41 research outputs found
Metabolomics of chronic obstructive pulmonary disease and obstructive sleep apnea syndrome : response to Maniscalco and Motta
We appreciate Maniscalco and Motta’s comments on our
recently published article ‘‘Fusion of the 1H NMR data of
serum, urine and exhaled breath condensate in order to
discriminate chronic obstructive pulmonary disease and
obstructive sleep apnea syndrome’’ (Zabek et al. 2015) and
we are grateful for the opportunity to clarify a number of
points from our work. We are glad that the authors
appreciated our data analysis and interpretation[…
Resynchronization therapy transvenous approach in dextrocardia and congenitally corrected transposition of great arteries
Cardiac resynchronization therapy (CRT) is an acknowledged treatment for advanced heart
failure in acquired dilated cardiomyopathy, resistant to pharmacotherapy. Although there are
no therapeutic standards regarding heart failure originating from congenital heart defects
with systemic right ventricle, a number of CRT implantations by transvenous approach in
congenitally corrected transposition of the great arteries (CCTGA) have been reported since
2001, even though none of them expressly referred to a case concomitant with dextrocardia and
situs inversus anomaly.
We present a 57 year-old patient with dextrocardia and CCTGA, who underwent surgical
closure of interatrial and interventricular septal defects at the age of 19, and in whom a VVI
pacemaker was subsequently implanted at age 36. A three-lead CRT system was implanted by
transvenous approach. Imaging techniques, including multi-slice computed tomography,
targeted to pacing system and unusual anatomical relationships were applied. Within
a 20-month follow-up, a significant improvement of functional NYHA class, systemic right
ventricle ejection fraction and exercise capability were observed.
Entirely transvenous CRT system implantation is feasible in patients with dextrocardia and
CCTGA, and has substantial potential for long-term benefits. (Cardiol J 2010; 17, 5: 503-508
Barriers to cervical cancer screening exist despite integrating HIV and gynaecological services for HIV-positive women in Poland
Objectives: HIV-positive women are at increased risk of HPV infection and cervical cancer. European and national guidelines advise yearly screening for cervical cancer, however due to the lack of a central registration of HIV infected persons there is a gap in offering such care through general healthcare services in many countries, including Poland.
Material and methods: In response to the above limitations, integrated gynaecological care (IGC) was established at the HIV Out-Patient Clinic in Warsaw. We analysed data from January 2007 to May 2014. Logistic regression models were used to identify factors associated with not using IGC by patients.
Results: Two hundred and forty women were registered in the observation period:59.6% infected through sexual contact, 18.7% through IDUs, 19.2 % through unknown causes and 2.5% by other (two were vertically infected). The median follow-up time was 2.35 (IQR 0.9–4.5) years and 78.3% were on combination antiretroviral therapy (cART). In total 145 of the women (60.4%) used IGC, from 72.1% of those registered in 2007 to 27.3% registered in 2014. There were in total 1075 gynaecoÂlogical visits and 254 cervical cytology tests performed. Seventy-five (51.7%) women were tested for HPV infection. FacÂtors decreasing the odds of not using IGC identified by multivariate regression models were being on cART (OR 0.25 [IQR: 0.10–0.59]; p = 0.003) and longer time of observation (0.69 [0.58–0.83]; p = 0.0001).
Conclusions: The utilisation of IGC was very high, but with a delay in commencing the IGC. Women on cART and with longer periods of follow-up had lower odds of not using IGC. A screening approach for women not yet on cART, or newly registered in the clinics, needs special attention
Późna perforacja prawej komory jako powikłanie stałej stymulacji serca - czy przestrzeganie wytycznych jest zawsze właściwym wyborem? Postępowanie niestandardowe : opis przypadku i przegląd piśmiennictwa
A case of a delayed perforation of the right ventricle by the pacemaker lead in a 67-year-old woman is presented. Perforation,
mimicking stenocardial symptoms, was incidentally diagnosed on a computed tomography chest scan. Percutaneous lead extraction
was successfully performed, with simultaneous implantation of a new pacemaker lead
Fulminant heart failure due to giant cell myocarditis affecting the left ventricle
A 56-year-old woman, previously healthy, was hospitalized after an episode of ventricular tachycardia in the course of infection. In view of the fulminant course of heart failure the patient was connected to an extracorporeal membrane oxygenation (ECMO) system. After 3 weeks of treatment with ECMO the patient received a heart transplant. A histopathological examination of the tissues of the explanted heart revealed giant cell myocarditis. The patient was treated with immunosuppression based on induction therapy followed by a standard regimen with steroids. Currently, the patient remains in good general condition with an left ventricular ejection fraction of 60%
Does beta-trace protein (BTP) outperform cystatin C as a diagnostic marker of acute kidney injury complicating the early phase of acute pancreatitis?
