Associations between cerebral and systemic endothelial function in migraine patients: a post-hoc study

Background  

There is a growing interest in the role of the endothelium in migraine. Recently, our group showed differences in endothelial function between the anterior and posterior cerebral circulation in healthy subjects, reduced vasodilatatory capacity of the posterior cerebral circulation and unimpaired systemic endothelial function in migraine patients without comorbidities. However, the relationship between cerebral and systemic endothelial function and the anterior and posterior cerebral endothelial function in migraine patients is still not clear.     

Glucocorticoid-induced osteoporosis: a cross-sectional study.

We studied 70 patients (48 women and 22 men) with either rheumatic disease (n = 25) or lung disease (n = 45) who had been treated with glucocorticoids for at least 6 months (mean cumulative dose, 24.2 +/- 27.1 g of prednisone; mean current dose, 11.0 +/- 8.6 mg/d, mean duration of therapy, 8.1 years. We measured bone mineral density (BMD) of the hip (femoral neck) and spine (L2-L4) using dual-photon absorptiometry and BMD of the distal one third radius using single-photon absorptiometry. Compared with age-matched controls, the study population had decreased BMD of the spine (87.0%), hip (87.2%), and radius (90.6%). Current dose, cumulative dose, and duration of therapy were not correlated with BMD in the spine or hip in the total study population. The most significant correlations with low bone mass at the hip and spine were short height and low weight. There was a high incidence of hypercalciuria (30%) as compared with an age- and sex-matched control group (6.4%). Glucocorticoids are known to decrease vertebral and radial bone density. We conclude that glucocorticoids also decrease hip bone density as measured at the femoral neck. The high incidence of hypercalciuria may have implications for therapy of glucocorticoid-induced osteoporosis.     

Pulmonary function,exhaled nitric oxide and symptoms in asthma patients with obesity: a cross-sectional study

Background

Obesity is a risk factor for the development of asthma. In patients with obesity the diagnosis of asthma is often based on symptoms, but without objective measurements. Nevertheless, obesity-associated asthma is recognized as a distinct asthma phenotype. Therefore, this study explores lung function and symptoms in asthma patients with and without obesity.

Methods

The Netherlands Epidemiology of Obesity (NEO) study is a population-based cohort study with 6671 participants (aged 45–65 years) of whom 472 had asthma. Of this latter group, linear regression analysis was used to examine differences in lung function and symptoms between asthma patients with (n?=?248) and without obesity (n?=?224), and between asthma patients with and without increased Fe_NO. Analyses were adjusted for confounders.

Results

Asthma patients with obesity had lower predicted FEV₁ and FVC values than patients without obesity [adjusted mean difference (MD) -3.3% predicted, 95% CI -6.5, ?0.2; adjusted MD ?5.0% predicted, 95% CI -7.8, ?2.1]. The prevalence of symptoms was higher in patients with obesity. Asthma patients with obesity and with increased Fe_NO had lower FEV₁ and FEV₁/FVC values compared with those with low Fe_NO (adjusted MD ?6.9% predicted, 95% CI -11.7, ?2.0; ?2.4%, 95% CI -4.6, ?0.2).

Conclusion

Asthma patients with obesity had lower FEV₁ and FVC values than patients without obesity. This suggests that patients with obesity have restrictive lung function changes, rather than obstructive changes. Asthma patients with obesity and increased Fe_NO showed more obstructive changes. Fe_NO might help to identify patients with eosinophilic inflammation-driven asthma, whereas patients with low Fe_NO might have an obesity-associated asthma phenotype in which symptoms are partly caused by the obesity.

     

The association between microvascular and macrovascular endothelial function in patients with rheumatoid arthritis: a cross-sectional study

Introduction  

Patients with rheumatoid arthritis (RA) are at an increased risk for cardiovascular disease (CVD). One of the earliest manifestations of CVD is endothelial dysfunction (ED). ED can occur in both the microcirculation and the macrocirculation, and these manifestations might be relatively independent of each other. Little is known about the association between endothelial function in the microcirculation and the macrocirculation in RA. The objectives of the present study were to examine the relationship between microvascular and macrovascular endothelial function in patients with RA.     

Associations between COPD related manifestations: a cross-sectional study

Background

Cardiovascular disease, osteoporosis and emphysema are associated with COPD. Associations between these factors and whether they predict all-cause mortality in COPD patients are not well understood. Therefore, we examined associations between markers of cardiovascular disease (coronary artery calcification [CAC], thoracic aortic calcification [TAC] and arterial stiffness), bone density (bone attenuation of the thoracic vertebrae), emphysema (PI-950 and 15th percentile) and all-cause mortality in a COPD cohort.

