Cardiovascular disease is the leading cause of deathamong patients with chronic kidney disease （CKD）.Vascular calcification （VC） is one of the independentrisk factors associated with cardiovascular disease andcard...Cardiovascular disease is the leading cause of deathamong patients with chronic kidney disease （CKD）.Vascular calcification （VC） is one of the independentrisk factors associated with cardiovascular disease andcardiovascular mortality in both the general populationand CKD patients. Earlier evidence revealed substan-tially higher prevalence of VC in young adults on chron-ic hemodialysis compared to the general population inthe same age range, indicating the infuence of CKD-related risk factors on the development of VC. Patho-genesis of VC involves an active, highly organized cel-lular transformation of vascular smooth muscle cells tobone forming cells evidenced by the presence of bonematrix proteins in the calcifed arterial wall. VC occursin both the intima and the media of arterial wall withmedial calcification being more prevalent in CKD. Inaddition to traditional cardiovascular risks, risk factorsspecific to CKD such as phosphate retention, excessof calcium, history of dialysis, active vitamin D therapy in high doses and deficiency of calcification inhibitors play important roles in promoting the development of VC. Non-contrast multi-slice computed tomography has often been used to detect coronary artery calcif-cation. Simple plain radiographs of the lateral lumbar spine and pelvis can also detect VC in the abdominal aorta and femoral and iliac arteries. Currently, there is no specifc therapy to reverse VC. Reduction of calcium load, lowering phosphate retention using non-calcium containing phosphate binders, and moderate doses of active vitamin D may attenuate progression. Parenteral sodium thiosulfate has also been shown to delay VC progression.展开更多
Vitamin D is known to be a key regulator of bone metabolism and is associated with muscle strength.Vitamin D deficiency is widely prevalent worldwide.In adults,vitamin D deficiency has been implicated in numerous heal...Vitamin D is known to be a key regulator of bone metabolism and is associated with muscle strength.Vitamin D deficiency is widely prevalent worldwide.In adults,vitamin D deficiency has been implicated in numerous health conditions including osteoporosis,cancer,diabetes,and autoimmune diseases.Considerable changes have occurred in lifestyles and childhood activities in the past years.Studies have shown that the children population is at high risks of vitamin D deficiency.The objective of this study was to learn about the extent of vitamin D deficiency in children worldwide and especially in sunny country like Israel.In this article we reviewed the extent and severity of vitamin D deficiency worldwide and especially in Israel,through a very comprehensive review of previous reports and research studies done during the last years.We found reports on vitamin D deficiency in children,which was associated with metabolic syndromes and obesity.It was more prevalent in children who spend less time on outdoor activities,in obese children,and in cases when there was imbalance between nutritional intakes and requirements.Vitamin D deficiency is common even in children living in sunny places like Israel.Health professionals should be aware of the fact that although vitamin D deficiency is prevalent in the elderly population,it is also common in children,and can be associated with different illnesses.We encourage supplementation of vitamin D to special populations(pregnant and lactating women,infants,and high risk groups).We also encourage implementation of international food fortification programs.展开更多
Excessive ethanol consumption affects virtually any organ,both by indirect and direct mechanisms.Considerable research in the last two decades has widened the knowledge about the paramount importance of proinflammator...Excessive ethanol consumption affects virtually any organ,both by indirect and direct mechanisms.Considerable research in the last two decades has widened the knowledge about the paramount importance of proinflammatory cytokines and oxidative damage in the pathogenesis of many of the systemic manifestations of alcoholism.These cytokines derive primarily from activated Kupffer cells exposed to Gram-negative intestinal bacteria,which reach the liver in supra-physiological amounts due to ethanol-mediated increased gut permeability.Reactive oxygen species(ROS)that enhance the inflammatory response are generated both by activation of Kupffer cells and by the direct metabolic effects of ethanol.The effects of this increased cytokine secretion and ROS generation lie far beyond liver damage.In addition to the classic consequences of endotoxemia associated with liver cirrhosis that weredescribed several decades ago,important research in the last ten years has shown that cytokines may also induce damage in remote organs such as brain,bone,muscle,heart,lung,gonads,peripheral nerve,and pancreas.These effects are even seen in alcoholics without significant liver disease.Therefore,alcoholism can be viewed as an inflammatory condition,a concept which opens the possibility of using new therapeutic weapons to treat some of the complications of this devastating and frequent disease.In this review we examine some of the most outstanding consequences of the altered cytokine regulation that occurs in alcoholics in organs other than the liver.展开更多
Electrical stimulation(ES)is predominantly used as a physical therapy modality to promote tissue healing and functional recovery.Research efforts in both laboratory and clinical settings have shown the beneficial effe...Electrical stimulation(ES)is predominantly used as a physical therapy modality to promote tissue healing and functional recovery.Research efforts in both laboratory and clinical settings have shown the beneficial effects of this technique for the repair and regeneration of damaged tissues,which include muscle,bone,skin,nerve,tendons,and ligaments.The collective findings of these studies suggest ES enhances cell proliferation,extracellular matrix(ECM)production,secretion of several cytokines,and vasculature development leading to better tissue regeneration in multiple tissues.However,there is still a gap in the clinical relevance for ES to better repair tissue interfaces,as ES applied clinically is ineffective on deeper tissue.The use of a conducting material can transmit the stimulation applied from skin electrodes to the desired tissue and lead to an increased function on the repair of that tissue.Ionically conductive(IC)polymeric scaffolds in conjunction with ES may provide solutions to utilize this approach effectively.Injectable IC formulations and their scaffolds may provide solutions for applying ES into difficult to reach tissue types to enable tissue repair and regeneration.A better understanding of ES-mediated cell differentiation and associated molecular mechanisms including the immune response will allow standardization of procedures applicable for the next generation of regenerative medicine.ES,along with the use of IC scaffolds is more than sufficient for use as a treatment option for single tissue healing and may fulfill a role in interfacing multiple tissue types during the repair process.展开更多
