Asymptomatic subjects with diabetes have a comparable risk of coronary artery disease to Non-diabetic subjects presenting chest pain: a 4-year community-based prospective study

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background Although diabetes mellitus is an important risk factor of coronary artery disease (CAD), routine screening for CAD is not recommended for asymptomatic diabetic patients. We assessed the impact of chest pain on CAD risk according to the presence or absence of diabetes mellitus. Methods We investigated the future CAD event rate in subjects with and without chest pain according to the presence or absence of diabetes in a prospective large-scale community-based study in Korea. Results Among 8,574 subjects (4,032 men and 4,542 women) without a history of CAD, 0.8% and 2.2% of non-diabetic and diabetic subjects, respectively, reported newly developed CAD events during 4 years of follow-up. Although the presence of chest pain at baseline was also significantly associated with an increased risk of CAD of more than 2-fold in both non-diabetic and diabetic subjects (P < 0.01), the risk of future CVD event in asymptomatic diabetic patients was not significantly different from that in non-diabetic subjects with chest pain (hazard ratio, 0.907; 95% confidence interval, 0.412 – 1.998). Conclusions The CAD event rate of asymptomatic subjects with diabetes was comparable to that of non-diabetic subjects reporting chest pain. Considering the high risk of CAD in asymptomatic diabetic patients, more clinical trials aimed at formulating strategies to screen asymptomatic diabetic subjects should be carried out

A Case of Near Total Aortic Replacement in an Adolescent With Loeys-Dietz Syndrome

Loeys-Dietz syndrome is a recently described autosomal dominant disorder caused by mutations in the genes for transforming growth factor-beta receptor type 1 or 2 (TGF-ßR 1/2). The syndrome predisposes patients to aortic aneurysm and dissections, along with craniofacial and musculoskeletal abnormalities. Here we report the case of an adolescent who underwent serial near total aortic replacement, from the aortic valve to the descending aorta. Loeys-Dietz syndrome was confirmed in this case by the detection of a mutation in the TGF-ßR 2 gene

Therapeutic potential of CKD-506, a novel selective histone deacetylase 6 inhibitor, in a murine model of rheumatoid arthritis

Abstract Objectives Histone deacetylase (HDAC) 6 promotes inflammation. We investigated the anti-arthritic effects of CKD-506, a novel HDAC6 inhibitor, in vitro and in a murine model of arthritis as a novel treatment option for rheumatoid arthritis (RA). Methods HDAC6 was overexpressed in mouse peritoneal macrophages and RAW 264.7 cells, and the effects of a HDAC6 inhibitor CKD-506 on cytokine production and activity of NF-κB and AP-1 signaling were examined. Peripheral blood mononuclear cells (PBMCs) from RA patients and fibroblast-like synoviocytes (FLS) were activated in the presence of CKD-506. Next, regulatory T cells (Tregs) were induced from RA patients and co-cultured with healthy effector T cells (Teffs) and cell proliferation was analyzed by flow cytometry. Finally, the effects of the inhibitor on the severity of arthritis were assessed in a murine model of adjuvant-induced arthritis (AIA). Results Overexpression of HDAC6 induced macrophages to produce TNF-α and IL-6. The inhibitory effect of CKD-506 was mediated via blockade of NF-κB and AP-1 activation. HDAC6 inhibition reduced TNF-α and IL-6 production by activated RA PBMCs. CKD-506 inhibited production of MMP-1, MMP-3, IL-6, and IL-8 by activated FLS. In addition, CKD-506 inhibited proliferation of Teffs directly and indirectly by improving iTreg function. In AIA rats, oral CKD-506 improved clinical arthritis in a dose-dependent manner. A combination of sub-therapeutic CKD-506 and methotrexate exerted a synergistic effect. Conclusion The novel HDAC6 inhibitor CKD-506 suppresses inflammatoryresponses by monocytes/macrophages, improves Treg function, and ameliorates arthritis severity in a murine model of RA. Thus, CKD-506 might be a novel and effective treatment option for RA

QT Prolongation and Life Threatening Ventricular Tachycardia in a Patient Injected With Intravenous Meperidine (Demerol®)

QT prolongation is a serious adverse drug effect, which is associated with an increased risk of Torsade de pointes and sudden death. Many drugs, including both cardiac and non-cardiac drugs, have been reported to cause prolongation of QT interval. Although meperidine has not been considered proarrhythmic, we present a unique case of a 16-year-old boy without an underlying cardiac disease, who developed polymorphic ventricular tachycardia, ventricular fibrillation and QT prolongation after an intravenous meperidine injection. He had no mutation in long QT syndrome genes (KCNQ1, KCNH2, and SCN5A), but single nucleotide polymorphisms were reported, including H558R in SCNA5A and K897T in KCNH2

Evaluation of the Chemical Characteristics and Predictive Model of Water-Soluble Inorganic Ions for Fine Particulate Matter Generated in Pohang

Objectives This study aims to contribute to establishing the regional effective management of fine particulate matter by evaluating the chemical characteristics and contribution of fine particulate matter, and the accuracy of predictive model of fine particulate matter through the measurement of water-soluble inorganic ions (WSIIs) and electrical conductivity for fine particulate matter generated in Pohang. Methods PM10 and PM2.5 samples were simultaneously collected using a low volume air sampler from April to November 2022. For sample analysis, cations of Ca2+, Mg2+, K+, NH4+, Na+ and anions of Cl-, NO3-, SO42-, and electrical conductivity were measured after pretreatment by ultrasonic extraction. Results and Discussion The average concentrations of WSIIs for PM10 and PM2.5 in Pohang were 12.1μg/m3 and 8.5μg/m3, respectively, accounting for 35.5% and 50.0% of each fine particulate matter. The sum of NH4+, NO3-, SO42- concentration was found to account for the majority of 71% and 78% of WSIIs in PM10 and PM2.5, respectively. The PM2.5/PM10 ratios for NH4+, K+, and SO42- were 95%, 89%, and 81%, respectively, mostly present in PM2.5. The average ratio of PM2.5/PM10 for NO3- was 54%, but it rose sharply to 79% in November when the temperature was low, indicating an increase in contribution to the generation of PM2.5 in winter. During the sampling period excluding April and July, the ion balance for cations and anions was relatively good at a 1:1 ratio and showed chemical properties of fine particulate matter close to neutral. A regression model was evaluated for the measured electrical conductivity of WSIIs and the concentration of fine particulate matter. The MAE and RMSE values for PM2.5 were 1.8μg/m3 and 2.4μg/m3, respectively, which were lower than PM10 (MAE 7.5 μg/m3, RMSE 10.3μg/m3), indicating high precision and accuracy. Conclusion This study confirmed the origin of fine particulate matter generated in Pohang through WSIIs analysis, and suggested that the measured electrical conductivity of WSIIs could be used as a key parameter for measuring the concentration of fine particulate matter