Complement activation in the tubulointerstitium: AKI, CKD, and in between.

Complement activation is actively regulated to prevent injudicious activation, such as on peritubular endothelia and basolateral aspects of tubules. Miao et al. studied mice in which the key complement regulator, Crry, was deleted from tubular cells.

Comparative effectiveness of less commonly used systemic monotherapies and common combination therapies for moderate to severe psoriasis in the clinical setting.

Background: The effectiveness of psoriasis therapies in real-world settings remains relatively unknown.

Objective: We sought to compare the effectiveness of less commonly used systemic therapies and commonly used combination therapies for psoriasis.

Methods: This was a multicenter cross-sectional study of 203 patients with plaque psoriasis receiving less common systemic monotherapy (acitretin, cyclosporine, or infliximab) or common combination therapies (adalimumab, etanercept, or infliximab and methotrexate) compared with 168 patients receiving methotrexate evaluated at 1 of 10 US outpatient dermatology sites participating in the Dermatology Clinical Effectiveness Research Network.

The implications of mechanical alignment on soft tissue balancing in total knee arthroplasty.

Purpose: We hypothesized that the individual bone geometry is the most important variable to achieve acceptable soft tissue balancing during total knee arthroplasty.

Methods: Long-standing 3-foot films and computer navigation data from 90 patients with varus (n = 45) or valgus deformity (n = 45) were utilized who underwent navigated total knee arthroplasty. Mean age was 65 ± 8 years with 50 women and 40 men.

Longitudinally extensive optic neuritis in neuromyelitis optica spectrum disorder.

Background: Neuomyelitis optica, sarcoid, and multiple sclerosis can all cause optic neuritis. Further means of distinguishing the causes of optic neuritis among these etiologies would be valuable for the clinician.

Methods: This is a retrospective, cohort study from a single university based hospital and neuro-ophthalmology clinic.

Placental alpha-microglobulin-1 and combined traditional diagnostic test: a cost-benefit analysis.

Objective: We sought to evaluate if the placental alpha-microglobulin (PAMG)-1 test vs the combined traditional diagnostic test (CTDT) of pooling, nitrazine, and ferning would be a cost-beneficial screening strategy in the setting of potential preterm premature rupture of membranes.

Study Design: A decision analysis model was used to estimate the economic impact of PAMG-1 test vs the CTDT on preterm delivery costs from a societal perspective. Our primary outcome was the annual net cost-benefit per person tested.

Neurogenic lower urinary tract dysfunction: how, when, and with which patients do we use urodynamics?

Neurogenic lower urinary tract dysfunction (NLUTD) affects many patients and requires close monitoring. Initial studies establishing patients at risk for upper tract disease revealed that high detrusor leak point pressures were predictive of upper tract disease. Urodynamics in patients with NLUTD have specific challenges.

Brain or strain? Symptoms alone do not distinguish physiologic concussion from cervical/vestibular injury.

Objective: To compare symptoms in patients with physiologic postconcussion disorder (PCD) versus cervicogenic/vestibular PCD. We hypothesized that most symptoms would not be equivalent. In particular, we hypothesized that cognitive symptoms would be more often associated with physiologic PCD.

Food reinforcement and parental obesity predict future weight gain in non-obese adolescents.

Background: Food reinforcement, the extent to which people are willing to work to earn a preferred snack food, and parental obesity are risk factors for weight gain, but there is no research comparing the predictive effects of these factors for adolescent weight gain.

Methods: 130 non-obese adolescents (M age=15.2 ± 1.

Hypothesizing Darkness Induced Alcohol Intake Linked to Dopaminergic Regulation of Brain Function.

Understanding the role of neurotransmission in the prefrontal cortex and mesolimbic brain regions has become the subject of intensive neuroscience research worldwide. In the 1970s, our group provided evidence that rats exposed to darkness significantly augmented their alcohol intake. At that time, we proposed that melatonin was the culprit.

Antagonism of the prostaglandin E2 EP1 receptor in MDCK cells increases growth through activation of Akt and the epidermal growth factor receptor.

The actions of prostaglandin E2 (PGE2) in the kidney are mediated by G protein-coupled E-prostanoid (EP) receptors, which affect renal growth and function. This report examines the role of EP receptors in mediating the effects of PGE2 on Madin-Darby canine kidney (MDCK) cell growth. The results indicate that activation of Gs-coupled EP2 and EP4 by PGE2 results in increased growth, while EP1 activation is growth inhibitory.

Incidence and predictors of atrial fibrillation and its impact on long-term survival in patients with supraventricular arrhythmias.

Aims: To determine the incidence and predictors of atrial fibrillation (AF) and its impact on survival in patients with other forms of supraventricular arrhythmias (SVAs) including atrial flutter (AFL), atrial tachycardia (AT), atrioventricular reentrant (AVRT), and AV nodal reentrant tachycardia (AVNRT). We hypothesized that SVA may increase risk of AF and concomitant AF may influence long-term survival.

Methods And Results: All patients who underwent catheter ablation for SVA from 2000 to 2010 were included in this study.

Treatment-refractory myasthenia gravis.

Myasthenia gravis (MG) is the most common disorder of neuromuscular transmission and is a prototypical autoimmune disorder. Most patients with MG are successfully treated with acetylcholinesterase inhibitors, corticosteroids, and/or steroid sparing agents such as azathioprine and mycophenolate mofetil. There is a small subset of patients, however, with treatment-refractory disease.

Cognitive deficits in pediatric-onset multiple sclerosis: what does the future hold?

