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Scientific Reports May 2024Dietary trans 10, cis 12-conjugated linoleic acid (t10c12-CLA) is a potential candidate in anti-obesity trials. A transgenic mouse was previously successfully...
Dietary trans 10, cis 12-conjugated linoleic acid (t10c12-CLA) is a potential candidate in anti-obesity trials. A transgenic mouse was previously successfully established to determine the anti-obesity properties of t10c12-CLA in male mice that could produce endogenous t10c12-CLA. To test whether there is a different impact of t10c12-CLA on lipid metabolism in both sexes, this study investigated the adiposity and metabolic profiles of female Pai mice that exhibited a dose-dependent expression of foreign Pai gene and a shift of t10c12-CLA content in tested tissues. Compared to their gender-match wild-type littermates, Pai mice had no fat reduction but exhibited enhanced lipolysis and thermogenesis by phosphorylated hormone-sensitive lipase and up-regulating uncoupling proteins in brown adipose tissue. Simultaneously, Pai mice showed hepatic steatosis and hypertriglyceridemia by decreasing gene expression involved in lipid and glucose metabolism. Further investigations revealed that t10c10-CLA induced excessive prostaglandin E2, adrenaline, corticosterone, glucagon and inflammatory factors in a dose-dependent manner, resulting in less heat release and oxygen consumption in Pai mice. Moreover, fibroblast growth factor 21 overproduction only in monoallelic Pai/wt mice indicates that it was sensitive to low doses of t10c12-CLA. These results suggest that chronic t10c12-CLA has system-wide effects on female health via synergistic actions of various hormones.
Topics: Animals; Female; Fibroblast Growth Factors; Mice, Transgenic; Mice; Linoleic Acids, Conjugated; Corticosterone; Dinoprostone; Glucagon; Epinephrine; Thermogenesis; Male; Lipid Metabolism; Adipose Tissue, Brown; Fatty Liver; Lipolysis; Hypertriglyceridemia; Adiposity
PubMed: 38816541
DOI: 10.1038/s41598-024-63282-7 -
The Medical Clinics of North America Jul 2024Allergy to penicillin can occur via any of the 4 types of Gel-Coombs hypersensitivity reactions, producing distinct clinical histories and physical examination findings.... (Review)
Review
Allergy to penicillin can occur via any of the 4 types of Gel-Coombs hypersensitivity reactions, producing distinct clinical histories and physical examination findings. Treatments include penicillin discontinuation, and depending on the type of reaction, epinephrine, antihistamines, and/or glucocorticoids. Most beta-lactams may be safely used in penicillin-allergic patients, with the possible exception of first-generation and second-generation cephalosporins. Penicillin testing includes skin testing, patch testing, and graded challenge. The selection of the type of testing depends on the clinical setting, equipment availability, and type of hypersensitivity reaction. Desensitization may be used in some cases where treatment with penicillins is essential.
Topics: Humans; Penicillins; Drug Hypersensitivity; Anti-Bacterial Agents; Skin Tests; Epinephrine; Patch Tests
PubMed: 38816110
DOI: 10.1016/j.mcna.2023.08.009 -
The Medical Clinics of North America Jul 2024Food allergy is a growing health problem affecting both pediatric and adult patients. Food allergies are often immunoglobulin E (IgE) mediated but other food-induced...
Food allergy is a growing health problem affecting both pediatric and adult patients. Food allergies are often immunoglobulin E (IgE) mediated but other food-induced non-IgE-mediated diseases exist. Diagnosis of food allergy relies on the combination of clinical and reaction history, skin and IgE testing as well as oral food challenges. Although oral immunotherapy has been able to achieve sustained unresponsiveness in some patients, no cure for food allergies has been found to date. Avoidance of the inciting food as well as availability of epinephrine autoinjectors remains the mainstay of treatment.
Topics: Humans; Desensitization, Immunologic; Epinephrine; Food Hypersensitivity; Immunoglobulin E; Skin Tests
PubMed: 38816109
DOI: 10.1016/j.mcna.2023.08.003 -
BMJ Open May 2024To determine the prevalence, causes and risk factors associated with visual impairment (VI) in the Nirmal district of Telangana, India, using extended Rapid Assessment...
OBJECTIVE
To determine the prevalence, causes and risk factors associated with visual impairment (VI) in the Nirmal district of Telangana, India, using extended Rapid Assessment of Visual Impairment (RAVI) methodology.
