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A comparative analysis of molecularly imprinted polymers based on different synthesis techniques was performed for the recognition of molnupiravir (MOL). The polymerizations were performed with 3-thienyl boronic acid (3-TBA) as a functional monomer by electropolymerization (EP) and with guanine methacrylate (GuaM) as a functional monomer by photopolymerization (PP). Morphological and electrochemical characterizations of the developed sensors were investigated to verify the constructed sensors. Moreover, quantum chemical calculations were used to evaluate changes on the electrode surface at the molecular and electronic levels. The dynamic linear range of both designed sensors under optimized experimental conditions was found to be 7.5 × 10-12-2.5 × 10-10 M and 7.5 × 10-13-2.5 × 10-11 M for EP and PP, respectively. The effect of various interfering agents on MOL peak current was assessed for the selectivity of the study. In the presence of 100 times more interfering agents, the RSD and recovery values were determined. The RSD values of GuaM/MOL@MIP/GCE and poly(Py-co-3-PBA)/MOL@MIP/GCE sensors were found to be 1.99% and 1.72%, respectively. Furthermore, the recovery values of the MIP-based sensors were 98.18-102.69% and 98.05-103.72%, respectively. In addition, the relative selectivity coefficient (k') of the proposed sensor was evaluated, and it exhibited good selectivity for MOL with respect to the NIP sensor. The prepared sensor was successfully applied to determine MOL in commercial serum samples and capsule form. In conclusion, the developed sensors provided excellent reproducibility, repeatability, high sensitivity, and selectivity against the MOL molecule.
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Ácidos Borônicos , Citidina/análogos & derivados , Hidroxilaminas , Polímeros Molecularmente Impressos , Reprodutibilidade dos Testes , Eletrodos , Guanina , MetacrilatosRESUMO
The placental cholinergic system; known as an important factor in intracellular metabolic activities, regulation of placental vascular tone, placental development, and neurotransmission; can be affected by persistent organic pesticides, particularly organochlorine pesticides(OCPs), which can influence various epigenetic regulations and molecular pathways. Although OCPs are legally prohibited, trace amounts of the persistent dichlorodiphenyltrichloroethane(DDT) are still found in the environment, making prenatal exposure inevitable. In this study, the effects of 2,4'-DDT and 4,4'-DDT; and its breakdown product 4,4'-DDE in the environment on placental cholinergic system were evaluated with regards to cholinergic genes. 40 human placentas were screened, where 42,50% (17 samples) were found to be positive for the tested compounds. Average concentrations were 10.44⯵g/kg; 15.07⯵g/kg and 189,42⯵g/kg for 4,4'-DDE; 2,4'-DDT and 4,4'-DDT respectively. RNA-Seq results revealed 2396 differentially expressed genes in positive samples; while an increase in CHRM1,CHRNA1,CHRNG and CHRNA2 genes at 1.28, 1.49, 1.59 and 0.4 fold change were found(p<0028). The increase for CHRM1 was also confirmed in tissue samples with immunohistochemistry. In vitro assays using HTR8/SVneo cells; revealed an increase in mRNA expression of CHRM1, CHRM3 and CHRN1 in DDT and DDE treated groups; which was also confirmed through western blot assays. An increase in the expression of CHRM1,CHRNA1, CHRNG(p<0001) and CHRNA2(p<0,05) were found from the OCPs exposed and non exposed groups.The present study reveals that intrauterine exposure to DDT affects the placental cholinergic system mainly through increased expression of muscarinic receptors. This increase in receptor expression is expected to enhance the sensitivity of the placental cholinergic system to acetylcholine.
