Effects of aspirin on nasal responses in atopic subjects

Preliminary experiments indicated that solutions of aspirin (ASA) in buffered saline, pH 7.35, did not significantly change nasal airways resistance (NAR) when 0.1 ml of solution containing 22.5 mg (or less) per deciliter was sprayed into each nostril. Subsequently it was shown that this quantity of ASA administered intranasally did not significantly change NAR responses 15 min later to intranasal administration of increasing concentrations of histamine, methacholine, or an irritant (NH₃ gas). However, the same atopic subjects demonstrated significantly decreased responses to intranasal challenge with short ragweed extract (SRW) after intranasal ASA. In addition, prior oral administration of ASA, Na salicylate, and indomethacin significantly inhibited nasal challenge responses to SRW in sensitive subjects under controlled conditions.     

Mothers of young children cluster into 4 groups based on psychographic food decision influencers

This study explored how mothers grouped into clusters according to multiple psychographic food decision influencers and how the clusters differed in nutrient intake and nutrient content of their household food supply. Mothers (n = 201) completed a survey assessing basic demographic characteristics, food shopping and meal preparation activities, self and spouse employment, exposure to formal food or nutrition education, education level and occupation, weight status, nutrition and food preparation knowledge and skill, family member health and nutrition status, food decision influencer constructs, and dietary intake. In addition, an in-home inventory of 100 participants' household food supplies was conducted. Four distinct clusters presented when 26 psychographic food choice influencers were evaluated. These clusters appear to be valid and robust classifications of mothers in that they discriminated well on the psychographic variables used to construct the clusters as well as numerous other variables not used in the cluster analysis. In addition, the clusters appear to transcend demographic variables that often segment audiences (eg, race, mother's age, socioeconomic status), thereby adding a new dimension to the way in which this audience can be characterized. Furthermore, psychographically defined clusters predicted dietary quality. This study demonstrates that mothers are not a homogenous group and need to have their unique characteristics taken into consideration when designing strategies to promote health. These results can help health practitioners better understand factors affecting food decisions and tailor interventions to better meet the needs of mothers.     

Impact of the COVID-19 pandemic on management and outcomes in acute appendicitis: Should these new practices be the norm?

BackgroundIn early 2020, the COVID-19 pandemic significantly altered management of surgical patients globally. International guidelines recommended that non-operative management be implemented wherever possible (e.g. in proven uncomplicated appendicitis) to reduce pressure on healthcare services and reduce risk of peri-operative viral transmission. We sought to compare our management and outcomes of appendicitis during lockdown vs a non-pandemic period.MethodsAll presentations to our department with a clinical diagnosis of acute appendicitis between 12/03/2020 and 30/06/2020 were compared to the same 110-day period in 2019. Quantity and severity of presentations, use of radiological investigations, rate of operative intervention and histopathological findings were variables collected for comparison.ResultsThere was a reduction in appendicitis presentations (from 74 to 56 cases), and an increase in radiological imaging (from 70.27% to 89.29%) (P = 0.007) from 2019 to 2020. In 2019, 93.24% of patients had appendicectomy, compared to 71.42% in 2020(P < 0.001). This decrease was most pronounced in uncomplicated cases, whose operative rates dropped from 90.32% to 62.5% (P = 0.009). Post-operative histology confirmed appendicitis in 73.9% in 2019, compared to 97.5% in 2020 (P = 0.001). Normal appendiceal pathology was reported for 17 cases (24.64%) in 2019, compared to none in 2020 (P < 0.001) – a 0% negative appendicectomy rate (NAR).DiscussionThe 0% NAR in 2020 is due to a combination of increased CT imaging, a higher threshold to operate, and is impacted by increased disease severity due to delayed patient presentation. This study adds to growing literature promoting routine use of radiological imaging to confirm appendicitis diagnosis. As we enter a second lockdown, patients should be encouraged to avoid late presentations, and surgical departments should continue using radiological imaging more liberally in guiding appendicitis management.     

