179 research outputs found

    Pararenalfat Tissue: Rate of Pararenal Obesity and Relation with Anthropometric Indices of Obesity

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    Aim. To study a rate of excessive pararenal fat tissue (PRFT) thickness and its relationship with anthropometric obesity indices.Material and methods. 372 patients (152 men and 220 women) were included in the study, the average age was 63.5±13.3 years. There were measured: height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), WC/height ratio, sagittal abdominal diameter (SAD), body fat percentage (BFP), body surface area (BSA), body adiposity index (BAI) and visceral obesity index (VAI). All subjects underwent abdominal multispiral computed tomography. PRFT thickness was detected on a single slice at the level of the left renal vein.Results. 27% of the examined group had BMI<25 kg/m2, 28% – excessive body mass, 45% – obesity. The median PRFT thickness was 1.61 (1.03; 2.46) cm. There were correlations between PRFT thickness and glucose (r=0,64, p<0,05) and uric acid (r=0,46, p<0,05) levels. The threshold of referential PRFT thickness was 1,91cm. The rate of pararenal obesity was 9,9% among those with normal body mass, 29,3% in excessive body mass, 66,1% – in 1 class obesity, 67,7% – in 2 class, and 90,1% – in 3 class. The correlation analysis revealed a significant positive correlation between the PRFT thickness and obesity indices with exception of VAI and BAI: with BMI (r=0.43, p<0.05), WC (r=0.57, p<0.05), SAD (r=0.58, p<0.05), BFP (r=0.48, p<0.05), WC/height ratio (r=0.46, p<0.05), and BSA (r=0.58, p<0.05).Conclusion. Excessive PRFT may be detected isolated without any external anthropometric signs of obesity, wherein it is an active component of metabolic disorders typical for obesity. The most significant indices for the detection of pararenal obesity may be WC, SAD, and BSA

    Meixner class of non-commutative generalized stochastic processes with freely independent values I. A characterization

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    Let TT be an underlying space with a non-atomic measure σ\sigma on it (e.g. T=RdT=\mathbb R^d and σ\sigma is the Lebesgue measure). We introduce and study a class of non-commutative generalized stochastic processes, indexed by points of TT, with freely independent values. Such a process (field), ω=ω(t)\omega=\omega(t), tTt\in T, is given a rigorous meaning through smearing out with test functions on TT, with Tσ(dt)f(t)ω(t)\int_T \sigma(dt)f(t)\omega(t) being a (bounded) linear operator in a full Fock space. We define a set CP\mathbf{CP} of all continuous polynomials of ω\omega, and then define a con-commutative L2L^2-space L2(τ)L^2(\tau) by taking the closure of CP\mathbf{CP} in the norm PL2(τ):=PΩ\|P\|_{L^2(\tau)}:=\|P\Omega\|, where Ω\Omega is the vacuum in the Fock space. Through procedure of orthogonalization of polynomials, we construct a unitary isomorphism between L2(τ)L^2(\tau) and a (Fock-space-type) Hilbert space F=Rn=1L2(Tn,γn)\mathbb F=\mathbb R\oplus\bigoplus_{n=1}^\infty L^2(T^n,\gamma_n), with explicitly given measures γn\gamma_n. We identify the Meixner class as those processes for which the procedure of orthogonalization leaves the set CP\mathbf {CP} invariant. (Note that, in the general case, the projection of a continuous monomial of oder nn onto the nn-th chaos need not remain a continuous polynomial.) Each element of the Meixner class is characterized by two continuous functions λ\lambda and η0\eta\ge0 on TT, such that, in the F\mathbb F space, ω\omega has representation \omega(t)=\di_t^\dag+\lambda(t)\di_t^\dag\di_t+\di_t+\eta(t)\di_t^\dag\di^2_t, where \di_t^\dag and \di_t are the usual creation and annihilation operators at point tt

    Аутоиммунные поражения печени у пациентов с болезнью Шёгрена, ассоциированной с антицентромерными антителами