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DDT , Diclorodifenil Dicloroetileno , Placenta , Humanos , DDT/toxicidade , Feminino , Placenta/efeitos dos fármacos , Placenta/metabolismo , Gravidez , Diclorodifenil Dicloroetileno/toxicidade , Receptores Colinérgicos/metabolismo , Receptores Colinérgicos/genética , Adulto , Inseticidas/toxicidadeRESUMO
PURPOSE: This study was designed to assess the pituitary functions of patients with traumatic maxillofacial fractures and compare the results with healthy controls. METHODS: Thirty patients (mean age, 38.14 ± 14.15 years; twenty-six male, four female) with a traumatic maxillofacial fracture at least 12 months ago (mean 27.5 ± 6.5 months) and thirty healthy controls (mean age, 42.77 ± 11.36 years; twenty-five male, five female) were included. None of the patients were unconscious following head trauma, and none required hospitalization in intensive care. Basal pituitary hormone levels of the patients were evaluated. All patients and controls had a glucagon stimulation test and an ACTH stimulation test to evaluate the hypothalamic-pituitary-adrenal axis and the GH-IGF-1 axis. RESULTS: Five of thirty patients (16.6%) had isolated growth hormone (GH) deficiency based on a glucagon stimulation test (GST). The mean peak GH level after GST in patients with hypopituitarism (0.54 ng/ml) was significantly lower than those without hypopituitarism (7.01 ng/ml) and healthy controls (11.70 ng/ml) (P < 0.001). No anterior pituitary hormone deficiency was found in the patients, except for GH. CONCLUSION: Our study is the first to evaluate the presence of hypopituitarism in patients with traumatic maxillofacial fractures. Preliminary findings suggest that hypopituitarism and GH deficiency pose significant risks to these patients, particularly during the chronic phase of their trauma. However, these findings need to be validated in larger scale prospective studies with more patients.
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BACKGROUND: The aim of this study was to evaluate the shear bond strength of three different calcium silicate-based cements (CBCs) with two different bulk-fill composite resins (CRs). METHODS: Plexiglas moulds with a diameter of 4 mm and a thickness of 2 mm were prepared (n = 60). The Biodentine, NeoPutty and MTA Cem LC samples were randomly divided into two subgroups containing 10 samples each. Surfaces of samples were air dried and Single Bond universal adhesive was applied. Cylindrical plastic capsules of 4 mm height and 2 mm inner diameter belonging to Filtek Bulk-fill and EverX Posterior CRs were centred on coating material and polymerized for 20 s. After shear bond strength (SBS) testing, all samples were examined by scanning electron microscopy (SEM) to identify failure patterns. Three samples, one from each group, were prepared to evaluate chemical composition of CBCs and examined with an energy dispersive X-ray spectroscopy for surface elemental analysis. RESULTS: The values obtained from the tests were evaluated as statistically significant (P < 0.05). After SBS testing, the difference between all CBCs was statistically significant in both CRs. CONCLUSION: According to the findings in this study, it was concluded that MTA Cem LC had highest SBS values in both CRs. © 2023 Australian Dental Association.
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Colagem Dentária , Cimentos de Resina , Humanos , Austrália , Resinas Compostas/química , Colagem Dentária/métodos , Cimentos de Ionômeros de Vidro/química , Teste de Materiais , Cimentos de Resina/química , Resistência ao Cisalhamento , Propriedades de SuperfícieRESUMO
BACKGROUND: Chylothorax is a rare condition due to leakage of chyle in the thoracic cavity. When large amounts of chyle leak into the thoracic cavity, it can lead to severe respiratory, immune, and metabolic complications. Chylothorax has many potential underlying etiologies, and the most common causes are traumatic chylothorax and lymphoma. Venous thrombosis of the upper extremities is a rare cause of a chylothorax. CASE PRESENTATION: A 62-year-old Dutch man with a medical history of gastric cancer, treated with neoadjuvant chemotherapy and surgery 13 months prior, presented with dyspnea and a swollen left arm. Computed tomography thorax showed bilateral pleural effusion that was more prominent on the left side. The computed tomography scan further revealed thrombosis of the left jugular and subclavian veins and osseal masses suggesting cancer metastasis. Thoracentesis was performed to confirm the suspicion of gastric cancer metastasis. The obtained fluid was milky with a high level of triglycerides, but contained no malignant cells; hence, the diagnosis of the pleural effusion was chylothorax. Treatment with anticoagulation and a medium-chain-triglycerides diet was started. Furthermore, bone metastasis was confirmed with a bone biopsy. CONCLUSION: Our case report demonstrates chylothorax as a rare cause of dyspnea in a patient with pleural effusion and a history of cancer. Therefore, this diagnosis should be considered in all patients with a history of cancer with new-onset pleural effusion and thrombosis of the upper extremities or clavicular/mediastinal lymphadenopathy.
