An Overview of the Obese-Asthma Phenotype in Children

Asthma is the most common chronic disease in childhood. Overweight and obesity are included among the comorbidities considered in patients with difficult-to-treat asthma, suggesting a specific phenotype of the disease. Therefore, the constant increase in obesity prevalence in children and adolescents raises concerns about the parallel increase of obesity-associated asthma. The possible correlation between obesity and asthma has been investigated over the last decade by different authors, who suggest a complex multifactorial relationship. Although the particular non-eosinophilic endotype of obesity-related asthma supports the concept that high body weight precedes asthma development, there is ongoing debate about the direct causality of these two entities. A number of mechanisms may be involved in asthma in combination with obesity disease in children, including reduced physical activity, abnormal ventilation, chronic systemic inflammation, hormonal influences, genetics and additional comorbidities, such as gastroesophageal reflux and dysfunctional breathing. The identification of the obesity-related asthma phenotype is crucial to initiate specific therapeutic management. Besides the cornerstones of asthma treatment, lifestyle should be optimized, with interventions aiming to promote physical exercise, healthy diet, and comorbidities. Future studies should clarify the exact association between asthma and obesity and the mechanisms underlying the pathogenesis of these two related conditions with the aim to define personalized therapeutic strategies for asthma management in this population.

Mouse Models of Osteoarthritis: A Summary of Models and Outcomes Assessment

Osteoarthritis (OA) is a multidimensional health problem and a common chronic disease. It has a substantial impact onpatient quality of life and is a common cause of pain and mobility issues in older adults. The functional limitations, lack of curative treatments, and cost to society all demonstrate the need for translational and clinical research. The use of OA models in mice is important for achieving a better understanding of the disease. Models with clinical relevance are needed to achieve 2 main goals: to assess the impact of the OA disease (pain and function) and to study the efficacy of potential treatments. However, few OA models include practical strategies for functional assessment of the mice. OA signs in mice incorporate complex interrelations between pain and dysfunction. The current review provides a comprehensive compilation of mousemodels of OA and animal evaluations that include static and dynamic clinical assessment of the mice, merging evaluationof pain and function by using automatic and noninvasive techniques. These new techniques allow simultaneous recordingof spontaneous activity from thousands of home cages and also monitor environment conditions. Technologies such as videographyand computational approaches can also be used to improve pain assessment in rodents but these new tools must first be validated experimentally. An example of a new tool is the digital ventilated cage, which is an automated home-cage monitor that records spontaneous activity in the cages.

Classifying Diabetes Disease Using Feedforward MLP Neural Networks

Diagnosing chronic diseases is about making accurate and quick decisions based on contradictory information and constantly evolving knowledge. Hence, there has been a persistent need to help health practitioners in making correct decisions. Diabetes is a common chronic disease. It is a global healthcare threat and the eighth leading cause of death in the world. Modern artificial intelligence techniques are being used in diagnosing chronic diseases including artificial neural networks. In this chapter, a feedforward multilayer-perceptron neural network has been implemented to help health practitioners in classifying diabetes. Through the work, an algorithm was proposed in purpose of determining the number of hidden layers and neurons in a MLP. Based on the algorithm, two topologies have been introduced. Both topologies exhibited good classification accuracies with a slightly higher accuracy for the MLP with only one hidden layer. The data set was obtained from King Abdullah University Hospital in Jordan.

The Effect of Inhaled Corticosteroid Therapy on Periodontal Status in Patients with Asthma

Asthma belongs to a broad group of allergic diseases and is the most common chronic disease found in children and adults up to four decades of age. Already published studies suggest that the use of inhaled anti-asthmatic medications affects both general health and oral health. The study included 120 adult patients aged 18 to 71 divided into three groups: I “PERIO-ASTHMA”—with asthma and periodontitis, II “ASTHMA”—with asthma without periodontitis, and control group III “CONTROL”—without asthma and periodontitis. The patients were monitored for oral health status for six months. Oral health was assessed by dental indices: DMF index, PI, BoP, PD, and CAL at interproximal sites. Significantly deeper pockets in the lateral segments of the dentition were observed in all study groups. In addition, the bronchial-only group had significantly deeper pockets in the lateral sextants than the control group at all time points. There was no significant worsening of periodontal status by CAL and PD in asthma patients treated with inhalation, irrespective of baseline periodontal status. Depending on the severity of asthma, an increase in BOP was observed in the central sextant in patients without periodontitis. The history of asthma and the use of ICS has an impact on the periodontal status of patients.

