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.

Positioning precarity: The contingent nature of precarious work in structure and practice.

Conceptualising precarity has come to rest on the multi-dimensional and differentiated insecurities of job and worker, this however belies the relationship between structure and experience where precarity originates. To bridge that relationship, I employ the landscape concept to position workers relative to the structural contingency of precarious work. To study this landscape, I conducted an ethnography involving job searching, working, and interviewing workers. While certainly insecure, these jobs displayed parallel characteristics of streamlined hiring and short-notice starts which workers took advantage of. I explore three ideal-typical 'jobs'-the first, only, and best job-to examine how vulnerability is balanced with contingency to produce precarity. This analysis and the landscape approach locate the political-economic transformation of work in the context of workers' lives and their labour market position. Taking precarious work is an act of balancing one's vulnerabilities in a way that constructs and thus naturalises precarity. Overall, the article contributes an image of an economy where workers have to be opportunistic in a continual struggle for work while stratified by their personal circumstances and position in this labour market.

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.

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.

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.

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.

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.

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.

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.

Management of high risk pulmonary embolism - a single center experience.

BACKGROUND AND AIM: Patients with acute pulmonary embolism (APE) associated with hemodynamic instability, i.e. high-risk APE (HR-APE), are at risk for early mortality and require urgent reperfusion therapy with thrombolysis or embolectomy. However, a considerable proportion of HR-APE subjects is not reperfused but only anticoagulated due to high bleeding risk. The aim of the present study was to assess the management of HR-APE in a single large-volume referral center. METHODS: A single-center retrospective study of 32 HR-APE subjects identified among 823 consecutive patients hospitalized for symptomatic APE. RESULTS: Out of 32 subjects with HR-APE (19 women, age 69 ± 19 years), 20 patients were unstable at admission and 12 subsequently deteriorated despite on-going anticoagulation. Thrombolysis was applied in 20 (62.5%) of HR-APE subjects, limited mainly by classical contraindications in the remainder. Percutaneous pulmonary embolectomy was performed in 4 patients. In-hospital PE-related mortality tended to be higher, albeit insignificantly, in the patients who developed hemodynamic collapse during the hospital course compared to those unstable at admission (67% vs. 40%, p = 0.14). Also, survival was slightly better in 22 patients treated with thrombolysis or percutaneous embolectomy in comparison to 10 subjects who received only anticoagulation (54% vs. 40%, p = 0.2). Major non-fatal bleedings occurred in 7 of 20 patients receiving thrombolysis (35%) and in 2 (17%) of the remaining non-thrombolysed 12 HR-APE subjects. CONCLUSIONS: Hemodynamically instability, corresponding to the definition of HR-APE, affects about 4% of patients with APE, developing during the hospital course in approximately one-third of HR-APE subjects. As almost 40% of patients with HR-APE do not receive thrombolytic therapy for fear of bleeding, urgent percutaneous catheter-assisted embolectomy may increase the percentage of patients with HR-APE undergoing reperfusion therapy. Further studies are warranted for a proper identification of initially stable intermediate-risk APE subjects at risk of hemodynamic collapse despite appropriate anticoagulation.

Cancer-associated circulating large extracellular vesicles in cholangiocarcinoma and hepatocellular carcinoma.

BACKGROUND & AIMS: Large extracellular vesicles, specifically AnnexinV+ EpCAM+ CD147+ tumour-associated microparticles (taMPs), facilitate the detection of colorectal carcinoma (CRC), non-small cell lung carcinoma (NSCLC) as well as pancreas carcinoma (PaCa). Here we assess the diagnostic value of taMPs for detection and monitoring of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). Specifically, the aim of this study was to differentiate liver taMPs from other cancer taMPs, such as CRC and NSCLC. METHODS: Fluorescence-activated cell scanning (FACS) was applied to detect various taMP populations in patients' sera that were associated with the presence of a tumour (AnnexinV+ EpCAM+ CD147+ taMPs) or could discriminate between cirrhosis (due to HCV or HBV) and liver cancers (AnnexinV+ EpCAM+ ASGPR1+ taMPs). In total 172 patients with liver cancer (HCC or CCA), 54 with cirrhosis and no liver neoplasia, and 202 control subjects were enrolled. RESULTS: The results indicate that AnnexinV+ EpCAM+ CD147+ taMPs were elevated in HCC and CCA. Furthermore, AnnexinV+ EpCAM+ ASGPR1+ CD133+ taMPs allowed the distinction of liver malignancies (HCC or CCA) and cirrhosis from tumour-free individuals and, more importantly, from patients carrying other non-liver cancers. In addition, AnnexinV+ EpCAM+ ASGPR1+ taMPs were increased in liver cancer-bearing patients compared to patients with cirrhosis that lacked any detectable liver malignancy. The smallest sizes of successfully detected cancers were ranging between 11-15mm. AnnexinV+ EpCAM+ ASGPR1+ taMPs decreased at 7days after curative R0 tumour resection suggesting close correlations with tumour presence. ROC values, sensitivity/specificity scores and positive/negative predictive values (>78%) indicated a potent diagnostic accuracy of AnnexinV+ EpCAM+ ASGPR1+ taMPs. CONCLUSION: These data provide strong evidence that AnnexinV+ EpCAM+ ASGPR1+ taMPs are a novel biomarker of HCC and CCA liquid biopsy that permit a non-invasive assessment of the presence and possible extent of these cancers in patients with advanced liver diseases. LAY SUMMARY: Microparticles (MPs) are small vesicles that bleb from the membrane of every cell, including cancer cells, and are released to circulate in the bloodstream. Since their surface composition is similar to the surface of their underlying parental cell, MPs from the bloodstream can be isolated and by screening their surface components, the presence of their parental cells can be identified. This way, it was possible to detect and discriminate between patients bearing liver cancer and chronic liver cirrhosis.

