Robust ferromagnetism in two-dimensional GeC/CrN heterobilayers.

We have investigated the electronic and finite temperature magnetic properties of germanium carbide (GeC) and ferromagnetic chromium nitride (CrN) heterobilayers by using first-principles calculations based on density functional theory with Hubbard U correction and an effective anisotropic Heisenberg spin model. The dynamical stability of different stacking formations of heterobilayers is ensured by considering the phonon spectra. All the stacking patterns show half-metallicity with an out-of-plane easy-axis ferromagnetic ground state. We find a high Curie temperature for GeC/CrN heterobilayers within the random phase approximation (RPA). In addition to the symmetric stackings, i.e., AA and AB, the electronic properties of non-symmetric stackings at three different twist angles are also analyzed. The electronic structure analysis of twisted structures demonstrates that the half-metallicity of the GeC/CrN heterobilayer is stack independent. Furthermore, we have investigated the electronic properties, magnetic anisotropy energy, Curie temperature, and spin wave spectrum in the presence of biaxial strain. It is shown that the compressive strain dramatically reduces the magnetic anisotropy energy of the GeC/CrN heterobilayer and Curie temperature, but the Curie temperature still remains well above room temperature for all strain values. The increasing values of tensile strain reduce the magnetic exchange while it increases the magnetic anisotropy energy of the heterobilayer system which enhances the Curie temperature of the structures. The monolayer CrN on the GeC with a wide band gap and commensurate lattice together with a high Tc value can be a feasible candidate for future spintronic applications.

Explaining Skeletal System Anatomy with Classical Method, Video Assisted Method and 3D Imaging Techniques and Comparison of Learning Levels Between Methods

SUMMARY: The aim of this research is to introduce the ideal lecture technique to the literature by explaining the anatomy of the skeletal system using the classical method, video-assisted method and 3D imaging techniques. The research was carried out with 180 students. The number of samples was determined by power analysis (a=0.05,b=0.20, effect size=0.25). Participants were pre-screened and divided into 4 groups with the closest group mean (group 1: control group: the group that did not take anatomy lessons, group 2: video-assisted anatomy education, group 3: 3D anatomy course, group 4: classical anatomy education group). The courses in the training groups were organised as 4 hours/day, 2 days/week for 5 weeks. At the end of the course, the students were re-examined and scaled to determine the difference in scores and self-efficacy between the groups. A one-way ANOVA test was performed because the data were normally distributed when comparing between groups. The mean scores were calculated as group 1=30.22±6.24, group 2=39.02±9.15, group 3=49.77±9.20 and group 4=59.28±8.95. In the post hoc comparison, in pairwise comparisons between all groups, the differences were highly significant (pgroup 3>group 2>group 1 (p<0.001). According to the results of this study, the laboratory method in skeletal anatomy teaching is the best alternative to 3D anatomy teaching.

El objetivo de esta investigación es introducir la técnica de lectura ideal en la literatura, explicando la anatomía del sistema esquelético, utilizando el método clásico, el método asistido por video y las técnicas de imágenes en 3D. La investigación se llevó a cabo con 180 estudiantes. El número de muestras se determinó mediante análisis de potencia (a=0,05, b=0,20, tamaño del efecto=0,25). Los participantes fueron preseleccionados y divididos en 4 grupos con la media de grupo más cercana (grupo 1: grupo de control: el grupo que no tomó lecciones de anatomía, grupo 2: educación de anatomía asistida por video, grupo 3: curso de anatomía 3D, grupo 4: grupo de educación en anatomía clásica). Los cursos en los grupos de formación se organizaron con 4 horas/día, 2 días/semana durante 5 semanas. Al final del curso, los estudiantes fueron reexaminados y escalados para determinar la diferencia en puntajes y autoeficacia entre los grupos. Se realizó una prueba de ANOVA de una vía debido a que los datos se distribuyeron normalmente al comparar entre grupos. Las puntuaciones medias se calcularon como grupo 1=30,22±6,24, grupo 2=39,02±9,15, grupo 3=49,77±9,20 y grupo 4=59,28±8,95. En la comparación post hoc, en comparaciones por pares entre todos los grupos, las diferencias fueron altamente significativas (pgrupo 3>grupo 2>grupo 1 (p<0,001). Según los resultados de este estudio, el método de laboratorio en la enseñanza de la anatomía esquelética es la mejor alternativa a la enseñanza de la anatomía en 3D.

