Anti-Endothelial Cell Antibodies are not frequently elevated in hospitalized patients with COVID-19

COVID-19 is now established to be associated with a thrombotic phenomenon, now called COVID-19 associated coagulopathy (CAC). Anti-Endothelial Cell Antibodies (AECA) are a heterogenous group of autoantibodies targeting various endothelial cell antigens or antigens adhering to endothelial cells, They are commonly observed in a variety of auto-immune and rheumatologic conditions, and were observed in patients with the severe acute respiratory syndrome (SARS) in 2005. We aimed to assess AECA status in patients with COVID-19 and their potential contributing role to endothelial injury and CAC. AECA identification was a relatively infrequent finding in COVID-19 patients on admission, and their presence, albeit in only 2/33 patients, was not associated with disease severity. However, as the autoantibodies were only measured at admission, we cannot exclude the possibility of pathogenic AECA developing later in the course of diseaseFurther studies using additional methods are needed to evaluate the presence and potential pathogenic role of AECA in later stages of COVID-19

International survey on D-dimer test reporting: a call for standardization

D-dimer is the biochemical gold standard for diagnosing a variety of thrombotic disorders, but result reporting is heterogeneous in clinical laboratories. A specific five-item questionnaire was developed to gain a clear picture of the current standardization of D-dimer test results. The questionnaire was opened online (December 24, 2014-February 10, 2015) on the platform "Google Drive (Google Inc., Mountain View; CA)," and widely disseminated worldwide by newsletters and alerts. A total of 409 responses were obtained during the period of data capture, the largest of which were from Italy (136; 33%), Australia (55; 22%), Croatia (29; 7%), Serbia (26; 6%), and the United States (21; 5%). Most respondents belonged to laboratories in general hospitals (208; 51%), followed by laboratories in university hospitals (104; 26%), and the private sector (94; 23%). The majority of respondents (i.e., 246; 60%) indicated the use of fibrinogen equivalent unit for expressing D-dimer results, with significant heterogeneities across countries and health care settings. The highest prevalence of laboratories indicated they were using "ng/mL" (139; 34%), followed by "mg/L" (136; 33%), and "\ub5g/L" (73; 18%), with significant heterogeneity across countries but not among different health care settings. Expectedly, the vast majority of laboratories (379; 93%) declared to be using a fixed cutoff rather than an age-adjusted threshold, with no significant heterogeneity across countries and health care settings. The results of this survey attest that at least 28 different combinations of measurement units are currently used to report D-dimer results worldwide, and this evidence underscores the urgent need for more effective international joined efforts aimed to promote a worldwide standardization of D-dimer results reporting

The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications.

Purpose: The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Materials and Methods: Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. Results: The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. Conclusion: The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint

Dark chocolate modulates platelet function with a mechanism mediated by flavan-3-ol metabolites

Cocoa is a rich source bioactive compounds, i.e., flavan-3-ols, and its consumption has been associated with several beneficial effects, such as the positive modulation of the hemostasis targeted by the platelet function. However, these phenolic compounds have a very low bioavailability and extensively undergo phase I and II metabolism, with the appearing into the bloodstream of (epi) catechin conjugates and phenyl-g-valerolactones and their conjugates, at different times. The aims of this study were to explore the effect of dark chocolate on platelet function and to investigate the relationship between this interplay and flavan-3-ol derived metabolites. Eighteen healthy male volunteers ingested 50 g of 90% cocoa chocolate within 5 minutes. Blood samples were collected immediately before chocolate ingestion (T0) and 4 hours afterwards (T1). Platelet function analyzer (PFA)-100 closure time was assessed using collagen/adenosine-50-diphosphate (COL/ADP) and collagen/epinephrine (COL/EPI) cartridges. Plasma flavan-3-ol metabolites were identified and quantified by means of liquid chromatography coupled to a triple quadrupole mass spectrometer (UHPLC-ESI-MS/MS). Results evidenced a significant increase of COL/ADP-induced PFA-100 closure time, but not COL/EPI, 4 hours after ingestion of dark chocolate. Total plasma structurally-related (epi)catechin metabolite (SREM) concentration significantly increased at T1, together with 4 out of the 6 detected metabolites. Total phenyl-g-valerolactone concentrations remained unchanged. Spearman correlations evidenced a strong correlation between COL/ADP closure time and SREMs, mainly led by (epi)catechin-sulfate isomers. These data confirm that the potential beneficial effect of dark chocolate on primary hemostasis may be mediated by flavan-3-ol circulating metabolites

