The ABCG8 polymorphism increases the risk of gallbladder cancer in the general population and gallstones in obese patients from Poland.

BACKGROUND: Gallstone disease (GD) is common but remains asymptomatic in most cases. However, gallstones can lead to complications like choledocholithiasis or gallbladder cancer. In this study, we analyse the common genetic risk factor for GD, the p.D19H variant in the sterol transporter ABCG8, in Polish patients with gallstones and gallbladder cancer. METHODS: Three adult cohorts were prospectively recruited: 65 patients with gallbladder cancer, 170 obese individuals scheduled for bariatric surgery and 72 patients who underwent endoscopic retrograde cholangiopancreatography due to recurrent choledocholithiasis. The control cohort consisted of 172 gallstone-free adults. The ABCG8 p.D19H (rs11887534) polymorphism was genotyped using TaqMan assays. RESULTS: The minor allele frequency (MAF) of the ABCG8 p.D19H polymorphism was significantly (p = .02) higher among cases with either gallstones or gallbladder cancer (MAF = 8.4%) as compared to controls (MAF = 4.0%). The highest frequency of the risk allele was detected in patients with gallbladder cancer (18.5%) and obese patients with GD (17.5%), followed by individuals with choledocholithiasis (13.9%). Notably, the p.19H variant was associated with an increased risk of developing gallbladder cancer (OR 2.76, 95% CI 1.16-6.54, p = .01) and an increased risk of GD in obese individuals scheduled for bariatric surgery (OR = 2.70, 95% CI 1.05-6.49, p = .03), but did not significantly affect the risk of choledocholithiasis. CONCLUSIONS: The ABCG8 p.D19H common risk variant increases the risk of developing gallbladder cancer in Central Europeans and enhances the risk of gallstones in the obese. Carriers of the p.D19H variant might benefit from personalized preventive strategies, particularly regarding gallbladder cancer.

Ukrainian migrants' and war refugees' admissions to hospital: evidence from the Polish Nationwide General Hospital Morbidity Study, 2014-2022.

BACKGROUND: Considering the rapid influx of Ukrainian migrants and war refugees into Poland, the knowledge of their health condition is becoming increasingly important for health system policy and planning. The aim of the study was to assess war-related changes in the frequency and structure of hospitalizations among Ukrainian migrants and refugees in Poland. METHODS: The study is based on the analysis of hospital admission records of Ukrainian patients, which were collected in the Nationwide General Hospital Morbidity Study from 01.01.2014 to 31.12.2022. RESULTS: In the study period, 13,024 Ukrainians were hospitalized in Poland, 51.7% of whom had been admitted to hospital after February 24, 2022. After the war broke out, the average daily hospital admissions augmented from 2.1 to 21.6 person/day. A noticeable increase in the share of women (from 50% to 62%) and children (from 14% to 51%) was also observed. The average age of patients fell from 33.6 ± 0.2 years to 24.6 ± 0.3 years. The most frequently reported hospital events among the migrants until 23.02.2022 were injuries (S00-T98) - 26.1%, pregnancy, childbirth and the puerperium (O00-O99) - 18.4%, and factors influencing health status and contact with health services (Z00-Z99) - 8.4%. After the war started, the incidence of health problems among migrants and war refugees changed, with pregnancy, childbirth and the puerperium (O00-O99) being the most common - 14.9%, followed by abnormal clinical and lab findings (R00-R99) - 11.9%, and infectious and parasitic diseases (A00-B99) - 11.0%. CONCLUSIONS: Our findings may support health policy planning and delivering adequate healthcare in refugee-hosting countries.

An application of the density standard and scaled-pixel-counting protocol to assess the radiodensity of equine incisor teeth affected by resorption and hypercementosis: preliminary advancement in dental radiography.

