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https://www.readbyqxmd.com/read/27911458/spondylodiscitis-a-rare-complication-following-percutaneous-nephrostomy
#1
Francesco Chiancone, Maurizio Fedelini, Clemente Meccariello, Luigi Pucci, Marco Fabiano, Paolo Fedelini
Spondylodiscitis is an inflammation of the intervertebral disc and the adjacent vertebral bodies. The spondylodiscitis can not only be a complication of medical interventions such as an operation near spinal column but also urogenital and vascular interventions and intravenous catheter use. A 71-year-old man was admitted to our emergency department with fever and severe abdominal pain. Antibiotic therapy had been performed with intravenous administration of 2 g of ceftriaxone and the patient underwent the placement of a percutaneous nephrostomy according to Seldinger technique...
November 28, 2016: Urologia
https://www.readbyqxmd.com/read/27909958/using-group-medical-visits-with-those-who-have-diabetes-examining-the-evidence
#2
REVIEW
Laura M Housden, Sabrina T Wong
The number of people with diabetes is expected to rise to over 592 million by the year 2035. Past work provides evidence that the conventional method of primary care delivery may not meet many patients' needs. An alternative to the conventional one-on-one appointment is care offered to a group of patients through group medical visits (GMVs). Group medical visits for diabetes have a positive impact on physiologic and self-care outcomes including improved HbA1c, blood pressure control and self-management skills...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27908765/long-term-requirement-for-pacemaker-implantation-after-cardiac-valve-replacement-surgery
#3
Francisco Leyva, Tian Qiu, David McNulty, Felicity Evison, Howard Marshall, Maurizio Gasparini
BACKGROUND: The risk of permanent pacemaker implantation (PPI) after cardiac valve replacement surgery is thought be highest in the post-operative period. Long-term risks are uncertain. OBJECTIVE: To determine rates and timing of PPI after valve replacement surgery. METHODS: We compared PPI rates patients undergoing aortic (AVR, n = 111,674), mitral (MVR, n = 18,402) valve replacement, AVR+MVR (n = 5,166) or AVR + MVR and tricuspid valve replacement (TVR, n = 114) or CABG without valve replacement (n=249,742)...
November 28, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27908315/-life-threatening-ketoacidosis-in-a-25-year-old-woman-treated-with-sodium-glucose-cotransporter-2-inhibitor
#4
Mats Jacob Hermansson Lindberg, Frans Brandt Kristensen, Alev Yildiz
We report a case of atypical ketoacidosis in a patient treated with a sodium-glucose cotransporter- (SGLT) 2 inhibitor. The 25-year-old woman, who one year earlier had been prescribed dapagliflozin for presumed Type 2 diabetes, came to the emergency department in a state of severe ketoacidosis, pH 6.85, and a plasma glucose level of 14.3 mmol/l. She received standard treatment and recovered. We discuss the increasing evidence for atypical ketoacidosis being a serious side effect of the SGLT2 inhibitors.
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27907062/sepsis-prevalence-and-outcome-on-the-general-wards-and-emergency-departments-in-wales-results-of-a-multi-centre-observational-point-prevalence-study
#5
Tamas Szakmany, Robert M Lundin, Ben Sharif, Gemma Ellis, Paul Morgan, Maja Kopczynska, Amrit Dhadda, Charlotte Mann, Danielle Donoghue, Sarah Rollason, Emma Brownlow, Francesca Hill, Grace Carr, Hannah Turley, James Hassall, James Lloyd, Llywela Davies, Michael Atkinson, Molly Jones, Nerys Jones, Rhodri Martin, Yousef Ibrahim, Judith E Hall
Data on sepsis prevalence on the general wards is lacking on the UK and in the developed world. We conducted a multicentre, prospective, observational study of the prevalence of patients with sepsis or severe sepsis on the general wards and Emergency Departments (ED) in Wales. During the 24-hour study period all patients with NEWS≥3 were screened for presence of 2 or more SIRS criteria. To be eligible for inclusion, patients had to have a high clinical suspicion of an infection, together with a systemic inflammatory response (sepsis) and evidence of acute organ dysfunction and/or shock (severe sepsis)...
