Obese Patients in Medical Intensive Care Unit: Influence of Counseling on Weight Loss and Cardiovascular Parameters

A case series of 12 obese patients admitted to medical intensive care unit (ICU) due to life-threatening diseases and the influence of weight loss on cardiovascular parameters is presented. We assessed body weight, body mass index (BMI), blood pressure, pulse, and laboratory values on admission. At discharge from ICU patients were counseled on how to lose weight. They were examined one and six months later. Statistically significant (p<0.05) decrease of body weight (median at the beginning of a treatment 134 kg, after six months 127.5 kg), BMI (median 41.5 kg/m2 at the beginning of a treatment; 38.9 kg/m2 after six months), systolic blood pressure (medians 145 mmHg and 130 mmHg), diastolic blood pressure (medians 95 mmHg and 85 mmHg) and pulse (medians 104 beats per minute, 78 beats per minute) was found. The reduction of the waist circumference was not significant. One patient died due to severe acute pancreatitis. Patients reported feeling much better after losing weight

Leitmotif: protein motif scanning 2.0

Motivation Motif-HMM (mHMM) scanning has been shown to possess unique advantages over standardly used sequence-profile search methods (e.g. HMMER, PSI-BLAST) since it is particularly well-suited to discriminate proteins with variations inside conserved motifs (e.g. family subtypes) or motifs lacking essential residues (false positives, e.g. pseudoenzymes). Results In order to make mHMM widely accessible to a broader scientific community, we developed Leitmotif, an mHMM web application with many parametrization options easily accessible through intuitive interface. Substantial improvement of performance (ROC scores) was obtained by using two novel parameters. To the best of our knowledge, Leitmotif is the only available mHMM applicatio

Prospektivno istraživanje prevencije kontrastne nefropatije u Republici Hrvatskoj

Aim: To explore the protective role of hydration, urine alkalization (Na bicarbonate) and high doses of antioxidant (N-acetylcysteine) in the prevention of CIN. Material and methods: In a prospective, randomized, single-blinded study patients were divided into three groups: 1) peroral hydration, 2) Na bicarbonate infusion and 3) N-acetylcysteine (NAC) plus NaHCO3 infusion. Serum creatinine (SCr), blood urea nitrogen (BUN), and neutrophil gelatinase-associated lipocalin (NGAL) were measured before and 48 hours after the angiography. Mehran score was calculated for each patient. Results: The study included 106 patients. Groups were comparable regarding the baseline characteristics. According to Mehran risk score 70 % of patients had a low risk, 24% medium and 6% high risk score for development of CIN. After the procedure renal function was preserved in all patients (SCr 103(87.0-121.5), BUN 5.8 (4.9-7.6), creatinine clearance 74.7(55.3-97.6), NGAL 11.4(5.4-19.9)) regardless of the Mehran risk score. The follow up was completed for 73 patients (68 %). Twenty two patients (32 %) developed chronic kidney disease, mostly classified as G3a and G3b according to KDIGO guidelines. Chronic kidney disease developed in patients with the positive history of diabetes and in patients who had higher Mehran score before the diagnostic procedure. Conclusion: The study showed that patients with preserved renal function are not prone to CIN. Regardless of the protocol used, no case of CIN was observed. Our results indicate that adequate hydration is a key component in maintaining the renal function. Higher Mehran score might be useful in predicting the development of chronic kidney disease.Cilj: Ispitati protektivnu ulogu hidracije, alkalizacije mokraće (natrijevim bikarbonatom) i visokih doza antioksidansa (N-acetilcistein) u prevenciji kontrastne nefropatije. Materijali i metode: U prospektivnom istraživanju pacijenti su bili podijeljeni u tri skupine: 1) peroralna hidracija, 2) infuzija natrijevog bikarbonata i 3) infuzija N-acetilcisteina (NAC) i NaHCO3. Serumska vrijednost kreatinina, ureje i neutrophil gelatinase-associated lipocalin (NGAL) izmjerene su prije i 48 sati nakon angiografije. Svakom pacijentu izračunati su Mehran bodovi koji predstavljaju rizik razvoja kontrastne nefropatije. Rezultati: U istraživanje je uključeno 106 pacijenata. Sve tri skupine pacijenata imale su usporedive osnovne karakteristike. Prema bodovima po Mehranu, 70 % pacijenata imalo je niski rizik, 24 % srednji i 6 % visoki rizik razvoja kontrastne nefropatije. Nakon kontrastne pretrage bubrežna funkcija bila je očuvana u svih pacijenata (serumski kreatinin 103 (87.0 – 121.5), urea 5.8 (4.9 – 7.6), klirens kreatinina 74.7 (55.3 – 97.6), NGAL 11.4 (5.4 – 19.9)) neovisno o riziku procijenjenom bodovima po Mehranu. Praćenje je završeno za 73 pacijenta (68 %). Dvadeset i dva pacijenta (32 %) razvila su kroničnu bubrežnu insuficijenciju, klasificiranu prema KDIGO smjernicama kao G3a i G3b. Kronična bubrežna insuficijencija razvila se u pacijenata sa šećernom bolesti i u pacijenata koji su imali viši broj bodova prema Mehranu prije dijagnostičke pretrage. Zaključak: Istraživanje je pokazalo da pacijenti s normalnom bubrežnom funkcijom imaju mali rizik razvoja kontrastne nefropatije. U ispitivanoj skupini pacijenata nije zabilježen niti jedan slučaj kontrastne nefropatije bez obzira na vrstu protokola koji je korišten za hidraciju. Naši rezultati ukazuju na to da je adekvatna hidracija ključna u prevenciji kontrastne nefropatije. Nadalje, postoji mogućnost da viši broj bodova po Mehranu može poslužiti kao prediktor razvoja kronične bubrežne bolesti

