Influence of L-carnitine supplementation on diurnal blood pressure rhythm in obese type 2 diabetic subjects with autonomic neuropathy

Wstęp Neuropatia cukrzycowa może wpływać na dobowy rytm ciśnienia tętniczego. Istnieją przypuszczenia, że w rozwoju neuropatii cukrzycowej oraz insulinooporności może brać udział zaburzona przemiana karnityny. Celem podjętych badań była ocena stężeń karnityny całkowitej i wolnej w surowicy oraz dobowego rytmu ciśnienia tętniczego u otyłych chorych na cukrzycę typu 2 z neuropatią autonomiczną i bez neuropatii, jak również ocena wpływu stosowania L-karnityny na funkcję układu autonomicznego i dobowy rytm ciśnienia u tych chorych. Materiał i metody Badaniami objęto 30 otyłych osób chorych na cukrzycę typu 2, leczonych lekami doustnymi. U 15 chorych stwierdzono subkliniczną neuropatię autonomiczną układu sercowo-naczyniowego (grupa NA(+)), natomiast u 15 osób nie stwierdzono obecności tego powikłania (grupa NA(-)). Grupę kontrolną stanowiło 15 otyłych osób bez cukrzycy. U wszystkich badanych wykonano pomiar wskaźnika masy ciała (BMI), wskaźnika talia/biodra (WHR), oznaczano stężenie karnityny wolnej i całkowitej, glukozy, insuliny, peptydu C, HbA1c i lipidów. Neuropatię autonomiczną układu sercowo-naczyniowego oceniano na podstawie baterii testów według Ewinga. Ambulatoryjny, 24-godzinny pomiar ciśnienia tętniczego wykonano za pomocą urządzenia SpaceLabs 90207. Badania przeprowadzono w warunkach wyjściowych oraz po 3 miesiącach stosowania L-karnityny podawanej doustnie w dawce 1000 mg/d. Wyniki We wszystkich badanych grupach wiek, płeć, wskaźnik BMI i WHR były zbliżone. Podobny był także dobowy rytm ciśnienia tętniczego i liczba osób wykazujących prawidłowy spadek ciśnienia w nocy. Grupy NA(+) i NA(–) nie różniły się pod względem stężenia karnityny wolnej i całkowitej, wyrównania cukrzycy, stężenia insuliny i peptydu C, a także stężeń cholesterolu i jego frakcji oraz triglicerydów. Mimo iż stosowanie karnityny u chorych na cukrzycę prowadziło do istotnego wzrostu jej stężenia w surowicy, nie miało wpływu na masę ciała, funkcję układu autonomicznego i dobowy rytm ciśnienia. Wnioski Obecność subklinicznej neuropatii autonomicznej u otyłych chorych na cukrzycę typu 2 nie wpływa na dobowy rytm ciśnienia i nie wykazuje związku ze stężeniami karnityny wolnej i całkowitej. Stosowanie karnityny nie wpływa na neuropatię autonomiczną ani na dobowy rytm ciśnienia tętniczego.Background Diabetic autonomic neuropathy can be associated with abnormalities in diurnal blood pressure rhythm. It has been suggested that carnitine deficiency can be involved in the development of both diabetic neuropathy and insulin resistance. The aim of the study was to assess serum carnitine levels and diurnal blood pressure rhythm in obese type 2 diabetic subjects with subclinical autonomic neuropathy and without neuropathy and to determine influence of L-carnitine supplementation on autonomic neuropathy and blood pressure rhythm. Material and methods Study was performed in 30 obese type 2 diabetic patients treated with oral antidiabetic agents. Subclinical autonomic neuropathy of cardiovascular system was present in 15 of them - group NA(+) and was not found in 15 others - group NA(-). Control group consisted of 15 obese, nondiabetic subjects. In all subjects body mass index (BMI), waist-hip ratio (WHR), fasting serum free and total carnitine, glucose, insulin, C-peptide, lipids and HbA1c were measured. Assessment of autonomic neuropathy was based on a Ewing’s battery of autonomic function tests. Ambulatory blood pressure monitoring was performed with SpaceLabs 90207. Investigation was performed twice, before and after supplementation of 1000 mg L-carnitine per day, given orally for 3 month. Results No differences in age, sex, BMI and WHR was found in all investigated groups. Diurnal blood pressure rhythm and number of subjects with normal night blood pressure fall was similar in NA(-) and NA(+) patients. Similar levels of free and total carnitine, glucose, insulin, C-peptide, HbA1c, total cholesterol, LDL, HDL cholesterol and triglicerides were found in NA(+) and NA(-) groups. After supplementation of L-carnitine in diabetic patients, serum carnitine levels increased but there was no change in BMI, autonomic nervous system function and blood pressure rhythm. Conclusions Subclinical autonomic neuropathy in obese type 2 diabetic subjects is not associated with serum carnitine concentration and abnormalities in blood pressure rhythm. Supplementation of L-carnitine does not influence the autonomic neuropathy and diurnal blood pressure rhythm

