Mast Cell Survival and Mediator Secretion in Response to Hypoxia

Tissue hypoxia is a consequence of decreased oxygen levels in different inflammatory conditions, many associated with mast cell activation. However, the effect of hypoxia on mast cell functions is not well established. Here, we have investigated the effect of hypoxia per se on human mast cell survival, mediator secretion, and reactivity. Human cord blood derived mast cells were subjected to three different culturing conditions: culture and stimulation in normoxia (21% O2); culture and stimulation in hypoxia (1% O2); or 24 hour culture in hypoxia followed by stimulation in normoxia. Hypoxia, per se, did not induce mast cell degranulation, but we observed an increased secretion of IL-6, where autocrine produced IL-6 promoted mast cell survival. Hypoxia did not have any effect on A23187 induced degranulation or secretion of cytokines. In contrast, cytokine secretion after LPS or CD30 treatment was attenuated, but not inhibited, in hypoxia compared to normoxia. Our data suggests that mast cell survival, degranulation and cytokine release are sustained under hypoxia. This may be of importance for host defence where mast cells in a hypoxic tissue can react to intruders, but also in chronic inflammations where mast cell reactivity is not inhibited by the inflammatory associated hypoxia

Оценка эффективности комплекса методов медицинской реабилитации пациентов с двигательной дисфункцией кисти вследствие острых нарушений мозгового кровообращения

МЕДИЦИНСКАЯ РЕАБИЛИТАЦИЯКИСТЬ РУКИКИСТЬПСИХОМОТОРНАЯ АКТИВНОСТЬДВИГАТЕЛЬНЫХ НАВЫКОВ РАССТРОЙСТВА /РЕАБИЛРЕАБИЛИТАЦИЯ /МЕТОДЫМОЗГОВОГО КРОВООБРАЩЕНИЯ РАССТРОЙСТВА /ОСЛ /РЕАБИЛЛЕЧЕБНАЯ ГИМНАСТИКАМЕЛКАЯ МОТОРИКАЦелью исследования являлось изучение эффективности комплекса медицинской реабилитации, разработанного на основе зеркальной визуальной обратной связи, элементов двигательной терапии индуцированным ограничением, метода тренировки двигательных навыков кисти с использованием латексных резинок и авторского метода тренировки мелких моторных навыков у пациентов с двигательной дисфункцией кисти вследствие острого нарушения мозгового кровообращения различной степени выраженности. В исследовании приняли участие 62 пациента, разделенные на 2 группы сравнения, сопоставимые по полу, возрасту, реабилитационному периоду и потенциалу. Для анализа результатов использовались методы оценки эффективности медицинской реабилитации пациентов с двигательной дисфункцией кисти, утвержденные министерством здравоохранения Республики Беларусь. По результатам исследования было выявлено межгрупповое различие в восстановлении мелкой моторики, показателей кистевой динамометрии, уровне самооценки пациентом утраты функции верхней конечности, степени выраженности тревожной и депрессивной симптоматики, проявляющееся в более качественном результате у пациентов клинической группы. Также выявлено преобладание увеличений показателей и при оценке качества жизни у респондентов, проходящих предложенный комплекс методов медицинской реабилитации над пациентами контрольной группы. Разработанный комплекс, в условиях применения в соответствии с алгоритмом, позволяет более качественно по сравнению с пациентами, проходящими стандартный курс медицинской реабилитации, восстановить двигательный навык, утраченный вследствие острого нарушения мозгового кровообращения, улучшить степень самообслуживания, качества жизни и приводит к снижению выраженности тревожно-депрессивной симптоматики.Objectives. To study the efficacy of the medical rehabilitation complex developed on the basis of mirror visual feedback, elements of constraint induced movement therapy, the method of hand motor skills’ training with the use of latex rubber bands and the author’s own method of fine motor skills training in patients with motor dysfunction of the hand caused by acute cerebral circulation of different severity degree. Material and methods. The study involved 62 patients, divided into 2 comparison groups, matched by sex, age, rehabilitation period, and potential. To analyze the results we used methods for assessing the effectiveness of medical rehabilitation of patients with motor dysfunction of the hand, which were approved by the Ministry of Health of the Republic of Belarus. Results. The study revealed an intergroup difference in restoring fine motor skills, hand dynamometry indices, the patient’s self-assessment of the upper limb function loss, the severity of anxiety and depression symptoms, which manifests itself in a better result in patients of the clinical group. The prevalence of the increased indicators was also revealed when assessing the life quality of respondents undergoing the proposed complex of medical rehabilitation methods over patients of the control group. Conclusions. The developed complex, in terms of application in accordance with the algorithm, allows more qualitatively compared with patients undergoing a standard course of medical rehabilitation, to restore the motor skill lost because of acute cerebral circulation disturbance, to improve the degree of self-care, quality of life and leads to a decrease in anxiety-depression symptoms

World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

BACKGROUND: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. METHODS: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40-80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance. FINDINGS: Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0·685 (95% CI 0·629-0·741) to 0·833 (0·783-0·882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40-64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt. INTERPRETATION: We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide. FUNDING: World Health Organization, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence, UK Medical Research Council, and National Institute for Health Research