Obese Patients in Medical Intensive Care Unit: Influence of Counseling on Weight Loss and Cardiovascular Parameters

A case series of 12 obese patients admitted to medical intensive care unit (ICU) due to life-threatening diseases and the influence of weight loss on cardiovascular parameters is presented. We assessed body weight, body mass index (BMI), blood pressure, pulse, and laboratory values on admission. At discharge from ICU patients were counseled on how to lose weight. They were examined one and six months later. Statistically significant (p<0.05) decrease of body weight (median at the beginning of a treatment 134 kg, after six months 127.5 kg), BMI (median 41.5 kg/m2 at the beginning of a treatment; 38.9 kg/m2 after six months), systolic blood pressure (medians 145 mmHg and 130 mmHg), diastolic blood pressure (medians 95 mmHg and 85 mmHg) and pulse (medians 104 beats per minute, 78 beats per minute) was found. The reduction of the waist circumference was not significant. One patient died due to severe acute pancreatitis. Patients reported feeling much better after losing weight

Co-Adaptive Control of Bionic Limbs via Unsupervised Adaptation of Muscle Synergies

Objective: In this work, we present a myoelectric interface that extracts natural motor synergies from multi-muscle signals and adapts in real-time with new user inputs. With this unsupervised adaptive myocontrol (UAM) system, optimal synergies for control are continuously co-adapted with changes in user motor control, or as a function of perturbed conditions via online non-negative matrix factorization guided by physiologically informed sparseness constraints in lieu of explicit data labelling. Methods: UAM was tested in a set of virtual target reaching tasks completed by able-bodied and amputee subjects. Tests were conducted under normative and electrode perturbed conditions to gauge control robustness with comparisons to non-adaptive and supervised adaptive myocontrol schemes. Furthermore, UAM was used to interface an amputee with a multi-functional powered hand prosthesis during standardized Clothespin Relocation Tests, also conducted in normative and perturbed conditions. Results: In virtual tests, UAM effectively mitigated performance degradation caused by electrode displacement, affording greater resilience over an existing supervised adaptive system for amputee subjects. Induced electrode shifts also had negligible effect on the real world control performance of UAM with consistent completion times (23.91 +/- 1.33 s) achieved across Clothespin Relocation Tests in the normative and electrode perturbed conditions. Conclusion: UAM affords comparable robustness improvements to existing supervised adaptive myocontrol interfaces whilst providing additional practical advantages for clinical deployment. Significance: The proposed system uniquely incorporates neuromuscular control principles with unsupervised online learning methods and presents a working example of a freely co-adaptive bionic interface.Peer reviewe

Bacterial single-stranded DNA-binding proteins are phosphorylated on tyrosine

Single-stranded DNA-binding proteins (SSBs) are required for repair, recombination and replication in all organisms. Eukaryotic SSBs are regulated by phosphorylation on serine and threonine residues. To our knowledge, phosphorylation of SSBs in bacteria has not been reported. A systematic search for phosphotyrosine-containing proteins in Streptomyces griseus by immunoaffinity chromatography identified bacterial SSBs as a novel target of bacterial tyrosine kinases. Since genes encoding protein-tyrosine kinases (PTKs) have not been recognized in streptomycetes, and SSBs from Streptomyces coelicolor (ScSSB) and Bacillus subtilis (BsSSB) share 38.7% identity, we used a B.subtilis protein-tyrosine kinase YwqD to phosphorylate two cognate SSBs (BsSSB and YwpH) in vitro. We demonstrate that in vivo phosphorylation of B.subtilis SSB occurs on tyrosine residue 82, and this reaction is affected antagonistically by kinase YwqD and phosphatase YwqE. Phosphorylation of B.subtilis SSB increased binding almost 200-fold to single-stranded DNA in vitro. Tyrosine phosphorylation of B.subtilis, S.coelicolor and Escherichia coli SSBs occured while they were expressed in E.coli, indicating that tyrosine phosphorylation of SSBs is a conserved process of post-translational modification in taxonomically distant bacteria