Recurrent septic shock in a 34-year-old woman

A 34-year-old woman presented to the Emergency Room (ER) with an acute presentation of septic shock that required fluid and pressor support in the Intensive Care Unit. History revealed this was her third episode of such a presentation with asymptomatic periods in between. She responded well to medical interventions but reported persistent joint pain. Immunologic workup revealed her diagnosis.

Substituted oxazolidinones as novel NPC1L1 ligands for the inhibition of cholesterol absorption

Cholesterol absorption inhibition (CAI) represents an important treatment option for hypercholesterolemia. Herein, we report the design and evaluation of a series of substituted oxazolidinones as ligands for the Niemann Pick C1 Like 1 (NPC1L1) protein, a key mediator of cholesterol transport. Novel analogs were initially evaluated in a brush border membrane NPC1L1 binding assay; subsequently, promising compounds were evaluated in vivo for acute inhibition of cholesterol absorption. These studies identified analogs with low micromolar NPC1L1 binding affinity and acute in vivo efficacy of >50% absorption inhibition at 3mg/kg.

Design and synthesis of hepatoselective, pyrrole-based HMG-CoA reductase inhibitors

This manuscript describes the design and synthesis of a series of pyrrole-based inhibitors of HMG-CoA reductase for the treatment of hypercholesterolemia. Analogs were optimized using structure-based design and physical property considerations resulting in the identification of 44, a hepatoselective HMG-CoA reductase inhibitor with excellent acute and chronic efficacy in a pre-clinical animal models.

Ischemic stroke: relation of age, lesion location, and initial neurologic deficit to functional outcome

OBJECTIVE

Establish the relation between age, gender, initial neurologic deficit, stroke location, prior stroke, hemisphere of stroke, and functional outcome in ischemic stroke.

DESIGN

Single group, multivariate, repeated measures design with 327 persons having ischemic stroke recruited from 20 participating centers.

SETTING

Twenty European stroke centers.

PATIENTS

Consecutive admissions of men and women between the ages of 40 and 85 yrs with a hemispheric stroke caused by middle cerebral artery ischemia and a Unified Neurological Stroke Scale score of 5 to 24.

INTERVENTIONS

Inpatients enrolled in the trial received traditional rehabilitation therapies including physical therapy, occupational therapy, and speech therapy when appropriate.

MAIN OUTCOME MEASURES

Barthel Index computed at 7 to 10 days and 3 months poststroke.

RESULTS

Positive functional outcomes were significantly related to the absence of prior strokes, a younger age, a less severe initial neurologic deficit, stroke involving cortical structures, and dominant (left hemisphere) lesions.

CONCLUSIONS

Despite some inconsistencies in existing literature, standardized prospective examination of outcome after stroke clearly demonstrated the effect of age, initial severity of stroke, and lesion location as predictors of functional outcome.

The effects of social setting, perceived weight category, and gender on eating behavior

Four hundred and sixteen male and 233 female subjects were observed in a university cafeteria at lunch time. They were categorized according to five perceived weight groups with category one being underweight and category five being overweight. The number of calories in the food bought for lunch by each subject was calculated and recorded. Males bought food containing more calories than females but for males the amount of calories did not differ by perceived weight category. Females purchased food with fewer calories than males but the heavier females bought food with higher caloric content.

Social perception of caloric value

Studies on obesity and overweight measure the actual caloric amount in the foods selected or consumed. However, the food choices of individuals partly depend, if weight is a concern, on their social perception of caloric values of various foods. The study concerned the accuracy of 53 males and 82 females of various weight categories in their perception of the caloric content of various types of food. The more females weigh the more calories they perceive in food while the more males weigh the less calories they perceive in food. Both males and females overestimate the caloric content of desserts, particularly in comparison to main dishes like meat and potatoes.