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1.
Background
In acute ischemic stroke patients, telestroke technology provides sustainable approaches to improve the use of thrombolysis therapy. How this is achieved as it relates to inclusion or exclusion of clinical risk factors for thrombolysis is not fully understood. We investigated this in a population of hypertensive stroke patients.Methods
Structured data from a regional stroke registry that contained telestroke and non telestroke patients with a primary diagnosis of acute ischemic stroke with history of hypertension were collected between January 2014 and June 2016. Clinical risk factors associated with inclusion or exclusion for recombinant tissue plasminogen activator (rtPA) in the telestroke and non telestroke were identified using multiple regression analysis. Associations between variables and rtPA in the regression models were determined using variance inflation factors while the fitness of each model was determined using the ROC curve to predict the power of each logistic regression model.Results
The non telestroke admitted more patients (62% vs 38%), when compared with the telestroke. Although the telestroke admitted fewer patients, it excluded 11% and administered thrombolysis therapy to 89% of stroke patients with hypertension. In the non telestroke group, adjusted odd ratios showed significant associations of NIH stroke scale score (OR?=?1.059, 95% CI, 1.025–1.093, P <?0.001) and coronary artery disease (OR?=?2.003, 95% CI, 1.16–3.457, P?=?0.013) with inclusion, while increasing age (OR?=?0.979, 95% CI, 0.961–0.996, P?=?0.017), higher INR (OR?=?0.146, 95% CI, 0.032–0.665, P?=?0.013), history of previous stroke (OR?=?0.39, 95% CI, 0.223–0.68, P?=?0.001), and renal insufficiency (OR?=?0.153, 95% CI, 0.046–0.508, P?=?0.002) were associated with rtPA exclusion. In the telestroke, only direct admission to the telestroke was associated with rtPA administration, (OR?=?4.083, 95% CI, 1.322–12.611, P?=?0.014).Conclusion
The direct admission of hypertensive stroke patients to the telestroke network was the only factor associated with inclusion for thrombolysis therapy even after adjustment for baseline variables. The telestroke technology provides less restrictive criteria for clinical risk factors associated with the inclusion of hypertensive stroke patients for thrombolysis.2.
Joo-Hyun Jun Mi Hwa Chung Eun Mi Kim In-Jung Jun Jung Hwa Kim Joon-Sang Hyeon Mi Hyeon Lee Hye Sun Lee Eun Mi Choi 《BMC anesthesiology》2018,18(1):201
Background
The purpose of this study is to assess whether the application of preoperative forced air warming set to high temperature (>?43?°C) for brief period can increase temperature on admission to the postanesthesia care unit (PACU) and prevent hypothermia or shivering during holmium laser enucleation of the prostate performed under spinal anesthesia.Methods
Fifty patients were enrolled were assigned randomly to receive passive insulation (control group, n?=?25) or forced-air skin surface warming for 20?min before spinal anesthesia (pre-warming group, n?=?25). The primary outcome was temperature at PACU admission.Results
The pre-warming group had a significantly higher temperature on admission to the PACU than the control group (35.9?°C [0.1] vs 35.6?°C [0.1], P?=?0.023; 95% confidence interval of mean difference, 0.1?°C–0.5?°C). The trend of decreasing core temperature intraoperatively was not different between groups (P?=?0.237), but intraoperative core temperature remained approximately 0.2?°C higher in the pre-warming group (P?=?0.005). The incidence of hypothermia on admission to the PACU was significantly lower in the pre-warming group (56% vs 88%, P?=?0.025). Shivering occurred in 14 patients in the control group, and 4 patients in the pre-warming group (P?=?0.007).Conclusion
Brief pre-warming at 45?°C increased perioperative temperature and decreased the incidence of hypothermia and shivering. However, it was not sufficient to modify the decline of intraoperative core temperature or completely prevent hypothermia and shivering. Continuing pre-warming to immediately before induction of spinal anesthesia or combining pre-warming with intraoperative active warming may be necessary to produce clearer thermal benefits in this surgical population.Trial registration
This trial was registered with Clinicaltrials.gov, NCT03184506, 5th June 2017.3.
