The severity of essential hypertension in terms of blood pressure values does not depend on NOS3 (rs2070744) and GNB3 (rs5443) genes polymorphisms in the West-Ukrainian population

Objective: to evaluate the association of essential arterial hypertension (EAH) and its severity with genes polymorphism of NOS3 (rs2070744) and GNB3 (rs5443) in West-Ukrainian population. Materials and methods. One-hundred EAH patients (48 – healthy control) participated in the cohort case-control study. Blood pressure (BP), Creatinine, glucose, lipids panel were studied. GNB3 (rs5443) and NOS3 (rs2070744) genotyping performed by TaqMan probes (CFX96™Real-Time PCR). Risk assessed by Relative Risk, Odds Ratio and 95% Confidential intervals. Results. A mutation of the NOS3 gene (786T>C, rs2070744) and the GNB3 gene (825C>T, rs5443) in the homozygous state in the West-Ukrainian population suffers from EAH occurs with a frequency of 16.67% and 8.33%, with no differences with the control subjects (p>0.05). In both groups dominate the T-allele of the NOS3 gene and the C-allele of the GNB3 gene: in patients by 12.5% ​​(c2=4.50; p=0.034) and 41.66% (c2=50.0; p<0.001), in the control – by 25.0% (c2=12.0; p<0.001) and 40.0% (c2=33.33; p<0.001), respectively. The results of the binary logistic regression analysis did not confirm the prediction of the EAH appearance by polymorphic variants of the NOS3 (rs2070744) and GNB3 (rs5443) genes. However, the TT genotype of the GNB3 gene (rs5443) increases unreliably the EAH risk almost twice as likely [OR=2.0; OR 95%CI:0.40-10.82; p>0.05]. Epidemiological analysis did not confirm the association of the NOS3 gene with the EAH severity. But T-allele of the GNB3 gene increases the probability of high normal BP almost 5 times [OR=4.86; OR 95%CI:0.99-24.75; p=0.042]. Conclusions: NOS3 (rs2070744) and GNB3 (rs5443) genes polymorphisms are not associated with blood pressure values and EAH severity as well

Association of biochemical, cytokine and echocardiographic markers of cardiovascular injuries with t894g polymorphism of endothelial nitric oxide synthase gene in patients with nonviral liver cirrhosis

Background & Aims: Alterations of vascular endothelium play an important role in the development of cardiovascular diseases, the occurrence of liver cirrhosis and the progression of its complications. Little is known about the impact of the endothelial nitric oxide synthase (eNOS) gene mutations on the development of cardiovascular disease in patients with liver cirrhosis. The aim of the study was to investigate the possible association of the T894G gene polymorphism of eNOS with biochemical, cytokine blood indices, structural and functional parameters of heart in patients with nonviral liver cirrhosis. Methods: Investigation of eNOS gene polymorphism (T894G) was performed in 50 patients with nonviral liver cirrhosis and in 10 healthy volunteers. Furthermore, biochemical blood analysis, estimations of tumor necrosis factor-α, transforming growth factor-β1, interleukin-4, atrial natriuretic propeptide (proANP) plasma levels, echocardiographic studies were performed. Results: It was established that the presence of T-allele of eNOS gene in patients with liver cirrhosis was associated with increased activity of aspartate aminotransferase, higher plasma content of proANP, larger left atrium diameter and increased left ventricular myocardium mass. In males with liver cirrhosis, T-allele was also associated with increased left ventricular myocardium mass index compared with patients with GG-genotype. Conclusion: The presence of T-allele of eNOS gene in patients with nonviral liver cirrhosis is associated with occurrence of more severe cardiovascular alterations

The activity of proliferation and apoptosis of thyrocytes in the thyroid tissue of patients of nodular goiter with autoimmune thyroiditis considering the polymorphism of the BCL-2 (RS17759659), CTLA-4 (RS231775), APO-1/FAS (RS2234767) genes