BACKGROUND: Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) syndrome is a dental disease where the radiographic signs may be quantified using radiographic texture features. This study aimed to implement the scaled-pixel-counting protocol to quantify and compare the image structure of teeth and the density standard in order to improve the identification of the radiographic signs of tooth resorption and hypercementosis using the EOTRH syndrome model. METHODS AND RESULTS: A detailed examination of the oral cavity was performed in 80 horses and maxillary incisor teeth were evaluated radiographically, including an assessment of the density standard. On each of the radiographs, pixel brightness (PB) was extracted for each of the ten steps of the density standard (S1-S10). Then, each evaluated incisor tooth was assigned to one of 0-3 EOTRH grade-related groups and annotated using region of interest (ROI). For each ROI, the number of pixels (NP) from each range was calculated. The linear relation between an original X-ray beam attenuation and PB was confirmed for the density standard. The NP values increased with the number of steps of the density standard as well as with EOTRH degrees. Similar accuracy of the EOTRH grade differentiation was noted for data pairs EOTRH 0-3 and EOTRH 0-1, allowing for the differentiation of both late and early radiographic signs of EOTRH. CONCLUSION: The scaled-pixel-counting protocol based on the use of density standard has been successfully implemented for the differentiation of radiographic signs of EOTRH degrees.

Meta-analysis of postoperative myocardial injury as a predictor of mortality after living donor liver transplantation.

BACKGROUND: The purpose of this study was to perform a systematic review and meta-analysis to investigate postoperative myocardial injury, as expressed by the postoperative concentration of high-sensitivity cardiac troponin I (hs-cTnI) as a predictor of mortality among living donor liver transplantation (LDLT) patients. METHODS: PubMed, Scopus, Embase and the Cochrane Library were searched through to September 1st 2022. The primary endpoint included in-hospital mortality. Secondary endpoints were 1-year mortality and re-transplantation occurrence. Estimates are expressed as risk ratios (RRs) and 95% confidence intervals (95% CIs). Heterogeneity was assessed with the I² test. RESULTS: During the search, 2 studies were found that fit the criteria and had a total of 527 patients. Pooled analysis showed that in-hospital mortality in patients with myocardial injury was 9.9%, compared to 5.0% for patients without myocardial injury (RR = 3.01; 95% CI: 0.97-9.36; p = 0.06). Mortality among 1-year follow-up was 5.0% vs. 2.4%, respectively (RR = 1.90; 95% CI: 0.41-8.81; p = 0.41). CONCLUSIONS: In recipients with normal preoperative cTnI, myocardial injury LDLT may be associated with adverse clinical outcomes during a hospital stay, but the results were inconsistent at 1-year follow-up. Although routine follow-up of postoperative hs-cTnI, even in patients with normal preoperative levels, might still help predict the clinical outcome of LDLT. In future large and more representative studies are needed to establish the potential role of cTns in perioperative cardiac risk stratification.

A green and fast microwave-assisted synthesis of selenium nanoparticles and their characterization under gastrointestinal conditions using mass spectrometry.

We present a novel microwave-assisted green synthesis of selenium nanoparticles (SeNPs) using yeast extract as source of a non-toxic reducing and capping agents. Effects of synthesis and gastrointestinal digestion conditions on the biogenic Se particle size distribution and number concentration using SP ICP MS were evaluated. The median equivalent diameter of SeNPs varied depending on the synthesis conditions. Upon incubation in simulated gastric juice, the increase of SeNPs size was observed, whereas after simulated intestinal juice addition, their size came back close to the initial value. The biomolecules contained in yeast extract, which play predominant role in the synthesis of SeNPs, were identified by non-targeted qualitative analysis using LC Orbitrap ESI MS. The use of the state-of-the-art MS techniques allowed both the comprehensive assessment of the processes leading to the SeNPs formation and the evaluation of their behavior under gastrointestinal conditions which is of utmost importance for their use as a novel selenium source.

Basic and advanced spectrometric methods for complete nanoparticles characterization in bio/eco systems: current status and future prospects.