文摘Cardiovascular disease is the leading cause of deathamong patients with chronic kidney disease （CKD）.Vascular calcification （VC） is one of the independentrisk factors associated with cardiovascular disease andcardiovascular mortality in both the general populationand CKD patients. Earlier evidence revealed substan-tially higher prevalence of VC in young adults on chron-ic hemodialysis compared to the general population inthe same age range, indicating the infuence of CKD-related risk factors on the development of VC. Patho-genesis of VC involves an active, highly organized cel-lular transformation of vascular smooth muscle cells tobone forming cells evidenced by the presence of bonematrix proteins in the calcifed arterial wall. VC occursin both the intima and the media of arterial wall withmedial calcification being more prevalent in CKD. Inaddition to traditional cardiovascular risks, risk factorsspecific to CKD such as phosphate retention, excessof calcium, history of dialysis, active vitamin D therapy in high doses and deficiency of calcification inhibitors play important roles in promoting the development of VC. Non-contrast multi-slice computed tomography has often been used to detect coronary artery calcif-cation. Simple plain radiographs of the lateral lumbar spine and pelvis can also detect VC in the abdominal aorta and femoral and iliac arteries. Currently, there is no specifc therapy to reverse VC. Reduction of calcium load, lowering phosphate retention using non-calcium containing phosphate binders, and moderate doses of active vitamin D may attenuate progression. Parenteral sodium thiosulfate has also been shown to delay VC progression.
文摘Vitamin D is known to be a key regulator of bone metabolism and is associated with muscle strength.Vitamin D deficiency is widely prevalent worldwide.In adults,vitamin D deficiency has been implicated in numerous health conditions including osteoporosis,cancer,diabetes,and autoimmune diseases.Considerable changes have occurred in lifestyles and childhood activities in the past years.Studies have shown that the children population is at high risks of vitamin D deficiency.The objective of this study was to learn about the extent of vitamin D deficiency in children worldwide and especially in sunny country like Israel.In this article we reviewed the extent and severity of vitamin D deficiency worldwide and especially in Israel,through a very comprehensive review of previous reports and research studies done during the last years.We found reports on vitamin D deficiency in children,which was associated with metabolic syndromes and obesity.It was more prevalent in children who spend less time on outdoor activities,in obese children,and in cases when there was imbalance between nutritional intakes and requirements.Vitamin D deficiency is common even in children living in sunny places like Israel.Health professionals should be aware of the fact that although vitamin D deficiency is prevalent in the elderly population,it is also common in children,and can be associated with different illnesses.We encourage supplementation of vitamin D to special populations(pregnant and lactating women,infants,and high risk groups).We also encourage implementation of international food fortification programs.
文摘Excessive ethanol consumption affects virtually any organ,both by indirect and direct mechanisms.Considerable research in the last two decades has widened the knowledge about the paramount importance of proinflammatory cytokines and oxidative damage in the pathogenesis of many of the systemic manifestations of alcoholism.These cytokines derive primarily from activated Kupffer cells exposed to Gram-negative intestinal bacteria,which reach the liver in supra-physiological amounts due to ethanol-mediated increased gut permeability.Reactive oxygen species(ROS)that enhance the inflammatory response are generated both by activation of Kupffer cells and by the direct metabolic effects of ethanol.The effects of this increased cytokine secretion and ROS generation lie far beyond liver damage.In addition to the classic consequences of endotoxemia associated with liver cirrhosis that weredescribed several decades ago,important research in the last ten years has shown that cytokines may also induce damage in remote organs such as brain,bone,muscle,heart,lung,gonads,peripheral nerve,and pancreas.These effects are even seen in alcoholics without significant liver disease.Therefore,alcoholism can be viewed as an inflammatory condition,a concept which opens the possibility of using new therapeutic weapons to treat some of the complications of this devastating and frequent disease.In this review we examine some of the most outstanding consequences of the altered cytokine regulation that occurs in alcoholics in organs other than the liver.
基金support from the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health(R01EB020640)the Connecticut Regenerative Medicine Research Fund(15-RMBUCHC-08)。
文摘Electrical stimulation(ES)is predominantly used as a physical therapy modality to promote tissue healing and functional recovery.Research efforts in both laboratory and clinical settings have shown the beneficial effects of this technique for the repair and regeneration of damaged tissues,which include muscle,bone,skin,nerve,tendons,and ligaments.The collective findings of these studies suggest ES enhances cell proliferation,extracellular matrix(ECM)production,secretion of several cytokines,and vasculature development leading to better tissue regeneration in multiple tissues.However,there is still a gap in the clinical relevance for ES to better repair tissue interfaces,as ES applied clinically is ineffective on deeper tissue.The use of a conducting material can transmit the stimulation applied from skin electrodes to the desired tissue and lead to an increased function on the repair of that tissue.Ionically conductive(IC)polymeric scaffolds in conjunction with ES may provide solutions to utilize this approach effectively.Injectable IC formulations and their scaffolds may provide solutions for applying ES into difficult to reach tissue types to enable tissue repair and regeneration.A better understanding of ES-mediated cell differentiation and associated molecular mechanisms including the immune response will allow standardization of procedures applicable for the next generation of regenerative medicine.ES,along with the use of IC scaffolds is more than sufficient for use as a treatment option for single tissue healing and may fulfill a role in interfacing multiple tissue types during the repair process.
