The role of the adenosine triphosphate-sensitive potassium channels in pinacidil-induced vasodilatation of the human saphenous vein in patients with and without type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) increases cardiovascular complications. Diabetic vascular dysfunction is associated with the reduced activity of the different smooth muscle potassium (K+) channels. Thus, the objective of our study was to investigate the role of the adenosine triphosphate (ATP)-sensitive K+ (KATP) channels in the relaxant effect of potassium channel opener, pinacidil on the human saphenous vein (HSV) obtained from the patients with and without T2DM. The rings of HSV without the endothelium, obtained from the patients who had undergone coronary bypass surgery, were mounted in an organ bath system and isometric tension was recorded. The relaxation of HSV, precontracted with phenylephrine, was produced by pinacidil. The expression of KATP subunits (Kir6.1, Kir6.2 and SUR2B) was detected by immunohistochemistry and Western blot. Pinacidil produces comparable effects on HSV in patients with and without T2DM. The suppression of pinacidil effect and its maximal relaxation by glibenclamide, selective blocker of KATP channels, was more pronounced on HSV in patients without T2DM. All three types of KATP subunits are expressed on the smooth muscle cells of HSV. While there are no differences in the expression of Kir6.1 and Kir6.2, the expression of SUR2B is lower in HSV in patients with T2DM. Pinacidil produced comparable KATP-dependent and -independent relaxation of the HSV in patients with/without T2DM. According to the effect of glibenclamide and the applied molecular analysis, presented findings demonstrated that diabetes mellitus was associated with the reduced expression of SUR2B subunit in the vascular smooth muscle of HSV.

Serum vitamin D levels and chronic periodontitis in adult, Caucasian population-a systematic review.

The aim of this systematic review was to explore the relationship between serum vitamin D levels and periodontal disease. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The focused PICO question was: Are serum vitamin D levels (I) associated with gingivitis or periodontitis (C) in healthy humans (P)? PubMed (Medline), Embase, Science Direct, the Cochrane library, and grey literature were searched up to 31 July 2017. Two reviewers independently selected studies and extracted data. Quality, risk of bias, and heterogeneity of the studies were assessed using the Newcastle-Ottawa Scale. In total, 365 studies were identified and 24 were analyzed. Seven studies fulfilled the inclusion criteria. Four case-control studies showed an influence of vitamin D and its metabolites on periodontal health status/disease. One interventional study suggested the proposed anti-inflammatory role of vitamin D. Two cross-sectional studies failed to show a relationship between vitamin D and periodontal condition. The literature on the effect of serum vitamin D levels on periodontal status remains scarce and controversial. Some data, however, support a "perio-protective" role for vitamin D. There is a need for well-designed randomized clinical trials to explore the possible anti-inflammatory effect of vitamin D on periodontal health.

Underlying theory of a model for the Renner-Teller effect in tetra-atomic molecules: X(2)Πu electronic state of C2H2(+).

In the present study, we prove the plausibility of a simple model for the Renner-Teller effect in tetra-atomic molecules with linear equilibrium geometry by ab initio calculations of the electronic energy surfaces and non-adiabatic matrix elements for the X(2)Πu state of C2H2 (+). This phenomenon is considered as a combination of the usual Renner-Teller effect, appearing in triatomic species, and a kind of the Jahn-Teller effect, similar to the original one arising in highly symmetric molecules. Only four parameters (plus the spin-orbit constant, if the spin effects are taken into account), which can be extracted from ab initio calculations carried out at five appropriate (planar) molecular geometries, are sufficient for building up the Hamiltonian matrix whose diagonalization results in the complete low-energy (bending) vibronic spectrum. The main result of the present study is the proof that the diabatization scheme, hidden beneath the apparent simplicity of the model, can safely be carried out, at small-amplitude bending vibrations, without cumbersome computation of non-adiabatic matrix elements at large number of molecular geometries.

The role of transapical cannulation in the operative management of acute aortic dissection.

