Real-World Application of Oral Therapy for Infective Endocarditis: A Multicenter, Retrospective, Cohort Study.

Background: We sought to compare the outcomes of patients treated with intravenous (IV)-only vs oral transitional antimicrobial therapy for infective endocarditis (IE) after implementing a new expected practice within the Los Angeles County Department of Health Services (LAC DHS).

Methods: We conducted a multicentered, retrospective cohort study of adults with definite or possible IE treated with IV-only vs oral therapy at the 3 acute care public hospitals in the LAC DHS system between December 2018 and June 2022. The primary outcome was clinical success at 90 days, defined as being alive and without recurrence of bacteremia or treatment-emergent infectious complications.

Targeted DNA methylation in human cells using engineered dCas9-methyltransferases.

Mammalian genomes exhibit complex patterns of gene expression regulated, in part, by DNA methylation. The advent of engineered DNA methyltransferases (MTases) to target DNA methylation to specific sites in the genome will accelerate many areas of biological research. However, targeted MTases require clear design rules to direct site-specific DNA methylation and minimize the unintended effects of off-target DNA methylation.

FOXO regulates RNA interference in Drosophila and protects from RNA virus infection.

Small RNA pathways are important players in posttranscriptional regulation of gene expression. These pathways play important roles in all aspects of cellular physiology from development to fertility to innate immunity. However, almost nothing is known about the regulation of the central genes in these pathways.

The insulin receptor cellular IRES confers resistance to eIF4A inhibition.

Under conditions of stress, such as limited growth factor signaling, translation is inhibited by the action of 4E-BP and PDCD4. These proteins, through inhibition of eIF4E and eIF4A, respectively, impair cap-dependent translation. Under stress conditions FOXO transcription factors activate 4E-BP expression amplifying the repression.

Primary hepatic carcinoma. Its incidence and relationship to HBsAg.

The records of all patients with primary hepatic carcinoma diagnosed between 1971 and 1976 at Michael Reese Hospital in Chicago were reviewed. Of 175,953 discharges only 43 were for primary hepatic carcinoma; one for 4,080 admissions as compared to one per 193 admissions for primary colonic carcinoma. The patients ranged in age from three to 80 years with a mean age of 60.

A case of Brunner's glands hyperplasia with diarrhea responsive to cimetidine.

A 64-year old woman is described who presented with diarrhea and was found to have diffuse nodular hyperplasia of Brunner's glands of the duodenum verified by endoscopy and biopsy. Gastric hyperacidity was demonstrated with basal acid output of 13.5 mEq.

Metastatic carcinoma of the breast: a cause of obstructive jaundice.

Two cases of jaundice are reported that were secondary to obstruction of the common bile duct by metastatic carcinoma of the breast and relieved by pallieative surgery. In one case, obstructive jaundice was the first evidence of spread beyond regional lymph nodes, in the other patient it was a late manifestation of the disease. In patients with prior history of carcinoma of the breast, jaundice may be secondary to obstruction of the common bile duct, and, because it is amenable to palliation, this possibility should be investigated before concluding that extensive hepatic involvement is the cause of jaundice.

Hepatic sinusoidal dilatation related to oral contraceptives. A study of two patients showing ultrastructural changes.

Two patients who have been on oral contraceptives for five and six years developed sinusoidal dilatation. Hepatic enlargement, tenderness and pain disappeared after the discontinuance of steroid drugs. Ultrastructural changes included dilatation of endoplasmic reticula with accumulation of granular electron dense material, disruption of mitochondrial membranes and deposits of collagen fibers in the intercellular spaces between hepatocytes and in the spaces of Disse.

Complications of vagotomy.

Most operations performed for peptic ulcer disease in the United States include vagotomy as part of the surgical procedure. This paper reviews the complications associated specifically with or increased in frequency and severity by this procedure. Included in this review are technical complications, gastric retention, recurrent ulceration, postvagotomy diarrhea, postvagotomy dysphagia and achalasia, postvagotomy biliary disease and nutritional problems.

Rapid development of micronodular cirrhosis following small bowel by-pass for obesity. A form of iatrogenic nutritional cirrhosis?

Two cases of rapidly progressive fatal liver disease in females after by-pass surgery for obesity are reported. Histologically the livers are similar to the florid cirrhosis of the alcoholic described by Popper and Szanto. It is postulated that the nutritional disturbance, including protein deficiency, and large amounts of fatty acids delivered to the liver from the fat depots, results in fatty metamorphosis, the Mallory bodies and finally cirrhosis.