Impact of Vitamin D Supplementation on Arterial Vasomotion, Stiffness and Endothelial Biomarkers in Chronic Kidney Disease Patients

Background: Cardiovascular events are frequent and vascular endothelial function is abnormal in patients with chronic kidney disease (CKD). We demonstrated endothelial dysfunction with vitamin D deficiency in CKD patients; however the impact of cholecalciferol supplementation on vascular stiffness and vasomotor function, endothelial and bone biomarkers in CKD patients with low 25-hydroxy vitamin D [25(OH)D] is unknown, which this study investigated. Methods: We assessed non-diabetic patients with CKD stage 3/4, age 17–80 years and serum 25(OH)D ,75 nmol/L. Brachial artery Flow Mediated Dilation (FMD), Pulse Wave Velocity (PWV), Augmentation Index (AI) and circulating blood biomarkers were evaluated at baseline and at 16 weeks. Oral 300,000 units cholecalciferol was administered at baseline and 8-weeks. Results: Clinical characteristics of 26 patients were: age 50614 (mean61SD) years, eGFR 41611 ml/min/1.73 m2, males 73%, dyslipidaemia 36%, smokers 23% and hypertensives 87%. At 16-week serum 25(OH)D and calcium increased (43616 to 84629 nmol/L, p,0.001 and 2.3760.09 to 2.4260.09 mmol/L; p = 0.004, respectively) and parathyroid hormone decreased (10.868.6 to 7.464.4; p = 0.001). FMD improved from 3.163.3% to 6.163.7%, p = 0.001. Endothelial biomarker concentrations decreased: E-Selectin from 566662123 to 525662058 pg/mL; p = 0.032, ICAM-1, 3.4560.01 to 3.1061.04 ng/mL; p = 0.038 and VCAM-1, 54633 to 42633 ng/mL; p = 0.006. eGFR, BP, PWV, AI, hsCRP, von Willebrand factor and Fibroblast Growth Factor-23, remained unchanged. Conclusion: This study demonstrates for the first time improvement of endothelial vasomotor and secretory functions with vitamin D in CKD patients without significant adverse effects on arterial stiffness, serum calcium or FGF-23. Trial Registration: ClinicalTrials.gov NCT0200571

Combination of probenecid-sulphadoxine-pyrimethamine for intermittent preventive treatment in pregnancy

The antifolate sulphadoxine-pyrimethamine (SP) has been used in the intermittent prevention of malaria in pregnancy (IPTp). SP is an ideal choice for IPTp, however, as resistance of Plasmodium falciparum to SP increases, data are accumulating that SP may no longer provide benefit in areas of high-level resistance. Probenecid was initially used as an adjunctive therapy to increase the blood concentration of penicillin; it has since been used to augment concentrations of other drugs, including antifolates. The addition of probenecid has been shown to increase the treatment efficacy of SP against malaria, suggesting that the combination of probenecid plus SP may prolong the useful lifespan of SP as an effective agent for IPTp. Here, the literature on the pharmacokinetics, adverse reactions, interactions and available data on the use of these drugs in pregnancy is reviewed, and the possible utility of an SP-probenecid combination is discussed. This article concludes by calling for further research into this potentially useful combination

Morphology, morphometry and some aspects of clinical anatomy in the skull and mandible of Sharri sheep

The aim of this study was to investigate and record data on the morphometrical parameters of the skull and mandible in Sharri sheep. We have evaluated 34 skulls (24 females and 10 males) of Sharri sheep (Ovis aries), a local breed of sheep from Northern Macedonia. Fifty-one measurements were evaluated in total: 37 parameters on the skull and 14 parameters on the mandible. The results of the study show that, in general, the morphology and morphometric parameters of the skull and mandible, of Sharri sheep are similar to those of other sheep breeds with few differences. The mean skull length (SL), skull height (SH), distance between two supraorbital foramina (DBTSF), orbital length (OL), mandible length (ML) and Sharri sheep diastema (D) were 247.47 +/- 13.12 mm, 104.71 +/- 6.21 mm, 50.73 +/- 3.44 mm, 41.21 +/- 1.99 mm, 185.91 +/- 13.33 mm and 45.81 +/- 3.73 mm, respectively. The results also show that out of 51 parameters, only 13 show a statistically significant difference between females and males, particularly the distance of akrokranion to opisthion (AO), articular surface length of mandibular condyle (ASL) and anterior limit of the mandibular foramen to cranial border of ramus mandible (RBMFRMRM). The findings of this study are important in many aspects: morphologically, morphometrically and especially clinically, during surgical interventions in the head region. With a lack of information in current literature on the investigated parameters in this sheep breed, the present data are a solid basis for further studies in comparative anatomy with other ruminants and in other areas such as zooarchaeology and animal welfare

Effects of insularity on digestion: living on islands induces shifts in physiological and morphological traits in island reptiles

“The final publication is available at Springer via http://dx.DOI: 10.1007/s00114-015-1301-8

Review: Hydraulic head measurements - New technologies, classic pitfalls

The hydraulic head is one of the most important metrics in hydrogeology as it underlies the interpretation of groundwater flow, the quantification of aquifer properties and the calibration of flow models. Heads are determined based on water-level measurements in wells and piezometers. Despite the importance of hydraulic head data, standard textbooks used in groundwater curricula provide relatively little discussion of the appropriate measurement procedures. This paper presents a review of the literature dealing with the determination of hydraulic heads, and aims to provide quantitative guidance on the likely sources of error and when these can be expected to become important. The most common measurement procedures are discussed and the main sources of error are identified, i.e. those related to (1) the measurement instruments, (2) the conversion from pressure to heads, (3) time lag effects, and (4) observation well defects. It is argued that heads should be determined following welldefined guidelines, and that it should become standard practice in hydrogeology to provide quantitative estimates of the measurement error.Water ManagementCivil Engineering and Geoscience