EDUKASI DAN PENDAMPINGAN DIET LANSIA DENGAN HIPERTENSI

ABSTRAKHipertensi adalah penyakit kronis yang umum di seluruh dunia dan faktor risiko utama penyakit kardiovaskular. Desa Sumber Harta Kabupaten Musi Rawas merupakan salah satu desa yang terletak di daerah dataran rendah padat penduduk yang rata-rata pekerjaannya sebagai petani. Data Puskesmas Sumber Harta menyebutkan bahwa angka kejadian hipertensi pada lansia sangat tinggi bahkan kunjungan terbanyak adalah penderita hipertensi mencapai 70%. Para lansia ini juga kurang memahami dampak jangka Panjang hipertensi seperti stroke. Tujuan dalam pengabdian ini adalah untuk meningkatkan pengetahuan lansia dan keluarga dalam mencegah komplikasi hipertensi. Mitra dalam pengabdian ini adalah Puskesmas dan Desa Sumber Harta (RT 09 dan 10). Peserta dalam kegiatan ini adalah lansia penderita hipertensi dan keluarga sebanyak 18 orang. Metode dalam kegiatan ini yaitu penyuluhan dan pendampingan pengelolaan diet hipertensi bersama keluarga. Keberhasilan tampak dari semangat dan antusiasnya lansia beserta keluarga. Lansia maupun keluarganya juga berperan aktif dalam menjawab evaluasi tentang materi yang telah disampaikan dan dapat mendemonstrasikan kembali pengolahan bahan makananan untuk diet hipertensi. Pelaksanaan kegiatan pengabdian terlaksana dengan lancar, pengetahuan lansia dalam memahami diet hipertensi bertambah serta berkomitmen dalam melaksanakan semua anjuran dari tim pengabdian untuk mencegah komplikasi hipertensi. Kata kunci: hipertensi; diet; lansia.ABSTRACTHypertension is a common chronic disease worldwide and a major risk factor for cardiovascular disease. Sumber Harta Village, Musi Rawas Regency is one of the villages located in a densely populated lowland area whose average occupation is as a farmer. Data from the Sumber Harta Health Center stated that the incidence of hypertension in the elderly was very high, even the most visits were people with hypertension reaching 70%. These elderly people also do not understand the long-term impact of hypertension such as stroke. The purpose of the service is to increase the knowledge of the elderly and their families in preventing complications of hypertension. Partners in this service are Puskesmas and Sumber Harta Village (RT 09 and 10). Participants in this activity are elderly people with hypertension and their families as many as 18 people. The method in this activity is counseling and assistance in managing hypertension diet with the family. The success of this event can be seen from the enthusiasm and enthusiasm of the elderly and their families. The elderly and their families also play an active role in answering the evaluation of the material that has been submitted and can demonstrate again the processing of food ingredients for the hypertension diet. The implementation of service activities was carried out smoothly, the knowledge of the elderly and their families in understanding the hypertension diet increased and they were committed to carrying out all the recommendations from the service team to prevent complications of hypertension Keywords: hypertension; diet; elderly people

Overexpression of E3 ubiquitin ligase Cbl attenuates endothelial dysfunction in diabetes mellitus by inhibiting the JAK2/STAT4 signaling and Runx3-mediated H3K4me3

Background Diabetes mellitus (DM), a most common chronic disease, is featured with impaired endothelial function and bioavailability of nitric oxide (NO), while E3 ubiquitin ligase appears to alleviate endothelial dysfunction as a promising option for DM treatment. Herein, we aimed to determine whether E3 ubiquitin ligase casitas B-lineage lymphoma (Cbl) alleviates endothelial dysfunction in DM rats by JAK2/STAT4 pathway. Methods A rat model of DM was developed through intraperitoneal injection of streptozotocin, followed by collection of aortic tissues to determine the expression of Cbl, JAK2, runt-related transcription factor 3 (Runx3) and STAT4. Human umbilical vein endothelial cells (HUVECs) were cultured in high glucose (HG) condition to induce DM as an in vitro model. With gain- and loss-function method, we assessed the aberrantly expressed Cb1 on endothelial dysfunction, NO production and apoptosis of HUVECs. Results Cbl was reduced in DM rat tissues and HG-induced HUVECs, where JAK2, Runx3 and STAT4 were elevated. It was found that overexpression of Cbl alleviated endothelial dysfunction by increasing NO production and restoring vasodilation and suppressing apoptosis of HUVECs. Mechanistically, Cb1 enhanced JAK2 ubiquitination and decreased JAK2 and STAT4 expression, where STAT4 improved Runx3 expression by regulating histone H3 lysine 4 trimethylation level. Overexpression of JAK2 and STAT4, or Runx3 increased apoptosis of HUVECs, abrogating the effect of Cb1 on endothelial function. Conclusion In conclusion, Cbl alleviates endothelial dysfunction by inactivation of the JAK2/STAT4 pathway and inhibition of Runx3 expression in DM. These evidence might underlie novel Cbl-based treatment against DM in the future.