Magnificent harmony in morphometric measurements of orbita and foramen magnum / Armonía magnífica en medidas morfométricas de órbita y foramen magno

SUMMARY: The foramen magnum (FM) is the key component of the craniovertebral junction, which connects the brain stem and medulla spinalis and is closely related to vital structures. FM dimensions are of great clinical importance. Considering the similarity in shape between FM and orbita, we thought that there might be a relationship between the lengths (sagittal diameter) and widths (transverse diameter) of these structures. Since it is not possible to reach FM directly, we set up our hypothesis as can we calculate the foramen magnum dimensions from orbital measurements before proceeding to costly tests. We also investigated this harmony in the skulls we used in the study. In the study, 21 dried skull bones from the Turkish population were used. FM and right Orbital length and width measurements were made. Precision digital caliper was used for measurements. Statistical validity and reliability analyzes were performed to prove the agreement between the measurements. We found that the length of the orbit and FM in the sagittal plane is close to each other, with 34.74±2.11 mm and 34.99±3.0 mm, and the width of the orbit in the coronal plane is approximately 1.40 times the width of the FM. We proved that the estimation of FM dimensions based on orbital measurements is also statistically valid and safe. Using orbital measurements, it is possible to estimate FM dimensions which are difficult to reach directly in living humans.

El foramen magno (FM) es el componente clave de la unión craneovertebral, que conecta el tronco encefálico y el bulbo raquídeo y está estrechamente relacionado con las estructuras vitales. Las dimensiones FM son de gran importancia clínica. Teniendo en cuenta la similitud de forma entre FM y órbitas, consideramos que podría haber una relación entre las longitudes (diámetro sagital) y las anchuras (diámetro transversal) de estas estructuras. Dado que no es posible llegar al FM directamente, establecimos nuestra hipótesis y calculamos las dimensiones del foramen magno a partir de mediciones orbitales antes de proceder a costosas pruebas. También investigamos esta armonía en los cráneos que usamos en el estudio. En el estudio, se utilizaron 21 huesos de cráneo secos de la población turca. Se realizaron mediciones FM y de longitud y anchura orbitales. Para las mediciones se utilizó un calibrador digital de precisión. Se realizaron análisis estadísticos de validez y confiabilidad para probar la concordancia entre las mediciones. Encontramos que la longitud de la órbita y FM en el plano sagital es cercana entre sí, con 34,74±2,11 mm y 34,99±3,0 mm, y el ancho de la órbita en el plano coronal es aproximadamente 1,40 veces el ancho de la FM. Demostramos que la estimación de las dimensiones FM basadas en mediciones orbitales también es estadísticamente válida y segura. Empleando mediciones orbitales, es posible estimar dimensiones FM que son difíciles de alcanzar directamente en humanos vivos.

Investigation of anastomoses between coronary arteries in Akkaraman sheep by plastic injection and corrosion method.

BACKGROUND: Since it is critical to understand the anatomy of the coronary arteries and the anastomoses between them in Akkaraman sheep, the coronary arteries will be examined using a plastic injection and corrosion technique. MATERIALS AND METHODS: In our investigation, researchers used 20 Akkaraman sheep's hearts collected from slaughterhouses in and near Kayseri, and hearts from animals aged 2-3 years were included. The anatomy of the coronary arteries of the hearts was studied by plastic injection and corrosion method. The macroscopically examined patterns of the excised coronary arteries were photographed and recorded. RESULTS AND CONCLUSIONS: This approach indicated arterial vascularisation of the heart in sheep, with a. coronaria dextra and a. coronaria sinistra developing from the commencement of the aorta. It was determined that a. coronaria sinistra, after leaving the initial part of the aorta, proceeds to the left and divides into two branches called r. interventricularis paraconalis and r. circumflexus sinister, forming a right angle between them, immediately after reaching the sulcus coronarius. Anastomosis of the branches of r. distalis atrii dextri with the branches of r. intermedius atrii dextri and r. ventriculi dextri; anastomosis of a thin branch separated from r. proximalis atrii sinistri with the branch of r. proximalis atrii dextri running in the initial part of the aorta; anastomosis of r. distalis atrii sinistri with r. intermedius atrii sinistri were detected. In one heart, the r. septalis protruded roughly 0.2 cm from the beginning of a. coronaria sinistra.

The usability of the ratio of bi-humerus breadth to maximum pelvic breadth in sex estimation.

BACKGROUND: Although sex can be determined with high accuracy in forensic anthropology, additional parameters are still required. AIM: To estimate with known simple statistical methods, the usability of the bi-humerus/maximum pelvic breadth ratio in sex estimation. SUBJECTS AND METHODS: Bi-humerus breadth and maximum pelvic breadth were measured using the topogram images (196 males, 171 females), the ratio between them was calculated. We examined the usability of the ratio of the distance between the lateral edges of the right and left humeral heads to the maximum distance between the two most lateral parts of the iliac crests in sex estimation. RESULTS: There was significant difference in the bi-humerus breadth and "bi-humerus breadth/maximum pelvic breadth" according to sex. The greatest breadth of the pelvis was higher in females, yet the difference was not statistically significant. The ratio yielded 80.6%-90.3% accuracy for females and 73.6%-74.7% for males, depending on arm position. CONCLUSIONS: The obtained data may contribute to the development of formulas created with metric measurements used in sex estimation. This can be used as a parameter to help in estimating the sex of skeletal remains found as a whole or excavated without losing their integrity, and also in the reconstruction of body structure.