Eyup Avci Tuncay Kiris Aykan Çelik Eser Variş Fatma Kayaalti Esin Diyar Köprülü Hasan Kadi 《BMC cardiovascular disorders》2018,18(1):226
Background
The prognostic significance of changes in mean platelet volume (MPV) during hospitalization in ST segment elevation myocardial infarction (STEMI) patients underwent primary percutaneous coronary intervention (pPCI) has not been previously evaluated. The aim of this study was to determine the association of in-hospital changes in MPV and mortality in these patients.Methods
Four hundred eighty consecutive STEMI patients were enrolled in this retrospective study. The patients were grouped as survivors (n?=?370) or non-survivors (n?=?110). MPV at admission, and at 48–72?h was evaluated. Change in MPV (MPV at 48–72?h minus MPV on admission) was defined as ΔMPV.Results
At follow-up, long-term mortality was 23%. The non-survivors had a high ΔMPV than survivors (0.37 (??0.1–0.89) vs 0.79 (0.30–1.40) fL, p?<? 0.001). A high ΔMPV was an independent predictor of all cause mortality ((HR: 1.301 [1.070–1.582], p?=?0.008). Morever, for long-term mortality, the AUC of a multivariable model that included age, LVEF, Killip class, and history of stroke/TIA was 0.781 (95% CI:0.731–0.832, p?<? 0.001). When ΔMPV was added to a multivariable model, the AUC was 0.800 (95% CI: 0.750–0.848, z?=?2.256, difference p?=?0.0241, Fig. 1). Also, the addition of ΔMPV to a multivariable model was associated with a significant net reclassification improvement estimated at 24.5% (p?=?0.027) and an integrated discrimination improvement of 0.014 (p?=?0.0198).Conclusions
Rising MPV during hospitalization in STEMI patients treated with pPCI was associated with long-term mortality.4.
M.-T. Rofe Y. Shacham A. Steinvi L. Barak M. Hareuveni S. Banai G. Keren A. Finkelstein H. Shmilovich 《Netherlands heart journal》2016,24(5):350-354
Objectives
To assess the prevalence of blood type A among patients referred for transcatheter aortic valve implantation (TAVI) and whether it is related to vascular complications.Backgrounds
Vascular complications following TAVI are associated with adverse outcomes. Various blood types, particularly type A, have been shown to be more prevalent in cardiovascular diseases and to be related to prognosis.Methods
The prevalence of various blood types in a cohort of 491 consecutive patients who underwent TAVI was compared with a control group of 6500 consecutive hospitalised patients. The prevalence and predictors of vascular complications and bleeding events were evaluated in the blood type A group and were compared with non-type A patients.Results
The mean age of TAVI patients was 83?±?6 years, and 40?% were males. Patients were divided into two groups: blood type A (n?=?220) and non-type A (n?=?271). Type A was significantly more prevalent in the TAVI group than in the control group (45 vs. 38?%, p?=?0.023). Compared with the non-type A group, patients with blood type A had more major and fatal bleeding (14.5 vs. 8.1?%, p?=?0.027) and more vascular complications (any vascular complication: 24.5 vs. 15.9?% p?=?0.016; major vascular complications: 12.3 vs. 7?% p?=?0.047). In a multivariable analysis, blood type A emerged as a significant and independent predictor for vascular complications and bleeding events.Conclusions
Blood type A is significantly more prevalent in TAVI patients than in the general population and is related to higher rates of vascular and bleeding complications.5.
Pierre-Jean Saulnier Manjula Darshi Kevin M. Wheelock Helen C. Looker Gudeta D. Fufaa William C. Knowler E. Jennifer Weil Stephanie K. Tanamas Kevin V. Lemley Rintaro Saito Loki Natarajan Robert G. Nelson Kumar Sharma 《Metabolomics : Official journal of the Metabolomic Society》2018,14(6):84
Introduction
Little is known about the association of urine metabolites with structural lesions in persons with diabetes.Objectives
We examined the relationship between 12 urine metabolites and kidney structure in American Indians with type 2 diabetes.Methods
Data were from a 6-year clinical trial that assessed renoprotective efficacy of losartan, and included a kidney biopsy at the end of the treatment period. Metabolites were measured in urine samples collected within a median of 6.5 months before the research biopsy. Associations of the creatinine-adjusted urine metabolites with kidney structural variables were examined by Pearson’s correlations and multivariable linear regression after adjustment for age, sex, diabetes duration, hemoglobin A1c, mean arterial pressure, glomerular filtration rate (iothalamate), and losartan treatment.Results
Participants (n?=?62, mean age 45?±?10 years) had mean?±?standard deviation glomerular filtration rate of 137?±?50 ml/min and median (interquartile range) urine albumin:creatinine ratio of 34 (14–85) mg/g near the time of the biopsy. Urine aconitic and glycolic acids correlated positively with glomerular filtration surface density (partial r?=?0.29, P?=?0.030 and r?=?0.50, P?<?0.001) and total filtration surface per glomerulus (partial r?=?0.32, P?=?0.019 and r?=?0.43, P?=?0.001). 2-ethyl 3-OH propionate correlated positively with the percentage of fenestrated endothelium (partial r?=?0.32, P?=?0.019). Citric acid correlated negatively with mesangial fractional volume (partial r=-0.36, P?=?0.007), and homovanillic acid correlated negatively with podocyte foot process width (partial r=-0.31, P?=?0.022).Conclusions
Alterations of urine metabolites may associate with early glomerular lesions in diabetic kidney disease.6.
