Biomarkers of oxidative stress in acute and chronic bronchial asthma

Objective: Oxidative stress plays an important role in inflammatory diseases of the airways, such as bronchial asthma. This study highlights the effects of the imbalance of oxidant/antioxidant parameters and their roles in the severity of asthma, in order to target the deficiency of antioxidants when treating asthmatic patients. Methods: The study included 45 male and 45 female subjects, aged 18–48 years, with and without asthma. They were classified into 3 groups: G1 was healthy volunteers (CT, n?=?15), G2 included patients with stable (chronic) conditions of asthma from the outpatients department (OP, n?=?15), and G3 included patients admitted emergency room (ER, n?=?15) with acute asthma attacks. For all subjects, the levels of total antioxidant capacity (TAC), reduced glutathione (GSH), malondialdehyde (MDA), and uric acid were colorimetrically estimated. The correlations between the studied parameters were statistically analyzed. Results: The levels of TAC and GSH in asthmatic patients, either male or female, were significantly decreased in the ER more than in the OP group as compared to the control (p?0.001). MDA increased significantly in the ER group and over the OP group when compared with healthy subjects. Significant positive correlations (p?0.001) were observed between MDA and other studied parameters TAC (r?=??0.74), GSH (r?=??0.69), and uric acid (r?=??0.35). Conclusions: The levels of total antioxidants were inversely related to the severity of asthma as observed in asthmatic patients visiting outpatient clinics and patients with acute asthmatic attacks admitted to emergency rooms. Meanwhile, those patients with acute attacks showed increased oxidative stress as reflected in the raised MDA levels.     

Systolic Blood Pressure Time in Target Range and Cardiovascular Outcomes in Patients With Hypertension

BackgroundStandard blood pressure control metrics may not account for fluctuations in blood pressure over time.ObjectivesThis study sought to estimate the independent association between time in systolic blood pressure target range and major adverse cardiovascular events among adults with hypertension.MethodsThis study was a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a randomized clinical trial that compared intensive (<120 mm Hg) and standard (<140 mm Hg) systolic blood pressure treatment interventions in adults with hypertension and high cardiovascular risk. Target range was defined as 110 to 130 mm Hg and 120 to 140 mm Hg for the intensive and standard arms, respectively. Time in target range was estimated over the first 3 months of follow-up using linear interpolation. The association between time in target range with major adverse cardiovascular events was estimated using adjusted Cox proportional hazards regression models.ResultsParticipants with greater time in target range were younger, had lower 10-year cardiovascular risk and lower baseline systolic blood pressure, and were more likely women and statin users. Each 1-SD increase in time in target range was significantly associated with a decreased risk of first major adverse cardiovascular event in fully adjusted models. Time in target range remained significantly associated with major adverse cardiovascular events despite adjustment for mean systolic blood pressure or systolic blood pressure variability. Among participants with mean systolic blood pressure at or below target, time in target range remained associated with major adverse cardiovascular events.ConclusionsTime in systolic blood pressure target range independently predicts major adverse cardiovascular event risk.     

Comparison between the safety profile and clinical results of the Cook detachable and Gianturco coils for transcatheter closure of patent ductus arteriosus in 272 patients

OBJECTIVES: We evaluated the occlusion rate and safety of Cook detachable coils versus Gianturco coils in transcatheter closure of patent ductus arteriosus (PDA). BACKGROUND: The Cook detachable coil recently was introduced in an attempt to improve the safety of transcatheter closure of PDA. METHODS: Between January 1994 and September 1998, 272 patients underwent transcatheter PDA closure. Cook detachable coils were used in 137 patients, with a mean age of 43.9 months and weight of 13.8 kg. In 135 patients, Gianturco coils were used, with a mean age of 56.8 months and weight of 17.8 kg. The mean narrowest diameter of the PDA in the Cook detachable coil group was 2.85 mm versus 2.32 mm for the Gianturco coil group. RESULTS: The Cook detachable coil group was younger and weighed less than the Gianturco group (P < 0.05 and 0.02, respectively). Their narrowest PDA diameter was larger (P < 0.01). Embolization rate was significantly lower in the Cook coil group (9[6.5%] of 137 vs 22 (16.3%) of 135; P = < 0.013). The mean follow-up for the Cook coil group was significantly shorter (0.55 years) than for the Gianturco coil group (1.18 years; P < 0.001). On an intention-to-treat basis, complete occlusion by echocardiography was achieved in 99 (72.3%) of 137 patients in the Cook detachable coil group, which was significantly less than the Gianturco coil group (114 [84.4%] of 135; P = 0.008). CONCLUSION: Cook detachable coils for transcatheter closures of the PDA are safer than Gianturco coils. Hence, children with large ductal can be treated earlier in life. Short-term complete occlusion rate was lower in the Cook detachable coil group. This rate can be explained by a shorter follow-up time, larger ductal diameter, and the different materials used for the detachable coils.     

