Characteristics of patients with the "malignant obesity hypoventilation syndrome" admitted to an ICU.

Background: The incidence of obesity in westernized nations is increasing at an alarming rate. We have noted an increasing number of patients admitted to our intensive care unit (ICU) with hypercapnic respiratory failure and multisystem organ dysfunction related to obesity. We have coined the term the malignant obesity hypoventilation syndrome (MOHS) to describe this entity.

Laurence Moon Bardet Biedl syndrome associated with dyslipoproteinaemia.

Laurance Moon Bardet Biedl (LMBB) syndrome is a rare disorder characterised by retinitis pigmentosa, hexadactyly, obesity, mental retardation and hypogonadism. In the present case report the patient presented with the features of Laurence Moon Bardet Biedl syndrome in association with dyslipoproteinaemia.

Treatment of pulmonary hypertension.

Pulmonary arterial hypertension (PAH) is a chronic progressive disease of the pulmonary vasculature characterized by elevated pulmonary arterial pressure and secondary right ventricular failure. PAH is considered a life-threatening condition unless treated. This article provides a comprehensive review of controlled and uncontrolled trials to define the risk-benefit for different therapeutic options of this clinical disorder.

Reduction in atherosclerotic events: a retrospective study in an outpatient cardiology practice.

Introduction: Although atherosclerotic disease cannot be cured, risk of recurrent events can be reduced by application of evidence-based treatment protocols involving aspirin, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statin medications. We studied atherosclerotic event rates in a patient population treated before and after the development of aggressive risk factor reduction treatment protocols.

Material And Methods: We performed a retrospective chart review of patients presenting for follow-up treatment of coronary artery disease in a community cardiology practice, comparing atherosclerotic event rates and medication usage in a 2-year treatment period prior to 2002 and a 2-year period in 2005-2008.

The impact of statin therapy on long-term cardiovascular outcomes in an outpatient cardiology practice.

Introduction: Statins reduce coronary events in patients with coronary artery disease.

Material And Methods: Chart reviews were performed in 305 patients (217 men and 88 women, mean age 74 years) not treated with statins during the first year of being seen in an outpatient cardiology practice but subsequently treated with statins. Based on the starting date of statins use, the long-term outcomes of myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABGs) before and after statin use were compared.

Tracking outpatient continuity and chronic disease indicators-a novel use of the new innovations clinic module.

The Accreditation Council for Graduate Medical Education common program requirements for Practice-based Learning and Improvement in Internal Medicine specify that trainees must "systematically analyze [his/her] practice using quality improvement methods, and implement changes with the goal of practice improvement" and that the training program "must include use of performance data" in the assessment of the resident's practice. Before implementation of an electronic health record at our academic medical center, we found meeting these requirements to be challenging. This prompted us to set up the New Innovations (New Innovations, Inc, Uniontown, OH) Software Suite's Patient Continuity module to permit analysis and tracking of both quality of care indicators and patient continuity.

CD44 expression in oro-pharyngeal carcinoma tissues and cell lines.

Expression of CD44, a transmembrane hyaluronan-binding glycoprotein, is variably considered to have prognostic significance for different cancers, including oral squamous cell carcinoma. Although unclear at present, tissue-specific expression of particular isoforms of CD44 might underlie the different outcomes in currently available studies. We mined public transcriptomics databases for gene expression data on CD44, and analyzed normal, immortalized and tumour-derived human cell lines for splice variants of CD44 at both the transcript and protein levels.

The impact of statin therapy on long-term cardiovascular outcomes in an outpatient cardiology practice.

Background: Statins reduce coronary events in patients with coronary artery disease.

Material/methods: Chart reviews were performed in 305 patients (217 men and 88 women, mean age 74 years) not treated with statins during the first year of being seen in an outpatient cardiology practice but subsequently treated with statins. Based on the starting date of statins use, the long-term outcomes of myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABGS) before and after statin use were compared.

A history of being prescribed controlled substances and risk of drug overdose death.

Objective: The abuse of prescription drugs has increased dramatically since 1990. Persons who overdose on such drugs frequently consume large doses and visit multiple providers. The risk of fatal overdose for different patterns of use of opioid analgesics and sedative/hypnotics has not been fully quantified.

Inhaled nitric oxide as salvage therapy in massive pulmonary embolism: a case series.

Inhaled nitric oxide (INO) has been shown to preferentially lower resistance in the pulmonary vasculature. The relative selectiveness of INO in accomplishing this effect makes it an attractive drug to administer as salvage therapy in patients with acute right ventricular failure secondary to pulmonary embolism. We describe 4 cases in which INO was used as a temporizing agent to decrease right ventricular after-load following massive near-fatal pulmonary embolism.

A photocrosslinking assay for reporting protein interactions in polyketide and fatty acid synthases.

Understanding protein-protein interactions that occur between ACP and KS domains of polyketide synthases and fatty acid synthases is critical to improving the scope and efficiency of combinatorial biosynthesis efforts aimed at producing non-natural polyketides. Here, we report a facile strategy for rapidly reporting such ACP-KS interactions based on the incorporation of an amino acid with photocrosslinking functionality. Crucially, this photocrosslinking strategy can be applied to any polyketide or fatty acid synthase regardless of substrate specificity, and can be adapted to a high-throughput format for directed evolution studies.