Background
The aim of this study was to explore the characteristics and prognostic information of estrogen receptor-positive/progesterone receptor-negative (ER+/PR?) male breast cancer.Methods
Using the US National Cancer Institute’s Surveillance, Epidemiology, and End Results database, we compared the demographics, clinical characteristics, and outcome of estrogen receptor-positive/progesterone receptor-positive (ER+/PR+) patients with ER+/PR? male breast cancer patients from 1990 to 2010. Two thousand three hundred twenty-two patients with ER+/PR+ tumors and 355 patients with ER+/PR? tumors were included in our study.Results
ER+/PR? patients were younger (P?=?0.008) and more likely to be African American (P?<?0.001) while presented with higher histological grade (P?<?0.001), larger tumor size (P?=?0.010), and more invasion to the lymph nodes (P?=?0.034) and distant sites (P?<?0.001), thus later stage (P?=?0.001). Despite higher chance of receiving chemotherapy (51.0% vs 36.5%, P?<?0.001), ER+/PR? patients experienced significantly worse breast cancer-specific survival (BSCC) (P?<?0.001) and shorter overall survival (OS) (P?=?0.003). Multivariate Cox model confirmed that tumor size, lymph node invasion, metastasis, and surgery were independent prognostic factors of both BSCC and OS for ER+/PR? male breast cancer. Age at diagnosis and chemotherapy were significantly associated with OS but not with BSCC.Conclusion
ER+/PR? male breast cancer was more aggressive and experienced shorter survival than ER+/PR+ patients. The prognosis was mainly associated with tumor size, lymph node invasion, metastasis, and surgery.7.
Alessandra Novello-Siegenthaler Mehdi Hamdani Irène Iselin-Chaves Roxane Fournier 《BMC anesthesiology》2018,18(1):191
Background
Multiorifice catheters have been shown to provide superior analgesia and significantly reduce local anesthetic consumption compared with end-hole catheters in epidural studies. This prospective, blinded, randomized study tested the hypothesis that, in continuous femoral nerve block (CFNB) under ultrasound guidance, multiorifice catheter would reduce local anesthetic consumption at 24?h compared with end-hole catheter.Methods
Eighty adult patients (aged ≥18?years) scheduled to undergo primary total knee arthroplasty under a combination of CFNB, sciatic nerve block and general anesthesia were randomized to CFNB using either a 3-pair micro-hole (Contiplex, BRAUN®, 20G - 400?mm) or an end-hole (Silverstim VYGON®, 20G - 500?mm) catheter. Once the femoral catheter was sited, a bolus of 20?mL lidocaine 1% was injected. An electronic pump then delivered an automated 5?mL bolus of ropivacaine 0.2% hourly, with 10?mL self-administered patient controlled analgesia boluses.Results
There was no inter-group difference in either median number of ropivacaine boluses on demand during the first 24?h (4(2–7) vs. 4(2–8) in six-hole and end-hole groups, respectively; P?=?0.832) or median ropivacaine consumption at 48?h (365(295–418) vs. 387(323–466); P?=?0.452).No significant differences were recorded between the groups at 24?h regarding median average verbal rate pain scale (2(0–3) vs. 2(0–4); P?=?0.486) or morphine consumption (0(0–20) vs. 0(0–20); P?=?0.749). Quadriceps muscle strength declined to 7% (0–20) and 10% (0–28) in the six-hole and end-hole groups, respectively, at 24?h after surgery (P?=?0.733).Conclusions
In this superiority trial, catheter orifice configuration did not influence the effectiveness of CFNB in this setting: quality of analgesia was similar, with no reduction in either local anesthetic or morphine consumption, and equivalent postoperative quadriceps weakness.Trial registration
Retrospectively registered at (NCT03376178). Date: 21 November 2017.8.
