Activity of selected plant extracts against honey bee pathogen Paenibacillus larvae

International audienceAbstractThe present study focuses on the antibacterial activity of selected plant extracts against Paenibacillus larvae, the causal agent of American foulbrood disease of honey bees. A gas chromatography-mass spectrometry method was used to analyze six diethyl ether extracts of two white birch species, black poplar and common aspen buds, as well as n-hexane, diethyl ether, and methanol extracts of young twigs from downy and silver birches. Among the identified extract constituents were flavonoids, phenylpropenoids, triterpenoids, and glucosides. In spite of significant differences in qualitative and quantitative composition, all tested in vitro extracts demonstrated high anti-P. larvae activity at minimal inhibitory concentration levels between < 1.0 and 125 μg/mL. To examine the cause of such disparity, the anti-P. larvae activity of some individual constituents naturally present in plant extract compounds was determined. A higher susceptibility of P. larvae (ERIC I) to relatively poorly polar triterpenoid levels compared to polar compounds, flavonoids, and glucosides was demonstrated

Wady zastawkowe serca i różne profile dobowe ciśnienia tętniczego

Introduction. Valvular heart diseases (VHD) increase the risk of cardiovascular morbidity and mortality. Little is known about the correlation between circadian blood pressure profile (CBPP) and VHD. The study aimed to clarify the association between CBPP and VHD prevalence. Material and methods. 103 consecutive patients (male: 50.5%), who underwent 24-hour ambulatory blood pressure measurement (ABPM) and Holter electrocardiography simultaneously were analysed. Patients were divided into 3 groups: dipping was defined as 10–20% (28.2%), non-dipping as &lt; 10% (50.5%) fall in nocturnal blood pressure (BP) and reverse-dipping as higher nocturnal than diurnal BP (21.4%). VHD was assessed by transthoracic echocardiography and described as mild, moderate or severe regurgitation or stenosis accordingly. Further, the severity of VHD, nocturnal fall pattern and ABPM features in all groups were compared. Results. The authors found no statistically significant association between severity of VHD and dipping status. The presented study showed some correlations between VHD severity and different ABPM parameters. Conclusions. Though severity of VHD did not influence dipping status obtained by ABPM, there were associations between VHD and ABPM outcomes. Further studies are needed.Wstęp. Wady zastawkowe serca (VHD) zwiększają ryzyko zachorowań i zgonów z przyczyn sercowo-naczyniowych. Niewiele wiadomo na temat zależności między profilem dobowym ciśnienia tętniczego (CBPP) a VHD. Celem tej pracy było wyjaśnienie związku między CBPP a VHD. Materiał i meody. Do badania włączono 103 kolejnych pacjentów (mężczyźni 50,5%), u których równocześnie wykonano całodobowy pomiar ciśnienia tętniczego (ABPM) i 24-godzinny zapis elektrokardiograficzny metodą Holtera. Podzielono ich na trzy grupy: dippers — zdefiniowanych jako osoby z ciśnieniem tętniczym (BP) w nocy o 10–20% niższym niż w ciągu dnia (28,2%), non-dippers — osoby ze spadkiem BP w nocy mniejszym niż 10% (50,5%), reverse-dippers — osoby z wyższymi wartościami BP w nocy niż w ciągu dnia (21,4%). Metodą echokardiografii przezklatkowej oceniano VHD jako małą, umiarkowaną lub ciężką. Następnie porównywano ciężkość VHD, CBPP i dane z ABPM we wszystkich grupach. Wyniki. Nie znaleziono istotnej statystycznie zależności między cięż kością VHD a CBPP. Zaobserwowano korelację między ciężkością VHD a niektórymi parametrami ocenianymi w trakcie ABPM. Wnioski. Choć ciężkość VHD nie wpływała na CBPP, to istnieją zależności między wynikami VHD i ABPM. Konieczne są dalsze badania

Determinants of the circadian blood pressure pattern in hospitalized hypertensive patients

