Progressive Decrease Research Articles

Autoantibody-based subgroups and longitudinal seroconversion in juvenile-onset systemic lupus erythematosus

ObjectiveTo explore the clinical value of autoantibody-based subgroup framework and the trend of autoantibody fluctuation in juvenile-onset SLE (JSLE).MethodsEighty-seven patients with JSLE were retrospectively collected and divided into subgroups via...

Training Load, Neuromuscular Fatigue, and Well-Being of Elite Male Volleyball Athletes During an In-Season Mesocycle.

Most high-intensity bouts of exercise in volleyball consist of jumping activities, which are responsible for inducing muscle damage, high levels of fatigue, and muscle soreness. Therefore, the aim of the current study was to quantify and analyze the training loads, neuromuscular fatigue, and perceptual well-being of a 5-week in-season mesocycle carried out by a professional male volleyball team. Fifteen volleyball players (age 28.51 [5.39]y; height 193.19 [9.87]cm; body mass 88.46 [13.18]kg) participated in this study. Internal training load assessed through the rating of perceived exertion, external training load (ETL; evaluated using an inertial motion unit), countermovement jump (CMJ) height and peak power, and wellness questionnaire responses were obtained from all athletes. Results indicated a progressive decrease of the internal training load during the week and by the undulatory pattern of the ETL during the microcycles. Moreover, training monotony increased across the microcycles and was negatively associated with CMJ peak power (r = -.681, P < .05). Finally, sleep quality (ρ = -.747, P < .01) and fatigue (ρ = -.789, P < .01) were negatively associated with weekly ETL. This study indicated that sleep quality and fatigue were negatively associated with weekly ETL. Therefore, decreases in weekly ETL might be needed to improve sleep quality and decrease fatigue in professional volleyball players. Plus, higher values of training monotony were associated with lower values of CMJ peak power. Consequently, avoiding training monotony might be important to improve jumping performance in professional volleyball athletes.

EVALUATION OF PHYSIOTHERAPY EFFECTS USING SPECIFIC TESTS IN DUCHENNE MUSCULAR DYSTROPHY – A CASE STUDY

Currently, patients with Duchenne muscular dystrophy manage to reach the fourth or fifth decade of life due to advances in the management of different specialties that are involved through evaluations and anticipatory therapies based on a type of suitable approach for identifying specific medical complications as early as possible. The progressive decrease in muscular strength that affects the cardiovascular, respiratory and musculoskeletal systems needs to be constantly managed. The purpose of this case study is to observe to what extent physiotherapy contributes to the modification of North Star Ambulatory Assessment (NSSA), NM-Score and Vignos Scale in a 27-year-old patient with Duchenne muscular dystrophy. NSAA is used to monitor disease progression and treatment effects but also to measure various motor skills. The NM-Score classifies functional abilities into three main motor domains. The Vignos Scale measures lower limb function. The scores obtained in the initial assessment were 11/34, 2/4, 1/4, 1/4 and 3/10, and the functional recovery treatment was carried out over a period of 6 months. Specific, non-specific and complex physiotherapy methods were used with the main objectives of improving joint range of motion, gait and balance, reducing muscle contractures, increasing endurance and promoting independence in carrying out daily activities. The final assessment showed improvements in all scores, so the objectives were accomplished. Along with the other medical specialties that help dystrophic patients improve their quality of life, physiotherapy plays an important role because movement is the key to a healthy and long life.

Sol-Gel controlled dispersion of Nb within TiO2 to obtain water tolerant catalysts with tunable acid-base properties for dihydroxyacetone transformation

Nanostructured Nb doped TiO2 were prepared by a novel Sol-Gel method using new N‐methyldiethanolamine‐modified precursors of Ti (IV) and Nb(V). Co-hydrolysis of Ti(IV) and Nb(V) precursors in suitable ratio resulted in the introduction of atomically dispersed Nb cation, along with the formation of small Nb oxo clusters homogenously dispersed within the TiO2 matrix. Characterizations showed a progressive decrease of the crystallinity as well as an increase in the defects and the BET surface areas of the TiO2 nanoparticles with the Nb doping. Upon Nb doping, gas phase calorimetry of NH3 and CO2 adsorption, evidenced the acidity but also the basicity increase. The aqueous phase dihydroxyacetone conversion increased significantly over Nb/TiO2 as compared to undoped TiO2. However, upon increasing the Nb doping, the base-catalyzed pathway, which forms hexoses from DHA, became the prevailing mechanism at the expense of the usual acid-catalyzed pathway leading to formation of Pyruvaldehyde.

