Resistin is an adipocytokine derived from adipose tissue. Studies showed that resistin is not only related to insulin resistance, but also possibly an important factor related to activating of inflammation and atherosclerosis. It influences the endothelial cells and the function of vessel. To investigate whether or not resistin play a role in the metabolic syndrome and ischemic stroke. we examined the plasma resistin concentrations as well as the 3¡¦ untranslated region +62 G/A polymorphism of resistin gene in a Taiwan population. In the first part of this study, 112 patients with ischemic cerebral vascular disease and 110 healthy subjects were included and analyses of demographic and biochemical parameter, high sensitive C-reactive protein and plasma resistin concentration measurements were performed. In the second part, 594 patients with ischemic cerebral vascular disease and 799 healthy control were examined for resistin 3¡¦ untranslated region +62 G/A polymorphism. Resistin concentration was analyzed by EIA method, and resistin 3¡¦ untranslated region +62 G/A polymorphism was done by PCR and RFLP. The mean plasma resistin concentration of 112 patients with ischemic cerebral vascular disease was significantly lower than that of the 110 controls (32 ¡Ó 59.7 ng/ml and 55.7 ¡Ó 82.5 ng/ml, p < 0.001).When the concentration of resistin was divided into 4 groups and analyzed as continuous variable, it was found that decreased plasma resistin concentration is associated with increased risk of ischemic cerebral vascular disease. After the multiple adjustment by logistic analysis, the adds ratio for the first, second and third quadrate were 7.8, 5.0 and 0.1, respectively). The genotype analysis of 594 patients with ischemic cerebral vascular disease and 799 healthy controls show that the resistin genotype was related statistically to the risk of ischemic stroke. In multiple regression analysis, resistin 3¡¦ untranslated region +62 G/A polymorphism was significantly associated with diastolic blood pressure (GA + AA : GG = 142.2 ¡Ó 19.2 : 139.3 ¡Ó 20.7 mmHg, p = 0.044) and fasting plasma sugar (GA + AA : GG : 83.4 ¡Ó 13.1 : 81.1 ¡Ó 13.1 mg/dl , p = 0.005). Our results indicated that resistin may be related to metabolic syndrome and ischemic cerebral vascular disease and possibly play a role in the development of atherosclerosis.

An increase in heart rate brought about by stimulation of the re centers at the junction of the pulmonary veins and the left atrium in dogs has been reported by Ledsome and Linden, (1964). Although extensive experimentation has shown the afferent pathway for such tachycardia is in the vagus nerve, and efferent impulses appear to travel via the cardiac sympathetics, the location of central synapses, and the degree of central control necessary for its existence are not known. Also unknown is the significance of this cardiovascular control mechanism in the unanaesthetized animal. The series of experiments described in this paper were designed to answer both these questions. A method for decerebrating mongrel dogs (8-18 Kg) by electrocoagulation was devised which avoided traumatic loss of blood, leaving a stable decerebrate preparation. The tachycardia initiated by the inflation of small balloons at the junction of the pulmonary veins with the left atrium was found to be unchanged by such a midcollicular decerebration. Both magnitude and neural characteristics of the increase in heart rate were unaltered. However, careful studies of these characteristics with both drugs and lesions of the spinal cord, revealed a discrepancy with previous reports. The tachycardia produced by balloon inflation could not be totally abolished by the infusion of the sympathetic blocking agent propranolol, either before or after decerebration. In addition small, but significant, increases in heart rate remained upon section of the spinal cord at the level of the first cervical vertebra. These results indicated that the efferent pathway for this reflex, though predominantly relayed by the cardiac sympathetics, may possess a vagal component. Using the same decerebrate preparation, two volatile anaesthetics were used to study the effects of anaesthetics on the response to balloon inflation. Halothane, or a nitrous oxide-sodium pentothal combination were administered prior to decerebration, then discontinued at completion of the section. Throughout the duration of both anaesthetics, cardiovascular reflexes such as the carotid sinus reflex, were depressed. The left atrial reflex was similarly small or absent as compared to dogs under chloralose anaesthesia. Removal of the anaesthetic circuit after successful decerebration coincided with the appearance of small but significant increases in heart rate at balloon inflation, and typical carotid sinus activity at occlusion of the carotid arteries. Neither reflex attained the magnitudes observed in dogs under chloralose anaesthesia, despite prolonged waiting, up to six hours after decerebration. / Medicine, Faculty of / Cellular and Physiological Sciences, Department of / Graduate