DESIGN
Cross-sectional study.
SETTING
Community setting.
PARTICIPANTS
Participants aged ≥16 years were enumerated from 90 randomly selected clusters and 4629/5400 (85.7%) participants were examined. Presenting visual acuity (VA) was assessed using a Snellen chart with E optotypes at a 6 m distance. Near vision was assessed binocularly using an N notation chart with tumbling E optotypes at a 40 cm distance. An anterior segment examination done followed by distance direct ophthalmoscopy at 50 cm. Non-mydriatic fundus images were obtained. VI was defined as presenting VA worse than 6/12 in the better eye. The prevalence of VI in the current study was compared with a RAVI study conducted in 2014 to assess the trends in VI among those aged ≥40 years.
PRIMARY OUTCOME
Prevalence, causes and risk factors for VI.
RESULTS
Among those examined, 55% were women, 53% had at least school-level education, 2.3% self-reported diabetes and 8.7% self-reported hypertension. The prevalence of VI was 8.81% (95% CI 8.01% to 9.67%). Overall, uncorrected refractive errors (49.5%) were the leading cause of VI, followed by cataracts (40.2%) and posterior segment diseases (4.9%). Among those aged ≥40 years, the prevalence of VI declined by 19.3% compared with the 2014 baseline study (from 20.2% to 16.3%; p<0.01).
CONCLUSION
The extended RAVI study conducted in the Nirmal district showed a considerable decline in the prevalence of VI. Targeted interventions are needed to provide adequate eye care for the high-risk groups in this district.
Topics: Humans; Cross-Sectional Studies; India; Female; Male; Middle Aged; Adult; Prevalence; Risk Factors; Aged; Young Adult; Adolescent; Visual Acuity; Vision Disorders; Cataract
PubMed: 38816051
DOI: 10.1136/bmjopen-2023-083199 -
Current Opinion in Allergy and Clinical... Aug 2024Perioperative hypersensitivity reactions are rare but potentially catastrophic events. This review acts to summarize recent recommendations for both immediate and... (Review)
Review
PURPOSE OF REVIEW
Perioperative hypersensitivity reactions are rare but potentially catastrophic events. This review acts to summarize recent recommendations for both immediate and poststabilization management of suspected reactions, alongside practical advice for anaesthetists who may be faced with these events.
RECENT FINDINGS
Prompt treatment is essential but may be hampered by delay in recognition. This can occur because there are multiple differential diagnoses for the observed clinical signs as well as variations in clinical presentation. Resuscitation is dependent on the use of adrenaline and fluids. Adrenaline should be administered in small, titrated intravenous boluses. Low-dose infusions should be commenced early if the response to boluses is poor. Large volume fluid resuscitation may be required to maintain adequate circulating volume. Chest compressions are recommended when there is evidence of inadequate perfusion, rather than waiting until cardiac arrest is confirmed. Antihistamines and corticosteroids are no longer recommended in the immediate management phase. Once the patient has been stabilized, it is important to obtain serial tryptase concentrations to aid the subsequent clinic investigation. The decision to proceed or abandon surgery will be based on an individual risk-benefit analysis. All cases of suspected perioperative hypersensitivity, including fatal cases, must be referred for formal investigation.
SUMMARY
There have been recent updates to management guidelines in perioperative hypersensitivity. Treatment algorithms, treatment packs and referral packs can all help the anaesthetist manage these complex cases, aid the subsequent investigation and ensure patient safety in the future.
Topics: Humans; Epinephrine; Perioperative Period; Anaphylaxis; Practice Guidelines as Topic; Hypersensitivity; Adrenal Cortex Hormones; Drug Hypersensitivity
PubMed: 38814699
DOI: 10.1097/ACI.0000000000001000 -
Biomedicine & Pharmacotherapy =... Jul 2024Alzheimer's disease (AD) presents a significant challenge due to its prevalence and lack of cure, driving the quest for effective treatments. Anshen Bunao Syrup, a...