The use of engineered nanoparticles in the environment and human life has increased in the last 20 years. The risk assessment concerning application of nanomaterials in biological systems requires their thorough characterization. Understanding the correlations between physicochemical properties of nanoparticles concerning not only the size, particle size distribution, number concentration, degree of aggregation, or agglomeration but also solubility, stability, binding affinity, surface activity, chemical composition, and nanoparticle synthesis yield allows their reliable characterization. Thus, to find the structure-function/property relationship of nanoparticles, multifaceted characterization approach based on more than one analytical technique is required. On the other hand, the increasing demand for identification and characterization of nanomaterials has contributed to the continuous development of spectrometric techniques which enables for their qualitative and quantitative analysis in complex matrices giving reproducible and reliable results. This review is aimed at providing a discussion concerning four main aspects of nanoparticle characterization: nanoparticle synthesis yield, particle size and number concentration, elemental and isotopic composition of nanoparticles, and their surface properties. The conventional and non-conventional spectrometric techniques such as spectrophotometry UV-Vis, mass spectrometric techniques working in conventional and single-particle mode, or those based on optical emission detection systems are described with special emphasis paid on their advantages and drawbacks. The application and recent advances of these methods are also comprehensively reviewed and critically discussed.

The rs12532734 Polymorphism Near the Solute Carrier 26A3 Gene Locus Is Associated With Gallstone Disease in Children.

Gallstones are increasingly frequent in children. In this candidate gene study, we genotyped 5 gene variants ( ANO1 , SPTLC3 , TMEM147 , TNRC6B , rs12532734) from a recent gallstone genome-wide association study (GWAS) in a cohort of 214 children with gallstones and 172 gallstone-free adult controls. In total, 138 genotyped children presented with symptomatic gallstone disease, 47 underwent cholecystectomy, and 126 received ursodeoxycholic acid (UDCA) as therapy for stones. Among 5 tested variants, the rs12532734 polymorphism modulated the gallstone risk in the studied cohort. Its genotype distribution significantly ( P = 0.025) departed from the Hardy-Weinberg equilibrium among cases, and the common allele was associated with increased odds of developing gallstones at young age (OR = 1.69, P = 0.014). SLC26A3 is the nearest gene to rs12532734 and is involved in the transepithelial bicarbonate and chloride transport. The association of rs12532734 with pediatric gallstones is a novel finding warranting further investigations also with regard to biliary bicarbonate flux and bile composition.

Common variant p.D19H of the hepatobiliary sterol transporter ABCG8 increases the risk of gallstones in children.

INTRODUCTION: Gallstones are increasingly common in children. Genetic analyses of adult cohorts demonstrated that the sterol transporter ABCG8 p.D19H and Gilbert UGT1A1*28 variants enhance the odds of developing gallstones. The genetic background of common lithiasis in children remains unknown. METHODS: Overall, 214 children with gallstone disease (1 month-17 years, 107 boys) were inclueded. The control cohorts comprised 214 children (age 6-17 years, 115 boys) and 172 adults (age 40-92 years, 70 men) without gallstones. The ABCG8 p.D19H and UGT1A1*28 polymorphisms as well as ABCB4 (c.504C>T rs1202283, c.711A>T rs2109505) and NPC1L1 variants (p.V1296V rs217434, c.-18C>A rs41279633) were genotyped using TaqMan assays. Serum concentrations of plant sterols and cholesterol precursors were measured by gas chromatography/mass spectrometry. RESULTS: The ABCG8 risk allele was associated with an increased risk of stones (OR = 1.82, p = .03). Children carrying the p.19H allele presented with lower serum concentrations of surrogate markers of intestinal cholesterol absorption and decreased ratios of phytosterols to the cholesterol precursor desmosterol. Carriers of the common NPC1L1 rs217434 allele had an increased gallstone risk compared with stone-free adults (OR 1.90, p < .01). This variant also affected the ratio of phytosterols to cholesterol precursors (p = .03). Other tested variants were not associated with gallstone risk. CONCLUSIONS: The p.D19H ABCG8 and, to a lesser extent, NPC1L1 rs217434 variants increase the risk of early-onset gallstone formation. These results point to the presence of a common lithogenic pathway in children and adults.

Some aspects related to the indentation-based viscoelastic modelling of trabecular bone tissue.

