Cigarette smoking and cerebral microvasculature in patients with type 1 diabetes: a pilot study

Introduction. A decrease in vasomotor reactivity reserve (VMRr) or an increase in pulsatility index (PI) are the early signs of cerebral microangiopathy in type 1 diabetes. Cigarette smoking is a risk factor for microvascular complications of type 1 diabetes, but cigarette smokers are routinely excluded from studies on VMRr or PI in type 1 diabetes (T1DM) and there is no evidence of any significant impact of smoking on these variables in T1DM. Therefore, we aimed to assess the impact of cigarette smoking on VMRr and PI in these patients. Methods. VMRr and PI of the middle cerebral artery were measured with Transcranial Doppler in 79 patients with T1DM (median age 33.0 years, range 20–51, 44% males) without a history of cerebrovascular events, coronary heart disease or carotid stenosis. The relationship between cigarette smoking (n = 20, mean pack-years 9.4 ± 6.1) and VMRr, PI, concomitant risk factors, medications and the presence of systemic microvascular complications were analysed. Results. Smokers and non-smokers did not differ in terms of their clinical characteristics, with an exception of higher circadian insulin demand in smokers (60 ± 12.9 v. 49.2 ± 14.2 units; p = 0.004). A correlation between pack-years and PI (r = 0.6, p = 0.004), but not with VMRr, was found in smokers. However, no significant differences between smokers and non-smokers were found regarding either VMRr (mean 85.9 ± 20% v. 84.1 ± 20.1%; p = 0.74) or PI (median 0.85, range 0.61–1.09 v. 0.88, range 0.48–1.52; p = 0.2). Conclusions. We did not prove any significant impact of smoking on VMRr in T1DM patients, but the association between pack-years and PI may indicate the negative impact of intensive cigarette smoking on the cerebral microvasculature in type 1 diabetes.

The impact of carotid intima - media complex index selection for the investigation of a correlation with chosen cardiovascular risk factors

