mothers than for fathers. In the reviewed studies child factors (age, conduct problems, emotional problems, and mental retardation), parent factors (SES, hope, appraised stress, coping, and parenting competence), family factors (family income, partner relationship, and family climate), and environmental factors (social support) were found to be associated with variations in parents' psychological adjustment. CONCLUSION: Meta-analysis proved to be helpful in organizing studies. Clinical implications indicate a need to be especially alert to psychological suffering in mothers of children with SB. Future research should increase sample sizes through multi-center collaborations

Etablierung eines Modells der akuten Herzinsuffizienz am atherosklerotisch vorerkrankten Schwein zur Evaluation kardialer Unterstützungssysteme

Die Arbeit beschreibt ein Modell der akuten Herzinsuffizienz zur hämodynamischen Untersuchung kardialer Unterstützungssysteme am atherosklerotisch vorerkrankten Schwein. Neben der erfolgreichen Induktion einer akuten Herzinsuffizienz wird gezeigt, dass sich die kardiale Funktion mittels Konduktanzkatheter unter verschiedenen hämodynamischen Anforderungen valide messen lässt