PURPOSE: The aim of this research was to verify to what extent the shape of an indenter tip influences the final form of the constitutive equation for the trabecular bone. METHODS: Trabecular bone was formulated as a non-linear viscoelastic material with Mooney-Rivlin hyperelastic model to describe the purely elastic response of the bone tissue. Tests of the mechanical properties of the trabecular bone, resected from the femoral head of a 56-year-old patient, were carried out with two types of indenter: the spherical tip of a diameter of 200 µm and pyramid Vickers tip with 136° between plane faces. Tests with both indenters included loading and unloading phases with no hold at peak force and with hold time t = 20 s and were conducted with a maximum load Pmax = 500 mN and loading/unloading rate V = 500 mN/min. RESULTS: The formulated constitutive model describes the trabecula behaviour very well. The model curves match the experimental results in the loading phase, holding period and most of the unloading ramp. The purely viscoelastic material constants are very close in value for both considered tips, but purely elastic constants differ. CONCLUSIONS: The results indicate that the constitutive model based on the indentation with the Vickers tip does not cover the plastic residual deformation. When a viscoelastic response of bone is expected, a model with constants calibrated for the spherical tip should be used, and the other set of parameters values (Vickers tip) when trabeculae may undergo plastic deformation.

Assessment of Concentrations of Heavy Metals in Postmyocardial Infarction Patients and Patients Free from Cardiovascular Event.

Cardiovascular diseases (CVDs) constitute the first cause of death among the population of developing and developed countries. Atherosclerosis, which is a disorder with multifactorial etiopathogenesis, underlies most CVDs. The available literature includes ample research studies on the influence of classic cardiovascular (CV) risk factors. However, environmental exposure to heavy metals, among other substances, is still an unappreciated risk factor of CVDs. This study aimed to assess the concentration of some heavy metals (copper (Cu), zinc (Zn), manganese (Mn), cobalt (Co), and iron (Fe)) in the blood serum of postmyocardial infarction (post-MI) patients and patients free from myocardial infarction (MI) as well as estimate the relationship between the occurrence of MI and increased concentration of heavy metals. The concentration of heavy metals (Cu, Zn, Mn, Co, and Fe) was assessed using the inductively coupled plasma mass spectrometry technique in a group of 146 respondents divided into two groups: post-MI group (study group (SG), n = 74) and group without cardiovascular event (CVE) having a low CV risk (control group (CG), n = 72). The concentration of the analyzed heavy metals was higher in SG. All the heavy metals showed a significant diagnostic value (p < 0.001). The highest value of area under the curve (AUC) was observed for manganese (Mn) (0.955; 95% confidence interval (CI) = 0.922-0.988), while the lowest value was found for zinc (Zn) (0.691; 95% CI = 0.599-0.782). In one-dimensional models, high concentrations of each of the analyzed heavy metals significantly increased the chances of having MI from 7-fold (Cu) to 128-fold (Mn). All the models containing a particular metal showed a significant and high discrimination value for MI occurrence (AUC 0.72-0.92). Higher concentrations of Cu, Zn, Mn, Co, and Fe were found to considerably increase the chances of having MI. Considering the increasingly higher environmental exposure to heavy metals in recent times, their concentrations can be distinguished as a potential risk factor of CVDs.

Sensitive determination of bioaccessible mercury in complex matrix samples by combined photochemical vapor generation and solid phase microextraction coupled with microwave induced plasma optical emission spectrometry.

The photochemical generation technique of mercury vapor (PCVG) coupled with headspace solid phase microextraction (SPME) and microwave induced plasma optical emission spectrometry (MIP-OES) has been developed and successfully applied for fast and sensitive determination of mercury in complex matrix samples. Mercury vapor was generated by UV photo-reduction of inorganic mercury and methylmercury to mercury vapor in 5% (v/v) formic acid with subsequent gas-liquid separation and preconcentration by solid phase microextraction. A stopped-flow mode of the PCVG-SPME unit was employed with the aim of increasing analyte preconcentration factor, thus improving both sensitivity of determination and detection limits for mercury. The calibration curves were linear up to 20 ng mL-1 with the limit of detection for inorganic mercury and methylmercury of 0.030 and 0.045 ng mL-1, respectively. This manifold allowed a repeatability, expressed as relative standard deviation, of below 5%. Due to differences in efficiency of Hg vapor generation for Hg2+ and CH3Hg+, the quantification was performed against external Hg2+ and CH3Hg+ aqueous standards, respectively. The method was validated by the analysis of two CRM materials of different matrix composition, i.e. estuarine sediment ERM CC580 for total mercury content and tuna fish ERM CE464 for methylmercury content, respectively. The results proved good accuracy of the method with recovery of 101% total mercury and 87.3% methylmercury and precision of 3.8% and 12.5%, respectively. Effect of concomitants in the stopped-flow generation of mercury vapor with the new manifold was also investigated. Next, the proposed method was successfully applied for monitoring of bioaccessible fraction of mercury during their incubation in simulated body fluid in the presence of selenium nanoparticles examined as a potential mercury detoxifying agent.

