Activation of Free Fatty Acid Receptor 4 Affects Intestinal Inflammation and Improves Colon Permeability in Mice

Diet is considered an important trigger in inflammatory bowel diseases (IBD), as feeding habits can affect intestinal permeability and clearance of bacterial antigens, consequently influencing the immune system. Free fatty acid receptors (FFARs), expressed on the intestinal epithelial cells, belong to the family of luminal-facing receptors that are responsive to nutrients. The objective of this study was to characterize the anti-inflammatory activity and the effect on intestinal barrier function of synthetic FFAR agonists in mouse models of colitis. Therapeutic activity of GW9508 (FFAR1 agonist), 4-CMTB (FFAR2 agonist), {"type":"entrez-nucleotide","attrs":{"text":"AR420626","term_id":"40175736"}}AR420626 (FFAR3 agonist), and GSK137647 (FFAR4 agonist) was investigated in two models of semi-chronic colitis: induced by trinitrobenzenesulfonic acid (TNBS), mimicking Crohn’s disease, as well as induced by dextran sulfate sodium (DSS), which recapitulates ulcerative colitis in humans. Moreover, we assessed the influence of FFARs agonists on epithelial ion transport and measured the ion flow stimulated by forskolin and veratridine. Administration of FFAR4 agonist GSK137647 attenuated both TNBS-induced and DSS-induced colitis in mice, as indicated by macroscopic parameters and myeloperoxidase activity. The action of FFAR4 agonist GSK137647 was significantly blocked by pretreatment with selective FFAR4 antagonist AH7614. Moreover, FFAR1 and FFAR4 agonists reversed the increase in the colon permeability caused by inflammation. FFAR4 restored the tight junction genes expression in mouse colon. This is the first evaluation of the anti-inflammatory activity of selective FFAR agonists, showing that pharmacological intervention targeting FFAR4, which is a sensor of medium and long chain fatty acids, attenuates intestinal inflammation.     

Succinylcholine: A Drug to Avoid in Bariatric Surgery

Succinylcholine is a paralytic agent regularly utilized in anesthesia. There are numerous adverse effects of succinylcholine ranging from mild to fatal; one such effect is succinylcholine myalgia. We report the case of a 34-year-old woman who received succinylcholine while undergoing laparoscopic Roux-en-Y gastric bypass and later developed succinylcholine myalgia leading to a prolonged hospital stay and subsequent pneumonia. In the presence of suitable alternative paralytic agents, succinylcholine should be avoided in patients undergoing bariatric surgery. The use of a designated anesthesia team familiar with bariatric operations can help maximize peri-operative management and minimize complications.     

Disparities in Late Stage Diagnosis,Treatment, and Breast Cancer-Related Death by Race,Age, and Rural Residence Among Women in Georgia

The objectives of this study were to examine the outcomes of late stage breast cancer diagnosis, receiving first course treatment, and breast cancer-related death by race, age, and rural/urban residence in Georgia. The authors used cross-sectional and follow-up data (1992–2007) for Atlanta and Rural Georgia cancer registries that are part of the National Cancer Institute's Surveillance, Epidemiology, and End Results Program (N = 23,500 incident breast cancer cases in non-Hispanic whites or non-Hispanic African Americans). Multilevel modeling and Cox proportional hazard models revealed that compared to whites, African American women had significantly increased odds of late stage diagnosis (odds ratio [OR] = 2.08, p = 0.0001) and unknown tumor stage (OR = 1.27, p = 0.0001), decreased odds of receiving radiation (OR = 0.93, p = 0.041) or surgery (OR = 0.50, p = 0.0001), and increased risk of death following breast cancer diagnosis (hazard rate ratio [HR] = 1.50, p = 0.0001). Increased age was significantly associated with the odds of late/unknown stage at diagnosis, worse treatment, and survival. Women residing in rural areas had significantly decreased odds of receiving radiation and surgery with radiation (OR = 0.59, p = 0.0001), and for receiving breast-conserving surgery compared to mastectomy (OR = 0.73, p = 0.005). Factors affecting each level of the breast cancer continuum are distinct and should be examined separately. Efforts are needed to alleviate disparities in breast cancer outcomes in hard-to-reach populations.     

Exogenous lipoid pneumonia (oil granulomas of the lung)

The authors observed three cases of exogenous lipid pneumonia clinically suspected of lung carcinoma. Histological examination of material after thoracotomy gave the possibility of correct diagnosis. The lesions in lungs were characteristic granulomas around lipid material and with surrounding advanced fibrosis.     

