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Fulltext A glimpse on the function of chitosan as a dental hemostatic agent

Lestari W, Yusry WNAW, Haris MS, Jaswir I, Idrus E

Jpn Dent Sci Rev, 2020 Nov;56(1):147-154.
PMID: 33204370 DOI: 10.1016/j.jdsr.2020.09.001

Managing a bleeding patient can be a challenge during dental surgery. Profuse hemorrhage due to platelet defects, coagulation disorders, vascular anomalies, medication-induced patients, as well as inherited bleeding ailments result in soft tissue hematoma, septic shock, compromised airway, and in some severe cases, death could occur. A vast array of surgical hemostatic agents are available to stop bleeding, including chitosan-based hemostatic agents. Chitosan has an advantage over other topical hemostatic materials for its ability to promote shorter bleeding times and assist in healing. Massive behind-the-scene research and development efforts are ongoing to increase the performance of chitosan as a hemostatic agent. Numerous studies on chitosan use in dental hemostasis have registered it as being safe, biodegradable, biocompatible, promoting healing, antimicrobial and bioactive. This article reviews the application of chitosan in managing hemostasis in dental patients.

Matched MeSH terms: Shock, Septic
Fulltext In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry

Venkatason P, Zubairi YZ, Wan Ahmad WA, Hafidz MI, Ismail MD, Hadi MF, et al.

BMJ Open, 2019 05 05;9(5):e025734.
PMID: 31061031 DOI: 10.1136/bmjopen-2018-025734

OBJECTIVES: Cardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristics and outcome of STEMI patients with CS in our population.
DESIGN: A retrospective analysis of STEMI patients from 18 hospitals across Malaysia contributing to the Malaysian National Cardiovascular Database-acute coronary syndrome) registry (NCVD-ACS) year 2006-2013.
PARTICIPANTS: 16 517 patients diagnosed of STEMI from 18 hospitals in Malaysia from the year 2006 to 2013.
PRIMARY OUTCOME MEASURES: In-hospital and 30 day post-discharge mortality.
RESULTS: CS complicates 10.6% of all STEMIs in this study. They had unfavourable premorbid conditions and poor outcomes. The in-hospital mortality rate was 34.1% which translates into a 7.14 times mortality risk increment compared with STEMI without CS. Intravenous thrombolysis remained as the main urgent reperfusion modality. Percutaneous coronary interventions (PCI) in CS conferred a 40% risk reduction over non-invasive therapy but were only done in 33.6% of cases. Age over 65, diabetes mellitus, hypertension, chronic lung and kidney disease conferred higher risk of mortality.
CONCLUSION: Mortality rates of CS complicating STEMI in Malaysia are high. In-hospital PCI confers a 40% mortality risk reduction but the rate of PCI among our patients with CS complicating STEMI is still low. Efforts are being made to increase access to invasive therapy for these patients.

Matched MeSH terms: Shock, Cardiogenic/complications*; Shock, Cardiogenic/mortality*; Shock, Cardiogenic/therapy
Fulltext A case report of pyomyoma: radiological diagnosis of a potentially fatal complication of uterine leiomyoma.

Mubarak, M.Y., Noordini, M.D.

International Medical Journal Malaysia, 2008;7(2):63-65.
MyJurnal

Pyomyoma (suppurative leiomyoma) is a rare complication of uterine leiomyoma. It results from infarction and infection of a leiomyoma. It may lead to diagnostic and therapeutic difficulties with potential complications such as bacteraemia, uterine rupture, compressive effect to adjacent structures and even death. We report a case of pyomyoma based on the Ultrasound (US) and Computed Tomography (CT) findings and literature review on the subject.

Matched MeSH terms: High-Energy Shock Waves
Fulltext Effectiveness of ultrasound as a triage tool in ruling out fractures among non-critical emergency department patients

Nik Muhamad, N.A., anesan Murthi, J., Nik Ismail, N.A.

