Renal injury in the extremely obese patients with normal renal function

We studied the glomerular architecture in renal biopsies of 95 patients undergoing bariatric surgery for extreme obesity but whose renal function was normal. The comparison group was 40 control patients having protocol biopsies. These latter patients had normal weight and renal function, were non-diabetic, non-hypertensive, and were undergoing nephrectomy or donating a kidney. Logistic regression models determined associations between the clinical and biochemical variables and glomerular lesions. Arterial hypertension, sleep apnea syndrome (SAS), and microalbuminuria were prevalent in the obese patients, as was hyperglycemia to a lesser extent. Focal and segmental glomerulosclerosis was present in only five extremely obese (EO) patients but absent in controls. Increased mesangial matrix, podocyte hypertrophy, mesangial cell proliferation, and glomerulomegaly were more frequent in the obese cohort than in the control group. Body mass index was a significant independent risk factor associated with glomerular lesions in all 135 patients and in the 95 EO patients, whereas SAS was associated with glomerulomegaly only in the EO. Our study shows that EO patients who lack overt clinical renal symptoms have a variety of glomerular abnormalities that correlate with body mass.     

A 96-well automated radioiodide uptake assay for sodium/iodide symporter inhibitors

A high-throughput screening method based on radioiodide uptake in human embryonic kidney 293 cells expressing the human sodium/iodide symporter was developed. Central to assay development was a homogeneous cell culture in the 96-well microplate coupled with the use of scintillation proximity technology. The assay is fast and highly reproducible with a Z' greater than 0.8. The automated procedure allows the screening of 4,000 compounds per day. Using this methodology, several known substrates of the sodium/iodide symporter were evaluated in a single day. Inhibition of iodide uptake was shown to follow the series PF(6)(-) > ClO(4)(-) > BF(4)(-) > SCN(-) > NO(3)(-) > IO(4)(-) > N(3)(-) > Br(-), in accord with the literature. This method represents an initial approach to the search for inhibitors of iodide transport mediated by the sodium/iodide symporter.     

Hypoglycaemic effect of quinolizidine alkaloids--lupanine and 2-thionosparteine on non-diabetic and streptozotocin-induced diabetic rats

The effects of the highly selective histamine H4 receptor antagonists JNJ7777120 and VUF6002 were investigated on the carrageenan-induced inflammation and thermal hyperalgesia in rats. JNJ7777120 (10 and 30 mg/kg, s.c.) and VUF6002 (10 mg/kg, s.c.) significantly reduced paw edema and hyperalgesia provoked by subplantar injection of carrageenan; the effect was evident against the early (2 h) phase of inflammation. An inactive analog of VUF6002, VUF6007 (10 mg/kg, s.c.) slightly aggravated paw edema, while leaving unaltered carrageenan-induced nociception. These findings indicate that histamine H4 receptors participate in the early phase of acute inflammation induced by carrageenan in rats, influencing both edema and thermal hyperalgesia.     

Safety of definitive in-theater repair of facial fractures

OBJECTIVE: To determine the safety of definitive in-theater facial fracture repair on American military personnel wounded during Operation Iraqi Freedom. METHODS: A retrospective review of all patients with head and neck trauma treated at the 322nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, from May 7, 2005, through September 18, 2005, was performed. This study focused on the outcomes of wounded American military personnel whose facial fractures were definitively repaired in theater. The criteria used to determine candidacy for definitive in-theater facial fracture repair on American military personnel were (1) the fracture site was exposed through either a soft tissue wound or because of an adjacent surgical approach, (2) treatment would not delay evacuation from theater, and (3) treatment would allow the military member to remain in theater. RESULTS: From May 2005 to September 2005, 207 patients were taken to the operating room and required 388 procedures. A total of 175 patients (85%) were operated on for traumatic injuries, and 52 of these patients required open reduction and internal fixation (ORIF) of a facial fracture. Of the 52 patients who underwent an ORIF, 17 were American military personnel. Of the 17 American patients who were definitively treated for their facial fractures in theater, 16 were contacted and/or followed up on the global military medical database. None of these patients developed an Acinetobacter baumannii infection or had a complication caused by the definitive in-theater ORIF. The range of follow-up was 2 months to 11 months, with a mean of 8.3 months. CONCLUSIONS: Definitive repair of facial fractures with ORIF on American military personnel in theater is advised when the aforementioned criteria are observed. An otolaryngologist is a crucial member of the head and neck trauma team.     

“No jobs,more crime. More jobs,less crime”: structural factors affecting the health of Latino men in Detroit

BackgroundLatinos comprise 14% of the United States (U.S.) population, and approximately 75% of Latinos in the U.S. are immigrants or children of immigrants. Urban Latino men face a distinct set of structural barriers that may influence their health and well-being. The collapse of the automobile industry in Detroit, Michigan, contributed to increased rates of racially stratified unemployment.MethodThrough semi-structured interviews and ethnography, we present a case study of nine Latino men who face decreasing opportunities for formal employment and navigate the constant threat of violence and deportation in the face of Detroit's rapid deindustrialization.ResultsIn light of scarce work opportunities, participants sought income from the informal labor sector. This work was often illegal or dangerous, such as drug dealing, and perpetuated a cycle of violence. The threat of violence and deportation limited mobility and contact with authorities, especially among undocumented participants.ConclusionIn order to promote the health of urban Latino men, a careful consideration of the structural factors that shape their lives is essential. Interventions should work to leverage an extensive skill set and drive to work into meaningful formal employment, and consider the overarching effects of documentation on social mobility.