Secondary Consequence Research Articles

When Crime Comes to the Neighborhood: Short-Term Shocks to Student Cognition and Secondary Consequences

When Crime Comes to the Neighborhood: Short-Term Shocks to Student Cognition and Secondary Consequences

Welche Inhalte soll ein Hochschulmodul „Klimawandel und Gesundheit“ vermitteln? Ergebnisse einer qualitativen Inhaltsanalyse von Experteninterviews

What content should a university module on “Climate Change and Health” convey? Results of a qualitative content analysis of expert interviews Objectives: The earth is in the midst of a climate change that has already led to worrying deteriorations in the social and environmental determinants of health. There is therefore an urgent need for action to familiarize teachers and learners with the effects of climate change on human health in the sense of planetary health. But what content should a university module on climate change and health convey? Methods: In order to find answers to this question, expert interviews were conducted in the summer of 2022 and subjected to a qualitative content analysis. Results: The interviews revealed considerable consistency of content between the topics mentioned by the experts. There were differences in how the health impacts of climate change were classified. Basic terms were not always defined consistently. There were also problems in applying the concept of prevention to the health impacts of climate change. The following structure of the module was proposed: (1) Basics: physical principles, climatic and ecological consequences of climate change, possible influence of climate change on physiology/epigenetics in humans, global concepts for considering health consequences caused by climate change, ethical aspects, topic-related methods, (2) primary, secondary and tertiary health consequences of climate change, (3) possibilities for prevention and adaptation. On this basis, a module description was finally developed. Conclusions: This description of a university module on climate change and health can form the basis for the development of further modules and courses in this subject area at German-speaking universities (especially in the health sector). This is intended to ensure not only that the knowledge acquired is applied and passed on, but also that the learners later use their knowledge to promote a climate-friendly, healthier environment and a fairer, healthier society. Keywords: climate change – health – planetary health – university studies – module description

A heterotrimeric complex of Toxoplasma proteins promotes parasite survival in interferon gamma-stimulated human cells.

Toxoplasma gondii secretes protein effectors to subvert the human immune system sufficiently to establish a chronic infection. Relative to murine infections, little is known about which parasite effectors disarm human immune responses. Here, we used targeted CRISPR screening to identify secreted protein effectors required for parasite survival in IFNγ-activated human cells. Independent screens were carried out using 2 Toxoplasma strains that differ in virulence in mice, leading to the identification of effectors required for survival in IFNγ-activated human cells. We identify the secreted protein GRA57 and 2 other proteins, GRA70 and GRA71, that together form a complex which enhances the ability of parasites to persist in IFNγ-activated human foreskin fibroblasts (HFFs). Components of the protein machinery required for export of Toxoplasma proteins into the host cell were also found to be important for parasite resistance to IFNγ in human cells, but these export components function independently of the identified protein complex. Host-mediated ubiquitination of the parasite vacuole has previously been associated with increased parasite clearance from human cells, but we find that vacuoles from GRA57, GRA70, and GRA71 knockout strains are surprisingly less ubiquitinated by the host cell. We hypothesise that this is likely a secondary consequence of deletion of the complex, unlinked to the IFNγ resistance mediated by these effectors.

Mutations in cdon and boc affect trunk neural crest cell migration and slow-twitch muscle development in zebrafish.

The transmembrane proteins cdon and boc are implicated in regulating hedgehog signaling during vertebrate development. Recent work showing roles for these genes in axon guidance and neural crest cell migration suggest that cdon and boc may play additional functions in regulating directed cell movements. We use newly generated and existing mutants to investigate a role for cdon and boc in zebrafish neural crest cell migration. We find that single mutant embryos exhibit normal neural crest phenotypes, but that neural crest migration is strikingly disrupted in double cdon;boc mutant embryos. We further show that this migration phenotype is associated with defects in the differentiation of slow-twitch muscle cells, and the loss of a Col1a1a-containing extracellular matrix, suggesting that neural crest defects may be a secondary consequence to defects in mesoderm development. Combined, our data add to a growing literature showing that cdon and boc act synergistically to promote hedgehog signaling during vertebrate development, and suggest that the zebrafish can be used to study the function of hedgehog receptor paralogs.