2016: PloS One
https://www.readbyqxmd.com/read/27904677/an-engineered-fgf21-variant-ly2405319-can-prevent-non-alcoholic-steatohepatitis-by-enhancing-hepatic-mitochondrial-function
#6
Ju Hee Lee, Yea Eun Kang, Joon Young Chang, Ki Cheol Park, Hyeon-Woo Kim, Jung Tae Kim, Hyun Jin Kim, Hyon-Seung Yi, Minho Shong, Hyo Kyun Chung, Koon Soon Kim
Non-alcoholic fatty liver disease (NAFLD) is a prevalent obesity-related disease that affects large populations throughout the world due to excessive calorie intake and an increasingly sedentary lifestyle. Fibroblast growth factor 21 (FGF21) has recently emerged as a promising therapeutic candidate for the treatment of obesity and diabetes. FGF21 is a starvation-induced pleiotropic hormone with various beneficial metabolic effects, and pharmacological treatment in rodents has been shown to improve insulin sensitivity and decrease simple fatty liver disease...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27904654/augmentation-of-histone-deacetylase-3-hdac3-epigenetic-signature-at-the-interface-of-proinflammation-and-insulin-resistance-in-patients-with-type-2-diabetes
#7
Chandrakumar Sathishkumar, Paramasivam Prabu, Mahalingam Balakumar, Raji Lenin, Durai Prabhu, Ranjith Mohan Anjana, Viswanathan Mohan, Muthuswamy Balasubramanyam
BACKGROUND: A role of proinflammation has been implicated in the pathogenesis of diabetes, but the up-stream regulatory signals and molecular signatures are poorly understood. While histone modifications such as changes in histone deacetylase (HDAC) are emerging as novel epigenetic biomarkers, there is lack of studies to demonstrate their clinical relevance in diabetes. Therefore, we investigated the extent of HDAC machinery and inflammatory signals in peripheral blood mononuclear cells (PBMCs) from patients with type 2 diabetes mellitus (T2DM) compared to control subjects...
2016: Clinical Epigenetics
https://www.readbyqxmd.com/read/27903852/topical-honey-in-the-management-of-pediatric-peritoneal-dialysis-exit-sites
#8
Thomas A Forbes, Loren Shaw, Catherine Quinlan
International guidelines in peritoneal dialysis (PD) advocate for regular application of topical mupirocin in chronic PD exit-site care. A strong evidence base links this treatment to reduced rates of exit-site infections and peritonitis. However, emerging reports of increasing mupirocin resistance and gram-negative infections are threatening the long-term viability of topical antibiotic ointments as a prophylactic treatment. Medical grade honey has multiple proven antibacterial and wound healing properties...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27903472/-endovascular-treatment-of-poplital-artery-aneurysms-a-word-of-caution-after-long-term-follow-up
#9
Cosimo Maraglino, Gianluca Canu, Renzo Ambrosi, Franco Briolini, Riccardo Gotti, Pietro Cefalì, Fabio Calliari, Paolo Ferrero, Franco Terraneo
PURPOSE: The aim of this work was to evaluate the long-term patency of endo-grafting in the treatment of popliteal artery aneurysms (Paa) and to identify which factors may be predictor of graft occlusion. METHODS: All the patients that underwent endovascular repair of Paa were analyzed from 2006 until 2014 on the basis of symptoms, comorbidities, limb salvage and long-term patency. The predictive value of the different variables was assessed in univariate analysis for primary patency and, for factors resulted significant, a multivariate analysis was performed...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27902390/virulence-determinants-in-clinical-staphylococcus-aureus-from-monomicrobial-and-polymicrobial-infections-of-diabetic-foot-ulcers
#10
Kavitha Shettigar, Spoorthi Jain, Deepika V Bhat, Raviraj Acharya, Lingadakai Ramachandra, Kapaettu Satyamoorthy, T S Murali
Antibiotic resistance in Staphylococcus aureus is a major public health concern and Methicillin Resistant S. aureus has emerged as an important pathogen. We characterized S. aureus isolates from monomicrobial and polymicrobial wound infections from 200 diabetic individuals with foot ulcers to understand their underlying diversity and pathogenicity. Staphylococcal Cassette Chromosome mec typing was performed and genes coding for production of biofilm, Panton-Valentine Leukocidin, Toxic Shock Syndrome Toxin, Leukotoxins DE and M were screened...