An analysis of Schottky barrier in silicene/Ga2SeS heterostructures by employing electric field and strain.

Two-dimensional materials are leading the way in nanodevice applications thanks to their various advantages. Although two-dimensional materials show promise for many applications, they have certain limitations. In the last decade, the increasing demand for the applications of novel two-dimensional materials has accelerated heterostructure studies in this field. Hence, restoring the combination of two-dimensional heterostructured materials has been reported. In this paper, we show that the effect of the external electric field and biaxial strain on the silicene/Ga2SeS heterostructure has a critical impact on the tuning of the Schottky barrier height. The findings such as the variation of the electronic band gap, interlayer charge transfer, total dipole moment, and n-type/p-type Schottky barrier transitions of the silicene/Ga2SeS heterostructure under external effects imply that the device performance can be adjusted with Janus 2D materials.

Diversity and enzymatic potential of thermophilic bacteria associated with terrestrial hot springs in Algeria.

This study aims to determine the diversity of culturable thermophilic bacteria isolated from eight terrestrial hot springs in Northeastern of Algeria using the conventional methods, SDS-PAGE fingerprinting of whole-cell proteins and 16S rRNA gene sequencing. In addition, their hydrolytic enzyme activities were also investigated. A total of 293 strains were isolated from the hot springs' water and sediment using different culture media. Overall, five distinct bacterial groups were characterized by whole-cell protein pattern analysis. Based on the 16S rRNA gene sequencing of 100 selected strains, the isolates were assigned to the following three major phyla: Firmicutes (93%), Deinococcus-Thermus (5%), and Actinobacteria (2%), which included 27 distinct species belonging to 12 different phylotypes, Aeribacillus, Aneurinibacillus, Anoxybacillus, Bacillus, Brevibacillus, Geobacillus, Laceyella, Meiothermus, Saccharomonospora, Thermoactinomyces, Thermobifida, and Thermus. The screening for nine extracellular enzymes showed that 65.87% of the isolates presented at least five types of enzyme activities, and 6.48% of strains combined all tested enzymes (amylase, cellulase, pectinase, esculinase, protease, gelatinase, lipase, lecithinase, and nuclease). It was found that Bacillus, Anoxybacillus, Aeribacillus, and Aneurinibacillus were the genera showing the highest activities. Likewise, the study showed an abundant and diverse thermophilic community with novel taxa presenting a promising source of thermozymes with important biotechnological applications. This study showed that a combined identification method using SDS-PAGE profiles of whole-cell proteins and subsequent 16S rRNA gene sequence analysis could successfully differentiate thermophilic bacteria from Algerian hot springs.

Examination of inclinations of the spine at childhood and adolescence.

BACKGROUND: Spine is a column that consists of consecutively lined up vertebras. It includes medulla spinalis. It contributes the motions of head, neck and body. Spine is not a straight column. There is a convexity towards the front of the spine (lordosis) at cervical and lumbar areas in adults and a convexity towards the back of the spine (kyphosis) at thoracic and sacral spine areas. MATERIALS AND METHODS: In this study, lateral magnetic resonance images of 731 children between 1 and 16 years of age were examined and their cervical lordosis, thoracic kyphosis and lumbar lordosis angles were measured with Cobb method using ImageJ programme for every age group. RESULTS: The mean calculated cervical lordosis angles in 1-16-year-old children were found to be 20.51o ± 6.11o (minimum 17.96o ± 6.29o, maximum 23.50o ± ± 4.14o). It has been observed that cervical angle values decrease with age. The mean thoracic kyphosis angle measured was 28.71o ± 6.99o (minimum 24.55o ± ± 5.65o, maximum 30.44o ± 4.68o). Lumbar lordosis angle was 28.08o ± 7.39o (minimum 20.36o ± 6.59o, maximum 32.68o ± 6.03o). Thoracic kyphosis and lumbar lordosis angle values increased with age. In our study, a statistical differ- ence was found in increasing thoracic kyphosis angle between 1-year-old group and 14-year-old group. Statistical difference was also found in decreasing cervical lordosis angle value between 1-year-old group and 16-year-old group. When we compare our study results with literature values, cervical lordosis values were similar, but lumbar lordosis values were lower. CONCLUSIONS: In summary, we think that knowing sagittal plane inclinations of the spine developing in childhood and adolescence will contribute to earlier de- termination of pathologies. We also hope that it will contribute to clinical stages and other studies in this field.