Methods

We assessed CAC, TAC, bone attenuation of the thoracic vertebrae, PI-950 and 15th percentile on low-dose chest computed tomography in COPD subjects. We measured arterial stiffness as carotid-radial pulse wave velocity (PWV), and identified deaths from the national register.

Results

We studied 119 COPD subjects; aged 67.8 ±7.3, 66% were males and mean FEV₁% predicted was 46.0 ±17.5. Subjects were classified into three pre-specificed groups: CAC = 0 (n = 14), 0 < CAC ≤ 400 (n = 41) and CAC > 400 (n = 64). Subjects with higher CAC were more likely to be older (p < 0.001) and male (p = 0.03), and more likely to have higher systolic blood pressure (p = 0.001) and a history of hypertension (p = 0.002) or ischemic heart disease (p = 0.003). Higher CAC was associated with higher PWV (OR 1.62, p = 0.04) and lower bone attenuation (OR 0.32, p = 0.02), but not with 15th percentile, after adjustment for age, sex and pack-years of smoking. In a Cox proportional hazards model, CAC, TAC and 15th percentile predicted all-cause mortality (HR 2.01, 2.09 and 0.66, respectively).

Conclusions

Increased CAC was associated with increased arterial stiffness and lower bone density in a COPD cohort. In addition, CAC, TAC and extent of emphysema predicted all-cause mortality.

Trial registration

Lothian NHS Board, Lothian Research Ethics Committee, LREC/2003/8/28.     

The association between functional and morphological assessments of endothelial function in patients with rheumatoid arthritis: a cross-sectional study

Introduction

Patients with rheumatoid arthritis (RA) are at an increased risk for cardiovascular disease (CVD). One of the earliest manifestations of CVD is endothelial dysfunction (ED), which can lead to functional and morphological vascular abnormalities. Several non-invasive assessments of vascular function and morphology can be utilised to assess vascular health, but little is known about the association between each of these assessments in patients with RA, and they tend to be used interchangeably in the literature. The objective of the present study was to examine associations between measures of vascular function and morphology in patients with RA.

Methods

A total of 201 RA patients (155 females, median (25^th to 75^th percentile) age: 67 (59 to 73)) underwent assessments of microvascular endothelium-dependent and endothelium-independent function (laser Doppler imaging with iontophoresis of acetylcholine and sodium-nitroprusside respectively), macrovascular endothelium-dependent and endothelium-independent function (flow-mediated dilatation and glyceryl-trinitrate-mediated dilation respectively), and vascular morphology (pulse wave analysis, carotid intima-media thickness (cIMT), and carotid plaque).

Results

Spearman''s correlations revealed that from the functional parameters, only macrovascular endothelium-independent function was inversely associated with cIMT (-0.294 (P < 0.001)) after applying the Bonferroni correction for multiple comparisons. For carotid plaque, t tests showed that macrovascular endothelium-independent function was lower in patients with plaque than without (15.5 ± 8.3 vs. 23.1 ± 9.1%, P = 0.002, respectively).

Conclusions

With the exception of macrovascular endothelium-independent function, all other measures of vascular function were not associated with vascular morphology. This suggests that different assessments of vascular function and morphology in patients with RA reflect quite distinct mechanisms and phases of the atherosclerotic process and should not be used interchangeably.     

Endothelial fenestral diaphragms: a quick-freeze, deep-etch study

The route by which water, solutes, and macromolecules traverse the endothelial cell has long been a subject of study for both physiologists and cell biologists. Recent physiologic studies describe a slit-shaped pore (5.1-5.7-nm wide) as the communicating channel, although no channel of such dimensions has been visible in electron microscopic preparations. That this channel should be found within the fenestral diaphragm has long been suggested. In this report, by the aid of a new technique in tissue processing, we are able to demonstrate a possible morphologic correlate within the fenestral diaphragm of fenestrated capillaries. Quick-freezing and deep-etching of whole tissue blocks allows the sublimation of water from the endothelial pores, thus leaving the channels through the diaphragms empty and readily replicated with a platinum-carbon shadow. The structure of the diaphragm was revealed thus to be composed of radial fibrils of 7 nm in diameter, interweaving in a central mesh, and creating by their geometric distribution, wedge-shaped channels around the periphery of the pore. The average channel had a maximum arc length of 5.46 nm. Fenestrated endothelia from various tissues, including endocrine and exocrine pancreas, adrenal cortex, and kidney peritubular capillaries, displayed the same diaphragmatic structure, whereas continuous capillaries in muscle had no such diaphragm. Photographic augmentation of electron micrographs of etched replicas displayed marked enhancement at n = 8, confirming an octagonal symmetry of the fenestral diaphragm. Finally, cationic ferritin, clearly visible as a marker after etching, heavily bound to the flowerlike structure within the fenestral pore. We conclude that the fenestral diaphragm contains the structure responsible for fenestrated capillary permeability and that the communicating channel has the shape of a wedge.     