Medicine & Health, 2015;10(2):103-111.
MyJurnal

The popularity of ultrasound for acute diagnosis of fractures in the Emergency Department (ED) has increased over the recent years. This present study aimed to determine the sensitivity and specificity of ultrasound use for detection of fractures in a different environment, which is at the triage area of the ED. We compared the results of bedside ultrasound in detecting non-critical fractures to the current gold standard of X-rays in the triage area. The design was a single centered crosssectional study. From August 2014 till November 2014, a total of 46 patients were recruited, creating 75 image pairs. Following consent, a bedside ultrasound was performed and subsequently compared with X-ray reporting regarding the presence or absence of fractures. SPSS analysis was used to determine the sensitivity and specificity of ultrasound in diagnosing fracture as compared to X-rays. Ultrasound had a sensitivity of 72% (95% CI, 50.6% - 87.9%) and a specificity of 80% (95%CI: 66.3 - 90%) when compared to X-rays in fracture diagnosis. The kappa analyses showed moderate inter observer agreement (0.5) between ultrasound and X-rays in diagnosing fractures. This study suggests that the use of ultrasound as a triage tool yet has unacceptable sensitivity and needs further evaluation and consideration.

Matched MeSH terms: High-Energy Shock Waves
Putative Roles for Metallothionein and HSP70 Genes in Relation with Heavy Metal Accumulation and Parasitic Cymothoid in the Fish Nemipterus furcosus

Thinh DD, Rasid MH, Deris ZM, Shazili NA, De Boeck G, Wong LL

Arch Environ Contam Toxicol, 2016 Nov;71(4):530-540.
PMID: 27638714

To assess stress level induced by multiple stressors in aquatic organism, biomarkers have been adopted as early warning indicator due to their high accuracy, rapidity, and sensitivity. We investigated the effects of ectoparasitic isopod infection on heavy metal bioaccumulation (Fe, Cu, Zn, and Cd) in the fish Nemipterus furcosus and profiled the expression of metallothionein (MT) and heat shock proteins 70 (HSP70) genes of the fish host. Sixty individuals (parasitized and nonparasitized with Cymothoa truncata) were collected from three sites differing in the levels of anthropogenic activities off the South China Sea. Our results revealed no significant difference in heavy metal concentrations between infected and nonparasitized fish. We observed a positive correlation between heavy metal bioaccumulation in the fish host and anthropogenic activities. Accordingly, expression analysis of MT genes in fish liver showed significant differences in expression level between sampling sites, with lowest level in the least exploited site (Batu Rakit). A reverse pattern in HSP70 gene expression was demonstrated in fish muscle, showing the highest expression at Batu Rakit. While cymothoid infection in N. furcosus had no significant impact on fish MT gene expression, it resulted in a reduction of HSP70 level in liver of parasitized fish. These findings highlight the putative roles of MT in heavy metal assessment. Future studies should determine the kinetics of cymothoid infection and other potential stressors in characterizing the HSP70 gene expression profile.

Matched MeSH terms: HSP70 Heat-Shock Proteins
Fulltext Transcriptome analysis of Pseudomonas aeruginosa PAO1 grown at both body and elevated temperatures

Chan KG, Priya K, Chang CY, Abdul Rahman AY, Tee KK, Yin WF

PeerJ, 2016;4:e2223.
PMID: 27547539 DOI: 10.7717/peerj.2223

Functional genomics research can give us valuable insights into bacterial gene function. RNA Sequencing (RNA-seq) can generate information on transcript abundance in bacteria following abiotic stress treatments. In this study, we used the RNA-seq technique to study the transcriptomes of the opportunistic nosocomial pathogen Pseudomonas aeruginosa PAO1 following heat shock. Samples were grown at both the human body temperature (37 °C) and an arbitrarily-selected temperature of 46 °C. In this work using RNA-seq, we identified 133 genes that are differentially expressed at 46 °C compared to the human body temperature. Our work identifies some key P. aeruginosa PAO1 genes whose products have importance in both environmental adaptation as well as in vivo infection in febrile hosts. More importantly, our transcriptomic results show that many genes are only expressed when subjected to heat shock. Because the RNA-seq can generate high throughput gene expression profiles, our work reveals many unanticipated genes with further work to be done exploring such genes products.

