Mast Cells in Human Stenotic Aortic Valves Are Associated with the Severity of Stenosis

Aortic valve stenosis (AS) is characterized by extensive calcification of the aortic valve leaflets and infiltration of inflammatory cells. Activated mast cells (MCs) may participate in the induction of fibrosis and calcification with ensuing valve stiffening. We sought to investigate whether the number of MCs within stenotic aortic valves is associated with the severity of AS. We studied 43 patients (19 men, 24 women) with dominant AS (age, 64.2?±?5.9 years; mean transvalvular pressure gradient, 62.11?±?24.47 mmHg) without atherosclerotic vascular disease, undergoing elective aortic valve replacement. MCs were detected in the excised valves by immunostaining. Aortic valves from five healthy subjects obtained on autopsy served as negative controls. The number of tryptase- and chymase-positive MCs was increased in AS valves compared with the control valves (6.9 [2.3–18.9]/mm² vs. 0.7 [0–2.2]/mm², P?=?0.0001 and 3.2 [2.1–9.4]/mm² vs. 0.3 [0–1.9]/mm², P?=?0.002, respectively). MCs that colocalized with macrophages and neovessels were detected mainly in the calcified regions of the leaflets. The number of MCs positively correlated with maximal (r?=?0.73, P?<?0.0001) and mean (r?=?0.78, P?<?0.0001) gradients and maximal aortic jet velocity (r?=?0.68, P?=?0.0005). An inverse correlation with aortic valve area (r?=??0.71, P?=?0.0001) was also observed. Multivariate regression analysis revealed that MC number and valve thickness were significantly associated with mean transvalvular gradient (R ²?=?0.74, P?<?0.000001) in AS patients. Increased MC number within human stenotic aortic valves is associated with the severity of AS.     

Validation of photoplethysmography as a method to detect heart rate during rest and exercise

Abstract

Despite their enhanced marketplace visibility, validity of wearable photoplethysmographic heart rate monitoring is scarce. Forty-seven healthy participants performed seven, 6-min exercise bouts and completed a valid skin type scale. Participants wore an Omron HR500U (OHR) and a Mio Alpha (MA), two commercial wearable photoplethysmographic heart rate monitors. Data were compared to a Polar RS800CX (PRS). Means and error were calculated between devices using minutes 2–5. Compared to PRS, MA data was significantly different in walking, biking (2.41?±?3.99?bpm and 3.26?±?11.38?bpm, p?<?0.05) and weight lifting (23.30?±?31.94?bpm, p?<?0.01). OHR differed from PRS in walking (4.95?±?7.53?bpm, p?<?0.05) and weight lifting (4.67?±?8.95?bpm, p?<?0.05). MA during elliptical, stair climbing and biking conditions demonstrated a strong correlation between jogging speed and error (r?=?0.55, p?<?0.0001), and showed differences in participants with less photosensitive skin.     

Blood lead levels,pulmonary function and agility in Polish schoolchildren

Background: Reduced vital capacity (VC) and forced vital capacity (FVC) are associated with lead (Pb) exposure.

Aim: The objective of this study is to analyse the effects of Pb on FVC and the shuttle run performance.

Subjects and methods: Data were available for 184 male and 189 female Polish schoolchildren aged 10–15?years. Regression analysis was performed of shuttle run performance (dependent) on Pb and FVC.

Results: Shuttle run time increased by 1.75 (±?0.77) and 1.97 (±?0.77) seconds for each 10?µg/dL increase in Pb blood among males and females, respectively. Higher shuttle run times indicate poorer performance. Average unadjusted blood Pb level in the sample was 5.27?μg/dL (±?0.19 SE) and 3.82?μg/dL (±?0.10 SE), respectively. Path analysis was used to assess the association of Pb level with shuttle run time. Blood Pb had a significant negative effect on VC (B=??13.60?±?3.28 [SE], p?B?=??13.08?±?3.27, p?B?=??0.04?±?0.007, p?B?=?1.59?±?0.75, p?B?=?1.49?±?0.73, p?Conclusions: Thus, Pb had direct and indirect effects that increased shuttle run time, i.e. negatively affected performance.     

