Vitamin D levels in Greek patients with systemic lupus erythematosus.

OBJECTIVES: Vitamin D deficiency has been observed in autoimmune rheumatic diseases, such as rheumatoid arthritis. The aim was to study vitamin D in patients with systemic lupus erythematosus (SLE) and its relationship with disease activity. METHODS: In a cohort of 45 patients with SLE, 41 females and 4 males, aged 47.07 ± 2.17 years (mean ± SEM), and range = 21-79 years, 25(OH)D3 levels were determined by electrochemiluminescence. C3 and C4 levels were also analyzed. SLE disease activity was estimated by SLEDAI-2K. Observations were also performed in a control group matched for age and sex. RESULTS: In this cohort of SLE patients, 25(OH)D3 levels were 40.36 ± 2.41 nmol/L (mean ± SEM) as opposed to 60.98 ± 4.28 nmol/L in the control group (p < 0.001, Student's t test). Vitamin D levels were related to C3 (p < 0.001, linear regression analysis), correlation coefficient 0.106, r2 = 0.011, and C4 (p < 0.001); correlation coefficient 0.316 and r2 = 0.100; and inversely related to disease activity (p < 0.001), correlation coefficient -0.572 and r2 = 0.327. 25(OH)D3 levels were 17.73 ± 1.20 nmol/L and 12.24 ± 0.93 nmol/L, in the groups without and with renal involvement, respectively (p = 0.001, Student's t test). CONCLUSIONS: Vitamin D levels are low in SLE patients and are inversely related to disease activity. Routine screening for vitamin D levels should be performed in SLE patients.

Synergistic enantioseparation systems with either cyclodextrins or cyclofructans and L-alanine Tert butyl ester lactate.

The combined use of chiral ionic liquids (CILs) and conventional chiral selectors (CSs) in CE, to establish a synergistic system, has proven to be an effective approach for the separation of enantiomeric pairs. In this study, a new CE method was developed, employing a binary system of a CS, either a cyclodextrin (CD) or a cyclofructan (CF), and a chiral amino acid ester-based ionic liquid (AAIL), for the chiral separation of four basic, acidic and zwitterionic drug compounds. In particular, the enantioseparation of two anticoagulants, warfarin (WAR) and coumachlor (COU), a non-opioid analgesic, nefopam (NEF) and a third-generation antihistamine, fexofenadine (FXD), was examined, by supporting the BGE with a CS and the chiral AAIL L-alanine tert butyl ester lactate (L-AlaC4 Lac). Parameters, such as the type of the CS, the concentration of both the CS and L-AlaC4 Lac, and the BGE pH, were methodically examined in order to optimize the chiral separation of each analyte. It was observed that, in some cases, the addition of the AAIL into the BGE improved both resolution (Rs ) and efficiency (N) significantly. In other cases, the synergistic effect enabled baseline separation of analyte enantiomers, at a much lower concentration of the CS. Finally, after optimization of separation conditions, baseline separations (Rs >1.5) of all four analytes were achieved in less than 5 min.

Sleep disorders and health-related quality of life in patients with interstitial lung disease.

BACKGROUND: Interstitial lung diseases (ILD) are chronic and restrictive lung diseases with poor survival and quality of life. The aim of this study was to investigate the frequency of sleep disorders in idiopathic pulmonary fibrosis (IPF) and sarcoidosis and to assess patients' quality of life in relation to these disorders. METHODS: Forty patients, 19 with IPF, and 21 with sarcoidosis stage II/III were included. They were compared with 15 healthy subjects. All patients performed all-night polysomnography (PSG) and completed the Epworth, Berlin, and Stop-Bang questionnaires. In order to evaluate the quality of life, all patients completed the Short-Form 36 (SF-36) questionnaire. RESULTS: Of the IPF patients, 68% were diagnosed with mild obstructive sleep apnea (OSA), 5.2% with moderate to severe, 5.2% with severe OSA, and 21% with no OSA. Of patients with sarcoidosis, 52.4% were diagnosed with mild OSA and 4.8% with moderate severity OSA. The remaining 42.8% did not have OSA. The health-related quality of life in both patients with IPF and patients with sarcoidosis was impaired especially in the domains concerning physical health and the level of independence, compared to the control group. CONCLUSIONS: In this sample of patients with IPF and sarcoidosis, obstructive sleep apnea is common at least in a mild degree of severity. The SF-36 questionnaire may be a useful tool for the evaluation of the quality of life in these patients.

Chiral selectors in CE: recent developments and applications (2012-mid 2014).

There is a large number of chiral selectors (CSs) that have, over the years, been synthesized and used in electrophoretic enantioseparations. This report highlights the most important CSs applied in CE during the period 2012 to mid-2014. It is mainly focused on method developments and validations, along with pharmaceutical and biomedical applications. Even though numerous publications have, through the years, reported the utilization of CSs in enantioseparations, only the ones applied in electrophoretic techniques the last approximately three years are demonstrated in this review article. In particular, cyclodextrins, cyclofructants, linear and branched oligo- and polysaccharides, antibiotics, and polymeric surfactants are presented, and their advantages, their chiral recognition mechanisms, and their performance are discussed.

