Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

Predictors of In-hospital Mortality in Oldest-Old Patients in Taiwan

Background: Elderly adults are at a higher risk of complications during their hospital stay and have a higher in-hospital mortality rate. The aim of this study was to analyze the risk factors associated with mortality in the oldest-old patients admitted to a large teaching hospital in Taiwan. Methods: All study participants, aged more than 75 years, were recruited from the unselected acutely ill patients admitted to our hospital between March and July 2009. Results: A total of 3945 admissions were included. Out of these, 2037 (51.6%) patients were female and the average age was 81.8 (±5.4) years. The overall in-hospital mortality rate was 8.2% (9.9% in medical wards; 3.7% in surgical wards). The main predictors for in-hospital mortality in medical wards were advanced age >80 years [odds ratio (OR), 1.83 (1.25–2.68)], plasma glucose at admission >160 or 80 U/L [OR, 2.78 (1.68–4.58)], creatinine >1.5 mg/dL [OR, 2.91 (2.06–4.12)], white cell count >12×103 or 180 or <90 mmHg [OR, 2.29 (1.31–3.99)]. Abnormal levels of hemoglobin (<9 g/dL), white cell count, and being transferred from the emergency room were significantly related to in-hospital mortality in surgical wards. Conclusions: Our findings suggest that particular attention should be paid to patients with an older age, those with abnormal levels of routine admission tests, or those being referred from an emergency room, which indicates critical health conditions, and higher in-hospital mortality

www.mdpi.com/journal/ijms Significant Overexpression of DVL1 in Taiwanese Colorectal Cancer Patients with Liver Metastasis

Abstract: Undetected micrometastasis plays a key role in the metastasis of cancer in colorectal cancer (CRC) patients. The aim of this study is to identify a biomarker of CRC patients with liver metastasis through the detection of circulating tumor cells (CTCs)

Elevated serum triglyceride and retinol-binding protein 4 levels associated with fructose-sweetened beverages in adolescents.

BACKGROUND: The metabolic effect of fructose in sugar-sweetened beverages (SSB) has been linked to de novo lipogenesis and uric acid (UA) production. OBJECTIVES: This study investigated the biological effects of SSB consumption on serum lipid profiles and retinol-binding protein 4 (RBP4) among Taiwanese adolescents. METHODS: We evaluated the anthropometric parameters and biochemical outcomes of 200 representative adolescents (98 boys and 102 girls) who were randomly selected from a large-scale cross-sectional study. Data were analyzed using multiple regression models adjusted for covariates. RESULTS: Increased SSB consumption was associated with increased waist and hip circumferences, body mass index (BMI) values and serum UA, triglyceride (TG) and RBP4 levels. Adolescents who consumed >500 ml/day of beverages half-to-heavily sweetened with high-fructose corn syrup (HFCS) exhibited TG and RBP4 levels 22.7 mg/dl and 13.92 ng/ml higher than non-drinkers, respectively. HFCS drinkers with hyperuricemia had higher TG levels than HFCS drinkers with normal UA levels (98.6 vs. 81.6 mg/dl). The intake of HFCS-rich SSBs and high value of BMI (≥24) interactively reinforced RBP4 levels among overweight/obese adolescents. Circulating RBP4 levels were significantly correlated with weight-related outcomes and TG and UA concentration among HFCS drinkers (r = 0.253 to 0.404), but not among non-drinkers. CONCLUSIONS: High-quantity HFCS-rich beverage consumption is associated with higher TG and RBP4 levels. Hyperuricemia is likely to intensify the influence of HFCS-rich SSB intake on elevated TG levels, and in overweight and obese adolescents, high BMI may modify the action of fructose on higher circulating levels of RBP4

Significant Overexpression of DVL1 in Taiwanese Colorectal Cancer Patients with Liver Metastasis