Arati Suvatha Sibin Madathan Kandi Dhananjaya Ishwara Bhat Narasinga Rao Vikas Vazhayil Chetan Ghati Kasturirangan 《Cellular & molecular biology letters》2017,22(1):25
Background
The rupture of a brain aneurysm causes bleeding in the subarachnoid space. This is known as aneurysmal subarachnoid hemorrhage (aSAH). We evaluated the association of apolipoprotein E (APOE) polymorphism and the risk of aSAH in a South Indian population.Methods
The study was performed on 200 subjects with aSAH and 253 healthy control subjects. Blood samples (5 ml) were used to isolate DNA and genotyping was performed for rs7412 and rs429358 using a Taqman allelic discrimination assay. Statistical software R.3.0.11 was used to statistically analyze the data and a p value <?0.05 was considered as statistically significant.Results
We found a significant association with the risk of aSAH in ε3/ ε4 genetic model (OR?=?1.91, 95% CI?=?1.16–3.14, p?=?0.01). However, in the other genetic models and allele frequency, there was no significant association with the risk of aSAH. In subtyping, we found a significant association of ε2 allele frequency with posterior communicating artery (PCOM) aneurysm (OR?=?3.59, 95% CI?=?1.11–11.64, p?=?0.03).Conclusion
Our results suggest that APOE polymorphism has an influence on the risk of aSAH in this South Indian population, specifically in the PCOM subtype.9.
F. van Kesteren M. S. van Mourik E. M. A. Wiegerinck J. Vendrik J. J. Piek J. G. Tijssen K. T. Koch J. P. S. Henriques J. J. Wykrzykowska R. J. de Winter A. H. G. Driessen A. Kaya R. N. Planken M. M. Vis J. Baan 《Netherlands heart journal》2018,26(9):445-453
Aim
In the evolving field of transcatheter aortic valve implantations (TAVI) we aimed to gain insight into trends in patient and procedural characteristics as well as clinical outcome over an 8?year period in a real-world TAVI population.Methods
We performed a single-centre retrospective analysis of 1,011 consecutive patients in a prospectively acquired database. We divided the cohort into tertiles of 337 patients; first interval: January 2009–March 2013, second interval: March 2013–March 2015, third interval: March 2015–October 2016.Results
Over time, a clear shift in patient selection was noticeable towards lower surgical risks including Society of Thoracic Surgeons predicted risk of mortality score and comorbidity. The frequency of transfemoral TAVI increased (from 66.5 to 77.4%, p?=?0.0015). Device success improved (from 62.0 to 91.5%, p?<?0.0001) as did the frequency of symptomatic relief (≥1 New York Heart Association class difference) (from 73.8 to 87.1%, p?=?0.00025). Complication rates decreased, including in-hospital stroke (from 5.0 to 2.1%, p?=?0.033) and pacemaker implantations (from 10.1 to 5.9%, p?=?0.033). Thirty-day mortality decreased (from 11.0 to 2.4%, p?<?0.0001); after adjustment for patient characteristics, a mortality-risk reduction of 72% was observed (adjusted hazard ratio [HR]: 0.28, 95% confidence interval [CI]: 0.13–0.62). One-year mortality rates decreased (from 23.4 to 11.4%), but this was no longer significant after a landmark point was set at 30 days (mortality from 31 days until 1 year) (adjusted HR: 0.69, 95% CI: 0.41–1.16, p?=?0.16).Conclusion
A clear shift towards a lower-risk TAVI population and improved clinical outcome was observed over an 8?year period. Survival after TAVI improved impressively, mainly as a consequence of decreased 30-day mortality.10.