Undoped and Fe-Doped Anatase/Brookite TiO2 Mixed Phases, Obtained by a Simple Template-Free Synthesis Method: Physico-Chemical Characterization and Photocatalytic Activity towards Simazine Degradation

For the first time, Fe-doping (0.05, 1.0, and 2.5 wt.% Fe) was performed on a high-surface-area anatase/brookite TiO2 by adopting a simple template-free sol-gel synthesis followed by calcination at a mild temperature. The powders’ textural and surface properties were characterized by following a multi-technique approach. XRD analysis showed that the anatase/brookite ratio slightly varied in the Fe-doped TiO2 (from 76.9/23.1 to 79.3/22.7); Fe doping noticeably affected the cell volume of the brookite phase, which decreased, likely due to Fe3+ ions occupying interstitial positions, and retarded the crystallite growth. N2 sorption at −196 °C showed the occurrence of samples with disordered interparticle mesopores, with an increase in the specific surface area from 236 m2 g−1 (undoped TiO2) to 263 m2 g−1 (2.5 wt.% Fe). Diffuse Reflectance UV-Vis spectroscopy showed a progressive decrease in the bandgap energy from 3.10 eV (undoped TiO2) to 2.85 eV (2.5 wt.% Fe). XPS analysis showed the presence of some surface Fe species only at 2.5 wt.% Fe, and accordingly, the ζ-potential measurements showed small changes in the pH at the isoelectric point. The photocatalytic degradation of simazine (a persistent water contaminant) both under UV and simulated solar light was performed as a probe reaction. Under UV light, Fe-doping improved simazine degradation in the sample at 0.05 wt.% Fe, capable of degrading ca. 77% simazine. Interestingly, the undoped TiO2 was also active both under UV and 1 SUN. This is likely due to the occurrence of anatase/brookite heterojunctions, which help stabilize the photogenerated electrons/holes.

Usefulness of Oral Fluid for Measurement of Methylone and Its Metabolites: Correlation with Plasma Drug Concentrations and the Effect of Oral Fluid pH.

The aim of this study was to investigate methylone and its metabolites concentration in oral fluid following controlled increasing doses, focusing on the effect of oral fluid pH. Samples were obtained from a clinical trial where twelve healthy volunteers participated after ingestion of 50, 100, 150 and 200 mg of methylone. Concentration of methylone and its metabolites 4-hydroxy-3-methoxy-N-methylcathinone (HMMC) and 3,4-methylenedioxycathinone in oral fluid were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Pharmacokinetic parameters were estimated, and the oral fluid-to-plasma ratio (OF/P) at each time interval was calculated and correlated with the oral fluid pH using data from our previous study in plasma. Methylone was detected at all time intervals after each dose; MDC and HMMC were not detectable after the lowest dose. Oral fluid concentrations of methylone ranged between 88.3-503.8, 85.5-5002.3, 182.8-13,201.8 and 214.6-22,684.6 ng/mL following 50, 100, 150 and 200 mg doses, respectively, peaked between 1.5 and 2.0 h, and were followed by a progressive decrease. Oral fluid pH was demonstrated to be affected by methylone administration. Oral fluid is a valid alternative to plasma for methylone determination for clinical and toxicological studies, allowing for a simple, easy and non-invasive sample collection.

