Activity of 11β-hydroxysteroid dehydrogenase of rat kidney and liver in inherited stress-induced arterial hypertension

11β-hydroxysteroid dehydrogenase (11β-HSD) catalyzing the interconversion of corticosterone and 11-dehydrocorticosterone is the key enzyme of glucocorticoid metabolism in rats. The activity of 11β-HSD in kidney of rats with inherited stress-induced arterial hypertension (ISIAH) was significantly (p < 0.05) higher than that in WAG rats. The opposite was observed in activity of liver 11β-HSD. No changes in the kidney 11β-HSD activity of both strains were observed under stress condition, however, the liver 11β-HSD activity in ISIAH rats was significantly (p < 0.05) higher as compared to basal level and stressed WAG rats. It is possible that the features of the 11β-HSD activity in ISIAH rats may reflect their hypertensive status.     

High immunoglobulin-M levels to oxidation-specific epitopes are associated with lower risk of acute myocardial infarction

Immunoglobulin M (IgM) autoantibodies to oxidation-specific epitopes (OSEs) can be present at birth and protect against atherosclerosis in experimental models. This study sought to determine whether high titers of IgM titers to OSE (IgM OSE) are associated with a lower risk of acute myocardial infarction (AMI) in humans. IgM to malondialdehyde (MDA)-LDL, phosphocholine-modified BSA, IgM apolipoprotein B100-immune complexes, and a peptide mimotope of MDA were measured within 24 h of first AMI in 4,559 patients and 4,617 age- and sex-matched controls in the Pakistan Risk of Myocardial Infarction Study. Multivariate-adjusted logistic regression was used to estimate odds ratio (OR) and 95% confidence interval for AMI. All four IgM OSEs were lower in AMI versus controls (P < 0.001 for all). Males, smokers and individuals with hypertension and diabetes had lower levels of all four IgM OSE than unaffected individuals (P < 0.001 for all). Compared to the lowest quintile, the highest quintiles of IgM MDA-LDL, phosphocholine-modified BSA, IgM apolipoprotein B100-immune complexes, and MDA mimotope P1 had a lower OR of AMI: OR (95% confidence interval) of 0.67 (0.58–0.77), 0.64 (0.56–0.73), 0.70 (0.61–0.80) and 0.72 (0.62–0.82) (P < 0.001 for all), respectively. Upon the addition of IgM OSE to conventional risk factors, the C-statistic improved by 0.0062 (0.0028–0.0095) and net reclassification by 15.5% (11.4–19.6). These findings demonstrate that IgM OSE provides clinically meaningful information and supports the hypothesis that higher levels of IgM OSE may be protective against AMI.     

International Guideline Adherence in Girls with Turner Syndrome: Multiple Subspecialty Clinics Versus Coordinated Multidisciplinary Clinic

ObjectiveTo evaluate the 2016 Cincinnati International Turner syndrome (TS) consensus guideline adherence within our pediatric tertiary referral center and determine if patients managed in our single-day, coordinated multidisciplinary clinic (MDC) format showed superior adherence rates when compared with those managed outside our MDC format.MethodsWe retrospectively reviewed the charts of patients with TS followed at our center from January 1, 2018, to April 30, 2020. The individual and overall adherence rates of 9 age-appropriate screening recommendations were evaluated along with rates of TS comorbidities within our cohort.ResultsA total of 111 girls met the study criteria. Sixty-eight were managed in the MDC and 43 were managed outside the MDC. Only 42% of all the girls met all 9 evaluated age-appropriate screening recommendations, of 47 girls, 33 (70%) were managed in MDC compared with 14 (30%) who were managed in the non-MDC. Girls managed in the MDC had higher screening adherence rates versus non-MDC girls for 7 of the 9 evaluated screenings with especially large differences noted for thyroid stimulating hormone (95% vs 78%, P = .034), auditory evaluation (97% vs 65%, P < .001), and HgA1c levels (82% vs 54%, P = .014).ConclusionGirls managed in the MDC format showed higher rates of screening guideline adherence, both overall and with multiple specific screening tests, than those managed outside the MDC format. Overall guideline adherence remained low (42%), highlighting the need for continued optimization and improvement in guideline adherence in this unique subset of the population.     

