Obesity in acute alcoholic hepatitis increases morbidity and mortality.

BACKGROUND: Alcohol and obesity synergise to increase the risk of liver-related mortality. We examined the influence of adiposity on clinical outcomes in alcoholic hepatitis (AH) and the underlying inflammatory crosstalk between adipose tissue (AT) and the liver. METHODS: A cohort of 233 patients with AH from the UK and USA provided data to analyse the effects of obesity in AH. Body mass index was corrected for the severity of ascites, termed cBMI. Inflammatory and metabolic profiling was undertaken by proteome analysis of human serum samples. The effect of alcohol on adipose tissue and CXCL11 expression was studied in 3 T3-derived adipocytes and in mice using the high-fat diet-plus-binge ethanol model. FINDINGS: Obesity was common amongst patients with AH, seen in 19% of individuals. Obesity (HR 2.22, 95%CI 1.1-4.3, p = .022) and underweight (HR 2.38, 1.00-5.6, p = .049) were independently associated with mortality at 3 months. Proteome analysis demonstrated multiple metabolic and inflammatory factors differentially expressed in obese AH verse lean AH, with CXCL11 being the most elevated factor in obese AH. In vitro analysis of cultured adipocytes and in vivo analysis of mouse models showed that alcohol induced CXCL11 expression in AT, but not in liver. INTERPRETATION: Obesity is common in AH and associated with a greater than two-fold increase in short-term mortality. Obese AH is associated with a different inflammatory phenotype, with the greatest elevation in CXCL11. These data confirm that adiposity is clinically important in acute alcohol-related liver disease and illustrate the adipose-liver inflammatory axis in AH. FUND: This work was supported in part by an EASL Sheila Sherlock Physician Scientist Fellowship. The funder played no role in gathering or analysing data or writing the manuscript. This paper presents independent research supported by the NIHR Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Nanomagnet logic: progress toward system-level integration.

Quoting the International Technology Roadmap for Semiconductors (ITRS) 2009 Emerging Research Devices section, 'Nanomagnetic logic (NML) has potential advantages relative to CMOS of being non-volatile, dense, low-power, and radiation-hard. Such magnetic elements are compatible with MRAM technology, which can provide input­output interfaces. Compatibility with MRAM also promises a natural integration of memory and logic. Nanomagnetic logic also appears to be scalable to the ultimate limit of using individual atomic spins.' This article reviews progress toward complete and reliable NML systems. More specifically, we (i) review experimental progress toward fundamental characteristics a device must possess if it is to be used in a digital system, (ii) consider how the NML design space may impact the system-level energy (especially when considering the clock needed to drive a computation), (iii) explain--using both the NML design space and a discussion of clocking as context­how reliable circuit operation may be achieved, (iv) highlight experimental efforts regarding CMOS friendly clock structures for NML systems, (v) explain how electrical I/O could be achieved, and (vi) conclude with a brief discussion of suitable architectures for this technology. Throughout the article, we attempt to identify important areas for future work.

Consanguinity-associated kidney diseases in Lebanon: an epidemiological study.

Consanguineous marriages are common in many countries of the Middle East including Lebanon. Their impact on the repartition of kidney diseases and on the risk for familial nephritis is not known. We surveyed all of the dialysis centers in Lebanon. Nine hundred and twenty-five (925) patients and their private physicians were asked to answer a questionnaire. More than half of the hemodialysis (HD) patients had an unknown etiology of their kidney disease. Diabetes, polycystic kidney disease (PKD), chronic pyelonephritis and nephrosclerosis (NS) were the most commonly documented diagnoses. Consanguinity was present in 26% of the total HD population. More consanguineous patients with unknown renal etiology were diagnosed with their kidney diseases and initiated on dialysis before the age of 30 when compared with their non-consanguineous counter-parts (45% versus 33%, P<0.02 and 42% versus 27%, P<0.01), respectively. Similarly, consanguineous polycystic patients were diagnosed and started earlier on dialysis when compared with the non-consanguineous population (34% versus 12%, P<0.05 and 28% versus 8%, P<0.05), respectively suggesting a different disease pattern. Furthermore, the risk for family history of kidney disease was noticeable in the non-consanguineous population and significantly higher among the consanguineous patients (12% versus 18%, P<0.04). Consanguinity-associated kidney diseases affected all religious communities, in particular the Muslim and the Druze (36 and 39%), respectively versus 17% of the Christian community. Certain geographical areas were more involved than others such as the North, South and the Bekaa with the highest percentage (40%) in the latter. Socio-economical level was not a contributing factor. We conclude that the documentation of the underlying etiology in end-stage renal diseases (ESRD) seems to be deficient. Furthermore, consanguinity is prevalent in the Lebanese dialysis patients population, in particular the Muslim and the Druze communities. Consanguinity-associated kidney diseases pattern seems to differ from that of the general HD population by disease diagnosis and initiation at a younger age and a significantly higher risk for familial renal disease. It is a cultural phenomenon prevalent predominantly in the rural areas. We recommend a multi-approach including educational, informative and probably legislative strategy in order to limit and hopefully discourage consanguineous marriages.

