Feasibility and clinical utility of real-time tele-echocardiography using personal mobile device-based pocket echocardiograph

IntroductionRecently introduced microUSB ultrasound probe, which can be connected to personal mobile device constitutes a new class of diagnostic pocket size imaging devices (PSID).The aim of this study was to assess the feasibility and clinical utility of real-time tele-echocardiography with the use such device.Material and methodsThe study group comprised 30 patients (18 men and 12 women; mean age: 54 ±14 years; mean body mass index: 27 ±6 kg/m²), admitted to various hospital departments (infectious diseases, internal medicine and cardiology). All patients underwent focused echocardiographic examination performed by an inexperienced operator using PSID and collaborating remotely in real-time with cardiologist by means of tele-consultation. Before commencing the examination, the operators underwent 1 h training in use of the PSID.ResultsIn most of patients PSID imaging provided sufficient diagnostic image quality. The dimensions of left ventricle, left atrium and the aorta obtained during the this examination showed good correlation with standard echocardiography (r = 0.89, r = 0.82, r = 0.92 respectively), but the correlation for TAPSE measurements was less pronounced (r = 0.52). The agreement in detection of pathologies (wall motion abnormalities, morphological and functional valvular abnormalities) between the tele-echocardiography and standard echocardiographic examination was good to very good (κ ranged from 0.648 to 0.823).ConclusionsPocket size imaging devices allows an inexperienced operator to perform a focused echocardiographic examination under a remote supervision of an experienced cardiologist. The introduction of new technology in the form of PSID with tele-echocardiography feature can revolutionize access to this imaging technique.     

Dried Wild-Grown Mushrooms Can Be Considered a Source of Selected Minerals

Dried mushrooms might be a source of mineral components, which are indispensable for human health. The aim of this study was to determine the contents of calcium (Ca), magnesium (Mg), iron (Fe), zinc (Zn), copper (Cu), manganese (Mn), and selenium (Se) in dried wild-grown mushrooms (Boletus edulis and Xerocomus badius) available for sale, and to evaluate these mushrooms’ contribution to the daily reference intake of the studied bioelements. The concentrations of mineral components in the mushroom samples were determined by the flame method (Ca, Mg, Fe, Zn, Cu, Mn) and the electrothermal (Se) atomic absorption spectrometry method. The mean Ca, Mg, Fe, Zn, Cu, Mn (in mg/kg), and Se concentrations (in µg/kg) in B. edulis were 82.1, 964.1, 233.4, 97.9, 25.3, 22.1, and 6501.6, respectively, whereas in X. badius: 67.5, 1060.2, 87.8, 197.2, 33.9, 19.8, and 282.4, respectively. We have shown that dried B. edulis can be considered a source of Se. In the case of the other microelements, the tested mushrooms may serve only as additional supplements. Therefore, the studied species of mushrooms cannot be regarded as potential nutritional sources of the macroelements in question. Consumers should be properly informed about this, which should be guaranteed by appropriate legal regulations.     

An Evaluation of Nutritional Status and Problems with Dietary Compliance in Polish Patients with Celiac Disease

Celiac disease (CD, enteropathy) is a genetic autoimmune disease (abnormal immune response that attacks healthy tissues) associated with gluten intolerance. The aim of this study was to evaluate and monitor the nutritional status of CD patients, explore the problems associated with diet planning and dietary adherence among children and adults, and assess the impact of these factors on the persistence of CD symptoms. This study was carried out as part of the project entitled “A gluten-free diet without obstacles—eating well and healthy” (POWR 03.01.00-00-T153/18), conducted in Lublin Voivodeship. The study involved 87 persons, including 23 children younger than 18. At the beginning of the study and after nine months, all adult participants (older than 18) were subjected to a body composition analysis with the SECA mBCA 515 analyzer. During the project, the participants attended three consultations with a dietician. During each visit, the subjects’ body weight, nutritional status and diets were evaluated; their diets were modified, and problems relating to dietary adherence were resolved. The initial body composition analysis revealed a risk of sarcopenic obesity in 30% of adult participants, in particular in women (p = 0.003) older than 45 (p = 0.001). The risk of being underweight was diagnosed in 25% of the subjects, in particular, in women younger than 35 (p = 0.0023) and in participants who had been affected by short stature and underweight in childhood, i.e., before CD diagnosis (p = 0.0024). The analysis demonstrated that patients with gastrointestinal symptoms (abdominal pain, diarrhea, vomiting) of CD were significantly more likely to avoid even accidental exposure to gluten and were more likely to strictly follow GFD recommendations (1.97; 95CI:1.56–2.12, p = 0.0001) and safety guidelines when preparing meals at home (1.76; 95CI: 1.34–192, p = 0.0023). Parents, in particular, parents of toddlers and preschoolers who are at significantly higher risk of CD, adhered strictly to dietary guidelines and did not allow for any exceptions when preparing meals (1.88; 95CI: 1.53–2.09, p = 0.001). Persons at risk of malnutrition were also far less likely to deliberately choose gluten-containing foods (0.74; 95CI: 0.53–0.91, p = 0.021), in particular, patients with Marsh type 3a and 3b classification (p = 0.01) and persons whose intestinal histology scores did not fully improve after switching to a GFD. An assessment of the effectiveness of diet therapy based on the phase angle revealed that dietary recommendations had a positive impact on patients who had been recently diagnosed with CD. In all age groups, the main problem was accidental exposure to gluten, in particular in foods that were not labeled with the crossed grain symbol. A comparative analysis of CDAT questionnaires revealed that dietary advice on eating out significantly improved adherence to a GFD and reduced the frequency of unintentional gluten exposure in all age groups.     