Indiana University-Purdue University Indianapolis (IUPUI) / Objectives: The aims of this study are to estimate the cumulative incidence of lower extremity amputation (LEA) revision and reamputation adjusting for a competing risk of death, estimate the one-year event-free mortality rates for patients with peripheral vascular disease undergoing LEA, and develop predictive models for LEA revision and reamputation adjusting for a competing risk of death. Methods: This was a retrospective review of the prospectively collected Vascular Quality Initiative (VQI) registry between 2013 and 2018. Adults undergoing unilateral LEA were included. Demographics, comorbidities, medications, smoking status, history of vascular procedures and revascularization attempts, and procedure urgency were considered. Models to predict LEA revision and reamputation were developed using multivariable regression on the interval-censored competing risks data using semiparametric regression on the cumulative incidence function. Results: The cumulative incidences of LEA revision and revision-free mortality within one year of index amputation are 14.9% and 15.5% respectively. Patient BMI, smoking status, aspirin use, history of revascularization, and level of planned LEA are significantly associated with the odds of LEA revision. Age, amputation urgency, dialysis, and level of planned LEA are associated with the one-year odds of revision-free mortality. A patient receiving an index above knee amputation (AKA) has 61% lower odds of LEA revision (p < 0.0001) but 51% higher odds of revision-free mortality following LEA (p < 0.0001). Previous revascularization procedures increase the odds of revision by 23% (p < 0.0001). The cumulative incidences of reamputation and one-year reamputation-free mortality following LEA are 11.5% and 16.9% respectively. Urgency of the procedure, history of revascularization procedures, and level of planned LEA are statistically associated with the odds of reamputation when adjusting for the competing risk of death. Patients receiving index AKA have 62% lower odds of reamputation (p < 0.0001) compared to BKA. Dialysis is the strongest predictor of one-year mortality (OR 2.576, p < 0.0001). Conclusions: Patients with appropriately managed PVD, which still progresses to amputation have higher odds of LEA revision and reamputation. Revision risk can be predicted and compared on the basis of patient factors and the planned index amputation.

Feed intake, growth, efficiency, and serum cholesterol levels (SCL) were recorded for 102 male mice, and voluntary physical activity and SCL were recorded for 113 male mice from lines selected for 22 generations for maximum 21- to 42-day gain (H), minimum 21- to 42-day gain (L), and a random-bred control (C). Heritability (h²), phenotypic and genetic correlations of SCL, activity, growth, and body moisture content were estimated for 466 sire-son pairs of mice from an unselected line. Blood samples were obtained by sinus orbital bleeding at 35 and 70 days of age in the line characterization study and at 62 days of age in the genetic parameters study and were analyzed for SCL by gas chromatography. Voluntary physical activity was recorded as revolutions of an exercise wheel every sixth day from 21 to 70 days of age in the line characterization study and at 28, 49, and 70 days of age in the genetic parameters study. Feed intake (of an 11% fat, 9% fat, and 4-1/2% fat diet) was recorded for several days each week and extrapolated to obtain weekly intake data. A least-squares analysis of variance from a model including lines, diets, and line x diet interactions indicated highly significant differences in the main effects but few significant interactions. Total SCL, growth, and efficiency were higher, and intake lower in mice on the higher fat diet. SCL (mg/100 ml) at 10 weeks of age was 220.3, 178.1, and 180.4 for animals fed an 11% fat diet and 143.3, 124.1, and 132.2 for animals fed a 4.5% fat diet. Activity scores (revolutions) for the H, C, and L lines were 79234, 107987, and 124409. Activity generally increased in all lines from 21 to 56 days of age, then declined slightly. Heritability estimates of SCL and body moisture 2 content were .31 ± .07 and .20 ± .11, and h² estimates for activity ranged from .27 ± .14 to .54 ± .12. Negative genetic correlations occurred between body moisture content and SCL and between body moisture content and weight gains. / Master of Science

