Urban case studies : general discussion

Urban case studies: general discussio

Role of atrial ischaemia and systemic inflammatory response in development of atrial fibrillation following coronary artery bypass surgery

Atrial fibrillation (AF) has been recognized as the most common arrhythmia occurring in the postoperative period after coronary artery bypass grafting. Studies have reported an incidence ranging from 20% to 40%. It is usually evident between the second and fourth postoperative day. It is associated with postoperative complications that prolong hospital stay and increase cost. The pathophysiology of new onset postoperarative AF remains unclear. It has been attributed to various preoperative, intraoperative and postoperative factors. According to recent studies postoperative AF has been associated with oxidative stress and inflammation. The aim of this study was to investigate the relationship between atrial ischemia and systemic inflammatory response with the occurrence of postoperative AF. The study included 50 patients with severe coronary artery disease managed with coronary artery bypass grafting. They were divided in two groups; group A consisted of 25 patients who remained postoperatively on sinus rhythm, while group B included 25 patients with documented new onset of postoperative AF. During preoperative evaluation all coronary angiograms were thoroughly studied with special emphasis given on identifying vessels supplying the right atrium and the atrioventricular node. The temperature at certain precispefied anatomic sites of the right atrium, the left ventricle and the interventricular septum was recorded before, during and after cardiopulmonary bypass with a special temperature probe. Furthermore, we investigated blood levels of factors related to oxidative stress, such as homocysteine, vitamin B12, folic acid, BNP and Pro-ANP as well as inflammatory markers like C-reactive protein. Both groups were comparable (p>0,05) in terms of age, cardiopulmonary bypass time, cross-clamp time, number of diseased vessels and number of grafted vessels. Folic acid levels were found to be statistically significantly related with preservation of sinus rhythm postoperatively. Systemic inflammation was found to be a statistically a important factor in development of postoperative AF. Critical high-grade stenosis of the right coronary artery was not related with occurrence of postoperative AF, as well as serum levels of homocysteine, vitamin B12, BNP and Pro-ANP Myocardial temperature was significantly related with postoperative AF both during cross-clamp time and during reperfusion.