The Role of Vitamin D Deficiency in Hepatic Encephalopathy: A Review of Pathophysiology, Clinical Outcomes, and Therapeutic Potential.

Hepatic encephalopathy (HE) is a neuropsychiatric condition frequently associated with cirrhosis and portosystemic shunting (PSS). It imposes a significant clinical and economic burden, with increasing attention toward identifying modifiable factors that could improve outcomes. Emerging evidence suggests that vitamin D deficiency (VDD), prevalent in patients with cirrhosis, may contribute to the development and severity of HE.

Potential of Vitamin D and l-Cysteine Co-supplementation to Downregulate Mammalian Target of Rapamycin: A Novel Therapeutic Approach to Diabetes.

Diabetes, a metabolic disease associated with an increased health care burden and mortality, is currently on the rise. Both upregulation of the mammalian target of rapamycin (mTOR) and decreased levels of vitamin D (VD) and l-cysteine (LC) have been associated with diabetes. The overactivation of mTOR leads to insulin desensitization and metabolic dysfunction including uncontrolled hyperglycemia.

Vitamin D/Bone Mineral Density and Triglyceride Paradoxes Seen in African Americans: A Cross-Sectional Study and Review of the Literature.

Vitamin D is known to have a positive effect on bone health. Despite the greater frequency of vitamin D deficiency in African Americans (AA), they have a higher bone mineral density (BMD) compared to whites, demonstrating a disconnect between BMD and vitamin D levels in AA. Another intriguing relationship seen in AA is the triglyceride (TG) paradox, an unusual phenomenon in which a normal TG status is observed even when patients house conditions known to be characterized by high TG levels, such as Type II diabetes.

Alzheimer's Disease: A Review of Pathology, Current Treatments, and the Potential Therapeutic Effect of Decreasing Oxidative Stress by Combined Vitamin D and l-Cysteine Supplementation.

Excess oxidative stress and neuroinflammation are risk factors in the onset and progression of Alzheimer's disease (AD) and its association with amyloid-β plaque accumulation. Oxidative stress impairs acetylcholine (ACH) and -methyl-d-aspartate receptor signaling in brain areas that function in memory and learning. Glutathione (GSH) antioxidant depletion positively correlates with the cognitive decline in AD subjects.

Development of Oligomeric Mannose-6-phosphonate Conjugates for Targeted Protein Degradation.

Lysosome targeting chimeras (LYTACs) are a new protein degradation strategy that has recently emerged. LYTACs utilize the native cell internalization process in the body to target and degrade therapeutically relevant extracellular proteins via the lysosomal pathways. The first lysosomal internalization receptor recently used for LYTACs is the mannose-6-phosphate receptor (M6PR).

Paraganglioma in a Young Adult Female Patient: A Case Report.

Paragangliomas are catecholamine-secreting neuroendocrine tumors that originate from the chromaffin cells of the sympathetic ganglia. Roughly 10% of paragangliomas are malignant, resulting in a rare occurrence of 90-95 cases per 400 million people. Herein, we report a case of a 29-year-old female patient who presented with nausea, vomiting, and bloating and was found to have a large left retroperitoneal tumor upon imaging.

Atypical Imaging Findings of Nonketotic Hyperglycemic Hemichorea: A Case Report and Review of the Literature.

Nonketotic hyperglycemic hemichorea (NH-HC) is a rare condition presenting in the clinical setting. Brain imaging plays an important role in diagnosing NH-HC, which typically shows basal ganglia changes contralateral to the side of the hemiballismus/hemichorea. Only a few articles in the literature have reported normal pertinent magnetic resonance/CT findings in patients presenting with NH-HC.

Adrenal Ganglioneuroblastoma of Adult Onset: A Literature Review.

Ganglioneuroblastomas (GNBs) are a rare subtype of neoplastic tumors that arise from the autonomic nervous system and contain both mature gangliocytes and immature neuroblasts. The primary age group affected by GNBs is the pediatric population, with less than 50 cases of adult GNBs existing in the literature. To the authors' best knowledge, only 21 cases of GNBs arising in the adrenal glands of adults have been reported.

The Positive Association of Plasma Levels of Vitamin C and Inverse Association of VCAM-1 and Total Adiponectin with Bone Mineral Density in Subjects with Diabetes.