Association of FTO and IRX3 genetic variants to obesity risk in north India

Abstract

Objective: Validation of body adiposity index (BAI) in a paediatrics sample; and to develop, if necessary, a valid BAI for paediatrics (i.e. BAI_p).

Methods: A total of 1615 children (52% boys) aged 5–12 years underwent anthropometry. Their body composition was assessed using a foot-to-foot bioimpedance. The validity of BAI?=?(Hip circumference/Height^1.5)???18 was tested by combining correlation and agreement statistics. Then, the sample was split into two sub-samples for the construction of BAI_p. A regression was used to compute the prediction equation for BAI_p-based percentage of body fat (%BF).

Results: The initial BAI over-estimated the %BF of children by 49% (29.6?±?4.2% versus 19.8?±?6.8%; p?<?0.0001). The original methodology led to a BAI_p?=?(Hip circumference/Height^0.8) ? 38 in children. When compared to BAI, BAI_p showed both better correlation (r?=?0.57; p?<?0.01 versus r?=?0.74; p?<?0.0001) and agreement (ICC?=?0.34; [95% CI?=??0.19–0.65] versus ICC?=?0.83; [95% CI?=?0.81–0.84]). However, there were some systematic biases between the two values of %BF as exemplified by the large 95% limit of agreement [?9.1%; 8.8%] obtained.

Conclusion: BAI over-estimates the %BF in children. In contrast, BAI_p appears as a new index for children’s body fatness, with acceptable accuracy. In its current form, this index is valid only for large-scale studies.     

Gender differences in the relationship between serum zinc concentration and metabolic syndrome

Background: Zinc, a co-factor of antioxidant enzymes, may be involved in the pathophysiology of metabolic syndrome (MetS).

Aim: To determine the association between serum zinc concentration and MetS in a population-based study.

Subjects and methods: In the Tehran Lipid and Glucose Study, serum zinc concentration was measured by flame atomic absorption spectrometry in 2626 adult participants. After removal of outliers, usable data was available for 2401 participants. Dietary zinc was assessed by a validated semi-quantitative food frequency questionnaire.

Results: Compared to those without the MetS, serum zinc concentration was significantly higher in men with syndrome (17.1?±?4.9 vs 16.5?±?4.6?μmol/L, p?=?0.035); however, values were comparable in females (16.1?±?4.8 vs 15.8?±?4.4, p?=?0.460). Men in tertile 3 of serum zinc had significantly higher chances of having MetS, even after multivariate adjustment (OR?=?1.48, 95% confidence interval (CI)?=?1.07–2.06, p?=?0.020). Women in tertile 2 of serum zinc had significantly lower chances of having MetS, which remained significant after multivariate adjustment (OR?=?0.68, 95% CI?=?0.47–0.99, p?=?0.046).

Conclusion: This study observed a gender difference between serum zinc and MetS, with higher levels being positively associated with MetS in men and having a protective effect in women. Further studies are needed to elucidate the role of zinc status in the development of MetS.     

Quality of documentation on antibiotic therapy in medical records: evaluation of combined interventions in a teaching hospital by repeated point prevalence survey

This study aimed to improve the quality of documentation on antibiotic therapy in the computerized medical records of inpatients. A prospective, uncontrolled, interrupted time series (ITS) study was conducted by repeated point prevalence survey (PPS) to audit the quality of documentation on antibiotic therapy in the medical records before and after a combined intervention strategy (implementation of guidelines, distribution of educational materials, educational outreach visits, group educational interactive sessions) from the antimicrobial stewardship team (AST) in the academic teaching hospital (CHU) of Liège, Belgium. The primary outcome measure was the documentation rate on three quality indicators in the computerized medical records: (1) indication for treatment, (2) antibiotics prescribed, and (3) duration or review date. Segmented regression analysis was used to analyze the ITS. The medical records of 2306 patients receiving antibiotics for an infection (1177 in the pre-intervention period and 1129 in the post-intervention period) were analyzed. A significant increase in mean percentages in the post-intervention period was observed as compared with the pre-intervention period for the three quality indicators (indication documented 83.4?±?10.4 % vs. 90.3?±?6.6 %, p?=?0.0013; antibiotics documented 87.9?±?9.0 % vs. 95.6?±?5.1 %, p?<?0.0001; and duration or review date documented 31.9?±?15.4 % vs. 67.7?±?15.2 %, p?<?0.0001). The study demonstrated the successful implementation of a combined intervention strategy from the AST. This strategy was associated with significant changes in the documentation rate in the computerized medical records for the three quality indicators.     

