Vascular complications of the transplanted kidney--angiographic study

The applied angiographic examination technique of the renal homotransplants performed during a 14-year period has been reported. 101 patients underwent 132 angiographic examinations in the course of 1971-1985. Thirty-two various vascular complications were diagnosed. Arterial stenoses during anastomoses were most frequent. Thromboembolic complications were second (4 arterial, 2 venous). One thrombosis of the iliac artery as a consequence of a wound infection following renal transplantation is described. In addition there were a few other single pseudoaneurysms of the arterial anastomoses and arteriovenous fistulas subsequent to renal biopsies. The importance of this examination technique and the diagnostic use of angiographic investigation of the transplanted kidney is pointed out.     

Prothrombogenic factors and reduced antioxidative defense in children and adolescents with pre-metabolic and metabolic syndrome.

BACKGROUND: The aim of this study was to examine prothrombogenic factors and antioxidative defense in obese children and adolescents with pre-metabolic and metabolic syndrome, and to analyze insulin secretion and resistance, early glycoregulation disorders and lipid status. METHODS: Insulin sensitivity was determined using the homeostasis model assessment for insulin resistance (HOMA-IR), while insulin secretion was determined using the homeostasis model assessment beta (HOMA-beta). Prothrombogenic factors analyzed were plasma plasminogen activator inhibitor-1 (PAI-1) and fibrinogen. Superoxide dismutase and glutathione peroxidase were measured as markers of antioxidative defense. RESULTS: Patients with metabolic syndrome were characterized with increased body mass index (BMI), waist circumference, and HOMA-IR and HOMA-beta levels, and all had increased blood pressure and triglyceride levels, low high-density lipoprotein cholesterol levels, increased PAI-1 levels and reduced antioxidative defense levels. Patients with pre-metabolic syndrome had higher levels of basal and mean insulinemia during an oral glucose tolerance test, higher levels of HOMA-beta and lower levels of antioxidative defense compared to patients with metabolic syndrome. CONCLUSIONS: Negative correlations between antioxidative defense parameters and BMI, abdominal obesity, insulin secretion, systolic blood pressure and atherogenic lipid factors, as well as correlations between PAI-1 and insulin resistance and basal glycemia in the metabolic syndrome group contribute to accelerated atherosclerosis. Positive correlations between PAI-1 and waist circumference and BMI, and negative correlations between BMI and antioxidative defense in the pre-metabolic syndrome patients show that this early stage preceding the metabolic syndrome is also characterized by atherosclerotic complication risks and evident hyperinsulinism and insulin resistance.     

X-linked angiotensin II type 2 receptor gene polymorphism -1332A/G in male patients with essential hypertension

BACKGROUND: The role of AT2R in regulation of blood pressure (BP) was mainly investigated in animal models. It is proposed to be a negative regulator of BP. X-linked AT2R -1332 A/G polymorphism has been denoted as functional. This polymorphism was associated with certain cardiovascular phenotypes in hypertensive patients, but it was poorly investigated in essential hypertension. The aim of our study was to evaluate possible association of -1332 A/G gene polymorphism with essential hypertension in males from Serbian population. METHODS: The study group included 304 men of Caucasian origin, 190 normotensive (NT) and 114 hypertensive (HT), free of cardiovascular disorders. Genotyping was done by PCR RFLP method. RESULTS: G/- genotype was in association with HT (OR 1.6, CI=1.0-2.6, p=0.04). Stratification by age (<40 years, mean 31.65+/-5.29 and >40 years, mean 51.36+/-8.32) pronounced significance only in older males (OR 2.4, CI=1.2-5.0, p=0.02). After adjustment for confounding factors the OR for hypertension remained unchanged and significant (adjusted OR 2.3, CI=1.0-5.4, p=0.04). Conclusion: Hemizygosity for the G allele was found to be susceptibility factor for hypertension in males. Still, clarifying the role of AT2R in development of human hypertension requires further replication studies in larger and different populations.     

It is Not (Always) the Mismatch That Beats You—On the Relationship Between Interaction of Early and Recent Life Stress and Emotion Regulation,an fMRI Study

Brain Topography - Stress may impact the ability to effectively regulate emotions. To study the impact of stressful experiences in early and recent life on emotion regulation, we examined the...     

