Impact of Vitamin D Supplementation on Arterial Vasomotion, Stiffness and Endothelial Biomarkers in Chronic Kidney Disease Patients

Background: Cardiovascular events are frequent and vascular endothelial function is abnormal in patients with chronic kidney disease (CKD). We demonstrated endothelial dysfunction with vitamin D deficiency in CKD patients; however the impact of cholecalciferol supplementation on vascular stiffness and vasomotor function, endothelial and bone biomarkers in CKD patients with low 25-hydroxy vitamin D [25(OH)D] is unknown, which this study investigated. Methods: We assessed non-diabetic patients with CKD stage 3/4, age 17–80 years and serum 25(OH)D ,75 nmol/L. Brachial artery Flow Mediated Dilation (FMD), Pulse Wave Velocity (PWV), Augmentation Index (AI) and circulating blood biomarkers were evaluated at baseline and at 16 weeks. Oral 300,000 units cholecalciferol was administered at baseline and 8-weeks. Results: Clinical characteristics of 26 patients were: age 50614 (mean61SD) years, eGFR 41611 ml/min/1.73 m2, males 73%, dyslipidaemia 36%, smokers 23% and hypertensives 87%. At 16-week serum 25(OH)D and calcium increased (43616 to 84629 nmol/L, p,0.001 and 2.3760.09 to 2.4260.09 mmol/L; p = 0.004, respectively) and parathyroid hormone decreased (10.868.6 to 7.464.4; p = 0.001). FMD improved from 3.163.3% to 6.163.7%, p = 0.001. Endothelial biomarker concentrations decreased: E-Selectin from 566662123 to 525662058 pg/mL; p = 0.032, ICAM-1, 3.4560.01 to 3.1061.04 ng/mL; p = 0.038 and VCAM-1, 54633 to 42633 ng/mL; p = 0.006. eGFR, BP, PWV, AI, hsCRP, von Willebrand factor and Fibroblast Growth Factor-23, remained unchanged. Conclusion: This study demonstrates for the first time improvement of endothelial vasomotor and secretory functions with vitamin D in CKD patients without significant adverse effects on arterial stiffness, serum calcium or FGF-23. Trial Registration: ClinicalTrials.gov NCT0200571

Steinert's syndrome presenting as anal incontinence: a case report

<p>Abstract</p> <p>Introduction</p> <p>Myotonic dystrophy (MD) or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.</p> <p>Case Presentation</p> <p>We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45.</p> <p>Conclusions</p> <p>In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.</p

The conservation status of the world’s reptiles

MB and MR were funded by a grant from the Esmee Fairbairn Foundation, BC by the Rufford Foundation. North American and Mexican species assessments were funded by the Regina Bauer Frankenberg Foundation for Animal Welfare. Species assessments under the Global Reptile Assessment (GRA) initiative are supported by: Moore Family Foundation, Gordon and Betty Moore Foundation, Conservation International, Critical Ecosystem Partnership Fund (CEPF), and European Commission. Additional acknowledgements are included in the online supplementary material. The assessment workshop for Mexican reptiles was kindly hosted by Ricardo Ayala and the station personnel of the Estacion de Biologia Chamela, Institut de Biologia, Universidad Nacional Autonoma de Mexico. Workshop and logistical organisation of the Philippines assessments was provided by the Conservation International Philippines Office, in particular Ruth Grace Rose Ambal, Melizar V. Duya and Oliver Coroza. Workshop and logistical organisation for the European Reptile and Amphibian Assessments was provided by Doga Dernegi, in particular Ozge Balkiz and Ozgur Koc. Workshop and logistical organisation for assessments of sea snakes and homalopsids was provided by the International Sea Turtle Symposium and Dr. Colin Limpus (Australian Government Environmental Protection Agency). Special thanks to Jenny Chapman (EPA) and Chloe Schaub le (ISTS). Thank you also to Dr. Gordon Guymer (Chief Botanist Director of Herbarium) for accommodating us at the Herbarium in the Brisbane Botanical Gardens, and Mark Read and Kirsten Dobbs (Great Barrier Reef Marine Parks Association) and Dave Pollard and Brad Warren (Ocean Watch Australia) for institutional support. Mohamed Bin Zayed Species Conservation Fund, Conservation International Madagascar and the Darwin Initiative contributed to funding the costs of the Madagascar reptile workshop.Effective and targeted conservation action requires detailed information about species, their distribution, systematics and ecology as well as the distribution of threat processes which affect them. Knowledge of reptilian diversity remains surprisingly disparate, and innovative means of gaining rapid insight into the status of reptiles are needed in order to highlight urgent conservation cases and inform environmental policy with appropriate biodiversity information in a timely manner. We present the first ever global analysis of extinction risk in reptiles, based on a random representative sample of 1500 species (16% of all currently known species). To our knowledge, our results provide the first analysis of the global conservation status and distribution patterns of reptiles and the threats affecting them, highlighting conservation priorities and knowledge gaps which need to be addressed urgently to ensure the continued survival of the world’s reptiles. Nearly one in five reptilian species are threatened with extinction, with another one in five species classed as Data Deficient. The proportion of threatened reptile species is highest in freshwater environments, tropical regions and on oceanic islands, while data deficiency was highest in tropical areas, such as Central Africa and Southeast Asia, and among fossorial reptiles. Our results emphasise the need for research attention to be focussed on tropical areas which are experiencing the most dramatic rates of habitat loss, on fossorial reptiles for which there is a chronic lack of data, and on certain taxa such as snakes for which extinction risk may currently be underestimated due to lack of population information. Conservation actions specifically need to mitigate the effects of human-induced habitat loss and harvesting, which are the predominant threats to reptiles.Esmee Fairbairn FoundationRufford FoundationRegina Bauer Frankenberg Foundation for Animal WelfareMoore Family FoundationGordon and Betty Moore FoundationConservation International, Critical Ecosystem Partnership Fund (CEPF)European Commission Joint Research CentreZayed Species Conservation FundConservation International MadagascarDarwin Initiativ

