Trends in Metabolic Disorder in U.S. Army Aviators, 20162018

INTRODUCTION: Recent epidemiological studies of U.S. Army aviators have suggested higher than anticipated rates of hyperlipidemia and metabolic disorder. The goal of this study was to determine whether this finding has persisted in 20162018 and to subsequently determine whether this trend is genuine and warrants further evaluation.METHODS: Data were requested from the U.S. Army Aeromedical Electronic Resource Office (AERO) and retrieved from the publicly available Defense Medical Surveillance System (DMSS) utilizing similar inclusion/exclusion criteria, where possible, as the earlier studies. For each year 20162018, incidence rates (per 1000 person years) for hyperlipidemia and metabolic syndrome were retrieved from DMSS, while percentages of aviators with these conditions were retrieved from AERO. The DMSS incidence rates were also age stratified. No formal analyses were conducted.RESULTS: Results from DMSS showed overall rates of hyperlipidemia ranging from 3.18 to 6.83 per 1000 person-years and for metabolic syndrome from 0.16 to 0.69 per 1000 person-years. The age stratified rates increased proportionally with age. AERO data showed a range of 0.81.5% of aviators had hyperlipidemia and for metabolic syndrome this ranged from 0.31 to 0.45%. These rates are broadly comparable to the previous studies findings.DISCUSSION: This studys findings suggest no continued increase in hyperlipidemia or metabolic disorder in aviators. While the exact cause is unknown, one could speculate a number of sources such as preferences in testing or encouragement from specific commanders or flight surgeons.Goldie C, McGhee J, Kelley AM. Trends in metabolic disorder in U.S. Army aviators, 20162018. Aerosp Med Hum Perform. 2021; 92(1):4346.

Study of critical manufacturing processes for the creation of 3D and fully transparent medical models of aneurysm and bronchi of the Lung

To support the training of neurosurgeons, innovative simulators associated with professional medical courses are needed. Virtual reality and 3D models have been making their way into surgical training facilities and medical schools for several years. However, both simulators cannot provide a hands-on and tactile experience of what it is like to see and feel in a real surgical procedure. Professor Pin-Chuan Chen of the Mechanical Engineering Department at the National Taiwan University of Science and neurosurgeon Dr Wei-Hsiu Liu of the National Defense Medical Center, are collaborating to design and create a new generation of lifelike medical simulators for neurosurgery training.

Trial Day Fourteen

On Friday, September 9, the prosecutor and defense summarize the case. The judge is expected to instruct the assessors the next day. Georgiadis says the assessors must consider whether Bill caused Peppy’s death, whether it was an unlawful act or omission, and whether there was malice aforethought. Georgiadis hammers away at the inconsistencies in the prosecution’s case, the failure to show any motive, and the overbearing weight of the defense medical testimony. Prosecutor Effiwat argues that the diary demonstrates Bill’s morbid state of mind, the eyewitness accounts must be believed, Dr. Dockeray’s testimony must be discounted since he is unregistered in Tanzania, and there is no reasonable explanation for why Bill had brought the pipe to the picnic.

FRI0429 UROLITHIN B ATTENUATES THE INFLAMMATORY AND NITROSATIVE STRESS ON INTERLEUKIN-1 INDUCED CHONDROCYTES

Background:Osteoarthritis (OA) is one of the most common degenerative disorders with cartilage degradation especially to the elderly resulting in disability. Many inflammatory cytokines involve the pathogenesis of the OA and causes destruction and decomposition of articular cartilage, including interleukin 1 beta (IL-1β). Urolithin B is a small polyphenolic compound, produced by gut flora from ellagitannins-rich foods, such as pomegranate, strawberries, raspberries, etc. Urolithin B has been documented in anti-inflammatory and antioxidant properties. However, the mechanism underlying the effects of Urolithin B on IL-1 stimulated human osteoarthritis (OA) chondrocytes remains unrevealedObjectives:The aim of this study was to investigate the biologic effects of Urolithin B on OA models and associated mechanism.Methods:Primary culture of human chondrocyte, knee joint obtained from total knee replacement of patients with osteoarthritis, were used IL-1β induced and treated with/without 100μM Urolithin B for 24 hours respectively. Total cell lysates were collected for western blotting to analyze the catabolic molecules. Culture medium were collected for gelatin zymography to analyze the secretion of MMP 2 and 9.Results:Urolithin B inhibits the overexpression of not only inflammatory marker COX2 and nitrosative marker NOS2, but also matrix metalloproteinases (MMPs)-1, -3, 13 in IL-1β induced chondrocytes by western blotting. It also restored the IL-1β induced glycosaminoglycan degeneration in ex vivo articular cartilage evaluated by Safranin O stain. Meanwhile, Urolithin B can activate autophagy, increasing LC3 II/I ratio, in IL-1β induced chondrocytes.Conclusion:Collectively, the study demonstrates that Urolithin B may be of value in the treatment of osteoarthritis through its anti-inflammatory, anti-oxidant and anti-proteinase activities.References:[1]Decker, R.S., E. Koyama, and M. Pacifici,Articular Cartilage: Structural and Developmental Intricacies and Questions.Curr Osteoporos Rep, 2015.13(6): p. 407-14.[2]Luo, Y., et al.,The minor collagens in articular cartilage.Protein Cell, 2017.8(8): p. 560-572.[3]Sophia Fox, A.J., A. Bedi, and S.A. Rodeo,The basic science of articular cartilage: structure, composition, and function.Sports Health, 2009.1(6): p. 461-8.[4]Carballo, C.B., et al.,Basic Science of Articular Cartilage.Clin Sports Med, 2017.36(3): p. 413-425.[5]Taruc-Uy, R.L. and S.A. Lynch,Diagnosis and treatment of osteoarthritis.Prim Care, 2013.40(4): p. 821-36, vii.[6]Rhon, D., Re: Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008;16:137-62. Osteoarthritis Cartilage, 2008.16(12): p. 1585; author reply 1589.[7]Wang, S.T., et al., Antimelanogenic Effect of Urolithin A and Urolithin B, the Colonic Metabolites of Ellagic Acid, in B16 Melanoma Cells. J Agric Food Chem, 2017.65(32): p. 6870-6876.Feng-Cheng Wu1, Feng-Cheng Liu2, Chih-Chien Wang3, Yi-Jen Peng1,4*1Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei, Taiwan, R.O.C.2Rheumatology, Immunology and Allergy, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.3Department of Orthopedic, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.4Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.Title:Urolithin B attenuates the inflammatory and nitrosative stress on interleukin-1 induced chondrocytesKey words:Urolithin B, Osteoarthritis, chondrocytes, Cyclooxygenase 2, Nitric Oxide Synthase 2, matrix metalloproteinaseDisclosure of Interests:None declared

