Teaching ultrasound in osteopathic medical schools.

CONTEXT: An important diagnostic tool, ultrasound (US) has been incorporated into the curriculum of medical schools for more than 20 years. In the last decade, the interest in US educational research has experienced exponential growth but mostly from Medical Doctor (MD)-granted schools. The extent to which US is embedded in the curricula of the colleges of osteopathic medicine (COM) still requires a comprehensive evaluation. OBJECTIVES: This survey is designed to evaluate the current status of US teaching in COMs with an emphasis on the inclusion of the US in osteopathic manipulative medicine (OMM) training. METHODS: An anonymous, voluntary, 22-question online survey was created and administered to all COMs to collect data about the current state of US teaching. A descriptive analysis was performed to describe and summarize the final data. Fisher's exact test was utilized for the comparison of study variables. RESULTS: We received responses from 36 of the 43 (83.7 %) COMs invited to participate in the survey, all of which had US training within their curriculum, most commonly integrated into the year 1 curriculum (86.1 %). Focused US training is incorporated into 83.3 % of these schools (30 of 36). Focused US training is covered in 83.3 % of schools (30 of 36). US is mostly taught in the anatomy course (38.8 %). US is incorporated in the OMM course in 12 of 36 schools (33.3 %). The majority of respondents feel that US training will make osteopathic students more competitive in the job market (88.9 %) and want more US in their curriculum (86.1 %). The idea that US is useful for a better understanding of the key OMM concepts is believed by 62.9 % of respondents. The major obstacle to the implementation of US in the curriculum is having appropriately trained faculty (86.1 %). The majority of the respondents did not feel that an adequate budget is a handicap to implementing US in the curriculum. CONCLUSIONS: US is included within the curriculum of all respondents to our survey, a third of whom included US within their OMM curriculum. US is treated as a useful and important skill for future osteopathic physicians. The majority of COMs desire more US training in the curriculum. The main barrier to implementing US in the curriculum is the lack of appropriately trained faculty.

First N-allyl-aminothiadiazole copper(I) π-complexes: synthesis and structural peculiarities of [Cu(L)CF3SO3] and [Cu2(L)2(H2O)2](SiF6) · 2.5H2O compounds (L = 2-(allyl)-amino-5-methyl-1,3,4-thiadiazole).

By means of alternating current electrochemical technique two crystalline copper(I) π-complexes with fluorine containing anions [Cu(L)CF3SO3] (1) and [Cu2(L)2(H2O)2](SiF6)2 · 2.5H2O (2) (L - 2-(allyl)-amino-5-methyl-1,3,4-thiadiazole) have been obtained and characterized by X-ray single crystal diffraction and Raman spectroscopy. In both structures the organic molecule L acts as chelate-bridging tridentate ligand being connected to copper(I) by two N atoms of thiadiazole ring and C=C bond from allyl group resulting in a formation of stable cationic dimers [Cu(L)2]2+. In the structure 1 oxygen atom from triflate-anion occupies an apical position of the metal coordination polyhedron, while in 2 located far from the metal centre hexafluorosilicate anion allows an appearance of the H2O molecule in copper environment. Hydrogen bonds (D)-H···A (where D = O, N, C; A = O, F) play a significant role in formation of 2D- (1) and 3D- (2) frameworks.

Antioxidant diet, gender and age affect renal expression of nitric oxide synthases in obese diabetic rats.

Development of diabetic nephropathy (DN) is associated with decreased renal nitric oxide production and increased oxidative stress. We studied nitric oxide synthase (NOS) expression in kidney of obese Zucker fa/fa rats, a model of Type 2 obesity-related DN. Male and female rats received a regular (REG) or antioxidant-fortified (AO) diet starting at age 4 weeks. Quantitative PCR and immunoblot analyses were performed on kidney cortex and medulla to determine levels of endothelial, neuronal and inducible NOS at 6, 13 and 20 weeks of age. Multiple antibody-specific proteins were detected for each form. These may represent monomeric splice forms, post-translationally modified forms and their dimers, consistent with the known complexity of regulation of these enzymes. Levels of eNOS and nNOS are higher in males than females at 6 weeks on the REG diet and 13 weeks on either diet; the relationship is reversed in females at 6 weeks on the AO diet. Levels of eNOS and nNOS are lower on the AO diet compared to REG, in males at 6 and 13 weeks and females at 13 weeks; the reverse is seen in 6 week females and 20 week males. All three isoforms show peak levels in the younger animals, at 6 or 13 weeks. Better preservation of kidney function is associated with higher prevalence of dimers with potential to increase production of NO and lower levels of potentially harmful monomers. Differential expression of NOS isoforms may be linked to renal functional and histopathological changes in this rat model of DN.

