329 research outputs found

    Ixodes ricinus spirochete and European erythema chronicum migrans disease.

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    From three endemic locations of erythema chronicum migrans disease in North Rhine-Westphalia, Germany, we recovered 19 isolates of a spirochete from Ixodes ricinus ticks. The infection rate in adult ticks was 16 percent. The isolated spirochete is immunologically related to the Ixodes dammini spirochete, Borrelia duttoni, and Treponema pallidum. Using indirect immunofluorescence, the sera of 90 patients with erythema chronicum migrans disease showed antibody titers against the isolated spirochete, which correlated with the clinical course. Similarly, antibodies were demonstrated in the sera of 21 patients with acrodermatitis chronica atrophicans. These results suggest an etiologic role for the Ixodes ricinus spriochete in European erythema chronicum migrans disease

    Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

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    Purpose In the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group. Key summary pointsAim To review current cardiovascular medications for benefits and potential harms during COVID-19. Findings Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on observational studies and age-specific data are scarce. Message Most current cardiovascular drugs can be safely continued during COVID-19, but general conditions common in older patients must be considered.Peer reviewe

    Components of metabolic syndrome in relation to plasma levels of retinol binding protein 4 (RBP4) in a cohort of people aged 65 years and older

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    Purpose Elevated plasma concentration of retinol binding protein 4 (RBP4) has recently emerged as a potential risk factor as a component of developing metabolic syndrome (MS). Therefore, this study aimed to analyse the relationship between components of MS and concentrations of plasma RBP4 in a population of subjects 65 years and older. Methods The study sample consisted of 3038 (1591 male) participants of the PolSenior study, aged 65 years and older. Serum lipid profile, concentrations of RBP4, glucose, insulin, C-reactive protein, IL-6, and activity of aminotransferases were measured. Nutritional status (BMI/waist circumference) and treatment with statins and fibrates were evaluated. Glomerular filtration rate (eGFR), de Ritis ratio, and fatty liver index (FLI), as well as HOMA-IR were calculated. Results Our study revealed a strong relationship between components of MS and RBP4 in both sexes: plasma RBP4 levels were increased in men by at least 3×, and in women by at least 4×. Hypertriglyceridemia was most strongly associated with elevated plasma RBP4 levels. Multivariate, sex-adjusted regression analysis demonstrated that chronic kidney disease [OR 1.86 (95% CI 1.78-1.94)], hypertriglyceridemia [OR 1.52 (1.24-1.87)], hypertension [OR 1.15 (1.12-1.19)], low serum HDL cholesterol [OR 0.94 (0.92-0.97)], and age > 80 years [OR 0.86 (0.81-0.90)] were each independently associated with RBP4 concentration (all p < 0.001). Conclusions In Caucasians 65 years and older, RBP4 serum levels are associated with a number of components of MS, independent of sex and kidney function. Hypertriglyceridemia as a component of MS is most signifcantly related to RBP4 concentration

    Protecting Older Patients with Cardiovascular Diseases from COVID-19 Complications Using Current Medications

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    Purpose: In the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods: We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results: Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions: Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.info:eu-repo/semantics/publishedVersio

    Influence of interaction between AGT G-6A, ACE D/I and AGTR1 A1166C gene polymorphisms on blood pressure and arterial stiffness

