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Title:
Impact of the Psychiatry Clerkship on Medical Student Attitudes Towards Psychiatry and to Psychiatry as a Career
Authors:
Lyons, Zaza
Abstract:
Objective The psychiatry clerkship forms part of the core curriculum of medical schools worldwide and provides psychiatric educators with an ideal opportunity to positively influence students. The aim of this paper is to systematically review literature on the impact of the psychiatry clerkship to determine the effect on attitudes towards psychiatry and to psychiatry as a career. Method A systematic review was undertaken. The following key search words were used to search a number of electronic databases: medical student/s, attitude/s, psychiatry and clerkship. Studies published in the English language from 1990 to the present were included. Studies were included if they were based on a pre-/post-design, i.e. the same students must have participated in the study both before and after the clerkship. Results Twenty-six studies from 19 countries were identified for the review. Sixteen studies reported an overall improvement in attitudes towards psychiatry post-clerkship, and ten found no change in attitudes. In terms of career choice, nine studies reported an increase in the number of students interested in psychiatry as a career post-clerkship, nine found no impact on career choice and, in eight studies, it was not assessed. A number of positive and negative factors regarding the clerkship were identified. Conclusion Overall, the psychiatry clerkship has a positive impact on students' attitudes towards psychiatry, but does not improve interest in psychiatry as a career option. For those students particularly interested in psychiatry, the challenge is to maintain their enthusiasm post-clerkship. Charismatic teachers, mentorship and stigma reduction may be effective
Published:
2014-02
Title:
Ketogenic diet for obesity: friend or foe?. [Review]
Authors:
Paoli, Antonio
Abstract:
Obesity is reaching epidemic proportions and is a strong risk factor for a number of cardiovascular and metabolic disorders such as hypertension, type 2 diabetes, dyslipidemia, atherosclerosis, and also certain types of cancers. Despite the constant recommendations of health care organizations regarding the importance of weight control, this goal often fails. Genetic predisposition in combination with inactive lifestyles and high caloric intake leads to excessive weight gain. Even though there may be agreement about the concept that lifestyle changes affecting dietary habits and physical activity are essential to promote weight loss and weight control, the ideal amount and type of exercise and also the ideal diet are still under debate. For many years, nutritional intervention studies have been focused on reducing dietary fat with little positive results over the long-term. One of the most studied strategies in the recent years for weight loss is the ketogenic diet. Many studies have shown that this kind of nutritional approach has a solid physiological and biochemical basis and is able to induce effective weight loss along with improvement in several cardiovascular risk parameters. This review discusses the physiological basis of ketogenic diets and the rationale for their use in obesity, discussing the strengths and the weaknesses of these diets together with cautions that should be used in obese patients.
Published:
2014-02
Title:
Krill oil supplementation lowers serum triglycerides without increasing low-density lipoprotein cholesterol in adults with borderline high or high triglyceride levels
Authors:
Berge, Kjetil; Musa-Veloso, Kathy; Harwood, Melody; Hoem, Nils; Burri, Lena
Abstract:
The aim of the study was to explore the effects of 12 weeks daily krill oil supplementation on fasting serum triglyceride (TG) and lipoprotein particle levels in subjects whose habitual fish intake is low and who have borderline high or high fasting serum TG levels (150-499 mg/dL). We hypothesized that Krill oil lowers serum TG levels in subjects with borderline high or high fasting TG levels. To test our hypothesis 300 male and female subjects were included in a double-blind, randomized, multi-center, placebo-controlled study with five treatment groups: placebo (olive oil) or 0.5, 1, 2, or 4 g/day of krill oil. Serum lipids were measured after an overnight fast at baseline, 6 and 12 weeks. Due to a high intra-individual variability in TG levels, data from all subjects in the four krill oil groups were pooled to increase statistical power, and a general time- and dose-independent one-way analysis of variance was performed to assess efficacy. Relative to subjects in the placebo group, those administered krill oil had a statistically significant calculated reduction in serum TG levels of 10.2%. Moreover, LDL-C levels were not increased in the krill oil groups relative to the placebo group. The outcome of the pooled analysis suggests that krill oil is effective in reducing a cardiovascular risk factor. However, owing to the individual fluctuations of TG concentrations measured, a study with more individual measurements per treatment group is needed to increase the confidence of these findings. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Published:
2014-02
Title:
Macronutrient replacement options for saturated fat: effects on cardiovascular health. [Review]
Authors:
Flock, Michael R.; Fleming, Jennifer A.; Kris-Etherton, Penny M.
Abstract:
SUMMARY: Modifying the macronutrient composition of the diet by replacing SFAs with unsaturated fatty acids, as well as lean protein and carbohydrate from whole grains, all lower CVD risk. Research is needed to identify food sources of macronutrients that optimize CVD risk reduction.
Published:
2014-02
Title:
Assessment of insulin resistance and metabolic syndrome in drug naive patients of bipolar disorder
Authors:
Guha, Prathama; Bhowmick, Kaushik; Mazumder, Piyanku; Ghosal, Malay; Chakraborty, Indranil; Burman, Prabir
Abstract:
The levels of fasting glucose, fasting insulin, insulin resistance (IR) and the prevalence of metabolic syndrome (MS) in a sample population of bipolar disorder (BPD) patients who were newly diagnosed and psychotropically naïve were assessed and compared with an age, sex and racially matched control population. 55 BPD-I patients (15-65 years) who were non-diabetic, nonpregnant, and drug naïve for a period of at least 6 months were included in the study. Diagnosis was made using the structured clinical interview for DSM-IV axis I disorders (SCID IV). IR was assessed using homeostasis model of insulin resistance (HOMA-IR); MS was defined according to National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Data were compared with 25 healthy controls. BPD patients had significantly higher mean levels of fasting plasma insulin (13.2 ± 9.2 vs. 4.68 ± 3.1 μIU/ml, p < 0.05), postprandial plasma insulin (27.2 ± 14.5 vs. 18.1 ± 9.3 μIU/ml, p < 0.05) and a higher value of HOMA-IR (3.16 ± 2.2 vs. 1.19 ± 0.8, p < 0.05) when compared to the controls. A significantly higher proportion of patients of BPD compared to controls were manifesting levels of fasting plasma glucose, serum triglyceride and blood pressure higher than the cut off while waist circumference and serum HDL cholesterol failed to show any significant difference in the proportion. There was a significantly higher proportion of prevalence of IR between BPD cases and controls (26/55 vs. 2/25, z value 9.97, p
Published:
2014-01
Title:
Autophagy regulation by nutrient signaling.
Authors:
Russell, Ryan C; Yuan, Hai-Xin; Guan, Kun-Liang
Abstract:
The ability of cells to respond to changes in nutrient availability is essential for the maintenance of metabolic homeostasis and viability. One of the key cellular responses to nutrient withdrawal is the upregulation of autophagy. Recently, there has been a rapid expansion in our knowledge of the molecular mechanisms involved in the regulation of mammalian autophagy induction in response to depletion of key nutrients. Intracellular amino acids, ATP, and oxygen levels are intimately tied to the cellular balance of anabolic and catabolic processes. Signaling from key nutrient-sensitive kinases mTORC1 and AMP-activated protein kinase (AMPK) is essential for the nutrient sensing of the autophagy pathway. Recent advances have shown that the nutrient status of the cell is largely passed on to the autophagic machinery through the coordinated regulation of the ULK and VPS34 kinase complexes. Identification of extensive crosstalk and feedback loops converging on the regulation of ULK and VPS34 can be attributed to the importance of these kinases in autophagy induction and maintaining cellular homeostasis.