Serum Osteoprotegerin Is an Independent Marker of Left Ventricular Hypertrophy,Systolic and Diastolic Dysfunction of the Left Ventricle and the Presence of Pericardial Fluid in Chronic Kidney Disease Patients

Background: Osteoprotegerin (OPG) is a molecule which belongs to the tumor necrosis factor receptor superfamily. OPG concentration is elevated in patients with left ventricle hypertrophy, heart failure and acute myocardial infarction. OPG concentrations rise in chronic kidney disease (CKD). The aim of this study was to investigate the association between OPG concentrations and cardiovascular complications, such as left ventricle hypertrophy, systolic and diastolic dysfunction of left ventricle and dysfunction of right ventricle in chronic kidney disease patients not treated with dialysis. The relation between OPG and the amount of pericardial fluid was also examined. Methods: One hundred and one men with CKD stage 3–5 not treated with dialysis were included in the study. Overhydration, body fat mass and lean body mass were measured using bioimpedance spectroscopy (BIS). Echocardiography was performed to evaluate the amount of pericardial fluid and to measure the thickness of the interventricular septum (IVS), systolic and diastolic function of left ventricle, as well as systolic function of right ventricle. Results: We observed a significant positive association between OPG and the thickness of the interventricular septum, the size of the left atrium (LA) and the presence of pericardial fluid. A negative relationship was observed between OPG and ejection fraction (EF). Conclusions: Our results suggest that OPG can be an independent marker of left ventricular hypertrophy, systolic and diastolic dysfunction of left ventricle and the presence of pericardial fluid in chronic kidney disease patients.     

The Role of Social Support in Machismo and Acceptance of Violence Among Adolescents in Europe: Lights4Violence Baseline Results

PurposeTo analyze the potential association between social support, experiences of violence, and sociodemographic characteristics of adolescents and the likelihood of acceptance of violence and machismo in different European countries.MethodsCross-sectional design. We recruited 1,555 participants ages 13–16 from secondary schools in Alicante (Spain), Rome (Italy), Iasi (Romania), Matosinhos (Portugal), Poznan (Poland), and Cardiff (UK). We used linear regression models to identify how social support from teachers and parents, experiences of violence—dating violence, bullying, cyberbullying, abuse in childhood—and sociodemographic characteristics were associated with violent thinking, specifically: machismo and acceptance of violence. The analysis was stratified by sex.ResultsAcceptance of violence was higher for those who had lower perceived social support from parents (β_girls = ?154, p < .001; β_boys = ?.114, p = .019) for both sexes. Perpetration of bullying and/or cyberbullying was associated with higher scores for machismo and acceptance of violence for both sexes (β_girls = .067, p = .035; β_boys = .225, p < .001; (β_girls = .118, p < .001; β_boys = .210, p < .001). Being the victim of dating violence, having suffered physical and/or sexual abuse in childhood, and lower perceived social support from teachers were associated with higher scores for both machismo and acceptance of violence. These associations differed between girls and boys.ConclusionsMachismo and acceptance of violence are widely present amongst adolescents in different European countries. Our results suggest the importance of providing educational/psycho-educational interventions with boys and girls to prevent these attitudes and, in turn, prevent interpersonal violence, including bullying and dating violence.     