Undetected micrometastasis plays a key role in the metastasis of cancer in colorectal cancer (CRC) patients. The aim of this study is to identify a biomarker of CRC patients with liver metastasis through the detection of circulating tumor cells (CTCs). Microarray and bioinformatics analysis of 10 CRC cancer tissue specimens compared with normal adjacent tissues revealed that 31 genes were up-regulated (gene expression ratio of cancer tissue to paired normal tissue > 2) in the cancer patients. We used a weighted enzymatic chip array (WEnCA) including 31 prognosis-related genes to investigate CTCs in 214 postoperative stage I–III CRC patients and to analyze the correlation between gene expression and clinico-pathological parameters. We employed the immunohistochemistry (IHC) method with polyclonal mouse antibody against DVL1 to detect DVL1 expression in 60 CRC patients. CRC liver metastasis occurred in 19.16% (41/214) of the patients. Using univariate analysis and multivariate proportional hazards regression analysis, we found that DVL1 mRNA overexpression had a significant, independent predictive value for liver metastasis in CRC patients (OR: 5.764; 95% CI: 2.588–12.837; p < 0.0001 on univariate analysis; OR: 3.768; 95% CI: 1.469–9.665; p = 0.006 on multivariate analysis). IHC staining of the immunoreactivity of DVL1 showed that DVL1 was localized in the cytoplasm of CRC cells. High expression of DVL1 was observed in 55% (33/60) of CRC tumor specimens and was associated significantly with tumor depth, perineural invasion and liver metastasis status (all p < 0.05). Our experimental results demonstrated that DVL1 is significantly overexpressed in CRC patients with liver metastasis, leading us to conclude that DVL1 could be a potential prognostic and predictive marker for CRC patients

Interactive effects of the type of sugar-sweetened beverage (SSB) consumed, overweight/obesity and hyperuricemia on: (A) serum triglyceride (TG) and (B) retinol-binding protein 4 (RBP4) levels.

<p><b>Note:</b> SSB groups were classified as non-intake, high-fructose corn syrup-containing drinks (HFCS drink) and sucrose/HFCS-mixed sugar-containing drinks (Mixed-sugar drink). Overweight (BMI≥24 to <27 kg/m²) and obesity (BMI≥27 kg/m²) are determined according to the criteria defined by the Department of Health, Executive Yuan of Taiwan. The multivariate-adjusted means were obtained using a linear regression model adjusted for age, gender, study area, physical activity, total calories, alcohol drinking and cigarette smoking, and where appropriate, the levels of serum uric acid and body mass index (BMI). * denotes a significant adjusted-mean difference as compared to the reference mean (<i>P</i><0.05). ??? denotes a significant interaction effect on RBP4 levels that was detected among adolescents with overweight/obesity and consuming HFCS drinks (<i>P</i> for interaction = 0.037). The waist circumference was 67.7 and 68.0 cm for non-drinkers, 66.4 and 83.8 cm for HFCS drinkers, and 90.4 and 85.3 cm for mixed-sugar drinkers with a BMI<24 and ≥24 kg/m², respectively.</p

Multivariate-adjusted differences in triglyceride and retinol-binding protein 4 (RBP4) associated with the type and amount of sugar-sweetened beverage consumed by adolescents.

<p><b>Abbreviations</b>: aDiff., adjusted difference; HFCS, high-fructose corn syrup; HSD, hand-shaken sugar-containing drink; BSD, bottled sugar-containing drink;</p>*<p>, <i>P</i><0.05.</p>a<p>Model I was adjusted for age, gender, study area, physical activity, total calories, alcohol drinking and cigarette smoking.</p>b<p>Model IIA: Model I was additionally adjusted for body mass index. Model IIB: Model I was additionally adjusted for uric acid.</p>c<p>Effect change (EC) associated with the inclusion of an additional covariate into model I.</p>d<p>HSD is only sweetened with HFCS, and BSD is sweetened with sucrose and/or HFCS.</p>e<p><i>P</i> values for dose-response trends were obtained based on the groups of non-drinkers, 1–500 ml/day and >500 ml/day drinkers.</p