Published:
2014-01
Title:
Characterization of Shiga Toxin-Producing Escherichia coli Isolated from Ground Beef Collected in Different Socioeconomic Strata Markets in Buenos Aires, Argentina
Authors:
Llorente, Patricia; Barnech, Laura; Irino, Kinue; Rumi, María Valeria; Bentancor, Adriana
Abstract:
Published:
2014-01
Title:
Diet rapidly and reproducibly alters the human gut microbiome
Authors:
David, Lawrence A.; Maurice, Corinne F.; Carmody, Rachel N.; Gootenberg, David B.; Button, Julie E.; Wolfe, Benjamin E.; Ling, Alisha V.; Devlin, A. Sloan; Varma, Yug; Fischbach, Michael A.; Biddinger, Sudha B.; Dutton, Rachel J.; Turnbaugh, Peter J.
Abstract:
Consuming diets rich in plant versus animal products changes the microbes found in the human gut within days, with important implications for our health and evolution.
Published:
2014-01
Title:
Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials123
Authors:
Johansson, Kari; Neovius, Martin; Hemmingsson, Erik
Abstract:
Background: Weight-loss maintenance remains a major challenge in obesity treatment., Objective: The objective was to evaluate the effects of anti-obesity drugs, diet, or exercise on weight-loss maintenance after an initial very-low-calorie diet (VLCD)/low-calorie diet (LCD) period (
Published:
2014-01
Title:
Effects of low-fat diet on serum lipids in premenopausal and postmenopausal women: a meta-analysis of randomized controlled trials. [Review]
Authors:
Wu, Liping; Ma, Di; Walton-Moss, Benita; He, Zhong
Abstract:
CONCLUSIONS: Overall results suggest that a low-fat diet is efficacious in reducing the concentrations of TC, HDL-C, and LDL-C but not in reducing TG and TC-to-HDL-C ratio in women. A low-fat diet is efficacious in reducing TC, HDL-C, and LDL-C in premenopausal women. Additional studies are needed to further address its effects on postmenopausal women.
Published:
2014-01
Title:
Genetic Polymorphisms in Glutathione (GSH-) Related Genes Affect the Plasmatic Hg/Whole Blood Hg Partitioning and the Distribution between Inorganic and Methylmercury Levels in Plasma Collected from a Fish-Eating Population
Authors:
de Oliveira, Andréia Avila Soares; de Souza, Marilesia Ferreira; Lengert, André van Helvoort; de Oliveira, Marcelo Tempesta; Camargo, Rossana Batista de Oliveira Godoy; Braga, Gilberto Ubida Leite; Cólus, Ilce Mara de Syllos; Barbosa Jr, Fernando; Barcelos, Gustavo Rafael Mazzaron
Abstract:
Published:
2014-01
Title:
Identification of early transcriptome-based biomarkers related to lipid metabolism in peripheral blood mononuclear cells of rats nutritionally programmed for improved metabolic health
Authors:
Konieczna, J.; Sánchez, J.; van Schothorst, E. M.; Torrens, J. M.; Bunschoten, A.; Palou, M.; Picó, C.; Keijer, J.; Palou, A.
Abstract:
Moderate maternal calorie restriction during lactation protects rat offspring against obesity development in adulthood, due to an improved ability to handle and store excess dietary fuel. We used this model to identify early transcriptome-based biomarkers of metabolic health using peripheral blood mononuclear cells (PBMCs), an easily accessible surrogate tissue, by focusing on molecular markers of lipid handling. Male and female offspring of control and 20 % calorie-restricted lactating dams (CR) were studied. At weaning, a set of pups was killed, and PBMCs were isolated for whole-genome microarray analysis. The remaining pups were killed at 6 months of age. CR gave lower body weight, food intake and fat accumulation, and improved levels of insulin and leptin throughout life, particularly in females. Microarray analysis of weaned rat PBMCs identified 278 genes significantly differentially expressed between control and CR. Among lipid metabolism-related genes, expression of Cpt1a, Lipe and Star was increased and Fasn, Lrp1 and Rxrb decreased in CR versus control, with changes fully confirmed by qPCR. Among them, Cpt1a, Fasn and Star emerged as particularly interesting. Transcript levels of Cpt1a in PBMCs correlated with their levels in WAT and liver at both ages examined; Fasn expression levels in PBMCs at an early age correlated with their expression levels in WAT; and early changes in Star expression levels in PBMCs correlated with their expression levels in liver and were sustained in adulthood. These findings reveal the possibility of using transcript levels of lipid metabolism-related genes in PBMCs as early biomarkers of metabolic health status.
Published:
2014-01
Title:
Ketone bodies as signaling metabolites
Authors:
Newman, John C.; Verdin, Eric
Abstract:
Traditionally, the ketone body β-hydroxybutyrate (βOHB) has been looked upon as a carrier of energy from liver to peripheral tissues during fasting or exercise. However, βOHB also signals via extracellular receptors and acts as an endogenous inhibitor of histone deacetylases (HDACs). These recent findings support a model in which βOHB functions to link the environment, in this case the diet, and gene expression via chromatin modifications. We review the regulation and functions of ketone bodies, the relationship between ketone bodies and calorie restriction, and the implications of HDAC inhibition by the ketone body βOHB in the modulation of metabolism and in diseases of aging. © 2013 Elsevier Ltd.
Published:
2014-01
Title:
Moderate replacement of carbohydrates by dietary fats affects features of metabolic syndrome: a randomized crossover clinical trial
Authors:
Rajaie, Somayeh; Azadbakht, Leila; Khazaei, Majid; Sherbafchi, Mostafa; Esmaillzadeh, Ahmad
Abstract:
OBJECTIVE: Earlier studies on the management of metabolic syndrome (MetS) have mostly focused on very low carbohydrate diets, whereas long-term adherence to such diets is difficult for apparently healthy people. The aim of this study was to examine the effects of moderate replacement of carbohydrates by dietary fats on insulin resistance and features of MetS among women. METHODS: This randomized crossover clinical trial was performed with 30 overweight or obese (body mass index [BMI] > 25 kg/m(2)) women with MetS. After a 2-wk run-in period, participants were randomly assigned to consume either a calorie-restricted high-carbohydrate (HC) diet (60%-65% of energy from carbohydrates and 20%-25% from fats) or a calorie-restricted moderately restricted carbohydrate (MRC) diet (43%-47% of total calories as carbohydrate and 36%-40% as dietary fats) for 6 wk. Protein contents of both diets were 15% to 17% of total energy. A 2-wk washout period was applied following which participants were crossed over to the alternate treatment arm for an additional 6 wk. Anthropometric, blood pressure, and biochemical measurements were performed before and after each phase of intervention. RESULTS: Mean age and BMI of study participants was 42.4 y and 33 kg/m(2), respectively. A trend toward greater reduction in waist (-3.9 versus -2.6 cm; P = 0.07) and hip circumferences (-2.7 versus -1.5 cm; P = 0.07) as well as serum triglyceride (TG) levels (-31.3 versus 0.13 mg/dL; P = 0.07) was observed after consumption of an MRC diet compared with an HC diet. The TG to high-density lipoprotein cholesterol (HDL-C) ratio had a tendency to improve with the MRC diet rather than the HC diet (-0.9 versus -0.1; P = 0.06). Consumption of the MRC diet resulted in a greater reduction of systolic blood pressure (-8.93 versus -2.97 mm Hg; P = 0.06) and diastolic blood pressure (-12.7 versus -1.77 mm Hg; P = 0.001) compared with the HC diet. The prevalence of MetS was significantly decreased following the consumption of the MRC diet (P = 0.03). The two diets were not significantly different in terms of their effect on fasting plasma glucose, serum HDL-C, low-density lipoprotein cholesterol, and total cholesterol, insulin levels, and Homeostasis Model Assessment-Insulin Resistance. CONCLUSION: Moderate replacement of carbohydrates by dietary fats was not associated with statistically different changes in fasting plasma glucose, insulin, or atherogenic dyslipidemia among individuals with the metabolic syndrome; however, it resulted in decreased diastolic blood pressure and lower prevalence of the metabolic syndrome.
