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31.
Alexander Dimitri Miras Anna Kamocka Beln Prez-Pevida Sanjay Purkayastha Krishna Moorthy Ameet Patel Harvinder Chahal Gary Frost Paul Bassett Lidia Castagnetto-Gissey Lucy Coppin Nicola Jackson Anne Margot Umpleby Stephen Robert Bloom Tricia Tan Ahmed Rashid Ahmed Francesco Rubino 《Diabetes care》2021,44(5):1082
OBJECTIVERoux-en-Y gastric bypass (RYGB) characteristically enhances postprandial levels of glucagon-like peptide 1 (GLP-1), a mechanism that contributes to its profound glucose-lowering effects. This enhancement is thought to be triggered by bypass of food to the distal small intestine with higher densities of neuroendocrine L-cells. We hypothesized that if this is the predominant mechanism behind the enhanced secretion of GLP-1, a longer intestinal bypass would potentiate the postprandial peak in GLP-1, translating into higher insulin secretion and, thus, additional improvements in glucose tolerance. To investigate this, we conducted a mechanistic study comparing two variants of RYGB that differ in the length of intestinal bypass.RESEARCH DESIGN AND METHODSA total of 53 patients with type 2 diabetes (T2D) and obesity were randomized to either standard limb RYGB (50-cm biliopancreatic limb) or long limb RYGB (150-cm biliopancreatic limb). They underwent measurements of GLP-1 and insulin secretion following a mixed meal and insulin sensitivity using euglycemic hyperinsulinemic clamps at baseline and 2 weeks and at 20% weight loss after surgery.RESULTSBoth groups exhibited enhancement in postprandial GLP-1 secretion and improvements in glycemia compared with baseline. There were no significant differences in postprandial peak concentrations of GLP-1, time to peak, insulin secretion, and insulin sensitivity.CONCLUSIONSThe findings of this study demonstrate that lengthening of the intestinal bypass in RYGB does not affect GLP-1 secretion. Thus, the characteristic enhancement of GLP-1 response after RYGB might not depend on delivery of nutrients to more distal intestinal segments. 相似文献
32.
Rashid Ghaznawi Maarten HT Zwartbol Nicolaas PA Zuithoff Jeroen de Bresser Jeroen Hendrikse Mirjam I Geerlings 《Journal of cerebral blood flow and metabolism》2021,41(6):1229
Global cerebral hypoperfusion may be involved in the aetiology of brain atrophy; however, long-term longitudinal studies on this relationship are lacking. We examined whether reduced cerebral blood flow was associated with greater progression of brain atrophy. Data of 1165 patients (61 ± 10 years) from the SMART-MR study, a prospective cohort study of patients with arterial disease, were used of whom 689 participated after 4 years and 297 again after 12 years. Attrition was substantial. Total brain volume and total cerebral blood flow were obtained from magnetic resonance imaging scans and expressed as brain parenchymal fraction (BPF) and parenchymal cerebral blood flow (pCBF). Mean decrease in BPF per year was 0.22% total intracranial volume (95% CI: –0.23 to –0.21). Mean decrease in pCBF per year was 0.24 ml/min per 100 ml brain volume (95% CI: –0.29 to –0.20). Using linear mixed models, lower pCBF at baseline was associated with a greater decrease in BPF over time (p = 0.01). Lower baseline BPF, however, was not associated with a greater decrease in pCBF (p = 0.43). These findings indicate that reduced cerebral blood flow is associated with greater progression of brain atrophy and provide further support for a role of cerebral blood flow in the process of neurodegeneration. 相似文献
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Sharjeel Usmani Najeeb Ahmed Gopinath Gnanasegaran Rashid Rasheed Fahad Marafi Mashari Alnaaimi Mohammad Omar Ahmed Musbah Fareeda al Kandari Stijn De Schepper Tim Van den Wyngaert 《The British journal of radiology》2021,94(1120)
Objective:A new Bayesian penalized likelihood reconstruction algorithm for positron emission tomography (PET) (Q.Clear) is now in clinical use for fludeoxyglucose (FDG) PET/CT. However, experience with non-FDG tracers and in special patient populations is limited. This pilot study aims to compare Q.Clear to standard PET reconstructions for 18F sodium fluoride (18F-NaF) PET in obese patients.Methods:30 whole body 18F-NaF PET/CT scans (10 patients with BMI 30–40 Kg/m2 and 20 patients with BMI >40 Kg/m2) and a NEMA image quality phantom scans were analyzed using ordered subset expectation maximization (OSEM) and Q.Clear reconstructions methods with B400, 600, 800 and 1000. The images were assessed for overall image quality (IQ), noise level, background soft tissue, and lesion detectability, contrast recovery (CR), background variability (BV) and contrast-to-noise ratio (CNR) for both algorithms.Results:CNR for clinical cases was higher for Q.Clear than OSEM (p < 0.05). Mean CNR for OSEM was (21.62 ± 8.9), and for Q.Clear B400 (31.82 ± 14.6), B600 (35.54 ± 14.9), B800 (39.81 ± 16.1), and B1000 (40.9 ± 17.8). As the β value increased the CNR increased in all clinical cases. B600 was the preferred β value for reconstruction in obese patients. The phantom study showed Q.Clear reconstructions gave lower CR and lower BV than OSEM. The CNR for all spheres was significantly higher for Q.Clear (independent of β) than OSEM (p < 0.05), suggesting superiority of Q.Clear.Conclusion:This pilot clinical study shows that Q.Clear reconstruction algorithm improves overall IQ of 18F-NaF PET in obese patients. Our clinical and phantom measurement results demonstrate improved CNR and reduced BV when using Q.Clear. A β value of 600 is preferred for reconstructing 18F-NaF PET/CT with Q.Clear in obese patients.Advances in knowledge:18F-NaF PET/CT is less susceptible to artifacts induced by body habitus. Bayesian penalized likelihood reconstruction with18F-NaF PET improves overall IQ in obese patients. 相似文献
34.