Matched MeSH terms: Heat-Shock Response
Dietary supplementation of L-glutamine and L-glutamate in broiler chicks subjected to delayed placement

Zulkifli I, Shakeri M, Soleimani AF

Poult Sci, 2016 Sep 1.
PMID: 27587729

This study was conducted to investigate the effect of dietary glutamine (Gln) + glutamic acid (Glu) supplementation on growth performance and physiological stress response in broiler chickens subjected to 24 h delay in placement. Equal number of day-old broiler chicks were assigned to either immediate placement or with 24 h delay in placement with no access to feed and water. Chicks from each placement group were fed either standard starter diet (control) or standard starter diet +1% AminoGut (AG; mixture of 10% Gln and 10% Glu) from 1 to 21 d. Blood and duodenal samples were collected at 21 d for analysis of serum levels of ceruloplasmin (CER), ovotransferin (OVT) and α-1 acid glycoprotein (AGP), duodenal heat shock protein (HSP) 70 expression, and villi length and crypt depth. Results showed that delayed placement for 24 h was detrimental to weight gain during the starter phase (1 to 21 d) but not thereafter. AG supplementation was not able to eliminate that reduction in weight gain and feed intake during the starter stage. However, the observed enhancement in villi length and crypt depth at d 21 resulted in improvement of FCR and weight gain during the finisher stage (22 to 42 d) and consequently the overall period (1 to 42 d). Broiler chickens supplemented with AG also showed lower mortality rate, and higher AGP, OVT, CER, and HSP 70 expression compared to their control counterparts. Based on AGP, OVT, CER, and HSP 70 expression, there is no indication that delayed placement was physiologically stressful to the broiler chickens at 21 d of age.

Matched MeSH terms: HSP70 Heat-Shock Proteins
Fulltext Necrotising Fasciitis of the Lower Limb caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus

Chan, C.K., Merican, A.M., Nawar, A.M., Hanifah, Y.A., Thong, K.L.

Malays Orthop J, 2010;4(3):36-38.
MyJurnal

Necrotising fasciitis caused by Community-Acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as a new entity. Although it is recognised worldwide, there have been no reported cases to date in Malaysia. We report a case of necrotising fasciitis of the left lower limb in an otherwise healthy 20-year-old man. He presented with septic shock and despite the paucity of clinical signs in the limb, the infection was aggressive. Methicillin-Resistant Staphylococcus aureus (MRSA) was isolated from the deep fascia of the leg. Panton-Valentine leucocidin gene (PVL), which is a stable genetic marker for CA-MRSA strain, was positive in this case. This case of community acquired MRSA necrotising fasciitis is of concern and may herald the emergence of this resistant organism in Malaysia. Vigilant surveillance and microbiological monitoring is needed to follow this CA-MRSA trend.

Matched MeSH terms: Shock, Septic
Fulltext Parkinsonism and brain MRI findings in a relapsed culture-proven salmonella typhi infection: a case report in Malaysia

Ng, Y.M., Cheng, J.T.

JUMMEC, 2016;19(1):1-2.
MyJurnal

Typhoid fever is a systemic infection caused by Salmonella typhi, which may be associated with extra-intestinal
complications. Neurological manifestations, particularly Parkinsonism, are rarely reported. We report a
17-year-old patient with relapsed culture-proven Salmonella typhi infection who developed septic shock and
subsequently Parkinsonism. Lumbar puncture revealed acellular cerebrospinal fluid with raised protein level.
Magnetic resonance imaging revealed cerebral petechial haemorrhages resulted from small vessels vasculitis.
His symptoms resolved spontaneously after 3 months.

Matched MeSH terms: Shock, Septic
Fulltext The 28-day mortality prediction in sepsis patients using static lactate concentration and early lactate clearance: an observational study

Noor Asmidar, A., Tan, T.L., Ong, W.J., Ahmad Fuad Fahmi, M.N., Chieng, Z.L., Noor Akmal, S.I.

Medicine & Health, 2014;9(2):124-133.
MyJurnal

Sepsis causes high mortality and morbidity. Static lactate concentration and early lactate clearance are cited to be a predictor for sepsis survival. This study examined the clinical utility of static lactate concentration and early lactate clearance within the first six hours of admission in Emergency Department (ED) to predict 28-day mortality rate in sepsis patients. Patients who presented with sepsis, severe sepsis or septic shock and admitted to ED of Universiti Kebangsaan Malaysia Medical Centre were recruited. Blood lactate concentrations were measured upon admission (H0), at 1st hour (H1) and 6th hour (H6), respectively. Either standard treatment of sepsis or early goal directed therapy was initiated according to sepsis severity. A follow-up report was conducted at 28 days via telephone call, e-mail or case notes. Patients were later classified into survivor and non-survivor as final outcome. Static lactate concentration appeared to be significantly higher for non-survivor as compared to the survival group at H0, H1 and H6 (p

