The effect of continuous positive airway pressure treatment on hypertensive disorder in pregnant women with obstructive sleep apnea.

PURPOSE: Our study aimed to determine the effect of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) on the incidence and severity of hypertensive syndrome in pregnancy. METHODS: The study included women with high-risk pregnancies and the Epworth Sleepiness Scale score ≥ of 10. Polygraphic testing was done between 18 and 20 weeks. Participants were divided into three groups: pregnant women with OSA starting treatment with CPAP for 4 weeks between 24 and 28 gestational weeks, women with OSA treated conservatively, and women without OSA as the control group. Participants were followed up regularly for 4 weeks until the delivery and 1 week after for the occurrence of hypertensive syndrome and other maternal complications. RESULTS: Among the 110 women enrolled in the study, the prevalence of hypertensive syndrome in 41 pregnant women with OSA treated conservatively was 39%, 50 women with OSA treated with CPAP 26%, and 19 women in the control group 21%, p = 0.1. The group treated with CPAP when compared with the conservatively treated group had a significantly lower incidence of severe forms of hypertensive syndrome (8% vs. 24%, p = 0.02.), and after 1 month of treatment had higher night oxygen saturation (92%, vs. 87%, p = 0.003) and lower Epworth Sleepiness Scale score (respectively, 4.2 ± 2.3 vs. 9.4 ± 4.1, p < 0001). The respiratory event index was significantly associated with hypertension severity (patients with preeclampsia 9.5 ± 4.9 vs. without hypertension 6.9 ± 4.5, p = 0.04). CONCLUSION: CPAP therapy significantly reduced the incidence of severe forms of hypertensive syndrome in pregnant women with OSA.

Catalytic pyrolysis of mechanically non-recyclable waste plastics mixture: Kinetics and pyrolysis in laboratory-scale reactor.

Post-consumer waste plastics that cannot be mechanically recycled represent a concerning environmental issue. According to the latest available data for Europe, as much as 25% of collected post-consumer waste plastics are landfilled, 43% is energy recovered, and 32% is recycled. One possible way of recovering non-recyclable plastics is pyrolysis, which is considered environmentally friendly technology for obtaining fuel or chemicals from plastic waste. To tackle the challenge of recovering non-recyclable plastics via pyrolysis, it is necessary to determine their actual composition. Visual separation of collected non-recyclable plastics was performed, and Fourier-transform infrared spectroscopy was used to confirm the accuracy of visual separation. A significant amount of plastics labelled as "other" was found. Since the composition of "other" waste plastics has not been sufficiently investigated, relatively few studies on their pyrolysis have been conducted. Therefore, they were characterised and added to the mixture with other found polymer types of non-recyclable plastics. Thermogravimetric analysis was conducted to determine thermochemical behaviour and kinetic parameters required for laboratory pyrolysis investigation. Kinetic analysis was conducted using the Friedman isoconversional model-free method and non-linear multivariate regression method. The goal of this paper was to analyse the kinetics, determine the product yield and characteristics of the pyrolysis process of non-recyclable plastics over zeolite catalysts. It was found how the decomposition of non-recyclable plastics occurs in two decomposition steps. The activation energy of non-recyclable plastics was 144 kJ/mol in the first stage of decomposition and 262 kJ/mol in the second stage of decomposition. It decreased by 34% and 6.5% after fresh fluid catalytic cracking catalyst was added and 41% and 18.3% with iron-modified Zeolite Socony Mobil-5 catalyst. The yield of condensate was 55% (wax) for the original sample, and it decreased to 50% (wax and oil) and 27% (mostly oil) with fresh fluid catalytic cracking and iron modified Zeolite Socony Mobil-5 catalysts. Processes with catalysts promoted the formation of olefins and aromatic compounds in pyrolytic oil. All pyrolysis products had a high value of higher heating value ranging from 39 MJ/kg to 43 MJ/kg showing good potential for further energy use.

[Drugs and urinary incontinence : Should we consider it ?] / Médicaments et incontinence urinaire : faut-il y penser ?

