Identification of Putative Causal Relationships Between Type 2 Diabetes and Blood-Based Biomarkers in East Asians by Mendelian Randomization

alexandrossfakianakis shared this article with you from Inoreader Identification of Putative Causal Relationships Between Type 2 Diabetes and Blood-Based Biomarkers in East Asians by Mendelian Randomization via American Journal of Epidemiology - Advance Access Abstract Observational studies revealed phenotypic associations between type 2 diabetes (T2D) and many biomarkers. However, causality between these conditions in East Asians is unclear. We leveraged genome-wide association study (GWAS) summary statistics of T2D (Ncase = 77,418; Ncontrol = 356,122) from the Asian Genetic Epidemiology Network (sample recruited during 2001-2011), and the GWAS summary statistics of 42 biomarkers (N = 12,303 to 143,658) from BioBank Japan (sample recruited during 2003-2008) to investigate causal relationships between T2D and biomarkers. Applications of Mendelian randomization (MR) approaches consistently revealed the genetically instrumented T2D associated with increased blood potassium (liability-scale β = [0.04, 0.10], p-value = [6.41×10-1 7, 9.85×10-5]) and decreased blood chloride (liability-scale β = [-0.16, -0.06], p-value = [5.22×10-27, 3.14×10-5]) whereas these two biomarkers showed no causal effects on T2D. Heritability estimation using summary statistics (ρ-HESS) and summary data-based Mendelian randomization (SMR) highlighted 27 genomic regions and three genes (MGAT1, TLE1, and HMGCR) interactively associated with the shared genetics underlying T2D and the two biomarkers. Thus, T2D may causally affect potassium and chloride in blood for East Asians. In contrast, the relationships from the potassium or chloride to T2D are not causal, suggesting the importance of monitoring the electrolyte disorder for T2D patients. View on Web

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SIRT3-mediated deacetylation protects inner hair cell synapses in a H2O2-induced oxidative stress model in vitro

alexandrossfakianakis shared this article with you from Inoreader SIRT3-mediated deacetylation protects inner hair cell synapses in a H<sub>2</sub>O<sub>2</sub>-induced oxidative stress model in vitro via ScienceDirect Publication: Experimental Cell Research Publication date: Available online 11 July 2022 Source: Experimental Cell Research Author(s): Chunli Zhao, Wenqi Liang, Zijing Yang, Zhongrui Chen, Zhengde Du, Shusheng Gong View on Web

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Circular Stapled Technique Versus Modified Collard Technique for Cervical Esophagogastric Anastomosis After Esophagectomy: A Randomized Controlled Trial

alexandrossfakianakis shared this article with you from Inoreader Circular Stapled Technique Versus Modified Collard Technique for Cervical Esophagogastric Anastomosis After Esophagectomy: A Randomized Controlled Trial via Annals of Surgery - Most Popular Articles Objective: This study was performed to investigate the efficacy of the modified Collard (MC) technique for reducing anastomotic stricture after esophagectomy compared with the circular stapled (CS) technique. Summary Background Data: The currently available techniques of anastomosis after esophagectomy are associated with a significant risk of anasto-motic complications. However, the optimal anastomotic technique after esophagectomy has not yet been established. Methods: We randomly allocated patients to either the CS group or the MC group. The primary endpoint was the incidence of anastomotic stricture. The secondary endpoints included the incidence of postoperative complications (including anastomotic leakage) and quality of life (QoL). All anastomoses were performed after indocyanine green evaluation for objective homogeni-zation of blood flow to the gastric conduit between the 2 techniques. Results: Among 100 randomized patients (CS group, n = 50; MC group, n = 50), anastomotic strictures were observed in 18 (42%) patients in the CS group and in no patients in the MC group. There were no significant between-group differences in anastomotic leakage (CS group, 7% vs MC group, 8%; P = 0.94). Quality of life domains of dysphagia and choking when swallowing at 3 months after surgery were significantly better in the MC group than in the CS group. Conclusions: The MC technique reduces the incidence of anastomotic stricture and improves postoperative quality of life. Furthermore, the incidence of anastomotic leakage is comparable between the 2 techniques based on accurate comparison under objective homogenization of the gastric conduit condition. View on Web

