Internal medicine physician embedded in an orthopedic service in a level 1 hospital: clinical impact

BACKGROUND

The aim of our study was to evaluate the impact of an internist physician specialized in diabetes, appointed as an in-house physician in the orthopedic wards, on improving clinical outcomes and in particular 30-day mortality.

METHODS

We analyzed a cohort of patients hospitalized more than 24 h in the orthopedic service. The analyses included a comparative analysis between the pre- and post-intervention time periods and an interrupted time series (ITS) analysis, which were conducted in stratification to three populations: whole population, patients with at least one chronic disease and/or older than 75 years of age and patients diagnosed with diabetes. The primary outcome was 30-day mortality following the hospitalization.

RESULTS

A total of 11,546 patients were included in the study, of which 19% (2212) were hospitalized in the post intervention period. Although in the comparative analysis there was no significant change in 30-day mortality, in the ITS there was a decrease in the mortality trend during the post intervention period in the entire and chronic disease/elderly populations, compared to no change during the pre-intervention period: a post-intervention slope of - 0.14(p value < 0.001) and  - 0.11(p value = 0.03), respectively. Additionally, we found decrease in length of stay, increase in transfers to the internal medicine department with a negative trend, increase in HbA1c testing during the hospitalization and changes in diabetes drugs administration.

CONCLUSION

The presence of an internist in the orthopedic wards is associated with health care improvement; decrease in the 30-day mortality trend, decrease in length of stay, increase in HbA1c testing during the hospitalization and an increase in diabetes drugs administration.

Higher Mast Cell Accumulation in Human Adipose Tissues Defines Clinically Favorable Obesity Sub-Phenotypes

The identification of human obesity sub-types may improve the clinical management of patients with obesity and uncover previously unrecognized obesity mechanisms. Here, we hypothesized that adipose tissue (AT) mast cells (MC) estimation could be a mark for human obesity sub-phenotyping beyond current clinical-based stratifications, both cross-sectionally and prospectively. We estimated MC accumulation using immunohistochemistry and gene expression in abdominal visceral AT (VAT) and subcutaneous (SAT) in a human cohort of 65 persons with obesity who underwent elective abdominal (mainly bariatric) surgery, and we validated key results in two clinically similar, independent cohorts (n = 33, n = 56). AT-MC were readily detectable by immunostaining for either c-kit or tryptase and by assessing the gene expression of KIT (KIT Proto-Oncogene, Receptor Tyrosine Kinase), TPSB2 (tryptase beta 2), and CMA1 (chymase 1). Participants were characterized as VAT-MC^low if the expression of both CMA1 and TPSB2 was below the median. Higher expressers of MC genes (MC^high) were metabolically healthier (lower fasting glucose and glycated hemoglobin, with higher pancreatic beta cell reserve (HOMA-β), and lower triglycerides and alkaline-phosphatase) than people with low expression (MC^low). Prospectively, higher MC accumulation in VAT or SAT obtained during surgery predicted greater postoperative weight-loss response to bariatric surgery. Jointly, high AT-MC accumulation may be used to clinically define obesity sub-phenotypes, which are associated with a “healthier” cardiometabolic risk profile and a better weight-loss response to bariatric surgery.

Phylogenetic relationships of two Ukrainian tomato isolates of potato virus M and genetic variability analysis of its population

The aim of this study was to investigate biological and molecular properties of two Ukrainian tomato isolates of potato virus M (PVM), K-16 and Pol-14, to determine their phylogenetic relationships and the genetic variability of PVM isolates. Study of phylogenetic relationships of two Ukrainian tomato PVM isolates with 35 isolates represented in GenBank was conducted. It was found that the coat protein (CP) gene sequence identity between two Ukrainian PVM isolates is 94.3% at the nucleotide level and 100% at the amino acid level. The highest level of the sequence identity (97.0% and 96.5% nt and 100% aa) have the isolates K-16 and Pol-14 with the German potato isolate DSMZ PV0273, Indian potato isolates Del 123, Del 134, Del 147, M 34 and Chinese isolate from pepino GS-6-2 (isolate K-16), which testifies about their common origin. Ukrainian tomato isolates K-16 and Pol-14 belong together with all European, Chinese, Iranian, Indian isolates to PVM-o clade or group I. It was found that the nucleotide substitutions in the capsid protein gene of all tomato PVM isolates (except the Italian) are synonymous. Analysis showed that the global dN/dS ratio for the entire CP gene sequences used in the study was 0.041 (p Keywords: potato virus M; Solanum lycopersicum; phylogenetic analysis; genetic variability; selection pressure.

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Thirty years after the Chernobyl explosion we still lack information regarding the genetic effects of radionuclide contamination on the plant population. For example, are plants adapting to the low dose of chronic ionising irradiation and showing improved resistance to radiation damage? Are they coping with changing/increased pathogenicity of fungi and viruses in the Chernobyl exclusion zone? Are plant populations rapidly accumulating mutational load and should we expect rapid microevolutionary changes in plants in the Chernobyl area? This review will try to summarise the current knowledge on these aspects of plant genetics and ecology and draw conclusions on the importance of further studies in the area around Chernobyl.

Role of siRNAs and miRNAs in the processes of RNA-mediated gene silencing during viral infections

Phenomenon of RNA-induced gene silencing is a highly conservative mechanism among eukaryotic organisms. Several classes of small RNAs (siRNAs and miRNAs) 21-25 nt in length, which play a significant role in the processes of development of an organism, occurred important components of antiviral defence in animals and plants. This review shortly describes the main stages of gene silencing mechanism, features of antiviral RNA silencing in plants, invertebrates, mammals, ways of suppression of RNA-interference by viruses, as well as possible approaches of utilization of abovementioned phenomenon for struggling against viral infections.