Statin-associated immune-mediated necrotizing myositis in Native Americans.

OBJECTIVES: Statin-associated immune-mediated necrotizing myopathy (IMNM) and idiopathic inflammatory myositis (IIM) are myopathies with overlapping features. This study compared the manifestations of IMNM to IIM in Native Americans. METHOD: Twenty-one Native American patients with inflammatory myopathy (IM) were characterized as to diabetes mellitus, hyperlipidaemia, statin exposure, myopathy diagnosis, muscle histology, autoimmune and myositis-specific autoantibodies, therapy and outcome. RESULTS: IM consisted of 52.4% IMNM, 42.9% IIM and 4.8% metabolic myopathy. IMNM vs IIM patients were older [61.6 years (s.d. 9.8) vs 39.8 (14.3)], diabetes mellitus (100% vs 55.6%), hyperlipidaemia (100% vs 33.3%), statin-exposure (100% vs 22.2%), creatine kinase [CK; 11 780 IU (s.d. 7064) vs 1707 (1658)], anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) antibodies (85.7% vs 11.1%) and necrotizing IM (81.8% vs 11.1%), but shorter disease duration [26.2 months (s.d. 395) vs 78.4 (47.9)], RP (9.1% vs 55.6%), cutaneous manifestations (0% vs 55.6%), ANA (18.2% vs 66.7%) or any autoantibody (18.2% vs 88.9%) (all P < 0.05). MRI abnormalities, histologic IM, myositis-specific autoantibodies, pulmonary hypertension, oesophageal dysfunction, interstitial lung disease, disability and persistently elevated CK were similar. IMNM vs IIM was treated more with IVIG (72.7% vs 11.1%; P = 0.009) and less with antimetabolites (45.5% vs 88.9%; P = 0.05) and rituximab (18.2% vs 55.6%; P = 0.09). CONCLUSIONS: IMNM may occur in Native Americans and is associated with diabetes mellitus, hyperlipidaemia, statin use and older age and is characterized by marked CK elevation, necrotizing myopathy and anti-HMGCR antibodies with few cutaneous or vascular manifestations.

Enhanced arthrocentesis of the effusive knee with pneumatic compression.

AIM: Complete arthrocentesis of the effusive knee ameliorates patient pain, reduces intra-articular and intraosseous pressure, removes inflammatory cytokines, and has been shown to substantially improve the therapeutic outcomes of intra-articular injections. However, conventional arthrocentesis incompletely decompresses the knee, leaving considerable residual synovial fluid in the intra-articular space. The present study determined whether external pneumatic circumferential compression of the effusive knee permitted more successful arthrocentesis and complete joint decompression. METHODS: Using a paired sample design, 50 consecutive effusive knees underwent conventional arthrocentesis and then arthrocentesis with pneumatic compression. Pneumatic compression was applied to the superior knee using a conventional thigh blood pressure cuff inflated to 100 mm Hg which compressed the suprapatellar bursa and patellofemoral joint, forcing fluid from the superior knee to the anterolateral portal where the fluid could be accessed. Arthrocentesis success and fluid yield in mL before and after pneumatic compression were determined. RESULTS: Successful diagnostic arthrocentesis (≥3 mL) of the effusive knee was 82% (41/50) with conventional arthrocentesis and increased to 100% (50/50) with pneumatic compression (P = .001). Synovial fluid yields increased by 144% (19.8 ± 17.1 mL) with pneumatic compression (conventional arthrocentesis; 13.7 ± 16.4 mL, pneumatic compression: 33.4 ± 26.5 mL; 95% CI: 10.9 < 19.7 < 28.9 mL, P < .0001). CONCLUSIONS: Conventional arthrocentesis routinely does not fully decompress the effusive knee. External circumferential pneumatic compression markedly improves arthrocentesis success and fluid yield, and permits complete decompression of the effusive knee. Pneumatic compression of the effusive knee with a thigh blood pressure cuff is an inexpensive and widely available technique to improve arthrocentesis outcomes.

Design and syntheses of 7-nitro-2-aryl-4H-benzo[d][1,3]oxazin-4-ones as potent anticancer and antioxidant agents.

