Search

Abstract Intravascular volume is largely regulated by the kidneys but how differences in intravascular volume profiles interact with chronic kidney disease (CKD) to influence outcomes in chronic heart failure (HF) has not been explored. Our hypothesis was that a greater degree of volume expansion (VE) would moderate the impact of CKD on HF‐related clinical outcomes. Quantitative blood volume (BV) data were available in 137 patients at the time of hospital discharge using a nuclear medicine radiolabeled albumin indicator‐dilution technique. The study patients were stratified by the cohort median glomerular filtration rate (GFR, 44 ml/min/1.73 m2). An a priori cut‐point of ≥+25% above normal BV was then used to further stratify the two GFR subgroups and prospectively analyzed for 1‐year HF‐related mortality or 1st re‐hospitalization. Persistent BV expansions ≥+25% were present in 51% of the cohort. In the subgroup with GFR above the median (N = 68) greater or lesser BV expansion from +25% did not differentiate outcomes. However, in the subgroup with GFR below the median (N = 69), BV expansion‐stratified risk (log‐rank p = 0.022) with

Analysis of saturation recovery data from spin-labeled proteins is extended to include the amplitudes in addition to the recovery rates for two-site exchange. It is shown that the recovery amplitudes depend strongly on the exchange rate between states as well as their populations and this dependence provides a simple criterion to identify exchange rates in the 10–1000 kHz range. Analysis of experimental SR relaxation curves via the uniform penalty (UPEN) method allows for reliable identification of single, double, or other multiple-component traces, and global fitting of a set of relaxation curves using both relaxation rates and amplitudes determined from the UPEN fits allows for the estimation of exchange rate in the above domain. The theory is tested on simple model systems, and applied to the determination of conformational exchange rates in spin-labeled mutants of T4 Lysozyme and intestinal fatty acid binding protein. Finally, an example of T1-weighted spectral editing is provided for systems in the slow exchange limit.

ABSTRACT: Bone health of broiler chickens is essential for welfare and production. In this study, the probiotic Bacillus amyloliquefaciens (BA) CGMCC18230 was compared with antimicrobial growth promoters (AGPs) for its ability to promote growth and bone health. To address this, a total of 180 Arbor Acres (AA) 1-day-old, male, broiler chicks were randomly allocated into 3 treatment groups, with 6 replicates, containing 10 chicks in each replicate. The treatment groups were: control group (CON) fed a corn-soybean based diet; BA treatment group fed the basal diet supplemented with 2.5 × 1010 CFU/kg BA CGMCC18230; AGPs treatment group was fed the basal diet containing the antibiotics aureomycin (75 mg/kg), flavomycin (5 mg/kg) and kitasamycin (20 mg/kg). Over the 42 d experiment, broilers fed BA and AGPs diets both had higher BW, and the ADG was significantly (P < 0.05) higher than that of the CON group both in the grower phase (22–42 d) and overall. Moreover, with BA birds had higher (P < 0.05) serum concentrations of phosphorus (P, day 42) and alkaline phosphatase (ALP, days 21 and 42). Conversely, the content of P in excreta decreased significantly (P < 0.05) on days 21 and 42. Tibia bone mineralization was improved in BA, and the mRNA of P transport related genes PiT-1,2 in the duodenum and jejunum were significantly up-regulated in the BA group than in the CON group (P < 0.05). 16S rRNA gene sequencing revealed that dietary BA supplementation increased the relative abundance of butyrate-producing bacteria (Ruminococcaceae) and polyamine-producing bacteria (Akkermansia and Alistipes), which had a positive effect on bone development. These data show that dietary supplementation of BA CGMCC18320 improves broiler growth performance and bone health similar to supplementation with AGPs through up-regulation of intestinal P transporters, microbial modulation and increase P retention. However, no significant influence of BA CGMCC18320 supplementation on the retention of Ca was found.

Fluid volume homeostasis in health and heart failure (HF) requires a complex interaction of 2 systems, the intravascular and interstitial‐lymphatic circulations. With the development of HF both the intravascular and interstitial compartments undergo variable degrees of volume remodeling which can include significant expansion. This reflects the impact of multiple pathophysiologic mechanisms on both fluid compartments which initially play a compensatory role to stabilize intravascular circulatory integrity but with progression in HF can evolve to produce the various manifestations of volume overload and clinical HF congestion. The intent of this review is to help enhance recognition of the pathophysiologic and clinical importance of the interlinked roles of these 2 circulatory systems in volume regulation and chronic HF. It would also be hoped that a better understanding of the interacting functions of the intravascular and interstitial‐lymphatic fluid compartments can potentially aid development of novel management strategies particularly addressing the generally undertargeted interstitial‐lymphatic system and help bring such approaches forward through a more integrated view of these 2 circulatory systems.