First Silver(I) - Complexes with Tetrazole Allyl Derivatives. Synthesis and Crystal Structure of [Ag2(C10H10N4S)2(H2O)2](BF4)2 and [Ag(C10H9ClN4S)(NO3)] π-Compounds (C10H10N4S and C10H9ClN4S - 5-(Allylthio)-1-phenyl- and 5-(Allylthio)-1-(4-chlorophenyl)-1H-tetrazole).

Crystalline silver(I) π complexes [Ag2(atpt)2(H2O)2](BF4)2 (1) (atpt - 5-(allylthio)-1-phenyl-1H-tetrazole (C10H10N4S)) and [Ag(atcpt)(NO3)] (2) (atcpt - 5-(allylthio)-1-(4-chlorophenyl)-1H-tetrazole (C10H9ClN4S)) complexes have been obtained using silver salt and the organic ligands. Compounds were characterized by X-ray single crystal diffraction: for 1 space group P21/n, a = 10.4560(5), b = 11.4008(5), c = 12.7550(7) Å, ß = 98.128(3)°, V = 1505.21(13) Å3 at 200 K, Z = 2; for 2: space group P21/a, a = 8.6790(8), b = 13.7324(10), c = 12.4597(13) Å, ß = 102.288(5)°, V = 1451.0(2) Å3 at 200 K, Z = 4. In both structures silver(I) atoms possess a trigonal pyramidal coordination environment with essentially different coordination modes of organic ligands. The Ag(I) arrangement in 1 involves the N3 and N4 atoms of two adjacent atpt molecules, an olefin C=C bond and a water molecule at the apical position. In crystal structure of 2 two O atoms from NO3- anions occupy two equatorial position of silver(I) coordination polyhedron, and atcpt is attached to the metal centre through the N4 atom of tetrazole core only. The weakly bound C=C bond is located at the apical position of Ag(I) environment.

Crystal structure and enantiomeric layer disorder of a copper(I) nitrate π-coordination compound.

The novel π-coordination compound [CuI(m-dmphast)NO3], where m-dmphast = 5-(allylthio)-1-(3,5-dimethylphenyl)-1H-tetrazole, is characterized using single-crystal X-ray diffraction and crystallizes in a noncentrosymmetric space group. Additionally, for the first time in this group of materials, the streaks of X-ray diffuse scattering in the reciprocal space sections were observed and described. This gave the possibility for a deeper insight into the local structure of the title compound. The conjecture about the origin of diffuse scattering was derived from average structure solution. It was then confirmed using the local structure modelling. The extended [Cu(m-dmphast)NO3]∞ chains, connected by weak interactions, produce layers which can exist in two enantiomeric forms, one of which predominates.

Paternal high-fat diet enhances offspring whole-body insulin sensitivity and skeletal muscle insulin signaling early in life.

Evidence suggests that paternal diet can predispose offspring to metabolic dysfunction. Despite this knowledge, little is known regarding the effects of paternal high-fat feeding on offspring insulin sensitivity. The purpose of this study was to investigate for the first time the effects of paternal high-fat feeding on whole-body and skeletal muscle insulin action in young and adult offspring. At 4 weeks of age, founder C57BL6/N males (F0) were fed a high-fat diet or control diet for 12 weeks and then bred with females on a control diet. Offspring (F1) were euthanized at 6 weeks, 6 months, or 12 months and insulin-stimulated insulin signaling was measured ex vivo in isolated soleus muscle. At 6 weeks of age, paternal high fat offspring (HFO) had enhanced whole-body insulin sensitivity (35%, P < 0.05), as well as, increased insulin-stimulated skeletal muscle phosphorylation of Akt threonine 308 (70%, P < 0.05) and AS160 threonine 642 (80%, P < 0.05) compared to paternal control fed offspring (CFO), despite both offspring groups consuming standard chow. At 6 months of age, HFO had increased percent body fat compared to CFO (74%, P < 0.005) and whole-body and skeletal muscle insulin signaling normalized to CFO. Body fat was inversely related with insulin signaling in HFO, but not CFO. These findings suggest that paternal high-fat feeding contributes to enhanced whole-body and skeletal muscle insulin sensitivity in HFO early in life; however, these benefits are lost by early adulthood, potentially due to premature increases in body fat.

Antioxidant diet and sex interact to regulate NOS isoform expression and glomerular mesangium proliferation in Zucker diabetic rat kidney.