A group of new nitro substituted benzoxazinones (3a-k) were synthesized from easily available 4-nitroanthranilic acid. All the synthesized compounds were characterized by FT-IR, 1H NMR, 13C NMR, mass spectrometry and elemental analysis. Anti-proliferative and pro-apoptotic potential of all the synthesized compounds (3a-k) was evaluated by MTT and Hoechst 33258 staining assay respectively whereas their antioxidant properties were determined via DPPH free radical scavenging assay. The most active compounds (3a, 3c and 3k) showed significant cytotoxic potential against HeLa cells with an inhibition of cell viability that ranged between 28.54 and 44.67% (P < 0.001). Albeit statistically different, the anti-proliferative effect of 3c was in close match with that of the reference drug doxorubicin. Likewise, the test compounds showed profound pro-apoptotic potential with an apoptotic index that ranged between 52.86 and 75.61%. Besides, the docking studies revealed a higher efficiency for compounds (3a and 3h) owing to their better affinity and inhibition constant (Ki = 4.397 and 3.713 nmol) respectively. The antioxidant potential of synthesized benzoxazinones (3a-k) was in close agreement with the experimental anticancer results with a percent inhibition from 34.45 to 85.93% as compared to standard (90.56%).

Open Set Domain Adaptation for Image and Action Recognition.

Since annotating and curating large datasets is very expensive, there is a need to transfer the knowledge from existing annotated datasets to unlabelled data. Data that is relevant for a specific application, however, usually differs from publicly available datasets since it is sampled from a different domain. While domain adaptation methods compensate for such a domain shift, they assume that all categories in the target domain are known and match the categories in the source domain. Since this assumption is violated under real-world conditions, we propose an approach for open set domain adaptation where the target domain contains instances of categories that are not present in the source domain. The proposed approach achieves state-of-the-art results on various datasets for image classification and action recognition. Since the approach can be used for open set and closed set domain adaptation, as well as unsupervised and semi-supervised domain adaptation, it is a versatile tool for many applications.

Congenital anomaly of coronary artery: absence of left circumflex artery.

The prevalence of congenital coronary artery anomalies is approximately 1% in the general population. They are a common cause of sudden death in younger persons. Congenital absence of the left circumflex artery is usually a benign condition but can cause symptoms of exertional angina. We present a case of a 59-year-old female who presented with complaints of chest pain. She was evaluated by the cardiology service. An invasive angiogram identified the absence of the circumflex artery, a large right coronary artery, and large septal and diagonal branches of the left main coronary artery possibly as a compensatory mechanism to supply blood to the LCx territories. It is important to define coronary anatomy as anomalies dictate which cardiac intervention should be attempted in cases of ischemia.

Green synthesis of ZnO and Cu-doped ZnO nanoparticles from leaf extracts of Abutilon indicum, Clerodendrum infortunatum, Clerodendrum inerme and investigation of their biological and photocatalytic activities.

In the present study, green synthesis and determination of the antioxidant, antibacterial, antifungal, anticancer and photocatalytic properties of the resultant Cu-doped zinc oxide nanoparticles (NAPs) were carried out. A superficial method (solution combustion method) was employed for the synthesis of un-doped ZnO NAPs from aqueous extract of Abutilon indicum, and synthesis of Cu-doped ZnO NAPs from aqueous extracts of Clerodendrum infortunatum (M1 NAPs) and Clerodendrum inerme (M2 NAPs). The synthesized un-doped ZnO, M1 and M2 NAPs were characterized by different spectroscopic techniques like Ultraviolet-visible (UV-Vis), Fourier Transform-Infrared (FT-IR), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX) and scanning electron microscopy (SEM). The antibacterial and antifungal activities of M1 and M2 NAPs were determined by agar diffusion method, while their antioxidant properties were assessed through DPPH radical scavenging and ferric thiocyanate (FTC) and assays. Under sunlight irradiation, photocatalytic disintegration potential of M1 and M2 NAPs were determined by the degradation of Acid Black 234 dye. Results from FT-IR, XRD, EDX and SEM confirmed successful synthesis, crystalline nature, and spheroid-to-rod-like shapes of un-doped ZnO, M1 and M2 NAPs, with grain sizes of 16.72nm, 17.49nm and 20.73nm; and band gap energies of 3.37eV, 3.36eV and 3.31eV, respectively. The NAPs were good catalysts for effective degradation of Acid Black 234. They also exhibited remarkable antioxidant and anticancer activities. Significant antibacterial activity was shown by M2 NAPs against E. coli, S. aureus, Klebsiella and B. subtilis, with zones of inhibition (ZOIs) of 13±0.09, 14±0.01, 18±0.07 and 20±0.10, respectively. Significant antifungal potential was also produced by M2 NAPs at 5mg with ZOIs of 17±0.07 and 24±0.08 against A. niger and T. harzianum, respectively. These results indicate that aqueous extracts of A. indicum, C. infortunatum and C. inerme are effective reducing agents for green synthesis of un-doped ZnO, and Cu-doped ZnO NAPs with significant antimicrobial, antioxidant, and antifungal potential. Thus they are good candidates for future therapeutic applications.