OBJECTIVES: The aim of the study was to investigate the usefulness of transapical cannulation as the routine cannulation site in patients with acute aortic dissection and to compare it with other cannulation methods. METHODS: Between January 2010 and December 2013, emergency surgery was performed in 111 consecutive patients with acute type A aortic dissection. Patients were divided into two groups: transapical cannulation group and other cannulation sites group (including femoral and axillary artery cannulation). Pre-, intra- and postoperative data were compared between these two groups of patients. RESULTS: Transapical cannulation was the most frequent cannulation site (78 patients, 70.3%), the femoral artery was selected in 24 patients (21.6%) and the axillary artery in 9 patients (8.1%). The mortality rate in the transapical group was 16.7% and 18.2% when other cannulation sites were chosen (p=0.85). No difference in postoperative stroke rate (6.4% vs 9.1%, p=0.62, transapical vs other cannulation sites group, respectively), myocardial infarction (6.4% vs 6.1%, p=0.94) and postoperative acute renal insufficiency incidence (9% vs 6.1%, p=0.61) was found. CONCLUSIONS: Routine transapical cannulation in patients with acute type A aortic dissection is a fast and safe way to establish cardiopulmonary bypass. There is no difference in major operative outcomes after transapical cannulation when compared to the other cannulation sites.

A density functional study of the spin state energetics of polypyrazolylborato complexes of first-row transition metals.

Density Functional Theory (DFT) was used to analyse and explain spin state energetics of first-row transition metals (Mn(II), Fe(II), Co(II); Cr(III), Mn(III), Fe(III), Co(III); Mn(IV)) in polypyrazolylborato complexes. We explored the effects of substitutions at the 3 and 5 positions of the pyrazolyl rings, as well as the influence of Jahn-Teller (JT) distortions on spin-state switching. Although the stabilizations due to JT distortion are sometimes substantial, this does not lead to switching of the spin ground-state. On the other hand, electron withdrawing or donating substituents do lead to significant changes in the spin-crossover (SCO) properties of the investigated complexes.

Predictors of competitive achievement among pubescent synchronized swimmers: an analysis of the solo-figure competition.

AIM: This study examined the applicability of sport-specific fitness tests (SSTs), anthropometrics, and respiratory parameters in predicting competitive results among pubescent synchronized swimmers. METHODS: A total of 25 synchronized swimmers (16-17 years; 166.2 ± 5.4 cm; and 58.4 ± 4.3 kg) volunteered for this study. The independent variables were body mass, body height, Body Mass Index (BMI), body fat percentage (BF%), lean body mass percentage, respiratory variables, and four SSTs (two specific power tests plus one aerobic- and one anaerobic-endurance test). The dependent variable was competitive achievement in the solo figure competition. The reliability analyses, Pearson's correlation coefficient and forward stepwise regression were calculated. RESULTS: The SSTs were reliable for testing fitness status among pubescent synchronized swimmers. The forward stepwise regression retained two SSTs, BF% and forced vital capacity (FVC, relative for age and stature) in a set of predictors of competitive achievement. Significant Beta coefficients are found for aerobic-endurance, SST and FVC. CONCLUSION: The sport-specific measure of aerobic endurance and FVC appropriately predicted competitive achievement with regard to the figures used in the competition when competitive results (the dependent variable) were obtained. Athletes and coaches should be aware of the probable negative influence of very low body fat levels on competitive achievement.

Translocation t(3;12)(q26;q21) in JAK2(V617F) Point Mutation Negative Chronic Idiopathic Myelofibrosis: A Case Report.

The myeloproliferative diseases (MPDs) or myelo-proliferative neoplasms (MPNs) are a group of diseases of the bone marrow in which excess cells are produced. Chronic idiopathic myelofibrosis (CIMF) is a stem cell defect characterized by splenomegaly with multiorgan extramedullary hematopoiesis, immature peripheral blood granulocytes and erythrocytes and progressive bone marrow fibrosis. The most common chromosomal abnormalities seen in CIMF patients include numerical changes of chromosomes 7, 8 and 9, and structural changes of 1q, 5q, 13q and 20q. At least 75.0% of patients with bone marrow abnormalities have one or more of these chromosomal anomalies. Detection of the Janus kinase 2 (JAK2) mutation may be a potential major breakthrough for understanding the pathobiology of MPNs, and is an essential part of the diagnostic algorithm. In this study, we describe a JAK2(V617F) mutation negative CIMF patient who has the chromosomal translocation t(3;12)(q26;q21) in her karyotype.