Development of an orally delivered GLP-1 receptor agonist through peptide engineering and drug delivery to treat chronic disease

Peptide therapeutics are increasingly used in the treatment of disease, but their administration by injection reduces patient compliance and convenience, especially for chronic diseases. Thus, oral administration of a peptide therapeutic represents a significant advance in medicine, but is challenged by gastrointestinal instability and ineffective uptake into the circulation. Here, we have used glucagon-like peptide-1 (GLP-1) as a model peptide therapeutic for treating obesity-linked type 2 diabetes, a common chronic disease. We describe a comprehensive multidisciplinary approach leading to the development of MEDI7219, a GLP-1 receptor agonist (GLP-1RA) specifically engineered for oral delivery. Sites of protease/peptidase vulnerabilities in GLP-1 were removed by amino acid substitution and the peptide backbone was bis-lipidated to promote MEDI7219 reversible plasma protein binding without affecting potency. A combination of sodium chenodeoxycholate and propyl gallate was used to enhance bioavailability of MEDI7219 at the site of maximal gastrointestinal absorption, targeted by enteric-coated tablets. This synergistic approach resulted in MEDI7219 bioavailability of ~ 6% in dogs receiving oral tablets. In a dog model of obesity and insulin resistance, MEDI7219 oral tablets significantly decreased food intake, body weight and glucose excursions, validating the approach. This novel approach to the development of MEDI7219 provides a template for the development of other oral peptide therapeutics.

Efficacy and Safety of Qushi Huayu Granule For Hyperlipidemia: Study Protocol For a Randomized, Double-Blind, Placebo-Controlled Trial

Background: Hyperlipidemia has become a common chronic disease worldwide in recent years. Studies shown that hyperlipidemia patients, especially those with a high level of serum low-density lipoprotein cholesterol (LDL-C), have a significantly higher prevalence of atherosclerosis, leading to coronary heart disease. Previous basic experiments and clinical studies have shown that Qushi Huayu granule (QSHY) can reduce blood lipids in patients with non-alcoholic fatty liver disease (NAFLD) accompanied by hyperlipidemia, but lack of clinical efficacy evaluation for patients with hyperlipidemia. This study aims to investigate the efficacy and safety of Qushi Huayu granule for Hyperlipidemia. Methods: This is a randomized, double-blind, placebo-controlled trial. 210 hyperlipidemia participants will be enrolled and randomized into QSHY or placebo granule groups in equal proportions, and receive treatment for 24 weeks. The primary outcome is the percentage change of LDL-C from baseline to week 12. Secondary outcomes are other serum lipid biochemical markers levels, life quality measuring health surveys, and Traditional Chinese Medicine (TCM) Pattern Scale. All related tests will be measured at baseline, week 12 and 24 after enrolment. Adverse events and safety of intervention will be monitored and evaluated.Discussion: We design a clinical trial of hyperlipidemia management with QSHY, a TCM formula. The results of this trial will present the efficacy and safety of QSHY in patients with hyperlipidemia, and provide clinical evidence for the treatment of hyperlipidemia.Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR2000034125. Registered on June 25, 2019.

COVID-19-Related Pneumonia in an Adolescent Patient with Allergic Asthma

Background. The latest coronavirus infection due to SARS-CoV-2, which started in China in December 2019, was announced as a pandemic by the World Health Organization (WHO) in March 2020. All epidemiological data so far show us that SARS-CoV-2 infection is less serious in children than in adults. Allergic asthma, the most common chronic disease in children, is usually not to be related to greater risk or severity for COVID-19 in pediatric populations. Although reports/research on asthma and COVID-19 in children have thus far been comforting, when coming across an asthma patient with any lower airway infection, attention should be given to evaluate their asthma control level and the possibility of SARS-CoV-2 infection. Case Report. Here, we report a rare adolescent case of COVID-19-related pneumonia development with underlying asthma. A 16-year-old male patient has been followed up by the pediatric allergy outpatient clinic with the diagnosis of asthma for the last 5 years. He was thought to have typical clinical and laboratory findings for SARS-CoV-2 infection combined with underlying pediatric (allergic) asthma. Pulmonary CT showed findings consistent with COVID-19-related pneumonia. He was discharged after 1 week when all his complaints regressed, his examination became normal, and 5-day favipiravir treatment was completed. Conclusion. When a physician comes across an asthma patient with any lower airway infection, attention should be given to evaluate their asthma control level and possibility of SARS-CoV-2 infection.

Evaluation of pediatric patients with јuvenile idiopathic arthritis treated with biological therapy Tocilizumab (Actemra)

Juvenile idiopathic arthritis (JIA) is the most common chronic disease in childhood. It manifests a heterogenic group of symptoms of arthritis, lasting at least 6 weeks and it appears before the age of 16. Patients who had no good therapeutic response to conventional therapy with Methotrexate were treated with biological therapy. The aim of this paper was to evaluate 9 patients who were receiving Tocilizumab at the Department of Rheumocardiology, University Clinic of Pediatric Diseases in Skopje. Materials and methods: Our study included 9 patients treated at our Department with biological therapy with Tocilizumab. Prior to initiation of the biological therapy, all patients underwent laboratory investigations, purified protein derivative (PPD) skin test for tuberculosis, X ray of the lungs and heart, and analysis of hepatitis markers. All patients were treated with amp. Actemra (tocilizumab) 8 mg/kg/tt i.v. Two of the patients had a severe form of the disease (one with severe systemic form and one with severe oligoarticular form of JIA). All presented patients had clinical remission of the disease. Conclusion: Therapy with tocilizumab in patients with juvenile idiopathic arthritis is a good therapeutic choice. The results obtained in our study have shown a significant therapeutic effect of tocilizumab even in severe forms of the disease.