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Quilotórax , Derrame Pleural , Neoplasias Gástricas , Trombose , Masculino , Humanos , Pessoa de Meia-Idade , Veia SubcláviaRESUMO
Transmembrane glycoprotein NMB (GPNMB) is a prognostic marker of poor outcome in patients with triple-negative breast cancer (TNBC). Glembatumumab Vedotin, an antibody drug conjugate targeting GPNMB, exhibits variable efficacy against GPNMB-positive metastatic TNBC as a single agent. We show that GPNMB levels increase in response to standard-of-care and experimental therapies for multiple breast cancer subtypes. While these therapeutic stressors induce GPNMB expression through differential engagement of the MiTF family of transcription factors, not all are capable of increasing GPNMB cell-surface localization required for Glembatumumab Vedotin inhibition. Using a FACS-based genetic screen, we discovered that suppression of heat shock protein 90 (HSP90) concomitantly increases GPNMB expression and cell-surface localization. Mechanistically, HSP90 inhibition resulted in lysosomal dispersion towards the cell periphery and fusion with the plasma membrane, which delivers GPNMB to the cell surface. Finally, treatment with HSP90 inhibitors sensitizes breast cancers to Glembatumumab Vedotin in vivo, suggesting that combination of HSP90 inhibitors and Glembatumumab Vedotin may be a viable treatment strategy for patients with metastatic TNBC.
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Antineoplásicos , Imunoconjugados , Neoplasias de Mama Triplo Negativas , Anticorpos Monoclonais , Antineoplásicos/uso terapêutico , Linhagem Celular Tumoral , Membrana Celular/metabolismo , Humanos , Imunoconjugados/efeitos adversos , Lisossomos/metabolismo , Glicoproteínas de Membrana/genética , Fatores de Transcrição , Neoplasias de Mama Triplo Negativas/tratamento farmacológicoRESUMO
Background: Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of advanced cancers. Antibodies directed against programmed cell death receptor 1 (PD-1) interrupt the ability of the cancerous cell to depress the immune system. Methods and results: We report three patients who developed different endocrine abnormalities after treatment with nivolumab, a monoclonal antibody directed against PD-1. First, we report a 76-year-old male presenting with generalized fat loss after treatment with nivolumab which predominantly affected his face and trunk. Second, we described the development of thyroiditis that presented with thyrotoxicosis and the expression of thyroid-stimulating hormone receptor antibodies (TRAb). Finally, we observed the emergence of adrenal insufficiency due to hypophysitis in another case. Conclusion: Although immune checkpoint inhibitors are an effective anticancer treatment modality, adverse effects are evident that can affect the endocrine system. These adverse events may relate to different endocrine systems that include the thyroid and pituitary glands. Also, acquired generalized lipodystrophy should be suspected in patients developing unusual fat loss after treatment with ICIs.
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Tumor-derived exosomes (TEXs) could be harnessed as an immunotherapeutic cancer vaccine. These nanovesicles are inherently possesses rich tumor antigen reservoirs. Due to their undesirable features such as poor or limited immunogenicity as well as facilitation of cancer development via mediating communication between tumor cells TEXs could be transformed into an effective immune adjuvant delivery system that initiates a strong humoral and cell-mediated tumor-specific immune response. Engineering TEXs to harbor immunostimulatory molecules still remains a challenge. Previously, we demonstrated that nucleic acid ligand encapsulated liposomes could trigger synergistic strong humoral, and cell mediated immune responses and provokes tumor regression to that of their standalone counterparts. In this study, we evaluated to immunogenicity of 4T1/Her2 cell-derived exosomes upon loading them with two potent immuno adjuvant, a TLR9 ligand, K-type CpG ODN and a TLR3 ligand, p(I:C). Engineered TEXs co-encapsulating both ligands displayed boosted immunostimulatory properties by activating antigen-specific primary and memory T cell responses. Furthermore, our exosome-based vaccine candidate elicited robust Th1-biased immunity as evidenced by elevated secretion of IgG2a and IFNγ. In a therapeutic cancer model, administration of4T1 tumor derived exosomes loaded with CpG ODN and p(I:C) to animals regress tumor growth in 4T1 tumor-bearing mice. Taken together this work implicated that an exosome-based therapeutic vaccine promoted strong cellular and humoral anti-tumor immunity that is sufficient to reverse established tumors. This approach offers a personalized tumor therapy strategy that could be implemented in the clinic.
