The Potential Diagnostic and Predictive Role of HbA1c in Diabetic, Septic Patients: A Retrospective Single-Center Study.

Background: As diabetes mellitus is a major risk factor of sepsis, we aimed to evaluate the possible effects of diabetes mellitus and poor glycemic control on the diagnosis of sepsis. Methods: In our retrospective study, we included diabetic, septic patients-in whom the diagnosis of sepsis was based on the systemic inflammatory response syndrome (SIRS) criteria (n = 112, SIRS group)-who had HbA1c levels measured either in the previous 30 days (n = 39, SIRS 30 d subgroup) or within 24 hours after their emergency department admission (n = 73, SIRS 24 h subgroup). We later selected those patients from the SIRS group, whose sequential organ failure assessment (SOFA) score was ≥2 (n = 55, SOFA group), and these patients were also divided based on the time of HbA1c measurement (n = 21, SOFA 30 d subgroup and n = 34, SOFA 24 h subgroup). We analyzed the relationship between laboratory parameters, length of hospital stay, and HbA1c. Results: We found a significant positive correlation between glucose and HbA1c (p < 0.001, p < 0.001, respectively), significant negative correlations between white blood cell count (WBC) and glucose (p=0.01, p=0.02, respectively), WBC and HbA1c levels (p=0.001, p=0.02, respectively) in the SIRS 24 h and SOFA 24 h subgroups. Furthermore, there was a significant positive correlation between length of hospital stay and HbA1c in the SOFA 24 h subgroup (p=0.01). No significant correlations were found in the SIRS 30 d and SOFA 30 d subgroups. Conclusion: Based on our results, normal WBC with elevated HbA1c might be considered a positive SIRS criterium in diabetic, SIRS 24 h patients. Besides this potential diagnostic role, HbA1c might also be an additional prognostic biomarker in diabetic, SOFA 24 h patients.

Afamin Levels and Their Correlation with Oxidative and Lipid Parameters in Non-diabetic, Obese Patients.

Background: Afamin is a liver-produced bioactive protein and features α- and γ-tocopherol binding sites. Afamin levels are elevated in metabolic syndrome and obesity and correlate well with components of metabolic syndrome. Afamin concentrations, correlations between afamin and vitamin E, afamin and lipoprotein subfractions in non-diabetic, obese patients have not been fully examined. Methods: Fifty non-diabetic, morbidly obese patients and thirty-two healthy, normal-weight individuals were involved in our study. The afamin concentrations were measured by ELISA. Lipoprotein subfractions were determined with gel electrophoresis. Gas chromatography-mass spectrometry was used to measure α- and γ tocopherol levels. Results: Afamin concentrations were significantly higher in the obese patients compared to the healthy control (70.4 ± 12.8 vs. 47.6 ± 8.5 µg/mL, p < 0.001). Positive correlations were found between afamin and fasting glucose, HbA1c, hsCRP, triglyceride, and oxidized LDL level, as well as the amount and ratio of small HDL subfractions. Negative correlations were observed between afamin and mean LDL size, as well as the amount and ratio of large HDL subfractions. After multiple regression analysis, HbA1c levels and small HDL turned out to be independent predictors of afamin. Conclusions: Afamin may be involved in the development of obesity-related oxidative stress via the development of insulin resistance and not by affecting α- and γ-tocopherol levels.

Creatine Supplementation Supports the Rehabilitation of Adolescent Fin Swimmers in Tendon Overuse Injury Cases.

Our purpose was to investigate the effect of creatine (Cr) supplementation on regeneration periods in tendon overuse injury rehabilitation of adolescent fin swimmers. The participants of this study were injured adolescent competitive fin swimmers (n = 18). The subjects were randomly assigned the creatine (CR) or placebo (PL) groups with a double-blind research design. The subjects were given Cr supplementation or received the placebo as part of the conservative treatment of the tendinopathy. We measured the segmental lean mass (SLM;kg), the ankle plantar flexion peak torque (PFT;N·m), the pain intensity (NRS;values), prior to immobilization, after immobilization (R2) and after the 2nd (R4) and 4th (R6) weeks of the rehabilitation period of the injured limb. The creatine kinase (CK; U/L) enzyme levels were measured before immobilization, and then every 24 hours for four days. There was a significant decrease in SLM (CR by 5.6% vs. PL by 8.9%; p < 0.03) after two weeks of immobilization in both groups (p < 0.001). After four weeks rehabilitation the SLM significantly increased in both groups (CR by 5.5% vs. PL by 3.8%; p < 0.01). The percent changes in PFT after supplementation in R4 (p < 0.001) and R6 (p < 0.03) were significantly different between groups. There was a significant percent increase measured in the CR group (R4 by 10.4%; p < 0.001; R6 by 16.8%; p < 0.001), whereas significant, but lower growth found in the PL group also took place (R4 by 7.1%; p < 0.001; R6 by 14.7%; p < 0.001) after four weeks of rehabilitation. Significantly faster decrease were found in NRS of CR versus PL group during treatment (p < 0.02). We detected significantly lower CK levels increase at the CR group compared to the PL group. The results of this study indicate that Cr supplementation combined with therapeutic strategy effectively supports the rehabilitation of tendon overuse injury of adolescent fin swimmers.