Since 1990 and the invention of the very first generation of ordered mesoporous silica materials, several innovative methodologies have been applied to synthesize, characterize, and modify silica/non-silica mesoporous materials. The growth of the mesoporous materials field has generated significant environmental and economic advantages compared to various other industrial developments. According to the literature, there are several key synthesis approaches and parameters that can affect the structural, textural and morphological characteristics of mesoporous materials. To date, huge attempts have been made to maximize the activities and selectivities of these materials through either the in situ or post-synthesis functionalization of the large interior surface areas and internal mesostructured frameworks in the presence of specific organic/inorganic components. However, the main challenge is to provide good control over the incorporation and distribution of multiple guest components within the mesostructured hosts. Mesostructured materials have received great attention for various applications, such as being used in electronics, medicine, photocatalysis, catalyst supports, catalysis, absorbers, sensors, gas separation, etc. In the current paper, several recent developments have been highlighted and reviewed regarding the fabrication and characterization of siliceous/non-siliceous mesoporous materials via various synthetic approaches. Furthermore, the availability of diverse functionalization methods has been reviewed to provide comprehensive approaches for synthesizing new generations of suitably modified mesoporous materials with superior structural, physicochemical, and textural characteristics.Since 1990 and the invention of the very first generation of ordered mesoporous silica materials, several innovative methodologies have been applied to synthesize, characterize, and modify silica/non-silica mesoporous materials. 相似文献
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36.
Roderick M. Card Muriel Mafura Theresa Hunt Miranda Kirchner Jan Weile Mamun-Ur Rashid Andrej Weintraub Carl Erik Nord Muna F. Anjum 《Antimicrobial agents and chemotherapy》2015,59(8):4410-4416
The aim of this study was to assess the impact of ciprofloxacin, clindamycin, and placebo administration on culturable Gram-negative isolates and the antibiotic resistance genes they harbor. Saliva and fecal samples were collected from healthy human volunteers before and at intervals, up to 1 year after antibiotic administration. Samples were plated on selective and nonselective media to monitor changes in different colony types or bacterial species. Following ciprofloxacin administration, there was a decrease of Escherichia coli in feces and after clindamycin administration a decrease of Bacteroides in feces and Leptotrichia in saliva, which all returned to pretreatment levels within 1 to 4 months. Ciprofloxacin administration also resulted in an increase in ciprofloxacin-resistant Veillonella in saliva, which persisted for 12 months. Additionally, 949 aerobic and anaerobic isolates purified from ciprofloxacin- and clindamycin-containing plates were screened for the presence of resistance genes. Resistance gene carriage was widespread in isolates from all three treatment groups, and no association was observed between genes and antibiotic administration. Although the anaerobic component of the microbiota was not a major reservoir of aerobe-associated antimicrobial resistance (AMR) genes, we detected the sulfonamide resistance gene sul2 in anaerobic isolates. The longitudinal nature of the study allowed identification of distinct Escherichia coli clones harboring multiple resistance genes, including one carrying an extended-spectrum β-lactamase blaCTX-M group 9 gene, which persisted in the gut for up to 4 months. This study provided insight into the effects of antibiotic administration on healthy microbiota and the diversity of resistance genes harbored therein. 相似文献
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40.
Mejbah Uddin Bhuiyan Stephen P. Luby Rashid Uz Zaman M. Waliur Rahman M. A. Yushuf Sharker M. Jahangir Hossain Choudhury H. Rasul A. R. M. Saifuddin Ekram Mahmudur Rahman Katharine Sturm-Ramirez Eduardo Azziz-Baumgartner Emily S. Gurley 《The American journal of tropical medicine and hygiene》2014,91(1):165-172
During April 2007–April 2010, surveillance physicians in adult and pediatric medicine wards of three tertiary public hospitals in Bangladesh identified patients who developed hospital-acquired diarrhea. We calculated incidence of hospital-acquired diarrhea. To identify risk factors, we compared these patients to randomly selected patients from the same wards who were admitted > 72 hours without having diarrhea. The incidence of hospital-acquired diarrhea was 4.8 cases per 1,000 patient-days. Children < 1 year of age were more likely to develop hospital-acquired diarrhea than older children. The risk of developing hospital-acquired diarrhea increased for each additional day of hospitalization beyond 72 hours, whereas exposure to antibiotics within 72 hours of admission decreased the risk. There were three deaths among case-patients; all were infants. Patients, particularly young children, are at risk for hospital-acquired diarrhea and associated deaths in Bangladeshi hospitals. Further research to identify the responsible organisms and transmission routes could inform prevention strategies. 相似文献