The University of New Mexico Hospital (locally known as either University Hospital, UNM Hospital, or shortened to UNMH) is a public teaching hospital located in Albuquerque, New Mexico, immediately north of the main campus of the University of New Mexico. The hospital is the only Level I trauma center in the state of New Mexico, and also houses the only certified burn unit and designated stroke center in the state. In addition, UNMH also contains the only children's hospital in New Mexico, and is the state's sole source of 13 pediatric sub-specialties. As a safety net hospital, UNMH serves a large percentage of the uninsured and under-insured population of the state. The hospital is the main teaching facility for the University of New Mexico School of Medicine.
Mutations in the RNA-binding protein roquin-1 are known to result in humoral autoimmunity. Heissmeyer and colleagues show that MALT1 cleavage of roquin and regnase-1 downstream of TCR signaling releases cooperatively repressed targets to promote T H 17 cell differentiation
Chronic prurigo (CPG) is a chronic neuroinflammatory skin disease characterized by persistent itch, repeated scratching, and the presence of multiple skin lesions. CPG is a highly burdensome disease that significantly impairs patients’ quality of life. The objective of these consensus recommendations is to summarize available evidence and provide standardized guidance for the diagnosis and management of patients with CPG. These recommendations were developed using a Delphi methodology, conducted over two rounds of online voting by the participation of 23 Portuguese dermatologists. The strength of consensus was defined as strong consensus (≥ 95
Abstract Background Reduced intensity and diversity of microbial stimulation and decreased intake of anti-inflammatory ω-3 polyunsaturated fatty acids (PUFAs) in Western diets may contribute to impaired postnatal immune development and increased allergy risk. Here, we hypothesize that early supplementation with probiotics and ω-3 PUFAs, starting during pregnancy and continuing during infancy, may promote appropriate immune maturation and thereby potentially prevent allergy development. Methods In this study, 117 mother‒baby pairs were randomized into four groups receiving the following supplements: Limosilactobacillus reuteri (L. reuteri), ω-3 PUFA, double supplementation, or placebo. Supplementation started from gestational week 20 until 3 months of age (3 mo) for ω-3 PUFA and continued until 12 mo for L. reuteri. Peripheral blood mononuclear cells (PBMCs) from infants were isolated at birth and at 6, 12, and 24 mo, and stimulated ex vivo with several allergens and ligands of Toll-like receptors (TLRs). Cytokines and chemokines related to Th1/Th2/Th17/Treg responses were quantified. Results Probiotic supplementation modulated the pattern of cytokine and chemokine secretion over time, whereas no clear effects were observed for ω-3 PUFA supplementation. L. reuteri supplementation led to a significant increase in Th1-associated C-X-C motif chemokine ligand 10 (CXCL10) levels induced by birch and cat allergens at 6 mo. Furthermore, L. reuteri induced more significant age-dependent changes under several types of stimulation than did the placebo, indicating enhanced immune maturation. Conclusion Pre- and postnatal probiotic supplementation may promote immune maturation during early childhood.
AIM:To evaluate whether a 3-month home-based neuromuscular electrical stimulation (NMES) program improved maximal walking distance (MWD) in patients with lower-extremity peripheral artery disease (PAD) compared with usual care. METHODS:This multicenter randomized clinical trial included 73 adults with PAD and walking impairment from five French university hospitals between September 2019 and July 2022, with final follow-up in November 2022. Participants were randomized to a NMES group (n = 34) or a usual care group (n = 39) for 3 months. Both groups received standard medical management and lifestyle advice; the NMES group performed calf NMES sessions at home for 2-3 hours/day, 5 days/week. The primary outcome was the 3-month change in treadmill MWD. Secondary outcomes included change in 6-minute total walking distance. RESULTS:Of the 73 randomized participants (mean [SD] age, 62.8 [9.2] years; 14 [19.2%] women), 64 (88%) completed the 3-month follow-up. Mean treadmill MWD increased from 148.5 m at baseline to 254.1 m at 3 months in the NMES group and from 142.5 m to 175.8 m in the usual care group (between-group difference, 69.9 m [95% CI, 10.8-129.0 m]; P = .02). The 6-minute total walking distance improved from 371.0 m to 405.4 m with NMES and from 342.5 m to 348.8 m with usual care (between-group difference, 29.6 m [95% CI, 5.1-54.1 m]; P = .02). CONCLUSIONS:In patients with PAD and walking impairment, a 3-month home-based calf NMES program significantly improved walking capacity. Further studies are needed to assess long-term effects. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT03795103.
Heart failure (HF) with preserved ejection fraction (HFpEF) is increasingly suspected in older adults. However, diagnosis remains challenging due to nonspecific symptoms, age-related structural cardiac changes, and confounding comorbidities. Reliability of algorithms developed in younger populations may be limited in this population. This prospective study enrolled inpatients aged > 75 years with at least one ESC-listed typical sign/symptom suggestive of HF and no prior HF diagnosis were evaluated for HFpEF using ESC 2021 criteria. Structural/functional transthoracic echocardiographic (TTE) abnormalities and age-adjusted NT-proBNP thresholds were recorded. Diagnostic accuracy of the H2FPEF and HFA-PEFF scores was evaluated. We also tested a modified HFA-PEFF score incorporating age-adjusted thresholds for NT-proBNP and for septal/lateral e’ velocity. Among 200 inpatients (median age 86.6 years, 58.0