Published:
2014-01
Title:
Nationwide prevalence of inflammatory bowel disease in Sweden: a population-based register study
Authors:
Büsch, K.; Ludvigsson, J. F.; Ekström-Smedby, K.; Ekbom, A.; Askling, J.; Neovius, M.
Abstract:
BACKGROUND: Regional studies on inflammatory bowel disease (IBD) suggest an increasing prevalence over time, but no nationwide estimate has been published so far. AIM: To estimate the IBD prevalence in 2010 in Sweden overall, by disease, and in specific patient segments. METHODS: Patients were identified according to international classification codes for ulcerative colitis and Crohn's disease in in-patient care (1987-2010), day surgery and nonprimary out-patient care (1997-2010) in the nationwide Swedish Patient Register. RESULTS: Requiring two or more diagnoses of IBD in nonprimary care, a total of 61 344 individuals with physician-diagnosed IBD were alive in Sweden in 2010 (mean age 50 years; 51% men), corresponding to a prevalence of 0.65% (95% CI, 0.65-0.66). The prevalence increased with age, and peaked in women at ages 50-59 years and in men at ages 60-69 years. Adding the requirement of IBD as main (vs. main or contributory) diagnosis code, or diagnosis from an internal medicine/gastroenterology/surgery department did not change the prevalence estimate. Prevalence of actively treated disease (defined as two or more IBD-related visits, of which one occurred in 2010, plus at least one dispensed prescription of IBD-related drugs in 2010) was 0.27% (95% CI, 0.27-0.28). CONCLUSIONS: The Swedish nationwide register-based IBD prevalence was higher compared with previous Swedish and international estimates. While prevalence estimates were robust across different case definitions, once two or more visits were required, only about one-third of prevalent patients were drawing resources from specialised care in 2010.
Published:
2014-01
Title:
Neurologic complications of electrolyte disturbances and acid-base balance
Authors:
Espay, Alberto J.
Abstract:
Electrolyte and acid-base disturbances are common occurrences in daily clinical practice. Although these abnormalities can be readily ascertained from routine laboratory findings, only specific clinical correlates may attest as to their significance. Among a wide phenotypic spectrum, acute electrolyte and acid-base disturbances may affect the peripheral nervous system as arreflexic weakness (hypermagnesemia, hyperkalemia, and hypophosphatemia), the central nervous system as epileptic encephalopathies (hypomagnesemia, dysnatremias, and hypocalcemia), or both as a mixture of encephalopathy and weakness or paresthesias (hypocalcemia, alkalosis). Disabling complications may develop not only when these derangements are overlooked and left untreated (e.g., visual loss from intracranial hypertension in respiratory or metabolic acidosis; quadriplegia with respiratory insufficiency in hypermagnesemia) but also when they are inappropriately managed (e.g., central pontine myelinolisis when rapidly correcting hyponatremia; cardiac arrhythmias when aggressively correcting hypo- or hyperkalemia). Therefore prompt identification of the specific neurometabolic syndromes is critical to correct the causative electrolyte or acid-base disturbances and prevent permanent central or peripheral nervous system injury. This chapter reviews the pathophysiology, clinical investigations, clinical phenotypes, and current management strategies in disorders resulting from alterations in the plasma concentration of sodium, potassium, calcium, magnesium, and phosphorus as well as from acidemia and alkalemia. © 2014 Elsevier B.V.
Published:
2014-01
Title:
Regulation of energy metabolism by long-chain fatty acids
Authors:
Nakamura, Manabu T.; Yudell, Barbara E.; Loor, Juan J.
Abstract:
In mammals, excess energy is stored primarily as triglycerides, which are mobilized when energy demands arise. This review mainly focuses on the role of long chain fatty acids (LCFAs) in regulating energy metabolism as ligands of peroxisome proliferator-activated receptors (PPARs). PPAR-alpha expressed primarily in liver is essential for metabolic adaptation to starvation by inducing genes for beta-oxidation and ketogenesis and by downregulating energy expenditure through fibroblast growth factor 21. PPAR-delta is highly expressed in skeletal muscle and induces genes for LCFA oxidation during fasting and endurance exercise. PPAR-delta also regulates glucose metabolism and mitochondrial biogenesis by inducing FOXO1 and PGC1-alpha. Genes targeted by PPAR-gamma in adipocytes suggest that PPAR-gamma senses incoming non-esterified LCFAs and induces the pathways to store LCFAs as triglycerides. Adiponectin, another important target of PPAR-gamma may act as a spacer between adipocytes to maintain their metabolic activity and insulin sensitivity. Another topic of this review is effects of skin LCFAs on energy metabolism. Specific LCFAs are required for the synthesis of skin lipids, which are essential for water barrier and thermal insulation functions of the skin. Disturbance of skin lipid metabolism often causes apparent resistance to developing obesity at the expense of normal skin function.
Published:
2014-01
Title:
Relation of hypothyroidism and incident atrial fibrillation (from the Framingham Heart Study)
Authors:
Kim, Eun-Jeong; Lyass, Asya; Wang, Na; Massaro, Joseph M.; Fox, Caroline S.; Benjamin, Emelia J.; Magnani, Jared W.
