Cardiovascular MRI evidence of reduced systolic function and reduced LV mass in rheumatoid arthritis: impact of disease phenotype.

The accelerated risk of cardiovascular disease (CVD) in Rheumatoid Arthritis (RA) requires further study of the underlying pathophysiology and determination of the at-risk RA phenotype. Our objectives were to describe the cardiac structure and function and arterial stiffness, and association with disease phenotype in patients with established) RA, in comparison to healthy controls, as measured by cardiovascular magnetic resonance imaging (CMR). 76 patients with established RA and no history of CVD/diabetes mellitus were assessed for RA and cardiovascular profile and underwent a non-contrast 3T-CMR, and compared to 26 healthy controls. A univariable analysis and multivariable linear regression model determined associations between baseline variables and CMR-measures. Ten-year cardiovascular risk scores were increased in RA compared with controls. Adjusting for age, sex and traditional cardiovascular risk factors, patients with RA had reduced left ventricular ejection fraction (mean difference - 2.86% (- 5.17, - 0.55) p = 0.016), reduced absolute values of mid systolic strain rate (p < 0.001) and lower late/active diastolic strain rate (p < 0.001) compared to controls. There was evidence of reduced LV mass index (LVMI) (- 4.56 g/m2 (- 8.92, - 0.20), p = 0.041). CMR-measures predominantly associated with traditional cardiovascular risk factors; male sex and systolic blood pressure independently with increasing LVMI. Patients with established RA and no history of CVD have evidence of reduced LV systolic function and LVMI after adjustment for traditional cardiovascular risk factors; the latter suggesting cardiac pathology other than atherosclerosis in RA. Traditional cardiovascular risk factors, rather than RA disease phenotype, appear to be key determinants of subclinical CVD in RA potentially warranting more effective cardiovascular risk reduction programs.

Hepatitis C virus core antigen as a possible alternative for evaluation of treatment effectiveness after treatment with direct-acting antivirals.

Background: Chronic hepatitis C is a major public health problem around the world. In monitoring treatment efficacy, although costly and labour-intensive methods of molecular biology are often used, much cheaper and technically easier serological methods evaluating the concentration of HCV core antigen in serum are available. We evaluated HCVcAg quantification as a possible assessment of the treatment efficacy instead of HCV RNA quantification.Methods: We collected 514 serum samples from treated HCV infected patients. Quantitative evaluation of HCV RNA and HCVcAg was carried out before treatment, at the end of treatment, and at least 12 weeks following treatment termination. HCV RNA was determined by automated assay (Roche COBAS) and HCVcAg quantitation with ARCHITECT ci8200 analyser.Results: There was a significant correlation between HCVcAg and HCV RNA concentrations at baseline and follow-up visits, but not at the end of treatment. Among samples collected before the treatment, at the end of treatment and follow-up visit, concordance of HCV RNA and HCVcAg reached level of 98.1%, 98.9% and 98.7%, respectively. Diagnostic sensitivity, specificity, positive and negative predictive values of HCVcAg detection were >97%.Conclusions: HCVcAg measurement could be an alternative for determining HCV treatment efficacy after chemotherapy and could be an option in the diagnosis of HCV infection.

Increased serum level of N-terminal Pro-B-type natriuretic peptide as a possible biomarker of cardiovascular risk in psoriatic patients.

BACKGROUND: Apparently, these days psoriasis is regarded as a systemic disease with frequent cardiovascular comorbidities, such as hypertension, myocardial infarction, valvular defects etc., which may lead to reduced lifespan or even sudden death. Therefore, it is important that biomarkers helpful in early detection or prediction of cardiovascular complications as well as their prevention should be identified. Even though the N-terminal pro B-type natriuretic peptide (NT-proBNP) is a well-known cardiovascular predictor in cardiovascular (CV) patients and in the general population, its usefulness in detection of CV comorbidities in psoriatic patients is still unclear. OBJECTIVE: The aim of the study was to determine whether the N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration was increased in psoriatic patients. METHODS: The study included 73 psoriatic patients and 45 age-matched healthy individuals. The serum NT pro-BNP concentration as well as lipid profile parameters were assessed in the study and control groups. Correlations between patients' clinical data, their serum NT-proBNP and lipid concentrations were calculated. RESULTS: The serum concentration of NT-proBNP was significantly higher in psoriatic patients (109.22 ± 172.59 pg/mL) in comparison with controls (35.82 ± 22.90 pg/mL) (P = 0.000054). In 28 (38.36%) psoriatic patients the lipid profile was within normal limits, whereas in 45 (61.64%) psoriatic patients triglyceride and/or total cholesterol were increased. Moreover, in both psoriatic groups, i.e. normo- and hyperlipidaemic, NT-proBNP concentrations were significantly higher compared to normo- and hyperlipidaemic controls, P = 0.02 and P = 0.001 respectively. A positive correlation was found between the NT-proBNP concentration and duration of psoriasis (P < 0.05). CONCLUSIONS: The study findings confirmed higher NT-proBNP concentrations in psoriatic patients, which could be a useful biomarker of CV disease in both normo- and hyperlipidaemic groups.