鼻康片联合色甘萘甲那敏治疗过敏性鼻炎的临床研究

目的 探讨鼻康片联合色甘萘甲那敏治疗过敏性鼻炎的临床疗效。方法 回顾性分析2020年10月—2021年10月在武汉市红十字医院治疗的110例过敏性鼻炎患者的临床资料,随机分为对照组和治疗组,每组各55例。对照组给予色甘萘甲那敏鼻喷雾剂,每次两侧鼻孔各喷1下,3～5次/d,每次间隔>3 h;在对照组基础上,治疗组口服鼻康片,5片/次,3次/d。两组患者均连续治疗8周。观察两组患者临床疗效,比较治疗前后两组患者过敏性鼻炎生活质量测评量表（RQLQ）、鼻症状总分表（TNSS）、伴随症状总分（TNNSS）和鼻内镜（MLK）评分,血清白细胞介素-13（IL-13）、白细胞介素-23（IL-23）、白细胞介素-27（IL-27）、可溶性血管细胞间黏附分子-1（sICAM-1）、可溶性程序性死亡配体-1（sPD-L1）和可溶性E-选择素（sE-selectin）水平,鼻通气功能指标总鼻气道阻力（NAR）、0～5 cm鼻腔容积（NCV）和鼻腔最小横截面积（NMCA）水平。结果 治疗后,对照组有效率为81.82%,明显低于治疗组96.36%（P<0.05）。治疗后,两组RQLQ、TNSS、TNNSS和MLK评分均明显改善（P<0.05）;两组患者血清IL-13、IL-23、sICAM-1和sE-selectin水平均明显降低,而sPD-L1和IL-27水平明显升高（P<0.05）;两组0～5 cm NCV、NMCA均明显升高,而NAR均明显降低（P<0.05）;且治疗组这些指标较对照组改善更明显（P<0.05）。结论 鼻康片联合色甘萘甲那敏鼻喷雾剂治疗过敏性鼻炎可有效改善患者鼻部症状,提高鼻通气,改善血清细胞因子表达,有利于提高患者生活质量。     

Effects of hypercapnia on BP in hypoalbuminemic and Nagase analbuminemic rats

STUDY OBJECTIVE: To determine if animals with abnormally low albumin levels are more susceptible to the effects of hypercapnia on BP compared to normal animals. DESIGN: Prospective, controlled laboratory experiment. SETTING: University research laboratory. Animals: Eighteen male Sprague-Dawley rats: 6 rats 10 to 12 weeks old (young Sprague-Dawley [YSD]), 6 rats 6 to 9 months old (old Sprague-Dawley [OSD]), and 6 rats 10 to 12 weeks old (Nagase analbuminemic mutant Sprague-Dawley [NAR]). METHODS: Under general anesthesia and paralysis, we varied the Paco(2) by changing the respiratory rate on mechanical ventilation. Mean arterial pressure (MAP) was monitored in a continuous fashion. We obtained arterial blood for blood gas and electrolyte analysis, and nitric oxide (NO) production. RESULTS: OSD rats had reduced serum albumin, while NAR rats were analbuminemic. Although NAR animals had a decreased buffer capacity compared to age-matched control animals (0.010 vs 0.013, p < 0.05), the MAP decreased in an identical fashion in all three groups. NO production increased with hypercapnia but was similar in all three groups. However, NAR rats had consistently higher plasma strong ion gap (2.8 to 4.1 mEq/L greater) compared to either YSD or OSD rats (p < 0.01), and baseline strong ion difference (mean +/- SD) was significantly lower in NAR rats (28.7 +/- 2.1 mEq/L) compared to either YSD rats (33.0 +/- 5.1 mEq/L) or OSD rats (31.2 +/- 5.1 mEq/L) [p < 0.05]. CONCLUSIONS: These findings suggest that analbuminemic or hypoalbuminemic rats are not more susceptible to hypercapnia-induced hemodynamic instability. Baseline values for apparent strong ion difference are lower in NA rats consistent with a reduced buffer base resulting from analbuminemia.     

Effect of H2 blockade in the challenged allergic nose

To examine whether H₂ blockade might prevent development of allergen-induced nasal congestion, we subjected 18 volunteers with allergic rhinitis to nasal allergen challenge after pretreatment with cimetidine or with placebo. Response after cimetidine was more severe than that which followed placebo. H₂ blockade has a subtle adverse effect on nasal allergic response.     