The predictive role of baseline pulmonary function test in lung carcinoma patients for radiation-induced lung toxicity treated with conformal radiation therapy

Abstract Introduction: Radiation-induced lung toxicity (RILT) is a major concern in patients who receive radiation to thorax. The purpose of the study was to evaluate the changes of pulmonary function tests (PFTs) in lung carcinoma patients treated with three-dimensional conformal radiation therapy (3-D CRT) and relation RILT with dosimetric and nondosimetric factors. Methods: This was a prospective observational study which included 65 patients of lung carcinoma treated with 3-D CRT. PFTs were assessed before the radiotherapy and at third and sixth month post-radiation therapy. Radiation pneumonitis (RP) was graded according to National Cancer Institute Common Toxicity Criteria (CTCAE) version 4.0. Results: Majority of patients already had poor lung function before commencing the radiotherapy. There was a modest decrease in pulmonary function after radiation therapy with (3-D CRT). Postradiotherapy, at third month, eight patients (12%) and at the sixth month, 16 patients (25%) were observed with Grade II RP. At the third month, the nondosimetric factors, age &gt;65 years (P = 0.027) and pretreatment Diffusion capacity of the Lung for Carbon monoxide (DLCO) 60% (P = 0.03) were significantly related to grade ≥ II Radiation pneumonitis (RP). Among dosimetric factors, mean lung dose ≥20 Gy (P = 0.001) and volume receving 20Gy ≥35% (P = 0.05) were significantly related to grade ≥ II RP. These factors were also related to grade ≥ II RP at the sixth month with a significant P value. Conclusion: There is a progressive decrease in pulmonary function after (3-D CRT) in lung carcinoma patients. The study suggested that the baseline PFT may be utilized for the identification of high-risk patients for RILT before starting the radiotherapy in lung carcinoma.

Impact of pneumocystosis on the Spanish health care system, 1997–2020: Profile of HIV and non-HIV immunocompromised patients

BackgroundPneumocystis jirovecii is an opportunistic fungus recognized for causing P. jirovecii pneumonia. The global prevalence is thought to be higher than 400,000 annual cases, although detailed information about epidemiological patterns is scarce. MethodologyA retrospective longitudinal descriptive study was performed among patients with diagnosis of pneumocystosis according to Classification of Diseases 9th edition, Clinical Modification (code 136.3 for the cases from 1997 to 2015; and 10th edition code B59.0 for cases from 2016 to 2020 in Spanish public hospitals from 1 January 1997–31 December 2020. ResultsA total of 25289 cases were diagnosed. The period incidence rate was 2.36 (95 % CI, 2.33–2.39) cases per 100,000 person-years. Infection was more frequent among men (72.2 %) than among women (27.8 %). Comorbidity was the main characteristic of this cohort. Up to 72.3 % of pneumocystis-infected patients (18293) had HIV coinfection. During the study period, there was a progressive decrease in the number of HIV coinfected cases as the group of patients without HIV infection increased, with the largest group in 2017. The lethality rate in the cohort was 16.7 %. The global cost was €229,234,805 and the average ( ± SD) cost per patient was €9065 ( ± 9315). ConclusionsThe epidemiology of pneumocystosis in Spain has changed in the last two decades. We noted in our study the possibility of a reemergence among non-HIV immunocompromised patients as patients with hematological and nonhematological neoplasia and other risk groups. The lethality of pneumocystosis continues to be high, and the underlying diseases are the main variable associated with lethality.

Chronological trends in the causation of malignant mesothelioma: Fiber burden analysis of 619 cases over four decades

Malignant mesothelioma is a relatively rare malignancy with a strong association with prior asbestos exposure. A percentage of cases is not related to asbestos, and fiber analysis of lung tissue is a useful methodology for identifying idiopathic or spontaneous cases. We have performed fiber analyses in more than 600 cases of mesothelioma over the past four decades and were interested in looking for trends in terms of fiber types and concentrations as well as percentages of cases not related to asbestos. Demographic information was also considered including patient age, gender, and tumor location (pleural vs. peritoneal). The histologic pattern of the tumor and the presence or absence of pleural plaques or asbestosis were noted. Fiber analysis was performed in 619 cases, using the sodium hypochlorite technique for digestion of lung tissue samples. Asbestos bodies were counted by light microscopy (LM) and coated and uncoated fibers by scanning electron microscopy (EM). The results were stratified over four decades. Trends that were observed included increasing patient age, increasing percentage of women, increasing percentage of peritoneal cases, and increasing percentage of epithelial histological type. There was a decreasing trend in the percentage of patients with concomitant asbestosis (p < 0.001). The percentage of cases with an elevated lung asbestos content decreased from 90.5% in the 1980s to 54.1% in the 2010s (p < 0.001). This trend also held when the analysis was limited to 490 cases of pleural mesothelioma in men (91.8% in the 1980s vs. 65.1% in the 2010s). There was a decrease in the median asbestos body count by LM from 1390 asbestos bodies per gram of wet lung in the 1980s to 38 AB/gm in the 2010s. Similar trends were observed for each of the asbestos fiber types as detected by EM. We conclude that there has been a progressive decrease in lung fiber content of mesothelioma patients during the past four decades, with an increasing percentage of cases not related to asbestos and an increase in median patient age.