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Adjuvantes Imunológicos/administração & dosagem , Antígenos de Neoplasias/administração & dosagem , Neoplasias da Mama/terapia , Vacinas Anticâncer/administração & dosagem , Exossomos/imunologia , Animais , Antígenos de Neoplasias/imunologia , Neoplasias da Mama/imunologia , Neoplasias da Mama/patologia , Vacinas Anticâncer/imunologia , Linhagem Celular Tumoral/transplante , Modelos Animais de Doenças , Feminino , Humanos , Células T de Memória/imunologia , Camundongos , Oligodesoxirribonucleotídeos/administração & dosagem , Oligodesoxirribonucleotídeos/imunologia , Poli I-C/administração & dosagem , Poli I-C/imunologia , Células Th1/imunologia , Receptor 3 Toll-Like/metabolismo , Receptor Toll-Like 9/metabolismoRESUMO
PURPOSE: To investigate colour agreement between different shades of Panavia V5 resin cement and their try-in pastes under zirconia-reinforced lithium silicate ceramics. METHODS: Forty-four zirconia-reinforced lithium silicate ceramic specimens were prepared at 0.8 ± 0.01 mm thickness. Composite resin tooth-shaded background specimens were obtained in two shades. Resin cement specimens were fabricated at 0.1-mm thickness. Colour difference values (ΔE) between Aquagel and both the try-in paste and resin cement were calculated using the CIE-Lab system. The CIEDE2000 (ΔE00) colour formula was used to determine colour differences. The three-way ANOVA test and a multiple comparisons test were used for statistical analysis (α = 0.05). RESULTS: A statistically significant difference was found between the ΔE00 values obtained from the cement shade colour measurements for all specimens (P < 0.05). According to the three-way ANOVA test, lower ΔE00 values were observed in the try-in paste group compared to the resin cement group. The ΔE00 values were significantly affected by the cement shade and tooth-shaded background (P < 0.05). CONCLUSIONS: The colour agreement between the try-in pastes and the corresponding resin cement differed, and the try-in pastes could not mask the dark dental background as much as the corresponding resin cement.
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Porcelana Dentária , Cimentos de Resina , Cerâmica , Cor , Humanos , Lítio , Teste de Materiais , Silicatos , Propriedades de Superfície , ZircônioRESUMO
BACKGROUND: Fasting and coronary functions are prestige fields for the study. There are a limited number of studies on these topics. The effect of Ramadan fasting on endothelial dysfunction, which can be manifested by loss of nitric oxide bioavailability, has been demonstrated via flow-mediated vasomotion in patients with the slow coronary flow in a small number of studies. To our knowledge, there is no study showing the relationship between TIMI frame count and Ramadan fasting. AIMS: We aimed to prove that Ramadan fasting can improve endothelial dysfunction which can be documented via the TIMI frame count method in angiography. METHOD: This retrospective study included 67 patients diagnosed with the coronary slow flow by coronary angiographic before Ramadan. All of them were evaluated again via TIMI frame count within a period of 1 to 3 months after Ramadan. We tested our hypothesis that fasting may improve endothelial dysfunction and it was proved by the TIMI frame count method in our study. RESULTS: TIMI frame counts measured angiographically from LAD, Cx, and RCA and they were significantly lower than the counts before fasting. All coronary frame count parameters showed significant improvement after Ramadan compared with the baseline values before the Ramadan fasting period (P < 0.001). CONCLUSION: Our results revealed that fasting and lifestyle changes during Ramadan may be beneficial for the improvement of endothelial dysfunctions in patients with the slow coronary flow and this can be showed easily using TIMI frame count. This is a practical and easy method for showing coronary functions.
