Yang LE, Sandberg MB, Can AD, Pihakaski-Maunsbach K, McDonough AA. Effects of dietary salt on renal Na ϩ transporter subcellular distribution, abundance, and phosphorylation status. Am J Physiol Renal Physiol 295: F1003-F1016, 2008. First published July 23, 2008 doi:10.1152/ajprenal.90235.2008 diet the kidney increases urinary Na ϩ and volume excretion to match intake. We recently reported that HS provokes a redistribution of distal convoluted tubule Na ϩ -Cl Ϫ cotransporter (NCC) from apical to subapical vesicles and decreases NCC abundance. This study aimed to test the hypothesis that the other renal Na ϩ transporters' abundance and or subcellular distribution is decreased by HS diet. Six-week-old Sprague-Dawley rats were fed a normal (NS) 0.4% NaCl diet or a HS 4% NaCl diet for 3 wk or overnight. Kidneys excised from anesthetized rats were fractionated on density gradients or analyzed by microscopy; transporters and associated regulators were detected with specific antibodies. Three-week HS doubled Na ϩ /H ϩ exchanger (NHE)3 phosphorylation at serine 552 and provoked a redistribution of NHE3, dipeptidyl peptidase IV (DPPIV), myosin VI, Na ϩ -Pi cotransporter (NaPi)-2, ANG II type 2 receptor (AT2R), aminopeptidase N (APN), Na ϩ -K ϩ -2Cl Ϫ cotransporter (NKCC2), epithelial Na ϩ channel (ENaC) ␤-subunit, and Na ϩ -K ϩ -ATPase (NKA) ␣1-and ␤ 1-subunits from low-density plasma membrane-enriched fractions to higher-density intracellular membrane-enriched fractions. NHE3, myosin VI, and AT 2R retraction to the base of the microvilli (MV) during HS was evident by confocal microscopy. HS did not change abundance of NHE3, NKCC, or NKA ␣ 1-or ␤1-subunits but increased ENaC-␤ in high-density intracellular enriched membranes. Responses to HS were fully apparent after just 18 h. We propose that retraction of NHE3 to the base of the MV, driven by myosin VI and NHE3 phosphorylation and accompanied by redistribution of the NHE3 regulator DPPIV, contributes to a decrease in proximal tubule Na ϩ reabsorption during HS and that redistribution of transporters out of low-density plasma membrane-enriched fractions in the thick ascending limb of the loop of Henle and distal nephron may also contribute to the homeostatic natriuretic response to HS diet. sodium chloride; kidney; natriuresis; salt-sensitive hypertension A HIGH DIETARY SODIUM LOAD provokes a thirst that increases extracellular fluid volume (ECFV), maintaining plasma Na ϩ concentration in a normal range (40). The kidneys affect natriuretic and diuretic responses to match salt and water output to intake and restore ECFV. If volume is not corrected, it provokes a generalized vascular contraction to normalize tissue blood flow, resulting in hypertension. Establishing the molecular mechanisms by which the kidney regulates Na ϩ and ECFV homeostasis under normal conditions is an important goal because it will identify candidates that may contribute to salt-sensitive hypertension (6). Na ϩ transport along the nephron can be regulated by altering 1) total transporter abundanc...

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The first reports of severe acute respiratory symptoms from a novel coronavirus called coronavirus disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China in December 2019. 1 The World Health Organization declared COVID-19 a global pandemic by March 2020. 1 The COVID-19 outbreak has resulted in a current global health emergency. Clinical information about the findings of COVID-19 and its associated complications are constantly evolving and becoming more widely available. Providers should be familiar with both typical symptoms and image study results for COVID-19 as well as less commonly reported complications of progressive COVID-19, such as spontaneous pneumomediastinum and spontaneous pneumothorax as highlighted in this case.

Invasive pulmonary mucormycosis and aspergillosis are rare, life-threatening fungal infections. Most documented cases have been reported in non-cirrhotic patients with diabetes mellitus, neutropenia, or treatment with corticosteroids. The prevalence of each infection is low among patients with hepatic cirrhosis. We report the first likely case of combined invasive pulmonary mucormycosis and aspergillosis in a male with decompensated hepatic cirrhosis. This report also highlights the first non-diabetic case of invasive pulmonary mucormycosis with decompensated hepatic cirrhosis.

Caregiver reported diabetes care responsibility (mostly parent, mostly child, shared between parent and child) varies for certain aspects of diabetes related care for children ages 6-13, depending upon the mode of insulin administration. Based on the reported degree of parental collaboration, HbA1C did not differ significantly. However, long-term effects are yet to be determined in longitudinal studies.

Introduction: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2.1 COVID-19 first occurred in Wuhan, China, in December 2019, and by March 2020 COVID-19 was declared a global pandemic.1 Case Presentation: We describe a case of a 52-year-old female with past medical history of asthma, type 2 diabetes, and previous tobacco use who presented to the emergency department with dyspnea and was found to be positive for COVID-19. We discuss the computed tomographic finding of “crazy-paving” pattern in the patient’s lungs and the significance of this finding in COVID-19 patients. Discussion: Emergency providers need to be aware of the different imaging characteristics of various stages of COVID-19 to appropriately treat, isolate, and determine disposition of COVID-19 infected patients. Ground-glass opacities are the earliest and most common imaging finding for COVID-19.2-4 Crazy-paving pattern is defined as thickened interlobular septa and intralobular lines superimposed on diffuse ground-glass opacities and should be recognized by emergency providers as a radiographic finding of progressive COVID-19.2-4

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