A gradual change is more likely to have caused the Mid-Pleistocene Transition than an abrupt event

The Mid-Pleistocene Transition (~1.2–0.8 million years) corresponds to a time interval when high-amplitude ~100,000 years glacial–interglacial cycles replaced the more subdued ~40,000 years glacial–interglacial cycles. Whether it was triggered by physical processes affecting the climate system at a specific time interval or more gradually over the course of the Pleistocene, is still an open question. Here we use an original approach based on conceptual modelling to identify the temporal structure of the Mid-Pleistocene Transition controlling factors. By comparing our new simulations of global ice volume changes with existing paleo-reconstructions over the past 2 million years, we find that it is more relevant to simulate the Mid-Pleistocene Transition with a gradual-rather-than-abrupt change in the climate system. Our results support the hypothesis that a progressive decrease in atmospheric carbon dioxide concentrations throughout the Pleistocene played a key role in triggering this major climatic transition.

Clinical risk factors for predicting anti-Sars-CoV-2 antibody immunoreactivity duration after mild COVID-19 infection

Introduction: coronavirus disease 2019 (COVID-19) is a complex multisystem disorder. It is not yet well known whether symptoms in the acute phase correlate with the duration of the immune response and the persistence of chronic symptoms.&#x0D; Objective: this study aimed to assess and monitor the clinical symptoms of COVID-19 and correlate them with the production of neutralizing antibodies.&#x0D; Methods: a cohort of 69 health workers at the University Hospital of the Federal University of Espírito Santo (HUCAM-UFES/EBSERH) diagnosed with SARS-CoV-2 infection confirmed via RT-PCR (Real-Time Reverse Transcription–Polymerase Chain Reaction) were evaluated from the onset of symptoms up to six months. SARS-CoV-2 IgG and IgM assays were used to detect the presence of IgG and IgM against the nucleocapsid protein of SARS-CoV-2 in serum samples. IgG and IgM antibody serology, pulmonary function via spirometry, and the clinical evolution of patients were performed at 15, 30, 45, 60, 90, and 180 days after the onset of COVID-19 symptoms.&#x0D; Results: sixty-nine health workers (age, 40 ± 10 years; 74% women) were evaluated for six months. All subjects showed mild to moderate COVID-19. The mean number of symptoms was 5.1 (± 2.3). The most common initial symptoms were muscle pain (77%), headache (75%), anosmia (70%), ageusia (64%), runny nose (59%), fever (52%), and coughing (52%). After 30 days, the patients had anosmia (18%), asthenia (18%), adynamia (14%), muscle pain (7%), and ageusia (7%). Regarding lung function, 9.25% presented with an obstructive pattern, and all recovered after six months. Of all analyzed participants, 18/69 (26%) did not have any reactive IgG or IgM values in any of the assessments. The IgG serology curve showed a peak, whereas IgM had the highest mean value on the 15th day. There was a progressive decrease and levels similar to those at baseline after 90 days, and 15/53 (28%) remained with reactive IgG after six months. Sore throat and shortness of breath were found to be independent risk factors, and patients with these symptoms were 5.9 times more likely to have reactive IgG on the 180th day. Patients with diarrhea were four times more likely to have reactive IgM.&#x0D; Conclusion: our findings showed that 26% of patients did not produce a humoral response post-mild COVID-19. Their antibody titers dropped significantly after 90 days, and only 28% maintained reactive IgG antibodies after six months. Sore throat and shortness of breath are predictors of a longer duration of the humoral immune response.