Synergistic effects of extracellular vesicle phenotyping and AFP in hepatobiliary cancer differentiation.

BACKGROUND: Biliary cancer, comprising cholangio- and gallbladder carcinomas, is associated with high mortality due to asymptomatic disease onset and resulting late diagnosis. Currently, no robust diagnostic biomarker is clinically available. Therefore, we explored the feasibility of extracellular vesicles (EVs) as a liquid biopsy tool for biliary cancer screening and hepatobiliary cancer differentiation. METHODS: Serum EVs of biliary cancer, hepatocellular carcinoma, colorectal cancer and non-small cell lung cancer patients, as well as from healthy individuals, were isolated by sequential two-step centrifugation and presence of indicated EVs was evaluated by fluorescence activated cell sorting (FACS) analysis. RESULTS: Two directly tumour-related antigen combinations (AnnV+ CD44v6+ and AnnV+ CD44v6+ CD133+ ) and two combinations related to progenitor cells from the tumour microenvironment (AnnV+ CD133+ gp38+ and AnnV+ EpCAM+ CD133+ gp38+ ) were associated with good diagnostic performances that could potentially be used for clinical assessment of biliary cancer and differentiation from other cancer entities. With 91% sensitivity and 69% specificity AnnV+ CD44v6+ EVs showed the most promising results for differentiating biliary cancers from HCC. Moreover using a combined approach of EV levels of the four populations with serum AFP values, we obtained a perfect separation of biliary cancer and HCC with sensitivity, specificity, positive and negative predictive value all reaching 100% respectively. CONCLUSIONS: EV phenotyping, especially if combined with serum AFP, represents a minimally invasive, accurate liquid biopsy tool that could improve cancer screening and differential diagnosis of hepatobiliary malignancies.

Determination of nanopowders using microwave plasma optical emission spectrometry operating in a single particle mode.

Material science requires advanced analytical methods which allow size-fractionated and chemical quantification of powdered nanomaterials. Nanopowders can be introduced to a helium plasma by pneumatic nebulization based on fluidized bed approach and measure with a time resolution of 4-20 ms. This new analytical technique is accessible by an microwave plasma optical emission spectrometry (MWP-OES) operated in single-particle mode, providing information about their elemental composition, size, dispersity and agglomeration of nanoparticles (NPs). Next, NPs can be characterized by the corresponding element-to-element molar ratios and compared to the theoretically expected values. For a series of nanooxides, size detection limits between 5 and 250 nm are achieved at an integration time of 10 ms. For mixed nanooxides sample, satisfactory temporal resolution is obtained with particle coincidence events below 5%.

D-dimer levels enhance the discriminatory capacity of bleeding risk scores for predicting in-hospital bleeding events in acute pulmonary embolism.

