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Hartmann Glenn posted an update 4 hours, 16 minutes ago
OBJECTIVE Even in high-risk trials pertaining to transcatheter aortic valve replacement (TAVR), patients with end-stage liver disease (ESLD) have been under-represented. We sought to study this population group from a large national United States population database. METHODS We used National Inpatient Sample (NIS) database from January 2005 to August 2015. Patients with ESLD were extracted using Goldberg’s algorithm. Propensity match analysis was done for comparative analysis between surgical aortic valve replacement (SAVR) and TAVR groups. Logistic regression analysis was used for predictors of in-hospital mortality. RESULTS Out of 309,959 ESLD patients, 1,375 underwent aortic valve replacement and 1,199 patients were included in our study. Mean age was 66.1 (SD, 9.1) years. In matched data, the in-hospital mortality was 5.5% in TAVR group when compared to 19.4% in SAVR group. Ventilator use (16.1 vs. 27.2%, p less then .01), tracheostomy ( less then 4 vs. 7.2%, p less then .01), and vasopressin use (0 vs. 7.4%, p less then .01) were utilized less in TAVR group as compared to SAVR group. The proportion of TAVR has increased from almost zero in 2011 to 51.3% in 2015. Mean cost for hospital stay has increased in SAVR group (from 254,427$ in 2005 to 321,791$ in 2015, p less then .01). Similarly, a large decrease in length of stay has been observed for TAVR group (14.5 days in 2011 to 5.4 days in 2015, p less then .01). TAVR (odds ratios [OR] 0.42, 95% confidence interval [CI] 0.20-0.87, p = .02) was associated with lower in-hospital mortality. CONCLUSION TAVR was associated with lower in-hospital mortality, morbidity, and resource utilization in high-risk ESLD patients. © 2020 Wiley Periodicals, Inc.OBJECTIVES Inflamed airways are hypothesized to contribute to rheumatoid arthritis (RA) pathogenesis due to RA-related autoantibody production, and smoking is the strongest environmental RA risk factor. However, the role of chronic airway diseases in RA development is unclear. We investigated whether asthma or COPD were associated with RA. METHODS We performed a prospective cohort study of 205,153 women in the Nurses’ Health Study (NHS, 1988-2014) and NHSII (1991-2015). OTS964 Exposures were self-reported physician-diagnosed asthma or COPD confirmed by validated supplemental questionnaires. Outcomes were incident RA confirmed by medical record review by 2 rheumatologists. Covariates (including smoking pack-years/status) were assessed via biennial questionnaires. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for RA were estimated using Cox regression. RESULTS We identified 15,148 women with confirmed asthma, 3,573 with confirmed COPD, and 1,060 incident RA cases during 4,384,471 person-years of follow-up in NHS and NHSII. Asthma was associated with increased RA risk (HR 1.53, 95%CI 1.24,1.88) compared to no asthma/COPD after adjusting for covariates including smoking pack-years/status. Asthma remained associated with increased RA risk among never-smokers only (HR 1.53, 95%CI 1.14,2.05). COPD was also associated with increased RA risk (HR 1.89, 95%CI 1.31,2.75). The association of COPD with RA was most pronounced in the subgroup of ever-smokers aged >55 years (HR 2.20, 95%CI 1.38,3.51). CONCLUSIONS Asthma and COPD were each associated with increased risk for incident RA, independent of smoking status/intensity and other potential confounders. These results provide support for the hypothesis that chronic airway inflammation may be crucial in RA pathogenesis. © 2019, American College of Rheumatology.Crosstalk between plant hormone signaling pathways is vital for controlling the immune response during pathogen invasion. Salicylic acid (SA) and jasmonic acid (JA) often play important but antagonistic roles in the immune responses of higher plants. Here, we identify a basic helix-loop-helix transcription activator, OsbHLH6, which confers disease resistance in rice by regulating SA and JA signaling via nucleo-cytosolic trafficking in rice (Oryza sativa). OsbHLH6 expression was upregulated during Magnaporthe oryzae infection. Transgenic rice plants overexpressing OsbHLH6 display increased JA responsive gene expression and enhanced disease susceptibility to the pathogen. Nucleus-localized OsbHLH6 activates JA signaling and suppresses SA signaling; however, the SA regulator OsNPR1 (Nonexpressor of PR genes 1) sequesters OsbHLH6 in the cytosol to alleviate its effect. Our data suggest that OsbHLH6 controls disease resistance by dynamically regulating SA and JA signaling. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Betaine is an essential nutrient for humans and a source of methyl donors for methionine and S-adenosylmethionine formation, and it is used as a biomarker for pharmacological activities and to evaluate the quality of Lycium species and common foods. However, because of its special structural features, poor ultraviolet-chromophore, and high polarity, the existing methods for betaine extraction and quantification cannot provide higher extraction efficiency, better sensitivity or resolution degree. A simple, fast, and efficient high-performance liquid chromatography-diode array detector coupled with solid-phase extraction was adopted for simultaneous separation and quantification of betaine in four types of Lycium species. The results revealed that after degreasing with dichloromethane, extraction with 80% ethanol (pH adjusted to 1.0 with hydrochloric acid), and elution with aluminum oxide (OH- form) the improvement in the average yield rate of betaine was thrice of that of the existing methods. In addition, trigonelline was identified as the interfering substance of betaine for the first time in Lycium species, and betaine and trigonelline were simultaneously separated and quantified. Furthermore, their chemical characteristics and content distribution in different Lycium species were carried out. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.