Shotgun metagenomic sequencing on skin microbiome indicates dysbiosis exists prior to the onset of atopic dermatitis.

While the microbiome is increasingly seen as a targetable contributor to atopic dermatitis (AD), questions remain as to whether the dysbiosis is secondary to diseased skin or if it predates symptom onset. Previous work has evaluated how the skin microbiome changes with age and established the influence of factors like delivery mode and breastfeeding on global microbiome diversity. However, these studies were unable to identify taxa which predict subsequent AD. Skin swab samples were collected from the first week of life for 72 children in the neonatal intensive care unit (NICU) at a single site hospital. Participants were followed for 3 years to determine their health status. We applied shotgun metagenomic sequencing to assess the microbiome differences between 31 children who went on to develop AD and 41 controls. We identified that subsequent development of AD was associated with differential abundance of several bacterial and fungal taxa as well as several metabolic pathways, each of which have been previously associated with active AD. Our work provides evidence of reproducibility for the previously reported dysbiotic signatures predating AD onset while also expanding prior findings through the first use of metagenomic assessment prior to AD onset. While extrapolation of our findings beyond the pre-term, NICU cohort is limited, our findings add to the evidence that the dysbiosis associated with AD pre-dates disease onset rather than reflect a secondary consequence of skin inflammation.

Models of Telehealth Service Delivery in Adults With Spinal Cord Injuries: Scoping Review

Background In Canada, approximately 86,000 people live with spinal cord injury (SCI), and there are an estimated 3675 new cases of traumatic or nontraumatic etiology per year. Most people with SCI will experience secondary health complications, such as urinary and bowel issues, pain syndrome, pressure ulcers, and psychological disorders, resulting in severe chronic multimorbidity. Moreover, people with SCI may face barriers in accessing health care services, such as primary care physicians’ expert knowledge regarding secondary complications related to SCI. Telehealth, defined as the delivery of information and health-related services through telecommunication technologies, may help address some of the barriers, and indeed, the present global COVID-19 pandemic has emphasized the importance of integration of telehealth in health care systems. As a result of this crisis, health care providers have increased the usage of telehealth services, providing health services to individuals in need of community-based supportive care. However, the evidence on models of telehealth service delivery for adults with SCI has not been previously synthesized. Objective The purpose of this scoping review was to identify, describe, and compare models of telehealth services for community-dwelling adults with SCI. Methods This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Studies published between 1990 and December 31, 2022, were identified by searching the Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, Web of Science, and CINAHL databases. Papers with specified inclusion criteria were screened by 2 investigators. Included articles focused on identifying, implementing, or evaluating telehealth interventions, including primary health care services and self-management services delivered in the community and home-based settings. One investigator performed a full-text review of each article, and data extraction included (1) study characteristics; (2) participant characteristics; (3) key characteristics of the interventions, programs, and services; and (4) outcome measures and results. Results A total of 61 articles reported telehealth services used for preventing, managing, or treating the most common secondary complications and consequences of SCI, including chronic pain, low physical activity, pressure ulcers, and psychosocial dysfunction. Where evidence exists, improvements in community participation, physical activity, and reduction in chronic pain, pressure ulcers, etc, following SCI were demonstrated. Conclusions Telehealth may offer an efficient and effective option for health service delivery for community-dwelling individuals with SCI, ensuring continuity of rehabilitation, follow-up after hospital discharge, and early detection, management, or treatment of potential secondary complications following SCI. We recommend that the stakeholders involved with patients with SCI consider the uptake of hybridized (blend of web-based and in-person) health care delivery models to optimize the care continuum and self-management of SCI-related care. The findings of this scoping review may be used to inform policy makers, health care professionals, and stakeholders engaged in establishing web-based clinics for individuals with SCI.

Time to eRAASe chronic inflammation: current advances and future perspectives on renin-angiotensin-aldosterone-system and chronic intestinal inflammation in dogs and humans.

