Serum amyloid A is independently related to apolipoprotein A-I but not to HDL-cholesterol in patients with angina pectoris

BackgroundInflammation processes are considered important links between classical lipid risk factors and the progression of atherosclerosis. The interrelationship of high density lipoproteins (HDL) and apolipoprotein apoA-1 with acute phase proteins and cytokines was examined in a clinical setting of patients with angina pectoris.MethodsOn exclusion criteria (myocardial infarction, heart failure, CHD > 2 years, anticoagulant therapy), 198 patients were recruited and were subdivided according to angiographically documented stenosis, no stenosis vs. = 50% stenosis, in accordance with CASS guidelines. Lipids, apoA-1 and apoB, C-reactive protein (hs-CRP), fibrinogen, serum amyloid A (SAA) and cytokines (IL-6, IL-8, IL-10, IL2R, TNFα) were measured.ResultsLow HDL-C (and apoA-I) is associated with advanced coronary stenosis (= 50%) and with the number of diseased vessels, independent of age, gender, diabetes, smoking and lipid-lowering therapy. In contrast to hs-CRP and fibrinogen, SAA as well as cytokine levels were not significantly associated with stenosis. SAA (P = 0.0003) and diabetes (P = 0.0002) were strong predictors of apoA-I concentration independent of age, gender, BMI, smoking, CRP, as well as IL-6 in a multiple regression model. High SAA (P = 0.0067) and TG (P = 0.0123) were significant predictors of apoA-I/HDL-C ratio. However, SAA was not independently related to HDL-C.ConclusionsSAA is independently and inversely related to apoA-I but not to HDL-C in patients with angina pectoris, reflecting the effect of SAA on the quality of HDL particles. However, HDL-c but not SAA is inversely related to the degree of coronary artery stenosis.     

Auricular Transcutaneous Vagus Nerve Stimulation Diminishes Alpha-Band–Related Inhibitory Gating Processes During Conflict Monitoring in Frontal Cortices

BackgroundPursuing goals is compromised when being confronted with interfering information. In such situations, conflict monitoring is important. Theoretical considerations on the neurobiology of response selection and control suggest that auricular transcutaneous vagus nerve stimulation (atVNS) should modulate conflict monitoring. However, the neurophysiological-functional neuroanatomical underpinnings are still not understood.MethodsAtVNS was applied in a randomized crossover study design (n = 45). During atVNS or sham stimulation, conflict monitoring was assessed using a Flanker task. EEG data were recorded and analyzed with focus on theta and alpha band activity. Beamforming was applied to examine functional neuroanatomical correlates of atVNS-induced EEG modulations. Moreover, temporal EEG signal decomposition was applied to examine different coding levels in alpha and theta band activity.ResultsAtVNS compromised conflict monitoring processes when it was applied at the second appointment in the crossover study design. On a neurophysiological level, atVNS exerted specific effects because only alpha-band activity was modulated. Alpha-band activity was lower in middle and superior prefrontal regions during atVNS stimulation and thus lower when there was also a decline in task performance. The same direction of alpha-band modulations was evident in fractions of the alpha-band activity coding stimulus-related processes, stimulus-response translation processes, and motor response–related processes.ConclusionsThe combination of prior task experience and atVNS compromises conflict monitoring processes. This is likely due to reduction of the alpha-band–associated inhibitory gating process on interfering information in frontal cortices. Future research should pay considerable attention to boundary conditions affecting the direction of atVNS effects.     

Incidence of post-dural puncture headache using the 24G "pencil tip" needle. Prospective study in 100 young patients]

We studied the incidence of headache after dural punction using a "pencil-tip" 24G needle in 100 patients aged 15 to 55 years (mean 31.4 years) undergoing surgical interventions that allowed early physical activity. The study variables were age, sex, anesthetic agent, and previous history of headache. All patients received 1,500 ml of Ringer lactate during the peroperative period and after 48 hours the presence of headache was investigated. Headache was not observed in any case. We conclude that the pencil-tip 24G needle has been effective in the prevention of headache after dural punction particularly in young patients, who are traditionally considered to be at risk.     

The Effect of Cilofungin (LY 121019) in Combination with Amphotericin B or Flucytosine AgainstCandidaSpecies

Cilofungin was combined with amphotericin B or flucytosine to determine if synergistic inhibition or killing occurred against 50 strains of various Candida species. Synergistic inhibition of growth occurred only once with amphotericin B and cilofungin and only 2 times with flucytosine and cilofungin. Synergistic killing occurred in 5 strains with the amphotericin B-cilofungin combination and in 7 strains with the flucytosine-cilofungin combination. Antagonism occurred frequently with both the amphotericin B-cilofungin and the flucytosine-cilofungin combinations.     

