Significant decrease in plasmad‐dimer levels and mean platelet volume after a 3‐month treatment with rosuvastatin in patients with venous thromboembolism

BackgroundInflammation has been considered as a possible mechanism for the initiation and recurrence of venous thromboembolism (VTE). Statins have anti‐inflammatory and potential immune‐modulatory effects, but their effect on plasmad‐dimer levels is controversial.HypothesisIn this study, we aimed to evaluate the impact of rosuvastatin on D‐dimer and other inflammatory serum markers in VTE patients.MethodsWe conducted a prospective, randomized study on 228 patients with VTE. Control group received conventional treatment (warfarin or rivaroxaban), whereas rosuvastatin‐intervention group received rosuvastatin 10 mg daily, in addition to their conventional treatment for 3 months. Serum markers were extracted from both groups at the baseline and 3 months after the beginning of treatment.ResultsAfter 3 months, in patients of the intervention group, there was a statistically significant decrease in levels ofd‐dimer and mean platelet volume (MPV) but no significant change in neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio.ConclusionsOur results showed that a 3‐month treatment with 10 mg rosuvastatin daily can significantly decrease the plasma levels ofd‐dimer and MPV, which would support a potential role of statins to reduce activated systemic inflammation among VTE patients. Such effects can be used to reduce the rate of recurrent VTE in these patients.     

CHA2DS2‐VASc and PESI scores are associated with right ventricular dysfunction on computed tomography pulmonary angiography in patients with acute pulmonary thromboembolism

BackgroundAccurate risk stratification is the most important step in the management of patients with acute pulmonary thromboembolism (PTE). Pulmonary embolism severity index (PESI) is a clinical tool for PTE risk stratification. CHA₂DS₂‐VASc score, a risk assessment tool in patients with atrial fibrillation, is recently considered for acute PTE. The presence of right ventricular (RV) dysfunction in imaging is more efficient in acute PTE risk evaluation.HypothesisThis study aims to evaluate the association between CHA₂DS₂‐VASc and PESI score and each of them with RV dysfunction on computed tomography pulmonary angiography (CTPA).MethodsOne hundred eighteen patients with a definite diagnosis of PTE were entered. The CHA₂DS₂‐VASc and PESI scores were calculated for all of them. RV dysfunction including an increase in RV to left ventricular diameter ratio, interventricular septal bowing, and reflux of contrast medium into the inferior vena cava was examined by CTPA.ResultsPESI and CHA₂DS₂‐VASc scores were significantly associated with RV dysfunction. In addition, different classes of PESI scores were correlated with RV dysfunction. Moreover, this study showed that the CHA₂DS₂‐VASc score and PESI score had a positive correlation. The area under the curve value for the CHA₂DS₂‐VASc score was 0.625 with 61.54% sensitivity and 60.0% specificity for predicting RV dysfunction while for PESI score was 0.635 with 66.7% sensitivity and 60.0% specificity.ConclusionThis study showed that not only CHA₂DS₂‐VASc and PESI scores are positively correlated, but they are both associated with RV dysfunction diagnosed by CTPA. CHA₂DS₂‐VASc and PESI scores are able to predict RV dysfunction.     

黄豆提取物的雌激素依赖作用对戊四唑诱发的大鼠癫痫的影响

目的：研究黄豆提取物对经戊四唑（pentylenetrazole,PTZ）诱发癫病发作的女性荷尔蒙缺失雌性大鼠与正常雌性大鼠的不同作用,以及因性别差异引起的植物雌性激素对行为的影响。方法：雄性Wistar大鼠被随机分为雄性生理盐水组,雄性低、中、高剂量黄豆提取物治疗组,每组8只;雌性Wistar大鼠随机分为假手术生理盐水组,假手术低、中、高剂量黄豆提取物治疗组,去卵巢生理盐水组,去卵巢低、中、高剂量黄豆提取物治疗组,每组8只。去卵巢大鼠在氯胺酮麻醉下行卵巢切除术。分别给予各组大鼠生理盐水及不同剂量黄豆提取物治疗2周后腹腔内注射戊四唑。将大鼠放置在树脂玻璃笼内,记录最小阵挛性癫痫发作（minialclonicseizure,MCS）潜伏期和强直性阵挛性癫痫发作（generalizedtonic-clonicseizure,GTCS）潜伏期。结果：与雄性生理盐水组大鼠比较,雄性低、中剂量黄豆提取物治疗组的MSC和GTCS潜伏期显著缩短（P〈10．05或P〈0．01）。雌性假手术大鼠在给予黄豆提取物治疗后,其MSC和GTCS潜伏期没有显著改变。与去卵巢生理盐水组比较,去卵巢低、高剂量黄豆提取物治疗组的MSC和GTCS潜伏期明显缩短（P〈0．05或P〈0．01）。结论：黄豆的植物雌激素能影响由PTZ诱发的癫痫发作的轻重程度,但其影响程度与卵巢激素水平有关。机制还有待进一步研究。     