Abstract:
BACKGROUND: Hyperthyroidism has a well-described association with atrial fibrillation (AF). However, the relation of hypothyroidism to AF has had limited investigation. Hypothyroidism is associated with cardiovascular risk factors, subclinical cardiovascular disease, and overt cardiovascular disease, all of which predispose to AF. We investigated 10-year incidence of AF in a community-dwelling cohort. METHODS: Among 6,653 Framingham heart Study participants, 5,069 participants, 52% female, with mean age of 57 ± 12 years, were eligible after excluding those with missing thyroid-stimulating hormone (TSH), TSH 19.9 μU/L, or prevalent AF. Thyroid-stimulating hormone was categorized by range (≥0.45 to <4.5, 4.5 to <10.0, 10.0 to ≤19.9 μU/L) and by quartiles. We examined the associations between TSH and 10-year risk of AF using multivariable-adjusted Cox proportional hazards analysis. RESULTS: Over 10-year follow-up, we observed 277 cases of incident AF. A 1-SD increase in TSH was not associated with increased risk of AF (hazard ratio 1.01, 95% CI 0.90-1.14, P = .83). In categorical analysis, using TSH ≥0.45 to <4.5 μU/L as the referent (equivalent to euthyroid state), we found no significant association between hypothyroidism and 10-year AF risk. Comparing the highest (2.6 < TSH < 19.9 μU/L) to lowest (0.45 < TSH
Published:
2014-01
Title:
The effect of sauna bathing on lipid profile in young, physically active, male subjects
Authors:
Gryka, Dorota; Pilch, Wanda; Szarek, Marta; Szygula, Zbigniew; Tota, \Lukasz
Abstract:
Objectives: The aim of the study was to evaluate effects of Finnish sauna bathing on lipid profile in healthy, young men. Material and Methods: Sixteen male subjects (20-23 years) were subjected to 10 sauna bathing sessions in a Finnish sauna every 1 or 2 days. The mean sauna temperature was 90±2°C, while humidity was 5-16%. Each session consisted of three 15-minute parts and a 2-minute cool-down between them. The following measurements were taken before and after the sauna sessions: body mass, heart rate, body skinfold thickness. The percentage fat content and then, the lean body mass were calculated. Total cholesterol, triacylglycerols, lipoprotein cholesterol LDL and HDL were measured in blood samples. Results: A statistically significant decrease of total cholesterol and LDL cholesterol was observed during 3 weeks of sauna treatment and in the week afterwards. A significant decline in triacylglycerols was found directly after the 1st and 24 h directly after the 10th sauna session. After the 10th sauna session the level of HDL cholesterol remained slightly increased, but this change was not statistically significant. A decrease in blood plasma volume was found directly after the 1st and the last sauna bathing session due to perspiration. An adaptive increase in blood plasma volume was also found after the series of 10 sauna sessions. Conclusions: Ten complete sauna bathing sessions in a Finnish sauna caused a reduction in total cholesterol and LDL cholesterol fraction levels during the sessions and a gradual return of these levels to the initial level during the 1st and the 2nd week after the experiment. A small, statistically insignificant increase in HDL-C level and a transient decline in triacylglycerols were observed after those sauna sessions. The positive effect of sauna on lipid profile is similar to the effect that can be obtained through a moderate-intensity physical exercise. © 2014 Versita Warsaw and Springer-Verlag Wien.
Published:
2014-01
Title:
The ketogenic diet for the treatment of pediatric status epilepticus
Authors:
O'Connor, Sunila E.; Ream, Margie A.; Richardson, Candy; Mikati, Mohamad A.; Trescher, Willam H.; Byler, Debra L.; Sather, Joan D.; Michael, Elizabeth H.; Urbanik, Kelly B.; Richards, Jennifer L.; Davis, Ronald; Zupanc, Mary L.; Zupec-Kania, Beth
Abstract:
BACKGROUND: Refractory status epilepticus carries a high risk of morbidity and mortality for children. Traditional treatment of status epilepticus consists of multiple anticonvulsant drugs and, if needed, induction of a medical coma. The ketogenic diet has been used for intractable epilepsy for many years. The purpose of this article is to report a case series of five patients with refractory status epilepticus successfully managed with the ketogenic diet. METHODS: A summary of pediatric patients with refractory status epilepticus treated with diet was performed. CONCLUSIONS: Ketogenic diet therapy should be considered as a treatment option in pediatric patients with refractory status epilepticus.
Published:
2014-01
Title:
[Anesthetic management for patients with mitochondrial disease].
Authors:
Imai, Yousuke; Yamada, Yoshitsugu
Abstract:
Mitochondrial diseases are caused by a decrease in ATP production due to mutations of mitochondrial or mitochondria-related nuclear DNA. Their effects are likely to appear in tissues with a high energy demand, including skeletal muscle, nervous, and cardiovascular systems. Cardiac manifestations of mitochondrial diseases can be divided into cardiomyopathies, which are primarily hypertrophic and dilated cardiomyopathies, and electropathies, which are primarily conduction system disease and ventricular pre-excitation. The first principle of anesthesia for patients with mitochondrial diseases is to avoid any additional burden on the already declined metabolic functions. Appropriate oxygenation, minimization of the oxygen demand, stable cardiovascular management, maintenance of a normal blood glucose level and body temperature, and effective perioperative pain control are of importance. Most anesthetics have been reported to reduce mitochondrial functions, and although enhancement of the sensitivity and prolongation of the duration of action have been reported, they are clinically used with no major problems. Detailed preoperative evaluation of the disease condition and careful intraoperative monitoring are important for the prevention of perioperative complications.
Published:
2014-01
Title:
"Eating addiction", rather than "food addiction", better captures addictive-like eating behavior
Authors:
Hebebranda, Johannes; Albayraka, Özgür; Adanb, Roger; Antel, Jochen; Dieguezc, Carlos; De Jongb, Johannes; Lenge, Gareth; Menziese, John; Mercer, Julian G.; Murphy, Michelle; Van der Plasse, Geoffrey; Dickson, Suzanne L.
Abstract:
"Food addiction" has become a focus of interest for researchers attempting to explain certain processes and/or behaviors that may contribute to the development of obesity. Although the scientific discussion on "food addiction" is in its nascent stage, it has potentially important implications for treatment and prevention strategies. As such, it is important to critically reflect on the appropriateness of the term "food addiction", which combines the concepts of "substance-based" and behavioral addiction. The currently available evidence for a substance-based food addiction is poor, partly because systematic clinical and translational studies are still at an early stage. We do however view both animal and existing human data as consistent with the existence of addictive eating behavior. Accordingly, we stress that similar to other behaviors eating can become an addiction in thus predisposed individuals under specific environmental circumstances. Here, we introduce current diagnostic and neurobiological concepts of substance-related and non-substance-related addictive disorders, and highlight the similarities and dissimilarities between addiction and overeating. We conclude that "food addiction" is a misnomer because of the ambiguous connotation of a substance-related phenomenon. We instead propose the term "eating addiction" to underscore the behavioral addiction to eating; future research should attempt to define the diagnostic criteria for an eating addiction, for which DSM-5 now offers an umbrella via the introduction on Non-Substance-Related Disorders within the category Substance-Related and Addictive Disorders.
Published:
2014
Title:
'Marcia hiantina shell matrix sites at Norman Creek, western Cape York Peninsula
Authors:
Cochrane, Grant WG
Abstract:
Published:
2014
Title:
'The way to a man's heart is through his gut microbiota' - Dietary pro- and prebiotics for the management of cardiovascular risk
Authors:
Tuohy, K.M.; Fava, F.; Viola, R.