Pediatric-onset multiple sclerosis is relatively rare and research regarding disease characteristics is in its infancy. Regardless, there are a growing number of studies finding early cognitive deficits in this population. There are some similarities in outcomes to those seen in the adult-onset multiple sclerosis population, but also several important differences.

Effects of vanadium (III, IV, V)-chlorodipicolinate on glycolysis and antioxidant status in the liver of STZ-induced diabetic rats.

Vanadium compounds exert various insulin-mimetic and anti-diabetic effects both in vitro and in vivo. Vanadium(III, IV, V)-chlorodipicolinate (Vdipic-Cl) compounds, including H[V(III)(dipic-Cl)2]·5H2O (V3dipic-Cl), V(IV)O(dipic-Cl)(H2O)2 (V4dipic-Cl) and K[V(V)O2(dipic-Cl)] (V5dipic-Cl), were synthesized with the indicated oxidation states. The present study was conducted to investigate if chemical valence and anti-oxidation effects of vanadium compounds are involved in the anti-diabetic effects observed in streptozotocin (STZ)-induced diabetic rats treated with these vanadium compounds.

The Role of Total Parotidectomy for Metastatic Cutaneous Squamous Cell Carcinoma and Malignant Melanoma.

Importance: Metastatic cutaneous malignancies of the head and neck, including cutaneous squamous cell carcinoma (cSCC) and malignant melanoma (MM), are aggressive cancers frequently involving the parotid-area lymph nodes (LNs). In such cases, controversy exists about the extent of surgical resection, with many centers choosing not to remove the parotid deep lobe LNs.

Objectives: To determine patterns of intraparotid and neck metastasis, to identify risk factors, and to report outcomes in patients with parotid superficial lobe LN metastasis from cSCC and MM.

The long-term prognostic value of the ST depression criteria for ischemia recommended in the universal definition of myocardial infarction in 43,661 veterans.

Background: The third Universal Definition of Myocardial Infarction (UDMI) includes electrocardiographic criteria for ischemia, specifying horizontal or down-sloping ST depression ≥0.05 mV in two contiguous electrocardiogram (ECG) leads. We used the surrogate of cardiovascular (CV) death to evaluate the criteria.

Cost-effectiveness of family-based group treatment for child and parental obesity.

Background: Obesity runs in families, and family-based behavioral treatment (FBT) is associated with weight loss in overweight/obese children and their overweight/obese parents. This study was designed to estimate the costs and cost-effectiveness of FBT compared to separate group treatments of the overweight/obese parent and child (PC).

Methods: Fifty overweight/obese 8- to 12-year-old children with overweight/obese parents were randomly assigned to 12 months of either FBT or PC treatment program.

Loss of CD11b exacerbates murine complement-mediated tubulointerstitial nephritis.

Acute complement activation occurs in the tubulointerstitium (TI) of kidneys transplanted from Crry(-/-)C3(-/-) mice into complement-sufficient wildtype mice, followed by marked inflammatory cell infiltration, tubular damage and interstitial fibrosis. We postulated iC3b-CD11b interactions were critical in this TI nephritis model. We transplanted Crry(-/-)C3(-/-) mouse kidneys into CD11b(-/-) and wildtype C57BL/6 mice.

Treatment of opioid-related central sleep apnea with positive airway pressure: a systematic review.

Objective: To systematically review the various modalities of positive airway pressure (PAP) in the treatment of opioid-related central sleep apnea (CSA).

Design: Systematic review.

Interventions: MEDLINE, the Cochrane Library, and EMBASE were screened through March 2013 to identify articles which investigated treatment of opioid related CSA with PAP.

Postural tachycardia syndrome (POTS) and other autonomic disorders in antiphospholipid (Hughes) syndrome (APS).

Background: Antiphospholipid syndrome (APS) is an autoimmune hypercoagulable disorder that has been shown to cause a large number of cardiac and neurological manifestations. Two recent studies have demonstrated abnormalities in cardiovascular autonomic function testing in APS patients without other cardiovascular or autoimmune disease. However, an association between autonomic disorders such as postural tachycardia syndrome and APS has not previously been described.

Contrasting effects of systemic monocyte/macrophage and CD4+ T cell depletion in a reversible ureteral obstruction mouse model of chronic kidney disease.

Using a reversible UUO model (rUUO), we have demonstrated that C57BL/6 mice are susceptible to development of CKD after obstruction-mediated kidney injury while BALB/c mice are resistant. We hypothesized that selective systemic depletion of subpopulations of inflammatory cells during injury or repair might alter the development of CKD. To investigate the impact of modification of Th-lymphocytes or macrophage responses on development of CKD after rUUO, we used an anti-CD4 antibody (GK1.

A curriculum on care for people with disabilities: effects on medical student self-reported attitudes and comfort level.

Background: Early, frequent encounters with people with disabilities may improve medical students' knowledge, attitudes and skills regarding their care. We developed and implemented a longitudinal four-year curriculum addressing caring for people with disabilities.

Objectives/hypothesis: To test differences in mean scores between intervention and control groups on individual post-survey items regarding attitudes toward people with disabilities, and to conduct exploratory procedures to examine individual factors that may account for group differences.

Effect of pretreatment prostate volume on urinary quality of life following intensity-modulated radiation therapy for localized prostate cancer.

Background: The aim of this study was to describe the effect of pretreatment prostate volume on urinary quality of life after intensity-modulated radiation therapy (IMRT) for clinically localized prostate cancer.

Methods: A total of 368 men treated with prostate IMRT (77.4-81 Gy) were stratified into three gland volume groups, ie, <30 g (group 1), 30-60 g (group 2), and >60 g (group 3).