Journal of Translational Internal Medicine

Open Access Published by De Gruyter Open Access

Volume 6 Issue 2

June 2018

Issue of Journal of Translational Internal Medicine

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Contents
Journal Overview

Editorials

Open Access June 26, 2018

Detecting CALR mutations in splanchnic vein thrombosis: Who and how?

Stephen E. Langabeer

Page range: 55-57

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Open Access June 26, 2018

Shear stress regulation of endothelium: A double-edged sword

Liang Bai, John Y-J. Shyy

Page range: 58-61

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Highlight

Open Access June 26, 2018

What a clinician should know about a renal replacement membrane?

Patrick M. Honore, Herbert D. Spapen

Page range: 62-65

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Perspective

Open Access June 26, 2018

Hypoxia-inducible factor may induce the development of liver fibrosis in Budd–Chiari syndrome by regulating CD248/endosialin expression: A hypothesis

Ye Tian, Han Deng, Lei Han, Sijun Hu, Xingshun Qi

Page range: 66-69

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Abstract

Budd-Chiari syndrome (BCS) leads to the development of liver fibrosis in most of the cases. However, the mechanism of BCS-related liver fibrosis is unclear, and it may be largely different from that induced by chronic viral hepatitis. Hepatic stellate cell (HSC) and its specific marker CD248/endosialin are known to play an important regulatory role in the development of liver fibrosis. Additionally, hypoxia microenvironment and hypoxia-inducible factor (HIF) are involved in the regulation of CD248/endosialin. Therefore, we hypothesize that hypoxia microenvironment which develops due to BCS can regulate the expression of CD248/endosialin in HSC via HIF signaling pathway, which then affects the function of HSC and development of liver fibrosis. To confirm the hypothesis, two major investigations are necessary: (1) in the BCS animal model and clinical studies, the relationship between the severity of liver fibrosis and the expression of HIF and CD248/endosialin in HSC will be explored; and (2) in the in vitro cell system, the effect of hypoxic microenvironment, HIF-1α or HIF-2α, on the expression of CD248/endosialin in HSC will be explored. It will be important to elucidate whether HIF signaling pathway regulates the expression of CD248/endosialin, thereby inducing the development of BCS-related liver fibrosis.

Review Articles

Open Access June 26, 2018

Adenosquamous carcinoma of the esophagus: A literature review

Dimitrios Schizas, Panagiotis Kapsampelis, Konstantinos S. Mylonas

Page range: 70-73

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Abstract

Adenosquamous carcinoma (ASC) of the esophagus is an uncommon type of esophageal cancer that contains both adenocarcinoma and squamous cell carcinoma elements. Data on this biologically unique type of cancer are limited and mainly stem from case reports and small case series. We performed an audit of the available literature and synthesized a review on the epidemiology, pathogenesis, histopathology, clinical manifestations, diagnosis, treatment and prognosis of ASCs. Adenosquamous carcinoma of the esophagus is a rare type of esophageal cancer. Histological examination is necessary to confirm the diagnosis of ASC and patients usually receive multimodal treatment. Patient outcomes are not well defined and further research could help us better understand the pathophysiology and unique needs of patients with this rare malignancy.

Open Access June 26, 2018

Acute respiratory distress syndrome: An update and review

Gautam Rawal, Sankalp Yadav, Raj Kumar

Page range: 74-77

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Abstract

Acute respiratory distress syndrome (ARDS) is a life threatening condition characterized by severe hypoxemia due to pulmonary gas exchange failure and was first recognized in 1960s.Since its first description, it has undergone intensive research in the past few decades to understand its pathogenesis and therapies. Despite this, the recommended therapies to decrease mortality in ARDS remain limited and include low-tidal volume mechanical ventilation, prone ventilation and recently, the ECMO rescue therapy in extreme cases. This review article will summarize the key features of ARDS with a brief overview of the therapeutic options in the management of ARDS.

Original Articles

Open Access June 26, 2018

Dyspepsia amongst end stage renal disease undergoing hemodialysis: Views from a large tertiary care center

Muhammad Ali Khalid, Jawaid Iqbal, Hassan Liaquat Memon, Farina M. Hanif, Muhammad Osama Tariq Butt, Nasir Hassan Luck, Zain Majid

Page range: 78-81

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Abstract

Background and Objectives Gastrointestinal symptoms are common in patients with end stage renal disease (ESRD) among which dyspepsia is frequently observed. The aim of the study was to determine the frequency and associations of dyspepsia in ESRD patients using the Leeds questionnaire. Methods All ESRD patients on maintenance hemodialysis were consecutively enrolled in the study. Leeds questionnaire was used to interrogate the patients for the assessment of dyspepsia. Mean and standard deviation were calculated for age, body mass index (BMI), disease duration and number of hemodialysis sessions. Independent t-test and Chi square tests were used for statistical analysis. Results Total number of patients was 200, out which 118 (59.3%) were male. The mean age was of 41.4 years. According to the Leeds questionnaire, dyspepsia was present in 62 (63.9%) patients. Younger patients (age 20–40 years) more frequently had dyspeptic symptoms (61.5% patients), retrosternal pain (156 patients, 78.0%), regurgitation (127 patients, 63.5%), dysphagia (67 patients, 33.5%), and nausea (142 patients, 71.0%). Patients presented with intermittent pattern of symptoms in 179 (89.5%) cases, while continuous symptoms in 6 (3.0%). Dyspepsia was associated with aspartate aminotransferase (AST) levels > 25 U/L ( P = 0.001), alanine aminotransferase (ALT) levels > 28U/L ( P = 0.000) and gamma glutamyl transferase (GGT) levels > 34 U/L ( P = 0.002). On multivariate analysis, urea, creatinine, and presenting symptoms of dysphagia and belching showed significant statistical association with dyspepsia. Conclusion Dyspepsia is a common problem affecting patients with end stage renal disease and is associated with raised serum AST, ALT and GGT in such patients.