Abstract: Acute pancreatitis (AP) belongs to the commonest acute gastrointestinal conditions requiring
hospitalization. Acute kidney injury (AKI) often complicates moderately severe and severe AP,
leading to increased mortality. Among the laboratory markers proposed for early diagnosis of AKI,
few have been studied in AP, including cystatin C and neutrophil gelatinase-associated lipocalin
(NGAL). Beta-trace protein (BTP), a low-molecular-weight glycoprotein proposed as an early marker
of decreased glomerular filtration, has never been studied in AP. We investigated the diagnostic
usefulness of serum BTP for early diagnosis of AKI complicating AP in comparison to previously
studied markers. BTP was measured in serum samples collected over the first three days of hospital
stay from 73 adult patients admitted within 24 h of mild to severe AP. Thirteen patients (18%)
developed AKI in the early phase of AP. Serum BTP was higher in patients who developed AKI,
starting from the first day of hospitalization. Strong correlations were observed between BTP and
serum cystatin C but not serum or urine NGAL. On admission, BTP positively correlated with
endothelial dysfunction. The diagnostic usefulness of BTP for AKI was similar to cystatin C and
lower than NGAL. Increased BTP is an early predictor of AKI complicating AP. However, it does not
outperform cystatin C or NGAL
Acute phase proteins and vitamin D seasonal variation in end-stage renal disease patients
: End-stage renal disease (ESRD) patients are vulnerable to vitamin D deficiency due to
impaired renal hydroxylation, low dietary intake and inadequate sun exposure. Vitamin D plays a
role in innate and adaptive immunity and its seasonal variation has been linked to mortality. ESRD is
associated with inadequate removal of pro-inflammatory cytokines regulating acute phase protein
(APP) synthesis. Our aim was to look for associations between lifestyle factors, diet, and vitamin D
seasonal variation and their relationship with selected APPs and calcium-phosphate metabolism. The
study included 59 ESRD patients treated with maintenance hemodialysis. A 24-hour dietary recall
was conducted in the post-summer (November 2018, PS) and post-winter (February/March 2019, PW)
period, and blood was collected for the measurements of serum total vitamin D, α1-acid glycoprotein
(AGP), C-reactive protein (CRP), albumin, prealbumin (PRE), parathormone, calcium and phosphate.
A self-constructed questionnaire gathered information on vitamin D supplementation, sun exposure
and physical activity. Higher caloric intake was observed PW compared PS. Less than 15% of
participants met the dietary recommendations for energy, protein, fiber, vitamin D and magnesium
intake. Vitamin D supplementation was associated with higher serum vitamin D regardless of season.
AGP, PRE, albumin, and vitamin D presented seasonal changes (higher values PS). In patients with
serum vitamin D below 25 ng/mL, vitamin D seasonal change correlated with CRP and prealbumin
change. Phosphate and Ca × P correlated positively with AGP. A low vitamin D serum level could
impact the inflammatory process; however, more studies are needed to confirm the relationship
Fusion of the 1H NMR data of serum, urine and exhaled breath condensate in order to discriminate chronic obstructive pulmonary disease and obstructive sleep apnea syndrome
Chronic obstructive pulmonary disease, COPD, affects the condition of the entire human organism and causes multiple comorbidities. Pathological lung changes lead to quantitative changes in the composition of the metabolites in different body fluids. The obstructive sleep apnea syndrome, OSAS, occurs in conjunction with chronic obstructive pulmonary disease in about 10–20 % of individuals who have COPD. Both conditions share the same comorbidities and this makes differentiating them difficult. The aim of this study was to investigate whether it is possible to diagnose a patient with either COPD or the OSA syndrome using a set of selected metabolites and to determine whether the metabolites that are present in one type of biofluid (serum, exhaled breath condensate or urine) or whether a combination of metabolites that are present in two biofluids or whether a set of metabolites that are present in all three biofluids are necessary to correctly diagnose a patient. A quantitative analysis of the metabolites in all three biofluid samples was performed using 1H NMR spectroscopy. A multivariate bootstrap approach that combines partial least squares regression with the variable importance in projection score (VIP-score) and selectivity ratio (SR) was adopted in order to construct discriminant diagnostic models for the groups of individuals with COPD and OSAS. A comparison study of all of the discriminant models that were constructed and validated showed that the discriminant partial least squares model using only ten urine metabolites (selected with the SR approach) has a specificity of 100 % and a sensitivity of 86.67 %. This model (AUCtest = 0.95) presented the best prediction performance. The main conclusion of this study is that urine metabolites, among the others, present the highest probability for correctly identifying patents with COPD and the lowest probability for an incorrect identification of the OSA syndrome as developed COPD. Another important conclusion is that the changes in the metabolite levels of exhaled breath condensates do not appear to be specific enough to differentiate between patients with COPD and OSA