Map of the sarcoglycan sub-complex in rat brain

The sarcoglycan-sub-complex is made up of six glycoproteins which play mechanosignaling functions, connecting the extracellular matrix to cytoskeleton. This protein complex has been identified in different kind of tissues; in central nervous system, instead, only the ζ-sarcoglycans and the ε-sarcoglycans are considered to be present, where they seem to play a different role from the role played in muscle. Although that, previous our study have shown the expression of the entire sarcoglycan sub-complex in some region of the rat brain and the colocalization of this complex with post-synaptic receptors as GABA and DOPA receptors. Since we found that each sarcoglycan changes in staining pattern level among the brain regions, in the present study we performed, for the first time, a map of sarcoglycans expression in whole brain of rat and we examined which kind of post-synaptic receptor colocalizes with sarcoglycans in each part of brain. Results have shown that in rat brain the staining pattern level for each sarcoglycan and the different kind of colocalization between sarcoglycans and post-synaptic receptors, sarcoglycan/GABA or sarcoglycan/ DOPA, are characteristic of each brain region. These results support a role of the sarcoglycan sub-complex in post-synaptic neurotransmission, maybe modulating post-synaptic receptor assembly and stabilization

fMRI study in human brain during chewing

The mastication is a rhythmic motor act involving peripheral effector organs and sensory inputs and it is attended by intense activity of brain stem. The prefrontal cortex has long been suspected to play an important role during mastication, in the ability to orchestrate thought and action in accordance with internal goals. Its neural basis, however, has remained a mystery (Ono Y. et al. 2010). We selected a sample of 10 healthy right-handed subjects who underwent fMRI during mastication as forced as free with soft and hard bolus. Results showed, during free mastication with hard or soft bole, in “left” cerebral cortex the activation of the primary (area 4) supplementary (area 6) motor areas and somesthesic primary area (area 3), with maximum activation during hard bole. At same time, in forced mastication, besides the previous areas, are activated also, in “right” cerebral cortex, area 10 and 11 and omolateral neostriatum. In conclusion, in the light of recent studies, we observed the significant role of basal ganglia in planning and execution of motor gesture process

A 3d and 4d anatomical study of the human heart: analysis by direct volume rendering technique

In this report we demonstrated an innovative use of 3D and 4D volume rendering, processing the data set images obtained by CT on heart of subjects not affected by any cardiologic disorders. This method is a direct technique for visualizing primitive volumes without any intermediate conversion of the volume data to surface presentation. Here, we are able to highlight all anatomical structures of the heart examining them contemporarily in the same image or selecting a tissue type. The present report demonstrates how the manipulation of appropriate algorithms permits to meliorate the interactive anatomical morphology visualization, observing the heart within thorax, contemporarily, and creating a good perception of depth. Besides, it was possible to study the integrity of papillary muscles, or the fibrous tissue of cardiac valve and cordae tendineae, or finally to designate the exact morphology and location of coronary arteries studying and describing their wall morphology. Furthermore, by 4D analysis it was possible to obtain three-dimensional images in movement, highlighting both the movement of the vessels during cardiac phases and the modification of internal cardiac structures during these phases. Our results demonstrated that one of the greatest advantage of algorithmic modifications of volume rendering is that this method provides all the necessary informations in a single radiologic study, meliorating anatomical description of all cardiac structures. Moreover, avoiding the invasive diagnostic methods as well as coronarography this methods allows to meliorate clinical study of the region also facilitating the therapeutic plans of the cardiac disease

Plasma Phospholipid Omega‐3 Fatty Acids and Incidence of Postoperative Atrial Fibrillation in the OPERA Trial

Background: Long‐chain polyunsaturated omega‐3 fatty acids (n‐3 PUFA) demonstrated antiarrhythmic potential in experimental studies. In a large multinational randomized trial (OPERA), perioperative fish oil supplementation did not reduce the risk of postoperative atrial fibrillation (PoAF) in cardiac surgery patients. However, whether presupplementation habitual plasma phospholipid n‐3 PUFA, or achieved or change in n‐3 PUFA level postsupplementation are associated with lower risk of PoAF is unknown. Methods and Results: In 564 subjects undergoing cardiac surgery between August 2010 and June 2012 in 28 centers across 3 countries, plasma phospholipid levels of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) were measured at enrollment and again on the morning of cardiac surgery following fish oil or placebo supplementation (10 g over 3 to 5 days, or 8 g over 2 days). The primary endpoint was incident PoAF lasting ≥30 seconds, centrally adjudicated, and confirmed by rhythm strip or ECG. Secondary endpoints included sustained (≥1 hour), symptomatic, or treated PoAF; the time to first PoAF; and the number of PoAF episodes per patient. PoAF outcomes were assessed until hospital discharge or postoperative day 10, whichever occurred first. Relative to the baseline, fish oil supplementation increased phospholipid concentrations of EPA (+142%), DPA (+13%), and DHA (+22%) (P<0.001 each). Substantial interindividual variability was observed for change in total n‐3 PUFA (range=−0.7% to 7.5% after 5 days of supplementation). Neither individual nor total circulating n‐3 PUFA levels at enrollment, morning of surgery, or change between these time points were associated with risk of PoAF. The multivariable‐adjusted OR (95% CI) across increasing quartiles of total n‐3 PUFA at enrollment were 1.0, 1.06 (0.60 to 1.90), 1.35 (0.76 to 2.38), and 1.19 (0.64 to 2.20); and for changes in n‐3 PUFA between enrollment and the morning of surgery were 1.0, 0.78 (0.44 to 1.39), 0.89 (0.51 to 1.55), and 1.01 (0.58 to 1.75). In stratified analysis, demographic, medication, and cardiac parameters did not significantly modify these associations. Findings were similar for secondary PoAF endpoints. Conclusions: Among patients undergoing cardiac surgery, neither higher habitual circulating n‐3 PUFA levels, nor achieved levels or changes following short‐term fish oil supplementation are associated with risk of PoAF. Clinical Trial Registration URL: Clinicaltrials.gov Unique identifier: NCT0097048