Toll/Interleukin-1 receptor member ST2 exhibits higher soluble levels in type 2 diabetes, especially when accompanied with left ventricular diastolic dysfunction

<p>Abstract</p> <p>Background</p> <p>Soluble ST2, a member of the of the Toll/IL-1 superfamily, is a novel biomarker with exceptional predictive value in heart failure and myocardial infarction- related mortality as well as in acute dyspneic states. Soluble ST2 is considered a decoy receptor of IL 33 that blocks the protective effects of the cytokine in atherosclerosis and cardiac remodeling. In the present study we investigated the differences in the levels of soluble ST2, BNP and hs-CRP between healthy controls and patients with type 2 diabetes with and without left ventricular diastolic dysfunction. A secondary aim was to investigate correlations between sST2 and other biomarkers of type 2 diabetes, such as HbA1c.</p> <p>Methods</p> <p>158 volunteers were recruited and underwent a complete Doppler-echocardiographic evaluation of both systolic & diastolic cardiac function. All subjects with ejection fraction < 50% were excluded. The study population was divided in 4 groups as follows: A: 42 healthy controls, B: 18 subjects without diabetes with LVDD, C: 48 patients with type 2 diabetes without LVDD & D: 50 patients with type 2 diabetes & LVDD. ELISA technique was performed to measure sST2 levels. Statistical analysis was performed with Kruskal-Wallis & Mann-Whitney test (continuous variables), chi squared & Fischer exact test (discrete variables), Spearman coefficient (univariate analysis) and step-wise backward method (multivariate analysis).</p> <p>Results</p> <p>Patients with type 2 diabetes with (p < 0.001) or without LVDD (p = 0.007) had higher serum ST2 levels compared to healthy controls, state found also for hs-CRP levels but not for the corresponding BNP levels (p = 0.213 & p = 0.207 respectively). Patients with type 2 diabetes & LVDD had higher serum ST2 in relation to diabetic patients without LVDD (p = 0.001). In multivariate analysis HbA1c positively and independently correlated with sST2 levels in both groups of patients with type 2 diabetes.</p> <p>Conclusions</p> <p>Patients with type 2 diabetes exhibit higher sST2 levels compared to healthy controls. The presence of LVDD in patients with type 2 diabetes is associated with even higher sST2 levels. A significant correlation between glycemic control and sST2 levels was also revealed.</p

Anxiety and Depression in Patients with Permanent Atrial Fibrillation: Prevalence and Associated Factors

Atrial fibrillation (AF) is an important public health problem that is increasing at an alarming rate, worldwide. The most common type is permanent AF followed by the paroxysmal and persistent AF. Purpose. This study was aimed at exploring anxiety and depression and the associated factors in patients with permanent AF. Materials and Methods. The sample of the study included 170 AF patients. Data collection was performed by the method of interview using the “Hospital Anxiety and Depression Scale” (HADS) to assess anxiety and depression and a questionnaire including patients’ characteristics. Results. 70% of the participants were men, and 32.4% were above 70 years old. Furthermore, 34.9% of the patients had high levels of anxiety, and 20.2% had high levels of depression. Anxiety levels were statistically significantly associated with gender p=0.022, age p=0.022, educational level p=0.025, years having the disease p=0.005, and relations with nursing staff p=0.040. Depression levels were statistically significantly associated with age p=0.037, degree of information of the state of health p<0.001, years having the disease p<0.001, and relations with medical staff p=0.041. Conclusions. Patients’ characteristics are associated with anxiety and depression and need to be evaluated when treating this frequently encountered arrhythmia

Linezolid: a Promising Agent for the Treatment of Multiple and Extensively Drug-Resistant Tuberculosis

Tuberculosis is a severe, infectious disease caused by Mycobacterium tuberculosis. The aim of this review was to present the efficacy of linezolid as an agent against multidrug and extensively drug-resistant tuberculosis as gathered from many recent research studies. Linezolid seems to have strongly the potential of being used as an anti-tuberculosis agent because it blocks bacterial ribosomal protein synthesis. Nevertheless caution is required because of the adverse effects it causes, especially when the linezolid daily dosage exceeds 600 mg. The most severe adverse effects include anemia, peripheral neuropathy, optic neuropathy and thrombocytopenia. Still, more trials and research need to be done in order to gather more information and value the cost-benefit dosage of the treatment.

In Vitro and In Vivo Evaluation of the Comparative Thrombogenicity of Cellulose Acetate Hemodialyzers with Radiolabeled Platelets

Platelet consumption and platelet kinetics during hemodialysis were quantified in Yorkshire pigs with In-111 labeled platelets. Six anesthetized pigs (20–25 kg) were hemodialyzed at 150 ml/min for 3 hr. All pigs were injected with autologous In-111 labeled platelets (300–420 μCi) 24 hr before dialysis and were systemically heparinized (ACT > 400 sec) before cannulation. Hemodialysis was instituted with a Drake-Willock hemodialysis machine and a hollow fiber dialyzer (Cobe4, 0.6 m). In vitro sham dialysis was carried out at 150 ml/min for 3 hr with six more dialyzers in a flow-loop with the blood reservoir maintained at 37°C. In vitro thrombogenicity over-estimates (10-fold) in vivo values. In both systems, platelet deposition on dialyzers reached a steady state, suggesting a constant rate of thrombus formation and embolization in the hollow fiber system. The relative thrombus distribution after 3 hr of dialysis was similar in both systems, with adherent thrombi in the entry and exit ports and highest numbers in the midsection of the hemodialyzer. Biodistribution after 3 hr of dialysis indicated that thrombosis of the hemodialyzer and arterial and venous traps as well as embolization reduced the platelet pool in the blood and increased platelet emboli in lung, brain, kidneys, and skeletal muscle, as measured by the In-111 labeled platelets

Ketogenic Diet and Vitamin D Metabolism: A Review of Evidence

The ketogenic diet (KD), which is low in carbohydrates and high to normal in fat and protein, has been traditionally used in epilepsy for the last 100 years. More recently, its application in obesity has been introduced. The present review aimed to investigate the effects of the KD on vitamin D. In total, five studies were done in healthy adults, one in subjects with type 2 diabetes, and seven in subjects with epilepsy that assessed the levels of vitamin D pre- and post-intervention. In the majority of studies, increases in circulating vitamin D were reported. The relationship of the KD with vitamin D was explained through several mechanisms: ketone bodies, macronutrient intake, the status levels of other fat-soluble vitamins, weight loss, changes in the hormonal milieu, and effects on gut microbiota. Moreover, potential nutrient&ndash;gene-related interactions were discussed. There is still a need to conduct multiple arm studies to compare the effects of the KD versus other diets and better decipher the particular effects of the KD on vitamin D levels and metabolism. Moreover, differentiations of the diet&rsquo;s effects according to sex and genetic makeup should be investigated to prescribe KDs on a more personalized basis