The Composite Severity Score for Lumbar Spine MRI: a Metric of Cumulative Degenerative Disease Predicts Time Spent on Interpretation and Reporting

Conventional measures of radiologist efficiency, such as the relative value unit, fail to account for variations in the complexity and difficulty of a given study. For lumbar spine MRI (LMRI), an ideal performance metric should account for the global severity of lumbar degenerative disease (LSDD) which may influence reporting time (RT), thereby affecting clinical productivity. This study aims to derive a global LSDD metric and estimate its effect on RT. A 10-year archive of LMRI reports comprising 13,388 exams was reviewed. Objective reporting timestamps were used to calculate RT. A natural language processing (NLP) tool was used to extract radiologist-assigned stenosis severity using a 6-point scale (0?=?“normal” to 5?=?“severe”) at each lumbar level. The composite severity score (CSS) was calculated as the sum of each of 18 stenosis grades. The predictive values of CSS, sex, age, radiologist identity, and referring service on RT were examined with multiple regression models. The NLP tool accurately classified LSDD in 94.8% of cases in a validation set. The CSS increased with patient age and differed between men and women. In a univariable model, CSS was a significant predictor of mean RT (R²?=?0.38, p?<?0.001) and independent predictor of mean RT (p?<?0.001) controlling for patient sex, patient age, service location, and interpreting radiologist. The predictive strength of CSS was stronger for the low CSS range (CSS?=?0–25, R²?=?0.83, p?<?0.001) compared to higher CSS values (CSS?>?25, R²?=?0.15, p?=?0.05). Individual radiologist study volume was negatively correlated with mean RT (Pearson’s R?=????0.35, p?<?0.001). The composite severity score predicts radiologist reporting efficiency in LMRI, providing a quantitative measure of case complexity which may be useful for workflow planning and performance evaluation.

     

Maternal early second trimester pregnancy weight in relation to birth outcome among Bengalee Hindus of Kolkata,India

Objective: The study examined to what degree maternal early second trimester pregnancy weight is useful and efficient in predicting birth outcome of Bengalee women.

Subjects and methods: The cross-sectional retrospective study was conducted in a government general hospital in South Kolkata, India. This hospital serves the needs of people belonging to lower and lower middle class socio-economic groups. Data were collected by one-to-one interview for confirmation of age, history of last menstrual period (LMP) including medical disorders. Mother's weight was recorded at 14–18 weeks of pregnancy from the history of LMP. Birth weight was measured within 24?h of delivery and gestational age was assessed by Ballard's method using newborn physical and neurological maturity scoring. Of the 331 Bengalees, 295 mother–baby pairs met the recruitment criteria and were included in this study.

Result: Mean?±?SD maternal early second trimester pregnancy weight and birth weight were 45.9?±?7.0?kg and 2612?±?371?g, respectively. The difference in mean weight (3.74?kg) between mothers who delivered low birth weight (LBW) and normal birth weight (NBW) babies was statistically significant (t?=?4.497, p?<?0.001). Overall, the prevalence of LBW was nearly 34%. A higher incidence of LBW and lower mean birth weight was observed in first quartile or low weight (≤40?kg) mothers. The rate of LBW decreased (χ²?=?14.47, p?<?0.01) and mean birth weight increased significantly with increasing maternal weight (F?=?9.218, p?<?0.001). Risk ratio (RR) for LBW, intrauterine growth retardation (IUGR) and preterm birth in low weight (first quartile or <40.0?kg) mothers were 2.72 (95% confidence interval (CI): 1.45–5.10), 3.54 (95% CI: 1.17–10.74) and 1.97 (95% CI: 0.56–6.90), respectively, compared with heavier (>50.0?kg) mothers. Finally, the present data showed that the maternal weight of <46.0?kg is the best cut-off for detecting LBW with 66% sensitivity and 75% negative predictive power.

