Serum phosphate and cognitive function in older men

Objective

Determine whether serum phosphate is associated with concurrent cognitive impairment and subsequent cognitive decline in older men independent of demographic covariates and atherosclerotic risk factors.

Methods

In a prospective study of 5529 men enrolled in the Osteoporotic Fractures in Men study, we measured baseline serum phosphate, baseline cognitive function, and change in cognitive function between baseline and follow‐up exams an average of 4.6 years later using the Modified Mini‐Mental State (3MS) Examination and Trails B.

Results

There was no association between serum phosphate and odds of cognitive impairment as assessed by baseline 3MS score or risk of cognitive decline as assessed by longitudinal change in 3MS score. Higher baseline serum phosphate was associated with higher odds of poor executive function as assessed by Trails B with fully adjusted odds ratios 1.12 (95% confidence interval: 0.83–1.52), 1.31 (0.97–1.77), and 1.45 (1.08–1.94) for men in the second, third, and fourth versus the bottom quartile (referent group) of serum phosphate (p‐trend 0.007). However, higher phosphate level was not associated with risk of decline in executive function as assessed by longitudinal change in Trails B score with fully adjusted odds ratios 0.94 (95% confidence interval 0.69–1.28), 0.96 (0.70–1.32), and 1.21 (0.89–1.66) for men in the second, third, and fourth versus the bottom quartile (referent group) of serum phosphate (p‐trend 0.22).

Conclusions

Higher serum phosphate in older men was associated with a higher likelihood of poor executive function, but not with impaired global cognitive function or decline in executive or global cognition. Copyright © 2017 John Wiley & Sons, Ltd.     

Novel use of cutting balloon to treat subintimal hematomas during chronic total occlusion interventions

Contemporary chronic total occlusion (CTO) percutaneous coronary interventional (PCI) techniques are increasingly dependent upon dissection and reentry techniques (DARTs) especially for long occluded lesions. DARTs can result in compressive hematomas during CTO interventions and traditional treatment with balloon angioplasty and/or coronary stenting are often suboptimal and may extend the hematoma distally. We describe the novel use of a cutting balloon to “express” these compressive hematomas and restore antegrade coronary blood flow.     

Physiological and hygienic assessment of work process and working conditions in processing sugar beets on mechanized MSK-15 production lines

The MSK-15 mechanized line for white-beet processing corresponds to the 2nd class (permissible conditions) with regard to the work-load of female beet-sorters, and to the 3rd class of labour intensity (1st degree of unhealthy conditions of work). By the end of the working shift the women-sorters were displaying functional overstrain of CNS and CVS, neuro-muscular overstrain of the upper extremities. Measures for working conditions improvement should include an ergonomic perfection of the working sites, improvement of the regimen of work and rest, means of individual technical safety.     

Development and evaluation of a shipping system for platelet components

BACKGROUND: Platelet concentrates and apheresis platelets must be maintained at a temperature as close as possible to 20 to 24 degrees C during transport. To improve temperature control, ensure component quality, and meet handling and freight carrier needs, a new insulated shipping container system was developed and evaluated. STUDY DESIGN AND METHODS: Molded polyurethane-insulated shipping containers were loaded with different payloads of simulated platelet components, with or without gel-based temperature stabilizing packs (TSPs). The containers were subjected to constant ambient temperature of 37, 4 or -10 degrees C. Payload temperatures were continuously monitored, in situ, for 24 hours. RESULTS: Temperature data are reported as the mean number of hours needed for components to warm or cool by 1 degree C. The temperature of payloads exposed to a constant 37 degrees C ambient temperature increased by 1 degree C in 2.5 to 3.8 hours when no TSPs were included in the shipment and in 6.1 to 6.9 hours when TSPs were used. Exposure to a constant 4 degrees C ambient temperature resulted in a 1 degree C temperature decrease in 1.8 to 3.4 hours without TSPs and in 4.6 to 5.6 hours with TSPs. At a -10 degrees C ambient temperature, there was a 1 degree C drop within 1.0 to 1.6 hours without TSPs and within 2.7 to 2.9 hours with TSPs. CONCLUSION: The container and packing methods described moderate the rate of change in the temperature of platelet components during their exposure to challenging ambient conditions. The use of TSPs substantially improves the performance of the system. In addition, the system meets freight carrier requirements and is easy to use, environmentally friendly, and durable.     

