Risk of coronary artery disease in patients with idiopathic inflammatory myopathies: A systematic review and meta-analysis of observational studies

Objectives

To investigate the risk of coronary artery disease in patients with idiopathic inflammatory myopathies (IIM).

Methods

We conducted a systematic review and meta-analysis of observational studies that reported odds ratios, relative risks, hazard ratios, or standardized incidence ratios comparing the risk of coronary artery disease in patients with IIM versus non-IIM participants. We searched published studies indexed in MEDLINE, EMBASE, and the Cochrane database from inception to December 2013 using the terms “coronary artery disease” OR “coronary heart disease” OR “myocardial infarction” OR “atherosclerosis” combined with the terms “dermatomyositis” OR “polymyositis” OR “Idiopathic inflammatory myopathy.” Pooled risk ratio and 95% confidence interval were calculated using a random-effect, generic inverse variance method.

Result

Overall, four studies were identified and included for data analysis. The pooled risk ratio of CAD in patients with IIM was 2.24 (95% CI: 1.02–4.92). The statistical heterogeneity of this meta-analysis was high with an I² of 97%.

Conclusion

Our study demonstrated a statistically significant increased risk of CAD among patients with IIM.     

Influence of Temperature on Void Collapse in Single Crystal Nickel under Hydrostatic Compression

Employing atomistic simulations, we investigated the void collapse mechanisms in single crystal Ni during hydrostatic compression and explored how the atomistic mechanisms of void collapse are influenced by temperature. Our results suggest that the emission and associated mutual interactions of dislocation loops around the void is the primary mechanism of void collapse, irrespective of the temperature. The rate of void collapse is almost insensitive to the temperature, and the process is not thermally activated until a high temperature (∼1200–1500 K) is reached. Our simulations reveal that, at elevated temperatures, dislocation motion is assisted by vacancy diffusion and consequently the void is observed to collapse continuously without showing appreciable strain hardening around it. In contrast, at low and ambient temperatures (1 and 300 K), void collapse is delayed after an initial stage of closure due to significant strain hardening around the void. Furthermore, we observe that the dislocation network produced during void collapse remains the sample even after complete void collapse, as was observed in a recent experiment of nickel-base superalloy after hot isostatic pressing.     

Effects of Fructo-Oligosaccharide Supplementation on Constipation in Elderly Continuous Ambulatory Peritoneal Dialysis Patients

♦ Background:

Fructo-oligosaccharides (FOS) exhibit soluble-fiber properties that beneficially affect bowel function and relieve constipation. The effects of FOS supplementation on constipation and biochemical parameters were examined in elderly continuous ambulatory peritoneal dialysis (CAPD) patients.

♦ Methods:

This randomized, double-blind, placebo-controlled, cross-over study was performed in elderly CAPD patients (5 males and 4 females) with chronic constipation. All subjects were randomly assigned to receive either 20 g FOS or placebo daily for 30 days. After a 14-day washout period, the patients were switched to the other substance for 1 more month. Before and after each treatment period, frequency of defecation, characteristics of feces, and colonic transit were evaluated. Biochemical parameters were also assessed.

♦ Results:

Fructo-oligosaccharides significantly increased the frequency of defecation (10.5 ± 2.0 vs 6.2 ± 1.4 times per week, p < 0.005) and changed the feces'' appearance from type 1 (nut-like) to type 4 (sausage–like). The colonic transit determined by geometric center (GC) was augmented after FOS supplementation (3.9 ± 0.3 vs 3.2 ± 0.4, p < 0.05). Fructo-oligosaccharides had no effects on biochemical parameters. Fructo-oligosaccharides caused mild discomforts which were well tolerated after dose adjustment.

♦ Conclusions:

Fructo-oligosaccharide supplementation is effective, well tolerated, and can be an alternative to other laxatives in CAPD patients with constipation. Further studies are needed to better assess the biochemical effects of FOS in the chronic kidney disease population.     

The Importance of CYP19A1 in Estrogen Receptor-Positive Cholangiocarcinoma

CYP19A1, also called aromatase, is a key enzyme for converting androgens to estrogens of estrogen synthesis. Elevated serum estrogen and high expression levels of estrogen-related proteins are found in cholangiocarcinoma (CCA; bile duct cancer). However, the expression of CYP19A1 in relation to estrogen-related proteins, including estrogen receptors (ERα, ERβ, and GPR30) and an estrogen response protein (TFF1), has never been explored in CCA. In this study, we investigated the expressions of CYP19A1 and estrogen-related proteins in CCA tissues (n?=?74; 51 males and 23 females) using immunohistochemistry. The results showed that CYP19A1 was overexpressed in CCA cells compared with that in normal bile duct cells in the adjacent tissues. High expression of CYP19A1 was correlated with the metastatic status of the patients. High CYP19A1 expression was also positively correlated with GPR30 expression. Correlation between high CYP19A1 expression in the tumor tissues and shorter survival time was more prominent in male than in female CCA patients. To elucidate further, the effect of CYP19A1 knockdown on a CCA cell line was examined using a specific siRNA. When CYP19A1 gene expression was suppressed, migration and proliferation activities of CCA cells were significantly reduced. Moreover, the cell proliferation of high CYP19A1-expressing KKU-213 cells was more profoundly suppressed by CYP19A1 inhibitors (exemestane and letrozole) than low CYP19A1-expressing KKU-100 cells. Thus, CYP19A1 promotes CCA progression with aggressive clinical outcomes via increased migration and proliferation activities of cancer cells. CYP19A1 can be a potential chemotherapeutic target for CCA, especially in male patients.     