Impact of comorbidities on hospital mortality in patients with acute pancreatitis: a population-based study of 110,021 patients

BackgroundThe impact of pre-existing comorbidities on acute pancreatitis (AP) mortality is not clearly defined. Our study aims to determine the trend in AP hospital mortality and the role of comorbidities as a predictor of hospital mortality.MethodsWe analyzed patients aged ≥ 18 years hospitalized with AP diagnosis between 2016 and 2019. The data have been extracted from the Spanish National Hospital Discharge Database of the Spanish Ministry of Health. We performed a univariate and multivariable analysis of the association of age, sex, and comorbidities with hospital mortality in patients with AP. The role of the Charlson and Elixhauser comorbidity indices as predictors of mortality was evaluated.ResultsA total of 110,021 patients diagnosed with AP were hospitalized during the analyzed period. Hospital mortality was 3.8%, with a progressive decrease observed in the years evaluated. In multivariable analysis, age ≥ 65 years (OR: 4.11, p < 0.001), heart disease (OR: 1.73, p < 0.001), renal disease (OR: 1.99, p < 0.001), moderate-severe liver disease (OR: 2.86, p < 0.001), peripheral vascular disease (OR: 1.43, p < 0.001), and cerebrovascular disease (OR: 1.63, p < 0.001) were independent risk factors for mortality. The Charlson > 1.5 (OR: 2.03, p < 0.001) and Elixhauser > 1.5 (OR: 2.71, p < 0.001) comorbidity indices were also independently associated with mortality, and ROC curve analysis showed that they are useful for predicting hospital mortality.ConclusionsAdvanced age, heart disease, renal disease, moderate-severe liver disease, peripheral vascular disease, and cerebrovascular disease before admission were independently associated with hospital mortality. The Charlson and Elixhauser comorbidity indices are useful for predicting hospital mortality in AP patients.

THE CONTRIBUTION OF DIFFUSION TENSOR IMAGING TO CONVENTIONAL MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF MULTIPLE SCLEROSIS PATIENTS

Aim: The aim of this study is to investigate whether anisotropic diffusion is superior to conventional magnetic resonance imaging for understanding the pathophysiology of multiple sclerosis (MS) disease by Fractional anisotropy (FA) measurements.&#x0D; Material and Methods: In our study, FA measurements were made from the plaque, the periplaque area, the normal appeared white matter contralateral to the plaque and normal appearing white matter areas in MS patients and from the normal white matter in the control group. 3D trography maps were made in all MS patients and it was evaluated whether white pathways were affected by MS disease.&#x0D; Results: When the degree of anisotropy was compared to the control group, the degree of plaques was found lowest. Increase was observed in periplaque, the normal appeared white matter contralateral to the plaque and normal appearing white matter, respectively. The active plaque FA value was found to be lower than the chronic plaque FA value, and the chronic plaque FA was found to be lower than the normal white matter FA value. It has been shown that plaques traced along axonal pathways in MS patients cause interruption in axonal pathways. &#x0D; Conclusion: Progressive decrease in anisotropy from normal appearing white matter to periplaque white matter and plaque level indicates myelin damage. This suggests that the white matter that appears normal on T2 images on conventional MR is not actually normal. Based on these results, it was thought that diffusion tensor imaging would be useful in evaluating the burden of disease in MS patients.

Age dynamics of the morphological structure of the cavernous arteries in healthy men according to complex morphometric analysis