High temperature and oxygen supplementation can mitigate the effects of hypoxia on developmental stability of bilateral traits during incubation of broiler breeder eggs.

Hypoxia strongly affects embryonic development during the pre-hatch period. This study was conducted to investigate the effects of oxygen supplementation (O) and a 38.5°C high temperature (HT) at high altitude (HA, 1720 m) on morphological traits during a pre-hatch period and on relative fluctuating asymmetry (relative FA) and allometric growth during an early post-hatch period in broilers. A total of 720 eggs were obtained from a 45-week-old Ross 308 broiler breeder flock raised at sea level (2 m). The eggs were divided into six incubation condition (IC) groups and were incubated at HA. O groups were exposed to 23.5% O2 for 1 h daily from either days 0 to 11 (O0-11), days 12 to 21 (O12-21) or days 18 to 21 (O18-21) of incubation. HT groups were exposed to 38.5°C daily from either days 12 to 21 (HT12-21) or days 18 to 21 (HT18-21) of incubation. A control was maintained at 37.8°C and 21% O2. The hatched chicks were raised for 6 days at HA. Embryo/chick and beak lengths and head diameter were measured during pre- and post-hatch periods. The face, middle toe and shank lengths were measured for each chick. The relative asymmetry (RA), mean RA (MRA) and allometric growth of the lengths were computed and the existence of FA was demonstrated. The IC significantly affected the embryo length, with embryos of the O0-11 group shorter than embryos of the other O groups. Chicks were longer in the O and HT groups than those in the control, except for the O0-11. We found significant interactions between the IC and each development period for beak length. During the post-hatch period, the head diameter of the O0-11 was significantly smaller than that of the other groups, but not in O12-21. The interactions among IC, age and sex were significant for the RA of the face and middle toe lengths and for MRA. All the examined bilateral traits were evaluated as allometric growth. The FA for bilateral traits was determined in both sexes. The right (R) - left (L) and IR-Ll were the lowest in females for face length and in males for shank length from the O18-21 and in males for middle toe length from the O0-11 and HT18-21 groups. Therefore, the effects of factors such as HT and O2 could mitigate the adverse effects of HA-induced hypoxia on optimal developmental stability of bilateral traits of broiler.

Effects of habitual knuckle cracking on metacarpal cartilage thickness and grip strength.

Joint cracking involves a manipulation of the finger joints resulting in an audible crack. This study aimed to determine whether habitual knuckle cracking (KC) leads to an alteration in grip strength and metacarpal head (MH) cartilage thickness. Thirty-five habitual knuckle crackers (cracking their joints ≥5times/day) (20 M, 15 F, aged 19-27 years) and 35 age-, gender-, and body mass index-matched non-crackers were enrolled in the study. MH cartilage thickness was measured with ultrasound and grip strength was measured with an analog Jamar hand dynamometer. Grip strength was similar between groups (P>0.05). Habitual knuckle crackers had thicker MH cartilage in the dominant and non-dominant hands than those of the controls (P=0.038 and P=0.005, respectively). There was no correlation between MH cartilage thickness and grip strength in both groups (P>0.05). While habitual KC does not affect handgrip strength, it appears to be associated with increased MH cartilage thickness.

Relationship between the DAT1 gene and the effects of methylphenidate administration in adult attention deficit hyperactivity disorder: a magnetic resonance spectroscopy study.

OBJECTIVE: This study investigated the relationship between DAT1 gene polymorphisms and the effects of methylphenidate (MPH) administration on N-acetyl aspartate (NAA), creatine (Cr), and choline (Cho) levels in the anterior cingulate cortex, prefrontal cortex, striatum, and cerebellum in adult patients with attention deficit hyperactivity disorder (ADHD). This was the first study to investigate the relationship between DAT gene variable number tandem repeat (VNTR) polymorphisms and the responses of brain metabolites to MPH. PATIENTS AND METHODS: Samples in this study were collected from 60 patients aged between 18 and 60 years with ADHD according to DSM-IV criteria. Genetic analysis of DAT1 gene polymorphisms was carried out using blood samples obtained after a detailed clinical evaluation. Levels of NAA, Cr, and Cho were measured in the anterior cingulate cortex, prefrontal cortex, striatum, and cerebellum by magnetic resonance spectroscopy. After this evaluation, 10 mg of MPH was given orally to patients, and the levels of the same metabolites were measured 30 min later. RESULTS: No marked difference in NAA, Cr, or Cho levels was detected before and after MPH administration with respect to the DAT1 gene VNTR polymorphisms. A considerable increase in Cr levels in the cerebellum was identified after MPH administration in individuals with the 10/10 repeat genotype as the DAT1 VNTR polymorphism (p=0.008). CONCLUSIONS: An increase in the previously decreased blood flow after MPH therapy may induce an increase in creatine levels in patients with the 10/10 repeat genotype. Our results thus suggest that the 10R allele as the DAT1 gene VNTR polymorphism might be associated with MPH-related changes in brain metabolites in adults with ADHD.