Urinary incontinence is a common urological condition. It is classified into several subtypes, among which most frequently encountered are stress, urgency and mixed incontinence. Urinary continence depends on many physiological factors, some of which can potentially be influenced by numerous medications. The most commonly implicated drugs in urinary incontinency are antipsychotics, antidepressants, benzodiazepines, alpha blockers, diuretics, and hormone replacement therapy for menopause. Although the prescription of these types of drugs continues to increase, their effect on continence has received little attention from prescribers.

L'incontinence urinaire est une affection urologique fréquente. Elle se classe en plusieurs types dont les plus fréquemment rencontrés sont les incontinences d'effort, d'urgence et mixte. La continence urinaire dépend de nombreux facteurs dont certains peuvent potentiellement être influencés par de nombreux médicaments. Les classes médicamenteuses le plus souvent incriminées dans l'incontinence sont les antipsychotiques, les antidépresseurs, les benzodiazépines, les alphabloquants, les diurétiques et les traitements hormonaux de substitution de la ménopause. Bien que la prescription de ces types de médicaments ne cesse d'augmenter, leur effet sur la continence est peu abordé par les prescripteurs.

Association of locally produced IL10 and TGFb1 with tumor size, histological type and presence of metastases in patients with lung carcinoma.

PURPOSE: Advanced lung carcinoma is charasterized with fast disease progression. Interleukin (IL)10 and transforming growth factor (TGF)b1 are immunosuppressive mediators and their role in lung carcinoma pathogenesis and in the antitumor response has not yet been elucidated. The purpose of this study was to correlate IL10 and TGFb1 levels in the serum and lung tumor microcirculation with clinical stage, disease extent, histological features and TNM stage. METHODS: The study included 41 lung cancer patients in clinical stage III and IV. Histological type was determined immunohistochemically, while tumor size, localization and dissemination were determined radiologically by multislice computerized tomography (MSCT). IL10 and TGFb1 levels were quantified with commercial flow cytometric test in serum and lung tumor microcirculation samples. RESULTS: Non small cell lung cancer (NSCLC) patients had significantly elevated TGFb1 while small cell lung cancer (SCLC) patients had significantly increased IL10 in tumor microcirculation. IL10 was significantly elevated in patients with the largest tumors, as well as in patients with III clinical stage and without metastases, both in the serum and tumor microcirculation. TGFb1 was significantly increased in serum and tumor microcirculation in patients with larger tumors. We found significant correlation between these two immunosuppressive cytokines, IL10 and TGFb1, in tumor microcirculation but not in patient serum samples. CONCLUSION: IL10 and TGFb1 in systemic and tumor microcirculation are significantly associated with particular histological type of lung cancer, tumor size and degree of disease extent.

Fast determination of diesel fuel oxidation stability by 1H NMR spectroscopy.

(1)H NMR spectroscopy and multiple linear regression analysis were used to determine diesel fuel oxidation stability. Oxidation stability is one of the most important properties which affect diesel fuel characteristics and quality. It has been demonstrated that integrated peak intensities of certain functional groups in (1)H NMR spectra correlated well with the oxidation stability. This approach is fast, nondestructive and requires small amounts of samples. It has a potential to be used as an alternative to existing standard methods.

Condensation reaction between carbohydrazide and salicylaldehyde: in-line vibrational spectroscopy monitoring and characterization of the reaction products in solution and solid state.

The condensation reaction between carbohydrazide and salicylaldehyde was monitored in-line by using vibrational NIR and Raman spectroscopies and statistical methods. Prior to in-line data analysis the reaction products were fully characterized in solution and solid state in order to check the potential of the in-line approach as a tool for in-process Schiff bases reaction control. It was demonstrated that a combination of vibrational spectroscopy and principal component analysis made it possible to detect and identify the reaction products, e.g. mono(salicylidene)carbohydrazide (1) and bis(salicylidene)carbohydrazide (2) in different solvents, and to determine the reaction end points in real time. Owing to complexity of the reaction mixtures and band overlapping, it was not possible to determine the relative ratio of the reaction products in-line. The off-line analysis showed that 1 was predominant in methanol while the highest portion of 2 was obtained in ethanol.

