Hypertrophic cardiomyopathy masquerading as infiltrative restrictive cardiomyopathy and refractory congestive failure-resolution with catheter ablation of atrial flutter – A case report

We report a case of a young male presenting as Restrictive cardiomyopathy, refractory heart failure and syncope due to typical right atrial flutter complicating hypertrophic cardiomyopathy.Successful catheter ablation of the flutter promptly ameliorated the congestive failure with resolution of restrictive physiology.     

Perceived access to health care and its influence on the prevalence of behavioral risks among urban African Americans

INTRODUCTION: Individuals who have difficulty gaining access to health care may delay seeking and obtaining treatment, underutilize preventive health care services, and may have a high prevalence of chronic disease risks. This report examines participant perception of the level of difficulty encountered when obtaining medical care and its influence on the prevalence of chronic disease behavioral risks among urban African Americans. RESULTS: We found a significantly higher prevalence of current cigarette smoking and alcohol consumption among African Americans who reported that they experienced difficulty in obtaining medical care than among those who did not. Compared to those who experienced no difficulty obtaining care, participants who perceived a high level of difficulty in obtaining care were less likely to have had a physical exam in the past year and to have seen the same doctor when services were obtained. CONCLUSION: The perception of a high level of difficulty obtaining health care may be associated with a higher prevalence of behavioral risks for chronic disease. The limited data suggest a need to more closely examine the perception of health care accessibility and its relationship to health services utilization and the prevalence of chronic disease behavioral risks.     

脑室给予不同剂量的Capsazepine对LPS致大鼠发热过程的影响

目的在大鼠侧脑室内给予不同剂量的瞬时受体电位香草酸受体1(transient receptor potential vanilloid 1,TRPV1)拮抗剂Capsazepine,观察对LPS致热过程的影响。方法在侧脑室内预先给与3种剂量Capsazepine,随之腹腔给与LPS致热。在腹腔内埋植发射子遥测体温变化过程,同时应用荧光测定法检测下丘脑细胞内钙离子浓度的变化,Western blot方法检测TRPV1表达水平。结果随着Capsazepine剂量增大,LPS致大鼠发热水平升高,下丘脑细胞内钙离子浓度减少,TRPV1表达水平降低。结论 Capsazepine作用于大鼠下丘脑,可使LPS诱导的发热水平提高,此效应可能与TRPV1的作用有关。     

Ethanol affects differentiation-related pathways and suppresses Wnt signaling protein expression in human neural stem cells

Background: Prenatal exposure of the fetus to ethanol (EtOH) can be teratogenic. We previously showed that EtOH alters the cell fate of human neural stem cells (NSC). As Wnt signaling plays an important role in fetal brain development, we hypothesized that EtOH suppresses Wnt signaling protein expression in differentiating NSC and thereby contributes to fetal alcohol spectrum disorder. Methods: NSC isolated from fetal human brains were cultured in mitogenic media to induce neurospheres, which were dissociated into single‐cell suspensions and used for all experiments. Equal numbers of NSC were cultured on lysine/laminin‐coated plates for 96 hours in differentiating media containing 0, 20, or 100 mM EtOH. Total mRNA was isolated from samples containing 0 or 100 mM EtOH and changes in expression of 263 genes associated with neurogenesis and NSC differentiation were determined by Oligo GEArray technology. The biological impact of gene changes was estimated using a systems biology approach with pathway express software and KEGG database. Based on the pathways identified, expression of Wnt proteins (Wnt3a and Wnt5a), Wnt‐receptor complex proteins (p‐LRP6, LRP6, DVL2, and DVL3), Wnt antagonist Naked‐2 (NKD‐2), and downstream Wnt proteins (β‐catenin, Tyr‐p‐GSK3β, Ser‐p‐GSK3β) were analyzed by Western blot. Results: Of the 263 genes examined, the expressions of 22 genes in differentiating NSC were either upwardly or downwardly affected by EtOH. These genes are associated with 5 pathways/cellular processes: axon guidance; hedgehog signaling; TGF‐β signaling; cell adhesion molecules; and Wnt signaling. When compared to controls, EtOH, at both 20 and 100 mM concentrations, suppressed the expression of Wnt3a and Wnt5a, receptor complex proteins p‐LRP6, LRP6 and DVL2, and cytoplasmic proteins Ser‐p‐GSK3β and β‐catenin. Expression of NKD‐2 and DVL3 remained unchanged and the expression of active Tyr‐p‐GSK3β increased significantly. Conclusions: EtOH can significantly alter neural differentiation pathway‐related gene expression and suppress Wnt signaling proteins in differentiating human NSC.     

Caries risk profile of 12 year old school children in an Indian city using Cariogram

Objectives: The present study was conducted with an aim to assess the caries profile of 12 year old Indian children using Cariogram. Study design: Hundred children were interviewed to record any illness, oral hygiene practices and fluoride exposure after obtaining a three day diet diary. Examination was done to record plaque and dental caries status. Stimulated saliva was collected and salivary flow rate, salivary buffering capacity, Streptococcus mutans and Lactobacillus were assessed. The information obtained was scored and Cariogram was created. Differences between mean decayed, missing and filled teeth ( DMFT) and Cariogram risk groups were assessed using ANOVA. Spearman Correlation coefficients were used to explore correlation among Cariogram scores and individual variables. Results: It was found that 21, 45, 21 and 13 children had 0-20%, 21-40%, 41-60% and 61-100% chance of avoiding caries respectively in future. Significant correlation was observed between cariogram score and DMFT, diet content, diet frequency, plaque scores, Streptococcus mutans counts and fluoride programme. Conclusions: Cariogram model can identify the caries-related factors that could be the reasons for the estimated future caries risk, and therefore help the dentist to plan appropriate preventive measures. Key words:Cariogram, caries risk assessment, risk factors, children, India     

Factors influencing adherence to antiretroviral treatment in Asian developing countries: a systematic review

Objective To systematically review the literature of factors affecting adherence to Antiretroviral treatment (ART) in Asian developing countries. Methods Database searches in Medline/Ovid, Cochrane library, CINAHL, Scopus and PsychINFO for studies published between 1996 and December 2010. The reference lists of included papers were also checked, with citation searching on key papers. Results A total of 437 studies were identified, and 18 articles met the inclusion criteria and were extracted and critically appraised, representing in 12 quantitative, four qualitative and two mixed‐method studies. Twenty‐two individual themes, including financial difficulties, side effects, access, stigma and discrimination, simply forgetting and being too busy, impeded adherence to ART, and 11 themes, including family support, self‐efficacy and desire to live longer, facilitated adherence. Conclusion Adherence to ART varies between individuals and over time. We need to redress impeding factors while promoting factors that reinforce adherence through financial support, better accessible points for medicine refills, consulting doctors for help with side effects, social support and trusting relationships with care providers.     

Visible light-mediated photocatalytic oxidative cleavage of activated alkynes via hydroamination: a direct approach to oxamates

The direct oxidative cleavage of activated alkynes via hydroamination has been described using organic photocatalyst under visible-light irradiation at room temperature. In this reaction, the single electron oxidation of an in situ formed enamine followed by radical coupling with an oxidant finally delivers the oxamate. The key features of this photocatalytic reaction are the mild reaction conditions, metal-free organic dye as a photocatalyst, and TBHP playing a dual role as “O” source and for the regeneration of the photocatalyst.

The direct oxidative cleavage of activated alkynes via hydroamination has been described using organic photocatalyst under visible-light irradiation at room temperature.