Cloning, purification and characterization of a cellulase-free xylanase from Geobacillus thermodenitrificans AK53.

Geobacillus thermodenitrificans AK53 xyl gene encoding xylanase was isolated, cloned and expressed in Escherichia coli. After purifying recombinant xylanase from G. thermodenitrificans AK53 (GthAK53Xyl) to homogeneity by ammonium sulfate precipitation and ion exchange chromatography, biochemical properties of the enzyme were determined. The kinetic studies for GthAK53Xyl showed K M value to be 4.34 mg/mL (for D-xylose) and V max value to be 2028.9 µmoles mg­1 min­1. The optimal temperature and pH for enzyme activity were found out to be 70°C and 5.0, respectively. The expressed protein showed the highest sequence similarity with the xylanases of G. thermodenitrificans JK1 (JN209933) and G. thermodenitrificans T-2 (EU599644). Metal cations Mg2+ and Mn2+ were found to be required for the enzyme activity, however, Co2+, Hg2+, Fe2+ and Cu2+ ions caused inhibitor effect on it. GthAK53Xyl had no cellulolytic activity and degraded xylan in an endo-fashion. The action of the enzyme on xylan from oat spelt produced xylobiose and xylopentose. The reported results are suggestive of a xylanase exhibiting desirable kinetics, stability parameters and metal resistance required for the efficient production of xylobiose at industrial scale.

Sclerostin and Dkk-1 in patients with ankylosing spondylitis.

OBJECTIVE: To determine the serum Dickkopf-related protein 1 (Dkk-1) and sclerostin levels, and their relationship to structural damage and disease activity in patients with ankylosing spondylitis (AS), as well as to compare the serum Dkk-1 and sclerostin levels in patients receiving and not receiving anti-TNF-a treatment. MATERIALS AND METHOds: This cross-sectional study included 44 AS patients and 41 healthy age- and gender- -matched controls. Demographic data, disease activity parameters, and Bath Ankylosing Spondylitis Radiologic Index (BASRI) scores were recorded. Serum Dkk-1 and sclerostin levels were measured using commercially available ELISA. RESULTS: Serum Dkk-1 levels were lower (P > 0.05) and sclerostin levels were significantly lower (P < 0.05) in the AS patients than in the controls. Dkk-1 and sclerostin levels were similar in the patients that did and didn't receive anti-TNF-a treatment, and in the patients with active and inactive disease (P > 0.05). There wasn't a correlation between serum Dkk-1 or sclerostin levels, and disease activity indices (P > 0.05). BASRI scores did not correlate with serum Dkk-1 or sclerostin levels (P > 0.05). DISCUSSIOn: Sclerostin expression is impaired in AS, but this is not the case for Dkk-1. The lack of an association between Dkk-1 or sclerostin levels, and anti-TNF-a treatment, disease activity indices, and radiological damage might indicate that neither the Dkk-1 nor sclerostin level induce inflammation and radiological damage in AS patients. Pathologic bone formation in AS might be due to molecular dysfunction of sclerostin and Dkk-1 at the cellular level.

Interaction of transport distance and body weight on preslaughter stress and breast meat quality of broilers.

1. The objective of the study was to investigate the effect of transport distance on blood metabolites and breast meat quality of broilers slaughtered at different weights. 2. The study was conducted on Ross 308 broilers from 27 different flocks reared under similar conditions. Slaughter weight was classified as <2·0 kg, 2·0-2·4 kg, and >2·4 kg. Transport distance was categorised as short (65 km), medium (115 km) and long (165 km) distance representing 90, 155 and 220 minutes at an average 45 km/h speed, for each slaughter weight. 3. Higher heterophils and heterophil:lymphocyte (H/L) ratios were obtained for broilers transported over a long distance. Long distance transport increased blood albumin, glucose, and triglycerides levels for <2·0 kg broilers, which did not differ from broilers slaughtered at >2·4 kg after long-distance transport. 4. Broilers slaughtered at >2·4 kg after long-distance transport had lower pH(u), and paler and tougher breast meat, than those broilers slaughtered at <2·0 kg after long-distance transport. 5. A negative correlation was obtained between pH(u) and L*, thawing loss and texture. The L* value was negatively correlated with a*; and positively correlated with b*, thawing and cooking losses. 6. It was concluded that the effect of transport distance could not be evaluated independently of slaughter weight. The interaction between transport distance and slaughter weight contributes to preslaughter stress and meat quality.

