Benefit of combined cardiac rehabilitation on exercise capacity and cardiovascular parameters in patients with type 2 diabetes

Favorable effects of exercise training on cardiovascular prognosis have been reported repeatedly in patients with diabetes mellitus type 2 (DM2). However, little is known about the cardiovascular rehabilitation effects in diabetic patients with coronary artery disease (CAD). This study has evaluated the benefits of combined aerobic-resistance training in two groups of patients--diabetics and non-diabetics--after percutaneous coronary intervention (PCI). Changes in exercise capacity parameters, resting cardiovascular and anthropometrical parameters were evaluated in 77 patients who completed 12-weeks of combined aerobic-resistance training: 32 patients with DM2 (DM) and 45 patients without DM2 (NDM). Significant improvements in exercise capacity (total peak workload [W(peak)], peak workload per kg of body weight [W(peak)/kg], total peak oxygen uptake [VO(2peak)], peak oxygen uptake per kg of body weight [VO(2peak)/kg]) were found in both DM and NDM (p < 0.01 and p < 0.001, respectively). The decrease in resting heart rate (HR(rest)), resting systolic (SBP(rest)) resting diastolic (DBP(rest)) blood pressures, body weight (BW) and BMI in the DM group was not statistically significant. However, there was a statistically significant decrease in SBP(rest), BW and BMI in the NDM group. In conclusion, this study demonstrated similar beneficial effects of combined cardiovascular training on exercise capacity in patients with or without type 2 diabetes mellitus. Our results suggest that the combined cardiac training is well tolerated and useful in secondary prevention in patients with DM2 and CAD.     

Cystic parathyroid adenoma within a multinodular goiter: a rare cause of primary hyperparathyroidism

Parathyroid cysts are uncommon lesions that do not have a specific sonographic appearance. We report a rare case of a functionally active cystic parathyroid adenoma as a cause of primary hyperparathyroidism and discuss the difficulties associated with the diagnosis. In this case, the association with a multinodular goiter made preoperative differentiation from thyroid cysts difficult. Demonstration of a high intact parathyroid hormone level in the aspirated cyst fluid was critical for the correct diagnosis.     

Serum lipids and neopterin in urine as new biomarkers of malnutrition and inflammation in the elderly

ObjectiveLevels of serum lipids are influenced by malnutrition and inflammation. The study aimed to find the relation of the lipidogram to positive and negative markers of inflammation in geriatric patients. Attention was paid to neopterin in urine as a non-protein positive bioindicator of inflammation.MethodsIt was a local, monocentric, prospective clinical study in hospitalized patients older than 80 y. The study included 101 patients (54 women, 47 men). The average age of the entire group was 85.37 ± 4.88 y. The dependence of the values of total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triacylglycerols (TAGs) on C-reactive protein (CRP), neopterin in urine, and prealbumin was examined.ResultsWhen we compared CRP and serum lipids, we found a statistically significant negative correlation between levels of CRP and total cholesterol (P < 0.05), HDL (P < 0.01), and LDL (P < 0.05). Also the level of neopterin in urine was negatively correlated with levels of total cholesterol (P < 0.05) and HDL (P < 0.01). A statistically highly significant interaction was demonstrated between levels of prealbumin and total cholesterol (P < 0.001), HDL (P < 0.001), LDL (P < 0.001), and TAG (P < 0.05).ConclusionA significant negative correlation between levels of inflammation markers (neopterin in urine, CRP) and total cholesterol and HDL was found. LDL was influenced to a lesser extent. A close relation between serum lipids and prealbumin was also demonstrated. Total cholesterol, HDL, and LDL can be considered novel biomarkers of malnutrition and inflammation in geriatric patients.     