Onychomycosis is a common nail infection. Terbinafine-resistant dermatophyte infections pose an emerging global public health concern, but few cases have been described in the United States. We retrospectively reviewed and characterized clinical, histopathological, and mycological features of patients with mycologically confirmed onychomycosis who failed oral terbinafine treatment for onychomycosis at a U.S. academic nail referral center and ascertained for terbinafine-resistant isolates. During 1 June 2022–31 January 2023 at Weill Cornell Medicine in New York City, USA, 96 patients with mycologically confirmed onychomycosis were treated with oral terbinafine. Among 64 patients with adequate follow-up, 36 had clinical or complete cure. Of 28 patients who failed treatment, 17 underwent terbinafine resistance testing. Trichophyton rubrum with terbinafine resistance-conferring mutations was isolated from two patients. Overall, terbinafine failures for onychomycosis were relatively common, with some cases associated with terbinafine-resistant T. rubrum infections. These findings underscore the need for a clinical awareness of this emerging problem and public health efforts to monitor and prevent spread. We highlight the importance of diagnostic testing and species identification for onychomycosis patients and the increasingly important role of fungal identification and susceptibility testing to guide therapy.

The three most commonly used methods for diagnosing non-dermatophyte mold (NDM) onychomycosis are culture, polymerase chain reaction (PCR), and histopathology. Toenail samples from 512 patients (1 sample/patient) with suspected onychomycosis were examined using all three diagnostic tests. A statistically significant association was found between PCR and histopathology results, as well as between fungal culture and histopathology results. All PCR-positive and culture-positive dermatophyte samples were confirmed by histopathology. However, 15/116 (12.9%) of culture-positive NDM samples had negative histopathology results, while all PCR-positive NDM samples were confirmed by histopathology. The overall rate of dermatophyte detection was higher using PCR compared to culture (38.9% vs. 11.7%); the lower rate of NDM detection by PCR (11.7% vs. 38.9%) could be attributed to the restriction of the assay design to seven pre-selected targets. When repeat sampling in the clinic is not possible, a combination of NDM detection by PCR and positive histopathology of hyphae may be a proxy for NDM infection, particularly where the NDM occurs without a concomitant dermatophyte. There was a high degree of correlation between negative PCR and negative histopathology. A negative PCR result with negative histopathology findings may be a reliable proxy for the diagnosis of non-fungal dystrophy.

Abstract Background Immunological stress decreases feed intake, suppresses growth and induces economic losses. However, the underlying molecular mechanism remains unclear. Label-free liquid chromatography and mass spectrometry (LC-MS) proteomics techniques were employed to investigate effects of immune stress on the hepatic proteome changes of Arbor Acres broilers (Gallus Gallus domesticus) challenged with Escherichia coli lipopolysaccharide (LPS). Results Proteomic analysis indicated that 111 proteins were differentially expressed in the liver of broiler chickens from the immune stress group. Of these, 28 proteins were down-regulated, and 83 proteins were up-regulated in the immune stress group. Enrichment analysis showed that immune stress upregulated the expression of hepatic proteins involved in defense function, amino acid catabolism, ion transport, wound healing, and hormone secretion. Furthermore, immune stress increased valine, leucine and isoleucine degradation pathways. Conclusion The data suggests that growth depression of broiler chickens induced by immune stress is triggered by hepatic proteome alterations, and provides a new insight into the mechanism by which immune challenge impairs poultry production.

Ivermectin, an antiparasitic agent, is not recommended for prophylaxis or treatment of coronavirus disease 2019 (COVID-19). Inappropriate use of ivermectin for treatment of COVID-19 may make it less available for patients with serious parasitic infections who could benefit from its use and worsen the current shortage of ivermectin in Canada. However, patients with COVID-19 who are candidates to receive immunomodulatory therapies (e.g. corticosteroids and interleukin-6 inhibitors) may be at risk of hyperinfection syndrome and disseminated disease from Strongyloides stercoralis. These complications can be severe and even fatal. It is important to recognize and screen patients who may be at risk of strongyloidiasis, as these patients may require treatment with ivermectin to avoid the potential for a hyperinfection syndrome and disseminated disease, which is frequently deadly. Clinicians should follow evidence-based recommendations to screen and treat for Strongyloides infection in patients with COVID-19 who are under consideration to receive specific COVID-19 therapies that alter immune response and may lead to hyperinfection syndrome or disseminated disease.

