Brainstem prolactin-releasing peptide contributes to cancer anorexia-cachexia syndrome in rats

p to 80% of cancer patients are affected by the cancer anorexia-cachexia syndrome (CACS), which leads to excessive body weight loss, reduced treatment success and increased lethality. The area postrema/nucleus of the solitary tract (AP/NTS) region emerged as a central nervous key structure in this multi-factorial process. Neurons in this area are targeted by cytokines and signal to downstream sites involved in energy homeostasis. NTS neurons expressing prolactin-releasing peptide (PrRP) are implicated in the control of energy intake and hypothalamus-pituitary-adrenal (HPA) axis activation, which contributes to muscle wasting. To explore if brainstem PrRP neurons contribute to CACS, we selectively knocked down PrRP expression in the NTS of hepatoma tumor-bearing rats by an AAV/shRNA gene silencing approach. PrRP knockdown reduced body weight loss and anorexia compared to tumor-bearing controls treated with a non-silencing AAV. Gastrocnemius and total hind limb muscle weight was higher in PrPR knockdown rats. Corticosterone levels were increased in the early phase after tumor induction at day 6 in both groups but returned to baseline levels at day 21 in the PrRP knockdown group. While we did not detect significant changes in gene expression of markers for muscle protein metabolism (MuRF-1, myostatin, mTOR and REDD1), mTOR and REDD1 tended to be lower after disruption PrRP signalling. In conclusion, we identified brainstem PrRP as a possible neuropeptide mediator of CACS in hepatoma tumor-bearing rats. The central and peripheral downstream mechanisms require further investigation and might involve HPA axis activation

Impact of Chest X-Ray Before Discharge in Asymptomatic Children After Cardiac Surgery—Prospective Evaluation

In many paediatric cardiac units chest radiographs are performed routinely before discharge after cardiac surgery. These radiographs contribute to radiation exposure. To evaluate the diagnostic impact of routine chest X-rays before discharge in children undergoing open heart surgery and to analyze certain risk factors predicting pathologic findings. This was a prospective (6months) single-centre observational clinical study. One hundred twenty-eight consecutive children undergoing heart surgery underwent biplane chest X-ray at a mean of 13days after surgery. Pathologic findings on chest X-rays were defined as infiltrate, atelectasis, pleural effusion, pneumothorax, or signs of fluid overload. One hundred nine asymptomatic children were included in the final analysis. Risk factors, such as age, corrective versus palliative surgery, reoperation, sternotomy versus lateral thoracotomy, and relevant pulmonary events during postoperative paediatric intensive care unit (PICU) stay, were analysed. In only 5.5% (6 of 109) of these asymptomatic patients were pathologic findings on routine chest X-ray before discharge found. In only three of these cases (50%), subsequent noninvasive medical intervention (increasing diuretics) was needed. All six patients had relevant pulmonary events during their PICU stay. Risk factor analysis showed only pulmonary complications during PICU stay to be significantly associated (p=0.005) with pathologic X-ray findings. Routine chest radiographs before discharge after cardiac surgery can be omitted in asymptomatic children with an uneventful and straightforward perioperative course. Chest radiographs before discharge are warrantable if pulmonary complications did occur during their PICU stay, as this is a risk factor for pathologic findings in chest X-rays before discharg

Enoxaparin therapy for arterial thrombosis in infants with congenital heart disease