October 19, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27900395/microbiome-and-metabolic-disease-revisiting-the-bacterial-phylum-bacteroidetes
#11
REVIEW
Elizabeth L Johnson, Stacey L Heaver, William A Walters, Ruth E Ley
Bacterial species composition in the gut has emerged as an important factor in obesity and its related metabolic diseases such as type 2 diabetes. Out of thousands of bacterial species-level phylotypes inhabiting the human gut, the majority belong to two dominant phyla, the Bacteroidetes and Firmicutes. Members of the Bacteroidetes in particular have been associated with human metabolic diseases. However, their associations with disease are not always consistent between studies. Delving deeper into the diversity within the Bacteroidetes reveals a vast diversity in genomes and capacities, which partly explain how not all members respond equally to similar environmental conditions in their hosts...
November 29, 2016: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
https://www.readbyqxmd.com/read/27899417/emerging-roles-of-glis3-in-neonatal-diabetes-type-1-and-type-2-diabetes
#12
Xianjie Wen, Yisheng Yang
GLI-similar 3 (GLIS3), a member of the Krüppel-like zinc finger protein subfamily, is predominantly expressed in the pancreas, thyroid, and kidney. Glis3 mRNA can be initially detected in mouse pancreas at embryonic day 11.5 and is largely restricted to β cells, pancreatic polypeptide-expressing cells, as well as ductal cells at later stage of pancreas development. Mutations in GLIS3 cause a neonatal diabetes syndrome, characterized by neonatal diabetes, congenital hypothyroidism, and polycystic kidney. Importantly, genome-wide association studies showed that variations of GLIS3 are strongly associated with both type 1 diabetes (T1D) and type 2 diabetes (T2D) in multiple populations...
November 29, 2016: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/27898522/context-dependent-effects-of-dipeptidyl-peptidase-4-inhibitors
#13
Edwin K Jackson
PURPOSE OF REVIEW: The antidiabetic mechanism of dipeptidyl peptidase 4 (DPP4) inhibitors is attributed to attenuation of incretin metabolism. Because DPP4 has at least 45 substrates, context-dependent off-target effects of DPP4 inhibitors are likely. Here, we consider the clinical ramifications of the context-dependent effects of DPP4 inhibitors. RECENT FINDINGS: Although incretins protect organs from diabetic injury, nonincretin DPP4 substrates also accumulate when DPP4 is inhibited...
November 24, 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27898055/increased-dna-methylation-variability-in-type-1-diabetes-across-three-immune-effector-cell-types
#14
Dirk S Paul, Andrew E Teschendorff, Mary A N Dang, Robert Lowe, Mohammed I Hawa, Simone Ecker, Huriya Beyan, Stephanie Cunningham, Alexandra R Fouts, Anita Ramelius, Frances Burden, Samantha Farrow, Sophia Rowlston, Karola Rehnstrom, Mattia Frontini, Kate Downes, Stephan Busche, Warren A Cheung, Bing Ge, Marie-Michelle Simon, David Bujold, Tony Kwan, Guillaume Bourque, Avik Datta, Ernesto Lowy, Laura Clarke, Paul Flicek, Emanuele Libertini, Simon Heath, Marta Gut, Ivo G Gut, Willem H Ouwehand, Tomi Pastinen, Nicole Soranzo, Sabine E Hofer, Beate Karges, Thomas Meissner, Bernhard O Boehm, Corrado Cilio, Helena Elding Larsson, Åke Lernmark, Andrea K Steck, Vardhman K Rakyan, Stephan Beck, R David Leslie
The incidence of type 1 diabetes (T1D) has substantially increased over the past decade, suggesting a role for non-genetic factors such as epigenetic mechanisms in disease development. Here we present an epigenome-wide association study across 406,365 CpGs in 52 monozygotic twin pairs discordant for T1D in three immune effector cell types. We observe a substantial enrichment of differentially variable CpG positions (DVPs) in T1D twins when compared with their healthy co-twins and when compared with healthy, unrelated individuals...
