Fuch's Endothelial Corneal Dystrophy in Cataract Patients Is Associated with Elevated Levels of Inflammatory Chemokines, but Not Growth Factors, in the Aqueous Humor.

The study investigated a profile of chemokines and growth factors in the aqueous humor (AH) of eyes with Fuch's endothelial corneal dystrophy (FECD) and cataracts in comparison with cataract patients as a control group. A total of 52 AH samples (26 FECD + cataract and 26 cataract/control) were collected before cataract surgery. None of the patients had any clinically apparent inflammation at the time of AH collection. The AH levels of MCP-1 (CCL2), MIP-1α (CCL3), MIP-1ß(CCL4), RANTES (CCL5), eotaxin (CCL11), IP-10 (CXCL10), FGF basic, G-CSF, GM-CSF, PDGF-bb, and VEGF were compared between the groups. The analyses were performed using the Bio-Plex 200 System from Bio-Rad. Among the studied parameters, the AH levels of RANTES, eotaxin, and IP-10 significantly increased in the FECD + cataract eyes, compared with the cataract controls (p < 0.05). Elevated levels of the RANTES, Eotaxin, and IP-10 indicate more intense inflammation in the eyes of patients in the FECD + cataract group. Moreover, these factors exhibit potential as predictive biomarkers for early detection of FECD in cataract patients. The discovery of elevated concentrations of biochemical markers in a patient, who has not yet received a clinical diagnosis, may suggest the need for heightened observation of the other eye to monitor the potential development of FECD.

Selective Upregulation of Interleukin 1 Receptor Antagonist and Interleukin-8 in Fuchs' Endothelial Corneal Dystrophy with Accompanying Cataract.

(1) Background: Patients with Fuchs' endothelial corneal dystrophy (FECD) may have coexisting cataracts and, therefore, may require a cataract surgery, which poses challenges due to potential endothelial cell damage. FECD is a degenerative eye disease of unclear etiology, with inflammatory cytokines maybe playing an important role in its development and progression. The present study aimed to investigate the cytokine profile in the aqueous humor of FECD eyes with cataract. (2) Methods: Fifty-two patients were included in the study, 26 with FECD + cataract and 26 with cataract as a control group. Samples of the aqueous humor were analyzed for pro- and anti-inflammatory cytokines using a Bio-Plex 200 system. (3) Results: Interleukin 1 receptor antagonist (IL-1Ra) and interleukin IL-8 levels were significantly higher in the aqueous humor of FECD + cataract patients compared to the control/cataract group. Moreover, the levels of anti-inflammatory IL-10 showed a strong trend to be higher in the FECD + cataract group compared to the control group. In contrast, there were no statistically significant differences in IL-1ß, IL-6, IL-4, IL-10, IL-13, IL-17A, and tumor necrosis factor TNF-α between the groups. (4) Conclusions: Presented research contributes to a better understanding of FECD pathogenesis. Elevated levels of IL-1Ra and IL-8 may serve as a defense mechanism in people with FECD and coexisting cataract.

The level of cytokines in tears as a novel indicator of demyelinating diseases.

INTRODUCTION: A novel research objective is to identify new molecules in more readily accessible biological fluids that could be used in the diagnosis of multiple sclerosis (MS) and other demyelinating disorders. AIM: To compare the level of selected cytokines in tears between patients with MS or other demyelinating disorder and healthy controls. MATERIAL AND METHODS: 84 patients with diagnosed MS during remission or with other demyelinating disease of the CNS and 70 healthy controls were enrolled in the study. Tears were collected without any stimulation and stored till the day of assessment. The concentration of selected cytokines was measured by the Bio-Plex Pro Human cytokine screening panel 27 cytokines assay according to the manufacturer's instructions. Statistical analysis was performed with Statistica 13. RESULTS: IL-1b level was significantly lower in the study group compared to the control group [3,6 vs 8.71, p < 0.001]. The same pattern was observed for IL-6 [3,1 vs 5.26, p = 0.027] and IL-10 [1,7 vs 10.92, p < 0.001] (Table 1). In the study group, IL-1RA (p = 0.015), IL-5 (p = 0.04), IL-9 (p = 0.014), and IL-15 (p = 0.037) showed significant correlations with age. In the total sample, IL-1Ra (p = 0.016) and IFN-g (p = 0.041) were significantly correlated with age, while in the control group, IL-8 (p = 0.09), MIP-1a (p = 0.009), and RANTES (p = 0.031) showed significant correlations. CONCLUSIONS: Our results show that MS and other demyelination diseases lead to decrease in the overall level of cytokines in tears. Further research is needed to determine the role of tear fluid in the assessment of demyelinating disorders like MS.

Assessment of the Retinal Vessels in Keratoconus: An OCT Angiography Study.