Objective: To investigate efficacy and safety of enoxaparin for catheter-related arterial thrombosis in infants with congenital heart disease. Design: Prospective observational study. Setting: Pediatric Intensive Care and Cardiology Unit at the University Children's Hospital of Zurich. Patients: Acohort of 32 infants aged 0-12 months treated with enoxaparin for catheter-related arterial thrombosis from 2002 to 2005. Measurements: Dose requirements of enoxaparin, resolution of thrombosis by Doppler ultrasound, and bleeding complications. Results: Catheter-related arterial thrombosis was located in the iliac/femoral arteries in 31 (97%) infants and aorta in 1 infant, and was related to indwelling catheters and cardiac catheterization in 17 (53%) and 15 (47%) cases, respectively. Newborns required increased doses of enoxaparin to achieve therapeutic anti-FXa levels (mean 1.62 mg/kg per dose) compared with infants aged 2-12 months (mean 1.12 mg/kg per dose; p = 0.0002). Complete resolution of arterial thrombosis occurred in 29 (91%) infants at amean of 23 days after initiation of enoxaparin therapy. Partial or no resolution was observed in 1 (3%) and 2 (6%) infants, respectively, at amean follow-up time of 4.3 months. Bleeding complications occurred in 1 (3%) infant. Conclusion: Enoxaparin is efficient and safe for infants with congenital heart disease and catheter-related arterial thrombosis, possibly representing avalid alternative to the currently recommended unfractionated hepari

A multi-data set comparison of the vertical structure of temperature variability and change over the Arctic during the past 100years

We compare the daily, interannual, and decadal variability and trends in the thermal structure of the Arctic troposphere using eight observation-based, vertically resolved data sets, four of which have data prior to 1948. Comparisons on the daily scale between historical reanalysis data and historical upper-air observations were performed for Svalbard for the cold winters 1911/1912 and 1988/1989, the warm winters 1944/1945 and 2005/2006, and the International Geophysical Year 1957/1958. Excellent agreement is found at mid-tropospheric levels. Near the ground and at the tropopause level, however, systematic differences are identified. On the interannual time scale, the correlations between all data sets are high, but there are systematic biases in terms of absolute values as well as discrepancies in the magnitude of the variability. The causes of these differences are discussed. While none of the data sets individually may be suitable for trend analysis, consistent features can be identified from analyzing all data sets together. To illustrate this, we examine trends and 20-year averages for those regions and seasons that exhibit large sea-ice changes and have enough data for comparison. In the summertime Pacific Arctic and the autumn eastern Canadian Arctic, the lower tropospheric temperature anomalies for the recent two decades are higher than in any previous 20-year period. In contrast, mid-tropospheric temperatures of the European Arctic in the wintertime of the 1920s and 1930s may have reached values as high as those of the late 20th and early 21st centurie

Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging

Objectives. To study the validity of both rheumatological and orthodontic examinations and ultrasound (US) as screening methods for early diagnosis of TMJ arthritis against the gold standard MRI. Methods. Thirty consecutive juvenile idiopathic arthritis (JIA) patients were included in this pilot study. Rheumatological and orthodontic examinations as well as US were performed within 1 month of the MRI in a blinded fashion. Joint effusion and/or increased contrast enhancement of synovium or bone were considered signs of active arthritis on MRI. Results. A total of 19/30 (63%) patients and 33/60 (55%) joints had signs of TMJ involvement on MRI. This was associated with condylar deformity in 9/19 (47%) patients and 15/33 (45%) joints. Rheumatological, orthodontic and US examinations correctly diagnosed 11 (58%), 9 (47%) and 6 (33%) patients, respectively, with active TMJ arthritis, but misdiagnosed 8 (42%), 10 (53%) and 12 (67%) patients, respectively, as having no signs of inflammation. The best predictor for active arthritis on MRI was a reduced maximum mouth opening. Conclusion. None of the methods tested was able to reliably predict the presence or absence of MRI-proven inflammation in the TMJ in our cohort of JIA patients. US was the least useful of all methods tested to exclude active TMJ arthriti