November 29, 2016: Nature Communications
https://www.readbyqxmd.com/read/27895393/emerging-role-of-obeticholic-acid-in-the-management-of-nonalcoholic-fatty-liver-disease
#15
EDITORIAL
Evangelia Makri, Evangelos Cholongitas, Konstantinos Tziomalos
Nonalcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease and its prevalence is increasing driven by the pandemic of obesity and type 2 diabetes mellitus. NAFLD can progress to cirrhosis and is associated with increased risk for cardiovascular disease and hepatocellular cancer. Diet and exercise are limited by suboptimal long-term adherence in patients with NAFLD. On the other hand, current pharmacological treatment of NAFLD has limited efficacy and unfavorable safety profile. In this context, obeticholic acid (OCA), a selective agonist of the farnesoid X receptors, might represent a useful option in these patients...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27895320/clinical-experience-with-pancreas-graft-rescue-from-severe-thrombus-after-simultaneous-pancreas-kidney-transplantation-by-early-detection-with-doppler-ultrasound-a-case-report
#16
Mitsunobu Takeda, Daisaku Yamada, Hidetoshi Eguchi, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Kunihito Goto, Koichi Kawamoto, Yutaka Takeda, Masahiro Tanemura, Toshinori Ito, Masaki Mori, Yuichiro Doki
BACKGROUND Graft thrombosis is the main cause of early graft loss after transplantation. In Japan, pancreases available for transplantation are frequently from marginal donors due to diverse backgrounds in the population. However, marginal tissues increase the risk of early thrombosis in the graft. CASE REPORT Here, we describe a 41-year-old woman with type 1 diabetes mellitus who underwent a simultaneous pancreas-kidney transplantation. The pancreas was retrieved from a 34-year-old man who had experienced severe hemodynamic instability...
November 29, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27895093/stroke-paradox-with-sglt-2-inhibitors-a-play-of-chance-or-a-viscosity-mediated-reality
#17
REVIEW
Konstantinos P Imprialos, Chrysoula Boutari, Konstantinos Stavropoulos, Michael Doumas, Asterios I Karagiannis
Diabetes mellitus is a major risk factor for cardiovascular morbidity and mortality. Current therapeutic strategies have not provided constant beneficial cardiovascular-related results. Sodium-glucose co-transporters 2 (SGLT-2) inhibitors have emerged as a novel antidiabetic class of drugs that exert favourable results in a variety of other cardiovascular risk factors too, such as increased blood pressure and body weight. The Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) study was the first trial that evaluated cardiovascular outcomes in patients with diabetes with the use of empagliflozin, a member of this new class of drugs...
November 28, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27893672/risk-factors-of-severe-hypoglycemia-requiring-medical-assistance-and-neurological-sequelae-in-patients-with-diabetes-a-case-control-study
#18
Ja Young Jeon, Se Ran Kim, Hae Jin Kim, Dae Jung Kim, Kwan-Woo Lee, Jung-Dong Lee, Seung Jin Han
Hypoglycemia commonly occurs in patients who are being treated for diabetes. In some cases, these patients suffer from severe hypoglycemia that requires medical assistance and which can unfortunately result in long-term disabilities. Therefore, we investigated risk factors associated with severe hypoglycemia requiring medical assistance (HMA) and the resulting neurological sequelae in patients with diabetes. This investigation was a case-control study that assessed 129 patients with diabetes and documented hypoglycemia from a single tertiary hospital between February 2013 and May 2015...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893617/differential-role-of-b-cells-and-il-17-versus-ifn-%C3%AE-during-early-and-late-rejection-of-pig-islet-xenografts-in-mice
#19
Hee Kap Kang, Shusen Wang, Anil Dangi, Xiaomin Zhang, Amar Singh, Lei Zhang, James M Rosati, Wilma Suarez-Pinzon, Xuelian Deng, Xiaoyan Chen, Edward B Thorp, Bernhard J Hering, Stephen D Miller, Xunrong Luo
BACKGROUND: Xenogeneic islet transplantation is an emerging therapeutic option for diabetic patients. However, immunological tolerance to xenogeneic islets remains a challenge. METHODS: The current study used a pig-to-mouse discordant xenogeneic islet transplant model to examine anti-donor xenogeneic immune responses during early and late rejection, and to determine experimental therapeutic interventions that promote durable pig islet xenograft survival. RESULTS: We found that during early acute rejection of pig islet xenografts, the rejecting hosts exhibited a heavy graft infiltration with B220 B cells and a robust anti-pig antibody production...
November 23, 2016: Transplantation
https://www.readbyqxmd.com/read/27893129/us-emergency-department-visits-for-outpatient-adverse-drug-events-2013-2014
#20
Nadine Shehab, Maribeth C Lovegrove, Andrew I Geller, Kathleen O Rose, Nina J Weidle, Daniel S Budnitz
Importance: The Patient Protection and Affordable Care Act of 2010 brought attention to adverse drug events in national patient safety efforts. Updated, detailed, nationally representative data describing adverse drug events can help focus these efforts. Objective: To describe the characteristics of emergency department (ED) visits for adverse drug events in the United States in 2013-2014 and describe changes in ED visits for adverse drug events since 2005-2006...
November 22, 2016: JAMA: the Journal of the American Medical Association
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