Chronic idiopathic intestinal inflammation is an increasing worldwide problem that affects companion animals, especially dogs, and human patients. Although these disease entities have been intensely investigated recently, many questions remain, and alternative therapeutic options are needed. Diarrhea caused by dysregulation of intestinal electrolyte transport and subsequent fluid and electrolyte losses often leads to secondary consequences for the patient. Currently, it is not exactly clear which mechanisms are involved in the dysregulation of intestinal fluid absorption, but differences in intestinal electrolyte shifts between human and canine patients suggest species-specific regulatory or counterregulatory mechanisms. Several intestinal electrolyte transporters are differentially expressed in human patients with inflammatory bowel disease (IBD), whereas there are virtually no studies on electrolyte transporters and their endocrine regulation in canine chronic inflammatory enteropathy. An important mechanism involved in regulating fluid and electrolyte homeostasis is the renin-angiotensin-aldosterone-system (RAAS), which may affect intestinal Na+ transport. While RAAS has previously been considered a systemic regulator of blood pressure, additional complex roles of RAAS in inflammatory processes have been unraveled. These alternative RAAS pathways may pose attractive therapeutic targets to address diarrhea and, thus, electrolyte shifts in human IBD and canine chronic inflammatory enteropathy. This article comparatively summarizes the current knowledge about electrolyte transport in human IBD and canine chronic inflammatory enteropathy and the role of RAAS and offers perspectives for novel therapeutic avenues.

Development of a sacral fracture model to demonstrate effects on sagittal alignment.

To develop a modeling framework to predict the secondary consequences on spinal alignment following correction and to demonstrate the impact of pedicle subtraction osteotomy (PSO) location on sagittal alignment. Six patients were included, and pelvic incidence (PI) was measured. Full-length standing radiographs were uploaded into PowerPoint and manipulated to model S1-S2 joint line sacral fractures at 15°, 20°, 25°, and 30°. PSO corrections with hinge points at the anterior superior corner and vertical midpoint of the L3-5 vertebral bodies were modeled. Anterior translation (AT) and vertical shortening (VS) were calculated for the six PSO locations in the four fracture angle (FA) models. PI had a strong effect in the mixed AT and VS models (P < 0.001). Both AT and VS were significantly different from zero at all FA (p < 0.001), and pairwise comparisons revealed all FA were different from each other with respect to both AT and VS after adjusting for PSO location (p < 0.001), increasing as FA increased. Varying PSO location resulted in significant differences in AT when comparing all locations (p < 0.001). AT was greatest for all FA in all patients when the PSO correction was performed at the L3-AS (p < 0.001). There were significant differences in VS when comparing the L5-Mid PSO location to the L3-AS, L3-Mid, L4-AS, and L4-Mid PSO locations (p < 0.034). PSO correction superior to a sacral fracture resulted in AT and VS of the spine. It is crucial that these changes in spinal measures be predicted and accounted for to optimize patient sagittal alignment and outcomes.

The Transcriptional Landscape of Pericytes in Acute Ischemic Stroke

The current treatment options for ischemic stroke aim to achieve reperfusion but are time critical. Novel therapeutic approaches that can be given beyond the limited time window of 3–4.5 h are still an unmet need to be addressed to improve stroke outcomes. The lack of oxygen and glucose in the area of ischemic injury initiates a pathological cascade leading to blood-brain barrier (BBB) breakdown, inflammation, and neuronal cell death, a process that may be intercepted to limit stroke progression. Pericytes located at the blood/brain interface are one of the first responders to hypoxia in stroke and therefore a potential target cell for early stroke interventions. Using single-cell RNA sequencing in a mouse model of permanent middle cerebral artery occlusion, we investigated the temporal differences in transcriptomic signatures in pericytes at 1, 12, and 24 h after stroke. Our results reveal a stroke-specific subcluster of pericytes that is present at 12 and 24 h and characterized by the upregulation of genes mainly related to cytokine signaling and immune response. This study identifies temporal transcriptional changes in the acute phase of ischemic stroke that reflect the early response of pericytes to the ischemic insult and its secondary consequences and may constitute potential future therapeutic targets.

Role of microbiome in autoimmune liver diseases.