Conclusion: The findings suggest a positive association between maternal early second trimester pregnancy weight and birth outcome. The present study provided an efficient cut-off point for detecting LBW. Antenatal caregivers in health institutions and community health workers in the field can use this cut-off value for screening pregnant women at early second trimester.     

Does the antiviral therapy of patients with chronic hepatitis exert nephrotoxic effects?

Introduction: HBV and HCV chronic hepatitis can be accompanied by secondary renal disease. In addition, these patients receive antiviral drugs with potential nephrotoxicity. It is known that interferon (IFN) therapy in HCV-infected kidney transplant recipients is followed by rejection of the transplant in 50% of the cases. Ribavirin is contraindicated in hemodialyzed patients and in patients with a GFR <50?ml/min/1.73 m². IFN therapy requires dosage reduction and close monitoring in patients with a GFR <50?ml/min/1.73 m² and in patients with end stage renal disease. The aim of our study was to assess the nephrotoxicity of antiviral drugs in patients with chronic hepatitis by measuring three renal biomarkers: urinary albumin, N-acetyl-β-d-glucosaminidase (NAG) and α 1-microglobulin, as well as glomerular filtration rate (GFR-MDRD4) before and at 6 months of therapy.

Methods: Fifty-five patients (28 male and 27 female, with a mean age of 47.85?±?12.03 years) with chronic hepatitis (40 patients with HCV, 13 patients with HBV, 1 patient with HBV+HCV, and 1 patient with HBV+HDV) were enrolled into the study. Different antiviral drug associations were used on a case-by-case basis. The 40 patients with HCV chronic hepatitis received either Peg-IFN-α 2a+Ribavirin (37 patients) or Peg-IFN-α 2b+Ribavirin (3 patients). The 13 patients with HBV chronic hepatitis received Peg-IFN-α 2a (9 patients), Lamivudine (2 patients), Entecavir (1 patient), or Adefovir (1 patient). The patient with HBV+HCV chronic hepatitis received Peg-IFN-α 2a+Ribavirin. The patient with HBV+HDV chronic hepatitis received IFN-α 2a. Urinary albumin (ELISA), NAG (colorimetrical method), α 1-microglobulin (ELISA), and serum creatinine were measured before and at 6 months of antiviral therapy. Urinary markers were expressed as either mg/gCr (for albumin and α 1-microglobulin) or U/gCr (for NAG). Statistical analysis (Pearson’s correlation coefficient, paired t-test and χ²-test) was performed.

Results: At 6 months of therapy urinary albumin/gCr did not increase significantly: 16.58?±?23.39 vs. 15.85?±?24.96?mg/gCr before therapy, p?=?0.87. Urinary NAG/gCr did not increase significantly: 4.21?±?3.37 vs. 3.83?±?3.2?U/gCr before therapy, p?=?0.53. Urinary α 1-microglobulin/gCr was almost unchanged: 4.38?±?4.47 vs. 4.38?±?3.57?mg/gCr before therapy, p?=?0.99. The GFR did not decline significantly: 92.41?±?22.21 vs. 94.59?±?36.1?ml/min/1.73 m² before therapy, p?=?0.7. Ten patients (18.18%) were albuminuric before therapy, and 14 patients (25.45%) were albuminuric at 6 months of therapy, a non-significant increase (p?=?0.35). We found a correlation between urinary albumin/gCr and NAG/gCr and between urinary albumin/gCr and α 1-microglobulin/gCr both at baseline and at 6 months of therapy: r?=?0.54, p?=?0.0005; r?=?0.29, p?=?0.03; r?=?0.51, p?=?0.0005; and r?=?0.4, p?=?0.002, respectively. In the patient receiving Adefovir, a known nephrotoxic drug, two of the three biomarkers (urinary albumin/gCr and NAG/gCr) increased, most notably NAG/gCr. Both HCV and HBV chronic hepatitis therapy were associated with non-significant changes in renal biomarker excretion and GFR.

Conclusions: With the exception of Adefovir, all of the drug associations used in this study were safe.     