Mi-Na Kim Seong-Mi Park Dong-Hyuk Cho Hack-Lyoung Kim Mi-Seung Shin Myung-A Kim Kyung-Soon Hong Wan-Joo Shim 《Biology of sex differences》2018,9(1):52
Background
Evidence suggests that epicardial adipose tissue (EAT) is closely related to coronary artery stenosis (CAS). However, sexual dimorphism may be present in adipose tissue, and its influence on CAS between men and women is controversial. We assessed the relationship between EAT and CAS by sex and menopausal status in patients with suspected angina.Methods
Six hundred twenty-eight consecutive patients (men/women n?=?257/371; mean age = 59.9?±?10.2?years) who had chest pain for angina and underwent coronary angiography were included. CAS was defined as >?50% luminal narrowing of at least one epicardial coronary artery. EAT thickness was measured by transthoracic echocardiography.Results
Of the 628 patients, 52.1% (n?=?134) of men and 35.3% (n?=?131) of women had CAS. The mean EAT thickness was not different between men and women and was larger in patients with CAS (8.04?±?2.39 vs 6.58?±?1.88?mm, P?<?0.001). EAT thickness was independently associated with CAS in both sexes (P?<?0.001). The odds ratio (OR) of EAT for the presence of CAS was higher in men (OR?=?1.43, 95% confidence interval [CI] 1.21–1.69) than in women (OR?=?1.24, 95% CI 1.10–1.40). EAT thickness was larger in postmenopausal women than in premenopausal women (7.59?±?2.25 vs 5.80?±?1.57?mm, P?<?0.001) and was independently related with CAS (OR?=?1.24, 95% CI 1.09–1.41). This was not the case in premenopausal women.Conclusion
In patients with suspected angina, an increase in EAT thickness was independently related to the presence of CAS in both men and women, with it being stronger in men. According to menopausal status in women, EAT thickness is significantly associated with CAS only in postmenopausal women.11.
Peng Huang Haozhi Fan Ting Tian Peiwen Liao Jun Li Rongbin Yu Xueshan Xia Yue Feng Jie Wang Yuan Liu Yun Zhang Ming Yue 《Virology journal》2017,14(1):235
Background
Recently, human leukocyte antigen (HLA) class-II gene polymorphisms have been reported to be related to Hepatitis C virus (HCV) infection and chronicity. The objective of this study was to explore the relationship of HLA-DP rs9277535 and HLA-DQ rs7453920 with the outcomes of HCV infection.Methods
The rs9277535 and rs7453920 were genotyped in 370 subjects with chronic HCV infection, 194 subjects with spontaneous HCV clearance, and 973 subjects with non-HCV infection from the Chinese population using the ABI TaqMan allelic discrimination assay.Results
Logistic regression analyses showed that the minor allele A of rs7453920 significantly increased the susceptibility of HCV infection in dominant model (adjusted OR?=?1.33, 95% CI: 1.04–1.71, P?=?0.026) and additive models (adjusted OR?=?1.30, 95% CI: 1.06–1.60, P?=?0.012). Rs9277535 A allele significantly increased the risk of chronic HCV infection in dominant model (adjusted OR?=?1.52, 95% CI: 1.01–2.28, P?=?0.046). Haplotype AA showed a higher risk of HCV infection than the most frequent haplotype GG (adjusted OR?=?1.37, 95% CI: 1.05–1.78, P?=?0.018).Conclusion
The HLA-DQ rs7453920 and -DP rs9277535 mutations were significantly associated with HCV infection susceptibility and chronicity, respectively.12.
A. B. E. Quast T. F. Brouwer K. M. Kooiman P. F. H. M van Dessel N. A. Blom A. A. M. Wilde R. E. Knops 《Netherlands heart journal》2018,26(12):612-619
Background
Young implantable cardioverter-defibrillator (ICD) patients are prone to complications and inappropriate shocks (IAS). The subcutaneous ICD (S-ICD) may avoid lead-related complications. This study aims to describe the incidence and nature of device-related complications in young transvenous ICD (TV-ICD) and S?ICD patients.Methods
Single-chamber TV-ICD and S?ICD patients up to and including the age of 25 years implanted between 2002 and 2015 were retrospectively analysed. Complications were defined as device-related complications requiring surgical intervention. IAS were defined as shocks for anything other than ventricular tachycardia or ventricular fibrillation. Follow-up data were collected 5 years post-implantation. Kaplan-Meier estimates for complications at 5?year follow-up were calculated with a corresponding 95% confidence interval.Results
Eighty-one patients (46 TV-ICD, 35 S-ICD) were included (median age 19.0 (IQR 16.0–23.0) and 16.5 (IQR 13.0–20.2) years respectively). Median follow-up was 60 and 40 months respectively. All-cause complication rate was 34% in the TV-ICD group and 25% in the S?ICD group (p?=?0.64). TV-ICD patients had more lead complications: 23% (10–36%) versus 0% (p?=?0.02). The rate of infections did not differ between TV-ICD and S?ICD: 2% (0–6%) versus 10% (0–21%) (p?=?0.15). No systemic infections occurred in the S?ICD patients. The rates of IAS were similar, TV-ICD 22% (9–35%) versus S?ICD 14% (0–30%) (p?=?0.40), as were those for appropriate shocks: 25% (11–39%) versus 27% (6–48%) (p?=?0.92).Conclusion
The rates of all-cause complications in this cohort were equal, though the nature of the complications differed. S?ICD patients did not suffer lead failures or systemic infections. An era effect is present between the two groups.13.