Background. Erectile dysfunction is associated with systemic vascular diseases and, to a greater extent, with age, while there is insufficient data in the literature on the morphological state of the cavernous arteries (CA) in men of different ages in normal.Aim. A detailed morphometric assessment of the CA of men of various ages in the absence of signs of atherosclerosis and hypertension.Materials and methods. The material was transverse fragments of cavernous bodies with paired CA obtained during autopsy (58 observations, a total of 116 CA were examined). Hematoxylin and eosin, fuchsylin and picrofuxin, and Mallory staining were used. Detailed morphometric analysis was carried out according to the original method by measuring the perimeter and then calculating the area of the corresponding component of the vascular wall.Results. In the studied age range from 17 to 74 years, there was an increase in the total area of the CA from 0.76 mm2 in the age period of 17–21 years to 0.99 mm2 in the period of 36–60 years and a decrease to 0.43 mm2 at the age of 61–74 years. А similar increase in absolute indicators of the area of the lumen with a decrease in old age was revealed. The absolute area of intimacy and media, increasing by the age of 36–60 years, also significantly decreases in the age range of 61–74 years. At the same time, the relative area of intima to the vessel lumen has insignificant fluctuations, remaining a stable value in all age groups. The specific area of intima relative to the entire area of the vessel as a whole has a stable indicator, increasing in old age. The Kernogan Index tends to decrease throughout the studied age range from 33 to 26 %, which indicates the preservation of the spacecraft throughput in all the studied groups, including the elderly. This is also evidenced by the dynamics of the ratio of the diameter of the CA lumen to the thickness of the vessel wall, including intima and media, reaching maximum values of 4.15 by the period of 36–60 years, remaining at a high level of 3.53 and in the oldest age group. At the same time, the specific share of media significantly decreases in all groups of the studied age range of 17–74 years from 62.1 to 50.5 %. The ratio of the maximum lumen area of the vessel to the minimum as an indicator of the potential possibility of increasing the lumen of the spacecraft turned out to be maximum atthe ages of 17–21 years and 22–35 years,significantly decreasing in older age groupsfrom 176 to 130 %.Conclusion. Age-related remodeling of the spacecraft consistsin fairly stable morphometric parameters of the spacecraft in the age range from 17–21 years to a period of 36–60 years with a decrease at an older age, when a decrease in the absolute area of the lumen and the entire spacecraft isrevealed. A significant progressive decrease in the specific proportion of media and an increase in the proportion of intima in the structure of the vessel wall are shown. At the same time, up to the age of 36–60 years, spacecraft maintain their throughput indicators at a high level. Further studies of CA in vascular pathology may be useful in understanding the causes and mechanisms of the association of erectile dysfunction with the age of men.

Predyktory prohnozuvannia sertsevo-sudynnykh podii ta inshykh uskladnen systemy krovoobihu u khvorykh iz hostrym koronarnym syndromom (ohliad literatury; rezultaty vlasnykh doslidzhen)

Introduction. More than 15 million cases of AMI are recorded annually in the world, and in Ukraine in 2017 – 41.786 cases. Undoubtedly, acute coronary syndrome (ACS) manifests various complications of blood flow. At the same time, in such patients, significantly fewer works are devoted to predictors of other complications of the cardiovascular system. The aim of the study. Write a literature review and include the results of own research on predictors of predicting cardiovascular events and other complications of the blood flow system in ACS. Materials and methods. We used 49 published articles and our own research results on the study of predictors of predicting cardiovascular events and other complications of the blood flow system after undergoing ACS. The results of our own research are presented in a complex algorithm for predicting SCD in cardiovascular pathology, and our own criteria for cardiovascular events are given. Results. It has been proven that an increase in the thickness of the LV wall in patients with hypertension can be associated with an almost 7-fold increase in the risk of death. In our opinion, LVH in STEMI in combination with hypertension has a negative impact on the development of cardiovascular events. The development of pathological remodeling of the LV leads to further dilatation, deformation of the walls and cavities of the heart, a progressive decrease in the inotropic function of the LV with the development of congestive heart failure. Some authors suggest prognostic predictors of the development of acute left ventricular failure. The prognostic role of endothelial dysfunction in cardiovascular events is poorly understood. Conclusions. In recent years, predictors of the development of cardiovascular events (death, non-fatal MI, stroke, UA), as well as such complications of the blood flow system as acute left ventricular failure, progression of heart failure, development of VE 3-5 grades according to Laun have been established in patients with a transferred STEMI and UA in recent years , severe heart blocks with the occurrence of syncopal states. According to our data, clinical, ECG, and echocardiographic diagnostic criteria are predictors of cardiovascular events. The specified predictors of cardiovascular events and various complications of the blood flow system after a STEMI and UA need to be taken into account by cardiologists, emergency physicians, and family physicians in their practice and to carry out therapeutic measures aimed at preventing their occurrence in patients.

