Prognostic value of positive T wave in lead aVR in patients with non‐ST segment myocardial infarction

Background

Lead aVR provides prognostic information in various settings in patients with ischemia. We aim to investigate the role of a positive T wave in lead aVR in non‐ST segment myocardial infarction (NSTEMI).

Methods

In a prospective cohort study, we included 400 patients with NSTEMI. Presentation electrocardiogram (ECG) was investigated for presence of a positive T wave as well as ST segment elevation (STE) in aVR and study variables were compared. Predictors of primary outcome defined as hospital major adverse cardiovascular events (MACE) and secondary outcome, defined as three‐vessel coronary disease and/or left main coronary artery stenosis (3VD/LMCA) stenosis in angiography, were determined in multivariate logistic regression analysis.

Results

Patients with a positive T wave in aVR were significantly older and were more likely to be female. Left ventricular ejection fraction was significantly lower in patients of positive T group. Positive T group was more likely to have 3VD/LMCA stenosis (58.3% vs. 19.8%, p < .001). The prevalence of a positive T wave in aVR was significantly higher in MACE group (54.9 % vs. 24.8%, p < .001). However, in multivariate analysis, it was not an independent predictor of MACE (OR: 1.083 95% CI: [0.496–2.365], p: .841). Though, it was independently associated with presence of 3VD/LMCA stenosis (OR: 3.747 95% CI: [2.058–6.822], p < .001).

Conclusion

Though positive T wave in lead aVR was more common in patients with MACE; it was not an independent predictor. Additionally, a positive T wave in aVR was an independent predictor of 3VD/LMCA stenosis in NSTEMI.

     

Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis–associated uveitis: A consensus effort from the multinational interdisciplinary working group for uveitis in childhood

Objective

To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)–associated uveitis.

Methods

The literature relating to outcome measures used in studies of uveitis in childhood and adolescence was reviewed. A set of core outcomes and domains was established using the Delphi process. This was reviewed by a representative multinational interdisciplinary working group. Nominal group technique consensus was reached on face and content validity of the range and content of the domains. The outcomes and the appropriate instruments for uveitis trials were adapted to the age ranges of patients with JIA‐associated uveitis.

Results

Consensus was reached that data should be reported at defined time points in longitudinal studies with patients stratified by prognostic markers. Visual acuity testing should be age appropriate. The severity of uveitis (measured as anterior chamber cell grade) and duration of active inflammation should be documented. Visually significant structural complications should be recorded and quantified with standard measures. The responses to treatment and corticosteroid‐sparing effects of treatment should be documented. Patient‐reported disease activity and age‐specific uveitis‐related quality of life should be reported using appropriate questionnaires.

Conclusion

The proposed outcome measures in JIA‐associated uveitis should aid in the standardization and comparison of future RCTs of the treatment regimens for this disease. The proposed outcome measures will be verified in a prospective validation study.     

Evaluation of rabbit antibody response against 8 and 16 kDa recombinant subunits of antigen B from Echinococcus granulosus

ObjectiveTo immunize rabbits with 12 and 16 kDa recombinant subunits of antigen B from Echinococcus granulosus (E. granulosus) and measuring polyclonal antibody and humoral immune response using ELISA and gel diffusion.MethodsTwo mentioned antigens were cloned and expressed in expression vector and purified by affinity chromatography. Four young rabbits were selected and challenged intradermally with yielded recombinant antigens. Rabbits' sera were collected post infection and were tested using ELISA and gel diffusion for polyclonal antibody detection 10 days after last injection.ResultsThe specific antibody against the recombinant peptides was efficiently produced within 4 weeks post infection.ConclusionsProduced recombinants proteins could induce the immune response of the rabbits successfully. This process might improve the clarification of diagnosis and vaccination as regards hydatidosis.     

Surgical management of cataract and posterior chamber intraocular lens implantation in Fuchs‘ heterochromic iridocyclitis

Background: To determine the inflammatory course and level of visual rehabilitation after cataract extraction and posterior chamber lens implantation in patients withFuchs‘ heterochromic iridocyclitis complicated by cataract. Methods: In a clinical trial, 32 eyes (visual acuity of 20/160 or worse) of 30 patients underwent extracapsular cataract extraction (19 eyes) or lensectomy(13 eyes) accompanied by posterior chamber intraocular lens implantation. Indirect ophthalmoscopy was performed intraoperatively prior to intraocular lens implantation and the extent of vitreous haze was assessed. If vitreous haziness was 3+ or more, core vitrectomy (two eyes) or three-port pars plana deep vitrectomy (four eyes) was performed. Results: After an average follow up of14.4 months (6 to 24 months), there was no statistically significant increase in cell and flare in the anterior chamber and vitreous or in keratic precipitates compared with the preoperative status of the eyes. However, 12%of the eyes developed synechiae (anterior and/or posterior) in comparison to preoperative condition (p< 0.05). Eighty-seven percent of the eyes gained visual acuity of 20/40 or better (P < 0.005). Using the logistic regression model, a higher level of preoperative inflammation was associated with reduced likelihood of gaining visual acuity of 20/25 or more (OR = 0.25, 95%CI 0.049, 1.255). The complications of surgery were synechiae, 12%; opaque posterior capsule, 12%; vitreous loss, 3%; chronic glaucoma, 3%; and retinal detachment,3%. Conclusions: Implantation of a posterior chamber intraocular lens can be well tolerated in patients with Fuchs‘ heterochromic iridocyclitis. Vitrectomy, whenever indicated in addition to cataract extraction, improves visual rehabilitation. This revised version was published online in August 2006 with corrections to the Cover Date.     