Matched MeSH terms: Shock, Septic
Single-walled carbon nanotubes (SWCNTs) inhibit heat shock protein 90 (HSP90) signaling in human lung fibroblasts and keratinocytes

Ong LC, Tan YF, Tan BS, Chung FF, Cheong SK, Leong CO

Toxicol Appl Pharmacol, 2017 08 15;329:347-357.
PMID: 28673683 DOI: 10.1016/j.taap.2017.06.024

Single-walled carbon nanotubes (SWCNTs) are carbon-based nanomaterials that possess immense industrial potential. Despite accumulating evidence that exposure to SWCNTs might be toxic to humans, our understanding of the mechanisms for cellular toxicity of SWCNTs remain limited. Here, we demonstrated that acute exposure of short (1-3μm) and regular-length (5-30μm) pristine, carboxylated or hydroxylated SWCNTs inhibited cell proliferation in human somatic and human stem cells in a cell type-dependent manner. The toxicity of regular-length pristine SWCNT was most evidenced in NP69>CYT00086>MCF-10A>MRC-5>HaCaT > HEK-293T>HepG2. In contrast, the short pristine SWCNTs were relatively less toxic in most of the cells being tested, except for NP69 which is more sensitive to short pristine SWCNTs as compared to regular-length pristine SWCNTs. Interestingly, carboxylation and hydroxylation of regular-length SWCNTs, but not the short SWCNTs, significantly reduced the cytotoxicity. Exposure of SWCNTs also induced caspase 3 and 9 activities, mitochondrial membrane depolarization, and significant apoptosis and necrosis in MRC-5 embryonic lung fibroblasts. In contrast, SWCNTs inhibited the proliferation of HaCaT human keratinocytes without inducing cell death. Further analyses by gene expression profiling and Connectivity Map analysis showed that SWCNTs induced a gene expression signature characteristic of heat shock protein 90 (HSP90) inhibition in MRC-5 cells, suggesting that SWCNTs may inhibit the HSP90 signaling pathway. Indeed, exposure of MRC-5 cells to SWCNTs results in a dose-dependent decrease in HSP90 client proteins (AKT, CDK4 and BCL2) and a concomitant increase in HSP70 expression. In addition, SWCNTs also significantly inhibited HSP90-dependent protein refolding. Finally, we showed that ectopic expression of HSP90, but not HSP40 or HSP70, completely abrogated the cytotoxic effects of SWCNTs, suggesting that SWCNT-induced cellular toxicity is HSP90 dependent. In summary, our findings suggest that the toxic effects of SWCNTs are mediated through inhibition of HSP90 in human lung fibroblasts and keratinocytes.

Matched MeSH terms: HSP90 Heat-Shock Proteins/antagonists & inhibitors*; HSP90 Heat-Shock Proteins/genetics; HSP90 Heat-Shock Proteins/metabolism
Tigecycline resistance may be associated with dysregulated response to stress in Mycobacterium abscessus

Ng HF, Ngeow YF, Yap SF, Zin T, Tan JL

Int J Med Microbiol, 2019 Nov 18.
PMID: 31784213 DOI: 10.1016/j.ijmm.2019.151380

Previously, we characterized 7C, a laboratory-derived tigecycline-resistant mutant of Mycobacterium abscessus ATCC 19977, and found that the resistance was conferred by a mutation in MAB_3542c, which encodes an RshA-like protein. In M. tuberculosis, RshA is an anti-sigma factor that negatively regulates the SigH-dependent heat/oxidative stress response. We hypothesized that this mutation in 7C might dysregulate the stress response which has been generally linked to antibiotic resistance. In this study, we tested this hypothesis by subjecting 7C to transcriptomic dissection using RNA sequencing. We found an over-expression of genes encoding the SigH ortholog, chaperones and oxidoreductases. In line with these findings, 7C demonstrated better survival against heat shock when compared to the wild-type ATCC 19977. Another interesting observation from the RNA-Seq analysis was the down-regulation of ribosomal protein-encoding genes. This highlights the possibility of ribosomal conformation changes which could negatively affect the binding of tigecycline to its target, leading to phenotypic resistance. We also demonstrated that transient resistance to tigecycline could be induced in the ATCC 19977 by elevated temperature. Taken together, these findings suggest that dysregulated stress response may be associated with tigecycline resistance in M. abscessus.