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Jejum , Infarto do Miocárdio , Angiografia Coronária , Circulação Coronária , Humanos , Estudos RetrospectivosRESUMO
The aim of this study was to investigate the reliability of distal interphalangeal joint (DIPJ) subluxation and articular surface involvement measurements during the assessment of bony mallet finger. Two observers measured articular involvement, subluxation ratio and rated joint congruency on 30 lateral radiographs of patients with bony mallet finger on two separate occasions. All measurements and ratings were done on magnified digital radiographs on a workstation. The intraclass correlation coefficient (ICC) and kappa statistics were used to establish relative agreement between observers. The intra-observer reliability for articular involvement and subluxation ratio were good for Observer A (ICCs 0.888 and 0.775) and excellent for Observer B (ICCs 0.958 and 0.910) on both occasions. However, the subluxation rating was moderate for both observers (kappa 0.772 and 0.780, respectively). Inter-observer reliability for articular involvement (ICC 0.884) and the subluxation ratio (ICC 0.818) was good on the first measurement. Although the subluxation rating was perfect for the first measurement (kappa 0.927), it was moderate for the second (kappa, 0.619). The reliability of articular involvement (%) and subluxation ratio (%) measurement was good and excellent. However, the decision on whether the DIPJ is congruent or incongruent was only moderately reproducible. These findings show us that surgeons should be cautious when assessing subluxation, which is the most important criterion for choosing the appropriate treatment.
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Artrite , Luxações Articulares , Articulações dos Dedos/diagnóstico por imagem , Humanos , Luxações Articulares/diagnóstico por imagem , Radiografia , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Contamination is a common problem in pediatric restorative dentistry and there are a few studies that investigate blood contamination, hemostatic agents, and tooth dentin. AIM: The purpose of this study was to evaluate the effects of blood contamination and hemostatic agents on the bond strength of two different bonding systems with the dentin of primary teeth. MATERIALS AND METHODS: Buccal and lingual dentin surfaces of 40 primary second molar teeth were used for this study. Specimens were divided into 4 groups according to the contamination and hemostatic agents (Blood-B, Ankaferd Blood Stopper-A, ViscoStat-V, Control-C) and then every group was further divided into two subgroups according to the bonding systems (Clearfil SE Bond-I, All Bond Universal-II, n = 10 per group). A bulk-fill composite resin was built-up on the surfaces. The specimens were tested in the micro shear mode at a crosshead speed of 1 mm/min on a universal test machine. Statistical analysis was performed with ANOVA and Tukey's tests at P < 0.05. RESULTS: Significant differences have been detected in the micro shear bond strengths only between the Ankaferd Blood Stopper (ABS) (AI = 13.72 ± 4.47 and AII = 9.12 ± 4.4) and control groups (CI = 22.78 ± 10.86 and CII = 16.49 ± 6.55) without regards to the bonding systems. The highest scores were obtained in the control groups. Clearfil SE Bond showed better performance than All Bond Universal in all groups. CONCLUSION: It was determined that only the ABS contamination groups showed statistically significant decreases in the bond strengths when compared with control groups.
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Sangue , Resinas Compostas/química , Colagem Dentária , Adesivos Dentinários/química , Hemostáticos/efeitos adversos , Análise do Estresse Dentário , Dentina , Humanos , Teste de Materiais , Dente Molar , Cimentos de Resina , Resistência ao Cisalhamento , Dente DecíduoRESUMO
OBJECTIVE: The aim of the present study was to demonstrate the relationship between hypertension stages according to JNC-8 classification and mean renal frame count (RFC), which is an indicator of renal perfusion. METHODS: In this retrospective study, 100 hypertensive patients without obstructive renal artery disease, who had been evaluated with renal artery angiography for hypertension, were allocated into 2 groups (Stage 1 and Stage 2 hypertension). During coronary angiography, the patients were evaluated by selective renal angiography using 6F Judkins catheter. Cineangiographic images were evaluated by the same clinician and mean RFC was estimated for both renal arteries. Injections during renal angiography were performed with power injector and same amount of radiopaque media with same speed was used for all patients. RESULTS: There was no significant difference between the groups in terms of age, sex, duration of hypertension, and laboratory markers. Stage 2 hypertensive patients (Group 2) had a significantly higher mean RFC than Stage 1 hypertensive patients (Group 1) (p<0.001). The mean RFC of both kidneys in Group 2 was significantly higher than that of Group 1 (p<0.001 and p=0.023, respectively). CONCLUSIONS: This study showed that the mean RFC increased with increases in hypertension levels and it could be used as an indicator of renal perfusion, which is an indirect marker of renal function. If renal artery flow gets slower, blood pressure levels increase and there is a proportional relationship between these two variables (mean RFC and blood pressure levels). This study also demonstrated that there was a statistically significant correlation between mean RFC and JNC-8 hypertension stages.