INCIDENTAL PAGET'S DISEASE DISGUISED AS BONE METASTASIS IN A PATIENT WITH ENDOMETRIUM CARCINOMA

Paget's disease is a disorder of aging bone which occurs in the setting of accelarated bone remodelling. In the presented case we discuss the difficulties in the diagnosis of Paget's disease in a 77 year old patient with coexisting endometrium carcinoma. The patient was initially diagnosed with metastatic bone disease due to endometrium adenocarcinoma when she was admitted to oncology clinic with pelvic pain. Bone scintigraphy with Tc99 and (18) F fluorodeoxyglucose positron emission tomography/CT revealed an increased uptake on the bone lesions which were reported as metastatic bone involvement. Although the (18) F-FDG uptake was much higher than the levels that would generally be anticipated in a case with Paget's disease, high levels of bone turnover markers indicated further evaluation in the differential diagnosis and the definitive diagnosis of Paget' s disease was established with the pathological evaluation of bone biopsy

Removal of Pb2+ Ions from Water by Poly(Acrylamide-co-Sodium Methacrylate) Hydrogels

The application of poly(acrylamide-co-sodium methacrylate) (AAm/SMA) hydrogel for the removal of Pb2+ ions from aqueous solutions has been investigated using batch adsorption technique. The extent of adsorption was investigated as a function of pH, adsorbent dose, and temperature. The Fourier transform infrared (FTIR) spectra showed that -NH2 and -COOH groups are involved in Pb2+ ion adsorption. The obtained results were analyzed by pseudo-first-order, pseudo-second-order, and intraparticle diffusion models using both linear and nonlinear methods. It was found that the Pb2+ ion adsorption followed pseudo-first-order kinetics. Nonlinear regression analysis of six isotherms, Langmuir, Freundlich, Redlich-Peterson, Toth, Dubinin-Radushkevich, and Sips, have been applied to the sorption data, while the best interpretation was given by Redlich-Peterson. Based on the separation factor, R (L), the Pb2+ ion adsorption is favorable, while the negative values of a dagger G indicates that the Pb2+ ion adsorption on the investigated hydrogel is spontaneous

Makrofaj mikroagregasyonunun i?nflamatuvar kolit tanısında rolü

Aim: Recent studies have advocated that the presence of macrophage microaggregations (MMA) may be a criterion in the diagnosis of Crohn's colitis (CC). In our study we aimed to investigate the role of MMA to differenti-ate ulcerative colitis (UC) and (CC). Material and Method: We analyzed the role of MMA in 29 patients with UC, 26 patients with CC and 22 healthy subjects without diagnosis of inflammatory bowel disease. For all subjects, esophagogastroduodenoscopy was performed. Biopsies were taken from non-lesion regions of stomach and duodenum. Biopsy materials underwent immunohistochemical staining for the microscopic investigation of the presence of MMA. Also, determination of Perinuclear Anti-Neutropil Cytoplasmic Antibodies (pANCA) and Anti-Saccharomyces Cerevisiae Antibodies (ASCA) (Immunoglobulin G and A) was done with ELISA in serum samples. In patient and control groups, presence of Helicobacter pylori (H. pylori) positivity was histopathologically evaluated. Results: MMA was higher in patients with both CC and UC compared with control groups (46.2%, 41.3%, and 9.1% respec-tively). There was statistically significant difference between patient groups and the control group in terms of MMA but there was no difference between CC and UC groups (p=0.007). No statistically significant difference was ob-tained between the groups in terms of ASCA and p-ANCA. H.pylori positivity was determined in 41.3% of MMA patients with CC, in 75% of patients with UC, and in 50% of healthy subjects. There was no significant difference between the three groups (p=0.344). Discussion: MMA positivity increases in patients with both CC and UC. In patients with inflammatory colitis, H. pylori existence, pANCA and ASCA positivity was similar to healthy subjects

A highly conserved gene locus in endofungal bacteria codes for the biosynthesis of symbiosis-specific cyclopeptides

The tight association of the pathogenic fungus Rhizopus microsporus and its toxin-producing, bacterial endosymbionts (Mycetohabitans spp.) is distributed worldwide and has significance for agriculture, food production, and human health. Intriguingly, the endofungal bacteria are essential for the propagation of the fungal host. Yet, little is known about chemical mediators fostering the symbiosis, and universal metabolites that support the mutualistic relationship have remained elusive. Here, we describe the discovery of a complex of specialized metabolites produced by endofungal bacteria under symbiotic conditions. Through full genome sequencing and comparative genomics of eight endofungal symbiont strains from geographically distant regions, we discovered a conserved gene locus (hab) for a nonribosomal peptide synthetase as a unifying trait. Bioinformatics analyses, targeted gene deletions, and chemical profiling uncovered unprecedented depsipeptides (habitasporins) whose structures were fully elucidated. Computational network analysis and labeling experiments granted insight into the biosynthesis of their nonproteinogenic building blocks (pipecolic acid and β-phenylalanine). Deletion of the hab gene locus was shown to impair the ability of the bacteria to enter their fungal host. Our study unveils a common principle of the endosymbiotic lifestyle of Mycetohabitans species and expands the repertoire of characterized chemical mediators of a globally occurring mutualistic association