The microbiome plays a crucial role in integrating environmental influences into host physiology, potentially linking it to autoimmune liver diseases, such as autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis. All autoimmune liver diseases are associated with reduced diversity of the gut microbiome and altered abundance of certain bacteria. However, the relationship between the microbiome and liver diseases is bidirectional and varies over the course of the disease. This makes it challenging to dissect whether such changes in the microbiome are initiating or driving factors in autoimmune liver diseases, secondary consequences of disease and/or pharmacological intervention, or alterations that modify the clinical course that patients experience. Potential mechanisms include the presence of pathobionts, disease-modifying microbial metabolites, and more nonspecific reduced gut barrier function, and it is highly likely that the effect of these change during the progression of the disease. Recurrent disease after liver transplantation is a major clinical challenge and a common denominator in these conditions, which could also represent a window to disease mechanisms of the gut-liver axis. Herein, we propose future research priorities, which should involve clinical trials, extensive molecular phenotyping at high resolution, and experimental studies in model systems. Overall, autoimmune liver diseases are characterized by an altered microbiome, and interventions targeting these changes hold promise for improving clinical care based on the emerging field of microbiota medicine.

#2697 ASSOCIATION OF CARDIOMETABOLIC PROTEINS WITH EGFR DECLINE IN OLDER ADULTS WITH ADVANCED CHRONIC KIDNEY DISEASE

Abstract Background and Aims Cardiovascular disease and advanced chronic kidney disease often coexist and share risk factors in older individuals. We investigated the association of cardiometabolic and cardiovascular proteins and pathways with decline in estimated glomerular filtration rate (eGFR). Method Two plasma protein panels (Olink® cardiometabolic T96 and cardiovascular II T96, Uppsala, Sweden) were analysed at the baseline visit of individuals enrolled in the prospective observational European QUALity (EQUAL) study of older people &amp;gt; 65 years with advanced CKD (incident eGFR &amp;lt; 20 ml/min/1.73m2). Generalised linear mixed effects models with a log link and random intercept and slope were used to determine annualised eGFR slope (CKD-EPI 2009 equation) using a complete case model. The model was executed in a “discovery” sample (Germany, United Kingdom and Poland) and positive results (&amp;lt; false discovery rate [FDR] of 5%) were tested in a Swedish “validation” sample using the same FDR criterion. The primary analysis was adjusted for baseline age, sex, country, diabetes mellitus status, primary renal disease, systolic blood pressure, urine albumin to creatinine ratio (ACR), and the use of renin-angiotensin aldosterone inhibitors and β-blockers. A sensitivity analysis was conducted to determine the effect of informative censoring on eGFR slope using a joint model. Results The discovery and validation samples had 254 subjects (median age 67 years, 41% female, median baseline eGFR 18 ml/min/1.73m2) and 247 (median age 75 years, 28% female and median baseline eGFR 18 ml/min/1.73m2) respectively with longer follow-up time for the validation sample (median 3.6 versus 2.6 years) primarily due to less kidney replacement therapy initiation (33% versus 37%) and fewer losses to follow up (5% versus 12%). Two of the 175 proteins showed more rapid eGFR annual decline per doubling in protein levels (Figure 1): Receptor-type tyrosine-protein phosphatase S [PTPRS] (-15%; 95% confidence interval [CI] –24 to –7%, pFDR = 0.01) and Insulin-like growth factor-binding protein 6 [IGFBP6] (–8%; 95% CI –12 to –3%, pFDR = 0.03) (Figure 2). Predicted slopes were similar across both samples and for the sensitivity analyses. Conclusion Receptor-type tyrosine-protein phosphatase S and Insulin-like growth factor-binding protein 6 were associated with more rapid CKD progression. Further research is needed to determine if these proteins are pathophysiologically linked to accelerated progression of CKD in older people or a secondary consequence of disturbances in protein sequestration or excretion.