Case Report: Labor induced coccydynia associated with Modic I changes successfully treated with platelet-rich plasma.

Imaging can aid in determining potential causes of coccygeal pain and therefore guide clinicians to carry out individualized treatment. We represent a case of postpartum coccydynia treated by platelet-rich plasma (PRP) which was assessed and followed by MRI. A primipara with uncomplicated labor developed coccygeal pain after delivery that significantly limited her postpartum recovery. On the first MR scan, recorded 6 months after delivery, there were edematous changes of the vertebral endplates of Co1-4 level (Modic type I) with the presence of pronounced precoccygeal venous drainage. Degenerative changes with signs of edema in the area of the pubic symphysis were recorded. The sacroiliac joints had regular morphological features. Since the patient was breastfeeding, PRP therapy was applied with a total of three injections in the area of the coccyx subcutaneously, once every 3 months. The subjective feeling of pain reduction after each injection was about 30%, with the complete withdrawal of pain after one year and still pain-free at the two-year follow-up. One year after the initial MR imaging, a follow-up MR examination was performed, where almost complete resolution of edematous changes in the previously present zones was observed, with residual minor edema of the vertebral endplates at the Co2-3 level. Edema of the pubic bones in the area of the pubic symphysis also subsided. A case of labor-induced coccydynia that was represented as Modic type I changes without neither fracture or luxation was successfully treated with PRP with complete resolution of symptoms.

Effects of bioreactive acrolein from automotive exhaust gases on human cells in vitro.

Acrolein is a toxic unsaturated aldehyde and widespread environmental pollutant produced during lipid peroxidation and also by burning of tobacco or liquid fuels. Inhalation or dermal exposure to acrolein could be toxic to organisms. This very reactive aldehyde has a strong affinity for binding to proteins thus forming pathogenic protein-adducts. In the present study we have analyzed formation of bioreactive acrolein-protein adducts in bovine serum albumin solution exposed to exhaust gases of mineral diesel fuel and of mineral diesel fuel supplemented with different amounts of a novel diesel fuel additive denoted Ecodiesel (produced by a genuine procedure of recycling of plant oils used for food preparation). The effects of acrolein-protein adducts were tested on human microvascular endothelial cells and on human osteosarcoma cells that are sensitive to bioactivities of lipid peroxidation products. The results have shown a reduction of the bioreactive acrolein in exhaust gases when mineral diesel was supplemented with 5-20% Ecodiesel. Moreover, acrolein-protein adducts obtained from mineral diesel supplemented with Ecodiesel were less toxic than those obtained from mineral diesel alone. Thus, we assume that supplementing mineral diesel fuel with Ecodiesel would be of benefit for the use of renewable energy, for environment and for human health due to reduced environmental pollution with bioreactive acrolein.

Improvement of the Nutraceutical Profile of Brewer's Spent Grain after Treatment with Trametes versicolor.

Brewer's spent grain (BSG) is an important secondary raw material that provides a readily available natural source of nutraceuticals. It finds its largest application as animal feed and part of the human diet, while the future perspective predicts an application in the production of value-added products. In order to investigate a sustainable BSG treatment method, two BSG samples (BSG1 and BSG2) were evaluated as substrates for the production of hydrolytic (xylanase, ß-glucosidase and cellulase) and lignolytic enzymes (laccase, manganese peroxidase and lignin peroxidase) by solid-state fermentation (SSF) with Trametes versicolor while improving BSG nutritional value. The biological treatment was successful for the production of all hydrolytic enzymes and laccase and manganese peroxidase, while it was unsuccessful for the production of lignin peroxidase. Because the two BSGs were chemically different, the Trametes versicolor enzymes were synthesized at different fermentation times and had different activities. Consequently, the chemical composition of the two BSG samples at the end of fermentation was also different. The biological treatment had a positive effect on the increase in protein content, ash content, polyphenolic compounds, and sugars in BSG1. In BSG2, there was a decrease in the content of reducing sugars. Cellulose, hemicellulose, and lignin were degraded in BSG1, whereas only cellulose was degraded in BSG2, and the content of hemicellulose and lignin increased. The fat content decreased in both samples. The safety-related correctness analysis showed that the biologically treated sample did not contain any harmful components and was therefore safe for use in nutritionally enriched animal feed.

