Inhibition of endotoxin-induced activation of the coagulation and fibrinolytic pathways using a recombinant endotoxin-binding protein (rBPI23)

A recombinant endotoxin-neutralizing protein, rBPI23, was shown to partially prevent endotoxin-induced activation of the fibrinolytic and coagulation systems in experimental endotoxemia in humans. In a placebo- controlled, blinded crossover study, eight volunteers were challenged twice with an intravenous bolus injection of endotoxin (40 EU/kg of body weight) and concurrently received either rBPI23 (1 mg/kg) or placebo (human serum albumin, 0.2 mg/kg). rBPI23 treatment significantly lowered the endotoxin-induced fibrinolytic response, ie, reduced the release of tissue-type plasminogen activator, urokinase- type plasminogen activator, plasminogen activator inhibitor antigen, and complex formation of plasmin alpha 2-antiplasmin (P = .0078 for each). Plasminogen activator inhibitor activity was also reduced, but not significantly according to the Hochberg method (P = .0304). The endotoxin-induced activation of the procoagulant state as reflected by increase in F1 + 2 fragments and TAT complexes was blunted by rBPI23 infusion (P = .0391 [not significant according to the Hochberg method] and .0078, respectively). These results indicate that rBPI23 is capable of reducing both the activation of the fibrinolytic and the coagulation systems after low-dose endotoxin infusion in humans.     

Dietary patterns and risk for Crohn's disease in children

BACKGROUND: Some dietary foods are considered protective (vegetables and fruits), whereas others (fatty foods) are thought to enhance the risk for Crohn's disease (CD). The evidence, however, is inconsistent. METHODS: We postulated that specific dietary patterns may influence the risk for CD. A case-control study was carried out. Newly diagnosed CD cases with population and/or hospital-based controls < or =20 years were selected from 3 tertiary hospitals across Canada. Pre-disease diet was assessed using a validated food frequency questionnaire (FFQ) administered within 1 month of diagnosis. Factor analyses and unconditional logistic regression (adjusted) was used to determine gender-specific dietary patterns and assess associated risks for CD. Odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were estimated. RESULTS: A total of 149 cases and 251 controls were included. The mean age (range) of the cases was 13.3 (2.6-20 years). There were more boys (61.1%). Four dietary patterns each were observed among both boys and girls. Pattern 1 in girls, characterized by meats, fatty foods, and desserts, was positively associated with CD (OR 4.7, 95% CI 1.6-14.2). Pattern 2, common to both boys and girls, was characterized by vegetables, fruits, olive oil, fish, grains, and nuts and was inversely associated with CD in both genders (girls: OR 0.3, 95% CI 0.1-0.9; boys: OR 0.2, 95% CI 0.1-0.5). CONCLUSIONS: Our results suggest that specific dietary patterns could be associated with higher or lower risks for CD in children. Larger prospective studies are required to confirm these findings.     

Motivations,Barriers, and Outcomes of Patient-Reported Shared Decision Making in Eosinophilic Esophagitis

Digestive Diseases and Sciences - Little is known about patient choice in treatment of eosinophilic esophagitis (EoE). Determine motivators and barriers to using common EoE therapies and describe...     

Left main occlusion secondary to aortic root rupture following transcatheter aortic valve replacement managed by left main stenting

Acute left main coronary occlusion secondary to a periaortic root hematoma secondary to annular rupture during transcatheter heart valve deployment is reported. © 2013 Wiley Periodicals, Inc.     

Alternatives assessment and informed substitution: A global landscape assessment of drivers,methods, policies and needs

There are increasing policy and market drivers for removing chemicals of concern from manufacturing processes and products. These drivers have centered primarily on developed countries. However, global activities through the United Nations, individual countries, and advocacy organizations are increasing concerns about chemical impacts in developing countries and economies in transition as well. While reducing the use of chemicals of concern is a primary goal, eliminating such substances without thoughtful consideration for their replacements can lead to regrettable substitutions. Against this backdrop there is growing attention to the identification, assessment, and adoption of safer chemicals, as well as product and process design alternatives. Informed substitution is a critical chemical risk management approach, focused on an intentional transition from chemicals of high concern to chemicals and technological processes of lower concern. Alternatives assessment, an interactive, step-defined process, has emerged as a critical approach to support informed substitution. Over the past decade, a number of tools, approaches, and case examples of alternatives assessment and informed substitution have emerged. Policies and practical experience have followed, improving the landscape of alternatives assessment and informed substitution. This article provides an assessment of the state-of-practice of both alternatives assessment and informed substitution methods, policies, and practices. We identify key needs and actions that can be taken by various stakeholder groups moving forward to advance the field. We conclude that there is a critical need for multi-stakeholder, multi-disciplinary collaboration at a global level to build capacity and support networks that can ensure the growth and success of informed substitution efforts in the future.