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The Efficacy of Liposomal Bupivacaine on Postoperative Pain Following Abdominal Wall Reconstruction: A Randomized, Double-blind, Placebo-controlled Trial

alexandrossfakianakis shared this article with you from Inoreader The Efficacy of Liposomal Bupivacaine on Postoperative Pain Following Abdominal Wall Reconstruction: A Randomized, Double-blind, Placebo-controlled Trial via Annals of Surgery - Most Popular Articles Objective: To study the efficacy of liposomal bupivacaine on postoperative opioid requirement and pain following abdominal wall reconstruction. Summary Background Data: Despite the widespread use of liposomal bupivacaine in transversus abdominis plane block, there is inadequate evidence demonstrating its efficacy in open abdominal wall reconstruction. We hypothesized that liposomal bupivacaine plane block would result in decreased opioid requirements compared with placebo in the first 72 hours after surgery. Methods: This was a single-center double-blind, placebo-controlled prospective study conducted between July 2018 and November 2019. Adult patients (at least 18 yrs of age) undergoing open, elective, ventral hernia repairs with mesh placed in the retromuscular position were enrolled. Patients were randomized to surgeon-performed transversus abdominis plane block with liposomal bupivacaine, simple bupivacaine, or normal saline (placebo). The main outcome was opioid requirements in the first 72 hours after surgery. Secondary outcomes included total inpatient opioid use, pain scores determined using a 100 mm visual analog scale, length of hospital stay, and patientreported quality of life. Results: Of the 164 patients who were included in the analysis, 57 patients received liposomal bupivacaine, 55 patients received simple bupivacaine, and 52 received placebo. There were no differences in the total opioid used in the first 72 hours after surgery as measured by morphine milligram equivalents when liposomal bupivacaine was compared with simple bupivacaine and placebo (325 ± 225 vs 350 ± 284 vs 310 ± 272, respectively, P = 0.725). Similarly, there were no differences in total inpatient opioid use, pain scores, length of stay, and patient-reported quality of life. Conclusions: There are no apparent clinical benefits to using liposomal bupivacaine transversus abdominis plane block when compared with simple bupivacaine and placebo for open abdominal wall reconstruction. View on Web

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Extramedullary focal fat - fluid level, a specific sign of osteomyelitis

Balaji Anvekar's Neuroradiology Cases

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Extramedullary focal fat - fluid level, a specific sign of osteomyelitis

Posted: 11 Jul 2022 09:37 PM PDT

 A 14 yo male with pain in calcaneum since 1months.

MRI foot for calcaneum with CT correlation shows:

Heterogeneous signal abnormality diffusely involving calcaneum with multiple low signal intensity foci diffusely scattered in calcaneum on T1-weighted images which are hyperintense on STIR. Rest of the intervening calcaneum medulla shows faint high signal on STIR.

No obvious density abnormality on CT. No obvious sclerotic or lytic lesion. No obvious cortical destruction or sclerosis.

There is a focal lentiform shaped parosteal collection measuring approximately 26 mm in height and 6 mm in thickness medially at 2 o'clock position and 4 mm in thickness laterally on plantar aspect at 7 o'clock position on axial section.

There is fat – fluid level within this collection, focal fat in the supernatant portion of this collection which is hyperintense on T1-weighted images with complete signal suppression on STIR, this portion follows classical fat density on CT.

There is an associated diffuse oedema involving muscles of plantar aspect of foot especially quadratus plantae muscle, medial as well as lateral teno synovitis.

This finding suggestive of extramedullary focal fat - fluid level which is a pathognomonic sign of acute to subacute osteomyelitis.

Findings were discussed with the referring physician before finalizing the report, who added that there is elevation of inflammatory markers in lab reports and the suspicion of osteomyelitis clinically as well, with a feedback of significant improvement clinically after IV antibiotics.

Take home note is during MSK MRI interpretation, a bone marrow signal abnormality with an associated focal periosteal extra medullary fat – fluid level, osteomyelitis should be in the list of your differential diagnosis.

References:

1. Extra-osseous fat fluid level: a specific sign for osteomyelitis. Kumar J, Bandhu S, Kumar A, Alam S. Skeletal Radiol. 2007 Jun;36 Suppl 1:S101-4. doi: 10.1007/s00256-006-0194-1. Epub 2006 Sep 19.

2. Intramedullary and extramedullary fat globules on magnetic resonance imaging as a diagnostic sign for osteomyelitis. Davies AM, Hughes DE, Grimer RJ. Eur Radiol. 2005 Oct;15(10):2194-9. doi: 10.1007/s00330-005-2771-4. Epub 2005 Apr 29.

Angstrom-confined catalytic water purification within Co-TiOx laminar membrane nanochannels

alexandrossfakianakis shared this article with you from Inoreader Angstrom-confined catalytic water purification within Co-TiOx laminar membrane nanochannels via Earth and environmental sciences : nature.com subject feeds View on Web

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Intrathecal Fluorescein for CSF Leak Detection

alexandrossfakianakis shared this article with you from Inoreader Intrathecal Fluorescein for CSF Leak Detection via Department of Otorhinolaryngology J. Paul Radabaugh (former rhinology fellow at McGovern Medical School) presented the results of a retrospective study of intrathecal fluorescein (IF) use for detection of cerebrospinal fluid leaks (CSF) at the American Rhinology Society annual meeting in Los Angeles. The... View on Web

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