This study investigated vascular density and foveal avascular zone (FAZ) parameters using optical coherence tomography angiography (OCT-A) in patients with keratoconus (KC). Participants with KC and healthy controls were included and underwent best-corrected visual acuity (BCVA), keratometry, anterior segment OCT, and macular OCT-A examinations. Of the 70 subjects (mean age 42.9 ± 15.31 years), 79 KC and 47 healthy eyes were included. Significant reductions in the KC group were recorded for the FAZ area, with a mean (±SD) of 0.19 ± 0.12 vs. 0.25 ± 0.09 mm2 p < 0.001. Central vascular density in KC patients was lower compared with the controls: 6.78 ± 4.74 vs. 8.44 ± 3.33 mm−1 p = 0.049; the inner density was also decreased in the study group (13.64 ± 5.13 vs. 16.54 ± 2.89 mm−1, p = 0.002), along with the outer density (14.71 ± 4.12 vs. 16.88 ± 2.42 mm−1, p = 0.004) and full density (14.25 ± 4.30 vs. 16.57 ± 2.48) p = 0.003. Furthermore, BCVA was positively correlated with central vascular density (R = 0.42 p = 0.004, total R = 0.40, p = 0.006) and inner density (R = 0.44, p = 0.002) in patients with KC but not in controls. Additionally, we found a correlation between K2 and inner vascular density (R = −0.30, p = 0.043) and central epithelium thickness and outer density (R = 0.03, p = 0.046). KC patients had lower macular vascular density and a smaller FAZ than healthy participants. The BCVA in KC patients was correlated with the vascular density.

Loss of Skeletal Muscle Mass and Intracellular Water as Undesired Outcomes of Weight Reduction in Obese Hyperglycemic Women: A Short-Term Longitudinal Study.

The current study is focused on the influence of hyperglycemia on weight loss in obese premenopausal women. Specifically, the study evaluated the impact of a six-month individualized low-calorie diet combined with moderate exercise on weight reduction and glucose metabolism in obese women with normoglycemia compared to obese women with moderate hyperglycemia. The results indicated that patients with normoglycemia achieved a successful weight loss, which was connected to a decrease in adipose tissue and reflected by diminished content of visceral fat area (VFA) and percent body fat. In contrast, weight reduction in patients with hyperglycemia was connected not only to the loss of VFA but also to undesired decrease in skeletal muscle mass as well as intracellular and total body water. These unfavorable outcomes were observed despite normalization of glucose metabolism reflected by statistically significant lowering glucose, fructosamine, advanced glycation end-products, and HOMA-IR levels. Overall, the obtained results indicate the importance of the measurement of the carbohydrate profile in obese women and the need for an early introduction of weight reduction strategies before the development of hyperglycemia.

PCR Detection of Epstein-Barr Virus (EBV) DNA in Patients with Head and Neck Squamous Cell Carcinoma, in Patients with Chronic Tonsillitis, and in Healthy Individuals.

Epstein-Barr virus (EBV) is a common virus worldwide that is an etiologic agent in the development of many diseases, including cancer. Recent reports have shown the association of EBV with tumorigenesis in head and neck squamous cell carcinoma (HNSCC). Moreover, EBV has been reported to be present in tonsillar tissues, which suggests a close relationship between viral infections and tonsillar diseases, including chronic tonsillitis. The aim of the study was to analyze the prevalence of EBV DNA in 86 patients with HNSCC, in 70 patients with chronic tonsillitis, and in 144 healthy individuals (control group) and the associations between EBV infection and clinicopathological and demographic characteristics and the use of stimulants in all study groups. The objective of this study was also to analyze the prevalence of coinfection with human papillomavirus (HPV). After prior DNA isolation, EBV detection was performed using an EBV kit by real-time polymerase chain reaction. The prevalence of EBV infection in patients with HNSCC, patients with chronic tonsillitis, and the control group was 47.7%, 60%, and 24.3%, respectively. Compared to controls, a significantly higher prevalence of EBV in patients with chronic tonsillitis and HNSCC may suggest that EBV is a potential risk factor. No association was found between EBV infection and demographic or clinical data. Further studies are warranted due to inconclusive reports that were mainly related to geographic distribution, sample type, and detection technique. Considering the prevalence of the virus and the risk of serious diseases, attention should be paid to screening diagnosis and prevention of the infection.

Successful correction of hyperglycemia is critical for weight loss and a decrease in cardiovascular risk in obese patients.

Weight loss is recommended for obese patients with cardiovascular risk; however, it remains questionable how hyperglycemia affects this process. To address this problem, we aimed to determine the association between weight loss, lipid profile, and body mass parameters in obese normoglycemic and hyperglycemic patients. Obese (body mass index30 kg/m2) normoglycemic and hyperglycemic volunteers were placed on a weight reduction program that included a balanced, low-calorie diet and moderate exercise for 6 months. Participants were assessed for serum glucose, ß-cell functions, insulin resistance, lipid metabolism, lipoprotein profile, and body mass parameters. This weight reduction program fully normalized serum glucose levels only in a subpopulation of patients. These individuals also exhibited a significant reduction in body weight, and significant improvement in serum lipid profile and insulin resistance. In contrast, the patients that remained hyperglycemic were characterized by persistent insulin resistance, increased levels of atherogenic fractions of LDL and HDL lipoproteins, and elevated values of a modified Atherogenic Index of Plasma. Correlation analysis indicated a strong positive association between the modified Atherogenic Index of Plasma with atherogenic lipid profile, insulin resistance, and body mass parameters, indicating its usefulness in clinical studies in obese patients. Overall, our data indicate that successful treatment of hyperglycemia facilitates weight loss and improves the composition of blood lipids, while persisting hyperglycemia negatively affects the weight loss process and maintains an atherogenic lipid profile. Because hyperglycemia predisposes to cardiovascular disorders, its correction should be the primary goal during weight reduction therapy.

