The usefulness of SPECT-CT with radioisotope-labeled leukocytes in diagnosing lead-dependent infective endocarditis

Background. Lead-dependent infective endocarditis (LDIE) is a life-threatening complication of permanent transvenous cardiac pacing. According to the 2015 European Society of Cardiology (ECS) guidelines, the diagnosis of LDIE is based on the modified Duke criteria (MDC), while single-photon emission computed tomography with conventional computed tomography (SPECT-CT) with radioisotope-labeled leukocytes serves as an additional tool in difficult cases. The major challenge is to differentiate between true vegetation and a thrombus.   Objectives. The aim of the study was to evaluate the usefulness of SPECT-CT with radioisotope-labeled leukocytes in diagnosing LDIE in patients with intracardiac masses (ICMs).   Material and Methods. The prospective registry included 40 consecutive patients admitted with an ICM on the lead and suspicion of LDIE. The confirmation or rejection of the LDIE diagnosis was made according to an algorithm based on the MDC. The cohort was divided into 2 groups: patients with definite and possible LDIE diagnoses based on the MDC (the LDIE-positive group), and patients with negative LDIE diagnoses according to the MDC (the LDIE-negative group). All patients underwent SPECT-CT with radioisotope-labeled leukocytes. The diagnostic ability of SPECT-CT was compared to the gold standard MDC.   Results. The LDIE-positive group with diagnosis based on the MDC consisted of 19 patients (LDIE definite – 11; LDIE possible – 8). The LDIE diagnosis was rejected on the basis of the MDC in 21 patients. The SPECT-CT results were compared with the MDC results and showed 73.7% sensitivity, 81.0% specificity, 77.5% accuracy, 77.8% positive predictive value (PPV), 77.3% negative predictive value (NPV), likelihood ratio positive (LR+) 3.868, likelihood ratio negative (LR–) 0.325, and moderate agreement (κ = 0.548, p < 0.001). After the exclusion of 5 patients treated with antibiotics at the time of the SPECT-CT, LR+ and LRimproved to 5.250 and 0, respectively, and inter-test agreement amounted to almost perfect concordance (κ = 0.773, p < 0.001).   Conclusion. Single-photon emission computed tomography with conventional CT with radioisotopelabeled leukocytes is a useful, efficient, single-step test for diagnosing LDIE

Platelet Carbonic Anhydrase II, a Forgotten Enzyme, May Be Responsible for Aspirin Resistance

Background. Thromboembolic events constitute a major health problem, despite the steadily expanding arsenal of antiplatelet drugs. Hence, there is still a need to optimize the antiplatelet therapy. Objectives. The aim of our study was to verify a hypothesis that there are no differences in platelet proteome between two groups of healthy people representing different acetylsalicylic acid (aspirin) responses as assessed by the liquid chromatography/mass spectrometry (LC/MS) technique. Patients/Methods. A total of 61 healthy volunteers were recruited for the study. Physical examination and blood collection were followed by platelet-rich plasma aggregation assays and platelet separation for proteomic LC/MS analysis. Arachidonic acid- (AA-) induced aggregation (in the presence of aspirin) allowed to divide study participants into two groups aspirin-resistant (AR) and aspirin-sensitive (AS) ones. Subsequently, platelet proteome was compared in groups using the LC/MS analysis. Results. The LC/MS analysis of platelet proteome between groups revealed that out of all identified proteins, the only discriminatory protein, affecting aspirin responsiveness, is platelet carbonic anhydrase II (CA II). Conclusions. CA II is a platelet function modulator and should be taken into consideration as a cardiovascular event risk factor or therapeutic target

Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe — recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency

