Hypertensive urgencies during the first wave of the COVID-19 pandemic in a tertiary hospital setting: a U-shaped alarming curve

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic provoked unprecedented disturbance in hypertension care, while alarming concerns arose about its long-term consequences. We investigated the trends of emergency visits and admissions regarding uncontrolled hypertension in order to assess the impact of COVID-19 spread on population behavior towards hypertension urgencies during its first wave.Material and methodsData from daily unscheduled visits and admission counts in the Cardiology sector were collected from the Emergency Department database of a tertiary General Hospital in Athens, Greece for the period January 15^th to July 15^th 2020. These data were compared with those from the previous year. Cases of patients who presented with hypertensive urgency or who were admitted due to uncontrolled hypertension were separately analyzed.ResultsA total of 7,373 patient records were analyzed. Hypertension urgency cases demonstrated a U-shaped distribution in 2020, showing a declining trend during the rapid virus spread, an image that was reversed after the transmission rate’s decline. COVID-19 incidence in Greece was inversely associated with uncontrolled hypertension admissions during its declining phase (r = –0.64, p = 0.009), whereas total attendance exhibited a similar correlation during the first and the following months of the pandemic (r = 0.677, p = 0.031, r = –0.789, p = 0.001). Uncontrolled hypertension rate on admission was positively related to the national incidence of COVID-19 cases during the first months of 2020 (r = 0.82, p = 0.045).ConclusionsHypertensive urgency-related visits followed a U-shape distribution during the pandemic’s first wave with the attendance nadir coinciding with the virus spread peak. This is a complex phenomenon, closely related to increased levels of public stress, disruptions in health care services and to a lesser extent to the imposed restrictions in transportation. The initial relative increase in uncontrolled hypertension-related admissions rate, combined with the later increase of hypertensive urgencies may be indicative of blood pressure deregulation among the studied population, which is multifactorial and potentially detrimental.     

Association of ENAM gene single nucleotide polymorphisms with dental caries in Polish children

Objectives

The objective of this study was to prove the association between dental caries and single nucleotide polymorphisms (SNPs) in the ENAM gene.

Material and methods

The research was carried out in 96 children (48 with caries and 48 counterparts free of this disease), aged 20–42 months, with 11–20 erupted teeth. All children were from four day nurseries located in Poznan. The study included the dental examination to select individuals to the research and oral swab collection for molecular evaluation. Seven selected SNPs markers of the ENAM gene were genotyped, five using TaqMan probe assay (rs2609428, rs7671281, rs36064169, rs3796704, and rs12640848) and two by Sanger sequencing (rs144929717 and rs139228330).

Results

Statistically significant higher prevalence of the alternative G allele and the alternative GG homozygote in the control group in comparison with the caries group in SNP rs12640848 was observed, respectively, p = 0.0062 and 0.0010. Although the prevalence of the AG heterozygote was higher for the caries subjects in comparison with controls (OR = 2.9), and the result was statistically significant (p = 0.0010), the overall prevalence of the G allele for this SNP was significantly higher in control group (OR = 2.3; p = 0.0062).

Conclusions

The study revealed the strong association between rs12640848 marker of ENAM gene and caries susceptibility in primary teeth in children from Poznan.

Clinical relevance

The presence of SNPs in the ENAM gene may be important as suspected predictive factor of dental caries occurrence in children.

     

Paraoxonase 2 gene C311S polymorphism is associated with a risk of large vessel disease stroke in a Polish population

BACKGROUND: Oxidative stress plays a role in atherosclerosis. Human paraoxonase (PON) gene products exhibit antioxidant properties. We studied the significance of the Q192R and M55L polymorphisms of the PON1 gene and the C311S polymorphism of the PON2 gene in different etiologies of ischemic stroke. METHODS: One hundred and thirty-six patients with large vessel disease (LVD) stroke, 140 with small vessel disease stroke, 272 with cardioembolic stroke, and their age- and sex-matched controls were included. PON genotypes were evaluated by PCR-RFLP analyses. RESULTS: The distribution of PON1 polymorphisms was similar in each stroke group and in the respective controls. Genotypes with the C allele of the PON2 gene C311S polymorphism were overrepresented in LVD stroke patients as compared with their controls, both in univariate and multivariate (dominant model: OR = 1.58, 95% CI: 1.006-2.48) analyses. CONCLUSION: The genotype with the C allele of the PON2 gene is a risk factor for LVD stroke in a Polish population.     

The First Report on Hybrid NOTES Adjustable Gastric Banding in Human

Background  

Despite their current limitations, metabolic surgery and natural orifice transluminal endoscopic surgery (NOTES), set new horizons. In this article, the first three cases of adjustable gastric banding (AGB) through transvaginal access in obese women are described.     