Monitoring great ape heart health through innovative electrocardiogram technology: Training methodologies and welfare implications

Assessing and treating cardiovascular disease (or heart disease) is a growing concern for institutions housing great apes, as it is a major cause of mortality in all four taxa managed in human care. As part of a proactive monitoring plan, zoological managers and veterinarians often elect to perform electrocardiograms (ECGs) on their great ape populations. ECGs noninvasively evaluate cardiac electrical activity, and are thereby capable of providing information regarding heart function. This electrical signature is transcribed as a visual display of waveforms, referred to as telemetry strips, and can detect irregularities in heart rhythm, also known as arrhythmia. While traditional 6- or 12-lead ECGs are recommended periodically as part of a thorough heart performance evaluation, here we discuss the KardiaMobile (KM) device as an additional primate welfare tool. KM is a small, Food and Drug Administration-cleared, clinical-grade mobile ECG monitor that requires only 30 s of pressure to flag heart rate or arrhythmic abnormalities. We detail the training process and applicability to great apes in human care.     

Estimation of cardiac output and stroke volume from thermal equilibration and heartbeat rates in fish

Cardiac output and stroke volume were estimated for a 200 g largemouth blackbass (Micropterus salmoides) by a modified whole-body thermodilution method using the relation between thermal equilibration rates and heartbeat frequencies. The reciprocal of the thermal time constant, k (min^–1), was related to the heartbeat frequency, F (beats min^–1), by the equation k=0.00146 F + 0.309; the slope is the weight-specific stroke volume (ml g^–1) and the intercept is the weight-specific heat transfer constant (cal °C^–1 min^–1 g^–1). Stroke volume was 0.292 ml (0.00146 ml/g body weight), yielding cardiac output values ranging from 44 ml kg^–1 min^–1 (at 30 beats min) to 158 ml kg^–1 min^–1 (at 108 beats min^–1), or 4.4 to 15.8% of body weight. Active (convective) heat transfer due to blood flow constituted an estimated 11 to 34% (mean 22.5%) of total heat transfer, depending on heartbeat frequency; this variability constitutes physiological thermoregulation.     

2021 PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients

In view of the increasing complexity of both cardiovascular implantable electronic devices (CIEDs) and patients in the current era, practice guidelines, by necessity, have become increasingly specific. This document is an expert consensus statement that has been developed to update and further delineate indications and management of CIEDs in pediatric patients, defined as ≤21 years of age, and is intended to focus primarily on the indications for CIEDs in the setting of specific disease categories. The document also highlights variations between previously published adult and pediatric CIED recommendations and provides rationale for underlying important differences. The document addresses some of the deterrents to CIED access in low- and middle-income countries and strategies to circumvent them. The document sections were divided up and drafted by the writing committee members according to their expertise. The recommendations represent the consensus opinion of the entire writing committee, graded by class of recommendation and level of evidence. Several questions addressed in this document either do not lend themselves to clinical trials or are rare disease entities, and in these instances recommendations are based on consensus expert opinion. Furthermore, specific recommendations, even when supported by substantial data, do not replace the need for clinical judgment and patient-specific decision-making. The recommendations were opened for public comment to Pediatric and Congenital Electrophysiology Society (PACES) members and underwent external review by the scientific and clinical document committee of the Heart Rhythm Society (HRS), the science advisory and coordinating committee of the American Heart Association (AHA), the American College of Cardiology (ACC), and the Association for European Paediatric and Congenital Cardiology (AEPC). The document received endorsement by all the collaborators and the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). This document is expected to provide support for clinicians and patients to allow for appropriate CIED use, appropriate CIED management, and appropriate CIED follow-up in pediatric patients.     

ppGpp and RNA-polymerase backtracking guide antibiotic-induced mutable gambler cells

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Body temperature responses of Great Tits Parus major to handling in the cold

Animals typically respond to stressful stimuli such as handling by increasing core body temperature. However, small birds in cold environments have been found to decrease body temperature (T_b) when handled over longer periods, although there are no data extending beyond the actual handling event in such birds. We therefore measured both the initial T_b decrease during ringing and standardized T_b sampling, and subsequent recovery of T_b after this handling protocol in wild Great Tits Parus major roosting in nestboxes in winter. Birds reduced their T_b by 2.3 °C during c. 4 min of handling. When birds were returned to their nestboxes after handling, T_b decreased by a further 1.9 °C over c. 2 min, reaching a T_b of 34.6 °C before taking 20 min to rewarm to 2.5 °C above their initial T_b. The T_b reduction during handling could be a consequence of increased heat loss rate from disrupted plumage insulation, whereas T_b reduction after handling might reflect reduced heat production. These are important factors to consider when handling small birds in the cold.