Efficacy of azithromycin versus systemic meglumine antimoniate (Glucantime) in the treatment of cutaneous leishmaniasis

Cutaneous leishmaniasis (CL) treatment is painful, and cosmetic results are often unsatisfying. Azithromycin has been reported to be effective in treatment of CL caused by Leishmania viannia braziliensis. The efficacy of azithromycin was compared with Glucantime in treatment of Old World leishmaniasis. Of 49 patients, 22 received 500 mg/day azithromycin for 5 days/month. Treatment cycles were repeated monthly to a maximum of 4 months; 27 patients received 60 mg/kg intramuscular meglumine antimoniate for 20 days. Both groups were followed up for 16 weeks. In the azithromycin group, 2 patients withdrew because of GI symptoms. The response rates of 20 patients (29 lesions) were as follows: full improvement, 10.3%; partial improvement, 27.6%; and 62.1%, no response. In the glucantime group with 27 patients (58 lesions), these rates were 34.4%, 13.8%, and 51.7%, respectively (P = 0.036). Azithromycin was determined to be not as effective as Glucantime in treatment of Old World CL.     

Cardiomyoplasty improves contractile reserve after myocardial injury in mice: functional and morphological investigations with reconstructive three-dimensional echocardiography

Cellular cardiomyoplasty (CMP) is a novel therapeutic approach to myocardial injury (MI). Post-MI remodeling of the left ventricle (LV) comprises dilatation and impairment of systolic function and gives rise to progressive hemodynamic deterioration. We aimed to investigate: a) the impact of CMP on global and regional parameters of LV remodeling (LVR) as well as contractile reserve and b) the suitability and validity of different echocardiographic methods in this scenario. Murine ventricular cardiomyocytes (E13.5-E16.5) were transplanted into cryolesioned hearts of male HIM-OF1 mice. Echocardiography was performed at rest 4 and 14 days postoperatively. For quantification of akinetic myocardial mass and contractile reserve 2 weeks postoperatively additionally low-dose dobutamine stress echocardiography was conducted. Reconstructive 3D-echocardiography (r3D-echo) was compared to "plain" echocardiographic investigations and was compared to invasive measurements with conduction catheter. CMP significantly attenuated LV dilatation and reduced LV function decline on day 14, as obtained with all echocardiographic modalities and confirmed with conduction catheter measurements. In contrast to plain echocardiography and invasive testing, r3D-echo allowed noninvasive quantification of scar size and assessment of regional contractile reserve. Cell transplanted hearts demonstrated a significant decrease of akinetic myocardial mass (-CMP: 13 ± 2%; +CMP 7 ± 1%; p < 0.001) and increased regional contractile reserve, an indirect sign of myocardial viability. The present study demonstrates beneficial effects of CMP on global and regional parameters of LVR and contractile reserve after MI. In contrast to "simple" 2D echocardiography, r3D-echo allowed the assessment of regional contractile reserve and quantification of akinetic myocardial mass as additive functional and morphological measures of LVR.     