Insulin resistance and glycemic abnormalities are associated with deterioration of left ventricular diastolic function: a cross-sectional study

Background

The purpose of this study was to test the hypothesis that sidestream tobacco smoke extracts would inhibit the culture of endothelial cells and enhance platelet aggregation under diabetic vascular conditions. Sidestream tobacco smoke and advanced glycation end products are known cardiovascular risk factors and we aimed to determine the combined interaction between these two risk factors to promote cardiovascular diseases associated with diabetes.

Methods

Human umbilical vein endothelial cells were cultured in the presence of sidestream tobacco smoke extracts (SHS) or nicotine and glycated albumin (AGE) or non-glycated albumin. After 3 days, endothelial cell viability and density were investigated. Platelets were also incubated with these compounds for up to 6 hours. Platelet aggregation and the surface expression of CD41 and CD62P were examined. In some experiments, platelets were added to the endothelial cell culture to determine if an interaction between platelets and endothelial cells occurs that can alter the responses to SHS or AGE.

Results

In general, the endothelial cell culture conditions were reduced in the presence of AGE and SHS. Nicotine, did not play a role in this reduction. Platelet aggregation proceeded faster in the presence of AGE and SHS. Interestingly, with the combined culture of endothelial cells and platelets, the endothelial cell culture conditions were improved and the platelet functional changes were diminished in the presence of SHS and AGE, as compared with the individual incubations.

Conclusions

Our data suggests that diabetics that are exposed to SHS may have a higher likelihood for cardiovascular disease development through a diminished endothelial cell viability and an increased platelet activity, which are partially mediated by CD41 and not CD62P. This study provides support for an increased cardiovascular risk for diabetic patients that are exposed to SHS. This study also provides a new experimental technique to monitor platelet-endothelial cell interactions.     

Facebook use and chronotype: Results of a cross-sectional study

Facebook has become the most popular social networking site round the world. In seeking an explanation for this phenomenon, individual differences in circadian functioning seem to be an interesting issue. The main aim of this study was to examine the potential associations between morningness/eveningness and Facebook use (intrusion and intensity). The participants were 663 Facebook users. The Facebook Intrusion Questionnaire, Facebook Intensity Scale and the Composite Scale of Morningness were used. Our results indicate that chronotype is negatively related with Facebook usage. Eveningness people use Facebook intensively and their Facebook use is more intrusive. Moreover, eveningness in combination with young age predicted Facebook intensity.     

Personality of outpatients with malignant tumors: a cross-sectional study

ABSTRACT: BACKGROUND: There have been scarce large-scale studies investigating the personality of patients with malignant tumors. The purpose of this study is to determine the characteristic personality in malignant tumors outpatients. METHODS: Three thousand and three among 5013 consecutive outpatients who consented to answer the Japanese Maudsley Personality Inventory questionnaires were divided into two groups. 603 outpatients diagnosed with malignant tumors (M group) and the other 2400 outpatients (non-M group) were enrolled in this study. We determined three scores such as introversion/extroversion (E-score), neuroticism (N-score), and lie detection (L-score). All data were used to compare the two groups. RESULTS: Average E-score was slightly higher, and average N-score was slightly lower in M group than that in non-M group, and no significant differences between the two groups. However, the average L-score in M group was significant higher than that in non-M group (p < 0.01). CONCLUSION: Outpatients with malignant tumors showed a significantly higher L-score on MPI when compared with patients with non-malignant tumors. These results stress the importance of taking the mentality of patients with cancer into consideration when conducting treatment and care.     