Favourable pregnancy outcome in a woman with secondary pulmonary hypertension complicating mitral stenosis.

Pulmonary hypertension (PH) is a rare condition with a high incidence of maternal and perinatal mortality (30-56% and 10-13%, respectively). Pulmonary hypertension is a contraindication to pregnancy because of high risk of maternal death, therefore the World Health Organisation (WHO) advises to discuss a termination in the event of pregnancy with women suffering from PH.

Cardiac status of persons qualified for living kidney donation--single-center experience.

UNLABELLED: Some of living kidney donors have medical conditions associated with future risk of cardiovascular diseases. It seems justified to identify risk factors and cardiological disorders prior to the donation. AIM: To determine the cardiological status of persons qualified as a living kidney donor. MATERIAL AND METHODS: We analyzed the data of 109 potential living kidney donors, aged 25-70 (mean 45.7 ± 10.9) years. They underwent clinical and biochemical examination. In some of them extended diagnostics was performed. The presence of risk factors of coronary artery disease were registered. RESULTS: Only 46 (42%) persons were qualified for kidney donation. As many as 40 of them had 21 risk factor. In 75 (68.8%) patients without hypertension, 24-hours ambulatory blood pressure monitoring was done. The masked hypertension was found in 6 persons. In 22 candidates aged > 50 years the exercise test was performed (positive or inconclusive in 3 persons). Coronarography was done in 5 individuals (in no any significant atherosclerotic lesions were found). 63 (58%) person were disqualified. In 15 (23.8%) person the reasons were cardiological. In 2 patient the abdominal aneurysms were found. Both men smoked and had severe dyslipidaemias. In 3rd patient we observed persistent atrial fibrillation. The next 2 men had the peripheral occlusive arterial disease. In 9 patients ≥ 2 risk factors and in the last one morbid obesity were present. CONCLUSION: In Poland candidates for living kidney donation have very often risk factors of cardiovascular disease. Among the persons proceeded for kidney donation cardiovascular problems are an important cause of disqualification.

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.

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.

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.

Use of fondaparinux in a pregnant woman with pulmonary embolism and heparin-induced thrombocytopenia.

BACKGROUND: A serious complication of heparin treatment, heparin-induced thrombocytopenia (HIT) is rarely observed in pregnant women. Drug therapy during pregnancy should always be chosen to minimize fetal risk. The management of HIT in pregnancy represents a medical challenge. Unlike heparins, the anticoagulants used in patients with HIT do cross the placenta, with unknown fetal effects. CASE REPORT: We present a case of a 24-year-old female presenting for care at 34 weeks of gestation with acute pulmonary embolism treated initially with unfractionated heparin (UFH) and low molecular weight heparin (LMWH), who developed HIT. She was then successfully treated with fondaparinux. CONCLUSIONS: To the best of our knowledge, this is one of the first case reports describing a successful use of fondaparinux in the treatment of HIT in a third-trimester pregnant woman, providing a novel approach for this subset of patients.

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.

Electrocardiographic differentiation between acute pulmonary embolism and non-ST elevation acute coronary syndromes at the bedside.

BACKGROUND: Clinical picture of acute pulmonary embolism (APE), with wide range of electrocardiographic (ECG) abnormalities can mimic acute coronary syndromes. OBJECTIVES: Assessment of standard 12-lead ECG usefulness in differentiation at the bedside between APE and non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: Retrospective analysis of 143 patients: 98 consecutive patients (mean age 63.4 +/- 19.4 year, 45 M) with APE and 45 consecutive patients (mean age 72.8 +/- 10.8 year, 44 M) with NSTE-ACS. Standard ECGs recorded on admission were compared in separated groups. RESULTS: Right bundle branch block (RBBB) and S(1)S(2)S(3) or S(1)Q(3)T(3) pattern were found in similar frequency in both groups (10 [11%] APE patients vs 6 [14%] NSTE-ACS patients, 27 [28%] patients vs 7 [16%] patients, respectively, NS). Negative T waves in leads V(1-3) together with negative T waves in inferior wall leads II, III, aVF (OR 1.3 [1.14-1.68]) significantly indicated APE with a positive predictive value of 85% and specificity of 87%. However, counterclockwise axis rotation (OR 4.57 [2.74-7.61]), ventricular premature beats (OR 2.60 [1.60-4.19]), ST depression in leads V(1-3) (OR 2.25 [1.43-3.56]), and negative T waves in leads V(5-6) (OR 2.08 [1.31-3.29]) significantly predicted NSTE-ACS. CONCLUSIONS: RBBB, S(1)S(2)S(3), or S(1)Q(3)T(3) pattern described as characteristic for APE were not helpful in the differentiation between APE and NSTE-ACS in studied group. Coexistence of negative T waves in precordial leads V(1-3) and inferior wall leads may suggest APE diagnosis.

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.