Assessment of clinical characteristics of cardiac amyloidosis as a potential underlying etiology in patients diagnosed with heart failure with preserved ejection fraction

Background: Heart failure with preserved ejection fraction (HFpEF) is heterogeneous clinical syndrome. Transthyretin cardiac amyloidosis (CA) is an underdiagnosed cause of HFpEF. Red flags are extremely useful for suspecting CA.Aims: We aimed to evaluate the frequency of cardiac and extracardiac manifestations of CA in HFpEF patients based on red flags.Methods: Baseline characteristics of 85 patients were recorded during admission. Electrocardiogram and echocardiography were performed. All patients were examined for red flags. Cardiac scintigraphy was performed in 85 patients.Results: The mean (standard deviation [SD]) age of the study group was 67.9 (9.8) years, and 52 (61.2%) patients were female. At least 1 red flag was observed in 67% of HFpEF patients. Only 4 of the patients had more than 3 red flags. The mean number of red flags in a patient with HFpEF was 1.3. Extracardiac clinical red flags were observed in only 9 (10.5%) patients. Cardiac clinical red flags were extremely rare. An electrocardiographic red flag was detected in 2 out of 10 patients and an echocardiographic red flag in 4 out of 10 patients with HFpEF. Scintigraphy showed that 17.6% of all patients have had a grade 2 or 3 cardiac uptake. The patients with wild-type transthyretin CA had twice as many red flags as those without.Conclusion: The results of the study showed that patients diagnosed with HFpEF had an average of 1.3 red flags suggestive of CA. In real life, extracardiac red flags are rare, while electrocardiographic and echocardiographic red flags are more common in patients with HFpEF

The impact of automatic retractors on the esophagus during anterior cervical surgery: an experimental in vivo study in a sheep model

Object. Postoperative dysphagia is a well-recognized complication of the anterior surgical approach to the cervical spine. However, its incidence and etiology remain unknown. The aim of this study was to investigate the impact of automatic retractor use on the esophagus and to describe the related pathological changes that might occur during cervical spine Surgery

Influences of sulfonated graphene oxide on gas exchange performance, antioxidant systems and redox states of ascorbate and glutathione in nitrate and/or ammonium stressed-wheat (Triticum aestivum L.)

Graphene oxide has unique physiochemical properties and a large surface area. After functionalization, its shape, surface, adsorption capacity, and toxicity levels can change. The potential impacts of sulfonated graphene oxide (SGO, modified with the sulfonic group) on metabolic processes and biological pathways are unanswered questions concerning NO3- or NH4+ toxicity. To fill this gap of knowledge, in the present study, SGO (50-250-500 mg L-1) was applied to Triticum aestivum cv. Ekiz with/without 140 mM nitrate (NS stress) and 5 mM ammonium (AS stress). Both stress treatments suppressed the growth, water content, osmotic potential, and photosynthetic capacity, as detected by a decrease in the carbon assimilation rate (A), stomatal conductance (g(s)), intercellular CO2 concentration (C-i), and transpiration rate (E), and an increase in stomatal limitation. After stress exposure, SGO provided positive responses to these parameters. There were different responses in the antioxidant system under stress: superoxide dismutase (SOD) and peroxidase (POX) under NS stress; SOD, catalase (CAT) and POX under AS and NS + AS stresses. However, hydrogen peroxide (H2O2) and lipid peroxidation increased because lack of effective antioxidant activation. In response to NS or AS, SGO successfully regulated SOD, CAT, glutathione peroxidase (GPX) and the enzyme/non-enzymes related to the AsA-GSH cycle, attenuating the high levels of H2O2, lipoxygenase (LOX) and TBARS-based damage. Along with the antioxidant system, SGO controlled the contents of NO3- or NH4+ by regulation of NPF6.3 and AMT1.2 genes. Interestingly, under NS plus AS, the alleviation action of SGO varied in a concentration-dependent manner: (i) low SGO concentration (50 mg L-1) protected the regeneration of ascorbate (AsA) and glutathione (GSH) and the high activities of GST and GPX; (ii) 250 mg L-1 SGO maintained the GSH redox state and the induced activity of glutathione S-transferase (GST); (iii) the highest SGO concentration (500 mg L-1) did not eliminate H2O2 accumulation, which coincided with the increased levels of TBARS and LOX. The toxicity of the high SGO concentration was further increased in wheat with non-stress or NS plus AS stresses. Our findings specified that the damage stimulated by NS and/or AS stress was removed by SGO applications through the increased antioxidant activity and gas exchange parameters, resulting in the protection of the redox state.Selcuk University Scientific Research Projects Coordinating Office [20401149]The authors would like to acknowledge to Advanced Technology Research and Application Center of Selcuk University for their kind help regarding analysis studies (SEM, HR-TEM, EDS). This work was supported by Selcuk University Scientific Research Projects Coordinating Office (Grant Number 20401149)

Nanomaterial sulfonated graphene oxide advances the tolerance against nitrate and ammonium toxicity by regulating chloroplastic redox balance, photochemistry of photosystems and antioxidant capacity in Triticum aestivum