Effects of feeding locally grown whole barley with or without enzyme addition and whole wheat on broiler performance and carcass traits.

Two experiments were conducted to investigate the impact of increasing dietary levels of whole barley (WB) with or without exogenous enzymes and of whole wheat (WW) without E fed from 7 d of age, on performance and carcass characteristics of broilers. Experiment 1 was conducted with corn-soybean meal grower diets containing WB at 0, 10, 10 + enzymes, 15, or 15% + enzymes. The finisher diets contained, as fed, WB at 0, 15, 20 + enzymes, 15, or 20% + enzymes. In Experiment 2, grower diets contained 0, 10, 10, 20, or 20% WW with 0, 20, 35, 20, or 35% WW in the finisher diets. No enzymes were used for WW diets. In each Experiment, 1,500 1-d-old Ross x Ross male broilers were randomly distributed in 30 floor pens of 50 birds each. Six replicates were allotted to each treatment. Body weight, average daily gain (ADG), feed intake (FI), and feed efficiency ratio (FER) were measured at 7, 21, and at 38 d of age. In Experiment 1, ADG was lower (P < 0.05) in the control vs. Diet 5. However, FER with enzyme addition was lower, and FI with enzymes was higher (P < 0.05). Final BW, gizzard, and pancreas weights were higher (P < 0.05) with WB inclusion. In Experiment 2, ADG and BW significantly increased with addition of WW, although the response was best for Diets 2 and 3. Abdominal fat and carcass weights increased (P < 0.05) with the WW levels in the diets.

Duplicación utero-vaginal con hematocolpos asociado a agenesia renal ipsilateral / Duplication utero-vaginal with hematocolpos associated with ipsilateral renal agenesis

Reportamos un caso de útero didelfo con tabique completo que compromete el cuello uterino y la vagina en todo su recorrido sin perforación del lado derecho a vulva, asociado a malformaciones renales diagnosticado por Resonancia Nuclear Magnética (RMN). Estas malformaciones congénitas son usualmente detectadas con la realización de una histerosalpingografía, urograma excreter y/o ecografía ante la sospecha de su existencia. En nuestro caso, la paciente, de 15 años de edad, eumenorreica, fue sometida a una RMN y a una laparoscopia diagnóstica y plástica vaginal luego de los hallazgos clínicos y ecográficos de sospecha de malformación congénita, tras la consulta por dolor pelviano, vómica menstrual y tumor pelviano. La RMN ayudó no solo a realizar un diagnóstico más preciso del tipo de malformación sino que además fue de extrema ayuda a la hora de decidir la terapéutica quirúrgica adecuada

Maryland physicians' survey on Lyme disease.

In a survey of 252 physicians practicing in Maryland, 170 responders diagnosed 142 cases of Lyme disease (LB) during 1990 and 1991. About 80% of the cases were diagnosed by primary care physicians. The most common clinical finding, erythema migrans (EM), was reported in half the cases and arthritis was reported in a quarter. Only 22.2% had a history of a tick bite; serological tests were ordered in a third of the cases. EM was treated with oral antibiotics for 10-21 days. Most physicians treated Lyme arthritis with the same therapy, although some used intravenous ceftriaxone. The most commonly used treatment for neurologic or cardiac complications was intravenous ceftriaxone. These preliminary data suggest that LB may be diagnosed by Maryland physicians more frequently than syphilis and tuberculosis. The data also indicate LB is a much larger problem in Maryland than suggested by official reports to the Centers for Disease Control. The clinical characteristics of the illness and the antibiotics prescribed for it in Maryland are similar to those reported in northeastern states.

Sweet preference and dental caries among Bedouin youth in Israel.

Sweet preference and caries prevalence were studied in Bedouin adolescents from two different communities. Twelve-year-old schoolchildren were surveyed in a rural village (30 examinees) and in a more urbanized settlement (30 examinees). Sweet preference was assessed using a free-choice method, while caries was measured by the DMFT index. Results revealed that the "urbanized" examinees preferred higher sugar concentrations and demonstrated higher DMFT scores than their "rural" counterparts. These differences between the two populations were statistically significant. Data were analyzed for correlation between caries prevalence and sweet preference. When each community was analyzed separately, a statistically significant correlation coefficient (Kendall's tau) was found in "rural" but not in "urbanized" children. In pooled data from both communities the correlation was found to be significant, controlling for the effect of the stratifying (community) variable.