Alzheimer's disease (AD) presents a significant challenge due to its prevalence and lack of cure, driving the quest for effective treatments. Anshen Bunao Syrup, a traditional Chinese medicine known for its neuroprotective properties, shows promise in addressing this need. However, understanding its precise mechanisms in AD remains elusive. This study aimed to investigate Anshen Bunao Syrup's therapeutic potential in AD treatment using a scopolamine-induced AD rat model. Assessments included novel-object recognition and Morris water maze tasks to evaluate spatial learning and memory, alongside Nissl staining and ELISA analyses for neuronal damage and biomarker levels. Results demonstrated that Anshen Bunao Syrup effectively mitigated cognitive dysfunction by inhibiting amyloid-β and phosphorylation Tau aggregation, thereby reducing neuronal damage. Metabolomics profiling of rats cortex revealed alterations in key metabolites implicated in tryptophan and fatty acid metabolism pathways, suggesting a role in the therapeutic effects of Anshen Bunao Syrup. Additionally, ELISA and correlation analyses indicated attenuation of oxidative stress and immune response through metabolic remodeling. In conclusion, this study provides compelling evidence for the neuroprotective effects of Anshen Bunao Syrup in AD models, shedding light on its potential as a therapeutic agent for AD prevention and treatment.
Topics: Animals; Alzheimer Disease; Neuroprotective Agents; Disease Models, Animal; Male; Cognitive Dysfunction; Rats; Drugs, Chinese Herbal; Rats, Sprague-Dawley; Oxidative Stress; Amyloid beta-Peptides; Maze Learning; Scopolamine; tau Proteins; Morris Water Maze Test
PubMed: 38810401
DOI: 10.1016/j.biopha.2024.116754 -
Plastic and Reconstructive Surgery Jun 2024After studying this article, the participant should be able to: 1. Explain the most important benefits of wide-awake surgery to patients. 2. Tumesce large parts of the...
LEARNING OBJECTIVES
After studying this article, the participant should be able to: 1. Explain the most important benefits of wide-awake surgery to patients. 2. Tumesce large parts of the body with minimal pain local anesthesia injection technique to eliminate the need for sedation for many operations. 3. Apply tourniquet-free surgery to upper and lower limb operations to avoid the sedation required to tolerate tourniquet pain. 4. Move many procedures out of the main operating room to minor procedure rooms with no increase in infection rates to decrease unnecessary cost and solid waste in surgery.
SUMMARY
Three disruptive innovations are changing the landscape of surgery: (1) minimally painful injection of large-volume, low-concentration tumescent local anesthesia eliminates the need for sedation for many procedures over the entire body; (2) epinephrine vasoconstriction in tumescent local anesthesia is a good alternative to the tourniquet and proximal nerve blocks in extremity surgery (sedation for tourniquet pain is no longer required for many procedures); and (3) evidence-based sterility and the elimination of sedation enable many larger procedures to move out of the main operating room into minor procedure rooms with no increase in infection rates. This continuing medical education article explores some of the new frontiers in which these changes affect surgery all over the body.
Topics: Humans; Anesthesia, Local; Epinephrine; Anesthetics, Local; Tourniquets; Vasoconstrictor Agents
PubMed: 38810165
DOI: 10.1097/PRS.0000000000011414 -
Postgraduate Medicine May 2024Over-testing and over-treatment are common in children with croup at pediatric emergency departments (PED). The objective of the study was to improve care for children...
OBJECTIVES
Over-testing and over-treatment are common in children with croup at pediatric emergency departments (PED). The objective of the study was to improve care for children with croup.
METHODS
In this quality improvement (QI) initiative, all pediatric residents starting their rotation in the PED attended an informative presentation about croup and were provided reminders throughout their rotation. The primary outcome of this QI initiative was to reduce nebulized epinephrine (NE) use among children with mild croup by 50% over 7 months. The secondary outcome was to reduce X-rays by 50% over 7 months. Other outcomes included the administration of dexamethasone to all children with croup, reduction of antibiotics, laboratory tests, and revisits, and shortening the duration between physical examination to dexamethasone and NE treatments, and the length of stay (LOS) at the PED.
RESULTS
NE administration to patients with mild croup decreased from 80.2% to 36.3% ( < 0.001). The proportion of children with X-rays decreased from 37.4% to 17.1% ( < 0.001). There was a significant increase in dexamethasone administration, and significant decreases in laboratory blood tests, expanded viral PCR panel tests, and antibiotic prescription among all croup cases ( < 0.001). Revisit rates were not significantly different ( > 0.05). Time to dexamethasone and LOS shortened significantly ( < 0.001).