The current study was designed to assess nanomaterial sulfonated graphene oxide (SGO) potential in improving tolerance of wheat chloroplasts against nitrate (NS) and ammonium (AS) toxicity. Triticum aestivum cv. Ekiz was grown under SGOs (50-250-500 mg L-1) with/without 140 mM NS and 5 mM AS stress. SGOs were eliminated the adverse effects produced by stress on chlorophyll fluorescence, potential photochemical efficiency and physiological state of the photosynthetic apparatus. SGO reversed the negative effects on these parameters. Upon SGOs exposure, the induced expression levels of photosystems-related reaction center proteins were observed. SGOs reverted radical accumulation triggered by NS by enabling the increased superoxide dismutase (SOD) activity and ascorbate (AsA) regeneration. Under AS, the turnover of both AsA and glutathione (GSH) was maintained by 50-250 mg L-1 SGO by increasing the enzymes and non-enzymes related to AsA-GSH cycle. 500 mg L-1 SGO prevented the radical over-accumulation produced by AS via the regeneration of AsA and peroxidase (POX) activity rather than GSH regeneration. 50-250 mg L-1 SGO protected from the NS+AS-induced disruptions through the defense pathways connected with AsA-GSH cycle represented the high rates of AsA/DHA and, GSH/GSSG and GSH redox state. Our findings specified that SGO to NS and AS-stressed wheat provides a new potential tool to advance the tolerance mechanism.Selcuk University Scientific Research Projects Coordinating Office [20401149]The authors would like to acknowledge to Advanced Technology Research and Application Center of Selcuk University for their kind help regarding the analysis study (XRD) . This work was supported by Selcuk University Scientific Research Projects Coordinating Office (Grant Number: 20401149)

Endometrial Staining of CD56 (Uterine Natural Killer), BCL-6, and CD138 (Plasma Cells) Improve Diagnosis and Clinical Pregnancy Outcomes in Unexplained Infertility and Recurrent IVF Failures: Standardization of Diagnosis with Digital Pathology

In women with unexplained infertility (UI) and recurrent in vitro fertilization (IVF) failures, the etiology is often unclear. Endometrial immune perturbations and the use of immune markers associated with these dysregulations are of great interest in the diagnosis and treatment of UI. However, reliable biomarkers and standardized quantification methods are lacking. Here, to address endometrial immune dysregulation in UI patients with recurrent IVF failures, we performed endometrial tissue sampling and immunostaining of CD56 (uNK), CD138, and BCL-6. Of these cases, 57.9% had positive CD56 in the endometrial stroma, while 46.1% had positive BCL-6 in the glandular epithelium, and 14.5% of the cases were found to be positive for CD138. Combined staining rates were 60.5%, 68.4%, and 71.05% for (CD56 or BCL-6), (CD56 or CD138), and (CD56, BCL-6, or CD138), respectively. There was a significant correlation between CD56 and BCL-6 positivity, while CD138 positivity was an independent parameter. After the recommended targeted therapy, pregnancy rates were found to increase from 58.5% to 61.6% and 73.8% in CD56-positive, (CD56- or BCL-6-positive), and (CD56-, BCL-6-, or CD138-positive) cases, respectively. Notably, a retrospective evaluation of digital pathology and light microscopy results showed a significant correlation. This study suggests that the examination of CD56, BCL-6, and CD138 in the same endometrial sample may be an effective method in determining the etiology of UI and reaching an early diagnosis and treatment options. Moreover, digital pathology can be used in the evaluation of CD56 and BCL-6 to provide objective, rapid, and reliable results

Post-discharge heart failure monitoring program in Turkey: Hit-PoinT

WOS: 000396901400006PubMed ID: 27488754Objective: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients. Methods: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC. Education included information on adherence to treatment, symptom recognition, diet and fluid intake, weight monitoring, activity and exercise training. Patients were contacted by telephone after 1, 3, and 6 months. The primary study endpoint was cardiovascular death. Results: Although all-cause mortality didn't differ between the EHFP and RC groups (p=NS), the percentage of cardiovascular deaths in the EHFP group was significantly lower than in the RC group at the 6-month follow up (5.6% vs. 8.9%, p=0.04). The median number of emergency room visits was one and the median number of all cause hospitalizations and heart failure hospitalizations were zero. Twenty-tree percent of the EHFP group and 35% of the RC group had more than a median number of emergency room visits (p=0.05). There was no significant difference regarding the median number of all-cause or heart failure hospitalizations. At baseline, 60% of patients in EHFP and 61% in RC were in NYHA Class III or IV, while at the 6-month follow up only 12% in EHFP and 32% in RC were in NYHA Class III or IV (p=0.001). Conclusion: These results demonstrate the potential clinical benefits of an enhanced HF education and follow up program led by a cardiologist in reducing cardiovascular deaths and number of emergency room visits with an improvement in functional capacity at 6 months in post-discharge ambulatory HF patientsWorking Group on Heart Failure of the Turkish Society of CardiologyThis study had been designed, supported and conducted by the Working Group on Heart Failure of the Turkish Society of Cardiology