Significance of plasma chromogranin A determination in neuroendocrine tumour (NET) diagnosis.

The secretory nature of NETs implies the determination of the CgA concentration as a standard marker. The concentration of CgA in plasma correlates with the degree of histopathological differentiation, tumor stage, and is an essential prerequisite for therapy. A retrospective analysis of the results of the plasma CgA concentrations in relation to histopathological and clinical findings (type of NET according to the WHO classification, severity of disease based on the presence of metastases and clinical symptoms) as well as somatostatin receptor scintigraphy was performed in 41 patients with NET. The patients were treated in The Regional Oncology of Lublin from February 2005 to May 2008. Data from the literature and results of this study suggest the use of CgA in the diagnosis and prognosis of NET. Plasma CgA concentration analysed together with histopathological assessment of tumor and the clinical picture is a useful marker in the diagnosis of neuroendocrine tumours. High plasma CgA concentrations may indicate the presence of highly-differentiated NET (WDNEC), and also may indicate the presence of tumor metastasis. The highest CgA concentrations were observed in patients with neuroendocrine tumors associated with carcinoid symptoms and the presence of metastases to the liver.

Evaluation of lipids peroxidation products vs. proinflammatory cytokines in hemodialized patients.

BACKGROUND: Patients with end-stage renal failure on chronic hemodialysis often demonstrate accelerated development of atherosclerotic changes and cardiovascular complications. In those patients oxidative stress facilitates the intensity of lipid peroxidation process, expressed as increased products of lipid peroxidation (malonaldehyde and 4-hydroxyalkenals). Simultaneously, structures modified by peroxidation and glycation of autoantigenic character are formed. Additionally, increase in proinflammatory cytokines is found in their patients on hemodialysis. The aim of the study was to find out the relations between the products of lipid peroxidation and proinflammatory cytokines in patients on hemodialysis. METHODS: Plasma concentrations of malonaldehyde and 4-hydroxyalkenals were estimated by spectrophotometric method, glutathione peroxidase as well as concentration of IL-6, its soluble receptor and TNFalpha were measured using ELISA kits. RESULTS: Aldehyde concentrations (malonaldehyde and 4-hydroxyalkenals) were found to be five fold higher in comparison with the controls. Concentrations of proinflammatory cytokines: IL-6, TNFalpha and soluble IL-6 receptor were also higher than in the control group. Patients on hemodialysis showed positive correlation between concentrations of MDA+4HNE and IL-6 and TNFalpha. CONCLUSION: The correlations found between the products of lipid peroxidation and proinflammatory cytokines suggest causative relation between the intensity of peroxidative processes and stimulation of immunological response in hemodialysed patients, which may increase the risk of atherosclerotic changes in those patients.

Effects of Venoruton on early postradiation damage in the lungs of rats.

The study aimed at testing the effects of Venoruton on the early postradiation damage in the lungs of rats. The chests of the rats were irradiated with Co-60, fractional dose 250 cGy/DD, total dose 2500 cGy/DD. Venoruton was given intraperitoneally, in quantities of 0.1 ml once daily for 90 days. The experiment have proved that Venoruton lowers the intensity of the early postradiation changes, mainly those which depend on the vascular damage.

[Tissue levels of EGF and collagen in ovaries of women]. / Tkankowe stezenia EGF i kolagenu w jajnikach u kobiet.

Tissue EGF concentration as well as collagen content were investigated in ovarian homogenates from both menstruating and menopausal women. EGF concentration was found to be higher, but not significant, in postmenopausal women, whereas total collagen as well as forms soluble in acetic acid and in this acid with pepsin were slightly higher in women with normal menstrual cycle. There were statistically significant negative correlations between above mentioned forms of collagen as well as ovarian EGF concentration in this group of patients. The potential role of epidermal growth factor in modulation of ovarian function and extracellular matrix remodelling within human ovary is discussed.