Combined use of l-alanine tert butyl ester lactate and trimethyl-ß-cyclodextrin for the enantiomeric separations of 2-arylpropionic acids nonsteroidal anti-inflammatory drugs.

In this study, a new CE method, employing a binary system of trimethyl-ß-CD (TM-ß-CD) and a chiral amino acid ester-based ionic liquid (AAIL), was developed for the chiral separation of seven 2-arylpropionic acid nonsteroidal anti-inflammatory drugs (NSAIDs). In particular, the enantioseparation of ibuprofen, ketoprofen, carprofen, indoprofen, flurbiprofen, naproxen, and fenoprofen was improved significantly by supporting the BGE with the chiral AAIL l-alanine tert butyl ester lactate (l-AlaC4 Lac). Parameters, such as concentrations of TM-ß-CD and l-AlaC4 Lac, and buffer pH, were systematically examined in order to optimize the chiral separation of each NSAID. It was observed that the addition of the AAIL into the BGE improved both resolution and efficiency significantly. After optimization of separation conditions, baseline separation (Rs >1.5) of five of the analytes was achieved in less than 11 min, while the resolution of ibuprofen and flurbiprofen was approximately 1.2. The optimized enantioseparation conditions for all analytes involve a BGE of 5 mM sodium acetate/acetic acid (pH 5.0), an applied voltage of 30 kV, and a temperature of 20°C. In addition, the results obtained by computing the %-RSD values of the EOF and the two enantiomer peaks, demonstrated excellent run-to-run, batch-to-batch, and day-to-day reproducibilities.

Evaluation of amino acid ester-based ionic liquids as buffer additives in CE for the separation of 2-arylpropionic acids nonsteroidal anti-inflammatory drugs.

The aim of the present study is the CE performance evaluation for the separation of 2-arylpropionic acid nonsteroidal anti-inflammatory drugs. In particular, the separation of indoprofen, carprofen, ketoprofen, ibuprofen, and flurbiprofen was obtained by supporting the BGE either with SDS or an amino acid ester-based ionic liquid (AAIL). The performance of these additives was evaluated by comparing migration times, efficiencies and %RSD values. The addition of the AAIL into the BGE provided baseline separation within 10 min, while in the case of SDS, the analytes eluted within 23 min. The optimum conditions involve a BGE of 100 mM Tris/10 mM sodium tetraboratedecahydrate (pH 8) and 40 mM l-alanine tert butyl ester lactate or 10 mM SDS and a temperature of 35°C for AAIL and 20°C for SDS. The run-to-run reproducibility was evaluated by computing the %RSD values of the EOF and the analyte peaks. When the AAIL was used, an excellent reproducibility was obtained, since all %RSD values were below 1.3%. On the contrary, the addition of SDS resulted in much higher RSD values (2.1-11.7%). The efficiency values of all analyte peaks were above 102 000 for l-AlaC4 Lac, in comparison to SDS, which provided efficiency values between 47000 and 76000. Finally, in an attempt to study the synergistic effect of SDS and AAIL, both additives were added into the BGE at concentrations of 10 and 40 mM, respectively. The results were similar to the ones obtained when SDS was used as the sole additive.

Blood Lactate and Maximal Lactate Accumulation Rate at Three Sprint Swimming Distances in Highly Trained and Elite Swimmers.

We examined the blood lactate response, in terms of the maximal post-exercise concentration (Lamax), time to reach Lamax, and maximal lactate accumulation rate (VLamax), to swimming sprints of 25, 35, and 50 m. A total of 14 highly trained and elite swimmers (8 male and 6 female), aged 14-32, completed the 3 sprints in their specialization stroke with 30 min of passive rest in between. The blood lactate was measured right before and continually (every minute) after each sprint to detect the Lamax. The VLamax, a potential index of anaerobic lactic power, was calculated. The blood lactate concentration, swimming speed, and VLamax differed between the sprints (p < 0.001). The Lamax was highest after 50 m (13.8 ± 2.6 mmol·L-1, mean ± SD throughout), while the swimming speed and VLamax were highest at 25 m (2.16 ± 0.25 m·s-1 and 0.75 ± 0.18 mmol·L-1·s-1). The lactate peaked approximately 2 min after all the sprints. The VLamax in each sprint correlated positively with the speed and with each other. In conclusion, the correlation of the swimming speed with the VLamax suggests that the VLamax is an index of anaerobic lactic power and that it is possible to improve performance by augmenting the VLamax through appropriate training. To accurately measure the Lamax and, hence, the VLamax, we recommend starting blood sampling one minute after exercise.