Influence of multisystemic affection on health-related quality of life in patients with myotonic dystrophy type 1.

AIM: To assess health-related quality of life (HRQoL) in patients with DM1, to identify muscular, multisystemic, central and social factors that may affect QoL and to define a DM1 patient in risk of poor QoL. PATIENTS AND METHOD: This cross-sectional study comprised 120 DM1 consecutive patients. The following scales were used: Multidimensional Scale of Perceived Social Support (MSPSS), Muscular Impairment Rating Scale (MIRS), battery of neuropsychological tests, acceptance of illness scale (AIS), Hamilton rating scale for depression (Ham-D), Krupp's Fatigue Severity Scale (FSS), Daytime Sleepiness Scale (DSS) and SF-36 questionnaire. RESULTS: HRQoL was impaired in DM1 patients in both physical and mental domains (PCS was 41.8±23.5, MCS 47.0±24.3 and total SF-36 score 45.6±24.0). The most significant factors correlating with better SF-36 total score were younger age (ß=-0.45, p<0.001), shorter duration of disease (ß=-0.27, p=0.001), higher education (ß=0.20, p=0.009), less severe muscular weakness (ß=-0.52, p<0.001), normal swallowing (ß=0.22, p=0.005), absence of fainting (ß=0.31, p=0.002), absence of snoring (ß=0.21, p=0.036), better acceptance of disease (ß=-0.17, p=0.036), lower depressiveness (ß=-0.46, p=0.001), lower fatigue (ß=-0.32, p=0.001), absence of cataract (ß=-0.21, p=0.034), absence of kyphosis (ß=0.31, p=0.004) and absence of constipation (ß=0.24, p=0.016). Second linear regression analysis revealed that depressed (ß=-0.38, p<0.001) and elder patients (ß=-0.27, p=0.007) and as well as those with poor acceptance of illness (ß=-0.21, p=0.006) were in especially higher risk of having poor HRQoL (R(2)=0.68). CONCLUSION: We identified different central, social, muscular, cardiorespiratory and other factors correlating with HRQoL. It is of great importance that most of these factors are amenable to treatment.

Honey bee (Apis mellifera) venom induces AIM2 inflammasome activation in human keratinocytes.

BACKGROUND: Following allergen exposure, cytokines and other pro-inflammatory signals play an important role in the immunological cascade leading to allergic sensitization. Inflammasomes sense exogenous and endogenous danger signals and trigger IL-1ß and IL-18 activation which in turn shape Th2 responses. Honey bee venom (BV) allergies are very common; however, the local inflammatory cascade leading to the initiation of allergic sensitization is poorly understood. In this study, the local inflammatory cascades in skin after exposure to BV were investigated. METHODS: The mechanisms of inflammasome activation in human skin and in cultured keratinocytes upon BV exposure were analyzed by ELISA, Western blot, flow cytometry, siRNA techniques, and immunofluorescence. RESULTS: In an ex vivo bee sting model, BV induced IL-1ß release suggesting the activation of inflammasomes. Indeed, in cultured keratinocytes, the BV component melittin triggered IL-1ß and IL-18 release via the AIM2 inflammasome. AIM2 is a cytosolic DNA receptor, and mitochondrial as well as genomic DNA was detected in the cytosol of melittin-treated keratinocytes as triggers of inflammasome activation. As a mechanism, melittin mediated destruction of mitochondrial membranes leading to the leakage of mitochondrial DNA into the cytosolic compartment. CONCLUSION: These data suggest that upon BV exposure, keratinocytes are involved in an innate immune response by the activation of the AIM2 inflammasome and subsequent IL-1ß and IL-18 release triggered by endogenous DNA. As IL-1ß and IL-18 are involved in Th2- and IgE-mediated immune reactions, these results could add to the understanding of the role of the tissue microenvironment to subsequent allergic responses.

