LC-MS/MS-based reference intervals for hair cortisol in healthy children

Background: Human scalp hair is a valuable matrix for determining long-term cortisol concentrations, with wide-spread applicability in clinical care as well as research. However, pediatric reference intervals are lacking. The aim of this cross-sectional study is to establish age-adjusted reference intervals for hair cortisol in children and to gain insight into hair growth velocity in children up to 2 years old. Methods: A total of 625 healthy children were enrolled through recruitment in pregnancy, infant-welfare clinics, and school visits. Scalp hair cortisol levels were measured using liquid chromatography-tandem mass spectrometry. Age-adjusted reference intervals were established in children from birth to 18 years old. Hair growth velocity was determined in children 0−2 years of age by measuring hair length at 4- to 10-week intervals. Results: Hair cortisol levels were high (162.4 pg/mg, 2.5th-97.5th percentile: 28.8–961) after birth with a sharp fall in the first 3 months of life. This is followed by lower values until age 6 and then by graduated and subtle higher values to adult concentrations are reached at the age of 18 years (3.0 pg/mg, 2.5th-97.5th percentile: 0.53–17.8). Average hair growth velocity measured in mm/month was significantly lower in infants 0–6 months of age compared to children 12–24 months (3.5 versus 9.4, P < 0.001). Conclusions: This is the first study to provide age-adjusted reference intervals for hair cortisol in children from 0−18 years. Higher hair cortisol concentrations in infants might be explained by the significantly lower hair growth rate in the first year of life. The establishment of pediatric hair cortisol reference ranges broadens the potential applications of this biomarker in pediatric clinical care

Survival rate after early treatment for acute type-A aortic dissection with ACTH-(1-24)

Haemorrhagic shock, usually as a consequence of major trauma, is the most frequent cause of death among people younger than 40 years. Reports Indicate that melanocortin peptides are effective in reversing haemorrhagic shock. We found that in patients with aortic-dissection-induced haemorrhagic shock, the addition of an early intravenous bolus Injection of the melanocortin andrenocorticotrophic hormone (ACTH)-(1.24) to standard treatment significantly improved cardiovascular function and increased survival rate. Because administration of ACTH-(1.24) is simple, and because melanocortin peptides have no acute toxicity, their use in the early critical care of patients in shock should be more extensively assessed

ACTH analogue in treatment of acute aortic dissection-Authors' reply.

Sir\u2014The fact that the mortality rate inour patients who were assigned to thestandard treatment, without ACTH-(1-24) addition, was higher than thatreported in previous studies might beexplained by their severe haemodynamiccompromise. We selectedsubjects with type A aortic dissectioncomplicated by aortic rupture andcardiac tamponade, and with clinicaland laboratory signs of haemorrhagicshock.We share Olsson\u2019s opinion thatACTH-(1-24) essentially modifies thecomplex pathophysiology of theperioperative period. Not only byimproving the cardiovascular function;indeed, several experimental datasuggest that melanocortins have also apeculiar, adrenal-independent antiinflammatoryactivity. They reduce theproduction of proinflammatorycytokines, such as interleukins 1, 1,and 6, and tumour necrosis factor(TNF) , and inhibit the activation ofthe transcription factor NF-kB, whileincreasing the production of the antiinflammatorycytokines interleukins 8and 10;1 in particular, in conditions ofhaemorrhagic shock, melanocortinsinhibit the overproduction of TNF,nitric oxide, and free radicals.2,3Moreover, melanocortins protectagainst the outcomes either of a shorttermmyocardial ischaemia followed byreperfusion or of the permanentocclusion of a coronary artery in rats.4Our patients underwent fluidreplacement en route and ventilatorysupport but no rescue surgery. Ourcardiac surgery unit is situated roughlyin the middle of a flat territory innorthern Italy, with a high populationdensity (about 1 million people), and areasonable road system. The time lapsefrom emergency call to arrival into thecasualty ward, by ambulance or byhelicopter, is 20\u201340 min.Our animal data suggest that thetime span of ACTH-(1-24) efficacy isbest if given within 5\u201315 min of shockinduction. We have fewer human data,but they suggest that treatment must bemade within 1 h of the first signs ofshock. In case of haemorrhagic shock(road or industrial accidents, &amp;c), webelieve ACTH should be given asintravenous bolus injection at thescene, or en route in the ambulance.The effect of ACTH lasts a few hours

Biocompatibility of chemically treated bovine pericardium in rats

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Studio istochimico e ultrastrutturale della calcificazione in protesi valvolari cardiache di pericardio bovino

É stato condotto uno studio istochimico ed ultrastrutturale su lembi valvolari cardiaci costruiti con pericardio bovino pretrattato con glutaraldeide e impiantati per 3 e 20 giorni nell'ostio della tricupside di pecora. È risultato che, già in un periodo sperimentale così breve, si attua una evidente calcificazione distrofica che inizia dalle cellule per estendersi successivamente alla sostanza fondamentale e alle fibre collagene. Il problema della fissazione, praticata prima del modellamento dei lembi valvolari protesici, viene discusso ai fini di prevenire o, quanto meno, dilazionare nel tempo la loro calcificazione.A histochemical and ultrastructural study was carried out on bioprosthetic heart valves fabricated from glutaraldehyde-treated bovine pericardium. It resulted that a periodi the mineralization first occurs in cell protoplasma and then in the ground substance and collagen fibers. The problem of fixation, made before modeling the semilunar bioprosthetic cusps, is discussed as regards the attempt to prevent or to delay their calcification

Thromboresistance of Ti6Al4vm coated with a thin film of turbostratic carbon for cardiovascular applications.

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