Influence of hereditary haemochromatosis on left ventricular wall thickness: does iron overload exacerbate cardiac hypertrophy?

Background: The left ventricular (LV) hypertrophy increases the risk of heart failure. Hypertension and infiltrative cardiomyopathies are the well-known reasons of LV hypertrophy. The growing interest of scientists in this issue affects hereditary haemochromatosis (HH), which is characterised by the excess deposition of iron mostly due to HFE gene mutation. The aim of our study was to investigate the possible influence of HH on LV parameters in patients with early-diagnosed (early HH) and long-lasting and long-treated (old HH) disease. Materials and methods: Thirty nine early HH and 19 old HH patients were prospectively enrolled in the study; age- and sex-matched healthy volunteers constituted the appropriate control groups. All participants had echocardiography performed (including three-dimension volume and mass analysis); the iron turnover parameters were measured at the time of enrolment in every HH patients. Results: Echocardiographic parameters regarding to left atrium (LA), LV thickness, mass and long axis length were significantly higher, whereas LV ejection fraction was lower in early HH in comparison to healthy persons. In old HH patients the differences were similar to those mentioned before, except LV ejection fraction. The presence of hypertension in both HH groups did not influence echo parameters, as well as diabetes in old HH. The strongest correlation in all HH group was found between the time from HH diagnosis and LA, LV thickness and volumes parameters, but the correlations between iron turnover and echo parameters were non-existent. Conclusions: Hereditary haemochromatosis, not only long-lasting, but also early-diagnosed, could lead to exacerbation of LV wall thickness and cardiac hypertrophy. This effect is not simply connected with hypertension and diabetes that are frequent additional diseases in these patients, but with the time from HH diagnosis

31/Palliative effectiveness and tolerance of endobronchial HDR brachytherapy in patients with lung cancer -the preliminary experience of Oncology Centre in Gliwice, Department of Brachytherapy

AlmEndobronchial HDR brachytherapy (E-HDR-BT) is a well-established method of palliative treatment in patients with lung cancer. There is, however, no consensus on optimal radiation and the rate of complications. The aim of the work is to evaluate early effectiveness and tolerance of E-HDR-BT in palliative treatment of patients with lung cancer treated in Oncology Centre in Gliwice.Material and methodsSince 2000 in Oncology Centre in Gliwice HDR (Ir192) E-HDR-BT is used in palliative treatment of patients with bronchial obturation due to lung cancer. Regression of bronchial obturation and improvement in dyspnoea, cough and haemoptysis after therapy was analyzed for the first thirty patients. The total dose was 18 Gy, calculated at 1cm from the source, in 3 fraction (of 6 Gy) given everyweek.ResultsTwenty-five patients finished therapy as planned. Five patients didn’t complete treatment: two of them (6.6%) died because of massive haemoptysis; one patients suffered from exaggeration of angina pectoris, one patients developed high hectic fever not responding for antibacterial treatment, one suffered from exaggeration of their symptoms prohibiting continuation of the treatment. Changes in obturation of the bronchi and in patient's symptoms are shown in Table 1.Table 1Changes in obturation of the bronchi and in patient's symptom.SymptomsImprovementNochangesExaggerationObturation #/%22/88%3/12%0Dyspnoea #/%15/54%11/40%2/7%Cough #/%4/27%10/67%2/7%Haemoptysis #/%2/14%10/72%2/14%More detailed analysis of improvements in symptoms has been carried out according to own scoring system for dyspnoea, cough and haemoptysis. Mean duration of palliative response was 55 days (1–405). Mean survival time was 114 days (2–406).ConclusionE-HOR-BT is an effective method of palliation of symptoms related to bronchial obturation in course of lung cancer. The most frequent serious treatment complication of E-HOR-BTwas massive haemoptysis

On the search for the right definition of heart failure with preserved ejection fraction

The definition of heart failure with preserved ejection fraction (HFpEF) has evolved from a clinically based “diagnosis of exclusion” to definitions focused on objective evidence of diastolic dysfunction and/or elevated left ventricular filling pressures. Despite advances in our understanding of HFpEF pathophysiology and the development of more sophisticated imaging modalities, the diagnosis of HFpEF remains challenging, especially in the chronic setting, given that symptoms are provoked by exertion and diagnostic evaluation is largely conducted at rest. Invasive hemodynamic study, and in particular — invasive exercise testing, is considered the reference method for HFpEF diagnosis. However, its use is limited as opposed to the high number of patients with suspected HFpEF. Thus, diagnostic criteria for HFpEF should be principally based on non-invasive measurements. As no single non-invasive variable can adequately corroborate or refute the diagnosis, different combinations of clinical, echocardiographic, and/or biochemical parameters have been introduced. Recent years have brought an abundance of HFpEF definitions. Here, we present and compare four of them: 1) the 2016 European Society of Cardiology criteria for HFpEF; 2) the 2016 echocardiographic algorithm for diagnosing diastolic dysfunction; 3) the 2018 evidence-based H2FPEF score; and 4) the most recent, 2019 Heart Failure Association HFA-PEFF algorithm. These definitions vary in their approach to diagnosis, as well as sensitivity and specificity. Further studies to validate and compare the diagnostic accuracy of HFpEF definitions are warranted. Nevertheless, it seems that the best HFpEF definition would originate from a randomized clinical trial showing a favorable effect of an intervention on prognosis in HFpEF

The effective increase in atomic scale disorder by doping and superconductivity in Ca3Rh4Sn13

A comprehensive study of the electronic structure, thermodynamic and electrical transport properties reveals the existence of inhomogeneous superconductivity due to structural disorder in Ca3Rh4Sn13 doped with La (Ca3−x La x Rh4Sn13) or Ce (Ca3−x Ce x Rh4Sn13) with superconducting critical temperatures T*c higher than those (T c ) observed in the parent compounds. The T − x diagrams and the entropy S(x) T isotherms document well the relation between the degree of atomic disorder and separation of the high-temperature T*c and T c -bulk phases. In these dirty superconductors, with the mean free path much smaller than the coherence length, the Werthamer–Helfand–Hohenber theoretical model does not fit well the H c2(T) data. We demonstrate that this discrepancy can result from the presence of strong inhomogeneity or from two-band superconductivity in these systems. Both the approaches very well describe the H − T dependencies, but the present results as well as our previous studies give stronger arguments for the scenario based on the presence of nanoscopic inhomogeneity of the superconducting state. A comparative study of La-doped and Ce-doped Ca3Rh4Sn13 showed that in the disordered Ca3−x Ce x Rh4Sn13 alloys the presence of spin-glass effects is the cause of the additional increase of T*c in respect to the critical temperatures of disordered Ca3−x La x Rh4Sn13. We also revisited the nature of structural phase transition at T*~130÷170 K and documented that there might be another precursor transition at higher temperatures. Raman spectroscopy and thermodynamic properties suggest that this structural transition may be associated with a CDW-type instability

A study of migration of polycyclic aromatic hydrocarbons in a sewage sludge-soil system

Sewage sludge can be used as a fertilizer in agricultural production. However frequent occurrence of dangerous contaminants such as polycyclic aromatic hydrocarbons (PAHs) due to their toxic potential, makes this technology controversial. The persistence and migration ability of PAHs in the sewage sludge-soil system was investigated. The results show that sewage sludge applications may cause an increase in migration of some marked compounds in the soil profile. Therefore it is important to perform a close monitoring of PAHs content during the sewage sludge fertilization procedure