Wstęp Ultrasonograficzna ocena IMT (intima-media thickness) w ścianie tętnicy szyjnej znajduje obecnie powszechne zastosowanie w badaniach klinicznych. Wielokrotnie potwierdzano, że zwiększona grubość kompleksu IMT jest cennym wskaźnikiem wystąpienia powikłań sercowo-naczyniowych. W publikowanych pracach występują jednak różne parametry opisujące IMT i nie ma jednomyślności co do przewagi któregoś z nich. Celem niniejszego badania było wskazanie różnic w zależnościach między różnymi wskaźnikami IMT a wybranymi czynnikami ryzyka sercowo-naczyniowego. Materiał i metody Badaniami objęto grupę 90 mężczyzn (wiek 46 &#177; 8 lat, BMI 27,7 &#177; 3,6 kg/m2, ciśnienie tętnicze 129 &#177; 8/81 &#177; 7 mm Hg, ABPM: SBP - 125,9 &#177; 7,9; DBP - 79,7 &#177; 6,3, stężenie cholesterolu całkowitego 237 &#177; 35,7 mg/dl, cholesterolu frakcji HDL 52 &#177; 13, triglicerydów 184 &#177; 99). U każdego pacjenta wykonano badanie echokardiograficzne serca z oceną funkcji skurczowej i rozkurczowej lewej komory. Pomiary IMT w ścianie tętnicy szyjnej wykonano za pomocą specjalistycznego oprogramowania analizującego cyfrowe obrazy ścian tętnic szyjnych. Uwzględniono zarówno średnią, jak i maksymalną IMT, pole powierzchni przekroju IMT (CSA-IMT), jak i wartości względne. Zależności między IMT a wybranymi czynnikami ryzyka sercowo- naczyniowego badano za pomocą analizy regresji wielokrotnej. Wyniki Stwierdzono najwyższe wskaźniki regresji wielokrotnej dla względnej średniej IMT (r = 0,689) i względnego CSA-IMT (r = 0.685). Relatywna średnia IMT była determinowana przez: wiek (p < 0,001), stężenie cholesterolu frakcji HDL (p = 0,02) oraz częstość akcji serca ocenianą w okresie nocy (p = 0,035). Względne CSA-IMT było determinowane przez: wiek (p < 0,001), stężenie cholesterolu frakcji HDL (p = 0,02), częstość akcji serca ocenianą w okresie nocy (p = 0,025), poziom glikemii na czczo (p = 0,021) oraz BMI (p = 0,045). Wnioski Względne CSA-IMT wśród innych parametrów opisujących IMT może być najlepszym wskaźnikiem ryzyka sercowo-naczyniowego. Ocena tego parametru może prowadzić do bardziej precyzyjnej oceny całkowitego ryzyka sercowo-naczyniowego.Nadciśnienie Tętnicze 2007, tom 11, nr 4, strony 335&#8211;349.Background Carotid intima-media thickness (IMT) is widely used in clinical research. There is strong evidence that increased IMT is a powerful predictor of cardiovascular complications. Varies indices of IMT are used in different studies. So far there is no agreement which marker best reflects cardiovascular risk. Therefore the aim of the study was to establish the association between chosen cardiovascular risk factors and different indices of IMT. Material and methods 90 males (mean age: 46 &#177; 8 yrs, BMI 27.7 &#177; 3.6 kg/m2, office blood pressure 129 &#177; 8/81 &#177; 7 mm Hg, 24-hour ambulatory blood pressure: SBP - 125.9 &#177; 7.9; DBP: 79.7 &#177; 6.3, total cholesterol 237 &#177; 35.7 mg/dl, HDL 52 &#177; 13, TG 184 &#177; 99) were studied. Doppler echocardiography with systolic and diastolic function evaluation was performed using ALOKA 5000 machine. CIMT measurement was obtained by analysis of ultrasonographic images with dedicated software. Varies indices of common carotid intima&#8211;media complex including average IMT, maximal IMT, average cross-sectional area of IMT (CSA-IMT), relative average IMT, relativemaximal IMT and relative CSA-IMT were calculated. The relationship between traditional risk factors and indices of IMT was analyzed by means of multiple regression. Results The analysis revealed the highest MR coefficients for relative average IMT (R = 0.689) and relative CSAIMT (R = 0.685). Relative average IMT was significantly determined by age (p < 0.001), HDL-cholesterol level (p = 0.02) and 24-ABPM night heart rate (p = 0.035). Relative CSA-IMT was significantly determined by age (p < 0.001), HDL-cholesterol level (p = 0.02), 24-ABPM night heart rate (p = 0.025), BMI (p = 0.045) and fasting glucose level (p = 0.021). Conclusions Among varies common carotid IM indices relative CSA-IMT may be the best marker of cardiovascular risk. Assessment of this variable may lead to a more precise stratification of the global cardiovascular risk. Arterial Hypertension 2007, vol. 11, no 4, pages 335-349

Evaluation of influence of blood pressure and anthropometric indices on peripheral blood flow estimated by strain-gauge plethysmography in subjectively healthy men