Interactions of Aminopropyl-Azithromycin Derivatives, Precursors in the Synthesis of Bioactive Macrozones, with E. coli Ribosome: NMR and Docking Studies.

The structure and interactions of several aminopropyl-azithromycin derivatives (1a-c) have been studied by using NMR spectroscopy and docking calculations. Compounds 1a-c are precursors in the synthesis of macrozones, novel bioactive azithromycin-thiosemicarbazone conjugates active against some resistant bacterial strains. Today, bacterial resistance is considered as one of the major threats to human health. Knowledge on drug binding mode and conformations is one of the key factors in the process of designing molecules to fight resistance. In solution state, compounds 1a and 1c exist in the 3-endo-folded-out conformation, while 1b adopts a classical folded-out conformation. 13C and 15N CPMAS NMR spectra pointed towards similar structures in the solid state. The transferred NOESY NMR spectra confirmed binding to the E. coli ribosome and suggest that dominant conformations in the bound state resemble those in the free one. STD experiments identified reactive groups of 1a-c in close contact with the ribosome resembling binding epitopes observed for the related 15-membered macrolides. Docking studies revealed that the studied compounds bind to the same ribosome binding pocket similarly to erythromycin in the crystal state, and that the binding is achieved through H-bonds and van der Waals interactions. The bound conformation is the same as determined by NMR. STD enhancements observed for methylene protons in the aminopropyl side chain indicate additional interactions which contribute to the overall binding energy.

Ocular rosacea and treatment of symptomatic Helicobacter pylori infection: a case series.

Rosacea is a chronic inflammatory skin disease characterized by recurrent episodes of facial flushing, erythema, papules, pustules, and telangiectasia. More than half of all rosacea patients may have ocular symptoms. Rosacea is associated with certain digestive diseases, such as gastritis, hypochlorhydria, or a number of jejunal mucosal abnormalities, and many patients have Helicobacter pylori infection. The role of Helicobacter pylori has often been a subject of investigation; these studies show conflicting results. Here we present results of the effects of treatment given for H. pylori eradication in seven patients with ocular rosacea that, at the same time, had clinical and serological evidence of H. pylori infection. Six weeks after completion of the treatment, all patients experienced improvement of their rosacea symptoms. Ocular disease responded better than cutaneous rosacea.

Pseudomesotheliomatous carcinoma of the lung.

Introduction: Pseudomesotheliomatous lung carcinoma is a special, rare entity characterized by large pleural growth and minor invasion of lung tissue. Clinically, radiologically, macroscopically and even histologically this tumor can be misdiagnosed as malignant pleural carcinoma. Case report: We represent a 64-year-old male patient, former smoker. Due to difficulties in the form of dry cough, feeling of dis-comfort and pain in the right hemithorax, fatigue, heavy breathing, sweating, fever up to 39.6°C the patient was treated as with combined antibiotic therapy (macrolides, cephalosporins and penicillin), but without improving of his condition. Chest radiography showed a shadow of pleural effusion by the height of the front end of the third right rib. Chest MSCT showed the extremely thickened pleura apically and to the posterior along the upper right lobe in addition to existence of massive pleural effusion. Subpleural condensation of parenchyma ranging about 30 mm was described in the upper right lobe. Cytological analysis of the pleural effusion showed the presence of malignant cells impossible to differentiate whether they were metastasis of adenocarcinoma or malignant pleural mesothelioma. By histochemical and immunohistohemical analyses of a pleural sample, pseudomesotheliomataus lung adenocarcinoma was diagnosed. Conclusion: Pseudomesotheliomataus carcinoma of the lungs can be a diagnostic problem. Its diagnosis is based on recognition of histopathological characteristics which enable its discernment from the epithelial variant of malignant pleural mesothelioma.