INTRODUCTION: Bleeding is a major complication of anticoagulation in acute pulmonary embolism (APE) while estimating individual bleeding risk remains challenging. Elevated D-dimer levels (DD) have been shown to predict bleeding events. OBJECTIVES: (1) direct comparison of the capacity of bleeding risk prediction scores (VTE-BLEED, RIETE, HAS-BLED, HEMORR2HAGES) to prognosticate in-hospital bleeding events in the acute phase of APE in a real-life population of APE patients;(2) augmentation of the discriminative capacity of fore mentioned scores with DD. MATERIALS: Post-hoc analysis of a prospective observational study. DD levels were measured using the VIDAS D-dimer Exclusion test. Receiver operating characteristic curves, areas under the curve (AUC) for bleeding prediction were calculated for scores and DD. Bleeding scores+DD were compared using an established index quantifying the reclassification of patients (net reclassification index, NRI). RESULTS: 310 APE patients were included. 35(11.3%) bleeding events occurred (hematomas, GI, urinary tract, retroperitoneal, uterine, CNS, respiratory tract): 17 major (MB) and 18 clinically-relevant non-major bleedings (CRNMB), none were fatal. All scores had satisfactory AUCs (0.754-0.767), except HAS-BLED (AUC = 0.512; 0.455-0.569). DD were higher in patients with bleeding events (29,911 ng/ml vs. 4805 ng/ml, p = .031), AUC 0.621(0.520-0.721), p = .02. DD = 5750 ng/ml was characterized by OR = 2.3(95%CI 1.05-5.0) for all bleeding events. Adding DD improved the discriminatory capacity of tested scores in the non-high risk of bleeding category, NRI 0.07-03. CONCLUSIONS: Of the tested scores RIETE, HEMORR2HAGES, VTE-BLEED performed best at identifying APE patients at risk of in-hospital bleeding complications. DD levels may predict in-hospital bleeding events and may improve identifying patients classified as non-high risk who experience bleeding complications.

Factors Affecting Health-Related Quality of Life in Liver Transplant Patients.

This study seeks to evaluate the metabolic parameters such as body mass index (BMI), percentage of total body fat percentage (%BF), blood glucose, homeostatic index for quantification of insulin resistance and beta-cell function (HOMA-IR), sleep efficiency, and physical activity in liver transplant patients. The study group consisted of 24 male and 18 female patients, which enabled the inter-gender comparison. We found that a majority of patients had exceeded the norms for BMI and %BF. The excessive weight was distinctly accentuated in male patients. Only 40.5% of patients have a correct BMI and 21.4% of patients have a correct %BF. The indices of glucose metabolism were increased, pointing to enhanced insulin resistance. Resting energy expenditure and metabolic equivalent of task were characteristic of sedentary lifestyle, and they were lower in female patients. Almost 65% of patients had sleep efficiency below the desired 85% cut-off level. Further, sleep efficiency was decreasing with increasing BMI, %BF, and blood glucose level. In conclusion, liver transplant patients are characterized by excessive body mass and less physical activity and have a shortened sleep duration, all of which may lead to a worse glucose metabolism and increased disease risk and may also have an impact on quality of life.

Potential pro-oxidative effects of single dose of mephedrone in vital organs of mice.

BACKGROUND: Mephedrone is a recreationally used synthetic cathinone, relatively new abusive substances with molecular structure similar to amphetamine. As there is still lack of scientific data regarding mechanisms of action as well as metabolism of mephedrone, especially in aspects other than neurotoxicity, addiction or behavioral changes, therefore we aimed, for the first time, to investigate potential pro-oxidative actions of a single dose of mephedrone in organs other than brain and its structures, i.e. in liver, kidneys, heart and spleen of Swiss mice. METHODS: The following biomarkers of oxidative stress were measured: concentration of ascorbic acid (AA) and malondialdehyde (MDA) as well as total antioxidant capacity (TAC) of the tissues homogenates. RESULTS: Our study revealed that mephedrone intoxication induces oxidative stress by reducing concentration of AA and TAC and increasing concentration of MDA in these organs. CONCLUSIONS: Such occurred state of antioxidant-oxidant imbalance may be etiopathological factor of a number of severe diseases within cardiovascular, digestive as well as immunological systems.