Wstęp Celem pracy była ocena zależności pomiędzy wskaźnikami antropometrycznymi oraz ciśnieniem tętniczym a obwodowym przepływem krwi w grupie subiektywnie zdrowych osób. Materiał i metody Grupę badaną stanowiło 72 subiektywnie zdrowych mężczyzn z medianą: wieku 41 lat (16-58), BMI 25,8 kg/m2 (16,9-34,6). Skład ciała analizowano przy użyciu metody bioimpedancji elektrycznej. Wartości beztłuszczowej masy ciała (FFM) wynosiły 66,6 kg (48,2-88,1), czyli 80% (68,6-96,3). Tłuszczowa masa ciała (FM) średnio wynosiła 16,5 (3-32,8) kg, czyli 20% (5,5-31,4). Średnie wartości skurczowego ciśnienia tętniczego (SBP) i rozkurczowego (DBP) dla całej doby (SBP24, DBP24), okresu dnia i nocy wyznaczano na podstawie rejestracji dokonanych aparatem Spacelabs 90207. Wartości SBP24 i DBP24 wynosiły odpowiednio 119 mm Hg (95-151) i 73 mm Hg (55&#8211;97). Obwodowy przepływ krwi badano przy użyciu pletyzmografii strain-gauge i opisywano za pomocą następujących parametrów: napływ tętniczy (AI), szybki napływ tętniczy (FBF), pojemność żylna (VC), częściowy odpływ żylny 0,5-2 s (VO0,5-2,0), odpływ żylny (VO). Wyniki Napływ tętniczy był determinowany głównie przez SBP24, a także przez FFM, jak i całkowitą masę ciała. Częściowy odpływ żylny był determinowany przez SBP24 i BMI. Szybki napływ tętniczy był determinowany wyłącznie przez SBP24. Wnioski Masa ciała (całkowita masa ciała, BMI) oraz średnie dobowe skurczowe ciśnienie tętnicze (SBP24) są istotnymi determinantami odpływu żylnego V0,5-2,0 oraz napływu tętniczego (AI). Ocena przepływu obwodowego za pomocą pletyzmografii powinna uwzględniać wskaźniki antropometryczne i ciśnienie tętnicze.Background The aim of the study was to estimate the relationship between anthropometric indices, blood pressure and peripheral blood flow in subjectively healthy subjects. Material and methods The study group consisted of 72 healthy men, aged 41 years (16-58), BMI 25.8 kg/m2 (16.9-34.6). Body composition was analyzed using bioelectrical impedance method. The value of fat free mass (FFM) were 66.6 kg (48.2-88.1), which means 80% (68.6-96.3). Fat mass (FM) was 16.5 kg (3-32.8) which means 20% (5.5-31.4). Mean values of systolic (SBP) and diastolic (DBP) blood pressure measurements for 24-hour period (SBP24, DBP24), as well as for daytime and nighttime periods were conducted using Spacelabs 90207 devices. SBP24 and DBP24 were 119 mm Hg (95-151) and 73 (55-97) mm Hg, respectively. Peripheral blood flow was assessed using forearm strain-gauge plethysmography and described by following indices: arterial inflow (AI), forearm blood flow (FBF), venous capacitance (VC), partial venous outflow 0.5-2 s (VO0.5-2.0), venous outflow (VO). Results Arterial inflow was mainly determined by SBP24 and by both FFM and body mass. Partial venous outflow was determined by SBP24 and BMI. Fast blood flow was determined by SBP24 only. Conclusions The parameters describing body mass (total body mass, BMI) and SBP24 are important determinants of V0,5-2,0 and arterial inflow. Our results suggest that arterial blood pressure should be taken into consideration when relationship between antropomethric indices and parameters of peripheral blood flow is examined

The relationship between left ventricular diastolic function and arterial stiffness in normotensive males