Η κολπική μαρμαρυγή είναι η συνηθέστερη επιπλοκή μετά από αορτοστεφανιαία παράκαμψη. Εμφανίζεται συνήθως τη 2η-4η μετεγχειρητική μέρα σε ποσοστό 20-40%. Η εμφάνιση της είναι δυνατό να οδηγήσει σε μετεγχειρητικές επιπλοκές, με αποτέλεσμα την παράταση της παραμονής του ασθενούς στο νοσοκομείο και αύξηση του κόστους νοσηλείας. Η παθοφυσιολογία της κολπικής μαρμαρυγής μετά από αορτοστεφανιαία παράκαμψη παραμένει ακόμα αδιευκρίνιστη. Μέχρι σήμερα έχουν μελετηθεί διάφοροι προεγχειρητικοί, διεγχειρητικοί, μετεγχειρητικοί παράγοντες ως πιθανά αίτια εμφάνιση της. Υπάρχουν μελέτες που αναφέρουν ως πιθανά αίτια εμφάνισης της, το οξειδωτικό στρες και τη φλεγμονή. Στόχος της μελέτης ήταν η διερεύνηση της σχέσης μεταξύ κολπικής ισχαιμίας και μετεγχειρητικής συστηματικής φλεγμονώδους αντίδρασης με την εμφάνιση κολπικής μαρμαρυγής μετεγχειρητικά. Συμμετείχαν 50 ασθενείς που υποβλήθηκαν σε αορτοστεφανιαία παράκαμψη λόγω στεφανιαίας νόσου, οι οποίοι χωρίσθηκαν σε δύο ομάδες: Ομάδα Α και ομάδα Β. Η ομάδα Α περιέλαβε 25 ασθενείς που διατήρησαν το φλεβοκομβικό ρυθμό μετεγχειρητικά και η ομάδα Β περιέλαβε 25 ασθενείς που εμφάνισαν κολπική μαρμαρυγή. Προεγχειρητικά έγινε λεπτομερής μελέτη των στεφανιογραφιών και δόθηκε ιδιαίτερη έμφαση στην εκτίμηση της αιμάτωσης του δεξιού κόλπου-κολποκοιλιακού κόμβου. Στη διάρκεια του χειρουργείου καταμετρήθηκε η θερμοκρασία του δεξιού κόλπου, της αριστερής κοιλίας και του μεσοκοιλιακού διαφράγματος σε σταθερά επιλεγμένες ανατομικές θέσεις πριν, κατά τη διάρκεια του χειρουργείου και αμέσως μετά την έξοδο από την εξωσωματική κυκλοφορία με ειδικό θερμόμετρο. Για να είναι ολοκληρωμένη η μελέτη διερευνήσαμε τους παράγοντες του οξειδωτικού στρες, όπως ομοκυστεΐνη, Β12, φολικό οξύ, ΒΝΡ και Pro-ΑΝΡ, καθώς και από τους παράγοντες φλεγμονής τη C αντιδρώσα πρωτεΐνη. Δεν υπήρχε στατιστική διαφορά (p>0,05) ανάμεσα στις δύο ομάδες ως προς την ηλικία, το χρόνο ισχαιμίας, το χρόνο αποκλεισμού της ανιούσας αορτής, τον αριθμό των αγγείων που έπασχαν, τον αριθμό των αγγείων που έγινε αορτοστεφανιαία παράκαμψη. Από τα αποτέλεσμα της μελέτης, το φολικό οξύ αποτελεί στατιστικά σημαντικό παράγοντα στη διατήρηση του φλεβοκομβικού ρυθμού. Η συστηματική φλεγμονώδης αντίδραση σχετίζεται με την εμφάνιση μετεγχειρητικής κολπικής μαρμαρυγής καθώς και η θερμοκρασία του μυοκαρδίου στη διάρκεια της χειρουργικής επέμβασης όταν η ανιούσα αορτή ήταν κλειστή (μετά τη χορήγηση του καρδιοπληγικού διαλύματος και αμέσως μετά την άρδευση του μυοκαρδίου από την έσω μαστική αρτηρία). Δεν αποτελούν στατιστικά σημαντικούς παράγοντες στην εμφάνιση ή μη της κολπικής μαρμαρυγής η κριτική βλάβη της δεξιάς στεφανιαίας αρτηρίας, η ομοκυστεΐνη, η βιταμίνη Β12 το ΒΝΡ και το Pro-ΑΝΡ

