Two patients with chromosome 22q11.2 deletion presenting with childhood obesity and hyperphagia

Chromosome 22q11.2 deletion syndrome is a clinically heterogeneous condition of intellectual disability, parathyroid and thyroid hypoplasia, palatal abnormalities, cardiac malformations and psychiatric symptoms. Hyperphagia and childhood obesity is widely reported in Prader-Willi Syndrome (PWS) but there is only one previous report of this presentation in chromosome 22q11.2 deletion syndrome. We describe two further cases of chromosome 22q11.2 deletion syndrome in which hyperphagia and childhood obesity were the presenting features. This may be a manifestation of obsessive behaviour secondary to some of the psychiatric features commonly seen in chromosome 22q11.2 deletion syndrome. Serious complications may result from hyperphagia and childhood obesity therefore early recognition and intervention is crucial. Due to the similar clinical presentation of these two patients to patients with PWS, it is suggested that the hyperphagia seen here should be managed in a similar way to how it is managed in PWS

The ISCIP Analyst, Volume V, Issue 10

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy

The Use of Paxlovid Amongst the Elderly & Reduced Hospital Stays

Coronaviruses are a large family of viruses infecting many species and cause a variety of illnesses. COVID-19 is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2). Understanding that COVID-19 can cause severe disease in vulnerable populations has launched the development of viral treatments. Nirmatrelvir-ritonavir (Paxlovid) is an oral antiviral treatment authorized for adults with mild to moderate symptoms who are at an increased risk for severe disease. These authors pose the question: For older adults over the age of 65 who have had COVID-19, does the use of Paxlovid reduce hospitalizations, compared to those not treated with Paxlovid? A literature search was conducted on Nursing Reference Center Plus, CINAHL, PubMed, and National Library of Medicine/PubMed Central. The following terms were used: cov*, paxlov*, hospital*, elder* which resulted in a total of 11 articles out of 82 articles. Inclusion criteria consist of individuals ≥ 65 with symptoms that onset within 3-5 days of receiving Paxlovid. They must also have one or more risk factors that increase the risk for severe infection. Exclusion criteria consist of individuals under the age of 18 or ≥ 65 with mild to moderate symptoms that have lasted longer than 5 days. As well as severe renal/hepatic impairment, history of significant reactions to the active ingredients in Paxlovid, or contraindicated medications. Limitations include inconsistencies in the day of diagnosis and medication compliance. The evidence found that Paxlovid was effective in reducing hospital stays in older adults as opposed to those who did not receive Paxlovid

The ISCIP Analyst, Volume II, Issue 13

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy

The ISCIP Analyst, Volume IV, Issue 10

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy

ADSC-EVs and Macrophage Polarization in Fat Grafting for Breast Reconstruction

Breast Cancer is the most commonly diagnosed cancer among women in New Zealand, with an estimated 3000 women diagnosed in New Zealand every year. The most common form of treatment is surgery, and following treatment, the approximate 5-year survival rate is 90%. A key part of the treatment process for breast cancer survivors is breast reconstruction surgery, as it improves the physical, physiological, and social aspects of every-day life. Autologous fat grafting is a relatively new breast reconstruction option that is becoming increasingly attractive, as this has the ability to create a natural cosmetic outcome with minimal surgical risk. The major limitation associated with fat grafting is that the percentage of grafted tissue volume that is retained post-surgery is hugely variable, prompting further breast reconstruction in some cases. Adipose derived stem cells (ADSCs) are a key cell being investigated in the donor tissue due to their high proliferative abilities, coupled with their potential to differentiate into adipocytes, indicating that they are important in the regeneration of adipose tissue. In the breast cavity, macrophages are thought to play an important role in graft retention as they are important in inflammation and wound healing. It is thought that improving the relationship between ADSCs in the donor tissue and stromal cells in the recipient site, such as macrophages, could be important for improving retention rates. One way in which these cells can interact is through the release of extracellular vesicles (EVs) from ADSCs into the surrounding environment. The overall aim of this study was to establish methodologies for in vitro ADSC and macrophage culture, for characterization of ADSC-derived EV (ADSC-EV) output during culture, and to determine the impact of ADSC-EVs on macrophage polarization. Adipose tissue samples were collected from patients undergoing fat grafting and ADSCs were isolated and cultured. ADSC cell specificity was confirmed using flow cytometry as well as successful differentiation into adipocytes and osteoblasts, indicating the successful establishment of methods to culture ADSCs from autologous fat graft samples. ADSC-EVs were isolated from the media of cultured ADSCs using size exclusion chromatography and characterised using tunable resistive pulse sensing. We demonstrate a mean size 150 – 190 nm across patient samples, which is within the expected size range of EVs. Mean concentrations also ranged from 2.3x108 and 7.4x108 particles/mL as expected. Western blot analysis on proteins known to be present in EVs further confirmed presence of EVs in the collected samples. Together, these techniques indicated the successful isolation of EVs from cultured ADSCs. Monocytes were isolated from healthy volunteers, cultured into M0 macrophages and further polarized towards M1 and M2 macrophage phenotypes. Successful polarization into M0, M1-like or M2-like macrophages was confirmed by assessing the morphology of cultures. Flow cytometry using known M1 and M2 markers, and RT-qPCR on pro- (TNFα, IL1-β) and anti-inflammatory (IL-10, TGFβ) markers were also used to assess successful polarization. However, low cell counts made these methods difficult for assessing polarization and further optimization is required. In a further experiment, ADSC-EVs were added to M0, M1-like and M2-like macrophage cultures at the time of polarization. To analyse the impact of ADSC-EVs on polarization state, RT-qPCR was conducted to assess macrophage expression of pro- (TNFα, IL1-β) and anti-inflammatory (IL-10, TGFβ) markers. The addition of ADSC-EVs to macrophage cultures altered the expression of pro- and anti-inflammatory markers in each of the polarization states, and could thus potentially influence polarization status of macrophages. The results of this study warrant further investigation to determine the role of ADSC-EVs on macrophage polarization. However, the preliminary data here provides an exciting platform for future research into the potential role of ADSC-EVs in fat graft retention via their interaction with cells in the breast cavity

The ISCIP Analyst, Volume V, Issue 13

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy

The ISCIP Analyst, Volume V, Issue 5

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy

The ISCIP Analyst, Volume IV, Issue 20

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy

The ISCIP Analyst, Volume IV, Issue 20

This repository item contains a single issue of The ISCIP Analyst, an analytical review journal published from 1996 to 2010 by the Boston University Institute for the Study of Conflict, Ideology, and Policy