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    Objective: to determine the frequency, spectrum and severity of liver affection in anti-centromere antibodies (ACA) positive patients with primary Sjogren's syndrome (pSS).Patients and methods. 119 ACA-positive patients with pSS were included in the study, 37 (31%) of them had signs of liver damage, 3 of these patients were excluded from the study (2 had cholelithiasis, 1 had viral hepatitis B). Signs of autoimmune liver damage were found in 34 (28.6%) patients, most of them were seropositive for antimitochondrial antibodies (AMA). The diagnosis of primary biliary cholangitis (PBC) and autoimmune hepatitis (AIH) was established according to the recommendations of the American Association for the Study of Liver Diseases, the Russian Gastroenterological Association and the Russian Society for the Study of the Liver. In 5 (14.7%) patients the cause of cholestasis remained unspecified.Results and discussion. AMA were found in 73.5% of patients, elevated serum IgM levels – in 57.6%. Clinically liver damage in most cases was characterized by an asymptomatic, slowly progressive course without a dramatic increase of symptoms over time. Liver cirrhosis was found in 14.7% of patients. According to clinical, laboratory and morphological manifestations, PBC was diagnosed in 21 patients, 4 of them also had a cross syndrome with AIH. AMA-negative PBC was found in 3 patients and isolated AIH – in 1. In most cases, histological stage I of PBC was detected. During follow-up, median of 7 years (range from 2 to 15 years), in 7 patients with stage I PBC and in 7 AMA-positive patients without functional liver disorders no clinical, laboratory or instrumental progression of liver damage was noted. In this regard, it was suggested that these patients have epitheliitis of the biliary ducts as manifestation of glandular affection in pSS, and not true PBC.Conclusion. Autoimmune liver lesions are detected in 28.6% of ACA-positive patients with pSS, most (41.2%) of them develop epitheliitis of the biliary ducts as pSS manifestation or a combination of pSS with PBC (with the same frequency), less often PBC / AIH cross syndrome is diagnosed. PBC / pSS-related epitheliitis of the biliary ducts in ACA-positive patients is characterized by a slowly progressive asymptomatic course in most cases and rarely leads to the development of liver cirrhosis.Цель настоящего исследования – определить частоту, спектр и тяжесть течения поражений печени у позитивных по антицентромерным антителам (АЦА) пациентов с болезнью Шёгрена (БШ).Пациенты и методы. У 37 (31%) из 119 включенных в исследование АЦА-позитивных пациентов с БШ при обследовании выявлены признаки поражения печени, 3 из них были исключены из исследования (у 2 имелась желчнокаменная болезнь, у 1 – вирусный гепатит В). Признаки аутоиммунного поражения печени обнаружены у 34 (28,6%) больных, большинство из которых были серопозитивны по антимитохондриальным антителам (АМА). Диагноз первичного билиарного холангита (ПБХ) и аутоиммунного гепатита (АИГ) устанавливался согласно рекомендациям Американской ассоциации по изучению заболеваний печени, Российской гастроэнтерологической ассоциации и Российского общества по изучению печени. Причина холестаза у 5 (14,7%) пациентов осталась неуточненной.Результаты и обсуждение. АМА обнаружены у 73,5% пациентов, повышение уровня IgM – у 57,6%. Клинически поражение печени в большинстве случаев характеризовалось бессимптомным медленно прогрессирующим течением, как правило, без выраженного нарастания симптомов в динамике. Признаки цирроза выявлены у 14,7% пациентов. На основании клинико-лабораторно-морфологических проявлений ПБХ диагностирован у 21 больного, у 4 из которых также имелся перекрестный синдром с АИГ. АМА-негативный ПБХ установлен у 3 пациентов и изолированный АИГ – у 1. В большинстве случаев определялась I гистологическая стадия ПБХ. При динамическом наблюдении, медиана которого составила 7 лет (мин. 2 года, макс. 15 лет), у 7 пациентов с I стадией ПБХ и у 7 АМА-позитивных больных без функциональных нарушений печени в течение всего периода наблюдения клинического и лабораторно-инструментального прогрессирования поражения печени не отмечено. В связи с этим сделано предположение, что у данных пациентов имеется эпителиит билиарных протоков как проявление железистых поражений при БШ, а не истинный ПБХ.Заключение. Аутоиммунные поражения печени выявляются у 28,6% АЦА-позитивных пациентов с БШ, у большинства из них с одинаковой частотой (41,2%) развиваются эпителиит билиарных протоков в рамках БШ либо сочетание БШ с ПБХ, реже диагностируется перекрестный синдром ПБХ/АИГ. ПБХ/эпителиит билиарных протоков в рамках БШ у АЦА-позитивных пациентов в большинстве случаев характеризуется медленно прогрессирующим бессимптомным течением и редко приводит к развитию цирроза печени

    NIBBS-Search for Fast and Accurate Prediction of Phenotype-Biased Metabolic Systems

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    Understanding of genotype-phenotype associations is important not only for furthering our knowledge on internal cellular processes, but also essential for providing the foundation necessary for genetic engineering of microorganisms for industrial use (e.g., production of bioenergy or biofuels). However, genotype-phenotype associations alone do not provide enough information to alter an organism's genome to either suppress or exhibit a phenotype. It is important to look at the phenotype-related genes in the context of the genome-scale network to understand how the genes interact with other genes in the organism. Identification of metabolic subsystems involved in the expression of the phenotype is one way of placing the phenotype-related genes in the context of the entire network. A metabolic system refers to a metabolic network subgraph; nodes are compounds and edges labels are the enzymes that catalyze the reaction. The metabolic subsystem could be part of a single metabolic pathway or span parts of multiple pathways. Arguably, comparative genome-scale metabolic network analysis is a promising strategy to identify these phenotype-related metabolic subsystems. Network Instance-Based Biased Subgraph Search (NIBBS) is a graph-theoretic method for genome-scale metabolic network comparative analysis that can identify metabolic systems that are statistically biased toward phenotype-expressing organismal networks. We set up experiments with target phenotypes like hydrogen production, TCA expression, and acid-tolerance. We show via extensive literature search that some of the resulting metabolic subsystems are indeed phenotype-related and formulate hypotheses for other systems in terms of their role in phenotype expression. NIBBS is also orders of magnitude faster than MULE, one of the most efficient maximal frequent subgraph mining algorithms that could be adjusted for this problem. Also, the set of phenotype-biased metabolic systems output by NIBBS comes very close to the set of phenotype-biased subgraphs output by an exact maximally-biased subgraph enumeration algorithm ( MBS-Enum ). The code (NIBBS and the module to visualize the identified subsystems) is available at http://freescience.org/cs/NIBBS

    Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

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    Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

    Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

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    Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

    Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

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    Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients
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