Microbiome Associations of Therapeutic Enteral Nutrition

One of the most effective forms of therapeutic enteral nutrition is designated as “exclusive enteral nutrition” (EEN). EEN constitutes the monotonous enteral delivery of complete liquid nutrition and has been most explored in the treatment Crohn’s disease (CD), a form of inflammatory bowel disease. While EEN’s mechanisms of action are not clearly understood, it has been shown to modify the composition of the intestinal microbiome, an important component of CD pathogenesis. The current literature on the intestinal microbiome in healthy individuals and CD patients is reviewed with respect to EEN therapy. Further investigations in this field are needed to better understand the role and potential for EEN in chronic human disorders.     

Effect of coenzyme Q10 alone and its combination with metformin on streptozotocin-nicotinamide-induced diabetic nephropathy in rats

Objectives:

This study was aimed to investigate the therapeutic potential of coenzyme Q10 and its combination with metformin on streptozotocin (STZ)-nicotinamide-induced diabetic nephropathy (DN).

Materials and Methods:

Type 2 diabetes in rats was induced with STZ-nicotinamide. The diabetic rats were treated with coenzyme Q10 (10 mg/kg, p.o.) alone or coenzyme Q10 + metformin. Various parameters of renal function tests such as serum creatinine, urea, uric acid, and markers of oxidative stress such as renal malondialdehyde (MDA) level, superoxide dismutase (SOD), and catalase (CAT) activities were measured. Tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO) activity, transforming growth factor-β (TGF-β), and nitrite content were estimated in renal tissues. All treated animal were subjected to histopathological changes of kidney.

Result:

Diabetic rats showed a significant reduction in renal function, which was reflected with an increase in serum urea, serum creatinine, uric acid. In addition, STZ-nicotinamide caused renal tubular damage with a higher MDA level, depletion of SOD and CAT activity and glutathione (GSH) level. Moreover, TNF-α, MPO activity, TGF-β, and nitrite content were significantly increased in diabetic rats, while treatment with coenzyme Q10 or metformin or their combination ameliorate STZ-nicotinamide induced renal damage due to improvement in renal function, oxidative stress, suppression of TNF-α, MPO activity, TGF-β and nitrite content along with histopathological changes.

Conclusions:

This finding suggests that the treatment with coenzyme Q10 or metformin showed significant renoprotective effect against STZ-nicotinamide-induced DN. However, concomitant administration of both showed a better renoprotective effect than coenzyme Q10 or metformin alone treatment.KEY WORDS: Coenzyme Q10, diabetic nephropathy, metformin, transforming growth factor-β, tumor necrosis factor-α     

SCAI expert consensus update on best practices in the cardiac catheterization laboratory

The current document commissioned by the Society for Cardiovascular Angiography and Interventions (SCAI) and endorsed by the American College of Cardiology, the American Heart Association, and Heart Rhythm Society represents a comprehensive update to the 2012 and 2016 consensus documents on patient-centered best practices in the cardiac catheterization laboratory. Comprising updates to staffing and credentialing, as well as evidence-based updates to the pre-, intra-, and post-procedural logistics, clinical standards and patient flow, the document also includes an expanded section on CCL governance, administration, and approach to quality metrics. This update also acknowledges the collaboration with various specialties, including discussion of the heart team approach to management, and working with electrophysiology colleagues in particular. It is hoped that this document will be utilized by hospitals, health systems, as well as regulatory bodies involved in assuring and maintaining quality, safety, efficiency, and cost-effectiveness of patient throughput in this high volume area.     

Incorporation of Obstacle Hardening into Local Approach to Cleavage Fracture to Predict Temperature Effects in the Ductile to Brittle Transition Regime

Ductile-to-brittle-transition refers to observable change in fracture mode with decreasing temperature—from slow ductile crack growth to rapid cleavage. It is exhibited by body-centred cubic metals and presents a challenge for integrity assessment of structural components made of such metals. Local approaches to cleavage fracture, based on Weibull stress as a cleavage crack-driving force, have been shown to predict fracture toughness at very low temperatures. However, they are ineffective in the transition regime without the recalibration of Weibull stress parameters, which requires further testing and thus diminishes their predictive capability. We propose new Weibull stress formulation with thinning function based on obstacle hardening model, which modifies the number of cleavage-initiating features with temperature. Our model is implemented as a post-processor of finite element analysis results. It is applied to analyses of standard compact tension specimens of typical reactor pressure vessel steel, for which deformation and fracture toughness properties in the transition regime are available. It is shown that the new Weibull stress is independent of temperature, and of Weibull shape parameter, within the experimental error. It accurately predicts the fracture toughness at any temperature in the transition regime without relying upon empirical fits for the first time.