Abstract:
The human gut microbiota has been identified as a possible novel CVD risk factor. This review aims to summarise recent insights connecting human gut microbiome activities with CVD and how such activities may be modulated by diet. Aberrant gut microbiota profiles have been associated with obesity, type 1 and type 2 diabetes and non-alcoholic fatty liver disease. Transfer of microbiota from obese animals induces metabolic disease and obesity in germ-free animals. Conversely, transfer of pathogen-free microbiota from lean healthy human donors to patients with metabolic disease can increase insulin sensitivity. Not only are aberrant microbiota profiles associated with metabolic disease, but the flux of metabolites derived from gut microbial metabolism of choline, phosphatidylcholine and l-carnitine has been shown to contribute directly to CVD pathology, providing one explanation for increased disease risk of eating too much red meat. Diet, especially high intake of fermentable fibres and plant polyphenols, appears to regulate microbial activities within the gut, supporting regulatory guidelines encouraging increased consumption of whole-plant foods (fruit, vegetables and whole-grain cereals), and providing the scientific rationale for the design of efficacious prebiotics. Similarly, recent human studies with carefully selected probiotic strains show that ingestion of viable microorganisms with the ability to hydrolyse bile salts can lower blood cholesterol, a recognised risk factor in CVD. Taken together such observations raise the intriguing possibility that gut microbiome modulation by whole-plant foods, probiotics and prebiotics may be at the base of healthy eating pyramids advised by regulatory agencies across the globe. In conclusion, dietary strategies which modulate the gut microbiota or their metabolic activities are emerging as efficacious tools for reducing CVD risk and indicate that indeed, the way to a healthy heart may be through a healthy gut microbiota. © The Authors 2014.
Published:
2014
Title:
A non-calorie-restricted low-carbohydrate diet is effective as an alternative therapy for patients with type 2 diabetes
Authors:
Yamada, Yoshifumi; Uchida, Junichi; Izumi, Hisa; Tsukamoto, Yoko; Inoue, Gaku; Watanabe, Yuichi; Irie, Junichiro; Yamada, Satoru
Abstract:
OBJECTIVE: Although caloric restriction is a widely used intervention to reduce body weight and insulin resistance, many patients are unable to comply with such dietary therapy for long periods. The clinical effectiveness of low-carbohydrate diets was recently described in a position statement of Diabetes UK and a scientific review conducted by the American Diabetes Association. However, randomised trials of dietary interventions in Japanese patients with type 2 diabetes are scarce. Therefore, the aim of this study was to examine the effects of a non-calorie-restricted, low-carbohydrate diet in Japanese patients unable to adhere to a calorie-restricted diet. METHODS: The enrolled patients were randomly allocated to receive a conventional calorie-restricted diet or low-carbohydrate diet. The patients received consultations every two months from a registered dietician for six months. We compared the effects of the two dietary interventions on glycaemic control and metabolic profiles. RESULTS: The HbA1c levels decreased significantly from baseline to six months in the low-carbohydrate diet group (baseline 7.6±0.4%, six months 7.0±0.7%, p=0.03) but not in the calorie-restricted group (baseline 7.7±0.6%, six months 7.5±1.0%, n.s.), (between-group comparison, p=0.03). The patients in the former group also experienced improvements in their triglyceride levels, without experiencing any major adverse effects or a decline in the quality of life. CONCLUSION: Our findings suggest that a low-carbohydrate diet is effective in lowering the HbA1c and triglyceride levels in patients with type 2 diabetes who are unable to adhere to a calorie-restricted diet.
Published:
2014
Title:
Added sugar intake and cardiovascular diseases mortality among us adults
Authors:
Yang, Quanhe; Zhang, Zefeng; Gregg, Edward W.; Flanders, W. Dana; Merritt, Robert; Hu, Frank B.
Abstract:
IMPORTANCE Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease (CVD) risk factors. Few prospective studies have examined the association of added sugar intake with CVD mortality. OBJECTIVE To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality. DESIGN, SETTING, AND PARTICIPANTS National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III], 1999-2004, and 2005-2010 [n = 31,147]) for the time trend analysis and NHANES III Linked Mortality cohort (1988-2006 [n = 11 733]), a prospective cohort of a nationally representative sample of US adults for the association study. MAIN OUTCOMES AND MEASURES Cardiovascular disease mortality. RESULTS Among US adults, the adjusted mean percentage of daily calories from added sugar increased from 15.7% (95% CI, 15.0%-16.4%) in 1988-1994 to 16.8% (16.0%-17.7%; P = .02) in 1999-2004 and decreased to 14.9% (14.2%-15.5%; P \textless .001) in 2005-2010. Most adults consumed 10% or more of calories from added sugar (71.4%) and approximately 10% consumed 25% or more in 2005-2010. During a median follow-up period of 14.6 years, we documented 831 CVD deaths during 163,039 person-years. Age-, sex-, and race/ethnicity-adjusted hazard ratios (HRs) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 (reference), 1.09 (95% CI, 1.05-1.13), 1.23 (1.12-1.34), 1.49 (1.24-1.78), and 2.43 (1.63-3.62; P \textless .001), respectively. After additional adjustment for sociodemographic, behavioral, and clinical characteristics, HRs were 1.00 (reference), 1.07 (1.02-1.12), 1.18 (1.06-1.31), 1.38 (1.11-1.70), and 2.03 (1.26-3.27; P = .004), respectively. Adjusted HRs were 1.30 (95% CI, 1.09-1.55) and 2.75 (1.40-5.42; P = .004), respectively, comparing participants who consumed 10.0% to 24.9% or 25.0% or more calories from added sugar with those who consumed less than 10.0% of calories from added sugar. These findings were largely consistent across age group, sex, race/ethnicity (except among non-Hispanic blacks), educational attainment, physical activity, health eating index, and body mass index. CONCLUSIONS AND RELEVANCE Most US adults consume more added sugar than is recommended for a healthy diet. We observed a significant relationship between added sugar consumption and increased risk for CVD mortality.
Published:
2014
Title:
Alzheimer's Prevention Education: If We Build It, Will They Come? www.AlzU.org.
Authors:
Isaacson, R S; Haynes, N; Seifan, A; Larsen, D; Christiansen, S; Berger, J C; Safdieh, J E; Lunde, A M; Luo, A; Kramps, M; McInnis, M; Ochner, C N
Abstract:
BACKGROUND Internet-based educational interventions may be useful for impacting knowledge and behavioral change. However, in AD prevention, little data exists about which educational tools work best in terms of learning and interest in participating in clinical trials. OBJECTIVES Primary: Assess effectiveness of interactive webinars vs. written blog-posts on AD prevention learning. Secondary: Evaluate the effect of AD prevention education on interest in participating in clinical trials; Assess usability of, and user perceptions about, an online AD education research platform; Classify target populations (demographics, learning needs, interests). DESIGN Observational. SETTING Online. PARTICIPANTS Men/Women, aged 25+, recruited via facebook.com. INTERVENTION Alzheimer's Universe (www.AlzU.org) education research platform. MEASUREMENTS Pre/post-test performance, self-reported Likert-scale ratings, completion rates. RESULTS Over two-weeks, 4268 visits were generated. 503 signed-up for a user account (11.8% join rate), 196 participated in the lessons (39.0%) and 100 completed all beta-testing steps (19.9%). Users randomized to webinar instruction about AD prevention and the stages of AD demonstrated significant increases (p=0.01) in pre vs. post-testing scores compared to blog-post intervention. Upon joining, 42% were interested in participating in a clinical trial in AD prevention. After completing all beta-test activities, interest increased to 86%. Users were primarily women and the largest category was children of AD patients. 66.3% joined to learn more about AD prevention, 65.3% to learn more about AD treatment. CONCLUSIONS Webinar-based education led to significant improvements in learning about AD prevention and the stages of AD. AlzU.org participation more than doubled interest in AD prevention clinical trial participation. Subjects were quickly and cost-effectively recruited, and highly satisfied with the AD education research platform. Based on these data, we will further refine AlzU.org prior to public launch and aim to study the effectiveness of 25 interactive webinar-based vs. blog-post style lessons on learning and patient outcomes, in a randomized, within-subjects design trial.
