The frequency of acute kidney injury in patients with chronic hepatitis C virus infection treated with sofosbuvir-based regimens.

BACKGROUND: Guidelines recommend withholding sofosbuvir (SOF) in patients with an estimated glomerular filtration rate (eGFR) of less than 30 mL/min. AIM: To assess the risk of acute kidney injury (AKI) in patients with no renal contraindications for SOF-based treatment. METHODS: This multicenter retrospective observational study included all consecutive patients that were treated with SOF-based or telaprevir/boceprevir (TVR/BOC)-based regimens at two tertiary university centers in North America. AKI was defined as an increase of ≥0.3 mg/dL (≥26.5 µmol/L) in serum creatinine level. Multivariable logistic regression analysis was used to identify risk factors for the occurrence of AKI. RESULTS: In total, 426 patients were included and treated with a SOF-based regimen (n=233, 54.7%) or TVR/BOC-based regimen (n=193, 45.3%). Among patients treated with a TVR/BOC-based regimen 34 (18%) of 193 patients experienced AKI compared to 26 (11%) of 233 patients treated with SOF-based regimens (P=.056). Multivariable logistic regression analysis showed that the presence of ascites (OR: 4.44, 95%CI: 1.46-13.54, P=.009) and the use of NSAIDs (OR: 4.47, 95%CI: 1.32-15.19, P=.016) were associated with a risk of AKI during SOF-based antiviral therapy. Creatinine levels returned to normal at end of follow-up in 23 (88%) of the 26 patients who experienced AKI with a SOF-based regimen and had a creatinine level available during follow-up. CONCLUSIONS: Although the risk for AKI was lower than for patients treated with TVR/BOC-based regimens, AKI was seen during 11% of SOF-based regimens and was mostly reversible. Patients with ascites and patients using NSAIDs have an increased risk for AKI during SOF-based antiviral therapy.

Characterization of short root anomaly in a Mexican cohort--hereditary idiopathic root malformation.

OBJECTIVE: The purpose of this study was to systematically characterize individuals with short root anomaly (SRA) without any history of orthodontic treatment. The long-term objective of the study was to improve diagnosis and treatment planning and determine risk factors for developing SRA. SETTING AND SAMPLE POPULATION: Twenty-seven patients including two families and 16 unrelated individuals from (9-48 years) reported to orthodontic and/or dental practitioners within the USA. MATERIALS AND METHODS: Digital panoramic and periapical films were analyzed to document pattern and frequency of SRA-affected teeth. Crown-to-root (CR) ratios of the affected teeth were used to characterize the extent of malformation. Pedigree analysis by inspection was completed for one family to determine pattern of inheritance. RESULTS: Twenty-six of the twenty-seven individuals were of Latino descent, and one was of Filipino descent. Hard tissues including enamel, dentin, pulp chambers and canals, and surrounding soft tissues were normal. We found that 25 of 27 individuals had localized SRA and two Latino individuals had generalized SRA. Teeth were affected bilaterally with maxillary central incisors (~63%) and mandibular second premolars most commonly involved (~33%). Affected teeth had a distinct, similar radiographic appearance; in the generalized cases, there was a more severe affection with larger (~twice) CR ratios. Ninety-four percent of affected individuals did not show a significant difference in the CR ratios at different ages. Pedigree analysis suggests an autosomal dominant inheritance pattern in one family. CONCLUSION: This is the first report to show that SRA occurs more frequently in Latino individuals and has a predilection for anterior teeth. The occurrence of SRA in two families further confirms a hereditary component and supports a distinct nosology and nomenclature, hereditary idiopathic root malformation (HIRM) and warrants further investigation.

Field demonstration of simultaneous wind and temperature measurements from 5 to 50 km with a Na double-edge magneto-optic filter in a multi-frequency Doppler lidar.