Matched MeSH terms: Heat-Shock Response
Fulltext Roles of Carotenoids in Invertebrate Immunology

Tan K, Zhang H, Lim LS, Ma H, Li S, Zheng H

Front Immunol, 2019;10:3041.
PMID: 32010132 DOI: 10.3389/fimmu.2019.03041

Carotenoids are biologically active pigments that are well-known to enhance the defense and immunity of the vertebrate system. However, in invertebrates, the role of carotenoids in immunity is not clear. Therefore, this study aims to review the scientific evidence for the role of carotenoids in invertebrate immunization. From the analysis of published literatures and recent studies from our laboratory, it is obvious that carotenoids are involved in invertebrate immunity in two ways. On the one hand, carotenoids can act as antioxidant enzymes to remove singlet oxygen, superoxide anion radicals, and hydroxyl radicals, thereby reducing SOD activity and reducing the cost of immunity. In some organisms, carotenoids have been shown to promote SOD activity by up-regulating the expression of the ZnCuSOD gene. Carotenoids, on the other hand, play a role in the expression and regulation of many genes involved in invertebrate immunity, including thioredoxins (TRX), peptidoglycan recognition receptor proteins (PGRPs), ferritins, prophenoloxidase (ProPO), vitellogenin (Vg), toll-like receptor (TLRs), heat shock proteins (HSPs), and CuZnSOD gene. The information in this review is very useful for updating our understanding of the progress of carotenoid research in invertebrate immunology and to help identify topics for future topics.

Matched MeSH terms: Heat-Shock Proteins
Fulltext Rare and lethal complication of barium enema intravasation

Loo GH, Marzuki F, Henry F

BJR Case Rep, 2018 Dec;4(4):20180017.
PMID: 30931138 DOI: 10.1259/bjrcr.20180017

Barium enema investigation is regarded as a safe investigative procedure. Rarely, it may cause complications such as colonic perforation and barium intravasation. Barium intravasation may be caused by the inadvertent introduction of the catheter into the vagina, thereby into the vaginal venous plexus. It may also occur through mechanical colonic perforation with the catheter, or via diseased bowel conditions. This may lead to complications such as liver microabscesses, massive pulmonary embolism, hypovolemic shock, disseminated intravascular coagulopathy and even sudden death. With that in mind, we would like to report an interesting case of barium intravasation into the portal venous system via the vagina venous plexus. The patient experienced abdominal discomfort with mild per vaginal bleed and went into disseminated intravascular coagulopathy. She received supportive management and she made a full recovery.

