Investigation of the Aortic Pulse Wave Velocity in Patients with Gilbert’s Syndrome

Arterial stiffness is currently the “gold standard” measure of aortic (carotid-femoral) pulse wave velocity (PWV), which is an important independent predictor of risk of developing a cardiovascular event. Gilbert’s syndrome is a congenital disorder characterized by intermittent and non-hemolytic elevation of indirect bilirubin levels due to the deficiency of the enzyme UDP-glucuronyl transferase in the liver and many prospective studies found an inverse relationship between bilirubin levels and cardiovascular events in these patients. We aimed to investigate serum bilirubin levels and arterial stiffness parameters in patients with Gilbert’s syndrome in this study. A total of 53 cases, consisting of 26 patients with a diagnosis of Gilbert’s syndrome and 27 healthy control subjects, were included in the study. Serum bilirubin levels, other routine blood chemistry, and arterial stiffness measurements were recorded. The mean ages of Gilbert’s syndrome and the control group were 31.5 ± 9.7 and 36.8 ± 11.1 years, respectively. PWV measurements were significantly lower in Gilbert syndrome patients (6.68 and 7.3 m/s in patients and controls; respectively) (P < .05). In correlation analysis in Gilbert’s syndrome patients, PWV had a significant correlation with total and indirect bilirubin levels (r = ?0.370, P = .009/r = ?0.495, P = .003, respectively). Gilbert’s syndrome patients have lower PWV measurements compared to healthy subjects, and the total and indirect bilirubin levels are also associated with PWV measurements. These findings may indicate the decreased atherosclerotic disease incidence in Gilbert’s syndrome patients.     

电磁脉冲辐射对原癌基因c-fos调控区的影响

目的　通过研究电磁脉冲 (electromagneticpulse ,EMP)辐射对原癌基因c fos调控区域的影响 ,探讨其诱导细胞功能改变的机制。方法　构建c fos启动区氯霉素乙酰化转移酶 (chloramphenicolacetyl transferase,CAT) ,然后转染HeLa癌细胞株 ,高场强EMP模拟源 (有界波模拟源 )辐射细胞 ,EMP场强为6× 10 4V/m ,脉冲上升时间为 2 0ns ,脉宽为 3 0 μs ,频率为 2 .5个脉冲 /min ,辐射 2min ,处理后 2 0min时观察细胞中CAT的活性。结果　EMP辐射转染的细胞后 2 0min ,转染了P50 0 ( -711～ -2 2 3bp)和P2 50 ( -3 62～-10 0 )的Hela细胞其CAT活性明显高于对照水平的活性 (P <0 .0 1)。结论　EMP辐射可引起c fos基因调控区的 -3 62～ -2 2 5明显改变。     

The Effects of Acute Bouts of Whole Body Vibration on Central Hemodynamics in Frail Older Adults: A Pilot Study

Abstract

Introduction: This study investigates whether an acute bout of whole body vibration (WBV): (i) improves measures of central hemodynamics and (ii) can be completed without inducing orthostatic intolerance in frail older adults. Methods: Nine rest home residents participated in a cross-over design incorporating WBV and non-vibrational control conditions (CON) on 2 separate testing days. The order of the two testing conditions was randomized. Participants completed 10 sets of 60?seconds of WBV training or CON with an inter-set rest period of 60?seconds. Results: During training, no interaction or between-condition effects were observed for any variable. Following training, there was an interaction effect reported for augmentation index (AIx) (P?<?0.019) and a significant large increase in AIx for WBV (P?=?0.020, Eta = 0.202). Three participants exhibited one-off notable decreases in either central systolic or diastolic blood pressure. Conclusion: An acute bout of WBV is a safe training method for frail older adults.     

Arterial stiffness and vascular complications in patients with type 1 diabetes: The Finnish Diabetic Nephropathy (FinnDiane) Study

Abstract

Introduction/aims. While patients with type 1 diabetes (T1D) are known to suffer from early cardiovascular disease (CVD), we examined associations between arterial stiffness and diabetic complications in a large patient group with T1D.