The Economic Impact of Lumpy Skin Disease and Cost-Effectiveness of Vaccination for the Control of Outbreaks in Pakistan

Lumpy Skin Disease (LSD) may cause major financial damage to farmers. It is a significant barrier to global trade. The Lumpy Skin Disease Virus (LSDV) is a member of the Capri poxvirus genus. The LSD significantly reduces milk production, which might drop from 10 percent to 85%. Consumption of milk and meat has decreased by 60percent to 70percent in Karachi (Pakistan) as a result of LSD usage. Cattle of all species and ages are affected, although lactating cows and young cattle are more at risk. Most LSD outbreaks take place in hot, humid environments when most of the flies that contribute as vectors are present. LSD might be transmitted more quickly by animals. While death is typically low (between 0 and 7%), morbidity ranges from 0.75 to 100%. Lesions can be seen in the reproductive, respiratory, and digestive system tissues. Mastitis, pneumonia, infections of the skin, limping, diarrhea, and myiasis are possible secondary consequences of severe LSD. Consuming milk and meat from diseased animals is dependable and safe. It is vital to choose infection control and preventive techniques. One of the main ways that LSD is spread in areas where it is not endemic is through the restricted mobility of infected animals. Another suggestion for disease control is to reduce the number of insects and vectors. Furthermore, the most effective method for disease control may involve vaccination or immunization with the homologous strain of the LSDV. For control measures to be chosen in time for the LSD to be reduced, diagnosis is therefore of utmost importance and should be rapid and accurate, particularly in endemic regions.

Distributional implications of informal economy in the EU countries: Accounting for the spread of tax evasion benefits and cultural characteristics

This study provides evidence about the impact of informal economy on income inequality by using annual cross-country panel data from 28 European Union countries observed during the period 2005–2017. Particular attention is dedicated to the cultural setting which is expected to impact taxpayers’ behaviour and thereby income distribution. The study reveals a relationship between the size of the underground economy and income inequality, which is negative when approaching domestic informality and positive when international tax evasion by individuals is related to the top-bottom income disparity. Moreover, a delay of one-year is needed for these effects to occur, sustaining the hypothesis of secondary consequences of the informality. The study also shows that a set of cultural peculiarities are relevant for the nexus of international tax evasion by individuals and income polarisation. The inequality enhancing effect of the offshore activities is larger in countries with high degree of uncertainty avoidance and power distance, and low level of indulgence and long-term orientation respectively.

Innate immune side of STAT1 GOF

STAT1 gain-of-function (GOF) mutations underlie an inborn error of immunity hallmarked by chronic mucocutaneous candidiasis (CMC). Beyond the fungal susceptibility, attributed to Th17 failure, over half of the reported patients suffer from autoimmune manifestations, which remain mechanistically unexplained. Surprisingly, little is known about the biological consequences of augmented STAT1 signaling in innate immune cells. Considering the importance of innate immune mechanisms in antifungal defense and autoimmune complications, we examined the phenotype and function of monocytes and dendritic cells in a cohort of patients with STAT1 GOF.We demonstrated that human ex vivo STAT1 GOF monocytes are characterized by proinflammatory phenotype and strong inflammatory skew of their secretory cytokine profile. The distribution of monocytes subpopulations’ is altered and they exhibit various functional abnormalities, which might represent a contributing mechanism in the pathogenesis of STAT1 GOF-associated autoimmunity, e.g., a selectively enhanced responsiveness to TLR7/8 stimulation, but not to other TLR ligands. Importantly, some of these features extend to STAT1 GOF myeloid dendritic cells, suggesting that the alterations observed in monocytes are, in fact, intrinsic due to STAT1 mutation, and not mere secondary consequence of the chronic inflammatory milieu.To follow up on the ex vivo data, we employed an in vitro model of monocyte-derived DC (moDC) and tolerogenic DC (tDC). Functional and signaling studies, co-culture experiments and RNA sequencing demonstrated that STAT1 GOF DCs were profoundly altered in their phenotype and functions, characterized by loss of tolerogenic functions, proinflammatory skew and decreased capacity to induce Th17. Cytokine signaling, autophagy and metabolic processes were identified as the most prominently altered cellular processes.In conclusion, we present first-ever data implying a direct involvement of monocytes and DCs in the STAT1 GOF-associated immune pathology, possibly contributing to both autoimmune manifestations and the failure of antifungal defense. Our work thus highlights a yet understudied innate immune background in STAT1 GOF which should be dissected in details by future research.