Anomalías en la función de la pared izquierda ventricular en pacientes con espondilitis anquilosante evaluados por gammagrafía de perfusión miocárdica sincronizada / Left ventricular wall function abnormalities in patients with ankylosing spondylitis evaluated by gated myocardial perfusion scintigraphy

Objetivo. La espondilitis anquilosante (AS) es una enfermedad inflamatoria crónica con inflamación importante en las articulaciones y los órganos extraarticulares. Los pacientes con AS tienen aproximadamente dos veces más riesgo de mortalidad que la población normal. Una de las razones de este aumento en mortalidad, es el aumento del riesgo cardiovascular. Este estudio se planificó para evaluar la perfusión miocárdica y función ventricular izquierda con 99mTc-MIBI perfusión miocárdica sincronizada computarizada por emisión de foton único (SPECT). Material y métodos. El grupo de estudio consistió en 28 pacientes con AS (19 hombres y 9 mujeres), y la edad media de 39,46±10,98 años. Todos los pacientes fueron sometidos a 99mTc-MIBI SPECT de perfusión miocárdica sincronizada con el protocolo del mismo día. Resultados. Hemos detectado varios factores de riesgo como el hábito de fumar en 12, antecedentes familiares de enfermedad cardiovascular en 12, la hipertensión arterial en 3, la hiperlipidemia en 9 pacientes. Hemos llevado a cabo la perfusión miocárdica SPECT para cada paciente, el patrón de perfusión normal siendo en las imágenes SPECT. De los 28 pacientes, ocho pacientes tuvieron una perfusión normal, pero anomalías en el movimiento de la pared. Conclusión. Hemos detectado que la perfusión miocárdica se preserva en los pacientes con AS. Sin embargo, se observa anormalias en el movimiento de la pared venticular izquierda. Llegamos a la conclusión que la espondilitis anquilosante pueda ser asociados con la disfunción microvascular y la gammagrafía de perfusión miocárdica sincronizada podría ser útil en pacientes con EA para la evaluación de la función del ventrículo izquierdo, aún si existe una baja puntuación en el índice de actividad de la enfermedad espondilitis anquilosante (BASDAI) y menor duración de la enfermedad(AU)

Background. Ankylosing spondilitis (AS) is a chronic inflammatory disease with prominent inflammation in joints and extraarticular organs. AS patients have approximately two times more risk of mortality than the normal population. One reason for this increase in mortality is increased cardiovascular risk. In this study, we have aimed to evaluate myocardial perfusion and left ventricular function using 99mTc-MIBI gated myocardial perfusion single photon emission computed tomography (SPECT). Material and methods. The study group consisted of 28 AS patients (19 men, 9 women), and mean age 39.46±10.98 years. All patients underwent 99mTc-MIBI gated myocardial perfusion SPECT with the same day protocol. Results. We detected various risk factors including smoking habits in 12, family history of cardiovascular disease in 12, hypertension in 3, hyperlipidemia in 9 patients. We performed a myocardial perfusion SPECT for each patient and found normal perfusion pattern in SPECT images. Out of 28 patients, eight patients had normal perfusion but wall motion abnormalities. Conclusion. We detected that myocardial perfusion is preserved in the patients with AS. However, left ventricular wall motion abnormalities are seen. We concluded that ankylosing spondylitis may be associated with microvascular dysfunction and gated myocardial perfusion scintigraphy could be valuable in AS patients for the evaluation of LV function even if the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score are low and the disease duration shorter(AU)

Left ventricular wall function abnormalities in patients with ankylosing spondylitis evaluated by gated myocardial perfusion scintigraphy.

BACKGROUND: Ankylosing spondilitis (AS) is a chronic inflammatory disease with prominent inflammation in joints and extraarticular organs. AS patients have approximately two times more risk of mortality than the normal population. One reason for this increase in mortality is increased cardiovascular risk. In this study, we have aimed to evaluate myocardial perfusion and left ventricular function using (99m)Tc-MIBI gated myocardial perfusion single photon emission computed tomography (SPECT). MATERIAL AND METHODS: The study group consisted of 28 AS patients (19 men, 9 women), and mean age 39.46±10.98 years. All patients underwent (99m)Tc-MIBI gated myocardial perfusion SPECT with the same day protocol. RESULTS: We detected various risk factors including smoking habits in 12, family history of cardiovascular disease in 12, hypertension in 3, hyperlipidemia in 9 patients. We performed a myocardial perfusion SPECT for each patient and found normal perfusion pattern in SPECT images. Out of 28 patients, eight patients had normal perfusion but wall motion abnormalities. CONCLUSION: We detected that myocardial perfusion is preserved in the patients with AS. However, left ventricular wall motion abnormalities are seen. We concluded that ankylosing spondylitis may be associated with microvascular dysfunction and gated myocardial perfusion scintigraphy could be valuable in AS patients for the evaluation of LV function even if the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score are low and the disease duration shorter.