Disseminated typical bronchial carcinoid tumor.

INTRODUCTION: Bronchial carcinoids belong to a rare type of lung tumors. If they do not expose outstanding neuroendocrine activity, they develop without clearly visible symptoms. They are often detected during a routine examination. According to their clinical pathological features, they are divided into typical and atypical tumors. Typical bronchial carcinoids metastasize to distant organs very rarely. Localized forms are effectively treated by surgery. The methods of conservative treatment should be applied in other cases. CASE REPORT: We presented a 65-year-old patient with carcinoid lung tumor detected by a routine examination. Additional analysis (chest X-ray, computed tomography of the chest, ultrasound of the abdomen, skeletal scintigraphy, bronhoscopy, histopathological analysis of the bioptate of bronchial tumor, as well as bronchial brushing cytology and immunohistochemical staining performed with markers specific for neuroendocrine tumor) proved a morphologically typical lung carcinoid with dissemination to the liver and skeletal system, which is very rarely found in typical carcinoids. CONCLUSION: The presented case with carcinoid used to be showed morphological and pathohistological characteristics of typical bronchial carcinoid. With its metastasis to the liver and skeletal system it demonstrated unusual clinical course that used to be considered as rare phenomenon. Due to its frequent asymptomatic course and varied manifestation, bronchial carcinoid could be considered as a diagnostic challenge requiring a multidisciplinary approach.

Does epidural clonidine improve postoperative analgesia in major vascular surgery?

AIM: To determine the quality and duration of the analgesic and haemodynamic effects of clonidine when used as an additional analgesic for postoperative epidural analgesia in major vascular surgery. METHODS: The prospective, single-blinded study involved 60 patients randomised into three groups (20 patients each): Group BM- bupivacaine 0.125% and morphine 0.1 mg/ml; Group BC-bupivacaine 0.125% and clonidine 5 µg/ml; Group MC-morphine 0.1 mg/ml and clonidine 5 µg/ml continuously infused at 5 ml/h. The quality and duration of the analgesia measured by the Visual Analogue Scale (VAS) at rest and on movement, additional analgesia requirements, sedation scores, haemodynamic parameters and side effects (respiratory depression, motor block, toxic effects, nausea and pruritus) were recorded. RESULTS: The average VAS scores at rest and on movement were significantly lower in Group MC at two, six and 24 hours following the start of epidural infusion (P<0.05). The duration of the analgesic effect after finishing the epidural infusion was significantly longer in Group MC (P<0.05). Patients from Group MC were intubated longer. Additional analgesia consumption, sedation scores and haemodynamic profiles were similar in all three groups. Pruritus was more frequent in morphine groups (P<0.05), but other side effects were similar in all three groups. CONCLUSIONS: Under study conditions, clonidine added to morphine, not 0.125% bupivacaine, provided significantly better pain scores at two, six and 24 hours following the start of epidural infusion and the longest-lasting analgesia following the discontinuation of epidural infusion. However, patients from the Group MC were mechanically ventilated longer than patients from other two groups. Continuous monitoring of the patient is necessary after the administration of clonidine for epidural analgesia.

Oropharyngeal dysphagia as dominant and life-threatening symptom in dermatomyositis.

BACKGROUND: Dysphagia can be a serious problem in patients with inflammatory myopathies. It may be associated with nutritional deficit, aspiration pneumonia, and poor prognosis. CASE REPORT: We presented a 60-year-old male, suffering from difficulty in swallowing, pain and weaknes in the proximal parts of his extremities, and skin manifestation. Laboratory findings showed increased creatine kinase and aldolase. Antinuclear antibodies to HEP-2 subtrate revealed titer of 1:40. Electromyoneurography demonstrated evidence of a proximal myopathy. A muscle biopsy revealed myositis. The baruim swallow test was remarkable for regurgitation, and nasal emerging of barium. Nuclear magnetic resonance images of cranium was normal. Tumor markers CEA, and Ca 19-9 were increased. A dose of 1 mg daily prednisolone was administered and percutaneous enteral feeding was performed. Two months later, the patient developed febrile state, aspiration pneumonia, and died due to respiratory failure. CONCLUSION: In cases of dermatomyositis with the serious dysphagia, percutaneous endoscopic gastrostomy should be performed as soon as possible. Overall survival rate is low, even with an adequate therapy administration. Inflammatory myopathies should be considered in any patient with oropharyngeal dysphagia.