Background
Presenilin-1 (PS1), the active component of the intramembrane γ-secretase complex, can be detected as soluble heteromeric aggregates in cerebrospinal fluid (CSF). The aim of this study was to examine the different soluble PS1 complexes in the lumbar CSF (CSF-PS1) of individuals with Alzheimer’s disease (AD), particularly in both symptomatic and asymptomatic genetically determined AD, in order to evaluate their potential as early biomarkers.Methods
Western blotting, differential centrifugation and co-immunoprecipitation served to determine and characterize CSF-PS1 complexes. We also monitored the assembly of soluble PS1 into complexes in a cell model, and the participation of Aβ in the dynamics and robustness of the stable PS1 complexes.Results
There was an age-dependent increase in CSF-PS1 levels in cognitively normal controls, the different complexes represented in similar proportions. The total levels of CSF-PS1, and in particular the proportion of the stable 100–150 kDa complexes, increased in subjects with autosomal dominant AD that carried PSEN1 mutations (eight symptomatic and six asymptomatic ADAD) and in Down syndrome individuals (ten demented and ten non-demented DS), compared with age-matched controls (n?=?23), even prior to the appearance of symptoms of dementia. The proportion of stable CSF-PS1 complexes also increased in sporadic AD (n?=?13) and mild-cognitive impaired subjects (n?=?12), relative to age-matched controls (n?=?17). Co-immunoprecipitation demonstrated the association of Aβ oligomers with soluble PS1 complexes, particularly the stable complexes.Conclusions
Our data suggest that CSF-PS1 complexes may be useful as an early biomarker for AD, reflecting the pathology at asymptomatic state.14.
Background
General anesthesia has been linked to impaired brain development in immature animals and young children. In this study the influence of orthopedic surgery under general anesthesia on the intelligence of school age children has been evaluated.Methods
A total of 209 subjects aged 6–12 years were recruited and allocated into 4 groups according to the duration of general anesthesia, including a control group (n?=?30), short (< 1 h, n?=?49), moderate- (1–3 h, n?=?51) and long-duration groups (> 3 h, n?=?79), respectively. The intelligence quotient (IQ) of the subjects was measured by the Raven’s Standard Progressive Matrices (RSPM) before and after orthopedic surgery under general anesthesia of various durations (vide supra).Results
The IQ score decreased significantly in the long-duration group at 1 month post-operation compared with the pre-operation score (P?<?0.001), and IQ did not recover completely at 3 months postoperatively (P?<?0.05), but had recovered when measured at the 1-year follow-up. Moreover, this study showed that the development of children’s intelligence was affected by the exposure time to anesthetics at a younger age (OR?=?5.26, 95% CI:2.70–8.41, P?<?0.001), having a mother with a low education level (OR?=?2.71, 95% CI:1.24–6.14, P?=?0.014) and premature birth (OR?=?2.76, 95% CI:1.34–5.46, P?=?0.005).Conclusions
More than 3 h general anesthesia influenced the IQ of school age children for up to 3 months after orthopedic surgery. Beside extended exposure time to anesthetics additional factors for post-operative IQ reduction were younger children age, mothers with low educational levels and premature birth.Trial registration
Chinese Clinical Trial Registry with registration number ChiCTR-OOC-17013497 retrospectively registered on 11/23/2017.15.