Context: Population studies have shown a trend in decreasing vitamin C status and increasing prevalence of osteoporosis in patients with diabetes and non-diabetic people. Dietary vitamin C consumption is linked to improvement in bone mineral density (BMD) in epidemiological studies. VCAM-1 and adiponectin are known to activate osteoclasts, which increase bone loss.

A Sleeve-Sheath With a Coaxial Exchangeable Catheter for Palliative Evacuation of Recurrent Thoracic and Abdominal Effusions.

Herein we describe an outer cannula sleeve-sheath with a coaxially inserted exchangeable drainage catheter (SCDC) for effective evacuation of recurrent symptomatic fluid collections in the thorax and abdomen on patients in lieu of, or failed, current evacuation catheters and methods. The design is an alternative to existing commercially available devices and adds distinct enhancements with the possibility of intrathoracic or intrabdominal trans outer sleeve-sheath diagnostic or therapeutic interventions. This device aims at requiring a single invasive procedure (thoracentesis and paracentesis) while offering catheter exchange and repositioning if malfunction or malposition occurs during the patient's lifetime.

A Primer and Literature Review on Internal and External Retention Mechanisms for Catheter Fixation.

Although catheters are commonplace in hospital settings, there is scarce literature discussing the internal and external retention mechanisms used to aid in catheter fixation. Additionally, exact definitions and detailed information on internal and external retention mechanisms are almost non-existent in the literature. This article serves three primary purposes.

An Atypical Presentation of West Nile Virus With Successful Treatment After Plasma Exchange and Intravenous Immunoglobulin.

West Nile (WN) disease is a relatively rare arboviral virus. Neuroinvasive cases of WN account for less than 1% of the total cases. The case described had difficult symptomatology and radical presentation, which included ascending paralysis.

Preoperative Embolization of a Delayed Femoral Metastasis of Renal Cell Carcinoma: A Case Report.

Preoperative embolization of hypervascular bone metastasis is an effective measure for reducing blood loss during open orthopedic surgery. When the clinician is experienced with the procedure, the risks of the procedure are minimal and final outcomes are typically good. In this study, we report a case of a 50-year-old female patient who presented with a delayed metastatic renal cell tumor in the left proximal femur one year after radical nephrectomy.

Swallow Syncope Associated With Intermittent Sinus Pause and High-Degree Atrioventricular Block: A Case Report.

Swallow syncope, also known as deglutition syncope, is a relatively rare neurogenic disorder that is triggered by oral intake. When diagnosed, swallow syncope is treatable, but it is challenging to identify without proper history and prior knowledge of this disorder. Here, we describe the case of a 68-year-old female with a complex history who presented to the emergency room with complaints of worsening long-term intermittent lightheadedness and dizziness associated with swallowing.

Mild Cu(OTf)-Mediated C-Glycosylation with Chelation-Assisted Picolinate as a Leaving Group.

C-Glycosylation reactions of glycosyl picolinates with allyltrimethylsilane or silyl enol ethers were developed. Picolinate as a chelation-assisted leaving group could be activated by Cu(OTf) and avoided the use of harsh Lewis acids. The glycosylations were operated under mild neutral conditions and gave the corresponding C-glycosides in up to 95% yield with moderate to excellent stereoselectivities.

Chemical Synthesis and Biological Application of Modified Oligonucleotides.

RNA plays a myriad of roles in the body including the coding, decoding, regulation, and expression of genes. RNA oligonucleotides have garnered significant interest as therapeutics via antisense oligonucleotides or small interfering RNA strategies for the treatment of diseases ranging from hyperlipidemia, HCV, and others. Additionally, the recently developed CRISPR-Cas9 mediated gene editing strategy also relies on Cas9-associated RNA strands.

Synthesis of Glycosyl Chlorides and Bromides by Chelation Assisted Activation of Picolinic Esters under Mild Neutral Conditions.

A general method has been developed for the formation of glycosyl chlorides and bromides from picolinic esters under mild and neutral conditions. Benchtop stable picolinic esters are activated by a copper(II) halide species to afford the corresponding products in high yields with a traceless leaving group. Rare β glycosyl chlorides are accessible via this route through neighboring group participation.