CONCLUSION
With this QI intervention, decreases in the rate of administration of NE to mild croup cases, antibiotic prescription, X-ray, laboratory blood and respiratory PCR panel tests in all croup cases were achieved without an increase in revisits. However, unnecessary NE, antibiotic, and X-ray rates are still high.
Topics: Humans; Croup; Emergency Service, Hospital; Dexamethasone; Quality Improvement; Epinephrine; Female; Male; Infant; Child, Preschool; Anti-Bacterial Agents; Child; Length of Stay; Bronchodilator Agents; Nebulizers and Vaporizers
PubMed: 38804969
DOI: 10.1080/00325481.2024.2360889 -
Nutrients May 2024Polymethoxyflavonoids, such as nobiletin (abundant in Citrus depressa), have been reported to have antioxidant, anti-inflammatory, anticancer, and anti-dementia effects,...
Polymethoxyflavonoids, such as nobiletin (abundant in Citrus depressa), have been reported to have antioxidant, anti-inflammatory, anticancer, and anti-dementia effects, and are also a circadian clock modulator through retinoic acid receptor-related orphan receptor (ROR) α/γ. However, the optimal timing of nobiletin intake has not yet been determined. Here, we explored the time-dependent treatment effects of nobiletin and a possible novel mechanistic idea for nobiletin-induced circadian clock regulation in mice. In vivo imaging showed that the PER2::LUC rhythm in the peripheral organs was altered in accordance with the timing of nobiletin administration (100 mg/kg). Administration at ZT4 (middle of the light period) caused an advance in the peripheral clock, whereas administration at ZT16 (middle of the dark period) caused an increase in amplitude. In addition, the intraperitoneal injection of nobiletin significantly and potently stimulated corticosterone and adrenaline secretion and caused an increase in expression in the peripheral tissues. Nobiletin inhibited phosphodiesterase (PDE) 4A1A, 4B1, and 10A2. Nobiletin or rolipram (PDE4 inhibitor) injection, but not SR1078 (RORα/γ agonist), caused acute expression in the peripheral tissues. Thus, the present study demonstrated a novel function of nobiletin and the regulation of the peripheral circadian clock.
Topics: Animals; Flavones; Circadian Clocks; Mice; Male; Corticosterone; Period Circadian Proteins; Epinephrine; Mice, Inbred C57BL; Nuclear Receptor Subfamily 1, Group F, Member 1; Circadian Rhythm
PubMed: 38794729
DOI: 10.3390/nu16101491 -
Cell Host & Microbe Jun 2024Inflammatory bowel disease (IBD) is characterized by dysbiosis of the gut microbiota and dysfunction of intestinal stem cells (ISCs). However, the direct interactions...
Inflammatory bowel disease (IBD) is characterized by dysbiosis of the gut microbiota and dysfunction of intestinal stem cells (ISCs). However, the direct interactions between IBD microbial factors and ISCs are undescribed. Here, we identify α-adrenergic receptor (ADRA2A) as a highly expressed GPCR in ISCs. Through PRESTO-Tango screening, we demonstrate that tyramine, primarily produced by Enterococcus via tyrosine decarboxylase (tyrDC), serves as a microbial ligand for ADRA2A. Using an engineered tyrDC-deficient Enterococcus faecalis strain and intestinal epithelial cell-specific Adra2a knockout mice, we show that Enterococcus-derived tyramine suppresses ISC proliferation, thereby impairing epithelial regeneration and exacerbating DSS-induced colitis through ADRA2A. Importantly, blocking the axis with an ADRA2A antagonist, yohimbine, disrupts tyramine-mediated suppression on ISCs and alleviates colitis. Our findings highlight a microbial ligand-GPCR pair in ISCs, revealing a causal link between microbial regulation of ISCs and colitis exacerbation and yielding a targeted therapeutic approach to restore ISC function in colitis.
Topics: Animals; Tyramine; Colitis; Mice; Receptors, Adrenergic, alpha-2; Mice, Knockout; Stem Cells; Humans; Mice, Inbred C57BL; Tyrosine Decarboxylase; Enterococcus faecalis; Gastrointestinal Microbiome; Intestinal Mucosa; Yohimbine; Disease Models, Animal; Enterococcus; Intestines; Cell Proliferation; Inflammatory Bowel Diseases; Dextran Sulfate
PubMed: 38788722
DOI: 10.1016/j.chom.2024.04.020