Asthma and delirium episodes during hospitalization.

BACKGROUND: Delirium incidences during hospitalization are an important problem in elderly patients. The problem of delirium episodes in patients with obstructive disease during hospitalization was investigated. MATERIAL AND METHODS: From a total of 37,156 subjects, the following were randomly selected: 32,261 patients with asthma, 4896 with chronic obstructive pulmonary disease (COPD), and 5455 without obstructive disease. Their ages ranged from 65-95 years, and they were hospitalized between 2006 and 2015. Delirium incidences were monitored based on the International Classification of Disease (ICD)-10 codes and medical documentation. RESULTS: The delirium episodes during all hospitalizations were independently associated with asthma (odds ratio [OR] = 2.91, confidence interval [CI] = 1.62-5.84), with severe type of asthma (OR = 4.24, CI = 1.94-8.93), partim controlled asthma (OR = 3.1, CI = 1.29-8.46), and uncontrolled asthma (OR = 4.88, CI = 2.12-9.42). It was comparable with COPD as follows: all incidences of delirium during hospitalization (OR = 3.17, CI = 1.42-7.23) or severe COPD (III degree OR = 5.15, CI = 2.01-13.69). Elderly patients with asthma with uncontrolled or partially controlled asthma with a coincidence of advanced age, dementia, or smoking had a greater predisposition to delirium episodes, particularly after surgery. Additionally, delirium incidence caused death more frequently in patients with asthma than in those with COPD. CONCLUSION: Elderly patients with asthma have a higher risk of delirium episodes during any hospitalization, and, frequently, it ends in death.

Retinal OCT Findings in Patients after COVID Infection.

PURPOSE: The aim of this study was to assess and compare the optic nerve, retina, and retinal vessel parameters in recovered COVID-19 patients and healthy patients by using optical coherence tomography angiography (OCT-a). METHODS: In all, 156 eyes of post-COVID-19 patients and 98 eyes of subjects from a control group were enrolled in our study. BCVA, intra ocular pressure (IOP) measurement, fundus examination, and OCT images, including macular cube, OCT-RNFL, and angio-OCT 6 × 6 mm examinations, were performed for both groups. The measurements were acquired using Swept Source OCT DRI OCT Triton. In the post-COVID-19 group, 762 OCT protocols were obtained. For statistical analysis, parameters from only one eye from each subject were taken. RESULTS: In the measured parameters, no significant differences were observed, i.e., central macular thickness (p = 0.249); RNFL (p = 0.104); FAZ (p = 0.63); and vessel density of superficial retinal vascular plexus in central (p = 0.799), superior (p = 0.767), inferior (p = 0.526), nasal (p = 0.402), and temporal (p = 0.582) quadrants. Furthermore, a slit-lamp examination did not reveal any COVID-19-related abnormalities. CONCLUSION: OCT examination did not detect any significant changes in morphology or morphometry of the optic nerve, retina, or the retina vessels due to COVID-19.

Prognostic Value of the Modified Atherogenic Index of Plasma during Body Mass Reduction in Polish Obese/Overweight People.

Although weight loss is recommended for obese patients, it remains questionable how much weight loss is optimal. A novel index that accurately determines the risk of cardiovascular diseases (CVDs) in terms of weight loss is needed. The modified Atherogenic Index of Plasma (AIP), presented here is unique in the literature. It is calculated based on data for anti-atherogenic, high-density lipoprotein cholesterol (HDL-C) fractions, instead of the total HDL-C. This study investigates whether weight loss correlates with CVD risk, and whether the modified AIP allows more accurate diagnostics in obese/overweight people. According to the increase or decrease of AIP during weight loss, 52 Polish patients were subdivided into two groups: group I (increased AIP; n = 16) and group II (decreased AIP; n = 36). The patients' body mass composition and fasting serum lipid parameters (total cholesterol, triglycerides, HDL-C, and LDL-C (low-density lipoprotein cholesterol)), and cholesterol in 21 lipoprotein sub-fractions were determined. Over six months, all patients reduced their body mass by about 10%. There were no significant differences in anthropometric measures between groups. Increases in large and intermediate HDL-C fractions 1 to 6 and decreases in smaller fractions 7 to 10 were observed in group II. In group I, HDL-C fractions 1 and 10 decreased, while cholesterol in other fractions increased. Increases were observed in the antiatherogenic HDL-C of 52% of group II and 4% of group I. As for atherogenic HDL-C, a decrease of 24% was observed in group II and an increase of 9% in group I. In group I, increases of very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and large LDL fractions were noticed, and the reverse in group II. The results show that the modified AIP is a more accurate indicator of CVD risk than existing indices, and that uncontrolled weight reduction does not necessarily have a beneficial influence, and may adversely affect the cardiovascular system.