Published:
2014
Title:
An NMR-based metabolomics study of pork from different crossbreeds and relation to sensory perception
Authors:
Straadt, I.K.; Aaslyng, M.D.; Bertram, H.C.
Abstract:
Meat extracts from five different pig crossbreeds including Duroc/Landrace/Yorkshire (DLY), Iberian/Duroc (ID), Iberian/Duroc/Landrace (ILY), Mangalitza/Duroc (MD), and Mangalitza/Landrace/Yorkshire (MLY) were analysed by nuclear magnetic resonance (NMR)-based metabolomics. The results were compared with technological traits and sensory analyses in order to elucidate the potential of NMR-based metabolomics to highlight meat metabolites of importance for technological and sensory attributes of meat. Amino acids including alanine, carnosine, isoleucine, methionine, phenylalanine, and valine, as well as lactate, inosine monophosphate (IMP), inosine, glycerol and choline-containing compounds were found to be significantly affected by crossbreed. The breed-specific differences in the metabolome were ascribed to differences in ante mortem metabolism, differences in the membrane properties and glycolytic potential of muscle fibres and differences in lipolysis and proteolysis. A high content of carnosine in the meat was associated with a low value of many sensory attributes related to meat flavor/taste, while IMP and inosine were in general not correlated with sensory attributes related to meat flavor/taste. © 2013 Elsevier Ltd.
Published:
2014
Title:
An introduction to earthern mound sites in SA
Authors:
Westell, Craig; Wood, Vivienne
Abstract:
Published:
2014
Title:
Analytical Methods for Determining Bioavailability and Bioaccessibility of Bioactive Compounds from Fruits and Vegetables: A Review
Authors:
Carbonell-Capella, Juana M.; Buniowska, Magdalena; Barba, Francisco J.; Esteve, María J.; Frígola, Ana.
Abstract:
Determination of bioactive compounds content directly from foodstuff is not enough for the prediction of potential in vivo effects, as metabolites reaching the blood system may be different from the original compounds found in food, as a result of an intensive metabolism that takes place during absorption. Nutritional efficacy of food products may be ensured by the determination of bioaccessibility, which provides valuable information in order to select the appropriate dosage and source of food matrices. However, between all the methods available, there is a need to establish the best approach for the assessment of specific compounds. Comparison between in vivo and in vitro procedures used to determine bioaccessibility and bioavailability is carried out, taking into account the strengths and limitations of each experimental technique, along with an intensive description of actual approaches applied to assess bioaccessibility of bioactive compounds. Applications of these methods for specific bioactive compound's bioaccessibility or bioavailability are also discussed, considering studies regarding the bioavailability of carotenoids, polyphenolic compounds, glucosinolates, vitamin E, and phytosterols.
Published:
2014
Title:
Annals of Internal Medicine Article Association of Hemoglobin A 1c with Cardiovascular Disease and Mortality in Adults : The European Prospective Investigation into Cancer in Norfolk
Authors:
Khaw, Kay-tee; Wareham, Nicholas; Bingham, Sheila; Luben, Robert; Welch, Ailsa; Day, Nicholas
Abstract:
Published:
2014
Title:
Anthocyanins in mediterranean diet: Common and innovative sources
Authors:
Guidi, L.; Penella, C.; Landi, M.
Abstract:
The Mediterranean diet is a nutritional recommendation based on the traditional foods and drinks of the countries surrounding the Mediterranean Sea. The peculiarity of this diet is represented by a high consumption of olive oil, legumes, cereals, fruit and vegetables, a moderately high consumption of fish and dairy products, a moderate consumption of wine and a low consumption of meat and meat-based produces. The high consumption of fruit and vegetables insures a high intake of phytochemicals, compounds that have long been recognized to play a positive role on human health. Phytochemicals are secondary metabolites that plants synthesize for their ecological interaction with biotic and abiotic factors. Anthocyanins are a class of pigments that cover the deep red to blue spectrum. Scientific research has also been focused on the possible benefits to human health from the ingestion of anthocyanin-rich foods. Anthocyanins are remarkably potent antioxidants and they have been associated with reductions in the incidence and severity of many other non-infectious diseases, including diabetes, cardiovascular disease and certain cancers. The chapter covers the biosynthesis and function of anthocyanins in plants but overall their presence in a wide range of Mediterranean food and drinks including their role in human health. At the end the use of innovative food as source of anthocyanins is reported. © 2015 by Nova Science Publishers, Inc. All rights reserved.
Published:
2014
Title:
Antibacterial, antiviral, and antifungal properties of wines and winery byproducts in relation to their flavonoid content
Authors:
Friedman, M.
Abstract:
Grapes produce organic compounds that may be involved in the defense of the plants against invading phytopathogens. These metabolites include numerous phenolic compounds that are also active against human pathogens. Grapes are used to produce a variety of wines, grape juices, and raisins. Grape pomace, seeds, and skins, the remains of the grapes that are a byproduct of winemaking, also contain numerous bioactive compounds that differ from those found in grapes and wines. This overview surveys and interprets our present knowledge of the activities of wines and winery byproducts and some of their bioactive components against foodborne (Bacillus cereus, Campylobacter jejuni, Escherichia coli, Listeria monocytogenes, Salmonella enterica, Staphylococcus aureus, Yersinia enterocolitica, Vibrio cholerae, Vibrio vulnificus), medical (Helicobacter pylori, Klebsiella pneumoniae), and oral pathogenic bacteria, viruses (adeno, cytomegalo, hepatitis, noro, rota), fungi (Candida albicans, Botrytis cinerea), parasites (Eimeria tenella, Trichomonas vaginalis), and microbial toxins (ochratoxin A, Shiga toxin) in culture, in vivo, and in/on food (beef, chicken, frankfurters, hot dogs, lettuce, oysters, peppers, pork, sausages, soup, spinach) in relation to composition and sensory properties. Also covered are antimicrobial wine marinades, antioxidative and immunostimulating aspects, and adverse effects associated with wine consumption. The collated information and suggested research needs might facilitate and guide further studies needed to optimize the use of wines and byproducts to help improve microbial food safety and prevent or treat animal and human infections. © This article not subject to U.S. Copyright. Published 2014 by the American Chemical Society.
Published:
2014
Title:
Atlantic salmon (Salmo salar L.) as a marine functional source of gamma-tocopherol
Authors:
Menoyo, D.; Sanz-Bayón, C.; Nessa, A.H.; Esatbeyoglu, T.; Faizan, M.; Pallauf, K.; De Diego, N.; Wagner, A.E.; Ipharraguerre, I.; Stubhaug, I.; Rimbach, G.