Wstęp: Wyniki badań z ostatnich lat dokumentują wiele korzyści wynikających z działania witaminy D na organizm człowieka na wszystkichetapach jego życia. Większość badań epidemiologicznych sugeruje, że niedobór witaminy D jest powszechny wśród mieszkańców EuropyŚrodkowej. Naturalną konsekwencją tej sytuacji jest konieczność ciągłego uświadamiania społeczeństwu oraz środowisku medycznemu,jaką rolę odgrywa witamina D w rozwoju i funkcjonowaniu organizmu ludzkiego.Metody: Na podstawie przeglądu danych literaturowych Polski Zespół Wielodyscyplinarny opracował tezy dotyczące zasad suplementacjiwitaminą D, które przesłano do członków Komitetu Naukowego konferencji „Witamina D — minimum, maksimum, optimum”,19–20 Październik, 2012, Warszawa. W trakcie powyższej konferencji z udziałem 550 delegatów oraz Ekspertów różnych dziedzin medycynyomówiono i przedyskutowano propozycje wytycznych suplementacji witaminą D populacji Europy Środkowej.Wyniki: W efekcie przeprowadzonych dyskusji Zespół Ekspertów opracował wytyczne suplementacji witaminą D dla wszystkich grupwiekowych populacji Europy Środkowej. Określono również kryteria diagnostyczne charakteryzujące stan zaopatrzenia organizmu w witaminę D: deficyt witaminy D ustalono jako stężenie 25(OH)D &lt; 20 ng/mL (&lt; 50 nmol/L)], suboptymalne zaopatrzenie jako stężenie25(OH)D wynoszące 20–30 ng/mL (50–75 nmol/L), a stężenie 30–50 ng/mL (75–125 nmol/L) uznano za docelowe dla zapewnienia efektuplejotropowego witaminy D.Wnioski: Poprawa obecnego stanu zaopatrzenia witaminy D w grupach dzieci, młodzieży, osób aktywnych zawodowo i seniorówpowinna zostać włączona do priorytetów polityki zdrowotnej społeczeństw Europy Środkowej.Introduction: Adequate Vitamin D intake and its concentration in serum are important for bone health and calcium–phosphate metabolismas well as for optimal function of many organs and tissues. Documented trends in lifestyle, nutritional habits and physical activityappear to be associated with moderate or severe Vitamin D deficits resulting in health problems. Most epidemiological studies suggest thatVitamin D deficiency is prevalent among Central European populations. Concern about this problem led to the organising of a conferencefocused on overcoming Vitamin D deficiency.Methods: After reviewing the epidemiological evidence and relevant literature, a Polish multidisciplinary group formulated theses onrecommendations for Vitamin D screening and supplementation in the general population. These theses were subsequently sent to ScientificCommittee members of the ‘Vitamin D — minimum, maximum, optimum’ conference for evaluation based on a ten-point scale.With 550 international attendees, the meeting ‘Vitamin D — minimum, maximum, optimum’ was held on October 19–20, 2012 in Warsaw(Poland). Most recent scientific evidence of both skeletal and non-skeletal effects of Vitamin D as well as the results of panellists’ votingwere reviewed and discussed during eight plenary sessions and two workshops.Results: Based on many polemical discussions, including post-conference networking, the key opinion leaders established ranges ofserum 25-hydroxyVitamin D concentration indicating Vitamin D deficiency [&lt; 20 ng/mL (&lt; 50 nmol/L)], suboptimal status [20–30 ng/mL(50–75 nmol/L)], and target concentration for optimal Vitamin D effects [30–50 ng/mL (75–125 nmol/L)]. General practical guidelines regardingsupplementation and updated recommendations for prophylactic Vitamin D intakes in Central European neonates, infants, childrenand adolescents as well as in adults (including recommendations for pregnant and breastfeeding women and the elderly) were developed.Conclusions: Improving the Vitamin D status of children, adolescents, adults and the elderly must be included in the priorities of physicians,healthcare professionals and healthcare regulating bodies. The present paper offers elaborated consensus on supplementationguidance and population strategies for Vitamin D in Central Europe

Survey of period variations of superhumps in SU UMa-type dwarf novae. VI. The sixth year (2013-2014)