Immunogenicity of recombinant human erythropoietin in Korea: a two-year cross-sectional study

Immunogenicity of erythropoietin (EPO) is related with pure red cell aplasia (PRCA). We sought to determine the prevalence of antibody (Ab)-mediated PRCA in Korea and threshold diagnostic criteria by dual parameters: Ab titer and neutralizing activity. This study was a multi-center, cross-sectional study for two years. In the first year study (1 YS), 209 samples suspected to be EPO resistance were collected. In the second year study (2 YS), all the patients who consented to participate (N = 946) were enrolled. In 1 YS, we found three and six serum samples that were positive and borderline for anti-EPO Abs, respectively. The first three patients had neutralizing activity (NT) and were diagnosed as PRCA. In 2 YS, seven patients were anti-EPO positives and six had borderline levels. Among them, one patient with NT was diagnosed as PRCA and one with NT as aplastic anemia. The prevalence of PRCA was 0.106%. The correlation analysis of the 22 patients who had anti-EPO Ab showed that dual crossed cut-off lines (anti-EPO Ab titer ≥ 40 ng/ml, % NT ≥ 25%) were able to clearly isolate red cell aplasia. We suggest novel diagnostic criteria for diagnosis and prediction of Ab-mediated PRCA with data from both Ab titer assays and NT bioassays.     

Determinants of exclusive breastfeeding among mothers in Ghana: a cross-sectional study

Background

Mothers are encouraged to practice exclusive breastfeeding for the first six months of a child’s life. The general objective of the study was to assess the predictors of exclusive breastfeeding among mothers in Ghana.

Methods

This was a cross-sectional study using data from the 2008 Ghana Demographic and Health Survey (GDHS). The study sample (n = 316) was based on infants (0–5 months old) during the survey period; extracted from the individual (women) data set. Binary logistic regression was used to examine the association between selected independent variables.

Results

In general, the rate of exclusive breastfeeding was 64 percent. Marital status, region and place of delivery were found to be associated with the practice of exclusive breastfeeding. The logistic regression model illustrated mothers from the Volta Region, those who delivered in a government health facility, and mothers who perceived their infants to be average in size were more likely to practice exclusive breastfeeding.

Conclusion

Appropriate health education programmes by the Ministry of Health targeting mothers who are less likely to practice exclusive breastfeeding are recommended.

     

Endothelial nitric oxide synthase haplotypes associated with aura in patients with migraine

There is strong evidence implicating nitric oxide (NO) in the pathophysiology of migraine and aura. Therefore, genetic polymorphisms in the endothelial NO synthase (eNOS) gene have been studied as candidate markers for migraine susceptibility. We compared for the first time the distribution of eNOS haplotypes including the three clinically relevant eNOS polymorphisms (T(-786)C in the promoter, rs2070744; Glu298Asp in exon 7, rs1799983; and a 27?bp variable number of tandem repeats in intron 4) and two additional tagging single-nucleotide polymorphisms (rs3918226 and rs743506) in 178 women with migraine (134 without aura and 44 with aura) and 117 healthy controls (control group). Genotypes were determined by TaqMan allele discrimination assay, real-time polymerase chain reaction, and polymerase chain reaction followed by fragment separation by electrophoresis. The GA (rs743506) genotype was more common in the control group than in women with migraine (odds ratio?=?0.47, 95% confidence interval [CI]?=?0.29-0.78, p?相似文献   

Age-related improvement in reproductive performance in a long-lived raptor: a cross-sectional and longitudinal study

In numerous iteroparous species, mean fecundity increases with age. Such improvement has been explained by: a) progressive removal of inferior breeders from the breeding population (selection‐hypothesis); b) delayed breeding of higher‐quality phenotypes (delayed‐breeder‐hypothesis); c) longitudinal enhancement of skills associated with age per se (age‐hypothesis); d) progressive improvement in the capability to conduct specific tasks facilitated by accumulated experience (breeding‐experience‐hypothesis); and e) increasing parental investment promoted by declining residual reproductive values (restraint‐hypothesis). To date, there have been few comprehensive tests of these hypotheses. Here, we provide such a study using a long‐term dataset on a long‐lived raptor, the black kite Milvus migrans (maximum lifespan 23 yr). Kites delayed breeding for 1–7 yr and all measures of breeding performance increased linearly or quadratically up to 11 yr of age. There was no support for the delayed‐breeder‐hypothesis: superior phenotypes did not delay breeding longer. Superior breeders were retained longer in the breeding population, consistent with the selection‐hypothesis. All measures of breeding performance increased longitudinally within individuals, supporting the age‐hypothesis, while some of them increased with accumulated previous experience, supporting the breeding‐experience‐hypothesis. Some analyses suggested the existence of trade‐offs between reproduction in the early years of life and subsequent survival, partially supporting the restraint‐hypothesis. The pattern of age‐related improvements in breeding rates observed at the population‐level could be ascribed to the combined effect of the progressive removal of inferior phenotypes from the breeding population and the individual‐level lack of specific skills which are progressively acquired with time and experience. It was also compatible with a longitudinal increase in reproductive investment. Results from previous studies suggest that different mechanisms may operate in different species and that age‐related improvements in reproduction may be frequently promoted by the complex interplay between longitudinal improvements and changes in the relative frequency of productive phenotypes in the breeding population.     