Determination of sensitivity of male Wistar rats to an equal dose of ketamine/xylazine injection at anesthetic dose in a chronic model of hypernatremia in comparison with control group

OBJECTIVE: To determine the sensitivity to an equal dose of ketamine/xylazine injection at anesthetic dose in a chronic model of hypernatremia. METHODS: This study was conducted at the Department of Physiology, Zanjan University of Medical Science, Zanjan, Iran in 2004. Sixty male Wistar rats, weighing 250 +/- 20 g were randomly allocated to 3 groups. The control group was provided with tap water, and first and second test groups consumed 1% and 2% salt concentrations for 144 hours. One hundred mg/kg ketamine and 10 mg/kg xylazine were used as an anesthetic agent. The measured anesthetic parameters comprises of righting reflex latency, required time for establishment of animal's immobility, immobility period, required time for appearance of animal's mobility and complete re-establishment of the righting reflex. RESULTS: The required time for inhibition of the righting reflex and animal's mobility in the second group was significantly shorter than the first and control groups. Immobility period, required time for appearance of animal's mobility and complete re-establishment of the righting reflex in the second group were significantly longer than the first and control groups. CONCLUSION: Hypernatremia increases the speed of transition from different steps of ketamine/xylazine anesthesia with significant delay in immobility period and recovery from anesthesia in rats, hence, anesthetic dose reduction in hypernatremia is necessary.     

Genetics of clinical expression in SLE

Systemic lupus erythematosus (SLE) is the prototype of complex autoimmune diseases and is characterized by extreme breakdown of self-tolerance which results in a wide range of immunologic abnormalities and immune complex formation. Genetic, hormonal and environmental factors are known to contribute to the expression of the disease. SLE is very heterogeneous in clinical manifestations and different autoantibodies may predict different set of clinical outcome, however, despite considerable accumulated knowledge, the detailed pathogenesis of SLE still remains unknown. In genetic studies, recent findings in gene expression analyses strongly support the direct role of cytokines and interferons in various immune dysregulations described in SLE. By recent advances in high-throughput SNP genotyping, the association studies of this complex disease have become more practical and for the first time new genetic association results can be confirmed in different population.     

Amyotrophic lateral sclerosis affects cortical and subcortical activity underlying motor inhibition and action monitoring

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by muscular atrophy, spasticity, and bulbar signs caused by loss of upper and lower motor neurons. Evidence suggests that ALS additionally affects other brain areas including premotor cortex and supplementary motor area. Here, we studied movement execution and inhibition in ALS patients using a stop‐signal paradigm and functional magnetic resonance imaging. Seventeen ALS patients and 17 age‐matched healthy controls performed a stop‐signal task that required responding with a button press to a right‐ or left‐pointing black arrow (go‐stimuli). In stop‐trials, a red arrow (stop‐stimulus) was presented shortly after the black arrow indicating to withhold the prepared movement. Patients had by trend higher reaction times in go‐trials but did not differ significantly in their inhibition performance. Patients showed stronger inhibition‐related activity in inferior, superior, and middle frontal gyri as well as in putamen and pallidum. Error‐related activity, conversely, was found to be stronger in healthy controls, particularly in the insula bilaterally. Patients also showed increased activity in the motor cortex during button presses. The results provide evidence for altered prefrontal and subcortical networks underlying motor execution, motor inhibition, and error monitoring in ALS. Hum Brain Mapp 36:2878–2889, 2015. © 2015 Wiley Periodicals, Inc.     

The evaluation of hepatitis C virus core antigen in immunized BALB/c mice

Background

Hepatitis infection represents one of the important causes of morbidity and mortality in developing countries, however there is not any effective vaccine against hepatitis C which is one of the significant problems in vaccine project.

Objectives

The aim of the present study is to evaluate the role of HCV core protein in inducing IFN-Gamma secretion and TCL activities as a vaccine in Balb/C mice.

Material and Methods

Our previous cloned plasmid (HCV Core gene into pETDuet-1) applied for protein expression in bacteria. The expressed and purified recombinant protein together with Freund’s adjuvant was injected to 15 Balb/c mice. The total IgG and IgG2a of immunized mice sera were evaluated after a week. Two weeks after booster injection, we studied the proliferation and IFNγ secretion of spleens, inguinal and popliteal lymph nodes lymphocytes by ELISA and ELISPOT.

Results

The FSFC (Frequency of spot forming cells) of secreting cells of immunized mice with HCV/Core protein and sera IgG2a were considerably higher than the control groups.

Conclusions

The core protein together with proper adjuvant can be a candidate vaccine against of HCV infection.