We report the first (to our knowledge) field demonstration of simultaneous wind and temperature measurements with a Na double-edge magneto-optic filter implemented in the receiver of a three-frequency Na Doppler lidar. Reliable winds and temperatures were obtained in the altitude range of 10-45 km with 1 km resolution and 60 min integration under the conditions of 0.4 W lidar power and 75 cm telescope aperture. This edge filter with a multi-frequency lidar concept can be applied to other direct-detection Doppler lidars for profiling both wind and temperature simultaneously from the lower to the upper atmosphere.

Na double-edge magneto-optic filter for Na lidar profiling of wind and temperature in the lower atmosphere.

A Na double-edge magneto-optic filter is proposed for incorporation into the receiver of a three-frequency Na Doppler lidar to extend its wind and temperature measurements into the lower atmosphere. Two prototypes based on cold- and hot-cell designs were constructed and tested with laser scanning and quantum mechanics modeling. The hot-cell filter exhibits superior performances over the cold-cell filter containing buffer gas. Lidar simulations, metrics, and error analyses show that simultaneous wind and temperature measurements are feasible in the altitude range of 20-50 km using the hot-cell filter and reasonable Na lidar parameters.

A multidimensional conceptualization of racism-related stress: implications for the well-being of people of color.

A conceptualization of racism-related stress and its impact on well-being is offered that integrates existing theory and research on racism, multicultural mental health, and the stress process. The conceptualization is relevant to diverse racial/ethnic groups, considers the larger social and historical context, and incorporates attention to culture-based variables that may mediate the relationship between racism and well-being. Implications for intervention are discussed.

Fluorine-19 nuclear magnetic resonance spectroscopic study of fluorophenylalanine- and fluorotryptophan-labeled avian egg white lysozymes.

We report the 470-MHz (11.7 T) 19F solution nuclear magnetic resonance (NMR) spectra of 2-, 3-, and 4-fluorophenylalanine incorporated into the egg white lysozymes (EC 3.2.1.17) of chicken, pheasant, and duck, as well as spectra of 4-fluorotryptophan incorporated into chicken, California valley quail, and Bob White quail and 5- and 6-fluorotryptophan-labeled chicken lysozyme. The 19F solution NMR spectrum of [4-F]Phe hen egg white lysozyme (HEWL) consists of three sharp resonances, which span a total chemical shift range of 4.8 ppm (at p2H = 6.1). For [3-F]Phe HEWL, the chemical shift range is much smaller, 1.0 ppm (at p2H = 5.9), due presumably to the occurrence of fast phenyl ring flips about the C beta-C gamma bond axis. For [2-F]Phe HEWL, six resonances are observed, spanning a chemical shift range of 7.4 ppm (at p2H = 5.8), due to slow C beta-C gamma ring flips, i.e., both ring-flip isomers appear to be "frozen in" because of steric hindrance. Rotation of the [2-F]Phe residues remains slow up to 55 degrees C (p2H = 4.7). With the [F]Trp-labeled proteins, we find a maximal 14.6-ppm shielding range for [4-F]Trp HEWL but only a 2.8- and 2.4-ppm range for [5- and 6-F]Trp HEWL, respectively, due presumably to increased solvent exposure in the latter cases. Guanidinium chloride denaturation causes loss of essentially all chemical shift nonequivalence, as does thermal denaturation. Spectra recorded as a function of pH show relatively small chemical shift changes (< 1.4 ppm) over the pH range of approximately 1.2-7.8.(ABSTRACT TRUNCATED AT 250 WORDS)

Pluralism, performance and meaning in Taiwanese healing: a case study.

A case of presumed psychosis in a 16-year-old Taiwanese girl is examined to show the role of performance in creating meaning in a plural medical system. The case illustrates that there is no necessary correspondence between diagnoses, authorities, and therapies; that consensus, if achieved at all, is tenuous and context-dependent; that meaning is created by performance, rather than the other way around; and that understanding of how therapies work depends on their efficacy.

Vitamin A (retinol and retinyl esters), alpha-tocopherol and lipid levels in plasma of captive wild mammals and birds.