Synthetic approaches toward stilbenes and their related structures.

Compounds belonging to the stilbene family have gained remarkable significance in pharmaceutical as well as material chemistry. The current review covers the various synthetic approaches for the syntheses of stilbene scaffold and related structures over last 30 years. In addition, this review also highlights the role of stilbene intermediates used in the synthesis of important molecules with diverse applications in the field of pharmaceutics and material science.

Effect of high temperature on grain filling period, yield, amylose content and activity of starch biosynthesis enzymes in endosperm of basmati rice.

BACKGROUND: High temperature during grain filling affects yield, starch amylose content and activity of starch biosynthesis enzymes in basmati rice. To investigate the physiological mechanisms underpinning the effects of high temperature on rice grain, basmati rice was grown under two temperature conditions - 32 and 22 °C - during grain filling. RESULTS: High temperature decreased the grain filling period from 32 to 26 days, reducing yield by 6%, and caused a reduction in total starch (3.1%) and amylose content (22%). Measurable activities of key enzymes involved in sucrose to starch conversion, sucrose synthase, ADP-glucose pyrophosphorylase, starch phosphorylase and soluble starch synthase in endosperms developed at 32 °C were lower than those at 22 °C compared with similar ripening stage on an endosperm basis. In particular, granule-bound starch synthase (GBSS) activity was significantly lower than corresponding activity in endosperms developing at 22 °C during all developmental stages analyzed. CONCLUSION: Results suggest changes in amylose/amylopectin ratio observed in plants grown at 32 °C was attributable to a reduction in activity of GBSS, the sole enzyme responsible for amylose biosynthesis.

Differences in computed tomography density of the renal papillae of stone formers and non-stone-formers: a pilot study.

PURPOSE: It is thought that Randall's plaques, calcium deposits in the renal papillae of patients with nephrolithiasis, may serve as a nidus for stone formation. We examined the density of renal papillae in patients with stones and control patients using attenuation measurements (HU) on Computed Tomography (CT) to determine whether nephrolithiasis is associated with radiographic changes in renal papillae. MATERIALS AND METHODS: Hounsfield density measurements of a 0.2 cm2 area of the renal papillae of 17 patients with a single renal calyceal calculus and 15 age-matched control patients were performed. Measurements were done for renal papillae upper, middle, and lower pole calyces for all patients. Statistical comparisons were made using the student's t-test. RESULTS: Patients with nephrolithiasis and control patients were similar with respect to mean age (41.2 years versus 42.2 years, p=0.82) and baseline serum creatinine (0.86 mg/dl versus 0.93 mg/dl, p=0.21). Mean Hounsfield density of renal papillae of stone patients in calyces with stones was significantly greater than that of location-matched papillae from control patients (54.4 versus 36.6, p<0.0001). Mean Hounsfield density of all papillae of the affected kidney (i.e., kidney with stone) in stone patients was significantly greater than that of control patients (50.9 versus 36.4, p<0.0001). Mean Hounsfield density of all papillae in the stone-free kidney of stone patients was significantly greater than that of control patients (50.0 versus 36.1, p<0.0001). In stone patients, when comparing the affected kidney with the stone-free kidney, there was no difference in mean papilla Hounsfield density (50.3 versus 50.9, p=0.59). CONCLUSIONS: Hounsfield density of the renal papilla is significantly increased in patients with nephrolithiasis when compared with age-matched controls. This is true of calyces with stones, calyces without stones in kidneys with stones, and calyces of the contralateral stone-free kidney. There is no difference in renal papilla Hounsfield density between kidneys with and without stones in patients with nephrolithiasis. In the future, this information may be useful in predicting which patients may develop nephrolithiasis.