Open Access June 26, 2018

Hepatitis C screening in commercially insured U.S. birth-cohort patients: Factors associated with testing and effect of an EMR-based screening alert

Amoah Yeboah-Korang, Mohammad I. Beig, Mohammad Q. Khan, Jay L. Goldstein, Don M. Macapinlac, Darryck Maurer, Amnon Sonnenberg, Claus J. Fimmel

Page range: 82-89

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Abstract

Background and Objectives Hepatitis C virus (HCV) testing rates among U.S. birth-cohort patients have been studied extensively, limited data exists to differentiate birth-cohort screening from risk- or liver disease-based testing. This study aims to identify factors associated with HCV antibody (HCV-Ab) testing in a group of insured birth cohort patients, to determine true birth cohort testing rates, and to determine whether an electronic medical record (EMR)-driven Best Practice Alert (BPA) would improve birth cohort testing rates. Methods All birth-cohort outpatients between 2010 and 2015 were identified. HCV-Ab test results, clinical, and demographic variables were extracted from the EMR, and factors associated with testing were analyzed by logistic regression. True birth-cohort HCV screening rates were determined by detailed chart review for all outpatient visits during one calendar month. An automated Best Practice Alert was used to identify unscreened patients at the point of care, and to prompt HCV testing. Screening rates before and after system-wide implementation of the BPA were compared. Results The historic HCV-Ab testing rate was 11.2% (11,976/106,753). Younger age, female gender, and African American, Asian, or Hispanic ethnicity, and medical comorbidities such as chronic hemodialysis, HIV infection, and rheumatologic and psychiatric comorbidities were associated with higher testing rates. However, during the one-month sampling period, true age cohort-based testing was performed in only 69/10,089 patients (0.68%). Following the system-wide implementation of the HCV BPA, testing rates increased from 0.68% to 10.76% ( P <0.0001). Conclusions We documented low HCV-Ab testing rates in our baby boomers population. HCV testing was typically performed in the presence of known risk factors or established liver disease. The implementation of an EMR-based HCV BPA resulted in a marked increase in testing rates. Our study highlights current HCV screening gaps, and the utility of the EMR to improve screening rates and population health.

Letter to the Editor

Open Access June 26, 2018

Does hepatic impairment influence renal function parameters in liver cirrhosis?

Tingxue Song, Zhe Jia, Xiaozhong Guo, Haitao Zhao, Wenchun Bao, Dan Han, Xinmiao Zhou, Xingshun Qi

Page range: 90-92

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About this journal

Print ISSN 2450-131X
Online ISSN 2224-4018

Journal of Translational Internal Medicine (JTIM), launched in Dec 2013, is an open access journal publishing articles in all areas of translational internal medicine. The journal focuses on information derived from human disease-related experimentations so as to optimize the communication between basic scientific research and clinical science. It has a cycling nature, namely from basic research to clinical practice and then from clinical practice back to basic research.

Aims and Scope

Journal of Translational Internal Medicine (JTIM) is devoted to promoting science and practice in translational medicine and internal medicine in the world. To this end, JTIM publishes articles from all areas of internal medicine. The journal publishes original articles, rapid communications, editorials, reviews, highlights, perspective and other information closed relevant to translational medicine, internal medicine and related fields. Other types of articles include advanced experience, ideological highlights, and Q&A from scholars and scientists in related fields. JTIM will also launch Special Issues in rapid response to the newest development directions of scientific research fields.

JTIM has the ambition to and will become the EXCELLENT international platform for the publication of outstanding studies from all over the world. JTIM is designed to report research progress and the most recent findings in Translational Internal Medicine field, accelerating successful transformation from basic research results to clinically practical theories，diagnosis and treatment techniques, methodologies and drug discovery. With the aims of health care delivery and policy making, JTIM will help to best balance benefits, qualities and costs of medications. At JTIM, we have a challenging mission: to improve the quality of human life and enable people live longer by facilitating disease prevention, treatment and eventually the CURE.

Journal of Translational Internal Medicine is academically supported by:

International Society of Translational Sciences,
Infectious Diseases Society of China,
Chinese Hypertension Committee of Chinese Medical Doctors Association,
China Alliance of COPD, China RTI Optimal Treatment Committee,
Drug Clinical Assessment Committee of Chinese Pharmaceutical Association.