Malondialdehyde-Modified LDL IgG Antibody Levels and Indices of Cardiac Function in Valvular Heart and Coronary Artery Disease Patients

Objective

To compare the changes in anti-malondialdehyde-modified low-density lipoprotein (MDA-LDL) IgG levels among patients undergoing off-pump and on-pump coronary artery bypass grafting (CABG) or valvuloplasty.

Subjects and Methods

A total of 38, 39 and 34 patients who underwent off-pump CABG, on-pump CABG and valvuloplasty, respectively, were enrolled in this study. Serum anti-MDA-LDL IgG values were measured 24 h before and after the operative procedures and at discharge. Echocardiography was also done before surgery and before discharge. The results were compared with values from 50 healthy controls.

Results

In all patients, a reduction in antibody titers was observed post-operatively. However, the decrease was significant only in the off-pump CABG–before surgery: 42.33 (25.83–58.51), after surgery: 30.86 (16.36–51.33) and at discharge: 10.96 (6.82–23.57; p = 0.027). There was a significant positive association between anti-MDA-LDL IgG levels and ejection fraction (r = 0.248, p = 0.036) and a negative association with E/E'', a marker of pulmonary capillary wedge pressure, in the coronary patients (r = −0.345, p = 0.012), but no significant associations were found in patients with valvular heart disease.

Conclusions

Serum anti-MDA-LDL IgG levels were associated with cardiac function indices in coronary patients undergoing CABG.Key Words: Anti-malondialdehyde-modified low-density lipoprotein, Valvular heart disease, Coronary artery bypass grafting, Cardiac function     

The influence of low molecular weight heparin on the expression of osteogenic growth factors in human fracture healing

Purpose  

Anticoagulant therapy with low molecular weight heparins (LMWH) and mechanical compression is considered the gold standard for the prevention of thrombosis. However, evidence exists that LMWHs impair bone metabolism. The aim of this study was therefore to analyse alterations in the expression of M-CSF, VEGF and TGF-?1 after treatment with enoxaparin in patients with long bone fracture to investigate the effect of LMWH on human fracture healing.     

Primary outcomes of the congenital vertical talus correction using the Dobbs method of serial casting and limited surgery

Introduction

The traditional treatment for congenital vertical talus, which involves serial casting and extensive soft-tissue releases, has been associated with severe stiffness and other complications in adolescents and adults. Our hypothesis is that favorable results will be obtained using the Dobbs method of serial manipulation, casting, and limited surgery for vertical talus correction, even in older children and syndromic cases. Therefore, the present study aimed at evaluating the Dobbs method in such cases.

Materials and methods

We treated 15 feet of 10 patients (aged from 1 month to 9 years) using manipulation and serial casting or the reverse Ponseti method followed by percutaneous Achilles tenotomy and limited open reduction of the talonavicular joint. All patients were evaluated both clinically and radiologically in a mean follow-up period of 2 years.

Results

After 2 years, all patients had plantigrade and flexible feet with good radiographic correction. The mean talocalcaneal angle before (70.5° ± 10.5) and after (31° ± 5.2) treatment and the talar axis metatarsal base angle before (60° ± 11.4) and after (15° ± 6.7) treatment were significantly improved (P < 0.001).

Discussion

Recent research has shown that manipulation and serial casting followed by limited surgery (Dobbs method) was successful in treating idiopathic congenital vertical talus. Our results also showed that this method resulted in an excellent outcome in both idiopathic and syndromic congenital vertical talus, even in older children.     

miRNA96 expression level within red blood cells is probably associated with RSL indicators during the storage of red blood cell units

Background and objectivesMany biochemical and hematological changes occur during the storage of RBC units. Collectively, these changes are known as RSLs. Previous studies found miRNA96 as non-coding RNA that its expression level changed during RBC storage. However, its correlation with mechanical and biochemical RSL indicators is not yet determined. Therefore, this study aimed to assess possible correlations between miRNA96a and some RSLs indicators to clarify its biomarker capability for evaluating the storage quality of RBC units.Materials and methodsSamples were collected from ten leuko-reduced RBC units on days 0, 14, 28, and 42 of storage. miRNA96 gene expression level and RSLs indicators including hemolysis, mechanical fragility index (MFI), total antioxidant capacity (TAC), lipid peroxidation (TBARs), thiol groups, and RBC indices were measured on the days mentioned above.ResultsSignificant correlations were found between the changes in miRNA96 expression level and the levels of hemolysis, TAC, TBARs, and MFI indices (p values < 0.05). The donors were classified into the high risk group and low risk group, according to four important characteristics and lifestyle habits (smoking, physical activity, age, and BMI). The high risk group had a significantly lower rate of hemolysis, free hemoglobin, MFI, TAC, and a higher rate of lipid peroxidation compared to low risk group (p values < 0.05).ConclusionThe finding suggested that upregulation of miRNA96 could prevent hemolysis of RBCs, despite the accumulation of oxidative injuries in them. The miRNA96 expression level was probably a potential predictor for mechanical and biochemical RSL indicators.     