Respiratory arrest in familial hemiplegic migraine: a clinical and neuropathological study.

We describe a fatal case of familial hemiplegic migraine. A transient respiratory arrest in this patient led to a persistent "vegetative state," culminating in death four months later. Neuropathological findings included deep microinfarcts in the basal ganglia and a remarkable sparing of brain-stem nuclei associated with the function of respiration.     

Amphotericin B deoxycholate for relapse visceral leishmaniasis in Bangladesh: a cross-sectional study

Objective

Based on studies in India (as there was no studies from outside India) amphotericin B deoxycholate has been considered as a backup drug for treatment of visceral leishmaniasis. However, treatment response and adverse effect to anti-leishmanial drugs may vary across different populations and in Bangladesh the effect to amphotericin B deoxycholate for treatment of visceral leishmaniasis is still unknown. Therefore, there is a need to explore cure rate and adverse effects to amphotericin B deoxycholate to justify its use on visceral leishmaniasis patients in Bangladesh.

Result

Here we report 34 visceral leishmaniasis patients who received treatment with amphotericin B deoxycholate in the Surya Kanta Kala-azar Research Centre from December 2011 to June 2015. The dose of the treatment was 1 mg/kg body weight for 15 days followed up until 12 months after treatment. Response to amphotericin B deoxycholate treatment was excellent as all 34 patients achieved a final cure. Hypokalaemia (47%), shivering (47%), vomiting (35%) and acidity (15%) were most common adverse events. However, we did not observe any serious adverse events. Amphotericin B deoxycholate for relapse visceral leishmaniasis was found to be highly effective and safe. Our study justified to include amphotericin B deoxycholate as a second line drug for visceral leishmaniasis in Bangladesh.

     

Endothelial function in highly endurance-trained men: effects of acute exercise

Exercise training reverses endothelial dysfunction, but the effect in young, healthy subjects is less clear. We determined the influence of maximal oxygen uptake (VO2max) and a single bout of high-intensity exercise on flow-mediated dilatation (FMD), brachial artery diameter, peak blood flow, nitric oxide (NO) bioavailability, and antioxidant status in highly endurance-trained men and their sedentary counterparts. Ten men athletes (mean +/- SEM age 23.5 +/- 0.9 years, height 182.6 +/- 2.4 cm, weight 72.5 +/- 2.4 kg, VO2max 75.9 +/- 0.8 mL.kg.min) and seven healthy controls (age 25.4 +/- 1.2 years, height 183.9 +/- 3.74 cm, weight 92.8 +/- 3.9 kg, VO2max 47.7 +/- 1.7 mL.kg.min) took part in the study. FMD, brachial artery diameter, and peak blood flow were measured using echo-Doppler before, 1 hour, 24 hours, and 48 hours after a single bout of interval running for 5 x 5 minutes at 90% of maximal heart rate. NO bioavailability and antioxidant status in blood were measured at all time points. Maximal arterial diameter and peak flow were 10-15% (P < 0.02) and 28-35% (P < 0.02) larger, respectively, in athletes vs. controls at all time points, and similar FMD were observed, apart from a transient decay of FMD in athletes 1 hour post exercise. NO bioavailability increased significantly after exercise in both groups and decreased to baseline levels after 24 hours in controls but remained increased 80% and 93% above baseline 24 and 48 hours post exercise in athletes. Antioxidant status was equal in the two groups at baseline and increased by approximately 10% 1 hour post exercise, an effect that lasted for 24 hours. Athletes had larger arterial diameter but similar FMD as untrained subjects, i.e., athletes had larger capacity for blood transport compared with their untrained counterparts. The observed FMD, bioavailability of NO, and antioxidant status in blood were highly dependent on the time elapsed after the exercise session.