Identification of Inflamed Atherosclerotic Lesions In Vivo Using PET-CT

Inflammation plays a major pathogenetic role in the development of atherosclerotic plaques and related thromboembolic events. The identification of vulnerable plaques is of the utmost importance, as this may allow the implementation of more effective preventive and therapeutic interventions. Fluorodeoxyglucose positron emission tomography (FDG-PET) has been shown to be useful for tracing inflammation within plaques. However, its relationship to immunohistochemical findings in different territories of the peripheral circulation was not completely elucidated. We aimed to determine whether plaque inflammation could be measured by PET in combination with computer tomography (CT) using FDG and what is the relationship between FDG uptake and immunohistochemical findings in the removed atherosclerotic lesions of the femoral and carotid arteries. The study included 31 patients, 21 patients with high-grade stenosis of the internal carotid artery (ICA) and 10 patients with occlusion of the common femoral artery (CFA), all of whom underwent endarterectomy. Before endarterectomy in all patients, FDG-PET/CT imaging was performed. FDG uptake was measured as the maximum blood—normalized standardized uptake value, known as the target to background ratio (TBR max). TBR max amounted to 1.72?±?0.8, and in patients with ICA, stenosis was not significantly different from patients with CFA occlusion. Immunohistochemical and morphometric analyses of the plaques obtained at endarterectomy showed that the density of T lymphocytes and macrophages (number of cells per square millimeter) was significantly higher in subjects with stenosis of the ICA than in subjects with occlusion of the femoral arteries: lymphocytes, 1.26?±?0.21 vs. 0.77?±?0.29; p?=?0.02 and macrophages, 1.01?±?0.18 vs. 0.69?±?0.23; p?=?0.003. In the whole group of patients, the density of inflammatory cells significantly correlated with FDG uptake represented by PET-TBR max: T lymphocytes, r?=?0.60; p?<?0.01 and macrophages, r?=?0.65; p?<?0.01. The results of our study show that FDG uptake is related to the accumulation of inflammatory cells in atherosclerotic lesions. This finding suggests that FDG uptake reflects the severity of atherosclerotic vessel wall inflammation, and in stenotic lesions, it could be an indicator of their vulnerability. However, data from large outcome studies is needed to estimate the usefulness of this technique in identifying the most dangerous atherosclerotic lesions and vulnerable patients.     

Human herpes virus co-infection is associated with mortality in HIV-negative patients with Pneumocystis jirovecii pneumonia

The purpose of this investigation was to characterize the management and prognosis of severe Pneumocystis jirovecii pneumonia (PJP) in human immunodeficiency virus (HIV)-negative patients. An observational cohort study of HIV-negative adults with PJP documented by bronchoalveolar lavage (BAL) through Gomori–Grocott staining or immunofluorescence, admitted to one intensive care unit (ICU) for acute respiratory failure, was undertaken. From 1990 to 2010, 70 patients (24 females, 46 males) were included, with a mean age of 58.6?±?18.3 years. The mean Simplified Acute Physiology Score (SAPS)-II was 36.9?±?20.4. Underlying conditions included hematologic malignancies (n?=?21), vasculitis (n?=?13), and solid tumors (n?=?13). Most patients were receiving systemic corticosteroids (n?=?63) and cytotoxic drugs (n?=?51). Not a single patient received trimethoprim–sulfamethoxazole as PJP prophylaxis. Endotracheal intubation (ETI) was required in 42 patients (60.0 %), including 38 with acute respiratory distress syndrome (ARDS). In-ICU mortality was 52.9 % overall, reaching 80.9 % and 86.8 %, respectively, for patients who required ETI and for patients with ARDS. In the univariate analysis, in-ICU mortality was associated with SAPS-II (p?=?0.0131), ARDS (p?<?0.0001), shock (p?<?0.0001), and herpes simplex virus (HSV) or cytomegalovirus (CMV) on BAL (p?=?0.0031). In the multivariate analysis, only ARDS was associated with in-ICU mortality (odds ratio [OR] 23.4 [4.5–121.9], p?<?0.0001). PJP in non-HIV patients remains a serious disease with high in-hospital mortality. Pulmonary co-infection with HSV or CMV may contribute to fatal outcome.     

