Acute kidney injury in patients with myocardial infarction and efficacy of thrombolytic therapy

Aim of the study was to assess rate and severity of acute kidney injury (AKJ) (RIFLE and AKIN criteria) in patients with ST-elevation myocardial infarction (STEMI), to determine relationship between AKJ, mortality and effectiveness of thrombolytic therapy (TLT). We examined 146 patients (117 men, 29 women, mean age 56.7+/-10.8 ) with STEMI subjected to TLT with streptokinase. AKJ was diagnosed and classified according to RIFLE and AKIN criteria by creatinine (RIFLECr, AKINCr) and diuresis (RIFLEou, AKINou). TLT was effective in 104(71%) patients. AKJ was found in 74 (51%) according to RIFLECr and in 86 (59%) - AKINCr, in 51 (35%) - RIFLEou and AKINou criteria. Eight patients 8 (5%) died. Results of logistic regression analysis showed that AKJ according to RIFLEou or AKINou irrespective of sex, age, and time after appearance of symptoms to hospitalization, was associated with mortality (relative risk [RR] 12.9, 95% confidence interval [95%CI] 1.45-115,58, p=0.002). Thus more than 50% of STEMI patients have AKJ according to RIFLECr AKINCr criteria. Frequency of AKJ according to RIFLEou and AKINou was by 40% and one third less than that according to AKINCr and RIFLECr, respectively. Presence of AKJ was associated with TLT inefficacy and elevation of mortality.     

The role of direct-acting P2Y12 inhibitors in acute coronary syndrome

P2Y12 receptor inhibitors are recommended for treatment of patients with acute coronary syndrome and/or percutaneous coronary intervention as a part of dual antiplatelet therapy. While thienopyridine group of P2Y12 inhibitors remains to be widely used treatment for patients with ACS, there are still complications for its application. Emerging antiplatelet treatments expand therapy strategies for management of ACS. The purpose of this article is to define the developing role of novel non-thienopyridine reversible P2Y12 inhibitor ticagrelor to present its pharmacokinetic, pharmacodynamic, and pharmacogenetic characteristics, based on current evidence.     

Association of 2B-adrenergic receptor gene polymorphism with disturbances of cardiac conduction

In this work we for the first time revealed on clinical - genetic material association between hereditary disturbances of cardiac conduction and polymorphism of 2-adrenergic receptor gene.     

MRI findings in people with epilepsy and nodding syndrome in an area endemic for onchocerciasis: an observational study

Background

Onchocerciasis has been implicated in the pathogenesis of epilepsy. The debate on a potential causal relationship between Onchocerca volvulus and epilepsy has taken a new direction in the light of the most recent epidemic of nodding syndrome.

Objective

To document MRI changes in people with different types of epilepsy and investigate whether there is an association with O. volvulus infection.

Methods

In a prospective study in southern Tanzania, an area endemic for O. volvulus with a high prevalence of epilepsy and nodding syndrome, we performed MRI on 32 people with epilepsy, 12 of which suffered from nodding syndrome. Polymerase chain reaction (PCR) of O. volvulus was performed in skin and CSF.

Results

The most frequent abnormalities seen on MRI was atrophy (twelve patients (37.5%)) followed by intraparenchymal pathologies such as changes in the hippocampus (nine patients (28.1%)), gliotic lesions (six patients (18.8%)) and subcortical signal abnormalities (three patients (9.4%)). There was an overall trend towards an association of intraparenchymal cerebral pathologies and infection with O. volvulus based on skin PCR (Fisher''s Exact Test p=0.067) which was most pronounced in children and adolescents with nodding syndrome compared to those with other types of epilepsy (Fisher''s Exact Test, p=0.083). Contrary to skin PCR results, PCR of CSF was negative in all patients.

Conclusion

The observed trend towards an association of intraparenchymal cerebral pathological results on MRI and a positive skin PCR for O. volvulus despite negative PCR of CSF is intriguing and deserves further attention.     

Smoking effect on oral fluid oxidative balance

Smoking effect on oral fluid protein metabolism and oxidative balance were studied in medical school students (15 smokers and 15 none-smokers as a control group, mean age 19,8±1,4 years). Smoking caused intensification of lipoperoxidation and decrease in antioxidation activity thus proving it to be the reason of harmful metabolic shift in oral fluid.     

Professor V.F. Voĭno-Iasenetskiĭ (Holy Hierarch Lucus): his life and role in Russian dental school development

The paper describes life and works of professor V.F. Voyno-Yaseneckiy (Holy Hierarch Lucas). Surgeon and Archibishop, he was officially glorified by the Patriarchate of Russia. Voyno-Yaseneckiy's early works represent the guidelines for regional anesthesia and his, Notes on Purulent Surgery, published in 1934 lad the foundation for an entire medical specialty.     

Primary Immunodeficiency Diseases in Latin America: The Second Report of the LAGID Registry

This is the second report on the continuing efforts of LAGID to increase the recognition and registration of patients with primary immunodeficiency diseases in 12 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Honduras, Mexico, Panama, Paraguay, Peru, Uruguay, and Venezuela. This report reveals that from a total of 3321 patients registered, the most common form of primary immunodeficiency disease was predominantly antibody deficiency (53.2%) with IgA deficiency reported as the most frequent phenotype. This category was followed by 22.6% other well-defined ID syndromes, 9.5% combined T- and B-cell inmunodeficiency, 8.6% phagocytic disorders, 3.3% diseases of immune dysregulation, and 2.8% complement deficiencies. All countries that participated in the first publication in 1998 reported an increase in registered primary immunodeficiency cases, ranging between 10 and 80%. A comparison of the estimated minimal incidence of X-linked agammaglobulinemia, chronic granulomatous disease, and severe combined immunodeficiency between the first report and the present one shows an increase in the reporting of these diseases in all countries. In this report, the estimated minimal incidence of chronic granulomatous disease was between 0.72 and 1.26 cases per 100,000 births in Argentina, Chile, Costa Rica, and Uruguay and the incidence of severe combined immunodeficiency was 1.28 and 3.79 per 100,000 births in Chile and Costa Rica, respectively. However, these diseases are underreported in other participating countries. In addition to a better diagnosis of primary immunodeficiency diseases, more work on improving the registration of patients by each participating country and by countries that have not yet joined LAGID is still needed. Latin American Group for Primary Immunodeficiency Diseases