Narrowband ultraviolet B treatment improves vitamin D balance and alters antimicrobial peptide expression in skin lesions of psoriasis and atopic dermatitis.

BACKGROUND: Narrowband ultraviolet B (NB-UVB) is a routine treatment for psoriasis and atopic dermatitis (AD) but its effect on vitamin D balance is not well studied. OBJECTIVES: To examine whether NB-UVB treatment in winter improves vitamin D balance in psoriasis and AD, and to study the effects of NB-UVB on antimicrobial peptide and cytokine expression in the skin. METHODS: Eighteen adult patients with psoriasis, 18 with AD and 15 healthy subjects received a total of 15 NB-UVB exposures on the whole body, given three times a week. Serum calcidiol (25-hydroxyvitamin D) was measured by radioimmunoassay. Antimicrobial peptide and cytokine expression in skin lesions was examined by real-time quantitative polymerase chain reaction. RESULTS: At onset 16 (89%) patients with psoriasis, 17 (94%) patients with AD and eight (53%) healthy subjects had vitamin D insufficiency (calcidiol < 50 nmol L(-1)). NB-UVB treatment significantly increased (P < 0.001) serum calcidiol. The increase was 59.9 nmol L(-1) (95% confidence interval, CI 53.5-66.9) in psoriasis, 68.2 nmol L(-1) (95% CI 55.4-80.1) in AD and 90.7 nmol L(-1) (95% CI 63.8-123.4) in healthy subjects. Psoriasis Area and Severity Index and SCORAD improved significantly (P < 0.001) but no correlation to the increase of serum calcidiol was found. Cathelicidin and human beta-defensin 2 (HBD2) expression was high in skin lesions of psoriasis. After six NB-UVB treatments cathelicidin increased further while HBD2 expression decreased. A similar trend was observed in AD lesions. NB-UVB caused a marked but nonsignificant decrease of interleukin (IL)-1beta and IL-17 in psoriasis lesions. CONCLUSIONS: The present study shows that in addition to a significant improvement of psoriasis and AD, NB-UVB treatment effectively corrects vitamin D insufficiency. It also increases cathelicidin and decreases HBD2 levels in healing skin lesions of psoriasis and AD. This effect might be mediated by improved vitamin D balance and the local cytokine network.

[Cardiac neoplasms: results of the surgical treatment between 2000. and 2008].

INTRODUCTION: The goal of this study was to show early and midterm results of surgical treatment of cardiac neoplasma. METHODS: Between 2000. and 2008., sixty-seven patients with a cardiac tumor or a subdiaphragmatic neoplasma with right atrial extension were operated in our institution. In 22 patients (32.8%), not only a simple extirpation of neoplasma, but an additional surgical procedure was done. RESULTS: A patient reoperated for a recurence of biatrial myxoma died early after operation (1.5% mortality rate). During follow-up period of 3.3 years, two patients (3.4%) out of 58 that were contacted died because of the neoplasma (Methastasis of adenocarcinoma, Carcinoma renis). CONCLUSION: Surgical treatment of cardic tumors resulted in low early mortality and an excellent survival rate after a follow-up period of 3.3 years.

[Cathelicidins: multifunctional defense molecules of the skin]. / Cathelicidine: multifunktionelle Abwehrmoleküle der Haut.

