Clinical and humoral determinants of congestion in heart failure. potential role of adiponectin

Background: Some patients with heart failure (HF) are more prone to systemic congestion than others. The goal of this study was to identify clinical and humoral factors linked to congestion and its prognostic impact in HF patients. Methods: A total of 371 advanced HF patients underwent physical examination, echocardiography, right heart catheterization, blood samplings, and Minnesota Living with HF Questionnaire. Subjects were followed-up for adverse events (death, urgent transplantation, or assist device implantation without heart transplantation). Results: Thirty-one percent of patients were classified as prone to congestion. During a median follow-up of 1,093 days, 159 (43%) patients had an adverse event. In the Cox analysis, the congestion-prone (CP) status was associated with a 43% higher event risk. The CP status was strongly (p ? 0.001) associated with body weight loss, right ventricular dysfunction (RVD), dilated inferior vena cava (IVC), diuretics, and beta-blockers prescription and the majority of tested hormones in the univariate analysis. In the multivariate analysis, the only independent variables associated with the CP status were adiponectin, albumin, IVC diameter, and RVD. Adiponectin by itself was predictive of adverse events. In a multivariate model, CP status was no longer predictive of adverse events, in contrast to adiponectin. Conclusions: CP patients experienced more severe symptoms and had shorter survival. Potential role of adiponectin, a new independent predictor of CP status, should be further examined

B-type natriuretic peptide: powerful predictor of endstage chronic heart failure in individuals with systolic dysfunction of the systemic right ventricle

Aim To assess whether B-type natriuretic peptide (BNP) can serve as a predictor of end-stage chronic heart failure (CHF) in patients with severe systolic dysfunction of the systemic right ventricle (SRV). Methods We performed a retrospective analysis in 28 patients with severe systolic dysfunction of the SRV (ejection fraction 23 ± 6%) who were evaluated as heart transplant (HTx) candidates between May 2007 and October 2014. The primary endpoints of the study (end-stage CHF) were progressive CHF, urgent HTx, and ventricular assist device (VAD) implantation. Plasma BNP levels were measured using a chemiluminescent immunoassay. Results During median follow-up of 29 months (interquartile range, 9-50), 3 patients died of progressive CHF, 5 patients required an urgent HTx, and 6 patients underwent VAD implantation. BNP was a strong predictor of end-stage CHF (hazard ratio per 100 ng/L: 1.079, 95% confidence interval, 1.042-1.117, P<0.001). The following variables with corresponding areas under the curve (AUC) were identified as the most significant predictors of end-stage CHF: BNP (AUC 1.00), New York Heart Association functional class class III or IV (AUC 0.98), decompensated CHF in the last year (AUC 0.96), and systolic dysfunction of the subpulmonal ventricle (AUC 0.96). Conclusion BNP is a powerful predictor of end-stage CHF in individuals with systolic dysfunction of the SRV

Calpain Cleavage of Brain Glutamic Acid Decarboxylase 65 Is Pathological and Impairs GABA Neurotransmission

Previously, we have shown that the GABA synthesizing enzyme, L-glutamic acid decarboxylase 65 (GAD65) is cleaved to form its truncated form (tGAD65) which is 2–3 times more active than the full length form (fGAD65). The enzyme responsible for cleavage was later identified as calpain. Calpain is known to cleave its substrates either under a transient physiological stimulus or upon a sustained pathological insult. However, the precise role of calpain cleavage of fGAD65 is poorly understood. In this communication, we examined the cleavage of fGAD65 under diverse pathological conditions including rats under ischemia/reperfusion insult as well as rat brain synaptosomes and primary neuronal cultures subjected to excessive stimulation with high concentration of KCl. We have shown that the formation of tGAD65 progressively increases with increasing stimulus concentration both in rat brain synaptosomes and primary rat embryo cultures. More importantly, direct cleavage of synaptic vesicle - associated fGAD65 by calpain was demonstrated and the resulting tGAD65 bearing the active site of the enzyme was detached from the synaptic vesicles. Vesicular GABA transport of the newly synthesized GABA was found to be reduced in calpain treated SVs. Furthermore, we also observed that the levels of tGAD65 in the focal cerebral ischemic rat brain tissue increased corresponding to the elevation of local glutamate as indicated by microdialysis. Moreover, the levels of tGAD65 was also proportional to the degree of cell death when the primary neuronal cultures were exposed to high KCl. Based on these observations, we conclude that calpain-mediated cleavage of fGAD65 is pathological, presumably due to decrease in the activity of synaptic vesicle - associated fGAD65 resulting in a decrease in the GABA synthesis - packaging coupling process leading to reduced GABA neurotransmission