Methods. This study included 807 subjects (622 T1D and 185 healthy volunteers (age 40.6 ± 0.7 versus 41.6 ± 1.2 years; P = NS)). Arterial stiffness was measured by pulse wave analysis from each participant. Furthermore, information on diabetic retinopathy, nephropathy, and CVD was collected. The renal status was verified from at least two out of three urine collections.

Results. Patients with T1D without signs of diabetic nephropathy had stiffer arteries measured as the augmentation index (AIx) than age-matched control subjects (17.3% ± 0.6% versus 10.0% ± 1.2%; P < 0.001). Moreover, AIx (OR 1.08; 95% CI 1.03–1.13; P = 0.002) was associated with diabetic laser-treated retinopathy in patients with normoalbuminuria in a multivariate logistic regression analysis. The same was true for AIx and diabetic nephropathy (1.04 (1.01–1.08); P = 0.004) as well as AIx and CVD (1.06 (1.00–1.12); P = 0.01) in patients with T1D.

Conclusions. Arterial stiffness was associated with microvascular and macrovascular complications in patients with T1D.     

Itraconazole (Sporanox®) in superficial and systemic fungal infections

Itraconazole (Sporanox^®) is a triazole antifungal agent with a broad activity spectrum and favorable pharmacokinetic and safety profiles. Numerous clinical trials have established the efficacy and safety of itraconazole in the treatment of superficial fungal infections. In this field, full exploitation of its pharmacokinetics in keratinized tissues has led to the development of intermittent (pulse) treatment regimens that allow similar efficacy with lower overall drug exposure as well as a reduction in treatment costs. The additional anti-inflammatory action of itraconazole also makes it suitable for application in difficult-to-treat inflammatory skin disorders, such as seborrheic dermatitis. Recently, a new oral liquid formulation and an intravenous formulation have been developed, extending the therapeutic application of itraconazole to systemic fungal infections. Due to its broad activity spectrum and excellent tolerability, itraconazole is a valuable addition to the antifungal armamentarium used for prophylactic and empiric treatment in immunocompromised hosts.     

Large-scale analysis of interindividual variability in single and paired-pulse TMS data

ObjectiveThis study brought together over 60 transcranial magnetic stimulation (TMS) researchers to create the largest known sample of individual participant single and paired-pulse TMS data to date, enabling a more comprehensive evaluation of factors driving response variability.MethodsAuthors of previously published studies were contacted and asked to share deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to variability in response to single and paired-pulse TMS data.Results687 healthy participant’s data were pooled across 35 studies. Target muscle, pulse waveform, neuronavigation use, and TMS machine significantly predicted an individual’s single-pulse TMS amplitude. Baseline motor evoked potential amplitude, motor cortex hemisphere, and motor threshold (MT) significantly predicted short-interval intracortical inhibition response. Baseline motor evoked potential amplitude, test stimulus intensity, interstimulus interval, and MT significantly predicted intracortical facilitation response. Age, hemisphere, and TMS machine significantly predicted MT.ConclusionsThis large-scale analysis has identified a number of factors influencing participants’ responses to single and paired-pulse TMS. We provide specific recommendations to minimise interindividual variability in single and paired-pulse TMS data.SignificanceThis study has used large-scale analyses to give clarity to factors driving variance in TMS data. We hope that this ongoing collaborative approach will increase standardisation of methods and thus the utility of single and paired-pulse TMS.     