The human skin is constantly exposed to microbial pathogens but infections only rarely occur. Innate cutaneous immunity is a primary system for protection against infection, and antimicrobial peptides (AMPs) expressed in skin are essential defence molecules. The AMPs include molecules such as the defensins that were first characterized for their antimicrobial properties as well as other peptides and proteins first known for their activity as chemokines, enzymes, enzyme inhibitors and neuropeptides. Cathelicidins are unique AMPs that act as defensive and signalling molecules. Two different pathways are involved in this function: cathelicidins have direct antimicrobial activity and they also initiate a host of cellular responses in cytokine release, inflammation and angiogenesis. Several skin diseases are associated with cathelicidin dysfunction. In atopic eczema, for example, cathelicidin expression is suppressed, whereas in rosacea cathelicidin peptides are abnormally processed to forms that induce cutaneous inflammation and a vascular response. In psoriasis cathelicidin peptide converts self-DNA to a potent stimulus in an autoinflammatory cascade. Current studies have unexpectedly identified vitamin D3 as a major factor for the regulation of cathelicidin expression. This finding may provide new strategies in the management of infectious and inflammatory diseases of the skin by targeting control of the expression and function of cathelicidin and other AMPs.

An ab initio study of the vibronic structure in the a1Delta g electronic state of C2H2++.

The results of an ab initio study of the vibronic structure in the a1Deltag electronic state of C2H2++ and its deuterated species (C2D2++) are presented. They are generated employing a simple model that incorporates the minimal number of terms contributing to the Renner-Teller effect. The trans- and cis-bending potential curves at planar nuclear arrangements are obtained by means of large-scale configuration interaction calculations. The corresponding harmonic vibrational frequencies are 717 and 650 cm-1 for C2H2++, and 549 and 477 cm-1 in the case of C2D2++. It is found that the splitting of the potential surfaces is moderate at trans-distortions of linearity, while it is extremely small at cis-bending vibrations. The eigenvalues and eigenfunctions of the model Hamiltonian employed are obtained by means of a perturbative and a variational approach.

[Endovascular and surgical management of carotid artery restenosis].

BACKGROUND: The incidence of recurrent carotid stenosis after primary endarterectomy ranges from 10-34%. We presented our four year experience and comparing reoperation versus endovascular treatment. METHODS: In period from 2001 to 2005, 50 patients, 37 men and 13 women, were treated surgically and endovascular due to restenosis. RESULTS: There were no minor or major stroke, death and myocardial infarction periprocedural and in first 30 days in either group. In endovascular group one patients 3.17% had transient ischemic attack and two patients 11.76% in surgical group. One patient died from myocardial infraction in follow up in surgical group. There were no restenosis > or = 50% in endovascular group, two patients have restenosis > or = 50% in surgical group. CONCLUSIONS: Endovascular treatment of carotid artery restenosis represents a safe and efficient way of treatment, connected with minor number of serious complications than redo operation.

[ Air embolism during carotid dilatation with a stent].

We presented the case of endovascular treatment of the restenosis of the carotid artery occuring after carotid endarterectomy. We have shown the need of applying the protection systems during the endovascular procedure, in order to prevent the distal embolisation cused by ahterosclerotic debris and/or air.

[Selective digestive decontamination. Why don't we apply the evidence in the clinical practice?]. / Descontaminación digestiva selectiva. 'Por qué no aplicamos la evidencia en la práctica clínica?

Selective digestive decontamination (SDD) is a prophylactic strategy whose objective is to reduce the incidence of infections, mainly mechanical ventilation associated pneumonia in patients who require intensive cares, preventing or eradicating the oropharyngeal and gastrointestinal carrier state of potentially pathogenic microorganisms. Fifty-four randomized clinical trials (RCTs) and 9 meta-analysis have evaluated SDD. Thirty eight RCTs show a significant reduction of the infections and 4 of mortality. All the meta-analyses show a significant reduction of the infections and 5 out of the 9 meta-analyses report a significant reduction in mortality. Thus, 5 patients from the ICU with SDD must be treated to prevent pneumonia and 12 patients from the ICU should be treated to prevent one death. The data that show benefit of the SDD on mortality have an evidence grade 1 or recommendation grade A (supported by at least two level 1 investigations). The aim of this review is to explain the pathogeny of infections in critical patients, describe selective digestive decontamination, analyze the evidence available on it efficacy and the potential adverse effects and discuss the reasons published by the experts who advise against the use of SDD, even though it is recognized as the best intervention evaluated in intensive cares to reduce morbidity and mortality of the infections.