Hamed Akbari Gholamreza Asadikaram Hamid Aria Saba Fooladi Sina Vakili Mohammad Masoumi 《BMC cardiovascular disorders》2018,18(1):237
Background
Klotho, possibly an age-regulating protein, is considered an important factor contributing to the lifespan and pathophysiology of hypertension and coronary artery disease (CAD). The present study was carried out aiming to investigate the association of Klotho-rs564481 (C1818T) gene polymorphism with hypertension and CAD.Methods
A total of 286 CAD-suspicious subjects were entered into this case-control study. The polymorphism was investigated in hypertensive patients with no CAD (H-Tens, n?=?60); hypertensive patients with CAD (CAD?+?H-Tens, n?=?95); CAD patients with no hypertension (CAD, n?=?61); and non-hypertensive non-CAD subjects, which were regarded as the control group (Ctrl, n?=?70). Genotype and allele frequencies were assessed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.Results
A significant difference was found in allele frequency of Klotho C1818T among the four research groups (P?=?0.03). It was also found that wild-type homozygote subjects were negatively associated with hypertension as compared to heterozygote ones (OR?=?0.07 [95% CI: 0.008–0.69] P?=?0.02). Moreover, in the subgroups older than 57?years old, dominant genetic model demonstrated a negative association with CAD combined with hypertension (OR?=?0.31 [95% CI: 0.10–0.95] P?=?0.04).Conclusions
In conclusion, Klotho C1818T variant may be associated with a decreased risk of hypertension. Moreover, aging enhanced positive effects of the Klotho polymorphism on CAD combined with hypertension, indicating the possibility that the KLOTHO gene might play a part in the age-related occurrence of CAD combined with hypertension.16.
Background
After coronary stenting, the risk of developing restenosis is from 20 to 35 %. The aim of the present study is to investigate the association of genetic variation in candidate genes in patients diagnosed with restenosis in the Kazakh population.Methods
Four hundred fifty-nine patients were recruited to the study; 91 patients were also diagnosed with diabetes and were excluded from the sampling. DNA was extracted with the salting-out method. The patients were genotyped for 53 single-nucleotide polymorphisms. Genotyping was performed on the QuantStudio 12K Flex (Life Technologies). Differences in distribution of BMI score among different genotype groups were compared by analysis of variance (ANOVA). Also, statistical analysis was performed using R and PLINK v.1.07. Haplotype frequencies and LD measures were estimated by using the software Haploview 4.2.Results
A logistic regression analysis found a significant difference in restenosis rates for different genotypes. FGB (rs1800790) is significantly associated with restenosis after stenting (OR?=?2.924, P?=?2.3E?06, additive model) in the Kazakh population. CD14 (rs2569190) showed a significant association in the additive (OR?=?0.08033, P?=?2.11E?09) and dominant models (OR?=?0.05359, P?=?4.15E?11). NOS3 (rs1799983) was also highly associated with development of restenosis after stenting in additive (OR?=?20.05, P?=?2.74 E?12) and recessive models (OR?=?22.24, P?=?6.811E?10).Conclusions
Our results indicate that FGB (rs1800790), CD14 (rs2569190), and NOS3 (rs1799983) SNPs could be genetic markers for development of restenosis in Kazakh population. Adjustment for potential confounder factor BMI gave almost the same results.17.
Claudia?Cicognola Davide?Chiasserini Paolo?Eusebi Ulf?Andreasson Hugo?Vanderstichele Henrik?Zetterberg Lucilla?Parnetti
Background
Cerebrospinal fluid (CSF) biomarkers have gained increasing importance in the diagnostic work-up of Alzheimer’s disease (AD). The core CSF biomarkers related to AD pathology (Aβ42, t-tau and p-tau) are currently used in CSF diagnostics, while candidate markers of amyloid metabolism (Aβ38, Aβ40, sAPPα, sAPPβ), synaptic loss (neurogranin), neuroinflammation (YKL-40), neuronal damage (VILIP-1) and genetic risk (apolipoprotein E) are undergoing evaluation. Diurnal fluctuation in the concentration of CSF biomarkers has been reported and may represent a preanalytical confounding factor in the laboratory diagnosis of AD. The aim of the present study was to investigate the diurnal variability of classical and candidate CSF biomarkers in a cohort of neurosurgical patients carrying a CSF drainage.Method
Samples were collected from a cohort of 13 neurosurgical patients from either ventricular (n?=?6) or lumbar (n?=?7) CSF drainage at six time points during the day, 1–7 days following the neurosurgical intervention. Concentrations of the core biomarkers were determined by immunoassays.Results
Although absolute values largely varied among subjects, none of the biomarkers showed significant diurnal variation. Site of drainage (lumbar vs. ventricular) did not influence this result. The different immunoassays used for tau and Aβ markers provided similar results.Conclusion
Time of day at CSF collection does not ultimately affect the concentration levels of classical and candidate AD biomarkers. Similar trends were found when using different immunoassays, thus corroborating the consistency of the data.18.