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    Wstęp Celem badania było ustalenie związku polimorfizmów G-6A genu AGT, D/I genu ACE i A1166C genu AGTR1 z wartościami ciśnienia tętniczego i usztywnienia tętnic oraz ocena łącznego wpływu wymienionych polimorfizmów genetycznych na wybrane parametry. Materiał i metody Badaniem objęto 52 rodziny (82 rodziców i 103 dzieci). U każdego uczestnika dokonano pomiarów ciśnienia tętniczego: obwodowego (metoda konwencjonalna - SBPP, DBPP, PPP i 24-godzinny zapis - SBPA, DBPA, PPA) i centralnego (analiza fali tętna - SBPC>, DBPC, PPC) oraz własności elastycznych tętnic (wzmocnienie fali aortalnej - AG, obwodowy - AIxP i centralny - AIxC, wskaźniki wzmocnienia fali). Ponadto wśród osób uczestniczących w badaniu wykonano analizy genetyczne. Wyniki Analizy, dotyczące pojedynczych polimorfizmów, wykazały zależność między polimorfizmem D/I genu ACE a SBPA, SBPC, PPA i PPC. Ponadto, stwierdzono obecność istotnych statystycznie interakcji między polimorfizmami D/I genu ACE i A1166C genu AGTR1 w odniesieniu do SBPP (p = 0,02), SBPA (p = 0,03), SBPC (p = 0,03), PPP (p = 0,008), PPA (p = 0,02) oraz PPC (p = 0,007). W analizowanej populacji, u nosicieli allelu C genu AGTR1, SBPC było o 7,5 mm Hg (p = 0,0005), PPP o 7,7 mm Hg (p = 0,003), PPA o 3,0 mm Hg (p = 0,09) a PPC o 8,4 mm Hg (p = 0,0007) wyższe u homozygot II genu ACE w porównaniu z homozygotami DD. Dla parametrów usztywnienia tętnic, u nosicieli allelu C genu AGTR1 AG było o 3,7 mm Hg (p = 0,004), AIxP o 7,1% (p = 0,07) a AIxC o 5,7% (p = 0,03) wyższe u homozygot II genu ACE w porównaniu z homozygotami DD. Wnioski Uzyskane wyniki wskazują na łączne działanie polimorfizmów D/I genu ACE i A1166C genu AGTR1, z niekorzystnym wpływem allelu I genu ACE i allelu C genu AGTR1 na ciśnienie tętnicze oraz sztywność tętnic.Background In a population-based approach we investigated whether polymorphisms in the genes encoding AGT (G-6A), ACE (D/I) and AGTR1 (A1166C), alone or in combination, affected blood pressure and arterial stiffness parameters. Materials and methods We randomly recruited 52 families (82 parents and 103 offspring). Peripheral pressures were derived from conventional (SBPP, systolic blood pressure, DBPP, diastolic blood pressure, PPP pulse pressure) and 24h-ambulatory BP measurements (SBPA, DBPA, PPA), respectively. Central pressures (SBPC, DBPC, PPC), augmentation pressure (AG), peripheral (AIxP) and central (AIxC) augmentation indexes were assessed by pulse wave analysis. Polymorphisms of selected genes of the RAA system were detected in all participants. Results In single gene analyzes, significant findings were revealed for ACE D/I polymorphism with respect to SBPA, SBPC, PPA and PPC. In further analyzes, the interactions between D/I ACE and A1166C AGTR1 gene polymorphisms reached statistically significant values with regard to SBPP (p = 0.02), SBPA (p = 0.03), SBPC (p = 0.03), PPP (p = 0.008), PPA (p = 0.02) and PPC (p = 0.007). In the analyzed population, for AGTR1 C allele carriers, SBPC was 7.5 mm Hg (p = 0.0005), PPP 7.7 mm Hg (p = 0.003), PPA 3.0 mm Hg (p = 0.09) and PPC 8.4 mm Hg (p = 0.0007) higher for ACE II homozygotes in comparison to DD homozygotes. For AGTR1 C allele carriers, with respect to arterial wall stiffness parameters, AG was 3.7 mm Hg (p = 0.004), AIxP 7.1% (p = 0.07) and AIxC 5.7% (p = 0.03) higher for ACE II homozygotes, as compared to DD homozygotes. Conclusions The interactions between D/I polymorphism of the ACE gene and A1166C polymorphism of the AGTR1 gene revealing joint negative effect of ACE I allele and AGTR1 C allele, with respect to blood pressure and arterial stiffness