Characterization of the newly isolated lytic bacteriophages KTN6 and KT28 and their efficacy against Pseudomonas aeruginosa biofilm

We here describe two novel lytic phages, KT28 and KTN6, infecting Pseudomonas aeruginosa, isolated from a sewage sample from an irrigated field near Wroclaw, in Poland. Both viruses show characteristic features of Pbunalikevirus genus within the Myoviridae family with respect to shape and size of head/tail, as well as LPS host receptor recognition. Genome analysis confirmed the similarity to other PB1-related phages, ranging between 48 and 96%. Pseudomonas phage KT28 has a genome size of 66,381 bp and KTN6 of 65,994 bp. The latent period, burst size, stability and host range was determined for both viruses under standard laboratory conditions. Biofilm eradication efficacy was tested on peg-lid plate assay and PET membrane surface. Significant reduction of colony forming units was observed (70-90%) in 24 h to 72 h old Pseudomonas aeruginosa PAO1 biofilm cultures for both phages. Furthermore, a pyocyanin and pyoverdin reduction tests reveal that tested phages lowers the amount of both secreted dyes in 48-72 h old biofilms. Diffusion and goniometry experiments revealed the increase of diffusion rate through the biofilm matrix after phage application. These characteristics indicate these phages could be used to prevent Pseudomonas aeruginosa infections and biofilm formation. It was also shown, that PB1-related phage treatment of biofilm caused the emergence of stable phage-resistant mutants growing as small colony variants

Production of medical Sc radioisotopes with an alpha particle beam

The internal α-particle beam of the Warsaw Heavy Ion Cyclotron was used to produce research quantities of the medically interesting Sc radioisotopes from natural Ca and K and isotopically enriched 42Ca targets. The targets were made of metallic calcium, calcium carbonate and potassium chloride. New data on the production yields and impurities generated during the target irradiations are presented for the positron emitters 43Sc, 44 gSc and 44 mSc. The different paths for the production of the long lived 44 mSc/44 gSc in vivo generator, proposed by the ARRONAX team, using proton and deuteron beams as well as alpha-particle beams are discussed. Due to the larger angular momentum transfer in the formation of the compound nucleus in the case of the alpha particle induced reactions, the isomeric ratio of 44 mSc/44 gSc at a bombarding energy of 29 MeV is five times larger than previously determined for a deuteron beam and twenty times larger than for proton induced reactions on enriched CaCO3 targets. Therefore, formation of this generator via the alpha-particle route seems a very attractive way to form these isotopes. The experimental data presented here are compared with theoretical predictions made using the EMPIRE evaporation code. Reasonable agreement is generally observed

