Chemical Composition and Antimicrobial Activity of Essential Oil of Fruits from Vitex agnus-castus L., Growing in Two Regions in Bulgaria

The chemical composition of Vitex agnus-castus L. (Verbenaceae family) fruits, collected from two regions in Bulgaria (south-central and north-east Bulgaria), was investigated. The content of proteins (5.3-7.4%), carbohydrates (73.9-78.8%), fiber (47.2-49.9%), ash (2.5-3.0%), essential oils (0.5%), and vegetable oil (3.8-5.0%) were identified in the fruits. The composition of the essential oils (EOs) of Vitex fruits from both regions was determined; the main compounds were 1,8-cineole (16.9-18.8%), α-pinene (7.2-16.6%), sabinene (6.7-14.5%), and bicyclogermacrene (7.3-9.0%), but significant differences in the quantitative and qualitative composition of EOs between the regions were found. The EOs of plants from north-east Bulgaria demonstrated antimicrobial activity against the pathogenic species Salmonella abony, Staphylococcus aureus, and Bacillus subtilis, but the Gram-negative bacteria Esсherichia coli and Pseudomonas aeruginosa exhibited resistance to the oil. Linoleic acid predominated in vegetable oil from both regions, followed by oleic acid. β-sitosterol and γ-tocopherol were the main components in the sterol and tocopherol fraction of the lipids. Phosphatidic acids were the main components in the vegetable oil from north-east Bulgaria, while in the vegetable oil from south-central Bulgaria, all phospholipids were found in almost the same quantity. Overall, significant differences were observed in the chemical composition (proteins, carbohydrates, ash and moisture) of the fruits from the two regions of Bulgaria, as well as in the content of the main components of their essential and vegetable oils.

Evaluation of the Impact of Different Management Methods on Tetranychus urticae (Acari: Tetranychidae) and Their Predators in Citrus Orchards

To evaluate the effectiveness of eco-friendly treatments based on detergents classified as non-hazardous and black soap on the pest Tetranychus urticae Koch 1836, and their predators (Euseius stipulatus Athias-Henriot, 1960, Typhlodromus sp., Phytoseiulus persimilis Athias-Henriot, 1957), different treatments were applied to citrus orchards planted with Valencia late (Orange) in the Mechraa Belksiri region of Morocco (T0 = control experiment; T1 = spirodiclofen 0.5 L/Ha; T2 = 125 L/Ha (5%) of black soap; T3 = detergent; 4 L/Ha of Oni product + 2 L/Ha of Tide product). The results obtained during the whole monitoring period indicated that the three treatments used, namely spirodiclofen, black soap, and detergents, ensured a reduction in the rate of population of the pest T. urticae compared to the untreated plot. In the untreated plot, the average was 45.01 A± 4.90 mobile forms, while the plot treated with spirodiclofen it was only 21.10 C ± 2.71, the black soap 31.49 B ± 3.35, and in the plot treated with detergents, the average was similar to that obtained by spirodiclofen (22.90 C ± 2.18). On the predators (E. stipulatus, P. persimilis, and Typhlodropmus sp.), the black soap and the treatment with detergents were less harmful compared to the chemical spirodiclofen.

Total Phenolic Content and Antioxidant and Antimicrobial Activities of Papaver rhoeas L. Organ Extracts Growing in Taounate Region, Morocco

The objective of this study is to valorize Papaver rhoeas L. from the Taounate region of Morocco by determining the total polyphenol content (TPC), the total flavonoid content (TFC) and the antioxidant and antimicrobial activities of four organs. The quantification of TPC and TFC in root, stem, leaf and flower extracts (RE, SE, LE and FE, respectively) was estimated by the Folin–Ciocalteu reaction and the aluminum trichloride method, respectively. Two tests were used to assess antioxidant power: the DPPH test and TAC assay. The antimicrobial activity was studied against five pathogenic bacteria and yeast, using two methods: disk diffusion and microdilution. The TPC in LE and LF was twice as high as that in RE and SE (24.24 and 22.10 mg GAE/g, respectively). The TFC values in the four extracts were very close and varied between 4.50 mg QE/g in the FE and 4.38 mg QE/g in the RE. The LE and FE showed low DPPH values with IC50 = 0.50 and 0.52 mg/mL, respectively. The TAC measurement revealed the presence of a significant amount of antioxidants in the studied extracts, mainly in LE and FE (6.60 and 5.53 mg AAE/g, respectively). The antimicrobial activity results revealed significant activity on almost all of the tested strains. The MIC of FE and SE against E. coli 57 was 1.56 and 0.78 mg/mL, respectively, while against the S. aureus it was 50 and 25 mg/mL, respectively. The low MLC value (1.56 mg/mL) was recorded against E. coli 57 by RE and SE.