肱－踝脉搏波传导速度和踝臂指数对冠状动脉疾病的预测价值

目的：探讨肱－脉搏波传导速度及踝臂指数对冠状动脉疾病的预测价值。方法入选472例疑似冠状动脉粥样硬化性心脏病（ CAD）的患者,根据CAG的结果,分为非CAD组（冠状动脉管腔狭窄＜5％）和CAD组（冠状动脉管腔狭窄≥50％）。收集患者的基线资料,对所有患者进行肱－踝脉搏波传导速度（ BaPWV）及踝臂指数（ ABI）的测量。用Logistic回归模型评价BaPWV、ABI及其他相关指标对冠状动脉病变程度的预测能力。结果（1）糖尿病、BaPWV＞1400 cm／s、典型胸痛,2组比较差异有统计学意义（P值均＜0．001）;ABI＜0．9,2组比较无统计学差异（P＞0．05）。（2）Logistic多因素回归分析显示,典型胸痛症状,PWV＞1400 cm／s和糖尿病史为CAD的独立预测因子（P值均＜0．001）。 OR值分别为8．442（95％可信区间5．063～14．077）,5．507（95％可信区间3．401～8．897）,3．027（95％可信区间1．854～4．941）。结论典型胸痛症状、PWV＞1400 cm／s和糖尿病病史是预测CAD的有效因素之一,BaP－WV作为无创伤检查方法可以有效预测冠状动脉疾病发生。而ABI＜0．9则没有表现出统计学意义。     

Low central blood pressure and sympathetic activity predispose for the development of intradialytic hypotension

Intradialytic hypotension (IDH) may lead to a poor life quality and was associated with cardiovascular mortality in patients under hemodialysis. This study investigated the autonomic nerve and cardiovascular function in the IDH episodes.In this case-control study, 70 end stage renal disease patients (198 visits) were recruited. Pulse wave analysis and heart rate variability were evaluated before hemodialysis. Two definitions of IDH were confirmed by medical records. IDH-f indicated a drop of systolic blood pressure or mean arterial pressure, accompanied with symptoms; IDH-n indicated a low nadir systolic pressure during the hemodialysis. All parameters were evaluated for the possible predisposing factors under each definition.A total of 24 IDH-f and 37 IDH-n were noted in 177 visits. For both definitions, central pulse pressure seemed to be a consistent predisposing factor. Furthermore, lower sympathetic activity (odds ratio [OR] 0.55; 95% confidence interval [CI] 0.35–0.87), lower pulse pressure (OR 0.95; 95% CI 0.92–0.98), and higher augmentation index (OR 17.36; 95% CI 1.48–204.10) were the possible predisposing factors for IDH-f. On the contrary, lower mean arterial pressure (OR 0.87; 95% CI 0.78–0.98) was identified as the possible factor for IDH-n.It was suggested that the lower central pulse pressure and sympathetic activity might be involved in the development of IDH.     

Correlation between 25-hydroxyvitamin D level and arterial elasticity in middle-aged and elderly cadres in Guiyang,China: A retrospective observational study

There is evidence that serum 25-hydroxyvitamin D [25-(OH) D] levels may be associated with cardiovascular disease and its risk factors. This study aimed to investigate the relationship between 25-(OH) D levels and blood pressure (BP), blood lipids, and arterial elasticity in middle-aged and elderly cadres in China.In this retrospective study, we included 401 civil servants and cadres aged >42 years who underwent medical examinations at Guiyang Municipal First People''s Hospital, China in 2018. The participants were assigned to deficiency (≤20 ng/mL), insufficiency (20–30 ng/mL), and sufficiency (≥30 ng/mL) groups according to 25-(OH) D levels in their blood. Demographics, brachial–ankle pulse wave velocity (baPWV), BP, ankle–brachial index (ABI), and blood lipids were compared among groups. The associations between 25-(OH) D and other parameters were evaluated using linear regression analysis.Median (range) 25-(OH) D levels in the deficiency (n = 162), insufficiency (n = 162), and sufficiency (n = 77) groups were 15.32 (2.93–19.88), 25.12 (20.07–29.91), and 33.91 (30.23–82.42) ng/mL, respectively. There were significant differences in systolic BP, pulse pressure, baPWV (left and right sides), ABI (left side), high-density lipoprotein-cholesterol, and triglycerides (TGs; all P < .05) among groups. Multivariate linear regression revealed that TG, left baPWV, and right baPWV were significantly negatively correlated with 25-(OH) D levels (all P < .05).In this study, 25-(OH) D levels were found to be associated with TG, left baPWV, and right baPWV values. 25-(OH) D deficiency may be associated with reduced arterial elasticity.