Economic and social cost of epilepsy in Poland : 5-year analysis

Introduction: Epilepsy affects nearly 50 million people around the world. As a common and chronic disease generates a high cost burden for healthcare system and patients. Aim: We aimed to determine the most current direct and indirect costs of epilepsy in Poland from the social perspective for the years 2014–2018, to analyze the changes of expenditures over time, indicate trends and to determine key cost-drivers. Material and Methods: Direct and indirect costs using a top-down approach were estimated based on the public institutions' data for the ICD-10 codes G40 and G41. Direct costs included pharmacotherapy, hospitalizations, outpatient specialist care and rehabilitation. A human capital approach was used to estimate loss of productivity due to sick leaves and long-term inability to work. Results: Annual total direct and indirect costs related to epilepsy accounted for EUR 410 million in 2014 and decreased in subsequent years to EUR 361 million in 2018. The indirect costs were dominant (76–83% of total costs) and in the majority related to the long-term absenteeism (87–92% of total indirect costs). In 2014–2018, patients with epilepsy generated EUR 341 million to EUR 282 million of indirect costs. Annual direct costs for patients with epilepsy were EUR 69 million in 2014 and increased to EUR 80 million in 2018. The biggest expenses were the costs of drugs (> 50%) and hospitalizations (~ 40%). Conclusions: Epilepsy is an expensive disorder in terms of consumption of resources and social costs. Decision-makers should take it under special consideration

Injuries of diaphragm in children : diagnostic problems

Background: Nine children with blunt trauma were hospitalized in our hospital from September 2000 to July 2005. The group consisted of 7 boys and 2 girls from 2 to 15 years old. Material/Methods: The object of our article is to present problems in diagnosis of diaphragmatic injuries and compare the possibilities of diagnosis among different methods. We observed 3 children with trauma of diaphragm: in two of them the injury was on left side of diaphragm, and in one- on the right side. Results: Results of our examinations allowed us only to suspect a trauma of the right side of diaphragm, and in one patient correct diagnosis was established based on autopsy. The left side diaphragmatic injury was diagnosed by means of the CT abdominal scan after the extubations. Conclusions: Although various diagnostic methods were applied, diaphragmatic injuries constitute a serious problem in the diagnosis. Chest X-ray is still an important part of diagnosis in patients with diaphragmatic trauma

Interfacial Self-Assembly to Spatially Organize Graphene Oxide Into Hierarchical and Bioactive Structures

Multicomponent self-assembly holds great promise for the generation of complex and functional biomaterials with hierarchical microstructure. Here, we describe the use of supramolecular co-assembly between an elastin-like recombinamer (ELR5) and a peptide amphiphile (PA) to organise graphene oxide (GO) flakes into bioactive structures across multiple scales. The process takes advantage of a reaction – diffusion mechanism to enable the incorporation and spatial organization of GO within multiple ELR5/PA layers. Scanning electron microscopy (SEM), transmission electron microscopy (TEM), and ImageJ software were used to demonstrate the hierarchical organisation of GO flakes within the ELR5/PA layers and the distribution profiles of GO throughout the ELR5/PA membranes. Furthermore,atomic force microscopy (AFM) revealed improved Young’s moduli of the ELR5/PA/GOmembranes compared to the ELR5/PA membranes. Lastly, we investigated biocompatibility of the ELR5/PA/GO membrane via various cell culture methods

Forecasting model of Corylus, Alnus, and Betula pollen concentration levels using spatiotemporal correlation properties of pollen count

The aim of the study was to create and evaluate models for predicting high levels of daily pollen concentration of Corylus, Alnus, and Betula using a spatiotemporal correlation of pollen count. For each taxon, a high pollen count level was established according to the first allergy symptoms during exposure. The dataset was divided into a training set and a test set, using a stratified random split. For each taxon and city, the model was built using a random forest method. Corylus models performed poorly. However, the study revealed the possibility of predicting with substantial accuracy the occurrence of days with high pollen concentrations of Alnus and Betula using past pollen count data from monitoring sites. These results can be used for building (1) simpler models, which require data only from aerobiological monitoring sites, and (2) combined meteorological and aerobiological models for predicting high levels of pollen concentration