The absence of physiological neonatal weight loss on the 1st–5th day is associated with decreased later physical indices

Abstract

Aim: To investigate associations between physiological neonatal weight loss on the 1st–5th day and physical indices from birth up to the age of 17 years.

Methods: Data were derived from the personal health records of healthy, full-term and breastfed children born in Vilnius in 1990 and 1996. Five hundred and thirty children (289 boys and 241 girls) who left a maternity unit on the 1st–5th day after birth were included in the analysis.

Results: Infants left the maternity unit on day 4.62?±?2.33. On the day of leaving a maternity unit, infants lost 105.06?±?130.48 g (2.85?±?3.65%) of birth weight. Girls who did not lose or gained weight after birth had already weighed less at birth (3163?±?547 and 3490?±?403 g, respectively, p?<?0.01) and remained lighter up to the age of 17 years (54.3?±?8.7 and 60.8?±?10.1?kg at the age of 17 years respectively, p?<?0.001). Girls who did not lose or gained weight after birth were also shorter than those who lost weight (164.3?±?5.7 and 168.6?±?5.4?cm at the age of 17 years, respectively, p?<?0.001).

Conclusion: Girls who did not lose or gained weight immediately after birth tended to remain shorter and lighter during childhood and adolescence. Only a few statistically significant differences were obtained in boys.     

Associations between interleukin-23R and interleukin-12B polymorphisms and psoriasis susceptibility: a meta-analysis

Objective: The aim of this study was to determine whether interleukin (IL)-23?R and IL-12B polymorphisms confer susceptibility to psoriasis.

Methods: The authors conducted a meta-analysis on associations between the IL-23?R and IL-12B polymorphisms and psoriasis susceptibility.

Results: A total of 14 comparison studies were included in this meta-analysis. The meta-analysis identified a significant association between psoriasis and 2 alleles of the rs11209026 and rs7530511 polymorphisms in Europeans (odds ratio [OR]?=?0.624, 95% confidence interval [CI]?=?0.565–0.697, p?<?1.0?×?10^?8; OR?=?0.804, 95% CI?=?0.743–0.869, p?=?3.0?×?10^?7, respectively). Meta-analysis of IL-12B showed a significant association between the 2 alleles of the rs6887695 and rs3212227 polymorphisms and the risk of developing psoriasis (OR?=?0.710, 95% CI?=?0.673–0.749, p?<?1.0?×?10^?8; OR?=?0.684, 95% CI?=?0.639–0.731, p?<?1.0?×?10^?8, respectively). Stratification by ethnicity identified an association between the rs6887695 and rs3212227 polymorphisms and psoriasis in Europeans.

Conclusions: This meta-analysis showed that the IL-23?R (rs11209026 and rs7530511) polymorphisms are associated with psoriasis risk in Europeans and that the IL-12B (rs6887695 and rs3212227) polymorphisms are associated with susceptibility to psoriasis in Europeans.     

Serum Growth Arrest-Specific Protein 6 Levels are a Reliable Biomarker of Disease Activity in Systemic Lupus Erythematosus

Purpose

Growth arrest-specific protein 6 (Gas6) has been suggested to be a biomarker of disease activity in patients with systemic lupus erthematosus (SLE). We investigated the clinical significance of this protein in Korean SLE.

Methods

Blood samples were collected from 150 SLE patients and 50 normal controls (NC). In addition, follow-up samples were collected from 50 SLE patients.

Results

Serum Gas6 levels of SLE patients (43.01?±?28.02 ng/mL) were higher than those of NC (20.15?±?9.23 ng/mL, p?<?0.001). When evaluated sensitivity and specificity of the Gas6 for diagnosing SLE using ROC curves, the sensitivity and specificity were 72.7 % and 84 % with a cut-off value of 25.3 ng/mL. In the ROC analysis of Gas6, anti-dsDNA antibody, ESR, complement 3 and complement 4 to identify patients with active lupus, area under the curve (AUC) of Gas6 was highest with 0.763. Serum Gas6 levels were significantly higher in the patients with serositis (70.04?±?30.85 ng/mL) and renal disorder (65.66 ±32.28 ng/mL) compared to those without (41.88?±?27.44 ng/mL, p?=?0.033, 40.3?±?26.33 ng/mL, p?=?0.001, respectively). Gas6 levels were correlated positively with anti-dsDNA antibody (r?=?0.199, p?=?0.015), ESR (r?=?0.204, p?=?0.013) and SLEDAI (r?=?0.512, p?<?0.001). In addition, serum Gas6 levels were correlated negatively with hemoglobin (r?=??0.165, p?=?0.043), lymphocyte count (r?=??0.165, p?=?0.043), complement 3 (r?=??0.343, p?<?0.001) and complement 4 (r?=??0.316, p?<?0.001). Furthermore, change in serum Gas6 levels was correlated with change in SLEDAI levels in the SLE patients that were followed up (r?=?0.524, p?<?0.001).