    Influence of selected genetic polymorphisms of angiotensinogen, angiotensin-converting enzyme and type-1 angiotensin II receptor on arterial pressure and large artery stiffness parameters - depending on sodium intake

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    Wstęp Celem pracy było ustalenie związku polimorfizmów G-6A genu AGT, D/I genu ACE i A1166C genu AGT1R z wartościami ciśnienia tętniczego i usztywnienia dużych tętnic oraz ocena zależności między czynnikami genetycznymi i środowiskowymi i ich łącznego wpływu na analizowane parametry. Materiał i metody Badaniem objęto 52 rodziny (82 rodziców i 103 dzieci). U każdego uczestnika dokonano pomiarów ciśnienia tętniczego: obwodowego (metoda konwencjonalna i zapis 24-godzinny) i centralnego (analiza fali tętna), a także właściwości elastycznych dużych tętnic. U osób uczestniczących w badaniu oznaczono dobowe wydalanie sodu z moczem oraz wykonano analizy genetyczne. Wyniki Analizy dotyczące pojedynczych polimorfizmów wykazały zależność między polimorfizmem D/I genu ACE a 24-godzinnym i centralnym ciśnieniem skurczowym (SBPA, SBPC) i tętna (PPA, PPC). Ponadto wykazano obecność istotnych statystycznie interakcji między polimorfizmem D/I genu ACE a dobowym wydalaniem sodu z moczem w odniesieniu do SBPC, konwencjonalnego ciśnienia tętna (PPP), PPC oraz wzmocnienia fali aortalnej (AG). W analizie asocjacji przeprowadzonej między parametrami ciśnieniowymi i usztywnienia ścian naczyń a polimorfizmem D/I w tercylach dobowego wydalania sodu z moczem, w grupie osób homozygotycznych II w porównaniu z nosicielami allelu D, w trzecim tercylu wydalania sodu, obserwowano istotnie statystyczne wyższe wartości SBPC, PPP, PPA, PPC oraz AG, czego nie obserwowano w pierwszym i drugim tercylu. Wnioski W badanej populacji wykazano istotne interakcje między polimorfizmem D/I genu ACE a dobowym wydalaniem sodu z moczem w zakresie wpływu na ciśnienie tętnicze i sztywność tętnic. Allel D genu ACE wykazywał ochronną rolę w grupie osób z wysokim dobowym spożyciem sodu.Background In a population-based and family-based approach we investigated, to what extent blood pressure and large artery stiffness relate to the AGT G-6A, ACE D/I and AGT1R A1166C gene polymorphisms, as well as the interaction between genetic and environmental factors and their joint influence on the aforementioned parameters. Materials and methods We recruited 52 families (82 parents and 103 offspring). Peripheral pressures were derived from conventional and 24h-ambulatory blood pressure measurements, respectively. Central pressures and large artery stiffness parameters were assessed by pulse wave analysis. All participants collected a 24-h urine sample for the measurement of sodium excretion as well as blood sample for the evaluation of genetic analyses. Results In single gene analyzes, significant findings were revealed for ACE D/I polymorphism with respect to 24h-ambulatory and central systolic (SBPA, SBPC) and pulse (PPA, PPC) pressures. In further analyzes, we found an interaction between ACE D/I genotype and 24-h urinary sodium excretion in relation to SBPC, conventional pulse pressure (PPP), PPC and augmentation pressure (AG). In the third tertile of the distribution of sodium excretion we observed significantly increased SBPC, PPP, PPA, PPC and AG in ACE II homozygotes compared to D allele carriers, which was not observed in first and second tertile. Conclusions In the examined group, the interactions between D/I polymorphism of the ACE gene and daily sodium excretion in the urine were revealed, in relation to the parameters of blood pressure and arterial wall stiffness.The D allele of ACE gene showed a protective role in the group of subjects with high daily sodium intake
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