Vitamin A (retinol and retinyl esters), vitamin E and lipids were determined in a wide variety of wild mammals and birds held in captivity. In mammals plasma levels of vitamin A were generally below 500 ng/ml and those of vitamin E were highly variable (0.1-2 micrograms/ml). In primates, vitamin E levels were 3 to 8 micrograms/ml. Whereas in Marsupialia, Chiroptera, primates, Rodentia, Proboscidea, Sirenia, Perissodactyla and Artiodactyla only retinol was found, retinyl esters (basically retinol palmitate/oleate) represented 10 to 50% of the total plasma vitamin A in some birds of the order Ciconiiformes and Falconiformes. Retinol levels in birds were higher compared to mammals (500-2,000 ng/ml). The same was true for lipids as well as for vitamin E levels (1-26 micrograms/ml) in the plasma of birds.

Open lung biopsy in the critically ill newborn.

Experience with 17 open lung biopsies in critically ill premature neonates was reviewed. Despite their small size, prematurity, and near maximal ventilator requirements, the infants suffered no significant complications. In three cases, an infectious agent was identified. In one case end-stage lung fibrosis associated with persistent (greater than 3 months), severe respiratory failure prompted termination of support. In the remainder of the cases, definitively ruling out infection allowed the confident trial of a course of steroids in an attempt to treat bronchopulmonary dysplasia. Unlike older patients, the definitive diagnosis of no infection in the premature neonate is just as informative as the diagnosis of an infection. Used judiciously, open lung biopsy can be performed in the premature infant with acceptable morbidity and mortality.

Effect of feeding on vitamin A concentrations in blood plasma of dogs.

The effects of different concentrations of vitamin A in food as well as different food compositions on serum vitamin A levels in dogs were investigated. Contrary to current knowledge for all other species, vitamin A levels in dogs were clearly affected by the daily vitamin A supply as well as the type of food. This behavior, similar to that of vitamin E, can be explained by the fact that dogs and other carnivores transport most of their vitamin A in blood as retinyl esters (mainly retinyl stearate) bound to lipoproteins. The differences in the retinyl ester pattern between vitamin A in liver and in blood indicates that the mobilization of vitamin A from the liver involves selective mechanism. The possible importance of nonspecific, lipoprotein-bound vitamin A esters in the blood of dogs is discussed.

Extracorporeal membrane oxygenation in the newborn.

Extracorporeal membrane oxygenation (ECMO) is used in the treatment of reversible pulmonary disease in the newborn. The ECMO program at Wilford Hall USAF Medical Center began in 1985 and to date, 57 patients have been placed on bypass for a mean of 125 hours. The indications for ECMO are severe, prolonged hypoxemia in patients with an estimated mortality of greater than 90% using conventional ventilator support. The major diagnoses in the patients placed on ECMO were meconium aspiration, congenital diaphragmatic hernia, and neonatal sepsis or pneumonia. Overall survival was 79%, or 45 out of 57. The most frequent complications were intracranial hemorrhage as well as hemorrhage from the surgical site. We have found ECMO to be an extremely valuable adjunct in the care of the critically ill newborn and believe it can significantly improve survival in infants with reversible pulmonary disease.

Vertical transmission of channel catfish virus.

Channel catfish broodfish were examined nondestructively for the presence of channel catfish virus (CCV), using a nucleic acid-probing technique. A dot blot assay was tested and shown to be accurate and rapid in the diagnosis of CCV. Two CCV-positive fish were successfully mated, and fertilized eggs were collected. Offspring that hatched were tested and were shown to have CCV. This result indicated vertical transmission of CCV, a herpesvirus.

Effect of human interferon on vesicular stomatitis virus released from bovine embryonic kidney cells.

Human lymphoblastoid interferon (IFN) had an antiviral activity in bovine embryonic kidney cells that resulted in the release of vesicular stomatitis virus (VSV) particles with decreased infectivity. The inhibition was dose dependent and the cells were highly sensitive to human IFN. Examination of the proteins of VSV released from bovine cells after IFN treatment showed a reduction in the glycoprotein. Electron microscopic studies revealed a large number of VSV particles with characteristic spike-like surface projections released from nontreated cells. There was a reduction in the number of mature virions produced in IFN-treated cells and the virions lacked the characteristic surface projections.