Conclusion

These results suggest that serum Gas6 can be a reliable clinical marker for monitoring disease activity and treatment response in SLE.     

Decreased proportions of CD4 + IL17+/CD4 + CD25 + CD127− and CD4 + IL17+/CD4 + CD25 + CD127 − FoxP3+ T cells in children with autoimmune thyroid diseases*

Until now, altered balance of Th1 and Th2 immune cells has been postulated to play an important role in the pathogenesis of autoimmune thyroid diseases (AITD). However, recent studies on thyroid diseases have suggested a new role for Th17 cells that have been classified as a new lineage, distinct from Th1, Th2 and Treg cells. Despite wide interest, the role of Th17 cells in the pathogenesis of inflammatory and autoimmune diseases is still debated. The aim of the study was to estimate the proportions of Th17/Treg T cells in peripheral blood from patients with Graves’ disease (GD; n?=?29, mean age 15.4?±?5.1 years), Hashimoto’s thyroiditis (HT; n?=?39, mean age 15.2?±?4.1 years) and in healthy controls (n?=?49, mean age 14.8?±?3 years). Polychromatic flow cytometry and several fluorochrome-conjugated monoclonal antibodies were applied to delineate Th17 and Treg cells. The analysis of Th17/Treg T cell proportions in peripheral blood from patients with Graves’ disease revealed significantly lower ratios of CD4?+?IL17+/CD4?+?CD25?+?CD127???(p?p?p?p?R?=?0.71, p?R?=?0.72, p?R?=?0.66, p?相似文献   

Muscle fiber conduction velocity is more affected after eccentric than concentric exercise

It has been shown that mean muscle fiber conduction velocity (CV) can be acutely impaired after eccentric exercise. However, it is not known whether this applies to other exercise modes. Therefore, the purpose of this experiment was to compare the effects of eccentric and concentric exercises on CV, and amplitude and frequency content of surface electromyography (sEMG) signals up to 24?h post-exercise. Multichannel sEMG signals were recorded from biceps brachii muscle of the exercised arm during isometric maximal voluntary contraction (MVC) and electrically evoked contractions induced by motor-point stimulation before, immediately after and 2?h after maximal eccentric (ECC group, N?=?12) and concentric (CON group, N?=?12) elbow flexor exercises. Isometric MVC decreased in CON by 21.7?±?12.0% (±SD, p?<?0.01) and by 30.0?±?17.7% (p?<?0.001) in ECC immediately post-exercise when compared to baseline. At 2?h post-exercise, ECC showed a reduction in isometric MVC by 24.7?±?13.7% (p?<?0.01) when compared to baseline, while no significant reduction (by 8.0?±?17.0%, ns) was observed in CON. Similarly, reduction in CV was observed only in ECC both during the isometric MVC (from baseline of 4.16?±?0.3 to 3.43?±?0.4?m/s, p?<?0.001) and the electrically evoked contractions (from baseline of 4.33?±?0.4 to 3.82?±?0.3?m/s, p?<?0.001). In conclusion, eccentric exercise can induce a greater and more prolonged reduction in muscle force production capability and CV than concentric exercise.     