Dutogliptin, a selective DPP4 inhibitor, improves glycaemic control in patients with type 2 diabetes: a 12-week, double-blind, randomized, placebo-controlled, multicentre trial.

AIM: To determine efficacy and tolerability of dutogliptin, a dipeptidyl peptidase 4 (DPP4) inhibitor, in patients with type 2 diabetes mellitus. METHODS: This was a 12-week, multicentre, randomized, double-blind, placebo-controlled trial in 423 patients with type 2 diabetes with suboptimal metabolic control. Following a 2-week single-blind placebo run-in, patients aged 18-75 years with a body mass index of 25-48 kg/m(2) and baseline HbA1c of 7.3-11.0% were randomized 2:2:1 to receive once-daily oral therapy with either dutogliptin (400 or 200 mg) or placebo on a background medication of either metformin alone, a thiazolidinedione (TZD) alone or a combination of metformin plus a TZD. RESULTS: Average HbA1c at baseline was 8.4%. Administration of dutogliptin 400 and 200 mg for 12 weeks decreased HbA1c by -0.52% (p < 0.001) and -0.35% (p = 0.006), respectively (placebo-corrected values), with absolute changes in HbA1c for the 400 mg, 200 mg and placebo groups of -0.82, -0.64 and -0.3%, respectively. The proportion of patients achieving an HbA1c < 7% was 27, 21 and 12% at dutogliptin doses of 400 and 200 mg or placebo, respectively (p = 0.008 for comparison of 400 mg vs. placebo). Fasting plasma glucose (FPG) levels were significantly reduced in both active treatment groups compared to placebo: the placebo-corrected difference was -1.00 mmol/l (p < 0.001) for the 400 mg group and -0.88 mmol/l (p = 0.003) for the 200 mg group. Dutogliptin caused significantly greater reductions in postprandial glucose AUC (0-2h) in both the 400 and 200 mg groups (placebo corrected values -2.58 mmol/l/h, p < 0.001 and -1.63 mmol/l/h, p = 0.032, respectively). In general, patients tolerated the study drug well. There were minor, not clinically meaningful differences in adverse events (AEs) between dutogliptin-treated patients and placebo controls, and 60% of all reported AEs were mild. Vital signs and body weight were stable, and routine safety laboratory parameters did not change compared with placebo. Trough ex vivo DPP4 inhibition at the end of the 12-week treatment period was 80 and 70%, at the 400 and 200 mg doses of dutogliptin, respectively. CONCLUSIONS: Dutogliptin treatment for 12 weeks improved glycaemic control in patients with type 2 diabetes who were on a background medication of metformin, a TZD or metformin plus a TZD. Tolerability was favourable for both doses tested. The 400 mg dose of dutogliptin resulted in larger changes of HbA1c and FPG and more subjects reached an HbA1c target of < 7% than the 200 mg dose.

The relationship between anti-cyclic citrullinated peptide and bone mineral density and radiographic damage in patients with rheumatoid arthritis.

OBJECTIVES: We aimed to investigate the relationship between anti-cyclic citrullinated peptide (anti-CCP) levels and bone mineral density (BMD), bone turnover, and radiographic damage in patients with rheumatoid arthritis (RA). METHODS: Eighty patients (68 females, 12 males, mean age 46.50+/-14.59 years) with RA were included in the study. Anti-CCP antibodies were measured by enzyme-linked immunosorbent assay (ELISA). Bone turnover was studied by analysing serum levels of C-terminal telopeptide of type I collagen (sCTX, ng/mL), using an enzyme immunoassay. BMD was measured by dual-energy X-ray absorptiometry (DXA). Disease activity was assessed according to the Disease Activity Score that includes 28 joint counts (DAS28). Functional capacity was assessed by the Health Assessment Questionnaire (HAQ). RESULTS: Anti-CCP-positive patients were defined as group 1 and anti-CCP-negative patients as group 2. The mean disease duration was 7.53+/-6.27 years in group 1 and 6.25+/-6.51 years in group 2. Anti-CCP had a limited negative correlation with lumbar BMD (r = -0.220, p = 0.050) and a negative correlation with femoral BMD (r = -0.242, p = 0.031). There was no statistically significant correlation between anti-CCP and sCTX values (r = 0.117, p = 0.301). Sharp scores were significantly higher in anti-CCP-positive than anti-CCP-negative patients (p = 0.012), and anti-CCP levels were significantly correlated with Sharp scores (r = 0.240, p = 0.032). CONCLUSIONS: We found that RA patients with higher levels of anti-CCP antibody had lower lumbar and femoral BMD. Anti-CCP levels were also associated with radiographic damage. Therefore, we suggest that anti-CCP may be a determinant of bone loss in patients with RA.