Surgical management and outcome of bile duct injuries following cholecystectomy: a single-center experience

Purpose  

Biliary injury is a severe complication of cholecystectomy. The Hepp–Couinaud reconstruction with the hepatic duct confluence and the left duct may offer best long-term outcome as long as the confluence remains intact (Bismuth I–III). Complex liver surgery is usually indicated in most proximal (Bismuth IV) injuries in non-cirrhotic patients. The aim of this study was to evaluate the surgical treatment and outcome of bile duct injuries managed in a referral hepatobiliary unit.     

Clinical analysis of patients with recurrences of borderline ovarian tumors including surgical treatment

OBJECTIVES: Risk of recurrences of borderline ovarian tumors is low (7-10%) but the cases with incidence of recurrence have worse prognosis. The time between primary operation and the first diagnosis of recurrence and treatment is different. DESIGN: The purpose of the current study was to evaluate frequency and the methods of treatment patients with recurrences of borderline ovarian tumors. MATERIALS AND METHODS: The analyzing group consists of 129 patients with borderline tumors of the ovary (BTO) diagnosed and treated in Department of Gynecology between years 1978-2000. RESULTS: In our recurrences developed in 7% of patients. The recurrences in BTO were connected with stage of BTO, types of primary operations and residual disease. Recurrences developed in 5,9% patients with stage I and in 18,1% patients with stage II/III. Similarly recurrences developed in 5,8% patients with no residual disease and in 20% patient with residual disease. A higher relapse rate was observed in patients treated conservatively but recurrences was quickly recognized and efficaciously treated. 5 years survival of patients without recurrences was 91,7% and with recurrences was 72,9%. CONCLUSIONS: 1. Risk of recurrences of BTO is low (7%) and depends on stage and residual disease. 2. Risk of recurrences is higher after primary conservative operation but long follow-up and regular gynecological examinations allows to early diagnosis and treatment of recurrences. 3. Prognosis of patients with recurrences of BTO is good. 5-years survival was 90,6% of group without and 72,9% of group with recurrences of BTO.     

Techniques for the induction of human pluripotent stem cell differentiation towards cardiomyocytes

The derivation of pluripotent stem cells from human embryos and the generation of induced pluripotent stem cells (iPSCs) from somatic cells opened a new chapter in studies on the regeneration of the post‐infarction heart and regenerative medicine as a whole. Thus, protocols for obtaining iPSCs were enthusiastically adopted and widely used for further experiments on cardiac differentiation. iPSC‐mediated cardiomyocytes (iPSC‐CMs) under in vitro culture conditions are generated by simulating natural cardiomyogenesis and involve the wingless‐type mouse mammary tumour virus integration site family (WNT), transforming growth factor beta (TGF‐β) and fibroblast growth factor (FGF) signalling pathways. New strategies have been proposed to take advantage of small chemical molecules, organic compounds and even electric or mechanical stimulation. There are three main approaches to support cardiac commitment in vitro: embryoid bodis (EBs), monolayer in vitro cultures and inductive co‐cultures with visceral endoderm‐like (END2) cells. In EB technique initial uniform size of pluripotent stem cell (PSC) colonies has a pivotal significance. Hence, some methods were designed to support cells aggregation. Another well‐suited procedure is based on culturing cells in monolayer conditions in order to improve accessibility of growth factors and nutrients. Other distinct tactics are using visceral endoderm‐like cells to culture them with PSCs due to secretion of procardiac cytokines. Finally, the appropriate purification of the obtained cardiomyocytes is required prior to their administration to a patient under the prospective cellular therapy strategy. This goal can be achieved using non‐genetic methods, such as the application of surface markers and fluorescent dyes. Copyright © 2016 John Wiley & Sons, Ltd.     

Multimodal instrument for high-sensitivity autofluorescence and spectral optical coherence tomography of the human eye fundus

In this paper we present a multimodal device for imaging fundus of human eye in vivo which combines functionality of autofluorescence by confocal SLO with Fourier domain OCT. Native fluorescence of human fundus was excited by modulated laser beam (λ = 473 nm, 20 MHz) and lock-in detection was applied resulting in improving sensitivity. The setup allows for acquisition of high resolution OCT and high contrast AF images using fluorescence excitation power of 50-65 μW without averaging consecutive images. Successful functioning of constructed device have been demonstrated for 8 healthy volunteers of different age ranging from 24 to 83 years old.OCIS codes: (110.0110) Imaging systems, (170.4460) Ophthalmic optics and devices, (170.4500) Optical coherence tomography, (170.5755) Retina scanning, (170.6280) Spectroscopy, fluorescence and luminescence