Organ donation: victory after death.

Despite the Transplantation of Human Organ Act passed in Indian Parliament in 1994, cadaver liver and/or kidney transplant are infrequently performed (in a few private hospitals) in our country compared to living donor liver or kidney transplant. The need for performing more cadaver liver and/or kidney transplants in private and public hospitals is obvious. Immediate measures which should be taken to facilitate more cadaver organ transplant both in private and public hospitals are suggested.

Granulomatous dermatitis due to Malassezia sympodialis.

A 67-year-old man, with multiple skin lesions that appeared over 2 years, had biopsies that disclosed granulomatous dermatitis with associated small yeasts. The urinary antigen test results were negative for Histoplasma infection; cultures from the biopsies did not grow any fungi or other potential pathogens. The chest roentgenogram results were normal.

In situ characterization of the brain-microdevice interface using device-capture histology.

Accurate assessment of brain-implantable microdevice bio-integration remains a formidable challenge. Prevailing histological methods require device extraction prior to tissue processing, often disrupting and removing the tissue of interest which had been surrounding the device. The Device-Capture Histology method, presented here, overcomes many limitations of the conventional Device-Explant Histology method, by collecting the device and surrounding tissue intact for subsequent labeling.

Armodafinil versus Modafinil in Patients of Excessive Sleepiness Associated with Shift Work Sleep Disorder: A Randomized Double Blind Multicentric Clinical Trial.

Aim. To compare the efficacy and safety of armodafinil, the R-enantiomer of modafinil, with modafinil in patients of shift work sleep disorder (SWSD). Material and Methods.

Does model for end-stage liver disease (MELD) require modification?

Model for End-stage Liver Disease (MELD) measures serum bilirubin (mg/dL), serum albumin (g/dL), International Normalised Ratio (INR) for prothrombin time. MELD score accurately predicts survival in 3 months for cirrhotic patients on the waiting list of liver transplantation. In about 15% of patients, it does not accurately predict survival and hence MELD-Na is recommended.

Glomerulitis during acute cellular rejection may be a surrogate marker of vasculitis in renal allografts--better index for diagnosis of vasculitis.

Background: The Banff criteria (from 2005 to 2009) use "T cell-mediated rejection" to indicate acute cellular rejection. Vasculitis in smaller arteries is an important diagnostic criterion for moderate and severe T cell-mediated rejection. The renal allograft endothelium is a significant target of inflammatory response-mediated tissue damage.

Comparison of radiographic stress views for scapholunate dynamic instability in a cadaver model.

Purpose: Many different stress views for the diagnosis of scapholunate (SL) instability have been described in the literature. The purpose of this study is to compare these stress views and determine which view has the greatest utility for demonstrating SL gap radiographically.

Methods: We performed a literature search for articles describing SL radiographic stress views.

T cell lymphoma presenting as esophageal obstruction and bronchoesophageal fistula.

Background: The mediastinum is an uncommon location for presentation of peripheral T cell lymphoma. Esophageal involvement by non-Hodgkin's lymphoma is extremely unusual. Although staging can be performed with routine imaging studies, surgical intervention is often required to ensure accurate histologic diagnosis of these lymphomas.

Synthesis and SAR studies of novel 2-(6-aminomethylaryl-2-aryl-4-oxo-quinazolin-3(4H)-yl)acetamide vasopressin V1b receptor antagonists.

Synthesis and structure-activity relationships (SAR) of a novel series of vasopressin V(1b) antagonists are described. 2-(6-Aminomethylaryl-2-aryl-4-oxo-quinazolin-3(4H)-yl)acetamide have been identified with low nanomolar affinity for the V(1b) receptor and good selectivity with respect to related receptors V(1a), V(2) and OT. Optimised compound 16 shows a good pharmacokinetic profile and activity in a mechanistic model of HPA dysfunction.

Validation of edible taste strips for identifying PROP taste recognition thresholds.

Objectives/hypothesis: The purpose of this study was to validate the use of edible taste strips for measuring taste recognition thresholds for the bitter-tasting compound 6-n-propylthiouracil (PROP).

Study Design: Taste recognition thresholds for PROP were obtained by two separate methods. Thresholds were also identified in subjects whose airflow through the nose was blocked.

Clinical outcomes in infants with cystic fibrosis transmembrane conductance regulator (CFTR) related metabolic syndrome.

An unavoidable outcome of cystic fibrosis newborn screening (CF NBS) programs is the detection of infants with an indeterminate diagnosis. The United States CF Foundation recently proposed the term cystic fibrosis transmembrane conductance regulator related metabolic syndrome (CRMS) to describe infants with elevated immunoreactive trypsinogen (IRT) on NBS who do not meet diagnostic criteria for CF. The objective of this study was to describe the clinical outcomes of infants with CRMS identified through an IRT/DNA algorithm.