White Blood Cell Subtypes after STEMI: Temporal Evolution, Association with Cardiovascular Magnetic Resonance��Derived Infarct Size and Impact on Outcome

The evolution of white blood cells after ST elevation myocardial infarction (STEMI) and their association with infarct size and major adverse cardiac events (MACE) remains unclear. Two hundred eleven patients underwent CMR after STEMI. Infarct mass (grams) was determined. Neutrophil, lymphocyte, and monocyte counts (×1,000 cells/ml) were measured upon arrival and at 12, 24, 48, 72, and 96 h. Patients with large infarctions (3rd tertile????28.5 g vs. 1st and 2nd tertiles?<?28.5 g) showed a larger neutrophil count at 12 h (14.8?±?4.8 vs. 11.4?±?3.3, p?<?0.0001) and an increased monocyte count (maximum at 24 h (0.65[0.50?C0.91] vs. 0.55[0.42?C0.71], p?=?0.004)) but no difference in lymphocyte count. Neutrophil count at 12 h independently predicted large infarctions (OR 1.14, 95%CI [1.04?C1.26], p?=?0.008). During follow-up (median 504 days), 25 MACE occurred. Neutrophil count at 96 h independently predicted MACE (HR 1.2, 95%CI [1.1?C1.4], p?=?0.003). Large infarctions show a marked neutrophil peak and an increasing monocyte count. Neutrophil count independently predicts large infarctions and MACE.     

Comparison between body mass index and a body shape index with adiponectin/leptin ratio and markers of glucose metabolism among adolescents

Background: Besides body mass index (BMI), new parameters have been developed to classify individual body shape.

Aim: To investigate the relationship between BMI, waist circumference (WC), a body shape index (ABSI) and ABSI-adolescents among adolescents and verify which would better predict lower adiponectin/leptin (A/L) ratio and disturbances on glucose metabolism.

Subjects and methods: A cross-sectional study with 197 Brazilian adolescents of 14–18?years. Serum leptin, adiponectin, glucose and insulin were measured. A/L ratio, ABSI, ABSI-adolescents, BMI, homeostasis model assessment estimates of insulin resistance (HOMA-IR) and β-cell function (HOMA-β) and the quantitative insulin sensitivity check index (QUICKI) were calculated.

Results: ABSI-adolescents positively correlated with WC (r?=?0.83, p?r?=?0.66, p?r?=?0.95, p?p?r?=??0.63, p?p?r?=??0.75; HOMA-IR: r?=?0.76; HOMA-β: r?=?0.77; insulin: r?=?0.79). Associations were confirmed by linear regression analysis, adjusted for sex and age.

Conclusions: ABSI-adolescents, but not ABSI, was related to A/L ratio and to markers of glucose metabolism, but not more strongly than BMI and WC.     

TNF-alpha Production by Peripheral Blood Monocytes in Multiple Sclerosis Patients and Healthy Controls

Background: Aberrant immune responses are evident in the pathogenesis of multiple sclerosis (MS) and it has been proposed that the spectrum of cytokines influence disease outcomes. Leptin and lipopolysaccharide (LPS) of Gram-negative bacteria are both potent cellular stimulators for production of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α). The aim of this study was to compare the TNF-α production by peripheral blood monocytes from MS patients with healthy controls.

Methods: Peripheral blood samples were stimulated with LPS or leptin. After blocking the Golgi apparatus, intracellular cytokine production was assessed using a monoclonal antibody against human TNF-α by the flow cytometry technique. Moreover, plasma level measurement of cytokines was performed using enzyme-linked immunosorbent assay (ELISA).

Results: Intracellular levels of TNF-α were 16.80?±?8.21 and 16.52?±?8.23in MS patients and healthy controls which showed no statistically significant difference between them (p?=?0.850). Leptin-stimulated and LPS-stimulated TNF-α production showed no significant difference between MS patients and the control group (p?=?0.263 and p?=?0.191, respectively). However, after treatment with leptin, a weak significant difference was shown between cases and control group (p?=?0.049). There were significant differences between cases and controls regarding serum levels of IL-6 and Toll-like receptor-4 (TLR-4) before and after stimulation with leptin and LPS, separately (p?<?0.05).

Conclusion: Taken together, we cannot definitely conclude that TNF-α does not play an important role in pathogenesis of MS. However, other characteristics of monocyte activation such as IL-6 or TLRs can elucidate implication of peripheral blood monocytes in MS pathogenesis.