Changes in triglyceride, HDL-C, and non-HDL-C levels in patients with acute coronary syndrome.

BACKGROUND: Changes in high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels have been linked to residual cardiovascular risk, whereas non-HDL-C levels have been shown to be more predictive of cardiovascular risk than are low-density lipoprotein cholesterol (LDL-C) levels. We aimed to investigate the impact of HDL-C, TG, and non-HDL-C levels on acute coronary syndrome (ACS) risk with on-target LDL-C levels. METHODS: In all, 424 Caucasian patients aged over 50 years who had LDL-C levels below 3.4 mmol/l with a first or subsequent ACS event were enrolled in a multicenter, retrospective study. Lipid samples were collected within 4 days after the cardiovascular event. The subjects of the age-matched, gender-balanced control group (n = 443) had LDL-C levels below 3.4 mmol/l and were free of cardiovascular diseases. RESULTS: Patients with ACS had significantly higher TG and lower HDL-C levels compared with the control patients; however, we did not find any significant difference regarding non-HDL-C levels between the two groups. In regression analysis, the risk of coronary heart disease increased significantly with 1 standard deviation (SD) increase in TG and 1 SD decrease in HDL-C levels. CONCLUSION: High TG and low HDL-C levels may contribute to residual cardiovascular risk in patients with well-controlled LDL-C levels; however, non-HDL-C levels at admission did not seem to be predictive for patients with ACS. Detection and treatment of secondary lipid targets such as high TG and low HDL-C levels may be important for the prevention of cardiovascular diseases.

Fluorescence in two-photon-excited diffusible samples exposed to photobleaching: a simulation-based study.

We created a simulation model to investigate the characteristics of fluorescence in two-photon-excited samples. In the model, the sample is a diffusible solution of fluorophore molecules, which is divided into cubic cells and illuminated by a train of focused laser pulses described as a Gaussian beam. Simulating the state transitions according to a multilevel photodynamic model (also including photobleaching and intersystem crossing), the simulator provides the expected number and the spatial distribution of emitted photons over time. Our simulations demonstrated how the illumination laser power, diffusion, and the photodynamic parameters of the fluorophore affect fluorescence. We revealed the unusual fluorescent profile that evolves as photobleaching progresses: the most photons are not emitted from the focus (where a "dark hole" appears) but from an ellipsoid around the focus. The model could be adapted to several fluorescent techniques (such as two-photon microscopy and fluorescence recovery after photobleaching). Furthermore, it might help to optimize the operating parameters of the measurement devices (e.g., in order to reach higher image quality and lower photobleaching).

Increased hair selenium concentration in hyperlipidemic patients.

Selenium is an essential trace element with potential anti-atherogenic and antioxidant effects. Experimental data suggest that selenium might be beneficial in the prevention of atherosclerosis and its complications, whereas human epidemiological studies have yielded conflicting results. Data on hair selenium status in hyperlipidemic patients are still lacking. Therefore, we analysed selenium concentrations by X-ray fluorescence in the hair of 81 statin-naïve patients with newly diagnosed Fredrickson-type IIa and IIb hyperlipoproteinemia and compared their data with 43 healthy volunteers. We also assessed the frequency of other classical risk factors of atherosclerosis. Hair selenium levels were found to be significantly higher in hyperlipidemic patients compared with volunteers with normal lipid levels. Also, a significantly increased number of traditional atherosclerosis risk factors were observed in hyperlipidemic patients with hair selenium concentrations above the median in contrast to those with below. Our results suggest that high hair selenium status might be associated with adverse blood lipid profile together with an increased number of traditional risk factors in a selenium-deplete population. These findings warrant further investigations to study the impact of selenium supplementation on the incidence of cardiovascular events.

Creatine supplementation improves the anaerobic performance of elite junior fin swimmers.

The objective of this study was to determine whether creatine supplementation (CrS) could improve mechanical power output, and swimming performance in highly trained junior competitive fin swimmers. Sixteen male fin swimmers (age:15.9+/-1.6 years) were randomly and evenly assigned to either a creatine (CR, 4x5 g/day creatine monohydrate for 5 days) or placebo group (P, same dose of a dextrose-ascorbic acid placebo) in a double-blind research. Before and after CrS the average power output was determined by a Bosco-test and the swimming time was measured in two maximal 100 m fin swims. After five days of CrS the average power of one minute continuous rebound jumps increased by 20.2%. The lactate concentration was significantly less after 5 minutes restitution at the second measurement in both groups. The swimming time was significantly reduced in both first (pre: 50.69+/-1.41 s; post: 48.86+/-1.34 s) and second (pre: 50.39+/-1.38 s; post: 48.53+/-1.35 s) sessions of swimming in CR group, but remained almost unchanged in the P group.The results of this study indicate that five day Cr supplementation enhances the dynamic strength and may increase anaerobic metabolism in the lower extremity muscles, and improves performance in consecutive maximal swims in highly trained adolescent fin swimmers.