Comparing Atmospheric Correction Performance for Sentinel-2 and Landsat-8 data

In terms of atmospheric impact, the volcanic eruption of Mt. Pinatubo (1991) is thebest characterized large eruption on record. We investigate here the stratosphericwarming following the Pinatubo eruption derived from SAGE II extinction data includ-ing most recent improvements in the processing algorithm and a data filling procedure in the opacity-induced “gap” regions. From these data, which cover wavelengths of1.024 micrometer and shorter, we derived aerosol size distributions which properly re-produce extinction coefficients at much longer wavelength. This provides a good basisfor calculating the absorption of terrestrial infrared radiation and the resulting strato-spheric heating. However, we also show that the use of this dataset in the global chemistry-climate model (CCM) SOCOL leads to exaggerated aerosol-induced strato-spheric heating compared to observations, even partly larger than the already too highvalues found by many models in recent general circulation model (GCM) and CCMintercomparisons. This suggests that the overestimation of the stratospheric warm-ing after the Pinatubo eruption arises from deficiencies in the model radiation codes rather than an insufficient observational data basis. Conversely, our approach reducesthe infrared absorption in the tropical tropopause region, in better agreement with thepost-volcanic temperature record at these altitudes.ISSN:1680-7375ISSN:1680-736

Congenital pulmonary lymphangiectasis mimicking congenital pulmonary interstitial emphysema in a patient with congenital diaphragmatic hernia

Congenital pulmonary lymphangiectasis is a rare abnormality of the lung characterized by dilated pulmonary lymphatic vessels. The diagnosis of congenital pulmonary lymphangiectasis is challenging due to its unspecific presentation, as well as possible radiological imitation of interstitial emphysema. We present a patient where diagnosis was hampered by the extremely rare combination of pulmonary lymphangiectasis and congenital diaphragmatic hernia

Ultra-low-dose lung multidetector computed tomography in children - Approaching 0.2 millisievert

PURPOSE To compare objective and subjective parameters in image quality and radiation dose of two MDCTs (helical 64 detector CT vs. axial 256 detector CT) in paediatric lung CT. METHODS Radiation dose and image quality were compared between non-enhanced lung CT from a helical 64-slice multidetector CT (MDCT 1) and a 256-slice scanner (MDCT 2) with axial wide-cone acquisition and using deep learning image reconstruction. In 23 size-matched paediatric studies (age 2-18 years) from each scanner, the radiation exposure, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image sharpness and delineation of small airways were assessed. Subjective image quality was rated by 6 paediatric radiologists. RESULTS While MDCT 2 provided higher SNR and CNR, subjective image quality was not significantly different between studies from both scanners. Radiation exposure was lower in studies from MDCT 2 (CTDIvol 0.26 ± 0.14 mGy, effective dose 0.23 ± 0.11 mSv) than from MDCT 1 (CTDIvol 0.96 ± 0.52 mGy, effective dose 1.13 ± 0.58 mSv), p < 0.001. Despite lower radiation dose for the scout images, the relative scout-scan-ratio increased from 2.64 ± 1.42 % in MDCT 1 to 6.60 ± 5.03 % in MDCT 2 (p = 0.001). CONCLUSIONS By using latest scanner technology effective radiation dose can be reduced to 0.1-0.3 mSv for lung CT in children without compromising image quality. Scout image dose increasingly accounts for substantial portions of the total scan dose and needs to be optimized. In children CT should be performed on state-of-the-art MDCT scanners with size-adapted exposure protocols and iterative reconstruction

Lower airway dimensions in paediatric patients - A computed tomography study

BACKGROUND: The aim of this study was to obtain lower airway dimensions in children by means of computed tomography (CT). METHODS: Chest CT scans from 195 pediatric patients (118 boys/77 girls) aged 0.04-15.99 years were analyzed. Tracheal and bronchial lengths, anterior-posterior and lateral diameters, as well as cross-sectional area were assessed at the following levels: mid trachea, right proximal and distal bronchus, proximal bronchus intermedius, and left proximal and distal bronchus. Mediastinal angles of tracheal bifurcation were measured. Data were analyzed by means of linear and polynomial regression plots. RESULTS: The strongest correlations were found between tracheal and bronchial diameters and age as well as between tracheal and bronchial lengths and body length. All measured airway parameters correlated poorly to body weight. Bronchial angles revealed no association with patient's age, body length, or weight. CONCLUSION: This comprehensive anatomical database of lower airway dimensions demonstrates that tracheal and bronchial diameters correlate better to age, and that tracheal and bronchial length correlate better to body length. All measured airway parameters correlated poorly to body weight