Endothelial NOS G894 T and MMP-3 5A/6A gene polymorphisms and hypertension in Serbian population

The incidence of hypertension is increasing and it is more common in man than in women. Up to date, MMP-3 5A/6A polymorphism has been associated with artery stiffening and elevated blood pressure, whereas results considering association of endothelial NOS (eNOS) G894 T polymorphism with hypertension are controversial. The aim of our study was to analyze the possible association of eNOS G894 T and MMP-3 5A/6A gene polymorphisms with hypertension in Serbian population. Study sample consisted of 172 hypertensive and 200 normotensive subjects divided by gender. Both female and male group was truncated according to age. All subjects were genotyped for MMP-3 5A/6A and eNOS G894 T polymorphism. There was a significantly higher (P < 0.05) prevalence of 5A/5A genotype in hypertensive females compared to normotensive ones (19.30 % vs. 10.84%) even more pronounced in group > or =50 years, according to its recessive effect. In young males (<40 years), we found 3.7-fold increased risk for hypertension associated with allele 6A (P < 0.01), and 8.1-fold with genotype 6A/6A (P = 0.01) according to recessive model. We found no association of eNOS G894 T polymorphism with hypertension. These results indicate that there were gender- and age-specific differences in association of MMP-3 5A/6A polymorphism with hypertension in Serbian population.     

Rationalizing blood management in orthopedics and traumatology

In recent years there has been growing interest in blood conservation and avoidance of transfusion in patients undergoing orthopedic surgery. The benefits of blood transfusion must be considered and evaluated in terms of risk factors relating to the adverse effects of transfusion. A number of strategies are available to reduce the need for blood transfusion. These strategies are maximally effective if combined to span the pre-operative, intra-operative and post-operative periods. Surgical, anesthetic and pharmacological techniques can reduce blood loss during operation and the use of allogenic blood. This article presents current opinions, on the base of contemporary literature, regarding risks of transfusion and several simple techniques that will reduce the need for transfusion in orthopedic procedures.     

Cyclodextrins: Efficient biocompatible solubilizing excipients for bromhexine liquid and semi-solid drug delivery systems

Bromhexine hydrochloride (bromhexine) is a mucolytic agent with very low aqueous solubility. However, with addition of cyclodextrins (CD) to the formulation, this disadvantage may be limited and therapeutic doses of bromhexine in solution can be achieved. The interaction of bromhexine with α-, β-, γ- and sulfobutylether (SBE)-β-CD, respectively, was elucidated by means of phase solubility diagrams and calorimetric analysis. The complexes were further characterized by size, and the effect of the CD concentrations used was evaluated in a viability assay. From phase solubility diagrams with α-, β-, γ- and SBE-β-CD and bromhexine, it was determined that the solubility of bromhexine significantly increased with addition of CDs, showing an A(L) type solubility curve for bromhexine/α- and β-CD, and an A(N) type for bromhexine/γ- and SBE-β-CD. The highest soluble concentrations of bromhexine were achieved with α- and SBE-β-CD, i.e. when using a 100mM α- or SBE-β-CD solution, 4 and 5.5 times more bromhexine was solubilized, respectively, compared to pure aqueous solubilization of bromhexine. The apparent association constants determined from the phase solubility studies showed very low values of 34, 17, 8 and 156 M(-1) for bromhexine/α-, β-, γ- and SBE-β-CD, respectively, as compared to the association constants determined by ITC which exhibited values of 89, 307 and 1680 M(-1) for bromhexine/α-, β- and SBE-β-CD, respectively. The formation of aggregates aided solubilization of bromhexine in the phase solubility studies explaining the difference in the association constants between the two methods. Due to very low signal to noise ratio, no information was extracted for bromhexine/γ-CD solutions from the ITC measurements. The effect on cellular viability of the CDs ranked β->α->SBE-β->γ-CD. In conclusion, the results altogether demonstrated that SBE-β-CD is the most suitable CD for future drug delivery systems from the aspect of high amounts of solubilized bromhexine and high safety of the SBE-β-CD.