Relationship to Deployment on Sarcoidosis Staging and Severity in Military Personnel

Introduction Ongoing studies are investigating the potential link between deployment to Operation Iraqi Freedom and Operation Enduring Freedom and relationship to increases in pulmonary disease. While increases in certain diseases such as asthma and airway hyperreactivity are well established, data on other chronic pulmonary diseases such as sarcoidosis have not been defined. Material and Methods A retrospective chart review was conducted of all active duty military personnel diagnosed with sarcoidosis from 2005 to 2010. Deployment dates and locations were obtained through the Armed Forces Health Surveillance Branch. Electronic medical records were reviewed to determine the following parameters: dates of diagnosis, temporal relationship of diagnosis and deployment, symptoms (pre- and/or post-deployment), spirometry, diffusing capacity, radiographic staging, and treatment course. Pulmonary sarcoidosis incidence rates were estimated using International Classification of Diseases (ICD-9) coded medical encounter data from the Defense Medical Surveillance System and compared between Army and nonArmy personnel, as well as between ever-deployed and never-deployed personnel. Results A cohort of 478 Army soldiers was identified with sarcoidosis based on ICD-9 codes and individual review of the medical records. The cohort was 80% male. 38.7% of soldiers with sarcoidosis never deployed. 11.7% were diagnosed prior to deployment, and 50.2% were diagnosed postdeployment. The diagnosis of sarcoidosis was established with a tissue diagnosis in 68% of the deployed cohort. Overall differences in spirometry were not identified. Obstructed spirometry was similar in all deployment groups (never, pre, and post) at 9.2%, 15.8% and 8.7%, respectively. Restrictive patterns based on total lung capacity (<70%) were similar at 9.2%, 12.5%, and 11.0%, respectively. Radiographic staging showed a similar distribution in the populations with the never/pre versus postdeployment groups having Stage 0 = 2.3 versus 3.5%, Stage I = 43.8 versus 41.6%, Stage II = 33.1 versus 41.0%, Stage III = 15.1 versus 12.1%, and Stage IV = 2.2 versus 1.7%, respectively. During 2005–2010, the estimated incidence rate of pulmonary sarcoidosis was low among active duty Army personnel (16.5 cases/100,000 person-years), and no trend in annual rates was observed, p = 0.89. Based on overall Department of Defense medical data, estimated pulmonary sarcoidosis rates were lower among ever-deployed personnel, relative to nondeployed personnel. Conclusion Based on this analysis of Army sarcoidosis patients, there was no difference in the rates of sarcoidosis diagnosis in deployed and nondeployed soldiers. Spirometry values, total lung capacity, and radiographic staging did not show significant differences between deployment groups.

Pathogen-specific Risk of Reactive Arthritis from Bacterial Causes of Foodborne Illness

Objective.Reactive arthritis (ReA) is a sequelae of common bacterial infections of acute gastroenteritis. We assessed incidence of ReA following Campylobacter, Salmonella, Shigella, or Yersinia infection utilizing a US Department of Defense medical database.Methods.Subjects with acute gastroenteritis attributed to these pathogens were matched with ≥ 4 unexposed subjects. Medical history was analyzed for 6 months postinfection to assess for incident ReA.Results.A total of 1753 cases of gastroenteritis were identified. ReA incidence ranged from 0 to 4 per 100,000 person-years.Conclusion.These data are consistent with prior studies and highlight the need for continued primary prevention efforts.