Abstract:
Gamma tocopherol (gT) exhibits beneficial cardiovascular effects partly due to its anti-inflammatory activity. Important sources of gT are vegetable oils. However, little is known to what extent gT can be transferred into marine animal species such as Atlantic salmon by feeding. Therefore, in this study we have investigated the transfer of dietary gT into salmon. To this end, fish were fed a diet supplemented with 170 ppm gT for 16 weeks whereby alpha tocopherol levels were adjusted to 190 ppm in this and the control diet. Feeding gT-rich diets resulted in a three-fold increase in gT concentrations in the liver and fillet compared to non-gT-supplemented controls. Tissue alpha tocopherol levels were not decreased indicating no antagonistic interaction between gamma- and alpha tocopherol in salmon. The concentration of total omega 3 fatty acids slightly increased in response to dietary gT. Furthermore, dietary gT significantly decreased malondialdehyde in the fillet, determined as a biomarker of lipid peroxidation. In the liver of gT fed salmon we observed an overall down-regulation of genes involved in lipid homeostasis. Additionally, gT improved the antioxidant capacity by up-regulating Gpx4a gene expression in the pyloric caeca. We suggest that Atlantic salmon may provide a marine functional source capable of enriching gT for human consumption. © 2014 by the authors licensee MDPI Basel Switzerland.
Published:
2014
Title:
Breath ketone testing: a new biomarker for diagnosis and therapeutic monitoring of diabetic ketosis
Authors:
Qiao, Yue; Gao, Zhaohua; Liu, Yong; Cheng, Yan; Yu, Mengxiao; Zhao, Lingling; Duan, Yixiang; Liu, Yu
Abstract:
BACKGROUND: Acetone, β -hydroxybutyric acid, and acetoacetic acid are three types of ketone body that may be found in the breath, blood, and urine. Detecting altered concentrations of ketones in the breath, blood, and urine is crucial for the diagnosis and treatment of diabetic ketosis. The aim of this study was to evaluate the advantages of different detection methods for ketones, and to establish whether detection of the concentration of ketones in the breath is an effective and practical technique. METHODS: We measured the concentrations of acetone in the breath using gas chromatography-mass spectrometry and β -hydroxybutyrate in fingertip blood collected from 99 patients with diabetes assigned to groups 1 (-), 2 (±), 3 (+), 4 (++), or 5 (+++) according to urinary ketone concentrations. RESULTS: There were strong relationships between fasting blood glucose, age, and diabetic ketosis. Exhaled acetone concentration significantly correlated with concentrations of fasting blood glucose, ketones in the blood and urine, LDL-C, creatinine, and blood urea nitrogen. CONCLUSIONS: Breath testing for ketones has a high sensitivity and specificity and appears to be a noninvasive, convenient, and repeatable method for the diagnosis and therapeutic monitoring of diabetic ketosis.
Published:
2014
Title:
Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
Authors:
Rp, Mattick
Abstract:
Background Buprenorphine maintenance treatment has been evaluated in randomised controlled trials against placebo medication, and separately as an alternative to methadone for management of opioid dependence.
Published:
2014
Title:
CLINICAL PHARMACOLOGY OF ATYPICAL ANTIPSYCHOTICS: AN UPDATE
Authors:
Mauri, M C; Paletta, S; Maffini, M; Colasanti, A; Dragogna, F; Pace, C Di; Altamura, A C
Abstract:
This review will concentrate on the clinical pharmacology, in particular pharmacodynamic data, related to atypical antipsychotics, clozapine, risperidone, paliperidone, olanzapine, quetiapine, amisulpride, ziprasidone, aripiprazole, asenapine, iloperidone, lurasidone and cariprazine. A summary of their acute pharmacokinetics properties are also reported.
Published:
2014
Title:
Calcium density of coronary artery plaque and risk of incident cardiovascular events
Authors:
Criqui, Michael H.; Denenberg, Julie O.; Ix, Joachim H.; McClelland, Robyn L.; Wassel, Christina L.; Rifkin, Dena E.; Carr, Jeffrey J.; Budoff, Matthew J.; Allison, Matthew A.
Abstract:
IMPORTANCE Coronary artery calcium (CAC), measured by computed tomography (CT), has strong predictive value for incident cardiovascular disease (CVD) events. The standard CAC score is the Agatston, which is weighted upward for greater calcium density. However, some data suggest increased plaque calcium density may be protective for CVD. OBJECTIVE To determine the independent associations of CAC volume and CAC density with incident CVD events. DESIGN, SETTING, AND PARTICIPANTS Multicenter, prospective observational MESA study (Multi-Ethnic Study of Atherosclerosis), conducted at 6 US field centers of 3398 men and women from 4 race/ethnicity groups; non-Hispanic white, African American, Hispanic, and Chinese. Participants were aged 45-84 years, free of known CVD at baseline, had CAC greater than 0 on their baseline CT, and were followed up through October 2010. MAIN OUTCOMES AND MEASURES Incident coronary heart disease (CHD) and all CVD events RESULTS During a median of 7.6 years of follow-up, there were 175 CHD events and an additional 90 other CVD events for a total of 265 CVD events. With both lnCAC volume and CAC density scores in the same multivariable model, the lnCAC volume score showed an independent association with incident CHD, with a hazard ratio (HR) of 1.81 (95% CI, 1.47-2.23) per standard deviation (SD = 1.6) increase, absolute risk increase 6.1 per 1000 person-years, and for CVD an HR of 1.68 (95% CI, 1.42-1.98) per SD increase, absolute risk increase 7.9 per 1000 person-years. Conversely, the CAC density score showed an independent inverse association, with an HR of 0.73 (95% CI, 0.58-0.91) per SD (SD = 0.7) increase for CHD, absolute risk decrease 5.5 per 1000 person-years, and an HR of 0.71 (95% CI, 0.60-0.85) per SD increase for CVD, absolute risk decrease 8.2 per 1000 person years. Area under the receiver operating characteristic curve analyses showed significantly improved risk prediction with the addition of the density score to a model containing the volume score for both CHD and CVD. In the intermediate CVD risk group, the area under the curve for CVD increased from 0.53 (95% CI, 0.48-0.59) to 0.59 (95% CI, 0.54-0.64), P = .02. CONCLUSIONS AND RELEVANCE CAC volume was positively and independently associated with CHD and CVD risk. At any level of CAC volume, CAC density was inversely and significantly associated with CHD and CVD risk. The role of CAC density should be considered when evaluating current CAC scoring systems.
Published:
2014
Title:
Cardiomyocyte-specific deficiency of ketone body metabolism promotes accelerated pathological remodeling
Authors:
Schugar, Rebecca C.; Moll, Ashley R.; André d'Avignon, D.; Weinheimer, Carla J.; Kovacs, Attila; Crawford, Peter A.