Zastosowanie midazolamu w zakładzie radiologii pediatrycznej : sedacja płytka przed diagnostycznymi badaniami obrazowymi

Background: The aims of the study were to evaluate the usefulness of midazolam administration for sedation prior to some diagnostic examinations in children and to present the requirements and rules for sedation in departments of pediatric radiology. Material/Methods: From Oct. 2001 to Aug. 2005, two hundred children were investigated after conscious sedation with midazolam. The examinations were: voiding cystourethrography (129), voiding sonocystography (64), barium enema (3), ultrasonography (1), urography (1), X-ray of facial bone (1), and brain CT (1). The children's age-range was 4 months to 13 years 9 months. The decision for sedation was based on conversation with the child and/or parents, their experience with previous examinations, emotional status of the child, and exclusion of contraindications (renal insufficiency, hepatic failure, respiratory/circulatory insufficiency, allergy to benzodiazepines in anamnesis). Midazolam was given orally in a dose of 0.5 mg/kg body weight, 15-20 minutes before examination (already at the department of pediatric radiology). The parents were informed of the possible side effects and what to do after the procedure. Results: All diagnostic procedures with conscious sedation were well tolerated by the children and accepted by the parents. The parents with experience from previous diagnostic procedures indicated that they would want their child to have midazolam again if the examination needed to be repeated. No significant complications were observed in the children receiving midazolam and few adverse effect on voiding during cystourethrography. In three children (2.5, 3, and 5 years old), paradoxical reactions occurred (psychomotor agitation) which disappeared spontaneously after some minutes and had no influence on the procedure. Conclusions: Application of midazolam for conscious sedation diminished anxiety and discomfort from diagnostic procedures and short anterograde amnesia protected the child's mind from painful experience. Conscious sedation should be widely used in children in whom exact psychological preparation is impossible, and anxiety before examination can make it difficult or inaccessible

Cyclotron production of 43Sc for PET imaging

Recently, significant interest in 44Sc as a tracer for positron emission tomography (PET) imaging has been observed. Unfortunately, the co-emission by 44Sc of high-energy γ rays (Eγ = 1157, 1499 keV) causes a dangerous increase of the radiation dose to the patients and clinical staff. However, it is possible to produce another radionuclide of scandium—43Sc—having properties similar to 44Sc but is characterized by much lower energy of the concurrent gamma emissions. This work presents the production route of 43Sc by α irradiation of natural calcium, its separation and purification processes, and the labeling of [DOTA,Tyr3] octreotate (DOTATATE) bioconjugate. Methods: Natural CaCO3 and enriched [40Ca]CaCO3 were irradiated with alpha particles for 1 h in an energy range of 14.8–30 MeV at a beam current of 0.5 or 0.25 μA. In order to find the optimum method for the separation of 43Sc from irradiated calcium targets, three processes previously developed for 44Sc were tested. Radiolabeling experiments were performed with DOTATATE radiobioconjugate, and the stability of the obtained 43Sc-DOTATATE was tested in human serum. Results: Studies of natCaCO3 target irradiation by alpha particles show that the optimum alpha particle energies are in the range of 24–27 MeV, giving 102 MBq/μA/h of 43Sc radioactivity which creates the opportunity to produce several GBq of 43Sc. The separation experiments performed indicate that, as with 44Sc, due to the simplicity of the operations and because of the chemical purity of the 43Sc obtained, the best separation process is when UTEVA resin is used. The DOTATATE conjugate was labeled by the obtained 43Sc with a yield >98 % at elevated temperature. Conclusions: Tens of GBq activities of 43Sc of high radionuclidic purity can be obtainable for clinical applications by irradiation of natural calcium with an alpha beam