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Hipertensão , Testes de Função Renal , Circulação Renal , Idoso , Meios de Contraste , Angiografia Coronária , Feminino , Humanos , Hipertensão/fisiopatologia , Rim , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
OBJECTIVE: This in vitro study aimed to compare the cyclic fatigue resistance of HyFlex EDM (HEDM), Vortex Blue (VB), ProTaper Gold (PG), and OneCurve (OC) nickel-titanium (NiTi) instruments. MATERIALS AND METHODS: About 12 HEDM (25/.~), 12 VB (25/.06), 12 PG (25/.08), and 12°C (25/.06) instruments were included in this study. All the instruments were tested with a 60° angle of curvature and a 3-mm radius of curvature. All the instruments were utilized until fracture occurred, and then the number of cycles to failure (NCF) was calculated. The data were analyzed statistically using Kruskal-Wallis H and Mann-Whitney U-tests. The statistical significance level was set at P < 0.05. RESULTS: HEDM instruments had the highest cyclic fatigue resistance among all the other instruments (P < 0.05). The OC instruments had a significantly higher fatigue resistance than the PG and VB instruments (P < 0.05); however, there was no significant difference between PG and VB instruments in the NCF (P > 0.05). CONCLUSION: Within the limitations of this in vitro study, it was found that the cyclic fatigue resistance was higher for the HEDM instruments than for the VB, PG, and OC instruments.
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Ligas Dentárias/química , Instrumentos Odontológicos , Falha de Equipamento , Teste de Materiais , Preparo de Canal Radicular/instrumentação , Ligas , Desenho de Equipamento , Ouro , Humanos , Níquel/química , Titânio/químicaRESUMO
OBJECTIVE: To introduce a rapid and simple technique to engage and localize through left common carotid (LCCA) artery during selective carotid angiography using the same type of catheter (6F Medtronic™/launcher Judkins Right Guide Catheter, 4.0 Tip,2 Side holes, U.S.A.). METHODS: Patients were divided into two groups as new method and conventional method group including 295 and 292 prior to carotid angiography, respectively. The primary endpoints of this study included an analysis of total procedure time, time required for cannulation of left common carotid artery, fluoroscopy time and selective imaging success for left common carotid artery, feasibility, safety, amount of radio opaque agent and radiation exposure. RESULTS: Our novel method applied using a single catheter shortened total procedure time (5.41 ± 1.56 min. vs. 7.52 ± 2.48 min., respectively, p<0.001), fluoroscopy time (98 ± 9 sec. vs. 210 ± 19 sec., respectively, p<0.001), duration of left carotid artery cannulation (15 ± 1.2 sec vs. 42 ± 1.9 sec, respectively, p< 0.001). Use of our method reduced radiation exposure (120 ± 17 mGy vs. 217 ± 11 mGy, respectively, p<0.001), amount of contrast agent (44.99 ± 12.84 ml vs. 59.89 ± 18.93 ml, respectively, p<0.001). Aortic arch angiography was not needed in the first group compared with the conventional method group (0% vs. 29%, respectively, p<0.001). Also a higher success was achieved in cannulation of left common carotid artery using an identical catheter compared with application of conventional methods requiring use of different types of catheter (100% vs. 60%, respectively, p<0.001). No major complication and mortality was found due to use of both methods. However, a statistically insignificant elevation in minor complication was encountered in the patient group who underwent coronary angiography by the conventional method (3% vs. 7%, respectively, p<0.064). CONCLUSIONS: This new method is more easily applicable with a shorter duration for cannulation and localization of LCCA, safer for the patients with use of a limited amount of radio-opaque agent and finally cost-effective by requiring only one type of catheter and a limited.