Body mass loss in dry sauna and heart rate response to heat stress / Perda de massa corporal em sauna seca e resposta cardíaca ao estresse por calor / Pérdida de masa corporal en sauna seca y respuesta de la frecuencia cardíaca al estrés por calor

ABSTRACT Objectives: The aim of the study was to determine the effects of sauna-induced heat exposure on body mass loss (BML) and its relationships with basic anthropometric and physiological variables. Methods: The sample comprised 230 healthy adult males aged 21.0 ± 1.08 years (age range: 20.0-24.5 years). Body surface area (BSA) was determined and two groups of individuals with high BSA (BSAH; n = 58) and low BSA (BSAL; n = 74) were extracted. The intervention consisted of two 10-min dry sauna sessions separated by a 5-min interlude. Pre-, peri-, and post-sauna measures of nude body mass (BM) and heart rate (HR) were taken. Results: BML differed between BSA groups by 0.28 kg (74.81%). Absolute and relative BML most strongly correlated with BM and BSA (p < 0.001). Among the four considered height-weight indexes, the Quetelet I Index and Body Mass Index showed the strongest associations (p < 0.001) with BML whereas the weakest were with the Rohrer Index (p < 0.01) and Slenderness Index (p < 0.05). Compared with BML, differences in HR were relatively minor (from 9.90% to 18.07%) and a significant association was observed between BML and HR at rest (p < 0.01) and in 10th and 20th min of sauna bathing (p < 0.001). Conclusions: The magnitude of BML in healthy adult males after passive heat exposure was dependent on BM and concomitantly BSA. The physiological cost of dry sauna-induced thermal strain (as assessed by BML and HR) is greater in individuals with high BM and BSA. BM and HR monitoring is also recommended in order to minimize the risk of homeostatic imbalance and cardiovascular events and this cohort should more frequently cool the body and consume a greater volume of fluids during sauna bathing. Evidence Level II; Prospective comparative study.

RESUMO Objetivos: O objetivo do estudo foi determinar os efeitos da exposição ao calor induzidos pela sauna sobre a perda de massa corporal (BML) e sua relação com as variáveis antropométricas e fisiológicas básicas. Métodos: A amostra esteve formada por 230 homens adultos saudáveis de 21.0 ± 1.08 anos (média de idade: 20.0-24.5 anos). Foi determinada a área da superfície corporal (BSA) e separados em dois grupos de indivíduos com alta BSA (BSAH, n = 58) e baixa BSA (BSAL, n = 74). A intervenção consistiu em duas sessões de sauna seca de 10 minutos, separadas por um intervalo de 5 minutos. Foram tomadas as medidas pre-, peri- e posteriores à sauna, da massa corporal (BM) sem roupa e a frequência cardíaca (HR). Resultados: Entre os dois grupos de BSA, a BML diferenciou-se em 0.28 kg (74.81%). A BML absoluta e relativa correlacionou-se com maior força com a BM e a BSA (p < 0.001). Entre os quatro índices de tamanho-peso considerados, o Índice Quetelet I e o Índice de Massa Corporal mostraram as associações mais consistentes (p < 0.001) com a BML, enquanto que as mais fracas foram com o Índice Rohrer (p < 0.01) e o Índice de Magreza (p < 0.05). Comparado com a BML, as diferenças no HR foram relativamente pequenas (de 9.90% a 18.07%) e foi observada uma associação significativa entre a BML e o HR em repouso (p < 0.01) e em banho de sauna aos 10 e 20 minutos (p < 0.001). Conclusões: A magnitude da BML em homens adultos saudáveis após a exposição passiva ao calor dependeu da BM e da BSA. O custo fisiológico da tensão térmica induzida pela sauna seca (avaliada pela BML e o HR) é maior em indivíduos com alta BM e BSA. Também é recomendado o monitoramento da BM e HR para minimizar o risco de desequilíbrio homeostático e episódios cardiovasculares. Assim, esta população deveria refrescar seu corpo com maior frequência e consumir um maior volume de líquidos durante a sessão de sauna. Nível de evidência II; Estudo comparativo prospectivo.