Complex interaction of hemoglobin (Hb) Nakhon Ratchasima [α63(E12)Ala→Val], a novel α2-globin chain variant with Hb E [β26(B8)Glu→Lys] and a deletional α(+)-thalassemia

Objectives: To describe the hematological and molecular features as well as diagnostic aspects of a complex hemoglobinopathy caused by interaction of a novel α2‐globin chain variant with hemoglobin (Hb) E and α⁺‐thalassemia. Methods: Blood specimen of a 41‐yr‐old Thai man was transferred to our center for the analysis of unknown Hb variant. Hb analysis was carried out using automated high‐performance liquid chromatography (HPLC) and capillary electrophoresis system. Mutation was identified by PCR and related techniques. Results: RBC analysis revealed a mild anemia but blood indices were within normal ranges. Hb‐HPLC analysis demonstrated, in addition to the Hb E and Hb A, two abnormal peaks not fully separated from Hb A and Hb E, but capillary electrophoresis showed a pattern of Hb E heterozygote with 4.0% Hb A₂. DNA analysis of the α2 globin gene identified a novel mutation (namely Hb Nakhon Ratchasima), GCC (Ala)→GTC (Val) at codon 63 in trans to the α⁺‐thalassemia (3.7‐kb deletion). Association of this novel α‐chain variant with β^E globin chain leads to the formation of another novel Hb derivative with different HPLC characteristics. Conclusion: Although Hb Nakhon Ratchasima might be clinically innocuous, differential diagnosis from other clinically relevant hemoglobinopathies is essential in routine setting. This could be made by using a simple PCR–restriction fragment length polymorphism assay or allele‐specific PCR assay developed in this study.     

A new phenanthrene dimer from Dendrobium palpebrae

A new phenanthrene dimer, namely dendropalpebrone (1), was isolated from the whole plant of Dendrobium palpebre, along with nine known compounds (2–10). All of the isolates were evaluated for their hydroxyl radical scavenging effects using a deoxyribose assay. Dendroflorin (10) showed an appreciable activity, and therefore was selected for further studied in RAW264.7 cells. Compound 10 significantly decreased ROS in H₂O₂-stimulated RAW264.7 cells in a dose-dependent manner, and improved activity of SOD, GPx, and CAT enzymes.     

Duodenal mature teratoma causing partial intestinal obstruction: A first case report in an adult

BACKGROUND A teratoma is a germ cell tumor that is composed of tissue derived from two or three germ layers.Duodenal teratomas are extremely rare and have been exclusively reported in neonates and children.This is the third case of a teratoma primarily arising in the duodenum and the first case that occurred in an adult.CASE SUMMARY A 31-year-old male presented with clinical partial gut obstruction(epigastric pain,nausea,and vomiting).The physical examination showed a palpable illdefined mass on the left side of the abdomen.The computed tomography scan revealed a multiseptated cystic tumor at the retroperitoneal area.First,he underwent gastrojejunostomy to relieve the symptoms and was referred to a tertiary-care hospital.The second operation revealed a 10-cm solid-cystic mass originating from the third part of the duodenum and adhering to the abdominal aorta and pancreas.Segmental duodenectomy was performed.The pathological diagnosis was a mature cystic teratoma.The patient was asymptomatic at 5 mo after the operation.CONCLUSION Duodenal teratomas are extremely rare but should be included in the differential diagnosis in patients who present with intestinal obstruction.Radiological imaging is helpful to reach the preoperative diagnosis.Multidisciplinary team planning is essential to avoid injury to the adjacent organ in duodenal operation.     

Double vs single primary tooth extraction in interceptive treatment of palatally displaced canines:: A randomized controlled trial

ObjectivesTo compare the impact of primary canine and primary first molar extractions with extractions of only the primary canine regarding correction of palatally displaced canines (PDCs).Materials and MethodsThirty-two children aged 9.5–13.5 years with 48 PDCs were randomly allocated to either the double-extraction group (DEG) or single-extraction group (SEG). Clinical and radiographic examinations were performed at baseline and at 6-month intervals until the canine emerged or orthodontic treatment was started. Outcome measures were: emergence of maxillary canine (yes/no), emergence of maxillary canine into a favorable position (yes/no), and maxillary canine positional change (angulation and sector). Factors influencing PDC emergence were analyzed using logistic regression.ResultsIn the DEG, 64% (16/25) of canines emerged into the oral cavity vs 78% (18/23) in the SEG (P = .283). Favorable PDC position at trial end was seen in 64% (16/25) of the DEG vs 57% (13/23) of the SEG (P = .600). Significant distal movement of PDCs was recorded in the DEG and SEG, though no significant difference was observed between groups. Significant predictors of canine emergence were initial canine angulation (Angle A) (P = .008) and space conditions at T₀ (P = .030).ConclusionsDouble or single primary tooth extraction procedures are equivalent in supporting PDC eruption into the oral cavity and into a favorable position in the dental arch. Initial canine angulation and space assessments may be used as predictors of successful PDC eruption.