Nodular goiter with autoimmune thyroiditis is one of the most important problems of modern endocrinology, with inadequately studied etiological and pathogenic mechanisms of development. It is characterized by the lack of objective and reliable diagnostic methods, effective treatment methods, uncertain therapy or indications for the choice of treatment methods. A total we have examined 125 patients who were operated for a nodular endemic goiter with autoimmune thyroiditis. Investigated the activity of proliferation and apoptosis of thyrocytes in the thyroid tissue of patients of nodular goiter with autoimmune thyroiditis considering the polymorphism of the bcl-2 (rs17759659), ctla-4 (rs231775), apo-1/fas (rs2234767) genes. The expression/density markers - Fas/ FasL, Bcl-2, p53 and Ki-67 on the thyrocytes in the lymphoid infiltration and destruction areas, as well as in normal thyroid tissue (as a control) were studied. The number of immunoreactive cells, which expressed the above-mentioned regulating apoptosis and proliferation markers in NGAIT patients, depending on the genes polymorphism BCL-2 (rs17759659), CTLA-4 (rs231775) and APO-1/Fas (rs2234767) were counted. It was found that in NGAIT patients a few links of programmable thyroid cell killing of Fas-induced apoptosis were activated, and associated with the polymorphic cite of BCL-2 (rs17759659) gene and almost 6 times weaker with CTLA-4 (rs231775) gene, through enhanced expression of Fas and Fas L on the cells surface in lymphoid infiltration and destruction areas (stronger in GG genotype carriers of BCL2 gene)

Clinical markers of immune disorders in the pathogenesis of Escherichia coli enteritis

Background. Escherichia coli enteritis is one of the most common causes of diarrhea in developed countries and is caused usually by pathogenic strains of Escherichia coli. Objectives. To investigate the role of reactive response of polymorphonuclear neutrophilic granulocytes (NG) of peripheral blood in the systemic inflammatory response mechanisms of acute Escherichia enterocolitis (AEC), depending on genes polymorphism of heat shock proteins (HSP) family 70-2 (HSP70-2, 1267A®G) and interleukin 10 (IL-10, C-592A). Material and methods. The genes polymorphism was analysed by PCR based method in 95 patients with AEC and 30 healthy individuals. Clinical markers of immune disorders were evaluated after hematological indices, based upon an extended general clinical blood analysis, using verified formulas. Results. The endogenous intoxication severity did not depend reliably on genotypes of IL-10 gene (rs1800872), however it was significantly 23.68% (р=0.043) higher in GG-genotype carriers of HSP70-2 gene (rs1061581). The reduction of cellular reactivity by 14.71-19.08% (р<0.01) did not depend on the analyzed genes genotypes. But general non-specific immune reactivity decreases 3.49-4.24 times (р<0.001) was deeper in GG-genotype carriers of HSP70-2 gene and AA-genotype carriers of IL-10 gene by 17.78% (р=0.009) and 12.37% (р=0.023) respectively. The immunologic resistance index was lower by 18.75% (р=0.024) in GG-genotype carriers than in patients with А allele. Conclusions. Hematological indices, based upon an extended general clinical blood analysis, are indicative and reliable non-specific clinical markers of immune disorders in case of AEC

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Assessment of Comorbidity as a Risk Factor for Edematous Pancreatitis Considering IL-4 (C-590T) Gene Polymorphism

The comorbidities affect the course of pancreatitis significantly; however, this effect has not been evaluated from the perspective of genetic component.The objective of the research was to analyse concomitant chronic diseases as potential risk factors for edematous pancreatitis considering genetic predictors.Materials and methods. The epidemiological analysis of comorbidities (cholelithiasis, urolithiasis, ischemic heart disease, past viral infection) as risk factors for edematous pancreatitis was performed. Polymorphic variants of the IL-4 (rs 2243250) gene being identified in 123 patients and 40 healthy individuals were also involved.Results. In patients with edematous pancreatitis, urolithiasis was observed more frequently than in the control group - by 37.30% (χ2=18.62, p&lt;0.001). The presence of cholelithiasis insignificantly increases the risk of edematous pancreatitis in the future (RR-1.156; 95% CI: 0.972-1.374). The presence of urolithiasis increased the risk of edematous pancreatitis twofold (RR-2.039; 95% CI: 1.346-3.090; p&lt;0.05).Conclusions. 1. Cholelithiasis increases the probability of developing edematous pancreatitis in carriers of the mutant T-allele of the IL-4 gene by 3.7 times (RR=3.69; OR=10.13; 95% CI OR: 3.17-32.42; p&lt;0.05). 2. In the C-allele carriers of the IL-4 (C-590T) gene, the risk of developing acute pancreatitis is twice higher in the presence of urolithiasis or ischemic heart disease, and almost five times higher in case of past viral infection (p&lt;0.05)