Oxidative stress contributes substantially to the pathophysiology of diabetic nephropathy (DN). Consumption of an antioxidant-fortified (AO) diet from an early age prevents or delays later development of DN in the Zucker rat female with type 2 diabetes. We hypothesize this is due to effects on mesangial matrix and renal nitric oxide synthase (NOS) distribution and to sex-specific differences in NOS responses in the diabetic kidney. Total glomerular tuft area (GTA) and PAS-positive tuft area (PTA), endothelial (e), neuronal (n) and inducible (i) NOS were quantified in males and females on AO or regular (REG) diet at 6 and 20 weeks of age. eNOS was observed in glomeruli and tubules. nNOS predominantly localized to tubular epithelium in both cortex and medulla. iNOS was expressed in proximal and distal tubules and collecting ducts. Sex, diabetes duration and AO diet affected the distribution of the three isoforms. GTA and PTA increased with duration of hyperglycemia and showed a negative correlation with renal levels of all NOS isoforms. AO diet in both genders was associated with less PAS-positive staining and less mesangial expansion than the REG diet, an early increase in cortical iNOS in males, and sex-specific changes in cortical eNOS at 20 weeks. These effects of AO diet may contribute to sex-specific preservation of renal function in females.

Epigenetic effects of paternal diet on offspring: emphasis on obesity.

Overnutrition, obesity, and the rise in associated comorbidities are widely recognized as preventable challenges to global health. Behavioral, metabolic, and epigenetic influences that alter the epigenome, when passed on to offspring, can increase their risk of developing an altered metabolic profile. This review is focused on the role of paternal inheritance as demonstrated by clinical, epidemiological, and experimental models. Development of additional experimental models that resemble the specific epigenetic sensitive situations in human studies will be essential to explore paternally induced trans-generational effects that are mediated, primarily, by epigenetic effects. Further elucidation of epigenetic marks will help identify preventive and therapeutic targets, which in combination with healthy lifestyle choices, can diminish the growing tide of obesity, type 2 diabetes, and other related disorders.

L-Arginine Supplementation in Type II Diabetic Rats Preserves Renal Function and Improves Insulin Sensitivity by Altering the Nitric Oxide Pathway.

Rat studies demonstrated that type II diabetes mellitus (T2DM) decreases both the production and bioavailability of nitric oxide (NO). L-arginine (LA) provides the precursor for the production of NO. We hypothesized that LA dietary supplementation will preserve NO production via endothelial nitric oxide synthase (eNOS) causing renal microvascular vasodilation and increased glomerular blood flow and thus increasing glomerular filtration rate (GFR). This would impede the formation of reactive oxygen species which contributes to cell damage and death. LA supplementation preserved GFR in the treated diabetic rats compared to untreated diabetic rats. We provide evidence that this effect may be due to increased levels of eNOS and urinary cyclic guanosine monophosphate, which leads to renal microvascular vasodilation. Plasma nitrotyrosine was decreased in the LA treated rats; however, plasma nitrite levels remained unaffected as expected. Marked improvements in glucose tolerance were also observed in the LA treated diabetic rats. These results demonstrate that LA supplementation preserves NO activity and may delay the onset of insulin resistance and renal dysfunction during hyperglycemic stress. These results suggest the importance of the NO pathway in consequent renal dysfunction and in the development of insulin resistance in diabetic rats.

Protective effects of antioxidant-fortified diet on renal function and metabolic profile in obese Zucker rat.

Oxidative stress contributes to the pathophysiology of type 2 diabetes mellitus and its complications, including nephropathy. The current study was designed to test the hypothesis that a diet fortified with antioxidants would be beneficial to delay or prevent the progression of this disease. Male and female Zucker fa/fa rats were fed a control or an antioxidant (AO)-fortified diet starting at 4 weeks of age. Metabolic parameters, renal function, and renal histopathology were analyzed at 6, 13, and 20 weeks of age. Females on the AO diet had significantly lower blood glucose at 6 and 13 weeks, less severe renal pathology at 20 weeks, and higher glomerular filtration rates (GFR) at 20 weeks than age-matched females on the regular diet (P < 0.05). Metabolic parameters including blood glucose, insulin resistance, and serum cholesterol, and mean arterial pressure (MAP), worsened with age in both males and females, as expected. GFR decreased and renal pathology also became more severe with age. Finally, females on the AO diet had higher GFRs and lower MAP at 20 weeks than males on the same diet. This may denote a protective effect of the AO diet in females, but not in males. These findings may have implications for the role of antioxidants as therapy in humans with T2DM.