Matched MeSH terms: Shock
Fulltext Advances in the study of nodavirus

Yong CY, Yeap SK, Omar AR, Tan WS

PeerJ, 2017;5:e3841.
PMID: 28970971 DOI: 10.7717/peerj.3841

Nodaviruses are small bipartite RNA viruses which belong to the family of Nodaviridae. They are categorized into alpha-nodavirus, which infects insects, and beta-nodavirus, which infects fishes. Another distinct group of nodavirus infects shrimps and prawns, which has been proposed to be categorized as gamma-nodavirus. Our current review focuses mainly on recent studies performed on nodaviruses. Nodavirus can be transmitted vertically and horizontally. Recent outbreaks have been reported in China, Indonesia, Singapore and India, affecting the aquaculture industry. It also decreased mullet stock in the Caspian Sea. Histopathology and transmission electron microscopy (TEM) are used to examine the presence of nodaviruses in infected fishes and prawns. For classification, virus isolation followed by nucleotide sequencing are required. In contrast to partial sequence identification, profiling the whole transcriptome using next generation sequencing (NGS) offers a more comprehensive comparison and characterization of the virus. For rapid diagnosis of nodavirus, assays targeting the viral RNA based on reverse-transcription PCR (RT-PCR) such as microfluidic chips, reverse-transcription loop-mediated isothermal amplification (RT-LAMP) and RT-LAMP coupled with lateral flow dipstick (RT-LAMP-LFD) have been developed. Besides viral RNA detections, diagnosis based on immunological assays such as enzyme-linked immunosorbent assay (ELISA), immunodot and Western blotting have also been reported. In addition, immune responses of fish and prawn are also discussed. Overall, in fish, innate immunity, cellular type I interferon immunity and humoral immunity cooperatively prevent nodavirus infections, whereas prawns and shrimps adopt different immune mechanisms against nodavirus infections, through upregulation of superoxide anion, prophenoloxidase, superoxide dismutase (SOD), crustin, peroxinectin, anti-lipopolysaccharides and heat shock proteins (HSP). Potential vaccines for fishes and prawns based on inactivated viruses, recombinant proteins or DNA, either delivered through injection, oral feeding or immersion, are also discussed in detail. Lastly, a comprehensive review on nodavirus virus-like particles (VLPs) is presented. In recent years, studies on prawn nodavirus are mainly focused on Macrobrachium rosenbergii nodavirus (MrNV). Recombinant MrNV VLPs have been produced in prokaryotic and eukaryotic expression systems. Their roles as a nucleic acid delivery vehicle, a platform for vaccine development, a molecular tool for mechanism study and in solving the structures of MrNV are intensively discussed.

Matched MeSH terms: Heat-Shock Proteins
Fulltext Drosophila larvae fed palm fruit juice (PFJ) delay pupation via expression regulation of hormetic stress response genes linked to ageing and longevity

Leow SS, Luu A, Shrestha S, Hayes KC, Sambanthamurthi R

Exp Gerontol, 2018 Mar 15;106:198-221.
PMID: 29550564 DOI: 10.1016/j.exger.2018.03.013

Palm fruit juice (PFJ) containing oil palm phenolics is obtained as a by-product from oil palm (Elaeis guineensis) fruit milling. It contains shikimic acid, soluble fibre and various phenolic acids including p-hydroxybenzoic acid and three caffeoylshikimic acid isomers. PFJ has also demonstrated beneficial health properties in various biological models. Increasing concentrations of PFJ and different PFJ fractions were used to assess growth dynamics and possible anti-ageing properties in fruit flies (Drosophila melanogaster) genotype w1118. Microarray gene expression analysis was performed on whole fruit fly larvae and their fat bodies, after the larvae were fed a control Standard Brandeis Diet (SBD) with or without PFJ. Transcripts from Affymetrix GeneChips were utilised to identify the possible mechanisms involved, with genes having fold changes > |1.30| and p shock proteins and the antioxidant enzyme Sod2, were up-regulated, while cell cycle and growth genes were down-regulated. Thus, PFJ supplementation lengthened the growth stages in fruit fly larvae that was reflected in extended ageing of adult flies, suggesting that larval expression of hormetic stress response genes was linked to subsequent ageing and longevity.

Matched MeSH terms: Heat-Shock Proteins
Fulltext Determinants of functional status among survivors of severe sepsis and septic shock: One-year follow-up

Al Khalaf MS, Al Ehnidi FH, Al-Dorzi HM, Tamim HM, Abd-Aziz N, Tangiisuran B, et al.

Ann Thorac Med, 2015 Apr-Jun;10(2):132-6.
PMID: 25829965 DOI: 10.4103/1817-1737.150731

RATIONALE: Sepsis is a leading cause of intensive care unit (ICU) admissions worldwide and a major cause of morbidity and mortality. Limited data exist regarding the outcomes and functional status among survivors of severe sepsis and septic shock.
OBJECTIVES: This study aimed to determine the functional status among survivors of severe sepsis and septic shock a year after hospital discharge.
METHODS: Adult patients admitted between April 2007 and March 2010 to the medical-surgical ICU of a tertiary hospital in Saudi Arabia, were included in this study. The ICU database was investigated for patients with a diagnosis of severe sepsis or septic shock. Survival status was determined based on hospital discharge. Patients who required re-admission, stayed in ICU for less than 24 hours, had incomplete data were all excluded. Survivors were interviewed through phone calls to determine their functional status one-year post-hospital discharge using Karnofsky performance status scale.
RESULTS: A total of 209 patients met the eligibility criteria. We found that 38 (18.1%) patients had severe disability before admission, whereas 109 (52.2%) patients were with severe disability or died one-year post-hospital discharge. Only one-third of the survivors had good functional status one-year post-discharge (no/mild disability). After adjustment of baseline variables, age [adjusted odds ratio (aOR) = 1.03, 95% confidence interval (CI) = 1.01-1.04] and pre-sepsis functional status of severe disability (aOR = 50.9, 95% CI = 6.82-379.3) were found to be independent predictors of functional status of severe disability one-year post-hospital discharge among survivors.
CONCLUSIONS: We found that only one-third of the survivors of severe sepsis and septic shock had good functional status one-year post-discharge (no/mild disability). Age and pre-sepsis severe disability were the factors that highly predicted the level of functional status one-year post-hospital discharge.
KEYWORDS: Disability; functional status; septic shock; severe sepsis

