Rehabilitation Nutrition for Iatrogenic Sarcopenia and Sarcopenic Dysphagia

The journal of nutrition, health & aging - Sarcopenia is a very important issue in rehabilitation medicine and nutritional care. The prevalence of sarcopenia in older people is approximately...     

The Prevalence and Prognosis of Sarcopenic Dysphagia in Patients Who Require Dysphagia Rehabilitation

The journal of nutrition, health & aging - The purpose of this study was to assess the prevalence and prognosis of sarcopenic dysphagia in patients who require dysphagia rehabilitation....     

Otolith dysfunction during vertiginous attacks in Ménière's disease

OBJECTIVE: Vertiginous attacks of Ménière's disease (MD) are characterized by various types of vertigo, namely rotatory vertigo, dizziness and drop attack. When a patient complains of dizziness without spontaneous nystagmus, otolith dysfunction cannot be ruled out. The purpose of this study was to evaluate otolith dysfunction during vertiginous attacks of MD or delayed endolymphatic hydrops. MATERIAL AND METHODS: Vestibular function tests were carried out daily for several days in 11 patients (MD, n = 9; delayed endolymphatic hydrops, n = 2) during vertiginous attacks. Otolith function was evaluated by means of the static torsional position of both eyes [static ocular torsion (OT)] whilst in an upright position. We defined otolith dysfunction as an abnormal change (range) in OT without spontaneous nystagmus or as an abnormal change in OT without a change in spontaneous nystagmus. RESULTS: Four patients had an abnormal change (range) in OT without spontaneous nystagmus or an abnormal change in OT without a change in spontaneous nystagmus during vertiginous attacks of MD. CONCLUSIONS: Otolith dysfunction occurs in patients during vertiginous attacks of MD. In cases of ataxia without spontaneous nystagmus, otolith dysfunction most likely causes atypical attacks of MD.     

Relapsed childhood acute myeloid leukemia patient with inversion of chromosome 16 harboring a low FLT3 internal tandem duplication allelic burden and KIT mutations

Inversion of chromosome 16 [inv(16)] has a good prognosis in acute myeloid leukemia (AML), but additional genetic aberrations influence the outcome. We herein describe the case of a 15‐year‐old Japanese boy with inv(16) harboring a low‐allelic burden internal tandem duplication of FLT3 (FLT3‐ITD) and KIT mutations. Conventional chemotherapy eradicated a clone with a low‐allelic burden FLT3‐ITD mutation, although another clone with a KIT mutation occurred 17 months later. Further investigation is necessary to identify AML with inv(16) conferring poor prognosis, to facilitate appropriate treatment with additional drugs, such as dasatinib or gemtuzumab ozogamicin.     

Enhanced interferon-gamma production and bacterial clearance in the liver of splenectomized mice in the models of Escherichia coli injection or intestinal obstruction

Although several studies have reported that splenectomy increases susceptibility to bacterial infections, other reports have indicated that splenectomy does not induce such susceptibility. To clarify this discrepancy, we studied the effects of splenectomy in the models of lipopolysaccharide (LPS) or Escherichia coli challenge and intestinal obstruction, focusing on cytokine production and bacterial clearance in the liver. Using C57BL/6 mice at 4 weeks after splenectomy or a sham operation, either LPS or E. coli was injected or an intestinal obstruction was made to examine the mortality, serum cytokine levels, cytokine production of the liver mononuclear cells (MNCs), and bacterial clearance in the liver. As a result, no differences were observed in survival rates after LPS or E. coli challenge between the mice with and without splenectomy. However, in a model of intestinal obstruction, splenectomized mice survived significantly longer than the sham-operated mice. Liver MNCs from splenectomized mice produced a significantly larger amount of interferon-gamma compared with those from sham-operated mice. Furthermore, bacterial counts in the liver at 2 h after E. coli injection and at 24 h after intestinal obstruction were significantly decreased in splenectomized mice compared with sham-operated mice. In conclusion, splenectomy does not impair host defense against bacteria infection provided that recovery is sufficient to allow compensatory processes in the liver to occur.     

Role of Toll-like receptors in the development of sepsis

The outcome of sepsis and septic shock has not significantly improved in recent decades despite the development of numerous drugs and supportive care therapies. To reduce sepsis-related mortality, a better understanding of molecular mechanism(s) associated with the development of sepsis and sepsis-related organ injury is essential. There is increasing evidence that Toll-like receptors (TLRs) play a key role in the mediation of systemic responses to invading pathogens during sepsis. However, the role of TLRs in the development of sepsis and in sepsis-related organ injury remains debatable. In this review, we focus on the biological significance of TLRs during sepsis. Medline was searched for pertinent publications relating to TLRs, with emphasis on their clinical and pathophysiological importance in sepsis. In addition, a summary of the authors' own experimental data from this field was set in the context of current knowledge regarding TLRs. In both animal models and human sepsis, TLRs are highly expressed on monocytes/macrophages, and this TLR expression may not simply be a ligand-specific response in such an environment. The fact that TLR signaling enables TLRs to recognize harmful mediators induced by invading pathogens may be associated with a positive feedback loop for the inflammatory response among different cell populations. This mechanism(s) may contribute to the organ dysfunction and mortality that occurs in sepsis. A better understanding of TLR biology may unveil novel therapeutic approaches for sepsis.     

Hepatitis C viral markers in patients who received blood that was positive for hepatitis C virus core antibody, with genetic evidence of hepatitis C virus transmission

BACKGROUND: Despite the use of the anti-c100-3 assay for blood donor screening, posttransfusion non-A,non-B hepatitis still occurred. A more sensitive assay should be developed to prevent this. STUDY DESIGN AND METHODS: Stored serum specimens from 2020 healthy blood donors who were negative for c100-3 antibody to hepatitis C virus (HCV) were retrospectively screened for the presence of antibodies against a core protein of HCV using an enzyme-linked immunosorbent assay and Western blot analysis as part of a study on posttransfusion non-A,non-B hepatitis. RESULTS: Eight (0.4%) of the 2020 donors were positive for HCV core antibody. Posttransfusion non-A,non-B hepatitis occurred in 5 of five patients known to have received blood that was positive for HCV core antibody and 1 of 141 patients transfused with blood that was negative for HCV core antibody. The total incidence of posttransfusion non-A,non-B hepatitis was 4.1 percent (6/146). The nucleotide sequence of the nonstructural 5 region of the HCV genome obtained from two donors and corresponding recipients was also analyzed. The HCV genome sequences were identical for one donor-recipient pair, and there was 99.4-percent homology for a second pair. CONCLUSION: Anti-core-positive blood proved to be highly infectious for HCV, and this validated the use of the second-generation anti-HCV assay for blood donor screening.     

A left ventricular lipoma diagnosed on three-dimensional electrocardiogram-gated cardiac computed tomography

Cardiac lipomas are extremely rare primary benign cardiac tumors. We describe a patient with a chief complaint of ventricular tachycardia associated with a lipoma arising in the left ventricular myocardium. The cardiac lipoma was qualitatively evaluated and its location was accurately determined noninvasively with the use of three-dimensional images reconstructed from data acquired by electrocardiogram-gated cardiac computed tomography (CT). Our experience suggests that high-resolution three-dimensional CT imaging may facilitate the determination of strategies for surgical treatment.