Tocilizumab as a first-line biologic treatment in rheumatoid arthritis patients – the impact of concomitant methotrexate treatment and Rheumatic Disease Comorbidity Index on the clinical response – results from the multicenter observational ACT-POL study

ObjectivesAccording to the EULAR recommendations, remission or low disease activity (LDA) in rheumatoid arthritis should be achieved by a maximum of 6 months (M6) of treatment. Data on the use of tocilizumab (TCZ) as first-line biologic treatment in rheumatoid arthritis (RA) in routine clinical practice in Poland are lacking.Material and methodsThis multicenter, non-interventional, prospective, observational study recruited adults, presenting with moderate-to-severe RA, showing an inadequate response or intolerance to disease-modifying antirheumatic drugs, where TCZ was the first-line biologic treatment. The effectiveness of TCZ was assessed by the proportion of patients achieving remission and low disease activity following 6 months of treatment with intravenous TCZ. The impact of comorbidities on treatment outcomes was measured using the Rheumatic Disease Comorbidity Index (RDCI).ResultsTotal remission rates at months 3 and 6 were 6% and 31%, respectively. Low disease activity was reported in 10% and 92% of the patients at 3 and 6 months, respectively. The response was comparable between TCZ as monotherapy and in combination with methotrexate. Mean DAS28 decreased from 6.61 at baseline to 4.27 at the scheduled time of the assessment (3 and 6 months). The Rheumatic Disease Comorbidity Index was not correlated with the number of patients achieving LDA at M3 and M6 or remission rates at M6. Remission rates correlated with RDCI at M3. A total of 114 adverse events were reported in 61 patients, among which five were considered as serious.ConclusionsThe study confirms the effectiveness and safety of TCZ in real-world settings as a first-line biologic treatment in patients with moderate-to-severe RA. Importantly, comorbidities do not affect the results of 6-month treatment with TCZ, that is, the optimal time to achieve at least LDA. Our results may improve the effects of RA therapy in Poland, especially in patients with comorbidities and those who, for various reasons, cannot receive optimal treatment with methotrexate.     

New Insight into the Fluorescence Quenching of Nitrogen-Containing Carbonaceous Quantum Dots—From Surface Chemistry to Biomedical Applications

Carbon-based quantum dots are widely suggested as fluorescent carriers of drugs, genes or other bioactive molecules. In this work, we thoroughly examine the easy-to-obtain, biocompatible, nitrogen-containing carbonaceous quantum dots (N-CQDs) with stable fluorescent properties that are resistant to wide-range pH changes. Moreover, we explain the mechanism of fluorescence quenching at extreme pH conditions. Our in vitro results indicate that N-CQDs penetrate the cell membrane; however, fluorescence intensity measured inside the cells was lower than expected from carbonaceous dots extracellular concentration decrease. We studied the mechanism of quenching and identified reduced form of β-nicotinamide adenine dinucleotide (NADH) as one of the intracellular quenchers. We proved it experimentally that the elucidated redox process triggers the efficient reduction of amide functionalities to non-fluorescent amines on carbonaceous dots surface. We determined the 5 nm–wide reactive redox zone around the N-CQD surface. The better understanding of fluorescence quenching will help to accurately quantify and dose the internalized carbonaceous quantum dots for biomedical applications.     

Development and Characterization of Active Gelatin Films Loaded with Rapeseed Meal Extracts

The use of industrial waste as a material for the development of natural innovative and active packaging is economically and environmentally appealing. The aim of this study was to develop and characterize active gelatin films incorporating rapeseed oil industry waste. Water (RM-WE) and methanolic (RM-MWE) extracts of rapeseed meal (RM) were used as active agents in film formulations. The active films were produced by a casting technique. The physicochemical, mechanical, optical, morphological, radical scavenging, and antibacterial properties of the films were analyzed. The addition of RM-WE and RM-MWE in the concentrations range between 4 and 12% promoted an increase of Young’s modulus (YM) and radical scavenging properties of films investigated by the direct QUick, Easy, New, CHEap and Reproducible procedure using 2,2-diphenyl-1-picrylhydrazyl (QUENCHER_DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (QUENCHER_ABTS) radicals. The antibacterial properties of films were examined against five bacterial strains: E. coli, S. enterica, M. luteus, L. monocytogenes, and S. aureus. Additionally, color and opacity of the control and fortified films differed significantly. The gelatin films with RM extracts are resistant to the microbial spoilage and could be used to produce active packaging for food that is vulnerable to rancidity effects.