Matthias Diebold Alex Soltermann Selma Hottinger Sarah R. Haile Lukas Bubendorf Paul Komminoth Wolfram Jochum Rainer Grobholz Dirk Theegarten Sabina Berezowska Kaid Darwiche Filiz Oezkan Malcolm Kohler Daniel P. Franzen 《Respiratory research》2017,18(1):210
Background
Although the majority of solitary fibrous tumors of the pleura (SFTP) follow a benign course, 10–25% of patients suffer from recurrence or metastatic disease. Several scoring models have been proposed to predict the outcome. However, none of these included immunohistochemical (IHC) markers as possible prognosticators.Methods
In this multicenter study, we collected clinical data and formalin-fixed and paraffin-embedded (FFPE) tissue blocks of patients with histologically proven SFTP which had been surgically resected between 2000 und 2015. After systematic and extensive IHC staining on tissue microarrays, the results were analyzed and compared to histomorphological and clinical data for their possible prognostic value.Results
In total, 78 patients (mean age 61?±?11 years) were included. Of these, 9 patients (11%) had an adverse outcome including SFTP recurrence (n?=?6) or SFTP-related death (n?=?3). Mean overall survival was 172?±?13 months. 1 and 10-year event-free survival rates were 99% and 93%. In the multivariable analysis only MIB-1 proliferation index (Ki-67) ≥10% (HR 12.3, CI 1.1–139.5, p?=?0.043), ≥4 mitoses per 10 high power fields (HR 36.5, CI 1.2–1103.7, p?=?0.039) and tumor size larger than 10 cm (HR 81.8, CI 1.7–4016.8, p?=?0.027) were independently associated with adverse outcome.Conclusion
A high proliferation rate by MIB-1 IHC was associated with impaired outcome. Upon this, we established a new score using mitosis, necrosis, size of the tumor and MIB-1, which performed better than the traditional scores in our data set. This prognostic score could help to better evaluate outcome of SFTP, but requires external validation.19.
Alberto M. Marra Michael Halank Nicola Benjamin Eduardo Bossone Antonio Cittadini Christina A. Eichstaedt Benjamin Egenlauf Satenik Harutyunova Christine Fischer Henning Gall Hossein Ardeschir Ghofrani Marius M. Hoeper Tobias J. Lange Karen M. Olsson Hans Klose Ekkehard Grünig 《Respiratory research》2018,19(1):258
Background
Riociguat is a soluble guanylate cyclase stimulator approved for pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTPEH). The objective of this study was to evaluate right heart size and function assessed by echocardiography during long term treatment with riociguat.Methods
Patients who started riociguat treatment (1.0–2.5?mg tid) within the trials phase II, PATENT, PATENTplus, EAS, CHEST and continued treatment for 3–12?months were included in this study. Echocardiography was analysed off-line at baseline, after 3, 6 and 12?months by investigators who were blinded to clinical data. Last and baseline observation carried forward method (LOCF, BOCF) were performed as sensitivity analysis.Results
Seventy-one patients (45% PAH, 55% CTEPH; 53.5% female; 60?±?13?years, mean pulmonary arterial pressure 46?±?10?mmHg, mean PVR 700?±?282dynes·sec·cm-5) were included. After 6?months, RA and RV area, RV thickness tricuspid regurgitation velocity showed a significant reduction. After 12?months, patients receiving riociguat therapy showed a significant reduction in right atrial (??2.6?±?4.4?cm2, 95% CI -3.84, ??1.33; p?<?0.001, n?=?49) and right ventricular (RV) area (??3.5?±?5.2?cm2, 95% CI -5.1, ??1.9; p?<?0.001; n?=?44), RV thickness (??0.76?±?2.2?mm, 95% CI -1.55, 0.03; n?=?32), and a significant increase in TAPSE (2.95?±?4.78?mm, 95% CI 1.52, 4.39; n?=?45) and RV fractional area change (8.12?±?8.87?mm, 95% CI 4.61, 11.62; n?=?27).Both LOCF and BOCF showed similar results but lower effect sizes.Conclusion
Patients under long-term treatment with riociguat show significantly reduced right heart size and improved RV function in PAH and CTEPH. Further controlled prospective studies are needed to confirm these results.20.
Zhengling Liu Zengyan Wang Changhong Hao Yonghui Tian Jingjing Fu 《Reproductive biology and endocrinology : RB&E》2018,16(1):120