Descontaminación digestiva selectiva. ¿Por qué no aplicamos la evidencia en la práctica clínica? / Selective digestive decontamination. Why don’t we apply the evidence in the clinical practice?

La descontaminación digestiva selectiva (DDS) es una estrategia profiláctica cuyo objetivo es reducir la incidencia de infecciones, principalmente la neumonía asociada a la ventilación mecánica, en los pacientes que requieren cuidados intensivos, previniendo o erradicando el estado de portador orofaríngeo y gastrointestinal de microorganismos potencialmente patógenos. Cincuenta y cuatro ensayos clínicos randomizados (ECR) y nueve metaanálisis han evaluado la DDS. Treinta y ocho ECR muestran una reducción significativa de las infecciones y cuatro de la mortalidad. Todos los metaanálisis muestran una reducción significativa de las infecciones y 5 de los 9 metaanálisis de la mortalidad. Se necesita tratar 5 pacientes de Unidad de Cuidados Intensivos (UCI) con DDS para prevenir una neumonía y 12 pacientes de UCI deben ser tratados para prevenir una muerte. Los datos que muestran un beneficio de la DDS sobre la mortalidad tienen un grado de evidencia 1 o un grado de recomendación A (soportada por al menos dos investigaciones de nivel 1). El objetivo de esta revisión es exponer la patogenia de las infecciones en los enfermos críticos, describir la DDS, analizar la evidencia disponible sobre su eficacia y los potenciales efectos adversos, y discutir las razones publicadas por los expertos que desaconsejan el uso de la DDS, a pesar de ser reconocida como la intervención mejor evaluada en cuidados intensivos para reducir la morbilidad y mortalidad de las infecciones

Selective digestive decontamination (SDD) is a prophylactic strategy whose objective is to reduce the incidence of infections, mainly mechanical ventilation associated pneumonia in patients who require intensive cares, preventing or eradicating the oropharyngeal and gastrointestinal carrier state of potentially pathogenic microorganisms. Fifty-four randomized clinical trials (RCTs) and 9 meta-analysis have evaluated SDD. Thirty eight RCTs show a significant reduction of the infections and 4 of mortality. All the meta-analyses show a significant reduction of the infections and 5 out of the 9 meta-analyses report a significant reduction in mortality. Thus, 5 patients from the ICU with SDD must be treated to prevent pneumonia and 12 patients from the ICU should be treated to prevent one death. The data that show benefit of the SDD on mortality have an evidence grade 1 or recommendation grade A (supported by at least two level 1 investigations). The aim of this review is to explain the pathogeny of infections in critical patients, describe selective digestive decontamination, analyze the evidence available on it efficacy and the potential adverse effects and discuss the reasons published by the experts who advise against the use of SDD, even though it is recognized as the best intervention evaluated in intensive cares to reduce morbidity and mortality of the infections

Pro-atrial natriuretic peptide hormone from right atria is correlated with cardiac depression in septic patients.

N-terminal pro-atrial natriuretic peptide [proANP(1-98)] has been extensively investigated in patients with chronic heart failure and ishemic heart disease. It is found to be a better marker of cardiac dysfunction than atrial natriuretic peptide (ANP). The possible involvement of proANP(1-98) in cardiac depression caused by sepsis has not been studied yet. Therefore, we analyzed atrial plasma concentration of proANP(1-98) in 17 septic patients with hemodynamic variables measured or calculated using pulmonary artery catheter. The results of altogether 96 measurements show a significant negative correlation of proANP(1-98) and cardiac index (p<0.024), oxygen delivery (p<0.03) and oxygen consumption (p<0.03). There is also a positive correlation with pulmonary vascular resistance (p<0.03). ProANP(1-98) is significantly higher in patients who developed acute respiratory distress syndrome (ARDS) (p<0.001). This study implies that proANP(1-98) is a possible novel hormone marker of cardiac depression caused by sepsis that could be used for prediction of ARDS.