Synthesis and beta-adrenergic antagonist activity of novel (3-cyanodihydropyridyl)propanolamines.

The synthesis and beta-adrenergic antagonist activities of 1-(1-dihydropyridyl)-3-alkylamino-2-propanols (9-16) in which the aryloxy group of aryloxypropanolamines (1) is replaced by a 1-[2-t-(n-)butyl-3-cyano-1,2-dihydropyridyl] (9-12) or 1-[6-t-(n-)butyl-3-cyano-1,6-dihydropyridyl] (13-16) moiety is described. These replacements resulted in a substantial reduction in beta 1 (atria) and beta 2 (trachea) adrenergic antagonist activities relative to the reference drug metoprolol. Structure-activity correlations indicate the relative potency order is 1,2-dihydropyridyl greater than 1,6-dihydropyridyl, n-Bu greater than t-Bu for dihydropyridyl substituents, and that this class of compounds are non-selective beta-antagonists with a beta 1/beta 2 selectivity ratio close to unity.     

The influence of tube voltage,X-ray exposure rate and thickness of filter material on image quality with dual-energy subtraction imaging in chest diagnostics

Digital luminescent radiography enables dual-energy subtraction imaging, because this computed system allows susbtraction of imaging data and image post processing, as for example special windowing or edge enhancement. In a special cassette a copper filter is placed between two imaging plates for energy separation by a single X-ray exposure. Image post-processing with subtraction of imaging data permits the elimination of either skeleton or soft tissue structures. The influence of filter thickness, tube voltage and the X-ray exposure dosage on image quality is examined by the use of an anthropomorphic quality is examined by the use of an anthropomorphic phantom of the chest. According to our initial results dual energy subtraction imaging in one-shot-technique seems to be useful in the diagnostics of skeletal lesions and especially pulmonary nodules.     

Sickle erythrocytes adhere to polymorphonuclear neutrophils and activate the neutrophil respiratory burst

The vasoocclusive process in patients with sickle cell disease (SCD) is complex and involves interactions among sickle erythrocytes (SS-RBC), vascular endothelium, and plasma and cellular components. The role of neutrophils (PMN) in vasoocclusion has not been examined. Patients with SCD appear to have chronically activated PMN. Because the first step in PMN activation is particle recognition, we explored whether normal PMN recognize SS-RBC and whether this recognition results in PMN monolayers, significantly more SS-RBC adhered to the PMN than did normal erythrocytes (AA-RBC; P < .001). Preincubation of erythrocytes with autologous plasma significantly increased the adherence of SS-RBC to PMN but had no effect on AA-RBC (P < .001). When adhesion of density fractionated SS-RBC was performed, dense SS-RBC showed greater adherence to the PMN monolayers than did light SS-RBC (P < .001). To determine mechanisms of this adhesion, IgG and Arg-Gly-Asp-Ser (RGDS) receptor sites on PMN were saturated. IgG inhibited adherence of dense SS-RBC, whereas RGDS inhibited adherence in both fractions, although to a greater extent in the light fraction. We measured SS-RBC activation of PMN by incubating SS-RBC with 2', 7'-Dichloro-fluroescin Diacetate (DCF)-labeled PMN. Incubation of PMN with SS-RBC resulted in a significant increase in fluorescence compared to AA-RBC. We show here that PMN recognize SS-RBC through multiple mechanisms and that this recognition results in activation of PMN. These findings contribute to the understanding of vasoocclusive crisis in patients with SCD and may have therapeutic implications.