Assessing the Effects and Environmental Implications of Biochar Amendment in Agricultural Soils

In recent years, the production and use of biochar have been increasing rapidly, and the biochar market is projected to continue growing between 2019 and 2025. Given that biochar has a long residence time in the environment (soil), a systematic review was conducted to assess the major environmental impacts of its application in agricultural soils. The results were largely consistent in indicating the positive effects of biochar on soil fertility, moisture content, and microbial communities. Moreover, biochar has been shown to improve soil physical properties and provide habitats for soil microorganisms. Biochar application in soil has the potential to mitigate climate change and reduce human health risks. However, the oxidation and ageing process of biochar has the potential to lead to the absorption, accumulation, and release of environmental pollutants such as heavy metals, polycyclic aromatic hydrocarbons (PAHs), dioxins, environmentally persistent free radicals (EPFRs), perfluorochemicals (PFCs), and volatile organic compounds (VOCs) depending on the type of biomass used. Therefore, when considering biochar application in soil for agricultural purposes, it is important to consider the biomass type and investigate the potential negative secondary environmental consequences.

TIR-1/SARM1 inhibits axon regeneration and promotes axon degeneration

Growth and destruction are central components of the neuronal injury response. Injured axons that are capable of repair, including axons in the mammalian peripheral nervous system and in many invertebrate animals, often regenerate and degenerate on either side of the injury. Here we show that TIR-1/dSarm/SARM1, a key regulator of axon degeneration, also inhibits regeneration of injured motor axons. The increased regeneration in tir-1 mutants is not a secondary consequence of its effects on degeneration, nor is it determined by the NADase activity of TIR-1. Rather, we found that TIR-1 functions cell-autonomously to regulate each of the seemingly opposite processes through distinct interactions with two MAP kinase pathways. On one side of the injury, TIR-1 inhibits axon regeneration by activating the NSY-1/ASK1 MAPK signaling cascade, while on the other side of the injury, TIR-1 simultaneously promotes axon degeneration by interacting with the DLK-1 mitogen-activated protein kinase (MAPK) signaling cascade. In parallel, we found that the ability to cell-intrinsically inhibit axon regeneration is conserved in human SARM1. Our finding that TIR-1/SARM1 regulates axon regeneration provides critical insight into how axons coordinate a multidimensional response to injury, consequently informing approaches to manipulate the response toward repair.

Alterations in Sleep Cycle among Nonhospitalized COVID-19-Affected Population during the Pandemic in Karnataka State—A Web-Based Study

Abstract Objectives The psychological and physiological distress and social isolation could adversely affect sleep. As sleep disturbances may persist and deteriorate health, it is important to assess prevalence and related factors of sleep disturbances among the residents of Karnataka state during the coronavirus disease 2019 (COVID-19) infection. Methods In this study, 250 responders across the state of Karnataka accessed the survey voluntarily during September 2021 and January 2022. Pittsburgh Sleep Quality Index, Insomnia Severity Index scales, features that are related to sleep quality, and some hypothesized risk factors of sleep disturbances in context of COVID-19 infection are employed to format a self-reported questionnaire. Results In this study, females 27(19.1%) experienced more sleep disturbances than males 9 (8.3%). The study revealed the participants who received both the doses of vaccination (126; 54.3%) had better sleep. The participants who reported themselves to be stressed (182; 72.8%) had more disturbances in sleep. A total number of 45 participants (18.4%) experienced difficulty in breathing and out of all the responders 11 (47.8%) were actually worried about their current sleep problem. Conclusion COVID-19 infection and changes imposed during the pandemic have led to a surge in individuals reporting sleep problems across the globe. The findings raise the need to screen for worsening sleep patterns to create more awareness about the secondary consequences of COVID-19 infection.

Prevalence of metabolic acidosis in ileal diversions more than one year after radical cystectomy and associated secondary metabolic effects