Chiral ionic liquids in chromatographic and electrophoretic separations.

This report provides an overview of the application of chiral ionic liquids (CILs) in separation technology, and particularly in capillary electrophoresis and both gas and liquid chromatography. There is a large number of CILs that have been synthesized and designed as chiral agents. However, only a few have successfully been applied in separation technology. Even though this application of CILs is still in its early stages, the scientific interest is increasing dramatically. This article is focused on the use of CILs as chiral selectors, background electrolyte additives, chiral ligands and chiral stationary phases in electrophoretic and chromatographic techniques. Different examples of CILs, which contain either a chiral cation, a chiral anion or both, are presented in this review article, and their major advantages along with their potential applications in chiral electrophoretic and chromatographic recognition are discussed.

Stem cells' guided gene therapy of cancer: New frontier in personalized and targeted therapy.

INTRODUCTION: Diagnosis and therapy of cancer remain to be the greatest challenges for all physicians working in clinical oncology and molecular medicine. The statistics speak for themselves with the grim reports of 1,638,910 men and women diagnosed with cancer and nearly 577,190 patients passed away due to cancer in the USA in 2012. For practicing clinicians, who treat patients suffering from advanced cancers with contemporary systemic therapies, the main challenge is to attain therapeutic efficacy, while minimizing side effects. Unfortunately, all contemporary systemic therapies cause side effects. In treated patients, these side effects may range from nausea to damaged tissues. In cancer survivors, the iatrogenic outcomes of systemic therapies may include genomic mutations and their consequences. Therefore, there is an urgent need for personalized and targeted therapies. Recently, we reviewed the current status of suicide gene therapy for cancer. Herein, we discuss the novel strategy: genetically engineered stem cells' guided gene therapy. REVIEW OF THERAPEUTIC STRATEGIES IN PRECLINICAL AND CLINICAL TRIALS: Stem cells have the unique potential for self renewal and differentiation. This potential is the primary reason for introducing them into medicine to regenerate injured or degenerated organs, as well as to rejuvenate aging tissues. Recent advances in genetic engineering and stem cell research have created the foundations for genetic engineering of stem cells as the vectors for delivery of therapeutic transgenes. Specifically in oncology, the stem cells are genetically engineered to deliver the cell suicide inducing genes selectively to the cancer cells only. Expression of the transgenes kills the cancer cells, while leaving healthy cells unaffected. Herein, we present various strategies to bioengineer suicide inducing genes and stem cell vectors. Moreover, we review results of the main preclinical studies and clinical trials. However, the main risk for therapeutic use of stem cells is their cancerous transformation. Therefore, we discuss various strategies to safeguard stem cell guided gene therapy against iatrogenic cancerogenesis. PERSPECTIVES: Defining cancer biomarkers to facilitate early diagnosis, elucidating cancer genomics and proteomics with modern tools of next generation sequencing, and analyzing patients' gene expression profiles provide essential data to elucidate molecular dynamics of cancer and to consider them for crafting pharmacogenomics-based personalized therapies. Streamlining of these data into genetic engineering of stem cells facilitates their use as the vectors delivering therapeutic genes into specific cancer cells. In this realm, stem cells guided gene therapy becomes a promising new frontier in personalized and targeted therapy of cancer.

Lymphangioleiomyomatosis: current and future.

Lymphangioleiomyomatosis is a rare slowly progressive lung disease that affects almost exclusively young women of reproductive age. It occurs sporadically or in association with Tuberous Sclerosis Complex. LAM is characterized by cystic remodeling of the lung parenchyma, due to proliferation of abnormal smooth muscle-like LAM cells and presence of extra pulmonary manifestations such as lymphadenopathy, angiomyolipomas and abdominal lymphangioleiomyomas. The most common clinical manifestations are progressive dyspnea on exertion, pneumothorax and chylous effusions. Currently there is no curative treatment for the disease, but the ongoing study of the genetic and molecular pathways implicated in the pathogenesis of the disease could lead to targeted therapy.

Pegylated liposomal doxorubicin in malignant pleural mesothelioma: a possible guardian for long-term survival.

Malignant pleural mesothelioma is a rare and aggressive malignancy of the pleura correlated with exposure to asbestos, with a medium survival of 11-12 months after diagnosis. A case of a 67-year-old male who had previously worked in the asbestos industry and is a current smoker is reported. The computed tomography evaluation revealed a right pleural mass with pleural thickening, and the pleural biopsy confirmed a diagnosis of malignant pleural mesothelioma. He was treated with chemotherapy consisting of etoposide, paclitaxel, and pegylated liposomal doxorubicin hydrochloride. After completion of chemotherapy, radiologic evaluation confirmed a reduction of pleural thickening and improvement in his symptoms. A complete presentation of each drug formulation and characteristics are also included in this paper. The patient's follow-up is continuing, and computed tomography reveals stable disease 9 years after initial examination.