Acute myocardial calcification in a patient with fulminant myocarditis.

Relationship with Industry: None A 38-year-old man was admitted with a 3-week history of rapid clinical deterioration. The patient presented with multisystem inflammatory syndrome associated with multi-organ failure (white blood and polynuclear cells counts at respectively 54.40 and 51.60 *109/L; C-reactive protein, Ferritin and Fibrinogen levels at respectively, 214 mg/L, 1624 μg/L, and 8.31 g/L; and creatinine and bilirubin levels at respectively 397 μmol/L (4,49 mg/dL) and 57 μMol/L (3,33 mg/dL)). Large screening and multiple testing for bacterial and viral infections remained negative in a patient with Covid-19 infection 3-months earlier without vaccination. The patient was transferred to the Intensive Care Unit necessitating mechanical ventilation, hemodialysis, and inotropic support. Rapidly, diffuse ST elevation on electrocardiogram and increased levels of high-sensitivity cardiac I troponin (hs-cTnI = 135000 ng/L) and natriuretic peptide (NT-ProBNP = 72114 ng/L) were found. Coronary angiogram showed no significant coronary disease and transthoracic echocardiography (TTE) showed reduced left ventricular ejection fraction (LVEF = 40%). Cardiac magnetic resonance imaging confirmed diffuse and extensive gadolinium uptake. Despite negative cardiac biopsies, the diagnosis of fulminant myocarditis was made and the patient underwent corticosteroids bolus and intravenous immunoglobulin therapies. Clinical evolution was deemed favourable with a progressive decrease in systemic inflammatory process associated with a decrease in cardiac biomarkers levels. However, 2 weeks later, chest X-ray (Panel A) and TTE (Panel B) showed acute and impressive left ventricular calcified remodelling process with diffuse epicardial calcification and septal patchy fibrosis (whites triangles). The positron emission tomography (PET-CT) confirmed the diffuse FDG uptakes suggesting persistent local inflammatory process (Panel C) associated with large epicardial calcified remodelling (Panel D). The patient was discharged 1 month after the index admission with optimized heart-failure therapy and planned follow-up at the Heart Failure Clinic.

Hormonal imbalance in patients with chronic renal failure in the pre-dialysis and dialysis periods (part1)

The review describes the problem of studying progressive changes of hormones concentrations (parathyroid hormone, insulin, somatotropin, prolactin) in patients with chronic renal failure on the pre-dialysis and dialysis stages. The pathogenetic relationships between kidney function deterioration and hormone concentrations as well as changes of their biological effects were evaluated. Parathyroid hormone is considered as an uraemic toxin, since its concentration in the blood begins to increase when the glomerular filtration rate decreases below 50 ml/min. All stages of chronic kidney disease are accompanied by disorders of calcium-phosphorus metabolism. Prolonged excess of parathyroid hormone leads to bone loss and to the progression to secondary hyperparathyroidism that is a frequent complication in patients with the later stages of chronic renal failure and, especially, in those on dialysis treatment. The elevation of insulin level in chronic renal failure is the consequence of progressive decrease in glomerular filtration rate and insulin excretion by proximal tubules. So, it results in insulin half-life prolongation. Long-term dialysis therapy eliminates factors that reduce the degradation of insulin by extrarenal tissues, which results in an improvement of their insulin sensitivity. Experimental and clinical studies have shown that an excess of somatotropin can adversely affect the kidneys that leads to glomerular hyperfiltration and the progression to glomerulosclerosis. The risk of possible side effects on kidneys should be taken into account when prescribing recombinant human insulin-like growth factor. The prolactin concentration is usually increased in chronic kidney disease due to reduced clearance and increased secretion. Hyperprolactinemia manifests as galactorrhea and hypogonadism. Dialysis therapy can’t normalize the increased concentration of prolactin. Modern options for pathogenetic treatment of endocrine disorders in patients with chronic renal failure are outlined in this article. It was found that kidneys play an important role in regulating hormones concentrations in the blood. Endocrine disorders are one of the most important components of the uraemic syndrome, which requires further clinical studies, aimed on the searching of better treatment strategies and prevention of hormonal imbalance on the pre-dialysis and dialysis stages of chronic kidney disease.