Co-existence of lip and epiglottis Kimura’s disease

Kimura’s disease is a rare, chronic inflammatory condition of unknown etiology; with a predilection in the head and neck region. However, the involvement of the lip and epiglottis is extremely rare, and poses a diagnostic challenge. Here, we report a case of a 32-year-old Saudi male presenting with lip mass and epiglottic swelling without any history of hoarse voice or airway compromise. Serology showed elevated immunoglobulin E levels, and histopathological examination of biopsied lesions revealed well-developed lymphoid follicles with eosinophilic infiltration confirming Kimura’s disease. At the time of last follow-up, his condition was satisfactory without any signs of recurrence.Kimura’s disease (KD) is a rare, chronic non-neoplastic inflammatory disease, that is predominantly seen in Asian males during the third decade of life.1 The common manifestation is slowly enlarging subcutaneous masses often found in the head and neck region along with raised serum immunoglobulin E (IgE) levels, and peripheral blood eosinophilia. Kimura’s disease affecting lips and larynx is an extremely rare entity, and only few case reports have been published.2 Here, we report a rare case of KD affecting lip and epiglottis and its related review of literature.     

Proliferative verrucous leukoplakia: Recognition and differentiation from conventional leukoplakia and mimics

The majority of conventional leukoplakia remains constant and only a subset progress to high‐grade dysplasia or invasive carcinoma. A less recognized form known as proliferative verrucous leukoplakia (PVL) represents a unique progressive and elusive variant. Identifying patients with this form can only be achieved through the keen clinical observation of the temporal gross and histologic progression in individual patients with squamous cell carcinoma. The difficulty in the early diagnosis of PVL stems from the overlapping clinical and pathologic features with conventional multifocal leukoplakia with dysplasia. We present the current view on the clinicopathologic and biological characteristics of PVL and discuss their diagnosis, differential diagnosis, and management. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1662–1668, 2014     

Correlation between blood pressure, cytokines and nitric oxide in conscious rabbits injected with Leiurus quinquestriatus quinquestriatus scorpion venom

Activation of the inflammatory response with the release and activation of pro-inflammatory cytokines is among the factors thought to be important in the pathogenesis of many deleterious inflammatory effects seen in case of scorpion envenomation. The released inflammatory mediators interact in the body with a large number of proteins and receptors; this interaction determines the eventual inflammatory effect of the venom. Thus, in the present study an attempt was made to map the time course of scorpion envenomation and correlate the effects observed on the cardiovascular and respiratory systems with the changes that could take place in the levels of selected cytokines and nitric oxide during the course of experimental envenomation. New Zealand white male conscious rabbits were prepared for blood pressure recording. Arterial blood pressure was measured from the left central ear artery while a cannula was inserted into the right central ear artery and blood samples collected at different time interval after venom injection for biochemical and hematological analyses. In general, subcutaneous injection of Leiurus quinquestriatus quinquestriatus venom caused a significant (P ± 0.05) triphasic effect on BP consisting of an initial transient reduction, followed by an increase that peaked 2 h after venom injection, and a gradual terminal hypotensive phase. The significantly high serum level of IL8, TNFα (P < 0.001) and nitric oxide (P < 0.0001) observed in the present study supports the evidence for the role of these potent vasodilators in the terminal hypotension that is usually observed in humans and animals after envenomation.     

Morphology and growth of the fetal stomach.

To assess the development of the fetal stomach, we performed 162 esophageal injections of contrast media into spontaneously aborted normal fetuses from 7.5 to 26 weeks of gestation. The length of esophagus and trunk, greater and lesser curvature, and vertical and oblique axis of stomach were measured, and the means and standard deviations at each gestational age were calculated. The most frequently encountered patterns of stomach shape were: the standard shape, 90%; steerhorn, 3%; and horizontal stomach, 2%. The final shape of the stomach is not assumed at least until the the age of 22 weeks. Regarding the growth of stomach, with age, the greater curvature grew at a much faster rate than the lesser curvature, and the distance between skin and outer border of the stomach increased. The oblique axis of the stomach did not rotate after eight weeks; gastric surface area showed the fastest growth after 14 weeks. The gastroesophageal junction cephalad relative to the trunk ascended through week 25, due to the differential growth of the trunk and esophagus.