Effect of albumin on hepatic uptake of warfarin in normal and analbuminemic mutant rats: Analysis by multiple indicator dilution method

Multiple indicator dilution studies of warfarin uptake were carried out on isolated perfused rat livers in the presence and absence of bovine serum albumin (BSA) in the perfusate using normal rats and Nagase analbuminemic rats (NAR). A distributed model was fitted to the dilution data and estimates of influx, efflux, and sequestration rate constants were obtained. In both groups of rats, the intrinsic clearance for unidirectional hepatic uptake (CL_inl,influx) of warfarin in the presence of 1.6g/dl BSA was approximately 37–45% of that in the absence of BSA, while the unbound fraction of warfarin with 1.6 g/dl BSA in the perfusate was only 4.2% of that in the absence of BSA. Thus the degree of BSA-induced reduction of the value of CL_inl,influx and that of the unbound fraction are different. From these observations, it was found that the hepatic uptake of warfarin is not driven solely by the unbound concentration of warfarin, supporting the recent concepts of albumin-mediated transport for tightly albumin bound ligands as reported by Ockner et al. In addition, the fact that the same hepatic uptake mechanism of warfarin was also observed in NAR suggested that the hepatic uptake of warfarin may not necessarily require a special albumin receptor on the hepatocyte surface.     

Discovery of SCH 900271, a Potent Nicotinic Acid Receptor Agonist for the Treatment of Dyslipidemia

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The higher susceptibility of congenital analbuminemic rats to Ca2+-induced mitochondrial permeability transition is associated with the increased expression of cyclophilin D and nitrosothiol depletion

Congenital analbuminemia is a rare autosomal recessive disorder characterized by a trace level of albumin in blood plasma and mild clinical symptoms. Analbuminemic patients generally present associated abnormalities, among which dyslipidemia is a hallmark. In this study, we show that mitochondria isolated from different tissues (liver, heart and brain) from 3-month-old analbuminemic rats (NAR) present a higher susceptibility to Ca²⁺-induced mitochondrial permeability transition (MPT), as assessed by either Ca²⁺-induced mitochondrial swelling, dissipation of membrane potential or mitochondrial Ca²⁺ release. The Ca²⁺ retention capacity of the liver mitochondria isolated from 3-month-old NAR was about 50% that of the control. Interestingly, the assessment of this variable in 21-day-old NAR indicated that the mitochondrial Ca²⁺ retention capacity was preserved at this age, as compared to age-matched controls, which indicates that a reduced capacity for mitochondrial Ca²⁺ retention is not a constitutive feature. The search for putative mediators of MPT sensitization in NAR revealed a 20% decrease in mitochondrial nitrosothiol content and a 30% increase in cyclophilin D expression. However, the evaluation of other variables related to mitochondrial redox status showed similar results between the controls and NAR, i.e., namely the contents of reduced mitochondrial membrane protein thiol groups and total glutathione, H₂O₂ release rate, and NAD(P)H reduced state. We conclude that the higher expression of cyclophilin D, a major component of the MPT pore, and decreased nitrosothiol content in NAR mitochondria may underlie MPT sensitization in these animals.     

Dietary pattern, nutritional density, and dietary quality were low in patients with cerebral infarction in Korea

The aim of this study was to examine if the dietary quality of patients with cerebral infarction (CI) was comparatively worse than those of non-CI subjects in Korea. This case-control study included 146 subjects recruited between May and July 2007 from Kyung Hee University Medical Center (Seoul, Korea). The eating habits, nutritional adequacies, dietary patterns, and overall dietary quality of the subjects were investigated. Patients with CI more frequently skipped meals, had more irregular meal times, and preferred saltier and spicier foods than non-CI subjects. Nutritional densities (vitamin C, vitamin B₁, vitamin B₂, folate, and calcium) and overall dietary quality measures of CI subjects were lower than for non-CI subjects. Frequencies in omission of food groups, particularly the fruit and dairy groups, and the number of food items consumed daily by CI subjects were significantly lower than non-CI subjects (P < .01). After controlling for age, sex, disease, and other health-related factors, high dietary quality scores, especially the variety and adequacy components (desirable diet patterns and quality) had a lower CI incidence (P < .05). In conclusion, we found that Korean patients with CI had a comparatively worse diet quality. Therefore, we suggest active medical nutrition therapy for patients with CI in clinical settings to manage diet quality.