RESUMEN Objetivos: El objetivo del estudio fue determinar los efectos de la exposición al calor inducidos por el sauna sobre la pérdida de masa corporal (BML) y sus relaciones con las variables antropométricas y fisiológicas básicas. Métodos: La muestra estuvo formada por 230 varones adultos saludables de 21.0 ± 1.08 años (rango de edad: 20.0-24.5 años). Se determinó el área de superficie corporal (BSA) y se separaron dos grupos de individuos con alta BSA (BSAH, n = 58) y baja BSA (BSAL, n = 74). La intervención consistió en dos sesiones de sauna seca de 10 minutos separadas por un intervalo de 5 minutos. Se tomaron medidas pre-, peri- y posteriores al sauna, de masa corporal (BM) sin ropa y la frecuencia cardíaca (HR). Resultados: Entre los dos grupos de BSA, la BML difirió en 0.28 kg (74.81%). La BML absoluta y relativa se correlacionó con más fuerza con la BM y la BSA (p < 0.001). Entre los cuatro índices de talla-peso considerados, el Índice Quetelet I y el Índice de Masa Corporal mostraron las asociaciones más fuertes (p < 0.001) con la BML, mientras que las más débiles fueron con el Índice Rohrer (p < 0.01) y el Índice de Esbeltez (p < 0.05). Comparado con la BML, las diferencias en el HR fueron relativamente pequeñas (de 9.90% a 18.07%) y se observó una asociación significativa entre la BML y el HR en reposo (p < 0.01) y en baño de sauna a los 10 y 20 minutos (p < 0.001). Conclusiones: La magnitud de la BML en varones adultos saludables posterior a la exposición pasiva al calor dependió de la BM y de la BSA. El costo fisiológico de la tensión térmica inducida por el sauna seco (evaluado por la BML y el HR) es mayor en individuos con alta BM y BSA. También se recomienda el monitoreo de BM y HR para minimizar el riesgo de desequilibrio homeostático y episodios cardiovasculares. Así, esta población debería refrescar su cuerpo con mayor frecuencia y consumir un mayor volumen de líquidos durante la sesión de sauna. Nivel de evidencia II; Estudio comparativo prospectivo.

New microscale constitutive model of human trabecular bone based on depth sensing indentation technique.

A new constitutive model for human trabecular bone is presented in the present study. As the model is based on indentation tests performed on single trabeculae it is formulated in a microscale. The constitutive law takes into account non-linear viscoelasticity of the tissue. The elastic response is described by the hyperelastic Mooney-Rivlin model while the viscoelastic effects are considered by means of the hereditary integral in which stress depends on both time and strain. The material constants in the constitutive equation are identified on the basis of the stress relaxation tests and the indentation tests using curve-fitting procedure. The constitutive model is implemented into finite element package Abaqus® by means of UMAT subroutine. The curve-fitting error is low and the viscoelastic behaviour of the tissue predicted by the proposed constitutive model corresponds well to the realistic response of the trabecular bone.

d-Dimer Assessment Improves the Simplified Pulmonary Embolism Severity Index for In-Hospital Risk Stratification in Acute Pulmonary Embolism.

d-dimer (DD) levels are used in the diagnostic workup of suspected acute pulmonary embolism (APE), but data on DD for early risk stratification in APE are limited. In this post hoc analysis of a prospective observational study of 270 consecutive patients, we aimed to optimize the discriminant capacity of the simplified pulmonary embolism severity index (sPESI), an APE risk assessment score currently used, by combining it with DD for in-hospital adverse event prediction. We found that DD levels were higher in patients with complicated versus benign clinical course 7.2 mg/L (25th-75th percentile: 4.5-27.7 mg/L) versus 5.1 mg/L (25th-75th percentile: 2.1-11.2 mg/L), P = .004. The area under the curve of DD for serious adverse event (SAE) was 0.672, P = .003. d-dimer =1.35 mg/L showed 100% negative predictive value for SAE and identified 11 sPESI ≥1 patients with a benign clinical course, detecting the 1 patient with SAE from sPESI = 0. d-dimer >15 mg/L showed heart rate for SAE 3.04 (95% confidence interval [CI]: 1-9). A stratification model which with sPESI + DD >1.35 mg/L demonstrated improved prognostic value when compared to sPESI alone (net reclassification improvement: 0.085, P = .04). d-dimer have prognostic value, values <1.35 mg/L identify patients with a favorable outcome, improving the prognostic potential of sPESI, while DD >15 mg/L is an independent predictor of SAE.