[Biochemical changes in extracellular matrix components of the amniotic sac during its premature rupture]. / Zmiany biochemiczne macierzy zewnatrzkomórkowej blon plodowych przy ich przedwczesnym pekaniu.

In the fetal membranes that have ruptured 12 hours before onset of the labour the tissue collagen content was lower than in control accompanying by similar local collagenase and elastase activity. These results excluded the inflammatory process as the main cause of prelabour preterm rupture of membranes (PPROM). The analysis of the collagen fractions taken from the site of rupture and the location close to umbilical cord indicates that in PPROM there are changes in posttranslational collagen molecule modification.

[Hydroxyproline urine excretion--potential marker of cervical ripening?]. / Wydalanie z moczem hydroksyproliny--potencjalny marker przedporodowego dojrzewania szyjki macicy?

Urinary hydroxyproline excretion does not change significantly within last two weeks of gestation among 89 healthy patients. Decreased hydroxyproline concentration found in cervices of pregnant women in the course of labor has not been accompanied by increased urinary excretion of this particular amino acid.

Solcoseryl prevents early postradiation changes in the lungs.

The aim of the study was to test the influence of Solcoseryl on early postradiation changes in the lungs of rats. The chests of the rats were irradiated with Co-60, fractional dose 250 cGy/DT, total dose 2500 cGy/DT. Solcoseryl was given intraperitoneally in quantities of 0,1ml daily, during 60 days of the experiment. Morphological examinations of the lungs revealed that Solcoseryl decreased significantly the effects of early postradiation damage of the respiratory organ in rats.

Female urinary stress incontinence in terms of connective tissue biochemistry.

The role of connective tissue in the aetiology of female stress incontinence has been investigated. Collagen content and extractability as well as estrogen receptor concentration in vesico-vaginal fascia were measured after small tissue biopsies had been obtained during vaginal repair surgery in cases of urinary incontinence. The mean concentration of estrogen receptor in vesico-vaginal fascia among incontinent women was 49.4 +/- 14.8 fmol/mg of protein as compared to 29.6 +/- 13.1 in continent control group (P < 0.03; t-test). The mean hydroxyproline concentration in vesico-vaginal fascia of incontinent women was 13.8 +/- 2.6 micrograms/mg wet weight, whereas in the control group it was significantly higher 20.6 +/- 2.4 (P < 0.001). The role of connective tissue components in the aetiology of female stress incontinence is discussed.

Cardiovascular diseases risk factors in male population from mining vocational schools of the Lublin Coal Basin.

Contrary to certain industrial countries which secure an impressive decrease in coronary heart mortality, Poland has had, especially in the last decade, the significant increase of morbidity and mortality caused by cardiovascular diseases. Although this phenomenon concerns mainly the middle-age mean groups, special care for the whole population should be undertaken. The successful way to decrease the death rate and morbidity attributed to coronary heart disease (CHD) are the long-term prevention programs as for example Multiple Risk Factor Intervention Trial, Belgian Heart Disease Prevention Project, Lipid Research Clinics Coronary Primary Prevention Trial and others. Because there is some evidence that certain risk factors occur also among children, it seems that the effectiveness and efficacy of such prevention programs may be increased when started in the young population.

[Risk factors of coronary artery disease in males during a 3 year follow up based on a cohort study in a selected region of Lublin]. / Czynniki ryzyka choroby wiencowej u mezczyzn w ciagu 3 lat obserwacji na podstawie badan kohortowych w wybranym regionie Lublina.

To assess changes in risk factors of coronary artery disease, examinations which had been performed in 1981 and 1982 were repeated in males aged 40-59, inhabitants of the district "Czechów" in Lublin. The study was based on Polish Experiment of Coronary Disease Multifactor Prevention assumptions 112 of 203 males investigated in 1981, 1982 underwent repeated examination (attendance rate - 55%). Statistical analysis was performed only in twice examined subjects. Significant increase of blood pressure, body weight, total serum cholesterol and uric acid concentration was stated in comparison with their respective initial values. Significant decrease of HDL-cholesterol and no changes in serum triglycerides concentration were observed. The only positive stated alteration was a lower percentage of tobacco smokers. Diagnosis of coronary artery disease remained unchanged despite of increased risk factors levels (increase of mean Rose's index score from 5 in initial examination to 6.5 in a control one). This high increase in risk factors occurrence allows an unfavourable prognosis for future incidence of coronary artery disease and also demands to undertake vigorous prevention.