Matched MeSH terms: Shock, Septic
Fulltext Weathering the Crisis: A Case of Thyroid Crisis with Propranolol-Induced Circulatory Collapse Successfully Treated with Therapeutic Plasma Exchange

Cheah JM, Ng D, Low MY, Foo SH

J ASEAN Fed Endocr Soc, 2019;34(2):206-209.
PMID: 33442157 DOI: 10.15605/jafes.034.02.12

Thyroid crisis is a life-threatening form of thyrotoxicosis characterized by multi-system dysfunction. Therapeutic plasma exchange has been reported to be effective in removing excessive circulating thyroid hormones. We present a 46-year-old female with recently diagnosed Graves' disease associated with thyrotoxic cardiomyopathy admitted for thyroid crisis complicated by propranolol-induced circulatory collapse, acute kidney injury and ischemic hepatitis. The tachyarrhythmia was refractory to conventional therapy. Initiation of TPE resulted in rapid clinical and biochemical stabilization.

Matched MeSH terms: Shock
Fulltext Palm kernel cake extract exerts hepatoprotective activity in heat-induced oxidative stress in chicken hepatocytes

Oskoueian E, Abdullah N, Idrus Z, Ebrahimi M, Goh YM, Shakeri M, et al.

BMC Complement Altern Med, 2014;14:368.
PMID: 25273634 DOI: 10.1186/1472-6882-14-368

Palm kernel cake (PKC), the most abundant by-product of oil palm industry is believed to contain bioactive compounds with hepatoprotective potential. These compounds may serve as hepatoprotective agents which could help the poultry industry to alleviate adverse effects of heat stress on liver function in chickens.

Matched MeSH terms: HSP70 Heat-Shock Proteins/metabolism
Goniothalamin enhances the ATPase activity of the molecular chaperone Hsp90 but inhibits its chaperone activity

Yokoyama Y, Ohtaki A, Jantan I, Yohda M, Nakamoto H

J. Biochem., 2015 Mar;157(3):161-8.
PMID: 25294885 DOI: 10.1093/jb/mvu061

Hsp90 is an ATP-dependent molecular chaperone that is involved in important cellular pathways such as signal transduction pathways. It is a potential cancer drug target because it plays a critical role for stabilization and activation of oncoproteins. Thus, small molecule compounds that control the Hsp90 function are useful to elucidate potential lead compounds against cancer. We studied effect of a naturally occurring styryl-lactone goniothalamin on the activity of Hsp90. Although many drugs targeting Hsp90 inhibit the ATPase activity of Hsp90, goniothalamin enhanced rather than inhibited the ATPase activity of a cyanobacterial Hsp90 (HtpG) and a yeast Hsp90. It increased both K(m) and k(cat) of the Hsp90s. Domain competition assays and tryptophan fluorescence measurements with various truncated derivatives of HtpG indicated that goniothalamin binds to the N-terminal domain of HtpG. Goniothalamin did not influence on the interaction of HtpG with a non-native protein or the anti-aggregation activity of HtpG significantly. However, it inhibited the activity of HtpG that assists refolding of a non-native protein in cooperation with the Hsp70 chaperone system. This is the first report to show that a small molecule that binds to the N-terminal domain of Hsp90 activates its ATPase activity, while inhibiting the chaperone function of Hsp90.

Matched MeSH terms: HSP90 Heat-Shock Proteins/chemistry*

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