L’ivermectine, un agent antiparasitaire, n’est pas recommandé pour la prophylaxie ou le traitement de la maladie à coronavirus 2019 (COVID-19). L’utilisation inappropriée de l’ivermectine pour le traitement de la COVID-19 peut en diminuer la disponibilité pour les patients atteints d’infections parasitaires graves qui pourraient en bénéficier et aggraver la pénurie actuelle de ce médicament au Canada. Cependant, les patients atteints de COVID-19 qui sont des candidats pour recevoir des thérapies immunomodulatrices (e.g. corticostéroïdes et inhibiteurs de l’interleukine-6) peuvent être exposés au risque de syndrome d’hyperinfection et de la maladie disséminée à Strongyloides stercoralis. Ces complications peuvent être graves, voire mortelles. Il est important de reconnaître et de dépister les patients qui présentent des risques de strongyloïdose, car ces patients peuvent avoir besoin d’un traitement à l’ivermectine pour éviter le risque d’un syndrome d’hyperinfection et d’une maladie disséminée, qui est souvent mortelle. Les médecins devraient suivre des recommandations fondées sur des données probantes pour dépister et traiter l’infection à Strongyloides chez les patients atteints de COVID-19 qui pourraient recevoir des traitements propres à la COVID-19 qui modifient la réponse immunitaire et qui peuvent entraîner un syndrome d’hyperinfection ou une maladie disséminée.

BackgroundThe identification of new therapies for high-risk (HR) hepatoblastoma is challenging. Children's Oncology Group study AHEP0731 included a HR stratum to explore the efficacy of novel agents. Herein, the authors report the response rate to the combination of vincristine (V) and irinotecan (I) and the outcome of patients with high-risk hepatoblastoma.MethodsPatients with newly diagnosed metastatic hepatoblastoma or those with a serum α-fetoprotein (AFP) level 1 log10 ) decline in their AFP level. Responders were to receive 2 additional cycles of VI intermixed with 6 cycles of the combination of cisplatin, doxorubicin, 5-fluorouracil, and vincristine (C5VD). Nonresponders were to receive 6 cycles of C5VD alone.ResultsA total of 32 patients with a median age at diagnosis of 26 months (range, 11-159 months) were enrolled between September 2009 and February 2012. Fourteen of 30 evaluable patients were responders (RECIST and AFP in 6 patients, RECIST only in 3 patients, and AFP only in 5 patients). The median AFP decline after 2 cycles of VI for the entire group was 345,565 ng/mL (85% of the initial AFP). The 3-year event-free and overall survival rates were 49% (95% confidence interval, 30%-65%) and 62% (95% confidence interval, 42%-77%), respectively.ConclusionsThe VI combination appears to have substantial activity against HR hepatoblastoma. The ultimate impact of this regimen in improving the outcomes of children with HR hepatoblastoma remains to be determined. Cancer 2017;123:2360-2367. © 2017 American Cancer Society.

Conformational equilibria of G-protein-coupled receptors (GPCRs) are intimately involved in intracellular signaling. Here conformational substates of the GPCR rhodopsin are investigated in micelles of dodecyl maltoside (DDM) and in phospholipid nanodiscs by monitoring the spatial positions of transmembrane helices 6 and 7 at the cytoplasmic surface using site-directed spin labeling and double electron-electron resonance spectroscopy. The photoactivated receptor in DDM is dominated by one conformation with weak pH dependence. In nanodiscs, however, an ensemble of pH-dependent conformational substates is observed, even at pH 6.0 where the MIIbH+ form defined by proton uptake and optical spectroscopic methods is reported to be the sole species present in native disk membranes. In nanodiscs, the ensemble of substates in the photoactivated receptor spontaneously decays to that characteristic of the inactive state with a lifetime of ∼16 min at 20 °C. Importantly, transducin binding to the activated receptor selects a subset of the ensemble in which multiple substates are apparently retained. The results indicate that in a native-like lipid environment rhodopsin activation is not analogous to a simple binary switch between two defined conformations, but the activated receptor is in equilibrium between multiple conformers that in principle could recognize different binding partners.