Brown Fat–Activating Lipokine 12,13-diHOME in Human Milk Is Associated With Infant Adiposity

Abstract Context Little is known about the specific breastmilk components responsible for protective effects on infant obesity. Whether 12,13-dihydroxy-9Z-octadecenoic acid (12,13-diHOME), an oxidized linoleic acid metabolite and activator of brown fat metabolism, is present in human milk, or linked to infant adiposity, is unknown. Objective To examine associations between concentrations of 12,13-diHOME in human milk and infant adiposity. Design Prospective cohort study from 2015 to 2019, following participants from birth to 6 months of age. Setting Academic medical centers. Participants Volunteer sample of 58 exclusively breastfeeding mother-infant pairs; exclusion criteria included smoking, gestational diabetes, and health conditions with the potential to influence maternal or infant weight gain. Main Outcome Measures Infant anthropometric measures including weight, length, body mass index (BMI), and body composition at birth and at 1, 3, and 6 months postpartum. Results We report for the first time that 12,13-diHOME is present in human milk. Higher milk 12,13-diHOME level was associated with increased weight-for-length Z-score at birth (β = 0.5742, P = 0.0008), lower infant fat mass at 1 month (P = 0.021), and reduced gain in BMI Z-score from 0 to 6 months (β = −0.3997, P = 0.025). We observed similar associations between infant adiposity and milk abundance of related oxidized linoleic acid metabolites 12,13-Epoxy-9(Z)-octadecenoic acid (12,13-epOME) and 9,10-Dihydroxy-12-octadecenoic acid (9,10-diHOME), and metabolites linked to thermogenesis including succinate and lyso-phosphatidylglycerol 18:0. Milk abundance of 12,13-diHOME was not associated with maternal BMI, but was positively associated with maternal height, milk glucose concentration, and was significantly increased after a bout of moderate exercise. Conclusions We report novel associations between milk abundance of 12,13-diHOME and adiposity during infancy.

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Health Industry Practices That Create Conflicts of Interest: A Policy Proposal for Academic Medical Centers

Yearbook of Dermatology and Dermatologic Surgery ◽

10.1016/s0093-3619(08)70170-9 ◽

2006 ◽

Vol 2006 ◽

pp. 221-222

Author(s):

B.H. Thiers

Keyword(s):

Conflicts Of Interest ◽

Academic Medical Centers ◽

Policy Proposal ◽

Medical Centers ◽

Academic Medical

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Multicenter point prevalence evaluation of the utilization and safety of drug therapies for COVID-19 at the onset of the pandemic timeline in the United States

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa426 ◽

2021 ◽

Author(s):

Nathaniel J Rhodes ◽

Atheer Dairem ◽

William J Moore ◽

Anooj Shah ◽

Michael J Postelnick ◽

...

Keyword(s):

Clinical Trials ◽

Drug Therapy ◽

Supportive Care ◽

The United States ◽

Primary Objective ◽

Point Prevalence ◽

Medical Centers ◽

Academic Medical ◽

History Of ◽

Secondary Objective

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods We conducted a non-interventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). Conclusion While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments.

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Can Anthropometry and Body Composition Explain Physical Fitness Levels in School-Aged Children?

Children ◽

10.3390/children8060460 ◽

2021 ◽

Vol 8 (6) ◽

pp. 460

Author(s):

Chih-Yu Hsu ◽

Liang-Sien Chen ◽

I-Jen Chang ◽

Wei-Ching Fang ◽

Sun-Weng Huang ◽

...

Keyword(s):

Body Composition ◽

Physical Fitness ◽

Cross Sectional Study ◽

Continuous Variables ◽

Z Score ◽

Fat Percentage ◽

Anthropometric Measures ◽

Muscle Weight ◽

Cross Sectional ◽

School Aged Children

Physical fitness (PF) is closely related to various health outcomes and quality of life among children. However, the associations between anthropometry, body composition (BC), and PF are not fully elucidated. This cross-sectional study aimed to investigate the associations between demographic metrics (age, sex), anthropometric measures (body mass index z-score (BMI z-score) waist/height ratio (WHtR)), BC parameters (body-fat percentage (BF%), muscle weight), and PF levels (800-m run, sit-and-reach, 1-min sit-ups, standing long jump) in school-aged children. Continuous variables were dichotomized by median splits. The results of 180 girls and 180 boys (mean age: 10.0 ± 0.7 years; mean BMI z-score: 0.366 ± 1.216) were analyzed. Multivariable linear regressions revealed that BF% (regression coefficient (B) = 3.4, 95% confidence interval (CI) = 2.5–4.3) was independently correlated with the 800-m run. Sex (B = 4.6, 95% CI = 3.0–6.3), age (B = 3.1, 95% CI = 1.9–4.3), and BMI z-score (B = −0.7, 95% CI = −1.4–−0.1) were independently related to sit-and-reach. Age (B = 3.3, 95% CI = 2.0–4.7), BF% (B = −0.3, 95% CI = −0.4–−0.2), and muscle weight (B = 0.7, 95% CI = 0.2–1.2) were independently associated with 1-min sit-ups. In addition to demography, anthropometry and BC provided additional information concerning some PF levels in school-aged children. Weight management and PF promotion should be addressed simultaneously in terms of preventive medicine and health promotion for children.