Magister Scientiae (Nutrition Management) - MSc(NM) / Introduction: Non-communicable diseases (NCDs) are among the leading causes of premature death in South Africa. As is the case with many countries in transition, in South Africa the burden of pre-NCDs such as overweight and obesity is increasing. The aim of this mixed method study was to gain an understanding on the knowledge, attitudes, practices and perceptions and related factors of primary and secondary school teachers in Limpopo Province of South Africa regarding nutrition related non-communicable diseases (NR-NCDs). Methodology: A mixed method approach, parallel convergent study design was used to collect both qualitative and quantitative data from a group of randomly selected public school teachers in Rakwadu Circuit, Limpopo, with due consideration of the ethical issues involved. For the quantitative inquiry, a previously validated structured questionnaire was adapted to collect data from 114 teachers, while 2 Focus Group Discussions (FGDs) were conducted by the researcher to collect the qualitative data. Information collected included teachers‟ dietary practices, physical activity levels and their knowledge, attitudes and perceptions towards nutrition related non-communicable diseases. Each of these variables had a number of questions which were scored and a mean score for each participant was obtained. Anthropometric measurements collected included Body Mass Index (BMI) and waist circumference (WC).

No description available.

Pulmonary vascular disease (PVD) and lung hypoplasia (LH) are the two main causes of mortality and morbidity in patients with congenital diaphragmatic hernia (CDH). Previous studies have shown that remodeling of the extracellular matrix (ECM) by elastase and matrix metalloproteinase (MMP) enzymes, concomitant with smooth muscle cell (SMC) proliferation and deposition of ECM proteins and growth factors, leads to primary pulmonary hypertension (PH) and that blockade of this pathway results in disease reversal. The aim of our study is to determine whether a similar pathway is induced in the PVD associated with CDH and to verify whether its inhibition will lead to reversal of PVD. Firstly, we confirmed various aspects of PVD in the nitrofen induced CDH rat model. These included: left lung hypoplasia, right ventricular hypertrophy, and increased arterial smooth muscle wall thickness alongside decreases in arterial lumen area and total number of distal pulmonary vessels. We also showed increases in elastase and matrix metalloproteinase (MMP) enzyme activities within distal pulmonary arteries (PAs), which, we were able to inhibit using serine elastase (sivelestat, elafin, and serpina1) and MMP (GM6001) inhibitors. Furthermore, we confirmed increased SMC proliferation and deposition of osteopontin (OPN) and epidermal growth factor (EGF) within the diseased vasculatures. We are now working on using sivelestat and GM6001 pharmaceuticals as well as endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) modified to express elafin and serpina1 to determine their abilities to reverse the PVD associated with CDH. This project is part of our translational research program with the ultimate goal of developing a novel strategy of targeting PVD in infants with CDH to improve patient survival and long-term outcome.

Peripheral arterial disease is a common and often overlooked entity responsible for considerable morbidity and mortality. Recent evidence suggests that nontraditional risk factors such as vitamin D deficiency may contribute to atherosclerosis and increased cardiovascular morbidity and mortality, hence monitoring of vitamin D status is essential. This review tries to examine this entity.

The absence of a practice guideline for peripheral artery disease (PAD) in the cardiology department creates differing practice preferences among providers, leading to deviations in practice among staff. Variations in practice can affect the quality of care that is provided to patients. This project was guided by research statements indicating that there was a difference in the screening approach for PAD among health practitioners at preimplementation and postimplementation and that an 85% compliance with the guideline would signify consistency in the provision of care. Rogers' theory of diffusion of innovations was used to facilitate the adoption of the guideline. This project helped close the gap between research (adoption of a guideline) and practice (compliance in the use of evidence in clinical practice). Using random medical record reviews and pretest-posttest design, the results of the project showed that patterns of using the PAD guideline in practice at preimplementation significantly differed compared to postimplementation. The rates of screening for the compliance of the PAD guideline showed approximately an eightfold increase. The adoption of the PAD guideline has implications for policy, because adopting the PAD guideline helped standardize the care, improve effectiveness of care in nursing practice, evaluate quality through use of research, and promote social change by improving patient outcomes.