© The Author 2014. Published by Oxford University Press on behalf of the Astronomical Society of Japan. All rights reserved. Continuing the project undertaken by Kato et al. (2009), we collected times of superhump maxima for 56 SU UMa-type dwarf novae mainly observed during the 2013-2014 season and characterized these objects. We detected negative superhumps in VW Hyi and indicated that the low number of normal outbursts in some supercycles can be interpreted as a result of disk tilt. This finding, combined with the Kepler observation of V1504 Cyg and V344 Lyr, suggests that disk tilt is responsible for modulating the outburst pattern in SU UMa-type dwarf novae. We also studied the deeply eclipsing WZ Sge-type dwarf nova MASTER OT J005740.99+443101.5 and found evidence of a sharp eclipse during the phase of early superhumps. The profile can be reproduced by a combination of the eclipse of the axisymmetric disk and the uneclipsed light source of early superhumps. This finding shows the lack of evidence for a greatly enhanced hot spot during the early stage of WZ Sge-type outburst. We detected growing (stage A) superhumps in MN Dra and give a suggestion that some of SU UMa-type dwarf novae situated near the critical condition of tidal instability may show long-lasting stage A superhumps. The large negative period derivatives reported in such systems can be understood as a result of the combination of stage A and B superhumps. Two WZ Sge-type dwarf novae, AL Com and ASASSN-13ck, showed a long-lasting (plateau-type) rebrightening. In the early phase of their rebrightenings, both objects showed a precursor-like outburst, suggesting that the long-lasting rebrightening is triggered by a precursor outburst

New Features of Entall Database: Comparison of Experimental and Model Formation Enthalpies/ Nowe Funkcje Bazy Danych Entall: Porównanie Doświadczalnych I Modelowych Entalpii Tworzenia

This paper presents a new version of the Entall database of the thermodynamic properties of metals and their alloys. The changes are related to the thermodynamic data of new binary and ternary systems as well as the integration of the database with an application for the modeling of the formation enthalpies of intermetallic phases with the use of the Miedema model. Using this tool, calculations of the enthalpies of formation of 38 intermetallic phases from 12 binary systems were performed and a comparative analysis conducted. The results of the analysis clearly showed a weak correlation between the model and experimental data. To improve this correlation, an intermediate method of proportional change was proposed, on the basis of the measurement of the enthalpy of formation for one of the phases. The values for the other phases obtained from this indirect method should not deviate much from the experimental ones provided that before the measurements (dissolving or pulping) or after them (direct synthesis), the phase being examined should undergo structural tests, in order to confirm its dominating amount in the samples.W pracy przedstawiona została nowa wersja bazy właściwośsci termodynamicznych metali i stopów Entall. Modyfikacja dotyczyła z jednej strony danych termodynamicznych nowych układów dwu i trójskładnikowych a z drugiej zaadaptowania do niej opracowanego programu (kalkulatora) do modelowania entalpii tworzenia faz międzymetalicznych modelem Miedemy. Korzystając z tego nowego narzędzia wykonane zostały obliczenia entalpii tworzenia dla 38 faz międzymetalicznych z 12 układów dwuskładnikowych oraz przeprowadzona została analiza porównawcza. Wyniki analizy pokazały jednoznacznie słaba korelacje między danymi modelowymi i doświadczalnymi. Dla poprawienia tej korelacji zaproponowana została pośrednia metoda proporcjonalnej zmiany w oparciu o pomiar entalpii tworzenia dla jednej z faz. Uzyskane z tej pośredniej metody wartości dla innych faz powinny niewiele odbiegąc od eksperymentalnych przy spełnieniu warunku, że faza dla której wykonywane były badania została przed pomiarami (rozpuszczanie lub roztwarzanie) lub po nich (bezpośrednia synteza) poddana badaniom strukturalnym, w celu potwierdzenia jej dominującej ilości w próbkach