Effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of cardiovascular disease : protocol for an overview of systematic reviews

INTRODUCTION: Major clinical practice guidelines recommend assessing risk of cardiovascular disease (CVD) using absolute/global/total CVD risk scores. However, the effectiveness of using them in clinical practice, despite publication of numerous randomised controlled trials (RCTs), is still poorly understood. To summarise and analyse current knowledge in this field, we will carry out an overview of existing systematic reviews (SRs). The objective of this overview will be to assess the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD compared with standard care. METHODS AND ANALYSIS: We will include SRs and meta-analyses which take into account RCTs and quasi-RCTs investigating the effect of using cardiovascular risk scoring in routine risk assessment in primary prevention of CVD. SRs will be retrieved from 4 bibliographical databases and reference lists of identified reviews. Additionally, the PROSPERO database will be searched for unpublished, ongoing or recently completed SRs. 2 reviewers will assess the SRs independently for eligibility and bias. The data will be extracted to a special form. Any disagreement will be resolved by discussion. In case of lack of consensus, a third author will arbitrate. The overview of SRs will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. ETHICS AND DISSEMINATION: Ethics approval is not required for overview of SRs. We will summarise evidence concerning whether use of the absolute/global/total CVD risk scoring tools in primary prevention of CVD is effective and supported with scientific data or not. If we face unsatisfactory confirmation, we will highlight a need for further research and advice on how to plan such a study. We will submit the results of our study for peer-review publication in a journal indexed in the international bibliographic database of biomedical information

The prevalence of cardiovascular risk factors and cardiovascular disease among primary care patients in Poland : results from the LIPIDOGRAM2015 study

Background and aim: To estimate the prevalence of cardiovascular (CV) disease and CV risk factors among Polish patients. Methods: A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the 4th quarter of 2015 and 1st and 2nd quarters of 2016; 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. Results: Nearly 19% of men and approximately 12% of women had cardiovascular disease (CVD). Over 60% of the recruited patients had hypertension (HTN), >80% had dyslipidaemia and <15% of patients were diagnosed with diabetes (DM). All of these disorders were more frequent in men. In 80% of patients the waist circumference exceed norm for the European population. Less than half of the patients were current smokers or had smoked in the past. Patients with CVD had significantly higher blood pressure and glucose levels but lower low density lipoprotein-cholesterol level. Conclusions: The prevalence of CVD and CV risk factors among patients in Poland is high. CVD is more common in men than in women. The most common CV risk factors are excess waist circumference, dyslipidaemia and HTN. Family physicians should conduct activities to prevent, diagnose early and treat CVD in the primary health care population. © 2021 Elsevier B.V. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Fadi Charchar” is provided in this record*

Effect of salt stress on prenol lipids in the leaves of Tilia ‘Euchlora’

Soil contamination caused by the NaCl used to de-ice slippery roads in winter is now recognized as one of the major causes of nutrient disorders and death in urban trees. It is believed that polyisoprenoids may have a specific role in the adaptation of plants to adverse conditions and habitats; it is further believed that in the cell, they may exhibit a protective effect in response to biotic and abiotic stress. The aim of this study was to evaluate the effect of salt stress on the content of prenol lipids in the leaves of Crimean linden (Tilia ‘Euchlora’). The Cl content in the slightly damaged (“healthy”) leaves averaged 0.96%, while that in the heavily damaged (“sick”) leaves averaged 2.02%. The leaves of control trees contained on average 0.57% Cl. The Na contents in the healthy and damaged leaves were 208 mg/kg and 1038 mg/kg, respectively, and the Na content in the control areas was 63 mg/kg. A mixture of polyprenols consisting of four compounds, prenol-9, prenol-10, prenol-11 and prenol-12, was identified in the leaves of Crimean linden. This mixture was dominated by prenol-10 (2.16–6.90 mg/g). The polyprenol content was highest in the leaves of “healthy” trees (approximately 13.31 mg/g), was lower in the case of “sick” trees (approximately 9.18 mg/g), and was the lowest in the control trees (mean 4.71 mg/g). No changes were observed in the composition of the mixture of polyprenols under these conditions. The results suggest that polyprenols may affect the accumulation of Cl in leaves. This phenomenon is evidenced by the high content of prenols in the leaves of trees considered “healthy” but growing under conditions of increased soil salinity and the lower content of prenols in the leaves of the “sick” and control trees. It is advisable to further investigate the role of prenol lipids in the leaves of trees subjected to salt stress. BACZEWSKA A., DMUCHOWSKI W., JÓŹWIAK A., GOZDOWSKI D., BRĄGOSZEWSKA P., DĄBROWSKI P., ŚWIEŻEWSKA E