Ocena niedosłuchu u osób powyżej 60. roku życia korzystających z aparatów słuchowych

Objective

To assess the hearing impairment in people over 60 years old using hearing aids. This was a single-center study, but it is planned to extend it further to the whole country.

Materials and methods

The study was focused on patients with hearing aids. During the assessment 57 people were included in the observation in order to control the status of their hearing loss and benefit from traditional hearing aids as well as the possibility to apply the auditory implants in case of a little benefit from hearing aids. The otoscopy and pure tone audiometry were performed as well as the questionnaires on demographic and epidemiological data of patients were collected as well as the quality of their life with hearing aids was subjectively assessed.

Results

The results show that 91% of patients have sensorineural hearing loss (SHL), the remaining 9% – severe mixed hearing loss. Severe SHL was found in 22 patients, the moderate hearing loss was observed in 37%, and the profound SHL was the case in 5 patients. Minimal SHL was observed in 7% of patients (n = 4). More than 73% of the study subjects were male (n = 38). The average age of the patients who completed the survey was 74 years old. Thirty-five patients used their hearing aid over 3 years and less than 70% of them used it every day all day. Hearing aid was not actively used by 10 patients. Over the last year 51.92% of the patients underwent a hearing examination.

Conclusions

The bone anchored hearing aid was suggested to 2% of subjects and the cochlear implant was offered to 10 patients. The data analysis shows the need to educate and inform the elderly about alternative methods of hearing loss treatment.     

Gram-positive microorganisms isolated from patients treated in the Department and Clinic of Rehabilitation at Rydygier Medical University in Bydgoszcz, Poland, 2000-2001

Background. The purpose of our study was to evaluate the occurrence of Gram-positive microorganisms isolated from patients hospitalized in the Department and Clinic of Rehabilitation at the Rydygier Medical University in Bydgoszcz. Materials and methods. The material analyzed consisted of 533 clinical samples collected from patients hospitalized in 2000-2001. The study included 485 Gram-positive bacterial strains isolated from clinical material. Morphological characteristics provided the basis for the identification of bacteria. The species were identified by using API 20 STREP and API STAPH tests (bioMerieux). The isolates were screened for antimicrobial susceptibility by the disk-diffusion method. Results. The most often isolated bacteria were Enterococcus spp. (46,8%) and Staphylococcus spp. (31,5%), followed by Corynebacterium spp. (9,1%) and Streptococcus spp. (6,6%). The most frequently identified Enterococcus species were E. faecalis (92,9%) and E. faecium (7,1%). All the Enterococcus strains were susceptible to glycopeptides. More than 90% of the Enterococus isolates were sensitive to nitrofurantoine, about 44% to high concentrations of gentamycin, 17,9% to ciprofloxacin. During this period, and S. simulans, and 21 strains of S. auerus (46,7%). 92% of all the tested CNS strains (80%) than in the S. aureus isolates (10%). Conclusions. The most frequently observed bacterium was E. faecalis, which showed significant resistance to quinolones and to high level aminoglycosides. The CNS strains showed a high level of resistance to methicilline. All these strains were susceptible to glycopeptides.     

A comparison of the combined ultrasound of the mediastinum by use of a single ultrasound bronchoscope versus ultrasound bronchoscope plus ultrasound gastroscope in lung cancer staging: a prospective trial

OBJECTIVES The aim of the study was to compare diagnostic utility of combined (i.e. transbronchial and transoesophageal) ultrasound imaging with needle biopsy of the mediastinum in lung cancer (LC) staging, (a) by use of a single ultrasound bronchoscope (CUSb) and (b) by using two scopes (CUS). METHODS In consecutive LC patients, clinical stage IA-IIIB the CUS or CUSb was performed under mild sedation and, if negative, underwent lung resection with confirmatory systematic lymph node dissection. RESULTS From 214 LC patients, 110 underwent CUS and 104 underwent CUSb (618 biopsies); both revealed metastases in 50% of cases. There was 'minimal N2' in 11 of 14 false negative patients. Diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CUS was 91.7%, 98%, 94.6%, 98.2% and 90.7% respectively and of CUSb was 85%, 93.2%, 88.5%, 94.4%, 82%, respectively with no significant difference in yield of CUS vs CUSb (P?=?0.255 and P?=?0.192). The mean time of CUS (25?±?4.4?min) was significantly longer as compared to CUSb (14.9?±?2.3?min) (P?相似文献