Wstęp Choroby układu sercowo-naczyniowego należą do głównych zagrożeń zdrowia w Polsce. W ostatnich latach duże zainteresowanie badaczy wzbudza rola zmian podatności naczyń i funkcji rozkurczowej w rozwoju chorób układu sercowo-naczyniowego. Celem badania była ocena, czy w grupie osób zdrowych istnieje związek pomiędzy parametrami funkcji rozkurczowej a podatnością naczyń tętniczych. Materiał i metody Badaniami objęto 24 zdrowych mężczyzn w wieku 43 lat (&plusmn; 8) o wskaźniku masy ciała (BMI) 26,9 &plusmn; 4,2 kg/m2, o następujących parametrach ciśnienia tętniczego uzyskanych podczas 24-godzinnego pomiaru metodą Halbera: skurczowe 127 &plusmn; 8 mm Hg, rozkurczowe 80 &plusmn; 5 mm Hg oraz o częstości akcji serca 76 &plusmn; 8 uderzeń na minutę. Sztywność tętnic oceniano na podstawie prędkości propagacji fali tętna (PWV). U każdego mężczyzny wykonano badania echokardiograficzne sonografem ALOKA 5000 wyposażonym w głowicę o częstotliwości 2,5-3,5 MHz ze szczególnym uwzględnieniem parametrów napływu mitralnego opisującego funkcję rozkurczową. Mierzono następujące parametry napływu mitralnego: maksymalną prędkość fali wczesnego napływu - fala E (m/s), maksymalną prędkość napływu przedsionkowego - fala A (m/s), decelerację fali E określającą stopień nachylenia ramienia zstępującego fali E - DecE (cm/s2), czas deceleracji fali E, czyli czas od szczytu fali E do czasu jej zaniku - DT E (ms). Wyniki Stwierdzono, że istnieje istotna korelacja pomiędzy PWV a parametrami funkcji rozkurczowej (PWV vs. E r = -0,531, p = 0,006; PWV vs. E/A r = -0,478, p = 0,016). W analizie związku między PWV a deceleracją fali E stwierdzono r = -0,353, p = 0,083. Nie wykazano także korelacji pomiędzy PWV a frakcją wyrzutową i indeksem masy lewej komory. Wnioski Wykazaną w obecnej pracy zależność pomiędzy funkcją rozkurczową lewej komory a własnościami naczyń można traktować jako wyraz równoległości procesów toczących się w ścianie naczyń oraz mięśniu sercowym. Wzrost sztywności ściany naczynia może być wczesnym wskaźnikiem uszkodzenia funkcji rozkurczowej lewej komory.Background Cardiovascular diseases are the main health problem in Poland. As described in numerous studies diastolic heart failure is common and causes significant alterations in prognosis. The mechanisms that cause abnormalities in diastolic function and arterial stiffness are similar and can both lead to the development of heart failure. The aim of this study was to evaluate the relationship between left ventricular diastolic function and arterial stiffness in normotensive males. Material and methods We examined 26 healthy male subjects aged 43 &plusmn; 8 years (BMI 26.9 &plusmn; 4.2 kg/m2, 24h-SBP 127 &plusmn; 8 mm Hg, 24h-DBP 80 &plusmn; 5 mm Hg, 24h-HR 76 &plusmn; 8 bpm). The carotid-femoral pulse wave velocity (PWV) was used as a measure of arterial stiffness. Doppler echocardiography was performed using ALOKA 5000 machine equipped with 2.5&#8211;3.5 MHz transducer. LV diastolic function was described by the peak of early (E) and late (A) transmitral flow velocity, deceleration time (DT) of E and slope of E peak deceleration (Dec E). Results Significant correlation coefficients were found between PWV and parameters of left ventricular diastolic function (PWV vs. E r = &#8211;0.531, p = 0.006; PWV vs. E/A r = &#8211;0.478, p = 0.016). The analysis of relationship between PWV and DecE revealed r = &#8211;0.353, p = 0.083. We did not observe any significant correlation between PWV and parameters of left ventricular structure (EF %, LVMI /m2), as well. Conclusion Our study revealed significant relationship between arterial stiffness and left ventricular diastolic function in normotensive males. Therefore, increased arterial stiffness may serve as an early evidence of impaired left ventricular diastolic function. This relationship revealed in healthy subjects may indicate that alterations in heart and arterial function may be parallel

Update on the role of Rifaximin in digestive diseases

© Journal of Gastrointestinal and Liver Diseases. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Various environmental factors affecting the human microbiota may lead to gut microbial imbalance and to the development of pathologies. Alterations of gut microbiota have been firmly implicated in digestive diseases such as hepatic encephalopathy, irritable bowel syndrome and diverticular disease. However, while these three conditions may all be related to dysfunction of the gut-liver-brain axis, the precise pathophysiology appears to differ somewhat for each. Herein, current knowledge on the pathophysiology of hepatic encephalopathy, irritable bowel syndrome, and diverticular disease are reviewed, with a special focus on the gut microbiota modulation associated with these disorders during therapy with rifaximin. In general, the evidence for the efficacy of rifaximin in hepatic encephalopathy appears to be well consolidated, although it is less supported for irritable bowel syndrome and diverticular disease. We reviewed current clinical practice for the management of these clinical conditions and underlined the desirability of more real-world studies to fully understand the potential of rifaximin in these clinical situations and obtain even more precise indications for the use of the drug.info:eu-repo/semantics/publishedVersio

A Roadmap for HEP Software and Computing R&D for the 2020s

Particle physics has an ambitious and broad experimental programme for the coming decades. This programme requires large investments in detector hardware, either to build new facilities and experiments, or to upgrade existing ones. Similarly, it requires commensurate investment in the R&D of software to acquire, manage, process, and analyse the shear amounts of data to be recorded. In planning for the HL-LHC in particular, it is critical that all of the collaborating stakeholders agree on the software goals and priorities, and that the efforts complement each other. In this spirit, this white paper describes the R&D activities required to prepare for this software upgrade.Peer reviewe

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Clinical relevance of circulating midkine in ulcerative colitis

