Citations

Metabolic memory (MM) is defined as the persistence of diabetic (DM) complications even after glycemic control is pharmacologically achieved. Using a zebrafish diabetic model that induces a MM state, we previously reported that, in this model, tissue dysfunction was of a heritable nature based on cell proliferation studies in limb tissue and this correlated with epigenetic DNA methylation changes that paralleled alterations in gene expression. In the current study, control, DM, and MM excised fin tissues were further analyzed by MeDIP sequencing and microarray techniques. Bioinformatics analysis of the data found that genes of theDNA replication/DNA metabolism processgroup (with upregulation of theapex1, mcm2, mcm4, orc3,lig1, anddnmt1 genes) were altered in the DM state and these molecular changes continued into MM. Interestingly, DNA methylation changes could be found as far as 6–13 kb upstream of the transcription start site for these genes suggesting potential higher levels of epigenetic control. In conclusion, DNA methylation changes in members of theDNA replication/repair processgroup best explain the heritable nature of cell proliferation impairment found in the zebrafish DM/MM model. These results are consistent with human diabetic epigenetic studies and provide one explanation for the persistence of long term tissue complications as seen in diabetes.

Abstract Recent reports show that three-dimensional cone-beam (CB) imaging with a floor-mounted (or ceiling-mounted) C-arm system has become a valuable tool in interventional radiology. Currently, a circular short scan is used for data acquisition, which inevitably yields CB artifacts and a short coverage in the direction of the patient table. To overcome these two limitations, a more sophisticated data acquisition geometry is needed. This geometry should be complete in terms of Tuy’s condition and should allow continuous scanning, while being compatible with the mechanical constraints of mounted C-arm systems. Additionally, the geometry should allow accurate image reconstruction from truncated data. One way to ensure such a feature is to adopt a trajectory that provides full R-line coverage within the field-of-view (FOV). An R-line is any segment of line that connects two points on a source trajectory, and the R-line coverage is the set of points that belong to an R-line. In this work, we propose a novel geometry called the extended ellipse-line-ellipse (ELE) for long-object imaging with a mounted C-arm system. This trajectory is built from modules consisting of two elliptical arcs connected by a line. We demonstrate that the extended ELE can be configured in many ways so that full R-line coverage is guaranteed. Both tight and relaxed parametric settings are presented. All results are supported by extensive mathematical proofs provided in appendices. Our findings make the extended ELE trajectory attractive for axially-extended FOV imaging in interventional radiology.

Takotsubo cardiomyopathy (TC) or stress-induced cardiomyopathy is also popularly referred to as “broken heart syndrome” or “apical ballooning syndrome”. [...]

Advancing age is associated with an increased risk of herpes zoster (shingles) infection and latent effects such as postherpetic neuralgia. The herpes zoster vaccine is recommended in those 60 years of age and older and has been shown to prevent both the primary disease and associated complications. While this recommendation applies to those living in long-term care facilities, there is little clinical evidence to support use in this population. Additionally, there are logistical barriers that may complicate the use of the vaccine. The article examines the evidence for vaccinating residents in long-term care facilities and discusses logistical barriers to vaccination. Pharmacists and providers may consider life expectancy and other factors when evaluating which patients should receive the vaccination.

The growing ability to collect and transmit patient-generated health data, also referred to as people-generated health data and patient-reported outcomes, is creating an opportunity to greatly improve how cancer survivors and their providers manage survivors’ health in the months and years following cancer treatment. Although cancer survivors are at higher risk of chronic health problems and early death as a result of cancer treatment, some experience difficulty identifying and receiving the care they need to optimize their health post-treatment. This article describes the challenges that cancer survivors and their providers face in managing survivors’ care and identifies several ways that using patient-generated health data can improve survivors’ and providers’ ability to manage survivorship care at the individual and population levels.

ObjectiveTo compare longitudinally extensive myelitis in neuromyelitis optica spectrum disorders (NMOSD) and spinal cord sarcoidosis (SCS).MethodsWe identified adult patients evaluated between 1996 and 2015 with SCS or NMOSD whose first myelitis episode was accompanied by a spinal cord lesion spanning ≥3 vertebral segments. All NMOSD patients were positive for aquaporin‐4–immunoglobulin G, and all sarcoidosis cases were pathologically confirmed. Clinical characteristics were evaluated. Spine magnetic resonance imaging was reviewed by 2 neuroradiologists.ResultsWe studied 71 patients (NMOSD, 37; SCS, 34). Sixteen (47%) SCS cases were initially diagnosed as NMOSD or idiopathic transverse myelitis. Median delay to diagnosis was longer for SCS than NMOSD (5 vs 1.5 months, p < 0.01). NMOSD myelitis patients were more commonly women, had concurrent or prior optic neuritis or intractable vomiting episodes more frequently, had shorter time to maximum deficit, and had systemic autoimmunity more often than SCS (p < 0.05). SCS patients had constitutional symptoms, cerebrospinal fluid (CSF) pleocytosis, and hilar adenopathy more frequently than NMOSD (p < 0.05); CSF hypoglycorrhachia (11%, p = 0.25) and elevated angiotensin‐converting enzyme (18%, p = 0.30) were exclusive to SCS. Dorsal cord subpial gadolinium enhancement extending ≥2 vertebral segments and persistent enhancement >2 months favored SCS, and ringlike enhancement favored NMOSD (p < 0.05). Maximum disability was similar in both disorders.InterpretationSCS is an under‐recognized cause of longitudinally extensive myelitis that commonly mimics NMOSD. We identified clinical, laboratory, systemic, and radiologic features that, taken together, help discriminate SCS from NMOSD. ANN NEUROL 2016;79:437–447