Disease activity in rheumatoid arthritis as a predictor of difficult intubation?

BACKGROUND AND OBJECTIVES: Rheumatoid arthritis is a lifelong systemic disease that can affect any joint with a synovium. Managing intubation in patients with rheumatoid disease is a special challenge in these patients especially if specific joints, which play an important role during intubation, are affected. We aimed to investigate if there was a correlation between the activity and duration of the disease and the commonly used predictors of difficult intubation in rheumatoid arthritis. METHODS: Sixty-six patients with the diagnosis of rheumatoid arthritis and 60 control patients were included in the study. Patient characteristics were recorded. Body mass index, disease activity scores, Mallampati classification, sternomental distance, thyromental distance, inter-incisor distance and atlanto-occipital joint extension were measured for each patient. Every patient was asked to complete the Stanford Health Assessment Questionnaire (HAQ score). Disease activity score (DAS 28 score) including 28 joints was used to assess the activity of the disease. Correlation between the predictors of difficult intubation and activity was assessed and was compared with the control group. RESULTS: Mallampati scores were higher (P = 0.000), sternomental distance (P = 0.005) and inter-incisor distance (P = 0.003) were shorter and also occlusal surfacetragus line angle were smaller in the rheumatoid arthritis group compared with controls (P = 0.000). We did not observe a correlation between the disease activity scores and the Mallampati score (P = 0.619), sternomental distance (P = 0.195), thyromental distance (P = 0.174), inter-incisor distance (P = 0.764), angle I (P = 0.372) and angle II (P = 0.609). There was no correlation between the HAQ score and the Mallampati score (P = 0.872), sternomental distance (P = 0.455), thyromental distance (P = 0.841), inter-incisor distance (P = 0.162), angle I (P = 0.768) and angle II (P = 0.287). There was no correlation between the duration of the disease and the Mallampati score (P = 0.619), sternomental distance (P = 0.505), thyromental distance (P = 0.426), inter-incisor distance (P = 0.813), angle I (P = 0.377) and angle II (P = 0.600). CONCLUSION: Tests of disease activity and the duration of the disease were not found to be correlated with the predictors of difficult intubation in this study. Thus, performing the predictive tests for difficult intubation especially in patients with very low scores or short disease is recommended.

The dipeptidyl peptidase-4 inhibitor PHX1149 improves blood glucose control in patients with type 2 diabetes mellitus.

AIM: To determine the efficacy and tolerability of PHX1149, a novel dipeptidyl peptidase-4 (DPP4) inhibitor, in patients with type 2 diabetes. METHODS: This is a multicentre, randomized, double-blind, placebo-controlled, 4-week study in patients with type 2 diabetes with suboptimal metabolic control. Patients with a baseline haemoglobin A(1c) (HbA(1c)) of 7.3 to 11.0% were randomized 1 : 1 : 1 : 1 to receive once-daily oral therapy with either PHX1149 (100, 200 or 400 mg) or placebo; patients were on a constant background therapy of either metformin alone or metformin plus a glitazone. RESULTS: Treatment with 100, 200 or 400 mg of PHX1149 significantly decreased postprandial glucose area under the curve AUC(0-2 h) by approximately 20% (+0.11 +/- 0.50, -2.08 +/- 0.51, -1.73 +/- 0.49 and -1.88 +/- 0.48 mmol/l x h, respectively, for placebo and 100, 200 and 400 mg (p = 0.002, 0.008 and 0.004 vs. placebo). Postprandial AUC(0-2 h) of intact glucagon-like peptide-1, the principal mediator of the biological effects of DPP4 inhibitors, was increased by 3.90 +/- 2.83, 11.63 +/- 2.86, 16.42 +/- 2.72 and 15.75 +/- 2.71 pmol/l x h, respectively, for placebo and 100, 200 and 400 mg (p = 0.053, 0.001 and 0.002 vs. placebo). Mean HbA(1c) was lower in all dose groups; the placebo-corrected change in the groups receiving 400 mg PHX1149 was -0.28% (p = 0.02). DPP4 inhibition on day 28 was 53, 73 and 78% at 24 h postdose in the groups receiving 100, 200 and 400 mg PHX1149, respectively. There were no differences in adverse events between PHX1149-treated and placebo subjects. CONCLUSIONS: Addition of the DPP4 inhibitor PHX1149 to a stable regimen of metformin or metformin plus a glitazone in patients with type 2 diabetes was well tolerated and improved blood glucose control.