Background: Non-invasive biochemical markers are needed to support the diagnosis of ulcerative colitis (UC), an incurable disease of unknown pathology. Midkine is an angiogenic cytokine, chemotactic towards neutrophils and macrophages, and a T-regulatory cell suppressor. Methods: Serum midkine was measured immunoenzymatically in 93 UC patients and 108 healthy subjects, and evaluated with respect to disease status, endoscopic, inflammatory and angiogenic activity. The diagnostic value of midkine was compared to C-reactive protein (CRP) using receiver operating characteristics (ROC) analysis. Results: Midkine was higher (p&#60;0.0001) in inactive (199 ng/L) and active UC (351 ng/L) compared with controls (93 ng/L), and reflected disease activity (r=0.427, p&#60;0.001). Midkine was correlated with CRP, erythrocyte sedimentation rate (ESR), leukocytes, platelets, interleukin-6, paraoxonase-1, albumin, transferrin, iron, hemoglobin, and hematocrit. Midkine correlated with angiogenic factors: vascular endothelial growth factor-A and platelet-derived growth factor-BB. As a marker of UC, midkine showed a diagnostic accuracy of 85%, sensitivity of 72%, specificity of 82%, whereas CRP showed 83%, 65% and 91%, respectively. As a marker of active UC, midkine showed a diagnostic accuracy of 87%, sensitivity of 84%, specificity of 75%, whereas CRP showed 75%, 63% and 83%, respectively. Combined assessment of midkine and CRP improved sensitivity but substantially decreased specificity. Conclusions: UC is associated with increased circulating midkine, which corresponds with clinical, endoscopic, inflammatory and angiogenic activity, and anemia. Performance of midkine as a marker of UC or active UC was comparable to that of CRP. Clin Chem Lab Med 2009;47:1085–90.Peer Reviewe

Emerging Comorbidities in Inflammatory Bowel Disease: Eating Disorders, Alcohol and Narcotics Misuse

Inflammatory bowel disease (IBD) is a chronic and potentially devastating condition of the digestive tract which is exemplified by increasing prevalence worldwide, byzantine pathogenesis with a poorly defined role of the environmental factors, and complex clinical demonstration. As a systemic disease, IBD may progress with a wide spectrum of extraintestinal manifestations (EMs) and comorbidities affecting different organs and systems, from anaemia, undernutrition, and cancer to those which are often neglected like anxiety and depression. Evolving IBD epidemiology and changing environment are reflected by an expanding list of IBD-related comorbidities. In contrast to the well-established role of smoking the connection between alcohol and IBD is still debatable on many levels, from pathogenesis to complications. Furthermore, little is known about narcotics use in IBD patients, even if there are obvious factors that may predispose them to narcotics as well as alcohol misuse. Last but not least, the question arises what is the prevalence of eating disorders in IBD. In our paper, we aimed to discuss the current knowledge on alcohol and drugs misuse and eating disorders as emerging extraintestinal comorbidities in IBD

Pancreatic Cancer in Celiac Disease Patients—A Systematic Review and Meta-Analysis

Background: Celiac disease (CD) is an autoimmune enteropathy affecting approximately 1% of the population and is associated with an increased risk of enteropathy-associated T-cell lymphoma and small bowel adenocarcinoma, whereas the association between CD and other malignancies is unclear. Since pancreatic cancer (PC) remains one of the most lethal neoplasms and its incidence is increasing despite numerous ongoing research on diagnostic biomarkers and novel therapies, we aimed to investigate whether CD has an impact on the risk of PC. Material and Methods: We performed a systematic review of the literature published from January 2000 to March 2022 in two databases: Web of Science and Scopus and a meta-analysis of eligible studies. Results: Our search identified eight publications included in the systematic review. A total of five studies involving 47,941 patients, including 6399 CD patients with malignancies and 1231 PC cases were included in the meta-analysis and 221 cases of PC in CD patients with other cancers were recognized. The pooled OR for PC was 1.46 (95% CI 1.26–1.7) with significant heterogeneity (89.1%; p < 0.05), suggesting that CD patients with malignancies were at higher risk for PC. Conclusions: The association between CD and PC is uncertain. However, the results of the current meta-analysis may indicate an increased risk of PC in the group of patients with CD and other cancers. Further multicenter studies are warranted