Echocardiographic assessment of left ventricular mass in neonatal and adult mice: accuracy of different echocardiographic methods

Echocardiography is an established method to estimate left-ventricular mass (LVM) in mice. Accuracy is determined by cardiac size and morphology and influenced by mathematical models. We investigated accuracy of three common algorithms in three early developmental stages. High-resolution echocardiography was performed in 35 C57/BL6-mice. Therefore, two-dimensional-guided M-mode echocardiography and parasternal short- and long-axis views in B-mode were obtained. LVM was assessed in vivo applying Penn (P), Area Length (AL), and Truncated Ellipsoid (TE) algorithms and validated with histomorphometry. Regression analysis of all mice showed fair estimation of LVM assessed with M-mode-based Penn algorithm (y = 0.6*x - 0.12, r: 0.71). In contrast two-dimensional assessment of LVM revealed close linear relationship with histomorphometry (y(AL)= 1.21*x - 12.1, r: 0.88, y(TE)= 1.38*x - 2.88, r: 0.86). Bias was lowest for LVM-AL at diastole underestimating 3.2%. In concordance with the summarized data, LVM-P revealed lower regression coefficients and significant underestimation in all three subgroups. Small hearts (<50 mg, n = 12) correlated best with LVM-AL at systole. Hearts of adolescent (50-75 mg, n = 13) and adult (75-100 mg, n = 10) mice revealed close linear relationship with LVM-AL and LVM-TE at diastole. Echocardiographic assessment of LVM is feasible in hearts weighting less than 50 mg and can be estimated best in systole. Hearts weighting more than 50 mg are estimated most accurately by means of LVM-AL at diastole.     

The prevalence of allergic fungal rhinosinusitis in sinonasal polyposis

Allergic fungal sinusitis (AFS) is a noninvasive form of fungal rhinosinusitis with a prevalence of 6–9 % among all rhinosinusitis cases requiring surgery. The fungi causing AFRS have a great diversity and regional variation in the incidence of AFS has been reported worldwide. The aim of this study was to evaluate the prevalence of AFS among rhinosinusitis patients in the north east of Iran. In a prospective cross-sectional study 127 patients with sinonasal polyposis who were candidates for surgery were recruited. All cases were evaluated by sinonasal CT scan, Prick test for common regional allergens, total serum immunoglobulin E (IgE) level, and allergic mucin culture for fungi in suspected cases. Data analyses were done using SPSS version 13.0. Their mean age was 37.4 ± 11.6 years, the male-to-female ratio was 69/58. Eleven patients (9.45 %) met the AFS criteria. Nine cases had a positive culture for Aspergillus specimen and three for Alternaria. Prick test was positive for at least one allergen in 28 cases (22.05 %). The most common allergen was weed. The total IgE level was significantly higher in AFS patients. This study showed the prevalence of AFS among patients with nasal polyposis to be 9.45 %.     

Effect of a New Synbiotic Mixture on Atopic Dermatitis in Children: a Randomized-Controlled Trial

Objective

Atopic dermatitis (AD) is the most common chronic relapsing skin disease seen in infancy and childhood. The intestinal microbiota play an important role in immune development and may play a role in the development of allergic disorders. Manipulation of the intestinal microbiota by synbiotics may therefore offer an approach to the prevention or treatment of AD and allergic diseases. We studied the clinical and immunologic effects of a new symbiotic (a mixture of seven probiotic strains of bacteria and Fructooligosaccharide) in infants and children with AD.

Methods

In a randomized, double-blind, placebo-controlled study, 40 infants and children aged 3 months to 6 years with AD received either a synbiotic or placebo for 8 weeks. The Severity Scoring of Atopic Dermatitis (SCORAD) index was recorded at baseline and also at 4 and 8 weeks of treatment.

Findings

There was no significant difference between the probiotic and placebo group in baseline characteristics including sex, age, family history, corticosteroid usage and prick testing. Mean age was 23 months. The synbiotic group showed a significantly greater reduction in SCORAD than did the placebo group (P=0.001). No specific effect was demonstrated of the probiotics employed on cytokine profile (P=0.4, P=0.6). Egg white was the most common (45%) allergen followed by peanut and cow''s milk.

Conclusion

This study provides evidence that a mixture of seven strains of probiotics and Fructooligosaccharide can clinically improve the severity of AD in young children. Further studies are needed to investigate the effects on underlying immune responses and the potential long term benefits for patients with AD.