Antibiofilm and antimicrobial-enhancing activity of Chelidonium majus and Corydalis cheilanthifolia extracts against multidrug-resistant Helicobacter pylori

Helicobacter pylori is a Gram-negative bacterium that colonizes the stomach of about 60% of people worldwide. The search for new drugs with activity against H. pylori is now a hotspot in the effective and safe control of this bacterium. Therefore, the aim of this research was to determine the antibacterial activity of extracts from selected plants of the Papaveraceae family against planktonic and biofilm forms of the multidrug-resistant clinical strain of H. pylori using a broad spectrum of analytical in vitro methods. It was revealed that among the tested extracts, those obtained from Corydalis cheilanthifolia and Chelidonium majus were the most active, with minimal inhibitory concentrations (MICs) of 64 µg/mL and 128 µg/mL, respectively. High concentrations of both extracts showed cytotoxicity against cell lines of human hepatic origin. Therefore, we attempted to lower their MICs through the use of a synergistic combination with synthetic antimicrobials as well as by applying cellulose as a drug carrier. Using checkerboard assays, we determined that both extracts presented synergistic interactions with amoxicillin (AMX) and 3-bromopyruvate (3-BP) (FICI = 0.5) and additive relationships with sertraline (SER) (FICI = 0.75). The antibiofilm activity of extracts and their combinations with AMX, 3-BP, or SER, was analyzed by two methods, i.e., the microcapillary overgrowth under flow conditions (the Bioflux system) and assessment of the viability of lawn biofilms after exposure to drugs released from bacterial cellulose (BC) carriers. Using both methods, we observed a several-fold decrease in the level of H. pylori biofilm, indicating the ability of the tested compounds to eradicate the microbial biofilm. The obtained results indicate that application of plant-derived extracts from the Papaveraceae family combined with synthetic antimicrobials, absorbed into organic BC carrier, may be considered a promising way of fighting biofilm-forming H. pylori

Quantitative and qualitative characteristics of cell wall components and prenyl lipids in the leaves of Tilia x euchlora trees growing under salt stress

The study was focused on assessing the presence of arabinogalactan proteins (AGPs) and pectins within the cell walls as well as prenyl lipids, sodium and chlorine content in leaves of Tilia x euchlora trees. The leaves that were analyzed were collected from trees with and without signs of damage that were all growing in the same salt stress conditions. The reason for undertaking these investigations was the observations over many years that indicated that there are trees that present a healthy appearance and trees that have visible symptoms of decay in the same habitat. Leaf samples were collected from trees growing in the median strip between roadways that have been intensively salted during the winter season for many years. The sodium content was determined using atomic spectrophotometry, chloride using potentiometric titration and poly-isoprenoids using HPLC/UV. AGPs and pectins were determined using immunohistochemistry methods. The immunohistochemical analysis showed that rhamnogalacturonans I (RG-I) and homogalacturonans were differentially distributed in leaves from healthy trees in contrast to leaves from injured trees. In the case of AGPs, the most visible difference was the presence of the JIM16 epitope. Chemical analyses of sodium and chloride showed that in the leaves from injured trees, the level of these ions was higher than in the leaves from healthy trees. Based on chromatographic analysis, four polyisoprenoid alcohols were identified in the leaves of T. x euchlora. The levels of these lipids were higher in the leaves from healthy trees. The results suggest that the differences that were detected in the apoplast and symplasm may be part of the defensive strategy of T. x euchlora trees to salt stress, which rely on changes in the chemical composition of the cell wall with respect to the pectic and AGP epitopes and an increased synthesis of prenyl lipids

Modeling of Dolichol Mass Spectra Isotopic Envelopes as a Tool to Monitor Isoprenoid Biosynthesis1

The cooperation of the mevalonate (MVA) and methylerythritol phosphate (MEP) pathways, operating in parallel in plants to generate isoprenoid precursors, has been studied extensively. Elucidation of the isoprenoid metabolic pathways is indispensable for the rational design of plant and microbial systems for the production of industrially valuable terpenoids. Here, we describe a new method, based on numerical modeling of mass spectra of metabolically labeled dolichols (Dols), designed to quantitatively follow the cooperation of MVA and MEP reprogrammed upon osmotic stress (sorbitol treatment) in Arabidopsis (Arabidopsis thaliana). The contribution of the MEP pathway increased significantly (reaching 100%) exclusively for the dominating Dols, while for long-chain Dols, the relative input of the MEP and MVA pathways remained unchanged, suggesting divergent sites of synthesis for dominating and long-chain Dols. The analysis of numerically modeled Dol mass spectra is a novel method to follow modulation of the concomitant activity of isoprenoid-generating pathways in plant cells; additionally, it suggests an exchange of isoprenoid intermediates between plastids and peroxisomes

Variation in pelvic shape and size in Eastern European males: a computed tomography comparative study