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Cateterismo Cardíaco/métodos , Artérias Carótidas/diagnóstico por imagem , Catéteres/normas , Meios de Contraste/normas , Angiografia Coronária/métodos , Fluoroscopia/métodos , Artéria Radial/diagnóstico por imagem , Idoso , Cateterismo , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVES: To evaluate the plasma galectin-3 concentration associated with the severity of HF and its use as a biomarker for clinical staging of heart failure (HF). METHODS: This was a cross-sectional study, in which 100 HF cases diagnosed by clinical parameters and echocardiography were included and subgrouped into NYHA classes (I-IV) based on clinical severity and functional limitations. Plasma galectin-3 was measured with respect to these subgroups. RESULTS: The median plasma galectin-3 concentration in pg/mL was 82.7 (95% confidence interval: 64.5-112.7), 267.2 (214.3-293.5), 694.8 (626.4-902.4), and 1530.4 (1443.1-2384.4) in NYHA class I, II, III, and IV subgroups, respectively (p <0.05). The proposed galectin-3 concentrations in mild, moderate, and severe HF were 100-460, 460-1170, and >1170 pg/mL, respectively. Galectin-3 was negatively correlated with LV Ejection fraction (EF) by Simpson's biplane method (r=-0.634, p<0.001). Pro BNP showed that the level of plasma galectin-3 was positively correlated with the level of plasma NT pro BNP (r = 0.878, p <0.001). CONCLUSIONS: The plasma galectin-3 concentration showed progressive increase with increasing severity of HF; therefore, it may be used in clinical staging of the disease.
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Biomarcadores/sangue , Galectina 3/sangue , Insuficiência Cardíaca/sangue , Adolescente , Adulto , Idoso , Proteínas Sanguíneas , Criança , Estudos Transversais , Feminino , Galectinas , Insuficiência Cardíaca/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Intravenous (IV) fluid resuscitation is one of the most common interventions in intensive care medicine. Despite clear guidelines, the choice of IV fluid is largely dependent on physician preference instead of high-quality evidence of efficacy and safety. This is particularly the case for synthetic colloids, such as hydroxyethyl starch (HES). The use of HES in critical care has been associated with increased rates of acute kidney injury (AKI), renal replacement therapy and mortality. In light of this, current guidelines and scientific and regulatory bodies do not recommend the use of HES for fluid therapy in critical illness and caution against its use in many other settings. Despite this, HES products are still debated and used. Awareness of the indications, contraindications, doses, benefits and adverse effects for IV fluids, as well as recommendations from scientific and regulatory bodies, is essential to guarantee patients' safety. Poor awareness of optimal IV fluid therapy has recently been revealed in some countries including Turkey. Therefore, we provide a review of fluids used for resuscitation, discuss safety data and adverse effects of HES, such as increased AKI and mortality, and discuss recent updates from scientific and regulatory bodies in order to raise awareness of fluid therapy. We conclude that given the lack of a clear benefit of HES in any clinical setting and the availability of safer alternatives, such as crystalloids and albumin, HES should be avoided.
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OBJECTIVE: Probing the change in water content is an emerging approach to assess early diagnosis of osteoarthritis (OA). We herein developed a new method to assess hydration status of cartilage nondestructively using Raman spectroscopy (RS), and showed association of Raman-based water and organic content measurement with mechanical properties of cartilage. We further compared Raman-based water measurement to gravimetric and magnetic resonance imaging (MRI)-based water measurement. DESIGN: Eighteen cadaveric human articular cartilage plugs from 6 donors were evenly divided into two age groups: young (n = 9, mean age: 29.3 ± 6.6) and old (n = 9, mean age: 64.0 ± 1.5). Water content in cartilage was measured using RS, gravimetric, and MRI-based techniques. Using confined compression creep test, permeability and aggregate modulus were calculated. Regression analyses were performed among RS parameters, MRI parameter, permeability, aggregate modulus and gravimetrically measured water content. RESULTS: Regardless of the method used to calculate water content (gravimetric, RS and MRI), older cartilage group consistently had higher water content compared to younger group. There was a stronger association between gravimetric and RS-based water measurement (Rg2 = 0.912) than between gravimetric and MRI-based water measurement (Rc2 = 0.530). Gravimetric and RS-based water contents were significantly correlated with permeability and aggregate modulus whereas MRI-based water measurement was not. CONCLUSION: RS allows for quantification of different water compartments in cartilage nondestructively, and estimation of up to 82% of the variation observed in the permeability and aggregate modulus of articular cartilage. RS has the potential to be used clinically to monitor cartilage quality noninvasively or minimally invasively with Raman probe during arthroscopy procedures.