Association between Low-Grade Inflammation and Left Ventricular Diastolic Dysfunction in Patients with Metabolic Syndrome and Hyperuricemia.

BACKGROUND: Hyperuricemia (HUA) induces inflammation and insulin resistance and is reportedly associated with left ventricular hypertrophy (LVH) and possibly with left ventricular diastolic dysfunction (LVDD). OBJECTIVES: To investigate associations among HUA, inflammation, and insulin resistance with LVDD. METHODS: We enrolled patients with metabolic syndrome (MetS) between August 1, 2017, and December 31, 2017. All participants underwent fasting blood tests and transthoracic echocardiography. HUA was defined as an serum uric acid level ≥ 7 mg/dl in men or ≥ 6 mg/dl in women. MetS was defined as at least three of the following Taiwanese criteria: central obesity, prehypertension, fasting glucose impairment, hypertriglyceridemia, and lower values of high-density lipoprotein cholesterol. LVDD was defined according to contemporary guidelines. RESULTS: The study included 63 patients (60% male) with a mean age of 53 ± 14 years and body mass index (BMI) of 29.4 ± 4.0 kg/m2. Prevalence rates of HUA, LVH, LVDD were 40%, 18%, and 10%, respectively. Baseline characteristics were similar between the HUA and normouricemia groups, except that the HUA group had significantly higher serum high-sensitivity interleukin 6 and tumor necrosis factor-alpha (TNF-α) levels. LVDD occurred more frequently in the HUA group (20.0% vs. 2.6%, p = 0.032). HUA was associated with LVDD [crude odds ratio (OR): 9.25, 95% confidence interval (CI): 1.01-84.7, p = 0.049]. In multivariate analysis, the most relevant factor associated with LVDD was TNF-α after adjustments for age, male sex, and body mass index (adjusted OR for TNF-α: 4.1, 95% CI: 1.02-16.5, p = 0.047). CONCLUSIONS: The association between HUA and LVDD partially reflected a low-grade inflammation due to elevated TNF-α rather than increased insulin resistance in MetS patients.

Hyperuricemia Is Associated With a Higher Prevalence of Metabolic Syndrome in Military Individuals.

Introduction: Hyperuricemia (HUA) is associated with metabolic syndrome (MetS) in the general population. Military individuals who perform high-intensity physical training might have lower rates of MetS. The present study aimed to investigate whether HUA might be associated with the prevalence of MetS in military individuals. Material and Methods: We retrospectively collected data from the annual military exam and randomly selected a single unit to represent the overall study population. The study population consisted of 460 military individuals between January 2016 and December 2016. We divided this cohort into the HUA group and the normouricemic group. Hyperuricemia is defined as a serum uric acid level of 7 mg/dL or more in men or 6 mg/dL or more in women. Results: The cohort consisted of 460 individuals with a mean age of 35.9 yr old; 80% were male and 15% were diagnosed with MetS between January 1, 2016 and December 31, 2016. The prevalence of MetS was greater in the HUA group than in the normouricemic group (32.5% vs. 8.8%, p < 0.001). HUA was independently associated with the prevalent MetS after adjusting for age, gender, creatinine, alanine transaminase, and hemoglobin (adjusted OR: 4.305, 95% CI: 2.370-7.818, p < 0.001). Given that the cohort was predominantly male, we divided the cohort into men and women for a subgroup analysis. A significant association was found in men but not in women (adjusted OR: 3.59 95% CI: 1.905-6.765, p < 0.001 for men and adjusted OR: 16.7 95% CI: 0.295-946, p = 0.172 for women, respectively). Conclusion: Hyperuricemia was independently associated with the prevalence of metabolic syndrome in a military cohort from Taiwan. Future studies should look at whether hyperuricemia in individuals without metabolic syndrome can predict the future onset of metabolic syndrome.

In Vitro Activities of Tedizolid and Linezolid against Gram-Positive Cocci Associated with Acute Bacterial Skin and Skin Structure Infections and Pneumonia.

Tedizolid is a novel, expanded-spectrum oxazolidinone with potent activity against a wide range of Gram-positive pathogens. A total of 425 isolates of Gram-positive bacteria were obtained consecutively from patients with acute bacterial skin and skin structure infections (ABSSSIs) or pneumonia. These isolates included methicillin-susceptible Staphylococcus aureus (MSSA) (n = 100), methicillin-resistant Staphylococcus aureus (MRSA) (n = 100), Streptococcus pyogenes (n = 50), Streptococcus agalactiae (n = 50), Streptococcus anginosus group (n = 75), Enterococcus faecalis (n = 50), and vancomycin-resistant enterococci (VRE) (Enterococcus faecium) (n = 50). The MICs of tedizolid and linezolid were determined by the agar dilution method. Tedizolid exhibited better in vitro activities than linezolid against MSSA (MIC90s, 0.5 versus 2 µg/ml), MRSA (MIC90s, 0.5 versus 2 µg/ml), S. pyogenes (MIC90s, 0.5 versus 2 µg/ml), S. agalactiae (MIC90s, 0.5 versus 2 µg/ml), Streptococcus anginosus group (MIC90s, 0.5 versus 2 µg/ml), E. faecalis (MIC90s, 0.5 versus 2 µg/ml), and VRE (MIC90s, 0.5 versus 2 µg/ml). The tedizolid MICs against E. faecalis (n = 3) and VRE (n = 2) intermediate to linezolid (MICs, 4 µg/ml) were 1 µg/ml and 0.5 µg/ml, respectively. The tedizolid MIC90s against S. anginosus, S. constellatus, and S. intermedius were 0.5, 1, and 0.5 µg/ml, respectively, and the rates of susceptibility based on the U.S. FDA MIC interpretive breakpoints to the isolates were 16%, 28%, and 72%, respectively. Tedizolid exhibited 2- to 4-fold better in vitro activities than linezolid against a variety of Gram-positive cocci associated with ABSSSIs and pneumonia. The lower susceptibilities of tedizolid against isolates of S. anginosus and S. constellatus than against those of S. intermedius in Taiwan were noted.

Granular cell tumor of the scrotum: a case report and literature review.

Granular cell tumors (GCTs) on the male genitalia are exceedingly rare. Solitary tumors have been reported on the penile shaft, prepuce, corpus cavernosum, glans penis, and scrotum. According to the latest serial analysis by using a MEDLINE search of the literature from January 1970 to December 2011, we identified seven reported GCTs involving the scrotum. We present a new case and perform a brief literature review.