Hydrolytic conditions for the formation of open-chain oligopeptides from cyclosporin A

In this work we report data on the hydrolysis of CsA, allowing interpretation on the formation of previously identified open chain oligopeptides from CsA. © Munksgaard 1997.     

Multiform Ventricular Ectopic Rhythm by Combined Parasystolic and Reentrant Activities

Multiform ventricular ectopic rhythm (MVER), i.e., at least two QRS configurations of ventricular ectopic beats (VEBs), was assessed by 24-hour ambulatory ECG recording in four patients with ventricular parasystole (VP). In two of these four patients, VEBs with fixed coupling to the preceding impulses coexisted with VP beats of different configuration. In case no. 1, the VEBs had an identical coupling interval to sinus bents and VP beats, suggesting a mechanism of reentry elicited from both dominant pacemakers. In case no. 2, an intermittent form of VP due to type II second-degree entrance block was present. In this patient, the VEBs were coupled to sinus beats and to sinus-VP fusion beats and appeared to be dependent on the sinus beats reaching the VP focus. A mechanism of reentry determined by the penetration of sinus beats into the VP area, with prematurity-dependent aberrancy of VEBs, was suggested for the coupled VEBs in this patient. These observations suggest that the coexistence of an automatic ventricular ectopic focus and of a reentrant activity determined by, or elicited from, an area of automaticity may constitute the underlying mechanism of MVER in some patients.     

SARS-CoV-2 associated rhabdomyolysis in 32 patients

Background/aimThis mini-review aims at summarising and discussing previous and recent findings concerning the clinical manifestations, therapeutic management, and outcome of SARS-CoV-2 associated rhabdomyolysis.Materials and methodsLiterature search in the PubMed database by applying appropriate search terms.ResultsA total of 26 articles reporting SARS-CoV-2 associated rhabdomyolysis in 32 patients were identified. Age ranged from 16 to 80 years. Four patients were female and 25 were male. Onset of rhabdomyolysis was prior to onset of COVID-19 in 7 patients, and after onset of COVID-19 in the remaining patients. Exposure to myotoxic medication was identified in 18 patients. Myotoxic drugs these patients were taking at the time rhabdomyolysis included azithromycin, hydroxy-chloroquine, placitaxel, propofol, imastinib, piperacillin and meropenem, hydrochlorothiazide, and acetaminophen. Peak creatine-kinase values ranged from 328 to >427656 U/l. The outcome was unreported in 8 cases, favourable in 15 partial, incomplete in 3 cases, and lethal in 6 cases.ConclusionSARS-CoV-2 associated rhabdomyolysis is rare, may be most frequently due to the side effects of myotoxic anti-COVID-19 drugs, and only rarely due to virus myositis, and may have a favourable outcome in most patients.     

Inhibition of Feline Immunodeficiency Virus Infectionin Vitroby Envelope Glycoprotein Synthetic Peptides

Sixty-six 20- to 23-amino-acid synthetic peptides, partially overlapping by 10–12 amino acids, spanning the entire sequence of the envelope SU and TM glycoproteins of the Petaluma isolate of FIV, have been used to investigate the Env domains involved in viral infection. Peptides 5 to 7, spanning amino acids²²⁵E–P²⁶⁴located in a conserved region of the SU protein, and peptides 58 to 61, spanning amino acids⁷⁵⁷N–P⁸⁰⁶and encompassing hypervariable region 8 of TM protein, exhibited a remarkable and specific antiviral effect against the homologous and one heterologous isolate, as judged by inhibition of FIV-induced syncytium formation and p25 production in CrFK cells. Peptides 5 and 7, but not peptides 58 and 59, also inhibited viral replication of a fresh FIV isolate on nontransformed lymphoid cells. By flow cytometry, peptides 5, 7, 58, and 59 were shown to bind the surface of FIV permissive cells. The antiviral activity of peptides 5 and 7, however, was time-dependent, as inhibition of FIV replication was seen when the peptides were administered before or within 3 hr after virus inoculation; in contrast, TM peptides 58 and 59 exerted a potent inhibitory effect when added up to 24 hr after virus inoculation. Circular dychroism analysis showed that peptide 5 folds to a helical conformation in the presence of a hydrophobic environment. Although the basis for the antiviral action of the peptides is not understood, our data suggest that the inhibitory peptides may act by interacting with cell-surface molecules involved in viral infection.     