[Dermatomyositis associated with metastatic rectal adenocarcinoma: case report].

INTRODUCTION: Dermatomyositis is an idiopathic inflammatory myopathy with characteristic cutaneous changes. The disease belongs to paraneoplastic dermatosis. Association of dermatomyositis with malignant conditions has been described in various studies. We present a patient with paraneoplastic dermatomyositis associated with metastatic rectal adenocarcinoma. CASE REPORT: A 66-year-old man was hospitalized in our Institute due to skin changes and myopathy in October 2006. According to the medical documents and history, he underwent surgery because of rectal adenocarcinoma in April 2006. Skin changes appeared 5 months before, while aggravation occurred 6 months after the surgery. The diagnosis of dermatomyositis was based on: characteristic clinical picture; the elevated serum level of following enzymes: creatinine kinase, lactate dehydrogenase; the presence of anti-Mi 2 antibodies in serum; electromyographic finding; and by histology of the muscle biopsy. Paraneoplastic nature of dermatomyositis was confirmed by computer tomography of the abdomen which revealed multiple deposits in the liver, by explorative laparotomy showing peritoneal dissemination and histopathological analysis that verified metastatic adenocarcinoma of the rectum. The oncological consulting team suggested chemotherapy which was not carried out because of the rapid lethal outcome. CONCLUSION: We report a case of paraneoplastic dermatomyositis associated with metastatic rectal adenocarcinoma and lethal outcome, and suggest a comprehensive evaluation of patients with dermatomyositis older than 50 years in order to exclude or verify the occult malignancy.

[Symptoms, physical findings and bronchial hypersensitivity in patients with bronchial asthma and normal spirometry].

BACKGROUND/AIM: The diagnosis of bronchial asthma, a chronic inflammatory disease of the respiratory tract, is made on the basis of anamnesis, pathologic auscultatory findings of the lungs, lung function disturbances, skin tests, as well as the basic indices of immunologic condition in bronchial trunk. The aim of the study was to find out correlation of objective indices of the disease and than relation with the symptoms in the patients with bronchial asthma. METHODS: The study included 60 young male non smokers with long lasting symptoms of bronchial asthma including shortness of breath, wheezing, hard breathing, nonproductive or productive cough, weakness and night hard breathing. There were no symptoms of respiratory infection over the past two months and lung radiography and spirometry were normal Based on the results of nonspecific bronchoprovocative test two groups of the patients were formed, group I (n=30) with positive histamine test (average value of the inhaled histamine concentration with FEV1 drop by 20% in regard with the initial value (PC20) = 2.99 +/- 0.51 mg/ml of histamine) and group II (n=30) with negative histamine test (PC20(a) = 14.58 +/- 6.34 mg/ml of histamine). RESULTS: The obtained spirometry results revealed a statistically significant difference in values of FEV1 between groups: I group--FEV1 3.2%; II group--EV1 = 101.8%; (p .05, Wilcoxon test), although all the FEV1 values were normal Regarding the presence of the most common symptoms there was not statistically significant difference between the groups (p>0.05, chi-square test). Pathologic auscultatory lung findings were found in 73.4% of the patients in the group I and 27.5% of the patients in the group II. There was statistically significant difference (p<0.05, chi-squared test). A positive correlation between the degree of hypersensitivity and lung physical findings was confirmed (p<0.05 Spearman's rho), but there was no correlation with FEV1 values. CONCLUSION: There is a correlation with lung pathologic physical findings, lower values of FEV1 (in a range of normal values) and the degree of nonspecific bronchial sensitivity as objective indices of activity of bronchial asthma. There is no correlation of these parameters with patient's symptoms as subjective indices of bronchial asthma.