Abstract:
Objective: Exploitation of protective metabolic pathways within injured myocardium still remains an unclarified therapeutic target in heart disease. Moreover, while the roles of altered fatty acid and glucose metabolism in the failing heart have been explored, the influence of highly dynamic and nutritionally modifiable ketone body metabolism in the regulation of myocardial substrate utilization, mitochondrial bioenergetics, reactive oxygen species (ROS) generation, and hemodynamic response to injury remains undefined. Methods: Here we use mice that lack the enzyme required for terminal oxidation of ketone bodies, succinyl-CoA:3-oxoacid CoA transferase (SCOT) to determine the role of ketone body oxidation in the myocardial injury response. Tracer delivery in ex vivo perfused hearts coupled to NMR spectroscopy, in vivo high-resolution echocardiographic quantification of cardiac hemodynamics in nutritionally and surgically modified mice, and cellular and molecular measurements of energetic and oxidative stress responses are performed. Results: While germline SCOT-knockout (KO) mice die in the early postnatal period, adult mice with cardiomyocyte-specific loss of SCOT (SCOT-Heart-KO) remarkably exhibit no overt metabolic abnormalities, and no differences in left ventricular mass or impairments of systolic function during periods of ketosis, including fasting and adherence to a ketogenic diet. Myocardial fatty acid oxidation is increased when ketones are delivered but cannot be oxidized. To determine the role of ketone body oxidation in the remodeling ventricle, we induced pressure overload injury by performing transverse aortic constriction (TAC) surgery in SCOT-Heart-KO and αMHC-Cre control mice. While TAC increased left ventricular mass equally in both groups, at four weeks post-TAC, myocardial ROS abundance was increased in myocardium of SCOT-Heart-KO mice, and mitochondria and myofilaments were ultrastructurally disordered. Eight weeks post-TAC, left ventricular volume was markedly increased and ejection fraction was decreased in SCOT-Heart-KO mice, while these parameters remained normal in hearts of control animals. Conclusions: These studies demonstrate the ability of myocardial ketone metabolism to coordinate the myocardial response to pressure overload, and suggest that the oxidation of ketone bodies may be an important contributor to free radical homeostasis and hemodynamic preservation in the injured heart.
Published:
2014
Title:
Cerebral glycolysis: A century of persistent misunderstanding and misconception
Authors:
Schurr, Avital
Abstract:
Since its discovery in 1780, lactate (lactic acid) has been blamed for almost any illness outcome in which its levels are elevated. Beginning in the mid-1980s, studies on both muscle and brain tissues, have suggested that lactate plays a role in bioenergetics. However, great skepticism and, at times, outright antagonism has been exhibited by many to any perceived role for this monocarboxylate in energy metabolism. The present review attempts to trace the negative attitudes about lactate to the first four or five decades of research on carbohydrate metabolism and its dogma according to which lactate is a useless anaerobic end-product of glycolysis. The main thrust here is the review of dozens of scientific publications, many by the leading scientists of their times, through the first half of the twentieth century. Consequently, it is concluded that there exists a barrier, described by Howard Margolis as "habit of mind," that many scientists find impossible to cross. The term suggests "entrenched responses that ordinarily occur without conscious attention and that, even if noticed, are hard to change." Habit of mind has undoubtedly played a major role in the above mentioned negative attitudes toward lactate. As early as the 1920s, scientists investigating brain carbohydrate metabolism had discovered that lactate can be oxidized by brain tissue preparations, yet their own habit of mind redirected them to believe that such an oxidation is simply a disposal mechanism of this "poisonous" compound. The last section of the review invites the reader to consider a postulated alternative glycolytic pathway in cerebral and, possibly, in most other tissues, where no distinction is being made between aerobic and anaerobic glycolysis; lactate is always the glycolytic end product. Aerobically, lactate is readily shuttled and transported into the mitochondrion, where it is converted to pyruvate via a mitochondrial lactate dehydrogenase (mLDH) and then is entered the tricarboxylic acid (TCA) cycle.
Published:
2014
Title:
Chrono-biology, chrono-pharmacology, and chrono-nutrition
Authors:
Tahara, Yu; Shibata, Shigenobu
Abstract:
The circadian clock system in mammals drives many physiological processes including the daily rhythms of sleep-wake behavior, hormonal secretion, and metabolism. This system responds to daily environmental changes, such as the light-dark cycle, food intake, and drug administration. In this review, we focus on the central and peripheral circadian clock systems in response to drugs, food, and nutrition. We also discuss the adaptation and anticipation mechanisms of our body with regard to clock system regulation of various kinetic and dynamic pathways, including absorption, distribution, metabolism, and excretion of drugs and nutrients. "Chrono-pharmacology" and "chrono-nutrition" are likely to become important research fields in chrono-biological studies.
Published:
2014
Title:
Chronological trends in late Holocene shell mound construction across northern Australia: insights from Albatross Bay, Cape York Peninsula
Authors:
Morrison, M.J.
Abstract:
Shell mound sites dating from the mid-Holocene and containing very large numbers of the estuarine bivalve Anadara granosa are found across northern Australia. It has recently been proposed that the economic, social and cultural practices linked to their formation ceased some 500–700 years ago across northern Australia as a result of environmental changes leading to the substantially reduced availability of A. granosa. This has been used in support of arguments that ethnographic data are irrelevant to archaeological interpretations of shell mound sites. The Albatross Bay region, Cape York Peninsula, has been cited as one area potentially showing a continuity of mound building after 500–700 cal. BP; however, radiocarbon data for the region have not been reviewed in the context of this debate. This paper reviews both new and previously published radiocarbon determinations from shell matrix sites at Albatross Bay and integrates these with newly available site data for the region. Analysis of this dataset shows a dramatic increase in mound construction activity during the last millennium, continuing up until ca 200 cal. BP. This shows that shell mound construction did not universally cease across northern Australia at 500–700 cal. BP. This paper calls for further refinement of the broader model via the development of more nuanced, regionally specific models.
Published:
2014
Title:
Daylight savings time and myocardial infarction
Authors:
Sandhu, Amneet; Seth, Milan; Gurm, Hitinder S.
Abstract:
© 2014, BMJ Publishing Group. All rights reserved. Background: Prior research has shown a transient increase in the incidence of acute myocardial infarction (AMI) after daylight savings time (DST) in the spring as well as a decrease in AMI after returning to standard time in the fall. These findings have not been verified in a broader population and if extant, may have significant public health and policy implications. Methods: We assessed changes in admissions for AMI undergoing percutaneous coronary intervention (PCI) in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) database for the weeks following the four spring and three fall DST changes between March 2010 and September 2013. A negative binomial regression model was used to adjust for trend and seasonal variation. Results: There was no difference in the total weekly number of PCIs performed for AMI for either the fall or spring time changes in the time period analysed. After adjustment for trend and seasonal effects, the Monday following spring time changes was associated with a 24% increase in daily AMI counts (p=0.011), and the Tuesday following fall changes was conversely associated with a 21% reduction (p=0.044). No other weekdays in the weeks following DST changes demonstrated significant associations. Conclusions: In the week following the seasonal time change, DST impacts the timing of presentations for AMI but does not influence the overall incidence of this disease.
Published:
2014
Title:
Diet and the intestinal microbiome: Associations, functions, and implications for health and disease
Authors:
Albenberg, L.G.; Wu, G.D.
Abstract:
The mutual relationship between the intestinal microbiota and its mammalian host is influenced by diet. Consumption of various nutrients affects the structure of the microbial community and provides substrates for microbial metabolism. The microbiota can produce small molecules that are absorbed by the host and affect many important physiological processes. Age-dependent and societal differences in the intestinal microbiota could result from differences in diet. Examples include differences in the intestinal microbiota of breastfed vs formula-fed infants or differences in microbial richness in people who consume an agrarian plant-based vs a Western diet, which is high in meat and fat. We review how diet affects the structure and metabolome of the human intestinal microbiome and may contribute to health or the pathogenesis of disorders such as coronary vascular disease and inflammatory bowel disease. © 2014 by the AGA Institute.
Published:
2014
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