The role of metal ions in Alzheimer's disease etiology is unresolved. For the redox-active metal ions iron and copper, the formation of reactive oxygen species by metal amyloid complexes has been proposed to contribute to Alzheimer's disease neurodegeneration. For copper, reactive oxygen species are generated by copper redox cycling between its 1+ and 2+ oxidation states. Thus, the AβCu(I) complex is potentially a critical reactant associated with Alzheimer's disease etiology. Through competitive chelation, we have measured the affinity of the soluble copper-binding domain of the amyloid-β peptide for Cu(I). The dissociation constants are in the femtomolar range for both wild-type and histidine-to-alanine mutants. These results indicate that Cu(I) binds more tightly to monomeric amyloid-β than Cu(II) does, which leads us to propose that Cu(I) is a relevant in vivo oxidation state.
Bariatric surgery represents a durable and safe treatment modality for morbid obesity. Bariatric surgery results in weight loss by one of two-and possibly both-primary mechanisms, reducing the amount of tolerable intake (restrictive) and reducing the amount of nutrients absorbed by bypassing absorptive intestine (malabsorptive). These procedures have consistently demonstrated superior resolution of obesity and many associated co-morbid conditions as compared to medical management. Beyond the periprocedural complications of surgery, there are longitudinal risks such as weight regain, anatomic complications, and micronutrient deficiencies. Complications related to the anatomic alteration after bariatric surgery include internal herniation, marginal ulcers, dumping syndrome, and gastric band-related complications. Physicians who take care of bariatric patients at any point in their post-operative care must be vigilant for these complications, as they may necessitate urgent intervention or re-operation. Micronutrient deficiencies, which commonly occur after malabsorptive procedures, may present with a wide range of symptoms-including neuropathies, anemia, poor wound healing, and hair loss, among others. Deficiencies of vitamins and minerals frequently result in the need for long-term supplementation and may necessitate intravenous repletion when severe. Bariatric surgery may also alter the absorption of commonly prescribed medications, including anti-psychotic medications.
nequities affecting underserved racial and ethnic groups continue to be identified across the spectrum of medical research. [1][2][3][4] From the disproportionate number of Black and Hispanic persons who have been hospitalized or died because of COVID-19 in 2020 [5][6][7][8] to discrimination against Asian American persons 9 and the comparatively poor perioperative outcomes even among low-risk racial and ethnic minority patients, 10,11 attentiveness to race and ethnicity has illuminated inequities and disparities throughout our health care systems. Recognition of health disparities through research has led to recent significant victories, such as the Henrietta Lacks Enhancing Cancer Research Act of 2019, 12 which became public law in January 2021, requiring officials to examine barriers to government-funded clinical trials for traditionally underrepresented groups. Unfortunately, race and ethnicity continue to be infrequently reported in the medical literature to describe study participants, and when race is described, the quality of the reporting is variable. [1][2][3][4][13][14][15][16] In 1978 (updated in 2019), the International Committee of Medical Journal Editors (ICMJE) developed recommendations for uniformity in manuscript submissions and promoting increased frequency and quality reporting of race. Current recommendations are that "[a]uthors should define how they determined race or ethnicity and justify their relevance," 17 and that a study "should aim for inclusion of representative populations into all study types and at a minimum provide descriptive data for these and other relevant demographic variables." [17][18][19] Despite these recommendations, studies examining the reporting of race continue to show infrequent use of race to desc ribe study partic ipants in sc ientific publications. [13][14][15][16] A 2020 article by Moore 14 revealed that in the ophthalmology literature, most articles (88%) reported baseline demographic information on study participants; however, only 43% of articles included data on race and ethnicity, and an even smaller fraction described how the information was determined. IMPORTANCEThe reporting of race provides transparency to the representativeness of data and helps inform health care disparities. The International Committee of Medical Journal Editors (ICMJE) developed recommendations to promote quality reporting of race; however, the frequency of reporting continues to be low among most medical journals.OBJECTIVE To assess the frequency as well as quality of race reporting among publications from high-ranking broad-focused surgical research journals. DESIGN, SETTING, AND PARTICIPANTSA literature review and bibliometric analysis was performed examining all human-based primary research articles
Donation after cardiac death (DCD) liver transplantation is associated with increased biliary complications and graft failure. Yet for unclear reasons, DCD recipients relisted for transplantation have lower wait-list mortality than other retransplant candidates. We used Organ Procurement and Transplantation Network and United Network for Organ Sharing data from 2002 to 2011 to evaluate all DCD recipients relisted for transplantation to evaluate the impact of the utilization of Model for EndStage Liver Disease (MELD) exception points on wait-list outcomes. Of 262 DCD recipients relisted for liver transplantation >2 weeks after initial transplantation, 82 (31.3%) applied for a nonstandardized MELD exception, and 68 (82.9%) had 1 exception approved. Of the relisted DCD recipients, 187 (71.4%) underwent retransplantation; among those with an approved MELD exception, 85.2% underwent retransplantation versus 57.1% of those with an exception denied and 69.4% of those not applying for an exception (P 5 0.02). In contrast, those receiving MELD exception points were significantly less likely to be removed from the wait list for death or clinical deterioration in comparison with those not applying for an exception (7.1% versus 19.4%, P 5 0.02). In multivariate models, patients with an approved exception were 3.3 times more likely to undergo retransplantation than those not applying for an exception. Standardized criteria for exception points among DCD recipients should be established to ensure uniform access to retransplantation. Liver Transpl 21:554-560, 2015. V C 2015 AASLD.Received October 10, 2014; accepted January 7, 2015.Despite advances in surgical techniques and medical therapies for end-stage liver disease, more than 20% of patients in certain regions of the United States die while awaiting a liver transplant on the wait list. 1,2 Despite the increasing demand, the supply of standard deceased donor allografts remains insufficient to satiate demand. As a result, donation after cardiac death (DCD) organs have been promulgated as a means of abrogating the mismatch between supply and demand. [2][3][4] In the United States, the outcomes of DCD liver transplants are inferior to the outcomes of livers from donation after brain death (DBD) donors, with significantly lower graft survival related to ischemic cholangiopathy. [4][5][6] As a result, relisting rates are significantly higher for recipients of DCD allografts versus DBD allografts (21.6% versus 8.8%, P < 0.01). 7 Patients on the liver transplant wait list continue to be prioritized by the Model for End-Stage Liver Disease (MELD) score, although there are limited data validating its role in predicting wait-list mortality in retransplant candidates after DCD allograft failure. 8 Because of the limitations of the MELD score in
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