Introduction and objectiveMetabolic acidosis (MA) is a well-known complication in patients with ileal urinary diversions. It is common in the early postoperative stages and decreases over time. Our objective is to investigate the prevalence of MA after more than one year of follow-up, identify the associated risk factors, and analyze its secondary metabolic consequences. Materials and methodsWe conducted an observational study between January 2018 and September 2022 following the STROBE guidelines. MA was defined as a serum bicarbonate level ​​<22mEq/L. Finally, we analyzed 133 patients with a mean follow-up of 55.24 ± 42.36 months. ResultsMA was observed in 16 (12%) patients. Patients with and without MA were comparable in age, sex, and follow-up time. The group with MA presented a higher rate of anemia (68,75% vs 19,65%, p < 0.001) and renal failure (100% vs 45,29%, p < 0.001), statistically significant higher levels of serum creatinine, chloride, potassium, parathyroid hormone, and phosphorus but lower serum values ​​of hemoglobin, renal glomerular filtration rate, total cholesterol, vitamin D, calcium, and albumin (all p < 0.05).Renal glomerular filtration rate was the only independent risk factor related to the development of MA (OR 0.914; 95% CI 0.878−0.95; p < 0.0001), proving a close correlation with venous bicarbonate values ​​(r = 0.387, p < 0.001). ConclusionsMA is a little prevalent disorder in ileal urinary diversions more than one year after radical cystectomy is performed but it has secondary consequences on hematologic, renal, protein, lipid, and bone metabolism. We recommend to a close follow-up in patients with renal failure for early diagnosis and treatment.

Experimental unilateral intracerebral hemorrhage induces delayed bilateral neurodegeneration of sciatic nerve fibres in rats.

Pathological processes, such as inflammatory effects, oxidative stress, apoptosis and cytotoxicity of blood after an intracerebral hemorrhage (ICH), generally contribute to a secondary injury. One of the secondary ICH consequences in the nervous system may be delayed neurodegeneration of the peripheral nerves. Therefore, the aim of our study was to investigate possible structural changes in the sciatic nerve and changes in the conduction velocity via this nerve at different terms after experimental ICH in male Wistar rats. Intracerebral hemorrhage was provided by direct injection of autologous blood into the capsula interna. On the 10th day after ICH mean conduction velocity in sciatic nerve was 15% smaller compared to the control. On the 30th and 90th days after ICH, highly significant decreases in the conduction velocity by 62% and 60%, respectively in comparison with the control group of animals were observed. The data of morphometric analysis demonstrated significant decreases in the mean diameter and density of myelinated fibres at all examined terms after ICH. A number of the myelin sheaths were swollen and lost their regular laminations. Axoplasmic and myelin degenerations were the most frequent events in these nerve fibres; reductions of the diameter of the axis cylinders were also observed. In the contralateral nerve (related to the hemisphere with ICH), negative changes were greater, while the ipsilateral nerve was also subjected to those. Our data demonstrate that the consequences of unilateral ICH in the capsula interna induce bilateral negative changes in the peripheral nervous system of rats.

Prevalencia de acidosis metabólica en derivaciones ileales tras más de un año de la cistectomía radical y repercusiones metabólicas secundarias asociadas

Introduction and objectiveMetabolic acidosis (MA) is a well-known complication in patients with ileal urinary diversions. It is common in the early postoperative stages and decreases over time. Our objective is to investigate the prevalence of MA after more than one year of follow-up, identify the associated risk factors, and analyze its secondary metabolic consequences. Materials and methodsWe conducted an observational study between January 2018 and September 2022 following the STROBE guidelines. MA was defined as a serum bicarbonate level <22mEq/L. Finally, we analyzed 133 patients with a mean follow-up of 55.24±42.36 months. ResultsMA was observed in 16 (12%) patients. Patients with and without MA were comparable in age, sex, and follow-up time. The group with MA presented a higher rate of anemia (68,75% vs 19.65%, P<.001) and renal failure (100% vs 45.29%, P<.001), statistically significant higher levels of serum creatinine, chloride, potassium, parathyroid hormone, and phosphorus but lower serum values of hemoglobin, renal glomerular filtration rate, total cholesterol, vitamin D, calcium, and albumin (all P<.05).Renal glomerular filtration rate was the only independent risk factor related to the development of MA (OR: 0.914; 95% CI: 0.878-0.95; P<.0001), proving a close correlation with venous bicarbonate values (r=.387, P<.001). ConclusionsMA is a little prevalent disorder in ileal urinary diversions more than one year after radical cystectomy is performed but it has secondary consequences on hematologic, renal, protein, lipid, and bone metabolism. We recommend to a close follow-up in patients with renal failure for early diagnosis and treatment.