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Discharge Practices for COVID-19 Patients: Rapid Review of Published Guidance and Synthesis of Documents and Practices at 22 US Academic Medical Centers

Journal of General Internal Medicine ◽

10.1007/s11606-021-06711-x ◽

2021 ◽

Author(s):

S. Ryan Greysen ◽

◽

Andrew D. Auerbach ◽

Matthew D. Mitchell ◽

Jennifer N Goldstein ◽

...

Keyword(s):

Academic Medical Centers ◽

Rapid Review ◽

Medical Centers ◽

Academic Medical

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Hospital Volume is Not a Predictor of Outcomes after Gastrectomy for Neoplasm

The American Surgeon ◽

10.1177/000313480907501015 ◽

2009 ◽

Vol 75 (10) ◽

pp. 932-936 ◽

Cited By ~ 5

Author(s):

Kevin M. Reavis ◽

Marcelo W. Hinojosa ◽

Brian R. Smith ◽

James B. Wooldridge ◽

Sindhu Krishnan ◽

...

Keyword(s):

Length Of Stay ◽

Hospital Mortality ◽

Gastric Surgery ◽

National Database ◽

Medical Centers ◽

Outcome Relationship ◽

Academic Medical ◽

Low Volume ◽

Poor Outcomes ◽

The University

Studies have shown conflicting data with regard to the volume and outcome relationship for gastrectomy. Using the University HealthSystem Consortium national database, we examined the influence of the hospital's volume of gastrectomy on outcomes at academic centers between 2004 and 2008. Outcome measures, including length of stay, 30-day readmission, morbidity, and in-hospital mortality, were compared among high- (13 or greater), medium- (6 to 12), and low-volume (five or less) hospitals. There were 10 high- (n = 593 cases), 36 medium- (n = 1076 cases), and 75 low-volume (n = 500 cases) hospitals. There were no significant differences between high- and low-volume hospitals with regard to length of stay, overall complications, 30-day readmission rate, and in-hospital mortality (2.4 vs 4.4%, respectively, P = 0.06). Despite the small number of gastrectomies performed at the low-volume hospitals, these same hospitals performed a large number of other types of gastric surgery such as gastric bypass for the treatment of morbid obesity (102 cases/year). Within the context of academic medical centers, lower annual volume of gastrectomy for neoplasm is not a predictor of poor outcomes which may be explained by the gastric operative experience derived from other types of gastric surgery.

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Unplanned Reoperation and Implant Revision After Total Wrist Arthroplasty

Hand ◽

10.1177/1558944719898817 ◽

2020 ◽

pp. 155894471989881 ◽

Cited By ~ 1

Author(s):

Taylor M. Pong ◽

Wouter F. van Leeuwen ◽

Kamil Oflazoglu ◽

Philip E. Blazar ◽

Neal Chen

Keyword(s):

Risk Factors ◽

Implant Removal ◽

Academic Medical Centers ◽

Implant Design ◽

Factors Associated ◽

Medical Centers ◽

Total Wrist Arthroplasty ◽

Academic Medical ◽

Related Risk ◽

Wrist Arthroplasty

Background: Total wrist arthroplasty (TWA) is a treatment option for many debilitating wrist conditions. With recent improvements in implant design, indications for TWA have broadened. However, despite these improvements, there are still complications associated with TWA, such as unplanned reoperation and eventual implant removal. The goal of this study was to identify risk factors for an unplanned reoperation or implant revision after a TWA at 2 academic medical centers between 2002 and 2015. Methods: In this retrospective study, 24 consecutive TWAs were identified using CPT codes. Medical records were manually reviewed to identify demographic, patient- or disease-related, and surgery-related risk factors for reoperation and implant removal after a primary TWA. Results: Forty-six percent of wrists (11 of 24 TWAs performed) had a reoperation after a median of 3.4 years, while 29% (7 of 24) underwent implant revision after a median of 5 years. Two patients had wrist surgery prior to their TWA, both eventually had their implant removed ( P = .08). There were no risk factors associated with reoperation or implant removal. Conclusion: Unplanned reoperation and implant removal after a primary TWA are common. Approximately 1 in 3 wrists are likely to undergo revision surgery. We found no factors associated with reoperation or implant removal; however, prior wrist surgery showed a trend toward risk of implant removal after TWA.

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