Establishment, growth and in vivo differentiation of a new clonal human cell line, EM-G3, derived from breast cancer progenitors

A new clonal cell line, EM-G3, was derived from a primary lesion of human infiltrating ductal breast carcinoma. The line consisted of cuboidal cells with occasional appearance of more differentiated branched cells apparently involved in cell-to-cell communication. The EM-G3 cells, population doubling time 34 h, are dependent on the epidermal growth factor. Multicolor fluorescence in situ hybridization (mFISH) analysis demonstrated a stable diploid genome with several genetic changes. Immunocytochemical analysis of EM-G3 in vitro revealed positivity for keratins (K) K5, K14, K18, nuclear protein p63, epithelial membrane antigen (EMA) and other proteins indicative of a pattern of mammary epithelium bipotent progenitors. Detection of integrins α-6, β-1, and protein CD44 by cDNA array also pointed to the character of basal/stem cells. In contrast, dominant cells in the human original tumor showed the luminal character (K18+, K19+, K5−, K14−, and p63−). However, cells with the immunocytochemical profile similar to that of cultured EM-G3 cells were found in minor clusters in the patient’s tumor sections. The EM-G3 cells formed limited tumors in nu/nu mice. The cells in mouse tumors were organized in primitive ductal-like structures consisting of 1–3 large central luminal-like cells (EMA+) surrounded by peripheral myoepithelial-like cells (p63+/EMA−). The large central cells gradually disintegrated, forming a pseudolumen. Apparently, EM-G3 cells are able to partially differentiate in vivo as well as in vitro. Our results indicate that EM-G3 cells were derived from a premalignant population of common progenitors of luminal and myoepithelial cells that were immortalized in an early stage of tumorigenesis.     

Kinesin's step dissected with single-motor FRET

The motor protein Kinesin-1 drives intracellular transport along microtubules, with each of its two motor domains taking 16-nm steps in a hand-over-hand fashion. The way in which a single-motor domain moves during a step is unknown. Here, we use Förster resonance energy transfer (FRET) between fluorescent labels on both motor domains of a single kinesin. This approach allows us to resolve the relative distance between the motor domains and their relative orientation, on the submillisecond timescale, during processive stepping. We observe transitions between high and low FRET values for certain kinesin constructs, depending on the location of the labels. These results reveal that, during a step, a kinesin motor domain dwells in a well-defined intermediate position for ≈3 ms.     

Is prophylactic 360-degree laser retinopexy protective? Risk factors for retinal redetachment after removal of silicone oil.

OBJECTIVES: To identify risk factors for retinal redetachment after removal of silicone oil. To determine the effectiveness of prophylactic laser in preventing retinal redetachment after removal of silicone oil. DESIGN: A nonrandomized retrospective comparative interventional trial. PARTICIPANTS: Three hundred seventy-six patients undergoing vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment at one institution over a 4-year period. Two hundred eighty-seven patients with fully attached retinas subsequently underwent removal of silicone oil. One hundred thirty-eight cases had undergone prophylactic 360 degrees laser retinopexy before removal of silicone oil, either at the time of their final retinal reattachment procedure (n = 36) or as a separate supplementary procedure (n = 102). METHODS: A retrospective case note review was performed to identify clinical and demographic factors associated with increased or reduced odds of retinal redetachment after removal of silicone oil. Both univariate and multiple variable analysis were used to identify significant risk factors. MAIN OUTCOME MEASURES: Incidence of retinal redetachment after removal of silicone oil. RESULTS: Median follow-up after removal of silicone oil was 272 days. Three hundred sixty-degree prophylactic laser retinopexy was associated with a reduction from 26% to 14% in the incidence of redetachment after removal of silicone oil (adjusted odds ratio, 0.42; 95% confidence interval, 0.22-0.78; P = 0.006). Patients requiring further retinal reattachment surgery after their first oil procedure were at twice the odds of re-detachment after oil removal (adjusted odds ratio, 2.10; 95% confidence interval, 1.03-4.26; P = 0.04). CONCLUSIONS: The need for retinal reattachment surgery subsequent to a first silicone oil procedure was associated with twice the odds of retinal redetachment after removal of silicone oil. Prophylactic laser retinopexy may halve the incidence of retinal redetachment after removal of silicone oil.     

Envenoming by the viperid snake Proatheris superciliaris: A case report

Snake bites caused by viperid snakes of Atheris genus are extremely rare, envenoming of a bite of related viper Proatheris superciliaris was described only once in the literature. The present case study depicts the envenoming of a 57 years old Czech man, a private herpetologist, who was bitten to his finger. He developed painful local reaction, nausea, hematuria, hypertension, chest and lumbar pain. Coagulopathy and thrombocytopenia subsequently developed as well as acute renal failure, hepatic and lung lesion. Intensive care therapy was purely symptomatic and supportive as no antisera exists. Treatment included haemodialysis, substitution of fresh frozen plasma and platelets. Patient completely recovered during 1 month.