Safety evalution of cryptography modules within safety related control systems for railway applications

The paper deals with the problem of safety evaluation of cryptographic modules used within safety-related control system for applications with increasing safety integrity level. The requirements to cryptographic techniques in safety-related communication for railway application are describe. The mainly part is oriented to description of mathematical apparatus for an error probability of cryptography code with a safety code, used in an additional safety communication layer. The practical results are related with the quantitative evaluation of an average error probability of code word for Euroradio protocol recommended for communication in European Train Control System

Profile bezpieczeństwa i zabezpieczeń sieci przemysłowych wykorzystywanych w zastosowaniach krytycznych dla bezpieczeństwa

The author describes the mechanisms of safety and security profiles of industry and communication networks used within safety - related applications in technological and information levels of process control recommended according to standards IEC 61784-3,4. Nowadays the number of vendors of the safety - related communication technologies who guarantees besides the standard communication, the communication amongst the safety - related equipment according to IEC 61508 is increasing. Also the number of safety - related products is increasing, e. g. safety Fieldbus, safety PLC, safety curtains, safety laser scanners, safety buttons, safety relays and other. According to world survey the safety Fieldbus denoted the highest growth from all manufactured safety products.The main part of this paper is the description of the safety-related Fieldbus communication system, which has to guaranty Safety Integrity Level.Autor przedstawia mechanizmy bezpieczeństwa i profili zabezpieczeń sieci przemysłowych i łączności używanych w aplikacjach związanych z bezpieczeństwem na poziomach technologicznym i informacyjnym sterowania procesami, rekomendowanych zgodnie z normami IEC 61784-3,4. Obecnie wzrasta liczba firm -dostawców technologii łączności związanymi z bezpieczeństwem, które gwarantują, poza standardową łącznością, łączność pomiędzy urządzeniami związanymi z bezpieczeństwem, zgodnie z IEC 61508. Zwiększa się także liczba wyrobów związanych z bezpieczeństwem, np. zabezpieczający Fieldbus, zabezpieczający PLC, osłony bezpieczeństwa, zabezpieczające skanery laserowe, przyciski bezpieczeństwa, przekaźniki zabezpieczające i inne. Zgodnie ze światowymi badaniami, zabezpieczający Fieldbus zarejestrował największy wzrost pośród wszystkich wytwarzanych wyrobów zabezpieczających, Główną częścią referatu jest opis związanego z bezpieczeństwem systemu łączności Fieldbus, który ma na celu zagwarantowanie Poziomu Integralności Bezpieczeństwa

Hash Mechanisms Suitable for Transmission of Safety - Related Messages

The paper deal with problems of data security in the safety - related transmission systems defined within railway process. In details is analysed possibility od using hash-coding techniques, which are generally defined in norm EN 50159-2. According to specification of transmission in railway applications the type of secure hash keying and nonkeyng techniques are recommended. There are discussed the results of experimental part, which are related to the comparison of time relation of hash code determination

Key Management System in ETCS

Paper deals with problems of KMS (Key Management System), which is developed in mobile communications GSM-R (Global System Mobile for Railway) recommended within the European Train Control System (ETCS), through the Euroradio system. Th e main part is oriented to safety procedures description of off-line KMS system between communication entities of ETCS system. In the experimental part the results of computational safety of modifi ed DES algorithm are summarised using special brute force attack to key – birthday paradox

Safety mechanisms of open safety profile and their modelling

Authors describe the solutions of safety industrial Ethernet with orientation to safety-related industrial control systems. Nowadays the numbers of safety solutions of industrial Ethernet are increasing (e. g. CIP Safety, ProfiSafe, Safety Interbus). Bernecker & Rainer is coming with the new solution - Open Safety, which was developed for technology Ethernet PowerLink (EPL), but open platform is compatible with the other types of industrial Ethernet too, e. g. Sercos, Ethernet/IP, Modbus, and Profinet. Mainly part of paper the safety analyses of Open Safety frame with orientation to safety codes used in two sub-frames are mentioned. Practical part is orientated to model realisation via Matlab, Simulink with the use of safety codes with possibility to demonstrate the detection capability of cyclic CRC codes dependence on characteristics of communications channel and generator polynomial selection

Modelling in Development of Safety-Related Communication Systems

The aim of the paper is the use of modelling within development of safety-related communication systems presented in the areas where guaranty of asafety integrity level is required. The basic principles and standards used in the process of safety evaluation in closed transmission systems are summarised in the paper. Dangerous states of the system are mainly caused by systematic failures within aspecification of the system, electromagnetic disturbance and random failures the HW effects. The main part of the paper describes the safety analysis process on the example of the end to end closed transmission system with the use of the fault tree and Markov's chain