Skin Care Formulations and Lipid Carriers as Skin Moisturizing Agents

Skin care formulations have evolved as the interaction of health and beauty products for the skin. Their benefits are based on the combination of cosmetic active ingredients and targeted application. Cosmetic actives have been used in novel formulations for decades (sunscreens, anti-aging treatments, etc.), but the problems with their low solubility, low penetration, and physicochemical instability when applied to the skin have yet to be solved. One way to circumvent these shortcomings is to use lipid carriers, which are known to play an important role in the solubility of poorly soluble compounds by facilitating skin permeation and improving stability. This review addresses recent advances in skin care products that use novel nanotechnology-based lipid systems (liposomes, solid lipid nanoparticles, etc.) to deliver moisturizing cosmetic actives and improve product efficacy

Design, Synthesis, and In Vitro Activity of Pyrazine Compounds

Despite the fact that there are several anticancer drugs available, cancer has evolved using different pathways inside the cell. The protein tyrosine phosphatases pathway is responsible for monitoring cell proliferation, diversity, migration, and metabolism. More specifically, the SHP2 protein, which is a member of the PTPs family, is closely related to cancer. In our efforts, with the aid of a structure-based drug design, we optimized the known inhibitor SHP099 by introducing 1-(methylsulfonyl)-4-prolylpiperazine as a linker. We designed and synthesized three pyrazine-based small molecules. We started with prolines as cyclic amines, confirming that our structures had the same interactions with those already existing in the literature, and, here, we report one new hydrogen bond. These studies concluded in the discovery of methyl (6-amino-5-(2,3-dichlorophenyl)pyrazin-2-yl)prolylprolinate hydrochloride as one of the final compounds which is an active and acceptable cytotoxic agent

Online Chemical Characterization and Source Identification of Summer and Winter Aerosols in Măgurele, Romania

Aerosols and organic source apportionment were characterized using data collected during two measurement campaigns. These campaigns were conducted during the summer and winter seasons at M˘agurele, a site located southwest of Bucharest, the capital of Romania and one of the largest cities in southeastern Europe (raking seven in Europe based on population). The summer campaign was conducted between 7 June–18 July 2012, and the winter campaign from 14 January–6 February 2013. Approximately 50% of the organic fraction contribution to the total submicron particulate matter sampled by aerosol mass spectrometer was evidenced during both seasons. Submicronic organic aerosol sources were quantified using the positive matrix factorization approach. For warm (summer) and cold (winter) seasons, more than 50% from total organics was represented by oxidized factors. For the summer season, separate analyses were conducted on data influenced by urban and non-urban sources. The influence of pollution from Bucharest on the measurement site was observed in aerosol concentration and composition. The primary organic aerosols have different contribution percentage during summer, depending on their main origin. The influence of Bucharest, during summer, included cooking contribution of 13%. The periods with more regional influence were characterized by lower contribution from traffic and biomass burning in a total proportion of 28%. In winter, the influence of local non-traffic sources was dominant. For more than 99% of the measurements, the biomass burning indicator, f 60, exceeded the background value, with residential heating being an important source in this area. Fossil fuel contribution was confirmed for one week during the winter campaign, when 14C analysis of total and elemental carbon revealed the presence of 17% fossil contributions to total carbon. Mass spectrometry, 14C and absorption data suggest biomass burning as the predominant primary source of organic aerosols for the winter season

A Systematic Review and Meta-Analysis of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Injections in Type-2 Diabetes

Diabetes mellitus (DM) has a growing prevalence worldwide, even in developing countries. Many antidiabetic agents are used to improve glycemic control; however, in cases of an insufficient outcome, insulin is administered. Yet, the timing of proper insulin administration is still a subject of intense research. To date, there have been no recommendations or guidelines for the use of continuous subcutaneous insulin infusion (CSII) in Type 2 Diabetes Mellitus (T2DM). In the present study, we have performed a meta-analysis to evaluate the use of CSII in patients with T2DM. An extensive literature search was conducted through the electronic databases Pubmed, Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) from October 2019–May 2022, for interventional studies related to T2DMI and CSII versus multiple daily injections (MDI). We included articles published in the English language only, yielding a total of thirteen studies. We found better outcomes in patients receiving CSII, in regard to glycated hemoglobin (HbA1c) and total insulin dose. In contrast, fasting plasma glucose and body weight did not show statistically significant differences between the two groups. Our analyses showed that CSII could be beneficial in patients with T2DM in order to achieve their glucose targets