Characterization of low density lipoprotein receptor (LDLR) gene mutations in Albania

Introduction

Familial hypercholesterolaemia (FH) is a clinical syndrome characterised by elevated serum total cholesterol (TCHOL) levels due to an increase in low-density lipoprotein (LDL) cholesterol, by tendon xanthomata and clinical manifestations of ischaemic heart disease in early life. Typically, it results from mutations in the low-density lipoprotein receptor (LDLR) gene. So far, more than 800 mutations have been reported for the LDLR gene and account for FH. The nature of LDLR gene mutations varies among different ethnicities. Until now no mutations of LDLR have been reported in the Albanian population.

Material and methods

We assessed the contribution of the LDLR gene mutations as causes of FH in an Albanian population. Fifty probands with a clinical diagnosis of FH were included. We analysed all the exons and the promoter of the LDLR gene by using restriction isotyping or direct sequencing.

Results

Twenty-one patients were heterozygous for the 1646G>A mutation (FH Genoa) in exon 11 and 9 patients were heterozygous for the 81T>C mutation in exon 2 of the LDLR gene.

Conclusions

This report describes two LDLR gene mutations accounting for FH in Albania (1646G>A, 81T>C).     

The Effect of Cilofungin (LY 121019) in Combination with Amphotericin B or Flucytosine Against Candida Species: Die Wirkung von Cilofungin (LY 121019) in Kombination mit Amphotericin B oder Flucytosin auf Candida-Arten

Cilofungin was combined with amphotericin B or flucytosine to determine if synergistic inhibition or killing occurred against 50 strains of various Candida species. Synergistic inhibition of growth occurred only once with amphotericin B and cilofungin and only 2 times with flucytosine and cilofungin. Synergistic killing occurred in 5 strains with the amphotericin B-cilofungin combination and in 7 strains with the flucytosine-cilofungin combination. Antagonism occurred frequently with both the amphotericin B-cilofungin and the flucytosine-cilofungin combinations.     

Susceptibility of Yeast-Like Fungi to a New Antifungal Agent, LY 121019

Summary:  LY 121019, a new antifungal antibiotic agent, was tested for activity against 200 clinical isolates of Candida and other yeast-like fungi. LY 121019 had its greatest inhibitory effect on C. albicans , and C. tropicalis. C. glabrata and most other Candida species were not as sensitive. Cryptococcus and other yeast-like fungi, with the exception of a few strains, were not susceptible to LY 121019.
Zusammenfassung:  LY 121019, ein neues Antimyzetikum, wurde auf seine Aktivität gegen 200 klinische Isolate von Candida und anderen, hefeähnlichen Pilzen untersucht. LY 121019 hat seine größte Hemmwirkung gegen C. albicans und C. tropicalis. C. glabrata und die meisten anderen Candida -Arten waren nicht so empfindlich. Cryptococcus und andere, hefeähnliche Pilze waren, mit Ausnahme weniger Stämme, nicht für LY 121019 empfindlich.     

Metachronous colorectal cancer risk in Lynch syndrome patients—should the endoscopic surveillance be more intensive?

Purpose

Regular follow-up for patients with Lynch syndrome (LS) is vital due to the increased risk of colorectal (50–80%), endometrial (40–60%), and other cancers. However, there is an ongoing debate concerning the best interval between colonoscopies. Currently, no specific endoscopic follow-up has been decided for LS patients who already have an index colorectal cancer (CRC). The aim of this study was to evaluate the risk of metachronous cancers (MC) after primary CRC in a LS population and to determinate if endoscopic surveillance should be more intensive.

Methods

A prospective cohort of patients with a confirmed diagnosis of hereditary CRC since 2009 was included. Patients with LS and a primary CRC were the cohort of choice.

Results

One hundred twenty-one patients were included with a median age of 44 years(16–70). At least one MC occurred in 39 patients (32.2%), with a median interval of 67 months (6–300) from index cancer. Fifteen (38.5%) developed two or more MCs during follow-up, with a median number of two (2–6) tumors occurring. Metachronous CRC were diagnosed after a median interval of 24 (6–57) months since last colonoscopy and were more commonly seen in MSH2 mutation carriers (58 vs. 35%, p?=?0.001). After a median follow-up of 52.9 (3–72) months, no cancer-related deaths were recorded.

Conclusion

Patients with LS have an increased risk of MC, especially CRCs. With a median time period of 24 months between colonoscopy and metachronous CRC, the interval between surveillance colonoscopies following primary CRC should not exceed 18 months, especially in patients with MSH2 mutation.