Resumo: A vitamina K, descoberta em 1929, tem reconhecida função na coagulação sangüínea. Esta vitamina age como co-fator na reação de carboxilação para biossíntese, após tradução, de resíduos de ácido gama carboxi-glutâmico (Gla) em limitado número de proteínas. A reação de carboxilação é passo necessário para a formação de fatores e proteínas da coagulação (fatores II, VII, IX, X, proteínas C e S) e proteínas envolvidas no metabolismo ósseo, como osteocalcina e proteína Gla da matriz. As drogas anticoagulantes orais são usadas na prevenção primária e secundária de fenômenos tromboembólicos e funcionam reduzindo a atividade plasmática das proteínas de coagulação vitamina K-dependentes. As causas da instabilidade da terapia anticoagulante são múltiplas e incluem: baixa adesão ao tratamento, interação droga-droga, resistência herdada à varfarina e alterações dietéticas. O presente trabalho versa sobre a influência do estado nutricional relacionado à vitamina K sobre a terapia de anticoagulação oral, em pacientes portadores de doença vascular. Levantou-se a hipótese de que o consumo de dieta com teor inadequado de vitamina K (elevado ou reduzido), assim como as concentrações plasmáticas da vitamina, podem estar associados a dificuldades na promoção da anticoagulação ou favorecer o estado de hipocoagulabilidade. Objetivou-se ainda a realização de avaliação do estado nutricional relacionado à vitamina K do grupo estudado, identificar as principais fontes dietéticas de vitamina K e investigar o efeito de diversas variáveis (chamadas variáveis descritivas) sobre a ingestão e concentrações plasmáticas de vitamina K. Para atender aos objetivos propostos, o trabalho incluiu dois estudos: transversal e longitudinal. Do estudo transversal, constam a aplicação de protocolo, que contém: os dados... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Vitamin K, which was discovered in the decade of 1930, has a recognized function in blood coagulation. The vitamin acts as a cofactor in posttranslational conversion of specific glutamyl residues to gammacarboxyglutamic acid (GLA) residues in limited numbers of proteins. The carboxylation reaction is a necessary step to synthesis of factors and anticoagulant proteins (factors II , VII, IX, X, proteins C and S) and proteins involved in bone metabolism, such as osteocalcin and matrix GLA-protein. The oral anticoagulant drugs have been used in the primary and secondary prevention of thromboembolic disorders and act reducing the plasmatic activity of blood coagulation proteins. Causes of the unstable anticoagulant therapy are multiple and include poor compliance, drug-drug interaction, inherited warfarin resistance and dietary changes. The present study examined the influence of vitamin K nutritional status on the warfarin anticoagulation therapy in vascular disease patients. We tested the hypothesis that inadequate diet intake of vitamin K (high or low), and the vitamin plasmatic concentrations are related to a disturbances of the coagulation leading to hypercoagulability or favoring hypocoagulability condition. The aim of the study was to assess the vitamin K nutritional status of the group, identify important food sources and investigate the effect of some variables on the dietary vitamin K intake and the vitamin plasmatic concentration. The work included a crosssectional and longitudinal study. The cross-sectional study consisted of clinical history and examination, a 24-hour recall method for assessment of recent food intake of vitamin K and laboratory methods for biochemical assessment, including coagulation test and body composition techniques. For the longitudinal study, a food frequency questionnaire was applied in order to... (Complete abstract click electronic access below) / Orientador: Sérgio Alberto Rupp de Paiva / Coorientador: Álvaro Oscar Campana / Doutor