ABSTRACT
OBJECTIVES: To elucidate the expression levels and prognostic value of the Lipoyltransferase 2 (LIPT2) gene in a pan-cancer view. METHODOLOGY: Our study comprehensively investigated the role of LIPT2 in pan-cancer, combining bioinformatics analyses with experimental validations. RESULTS: Analysis of LIPT2 mRNA expression across various cancers revealed a significant up-regulation in 18 tumor types and down-regulation in 8 types, indicating its diverse involvement. Prognostic assessment demonstrated a correlation between elevated LIPT2 expression and poorer outcomes in Overall Survival (OS) and Disease-Free Survival (DFS), particularly in Glioblastoma Multiforme (GBM), Liver Hepatocellular Carcinoma (LIHC), and Pheochromocytoma and Paraganglioma (PCPG). Protein expression analysis in GBM, LIHC, and PCPG affirmed a consistent increase in LIPT2 levels compared to normal tissues. Examining the methylation status in GBM, LIHC, and PCPG, we found reduced promoter methylation levels in tumor samples, suggesting a potential influence on LIPT2 function. Genetic mutation analysis using cBioPortal indicated a low mutation frequency (< 2%) in LIPT2 across GBM, LIHC, and PCPG. Immune correlation analysis unveiled a positive association between LIPT2 expression and infiltration levels of immune cells in GBM, LIHC, and PCPG. Single-cell analysis illustrated LIPT2's positive correlation with functional states, including angiogenesis and inflammation. Enrichment analysis identified LIPT2-associated processes and pathways, providing insights into its potential molecular mechanisms. Drug sensitivity analysis demonstrated that elevated LIPT2 expression conferred resistance to multiple compounds, while lower expression increased sensitivity. Finally, RT-qPCR validation in HCC cell lines confirmed the heightened expression of LIPT2 compared to a control cell line, reinforcing the bioinformatics findings. CONCLUSION: Overall, our study highlights LIPT2 as a versatile player in cancer, influencing diverse aspects from molecular processes to clinical outcomes across different cancer types.
ABSTRACT
The annual incidence is about 150 per million in the UK, but this figure is six times greater in the >80 years old group. Prerenal azotemia is considered as the most serious reason in community or hospital acquired acute renal failure (ARF). A 67-year-old middle age male was admitted to the hospital with a chief complaint of generalized weakness, volume depletion and dysuria. He has treated with metronidazole for diarrhoea caused by Clostridium difficile considered as the precipitating factor for the ARF. The patient has severe osteoarthritis and takes high dose non-steroidal anti-inflammatory drugs from the last two years. He also complains for obstructive sleep apnea (OSA) and obesity. He has controlled hypertension was on lisinopril to control blood pressure. ARF is quite common, occurring in 80 million populations. Urinary obstruction should be excluded (a cause in around 5-10 of cases) because this is readily reversible if it is diagnosed early. A renal US will be sufficient to identify obstruction in 95 of cases. Most cases of ARF are expected to pre renal failure/acute tubular necrosis (ATN) 70-80%. Risk factor for development for at ATN are old age, drugs (non-steroidal anti-inflammatory drugs, gentamicin), sepsis, and chronic kidney disease and must be considered.
ABSTRACT
Several advances in dialysis therapies have been made. Still, the mortality in end-stage renal disease (ESRD) remains high at rates exceeding 15%. Cardiovascular disease from heart failure or sudden death remains an important cause for mortality in these groups. The most common cardiac anomaly in ESRD is cardiac hypertrophy and this has been observed in 75% of patients at the time of starting dialysis. Also, in patients on conventional hemodialysis (CHD) (4 hours, 3 times per week), left ventricular hypertrophy (LVH) is an independent risk factor for mortality, arrhythmias, heart failure and myocardial ischemia. Stroke work index and left ventricular mass (LVM) are closely associated, in ESRD.
ABSTRACT
BACKGROUND: It was not until mid nineties when UK (RAS) and US (K/DOQI) first launched the nutritional and biochemical standards for haemodialysis in patients with ESRF. The present case is related to a patient who's blood results diverged widely from the nutritional and biochemical standards set by the RAS. And how the multidisciplinary team with this patient aimed to achieve these standards. CASE: A 52-year old, staff nurse presented with end stage renal failure due to polycystic kidney disease with bilateral nephropathy, established on haemodialysis unusual inter-dialytic weight gains, often severe intradialytic cramps and hypotension to the point of being unresponsive. The patient's high weight gain and high serum potassium and phosphate levels led to the patient being labelled non-compliant. Other contributing factors together with weight gains have to be explored. CONCLUSION: Renal health care professionals have guidelines which they can work with their patients. Outside target results should be investigated to ensure that patient receives the right treatment. Treatment modality and prescription have to be individualized according to the patient's needs. Like this case it is worth considering other factors like events in the patient's life cycle, personal, social and economical factors and staff's attitude may contribute to the perceived non-compliance.