Background The significantly accelerated development of human society in the last millennium has brought about changes in human behavior and body mass that may have influenced human bone morphology. Our objective was to analyze the variation in pelvic shape and size in males from modern and medieval populations. Methods We obtained 22 pelvic girdles of adult males from a medieval cemetery located in Cedynia, Poland. The control group comprised 31 contemporary male pelves from individuals inhabiting the same region. The analyzed parameters were: interspinous distance (ISD), intercristal distance (ICD), intertuberous distance (ITD), anatomic conjugate of the pelvis, height of the pelvis (HP), iliac opening angle (IOA), iliac tilt angle (ITA), and ISD/ITD/HP ratio. Geometric morphometrics was used to analyze differences in shape in the pelves. All analyses were carried out on three-dimensional CT reconstructions of pelves. Results ISD, ICD, and IOA were significantly greater in modern pelves than in those from Cedynia, but no significant differences were seen between the two groups in ITD, anatomical conjugate, HP, or ITA. ISD/ITD/HP ratios were significantly lower in the Cedynia group. Geometric morphometrics revealed significant differences in pelvic shape between the analyzed groups. Discussion The pelves of modern males are larger, wider, and flatter than those of medieval males. Changes in the set of daily activities that produce mechanical loading and estimated body mass may constitute the main factors explaining pelvic variability. However, differences in ontogenesis should also be taken into consideration, especially since growth in past populations is often found to be reduced relative to modern populations

Effect of salt stress in urban conditions on two Acer species with different sensitivity

Background. The benefits of trees in urban areas include the following: an increase in ecosystem health, an increase in human health, the mitigation of the effects of heat and drought at microclimate level, the storage and sequestration of carbon, and a reduction in air pollution and noise. These ecosystem services can be provided only by trees that are in good health. The main cause of salt stress in urban environments is the use of deicing salts on the streets in winter. Salt stress is a complex process that includes changes in plants on the physiological, histological, cellular and molecular levels, leading to limitations in nutrient uptake, disrupting the ionic balance of trees and resulting in the death of roadside trees. In response to salinity, trees have developed a variety of defence mechanisms that allow them to minimize the effects of stress and maintain homeostasis. Methodology. The reactions of two species Acer species: A. platanoides and A. campestre, which have different sensitivities to the unfavourable conditions of the urban environments (mainly salt stress), were investigated. The research included two experiments: a field experiment with city trees and a controlled pot experiment with young trees treated with increasing doses of salt. In both experiments, the following were performed: an assessment of the health condition of the trees and the content of macroelements as well as the Cl and Na in leaves and a qualitative and quantitative analysis of polyprenols. Results. A. campestre had a more specific strategy than A. platanoides for dealing with Na and Cl, which resulted in undamaged leaves. Under the same conditions, A. platanoides leaves contained more Cl and Na and were severely damaged. The disruption of the ion balance due to salt stress was lower in A. campestre than in A. platanoides. Compared with A. platanoides, A. campestre synthesized more polyprenols in the field experiment. This ability was acquired during the process of acclimation, because it occurred only in the mature trees in the field experiment and not in the young trees in the pot experiment. Conclusions. The use of two experimental methods (i.e., the field and pot experiments) allowed for a more complete assessment of tree strategies to mitigate salt stress. A. campestre displayed a more specific strategy than A. platanoides. This strategy was based on several elements. A. campestre limited Cl and Na transport to the leaves, which resulted in a lack of damage to those organs. Under the same conditions, A. platanoides individuals contained more Cl and Na in their leaves and were seriously damaged. A. campestre synthesized larger amounts of polyprenols, which probably have the ability to mitigate salt stress. This ability was acquired during the process of acclimation, because it occurred only in the mature trees in the field experiment and was not observed in the young trees in the pot experiment

Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for the routinely used magnetic resonance imaging protocol in patients with multiple sclerosis

Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis (MS) that is essential for the detection and follow-up of the disease. The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of the recommendations for examinations routinely conducted in magnetic resonance imaging departments in patients with MS, which include new data and practical comments for electroradiology technicians and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics that are necessary to establish a diagnosis as well as monitor patients with MS, which directly translates into significant clinical decisions. MS is a chronic idiopathic inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in the CNS destruction process disseminated in time and space. MRI detects focal lesions in the white and grey matter with high sensitivity (with significantly less specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume and white matter volume as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in magnetic resonance techniques, as well as the abilities of postprocessing the obtained data, has become the basis for the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MRI is unquestionably the best diagnostic tool used to follow up the course of the disease and to treat patients with MS. However, to diagnose and follow up the patients with MS on the basis of MRI in accordance with the latest standards, an MRI study must meet certain quality criteria, which are the subject of this paper