Background. Non-dipping hypertension might be associated with increased cardiovascular risk and multiple diseases. The aim of our study was to assess if there are parameters identified in 24-hour ECG-Holter monitoring (ECG-Holter), transthoracic echocardiography (TTE), ECG parameters or laboratory data that allow prediction of circadian blood pressure profile (CBPP). Material and methods. One hundred and three consecutive patients (male: 50.5%), who underwent 24-hour ambulatory BP measurement and ECG-Holter simultaneously were analyzed. We divided patients into 3 groups: dipping was defined as 10–20% (28.2%), non-dipping as &lt; 10% (50.5%) fall in nocturnal BP and reverse-dipping as higher nocturnal than diurnal BP (21.4%). Additionally, we performed TTE and laboratory check-up in all patients. We built multivariable models for nocturnal fall in systolic BP (SBP) and CBPP. Results. Multivariable model based on clinical factors was: nocturnal fall in SBP (%) = [13.28 – 0.11 × age – 8.33 × (dilated cardiomyopathy) – 5.95 × PAD – 6.02 × a-adrenolytic]. Multivariable model based on laboratory, echocardiographic and electrocardiographic parameters was: nocturnal fall in SBP (%) = [–27.28 + 1.47 × hemoglobin – 0.14 × CK-MB + 0.14 × maximal heart rate]. Multivariable model for CBPP based on clinical factors included use of beta- or alpha-adrenolytics or torasemide. Conclusions. We proved that nocturnal fall in SBP and CBPP could be predicted based on ECG-Holter parameters, laboratory data and TTE results, as well as based on detailed medical history. These findings may have implications on care of patients with hypertension

Comparison of dedicated BIOSS bifurcation stents with regular drug-eluting stents for coronary artery bifurcated lesions: Pooled analysis from two randomized studies

  Background: Coronary bifurcation treatment poses a therapeutic challenge. The aim of this study was to analyze pooled data of two randomized clinical trials, POLBOS I and POLBOS II, to compare 1-year follow-up results and identify possible prognostic factors. Methods: In POLBOS trials dedicated bifurcation BiOSS® stents were compared with regular drug eluting stents (rDES) in patients with stable coronary artery disease or non ST-segment elevation acute coronary syndrome (POLBOS I: paclitaxel eluting BiOSS® Expert vs. rDES; POLBOS II: sirolimus eluting BiOSS® LIM vs. rDES). Provisional T-stenting was the default strategy. Angiographic control was performed at 12 months. The primary endpoint was major adverse cardiovascular events (MACE) rate defined as the rate of cardiac death, myocardial infarction (MI) or target lesion revascularization (TLR). Results: 445 patients, with 222 patients in the BiOSS group and 223 patients in the rDES group, were analyzed. In 26.7% cases procedures were performed within distal left main, and true bifurca­tions which accounted for 81.6% of treated lesions. At 12 months the whole population exhibited no statistical differences in terms of MACE, TLR, MI or cardiac death between rDES and BiOSS groups. In multivariate analysis odds for MACE decreased with female sex (OR 0.433, 95% CI 0.178–0.942, p = 0.047) and with proximal optimization technique use (OR 0.208, 95% CI 0.097–0.419, p &lt; 0.001), whereas the odds for MACE increased with main vessel predilatation (OR 2.191, 95% CI 1.042–5.066, p = 0.049) and diabetes mellitus treated with insulin (OR 2.779, 95% CI 1.1–6.593, p = 0.024). Conclusions: Pooled data showed no significant difference between MACE and TLR rates for BiOSS® group vs. rDES group

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Gene expression profiling reveals potential prognostic biomarkers associated with the progression of heart failure

Abstract BACKGROUND: Heart failure (HF) is the most common cause of morbidity and mortality in developed countries. Here, we identify biologically relevant transcripts that are significantly altered in the early phase of myocardial infarction and are associated with the development of post-myocardial infarction HF. METHODS: We collected peripheral blood samples from patients with ST-segment elevation myocardial infarction (STEMI): n = 111 and n = 41 patients from the study and validation groups, respectively. Control groups comprised patients with a stable coronary artery disease and without a history of myocardial infarction. Based on plasma NT-proBNP level and left ventricular ejection fraction parameters the STEMI patients were divided into HF and non-HF groups. Microarrays were used to analyze mRNA levels in peripheral blood mononuclear cells (PBMCs) isolated from the study group at four time points and control group. Microarray results were validated by RT-qPCR using whole blood RNA from the validation group. RESULTS: Samples from the first three time points (admission, discharge, and 1 month after AMI) were compared with the samples from the same patients collected 6 months after AMI (stable phase) and with the control group. The greatest differences in transcriptional profiles were observed on admission and they gradually stabilized during the follow-up. We have also identified a set of genes the expression of which on the first day of STEMI differed significantly between patients who developed HF after 6 months of observation and those who did not. RNASE1, FMN1, and JDP2 were selected for further analysis and their early up-regulation was confirmed in HF patients from both the study and validation groups. Significant correlations were found between expression levels of these biomarkers and clinical parameters. The receiver operating characteristic (ROC) curves indicated a good prognostic value of the genes chosen. CONCLUSIONS: This study demonstrates an altered gene expression profile in PBMCs during acute myocardial infarction and through the follow-up. The identified gene expression changes at the early phase of STEMI that differentiated the patients who developed HF from those who did not could serve as a convenient tool contributing to the prognosis of heart failure