Chronic fatigue syndrome in 57-year-old woman

Chronic fatigue syndrome (CFS) is characterized by unexplained fatigue lasting for more than 6 months and accompanied by flulike symptoms. It most commonly affects women aged between 30 and 60 years. To date, clear diagnostic criteria allowing for unambiguous diagno-sis of CFS have not been established. We present a case of a 57-year-old woman with chronic fatigue syndrome in order to showcase the symptoms of this condition and propose a diagnos-tic protocol.     

Peripheral vascular complications after intracoronary stent placement: Prevention by use of a pneumatic vascular compression device

Peripheral vascular complications are a significant source of morbidity after coronary artery stent implantation. The goal of this study was to assess the incidence, risk factors, and management of vascular complications after stent placement. The study population consisted of 101 consecutive patients who underwent stent placement for either elective or bailout indications. All patients received a standardized anticoagulation regimen of aspirin, dipyridamole, low molecular weight dextran, heparin, and warfarin. Peripheral vascular access sites were examined daily until hospital discharge. Vascular complications occurred in 16 of 101 (16%) patients, including femoral artery pseudoaneurysm (n = 11), hematoma requiring transfusion or surgery (n = 4), and arterlovenous fistula (n = 1). Intervention was required in 14 of 16 (88%) patients with complications. These included transfusion (n = 7), ultrasound-guided compression (n = 8), and/or vascular surgery (n = 7). Length of hospital stay was prolonged in patients with complications (14 ± 9 vs. 8 ± 5 d, P < 0.001). The development of peripheral vascular complications did not correlate with clinical or procedural variables such as age, cardiovascular risk factors, arterial sheath size, or elective vs. bailout indication. After the introduction of a pneumatic vascular compression device (FemoStop, C.A. Bard, Billerica, MA), a significant reduction In vascular complications was observed. Complications occurred in only 1 of 41 (2.4%) patients in whom the compression device was used in contrast to 13 of 58 (22.4%) patients compressed manually (P < 0.01). Thus peripheral vascular complications are frequent after coronary artery stent placement and are associated with serious morbidity and prolongation of hospital stay. These complications are significantly reduced by the use of a pneumatic vascular compression device despite intensive systemic anticoagulation. © 1996 Wiley-Liss, Inc.     

Effect of Different Types of Intermittent Fasting on Biochemical and Anthropometric Parameters among Patients with Metabolic-Associated Fatty Liver Disease (MAFLD)—A Systematic Review

Metabolic-associated fatty liver disease (MAFLD), previously called non-alcoholic fatty liver disease (NAFLD), is the most common chronic liver disease worldwide. It is characterised by excessive fat accumulation in hepatocytes. Currently, no pharmacological therapy is effective for this disease, so non-pharmacological alternatives such as diet, supplementation or physical activity are being sought. For this reason, we reviewed the available databases to analyse the studies conducted to date using different modifications of intermittent fasting among patients with MAFLD. Eight studies using this dietary strategy were included in this review. The results obtained in the different trials are varied and do not allow a clear determination of the effect of the different types of intermittent fasting on anthropometric and biochemical parameters among patients with MAFLD. However, this type of diet seems to show some therapeutic potential, but further studies are needed.     

Persistence in degenerating sciatic nerve of substances having a trophic influence upon cultured muscle

Citrate-soluble proteins were extracted from normal and degenerating chicken sciatic nerves and added to chick embryonic skeletal muscle cultures to determine the trophic influences of the soluble proteins upon muscle cells. The soluble protein from normal or degenerating nerves was equally effective in promoting the protein synthesis, maturation, and long-term maintenance of muscle cells. Normal or degenerating nerve protein stimulated [¹⁴C]leucine incorporation into muscle cell protein and enhanced the morphologic maturation of muscle cells in culture. Furthermore, matured, cross-striated myotubes survived longer in the presence of normal or degenerating nerve protein than in control cultures. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis on thin-layer gels revealed similar electrophoretic patterns for normal and degenerating nerve proteins. Electrophoretic gels also revealed the presence in these extracts of a protein with MW_R 84,000 which migrated in a manner identical to a neurotrophic protein which was recently purified from chicken sciatic nerves. The present results indicate that neural proteins having trophic influences upon muscle in vitro persist in degenerating sciatic nerve. We therefore conclude that the in vivo changes in muscle after denervation are not due to the depletion of trophic substances following nerve transection.     

Role of lipoprotein-associated phospholipase A2 in atherosclerosis: biology, epidemiology, and possible therapeutic target

The development of atherosclerotic vascular disease is invariably linked to the formation of bioactive lipid mediators and accompanying vascular inflammation. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme that is produced by inflammatory cells, co-travels with circulating low-density lipoprotein (LDL), and hydrolyzes oxidized phospholipids in LDL. Its biological role has been controversial with initial reports purporting atheroprotective effects of Lp-PLA2 thought to be a consequence of degrading platelet-activating factor and removing polar phospholipids in modified LDL. Recent studies, however, focused on pro-inflammatory role of Lp-PLA2 mediated by products of the Lp-PLA2 reaction (lysophosphatidylcholine and oxidized nonesterified fatty acids). These bioactive lipid mediators, which are generated in lesion-prone vasculature and to a lesser extent in the circulation (eg, in electronegative LDL), are known to elicit several inflammatory responses. The proinflammatory action of Lp-PLA2 is also supported by a number of epidemiology studies suggesting that the circulating level of the enzyme is an independent predictor of cardiovascular events, despite some attenuation of the effect by inclusion of LDL, the primary carrier of Lp-PLA2, in the analysis. These observations provide a rationale to explore whether inhibiting Lp-PLA2 activity and consequent interference with the formation of bioactive lipid mediators will abrogate inflammation associated with atherosclerosis, produce favorable changes in intermediate cardiovascular end points (eg, biomarkers, imaging, and endothelial function), and ultimately reduce cardiovascular events in high-risk patients.     

Measurement of phycocyanin fluorescence as an online early warning system for cyanobacteria in reservoir intake water

Cyanobacterial blooms in drinking water reservoirs may cause a variety of water quality problems, including those of taste and odor, and can compromise the water supply destined for human consumption. In response to this problem an online monitoring tool for analyzing the cyanobacterial concentration in intake water is of practical value. This study demonstrated a positive correlation between phycocyanin fluorescence and cyanobacterial biomass during Microcystis aeruginosa blooms in a lowland drinking water reservoir, using online detection. The highest correlation coefficients were found for a cyanobacterial biomass concentration below 15 mg freshweight/L, indicating that this method can be an effective early warning system. Rapid changes in fluorescence were observed when wind drift moved higher cyanobacterial concentrations into the water intake, indicating that fluorescence could be employed as a quick warning for changed requirements for plant operations.