Sarajevo Canton Winter Field Campaign 2018

Nowadays, urban centres in countries of the Western Balkan region (including Bosnia and Herzegovina (B&H)) are experiencing some of the poorest European and global air quality due to the extensive use of solid fuels (e.g., wood, coal) and old vehicle fleet. Western Balkan countries lack state-of-the-art atmospheric sciences research despite high levels of ambient pollution, which makes the efforts to understand the mechanisms of their air pollution imperative. The city of Sarajevo, the capital of B&H, is situated in a basin surrounded by mountains. Particularly during the winter months, topography and meteorology cause significant pollution episodes. The Sarajevo Canton Winter Field Campaign 2018 (SAFICA) took place from Dec 04, 2017 to Mar 15, 2018 with on-line aerosol measurements and collection of daily, continuous filter PM10 samples for off-line laboratory analyses. SAFICA aimed to give the first detailed characterization of the Western Balkans aerosol composition including organic aerosol (OA) to elucidate aerosol emission sources and atmospheric processing and to estimate the adverse health effects. PM10 samples (ntotal=180) were collected at four sites in the Sarajevo Canton: a) Bjelave and b) Pofalići (urban background)c) Otoka (urban)d) Ivan Sedlo (remote). The urban sites were distributed along the city basin to study the pollutants’ urban evolution and the remote site was chosen to compare urban to background air masses. SAFICA PM10 samples underwent different off-line laboratory chemical analyses: 1) Bulk chemical composition of the total filter-collected water-soluble inorganic and OA by a high-resolution Aerodyne Aerosol Mass Spectrometer (AMS). The measured AMS OA spectra were further analysed by Positive Matrix Factorization (PMF) using the graphical user interface SoFi (Source Finder) to separate OA into subtypes characteristic for OA sources and atmospheric processes. 2) Organic and elemental carbon (OC/EC), water-soluble organic carbon, polycyclic aromatic hydrocarbons, levoglucosan, and 14C content of total carbon to evaluate OA chemical composition. 3) Major inorganic anions and cations to evaluate aerosol inorganic species. 4) Metal content in aerosol determined by two analytical techniques (AAS and ICP-MS). SAFICA on-line measurements of black carbon (Aethalometer) and the particle number concentration (Condensation Particle Counter and Optical Particle Sizer) enabled the insights into the daily evolution of primary pollutants and an assessment of aerosol size and number distribution. The combined SAFICA results for on- and off-line measurements will be presented. Our results show that the carbon-containing species make ~2/3 of PM10 mass and the majority are oxygenated, water-soluble OA species with an average OM/OC = 1.9 (Fig.1). Urban air pollution crises in the Western Balkan will be put in the context of local, regional and global air quality. Finally, we will present the scientific questions opened by SAFICA, including the advantages and limitations of SAFICA data set, and give the recommendations for future studies

Oxidative stress-induced inflammation in susceptible airways by anthropogenic aerosol

Ambient air pollution is one of the leading five health risks worldwide. One of the most harmful air pollutants is particulate matter (PM), which has different physical characteristics (particle size and number, surface area and morphology) and a highly complex and variable chemical composition. Our goal was first to comparatively assess the effects of exposure to PM regarding cytotoxicity, release of pro-inflammatory mediators and gene expression in human bronchial epithelia (HBE) reflecting normal and compromised health status. Second, we aimed at evaluating the impact of various PM components from anthropogenic and biogenic sources on the cellular responses. Air-liquid interface (ALI) cultures of fully differentiated HBE derived from normal and cystic fibrosis (CF) donor lungs were exposed at the apical cell surface to water-soluble PM filter extracts for 4 h. The particle dose deposited on cells was 0.9–2.5 and 8.8–25.4 μg per cm2 of cell culture area for low and high PM doses, respectively. Both normal and CF HBE show a clear dose-response relationship with increasing cytotoxicity at higher PM concentrations. The concurrently enhanced release of pro-inflammatory mediators at higher PM exposure levels links cytotoxicity to inflammatory processes. Further, the PM exposure deregulates genes involved in oxidative stress and inflammatory pathways leading to an imbalance of the antioxidant system. Moreover, we identify compromised defense against PM in CF epithelia promoting exacerbation and aggravation of disease. We also demonstrate that the adverse health outcome induced by PM exposure in normal and particularly in susceptible bronchial epithelia is magnified by anthropogenic PM components. Thus, including health-relevant PM components in regulatory guidelines will result in substantial human health benefits and improve protection of the vulnerable population