Postoperative discoloration of a multifocal hydrophobic acrylic lens: case report with laboratory analyses

Introduction: A case of discoloration of a multifocal hydrophobic acrylic intraocular lens (IOL), which was explanted and exchanged as well as underwent laboratory analysis, is reported. Patient and Clinical Findings: The patient presented with a corrected distance visual acuity of 20/50 and glare in the right eye 8 years after implantation. Slitlamp examination revealed a nasally decentered IOL with a whitish-brownish haze throughout. Diagnosis, Intervention, and Outcomes: The discolored IOL (ZMB00) was explanted and exchanged for a 3-piece IOL (sulcus fixation). Grossly, the explanted IOL showed a whitish discoloration of the optic only after hydration, corresponding to a yellowish-brownish discoloration observed under light microscopy. Back light scattering revealed bulk scatter throughout the optic. Light transmittance (%T) showed a slight progressive decrease starting at 500 nm when compared with %T in the directions for use (DFUs). Although modulation transfer function analysis demonstrated similar values to the control lens, the contrast of U.S. Air Force targets appeared slightly decreased. Conclusions: To the authors' knowledge, this is the first reported case of a discolored ZMB00 IOL that underwent explantation and laboratory assessment. Although current analyses did not reveal the etiology of the discoloration, surgeons should be aware of this possible occurrence with this lens design and carefully assess signs and symptoms before explantation.

The dynamics of neutralizing antibodies against SARS-CoV-2 in cats naturally exposed to virus reveals an increase in antibody activity after re-infection

Severe Acute Respiratory Syndrome Coronavirus 2 is the causative agent of Coronavirus Disease 2019 in humans. To date, little is known about the persistence of antibodies against SARS-CoV-2 in animals under natural conditions, in particular susceptible pets such as cat. This study reports the detection and monitoring of the humoral response against SARS-CoV-2 including the detection of immunoglobulins G specific for receptor binding domain of SARS-CoV-2 spike protein by an enzyme-linked immunosorbent assay and neutralizing antibodies by virus neutralization assay. Results showed that these antibodies last longer than 16 months in two naturally apparently healthy infected cats with the absence of clinicopathological findings during the follow-up. Moreover, re-infection is also possible with an important increase in virus neutralization test titers in both animals with no evident systemic signs found during each physical examination and with values of hematologic and biochemical parameters inside the normal reference intervals. Our results confirm a slow but progressive decrease of the kinetics and immunity of neutralizing antibodies in cats after the infection. Furthermore, similar to humans SARS-CoV-2 reinfection can stimulate an increase of the neutralizing antibodies determined by these two serological techniques in domestic cats.

Follicular Atresia, Cell Proliferation, and Anti-Mullerian Hormone in Two Neotropical Primates (Aotus nancymae and Sapajus macrocephalus).

This study evaluated the follicular atresia, cell proliferation, and anti-Mullerian hormone action in Aotus nancymae and Sapajus macrocephalus during three sexual phases (follicular, luteal, and gestational). Follicular quantification and immunolocalization of Caspase-3 protein, B-cell lymphoma 2 (BCL-2), proliferating cell nuclear antigen (PCNA), and anti-Mullerian hormone (AMH) were performed. A significant difference in the quantification between preantral and antral follicles, with a progressive decrease in the antrals, was identified. Protein and hormonal markers varied significantly between follicle cell types (A. nancymae p = 0.001; S. macrocephalus, p = 0.002). Immunostaining in the preantral and antral follicles was present in all sexual phases; for Caspase-3, in granulosa cells, oocytes, and stroma; for BCL-2, in granulosa cells, oocytes, and theca; and for PCNA and AMH, in oocytes and granulosa cells. The immunostaining for Caspase-3 was more expressive in the preantral follicles (follicular phase, p < 0.05), while that for BCL-2 and PCNA was more expressive in the antral follicles of the follicular phase. The AMH was more expressive in the primary and antral follicles of nonpregnant females, in both the follicular and luteal phases. Our results contribute to understanding the ovarian follicular selection, recruitment, and degeneration of these species.