GERIATRIC NURSES’ ATTITUDES TOWARDS THE USE OF NASOGASTRIC FEEDING-TUBES IN DEMENTED PATIENTS

Geriatric nurses’ attitudes towards the use of nasogastric feeding-tubes in severely demented patients were evaluated. A questionnaire was administered to 232 geriatric nurses asking whether they would favour enteral feeding for demented patients who were unable or refused to eat. The great majority of nurses (73.3%) were favourable; previous experience with nasogastric feeding-tubes and a moderate to high level of religiosity were both significantly associated with this attitude. For the great majority (70.6%) of those favourable the patient's mental status was immaterial to their attitude. Also irrelevant were patients’ and/or caregivers’ wishes and economic and quality of life issues. This survey suggests that the majority of nurses consider enteral feeding as an ordinary basic practice, disregarding the complexity of the problem, which needs an individualized, multifaceted approach.     

Electrograms for Identification of the Atrial Ablation Site During Catheter Ablation of Accessory Pathways

Background: Catheter ablation of accessory pathways using radiofrequency current has been shown to be effective in patients with Wolff-Parkinson-White syndrome, by using either the ventricular or atrial approach. However, the unipolar electrogram criteria for identifying a successful ablation at the atrial site are not well established. Methods and Results: One hundred patients with Wolff-Parkinson-White were treated by delivering radiofrequency energy at the atrial site. Attempts were considered successful when ablation (disappearance of the delta wave) occurred in < 10 seconds. In eight patients with concealed pathway, the accessory pathway location was obtained by measuring the shortest V-A interval either during ventricular pacing or spontaneous or induced reciprocating tachycardia. In 92 patients both atrioventricular valve annuli were mapped during sinus rhythm, in order to identify the accessory pathway (K) potential before starting the ablation procedure. When a stable filtered (30–250 Hz) “unipolar” electrogram was recorded, the following time intervals were measured: (1) from the onset of the atrial to the onset of the K potential (A-K); (2) from the onset of the delta wave to the onset of the K potential (delta-K); and (3) from the onset of the K potential to the onset of the ventricular deflection (K- V). During unsuccessful versus successful attempts, A-K (51 ± 11 ms vs 28 ± 8 ms, P < 0.0001 for left pathways [LPs]; and 44 ± 8 ms vs 31 ± 8 ms, P < 0.02 for right pathways [RPs]) and delta-K intervals (2 ± 9 ms vs -18 ± 10 ms, P < 0.0001 for LPs; and 13 ± 7 ms vs 5 ± 8 ms, P < 0.02 ms for RPs) were significantly longer. Conclusions: Short A-K interval (< 40 ms), and a negative delta-K interval recorded from the catheter positioned in the atrium are strong predictors of successful ablation of LPs and RPs. Therefore, the identification of the K potential appears to be of paramount importance for positioning of the ablation catheter, followed by analysis of A-K and delta-K unipolar electrogram intervals. However, it appears that the mere recording of K potential is not, per se, predictive of successful outcome, but rather the A-K and delta-K interval.     

LIFE EVENTS AND MYOCARDIAL INFARCTION

Life events reported to have occurred twelve months before the onset of the illness were compared in 55 in-patients who had a first episode of myocardial infarction and 55 control in-patients matched for age, sex, marital status and social class and afflicted with acute abdomen, trauma and multiple trauma. The Paykel interview for Recent Life Events was used. Myocardial infarction patients reported significantly more previous events than the control group (p<0.001) with more undesirable (p<0.01) and uncontrolled (p<0.01) events. Moreover, myocardial infarction patients had significantly more events (p<0.01) which had an “objective negative impact” (rated as being traumatic). These findings are consistent with the view that certain recent life events have a positive association with the onset of a first episode of myocardial infarction.