The effect of a semi-rigid thoracolumbosacral orthosis (TLSO) on foot pressure in elderly subjects presenting with spinal hyperkyphosis

Abstract

Purpose: The ageing process can be accompanied by a degeneration of the spine and increase the risk of thoracic hyperkyphosis (excessive spinal forward curvature) amongst elderly people. This condition can in turn impair mobility, reduce balance, and increase the risk of falling and mortality in affected individuals. The use of corrective orthotic bracing has been shown to improve spinal posture, and increase stability and balance amongst the elderly. However, there is little evidence that evaluates the use of corrective braces on foot pressure changes in these subjects.

Methods: In this study, we evaluated the use of a thoracolumbosacral orthosis (TLSO) on 19 subjects over 60?years old who presented with hyperkyphosis. We measured foot pressure using the Pedar-X system before (without brace) and after (with brace) immediate using a TLSO in both static (quite standing) and dynamic (walking on a 5 meters freeway) scenarios.

Results: The results demonstrated that using a TLSO immediately decreases forefoot pressures in stasis, and around the first metatarsal, as well as pressures relating to the second to fifth metatarsals under dynamic conditions. Hindfoot pressures were increased, but not significantly.

Conclusion: This study showed that using a TLSO can be beneficial for elderly people with hyperkyphosis.

• Implications for rehabilitation

• The ageing process can be accompanied by a degeneration of the spine and increase the risk of thoracic hyperkyphosis.

• The use of corrective orthotic bracing has been shown to improve spinal posture, and increase stability and balance amongst the elderly.

• Using a TLSO decreases forefoot pressures in stasis, and around the first metatarsal, as well as pressures relating to the second to fifth metatarsals under dynamic conditions.

     

KIR3DL1+HLA-B Bw4Ile80 and KIR2DS1+HLA-C2 combinations are both associated with ankylosing spondylitis in the Iranian population

Contribution of killer cell immunoglobulin-like receptors (KIR) and their human leucocyte antigen (HLA) class I ligands in the pathogenesis of autoimmune diseases has been shown in several studies. In this study, the possible association of KIR genes, their known HLA ligands and compound KIR/HLA genotypes with ankylosing spondylitis (AS) was assessed. Combined KIR/HLA ligand genotyping was performed by a polymerase chain reaction-sequence-specific primers assay in 35 Iranian patients with AS, and genotypes were compared to those in 200 healthy individuals. The frequencies of telomeric cluster genes KIR2DL5A, KIR2DS1 and KIR3DS1 were significantly increased in AS patient group (P(c) = 0.0082, P(c) = 0.0195 and P(c) = 0.0328, respectively). Conversely, HLA-Bw4 ligand (the presence of one or more -B Bw4(Ile80) , -B Bw4(Thr80) and -A Bw4 epitopes) (P(c) = 0.0004) and HLA-B Bw4(Ile80) (P(c) = 0.053) were less frequent in these patients. Meanwhile, compound KIR/HLA genotype analyses revealed lower frequency of KIR3DL1+HLA-B Bw4(Ile80) (P(c) = 0.0343) and higher frequency of KIR2DS1+HLA-C2 (P(c) = 0.0308) combinations in patients with AS than in controls. In addition, the genotypes iKIR+HLA > aKIR+HLA (P(c) = .0308) and iKIR+HLA > aKIR (P(c) = 0.0258) were statistically less common, and genotypes iKIR+HLA = aKIR+HLA (P(c) = 0.0081) and iKIR+HLA < aKIR (P(c) = 0.077) were more common in patient group. Our findings suggest a role for excessive or inappropriate NK cell activation through 'KIR/HLA' system in AS disease.     

Molecular Epidemiology of Different Hepatitis C Genotypes in Serum and Peripheral Blood Mononuclear Cells in Jahrom City of Iran

Background:

The Hepatitis C Virus (HCV) is considered essentially hepatotropic, yet the virus compartments have also been found in important extra hepatic sites. Detection of HCV RNA in extra hepatic reservoirs such as peripheral blood mononuclear cells (PBMCs) is important for determining disease progression and treatment effectiveness.

Objectives:

The present study aimed to determine different HCV genotypes in patients'' plasma and PBMC specimens, in Jahrom city of Iran.

Patients and Methods:

Blood samples of 137 patients with established HCV were collected at the Honari clinic. These patients were anti-HCV and plasma HCV RNA positive. After plasma RNA extraction and obtaining a pellet of approximately 3-5 × 10⁶ PBMCs, Real-time PCR was performed, using specific-genotype primers. Finally, data analysis was done by the Statistical Package for Social Sciences (SPSS) software.

Results:

Subtype 3 was the most common genotype in plasma (57.7%) and PBMCs (51.1%). Subtype 1a was detected in 36.5% and 30.7% of plasma samples and PBMCs, respectively whereas subtype 4 was not detected in any of the cases. There was a genotype difference between plasma and PBMCs of 12.4% of patients. In four patients no genotype was detected in their plasma but genotype 3 was detected in the PBMCs.

Conclusions:

It is suggested that determination of the target genotype by plasma subtyping for choosing the proper antiviral therapy is essential but may result in therapy failure. HCV genotyping in PBMC samples, along with plasma specimens, might be more beneficial. Therefore determining the HCV genotype in PBMCs, before beginning the therapy is useful due to the possibility of occult infection detection.