Contribution to the Evaluation of Physicochemical Properties, Total Phenolic Content, Antioxidant Potential, and Antimicrobial Activity of Vinegar Commercialized in Morocco

Vinegar is a natural product widely used in food and traditional medicine thanks to its physicochemical properties and its richness in bioactive molecules. However, its direct use by consumers can have complications and undesirable effects. Therefore, this study contributes to investigating the physicochemical and biological properties of eleven vinegars marketed in Morocco. Determination of pH, acetic acid, conductivity, total soluble solids and alcohol content in vinegar was carried out. The polyphenols (TP), flavonoids (TF), and condensed tannins (CT) content was determined, and their antioxidant activities were evaluated using 2,2-diphenyl-1-picryl Hydrazyl (DPPH), Ferric Reducing Antioxidant Power (FRAP) and Phosphomolybdenum Reduction Assay (TAC). Then, the antimicrobial activity was studied against four pathogenic bacteria and two fungal strains, using the disk diffusion and the microdilution method. This study showed a wide range of acetic acid values from 0.65 ± 0.29 to 5.15 ± 0.20%. The high value of TP, TF, and CT in our samples V10, V9, and V4 was 655.00 ± 22.2 µgGAE/mL, 244.53 ± 11.32 µgQE/mL and 84.63 ± 1.00 µgTAE/mL, respectively. The tested strains showed variable sensitivities to the different samples with inhibition zones ranging from 6.33 ± 2.08 to 34.33 ± 0.58 mm. The lowest minimum inhibition concentrations were recorded against Staphylococcus aureus ATCC29213 ranging from 1.95 to 7.81 µL/mL. While Aspergillus niger ATCC16404 showed resistance against all of the analyzed samples. In general, vinegar commercialized in Morocco presents a variable range of products with variable properties. Indeed, must take into account this diversity when using it. A future study is needed to identify the phytochemical composition that will further the comprehension of this variability and contribute to its valorization.

An Intervention Study to Increase the Medication Compliance of 60 Years and Older Individuals

Background

In older age, taking medication at the desired level contributes to the health and well-being, and therefore, constitutes an essential part of the effectiveness of treatment and ultimately desired public health impact and reduced healthcare budgets. However, it is known that medication compliance among older persons is frequently not at a desired level. Therefore, in this study, it was aimed to increase medication compliance through an educational intervention for patients aged 60 and over, who applied to two healthcare facilities in Ankara, Turkey.

Methods

This intervention study was implemented in two public health hospitals between March and June 2019. 315 people aged 60 and over participated in the study. The intervention tool was the “teach-back” method. SPSS program was used for data entry and analysis. P value less than 0.05 was indicated for statistical significance.

Results

Mean age of the participants was found to be 70.16±7.9 for the control group and 70.27±7.4 for the intervention group. In the intervention group, a statistically significant increase was found in the capacity of learning the long-term benefits of drugs, their side effects and storage conditions, and knowing when the drugs shouldn't be taken, and repeating information about the drugs used (p = 0.000).

Conclusions

This study has revealed that medication compliance among older individuals can be increased with an appropriate communication and training method in healthcare settings. Time allocated by health workers in this regard has a potential to respond to the compliance-related needs. With the “Teach-back” method utilized in the interactions between older patients and health workers, it is possible to attain meaningful, large-scale and cost-effective public health outcomes that contribute to the clinical benefits of treatments and the effectiveness of health systems.

Key messages

Older people are open to receive information on the actual health needs. A well-structured interaction between healthcare workers and patients involving “teach-back” method contributes to medication compliance among the elderly.

The prevalence of non-vascular pulmonary manifestations in Takayasu's Arteritis patients: A Retrospective multi-centred Turkish cohort study

Objectives Takayasu's arteritis (TAK) is a rare vasculitis characterized by inflammation of intermediate- to large-size arteries. Although pulmonary artery involvement (PAI) is an expected finding in some TAK patients, data on non-vascular pulmonary involvement (NVPI) are limited. We aimed to investigate the frequency of NVPI, including parenchymal infiltration, nodules/cavities, pleural effusion, and haemorrhage, in TAK.Method We assembled a retrospective cohort of TAK patients from nine tertiary centres in Turkey. The demographics and clinical characteristics of patients were extracted from medical records and the imaging findings were evaluated for pulmonary manifestations.Results As of January 2021, 319 TAK patients (female/male 276/43; mean age 42.4 ± 13.5 years) were recruited. Eighty-two patients had cough and/or dyspnoea and four had haemoptysis as pulmonary symptoms. On computed tomography assessment, the overall frequency of NVPI was 7.2%; parenchymal infiltrations were present in 10 (3.1%), pleural effusion in eight (2.5%), nodules/cavities in six (1.9%), and pulmonary haemorrhage in four patients (1.3%). In the whole cohort, 10.3% of patients had pulmonary artery hypertension (PAH) and 5.6% had PAI. Among patients with PAH or PAI, the overall frequency of NVPI was significantly higher than in the rest of the group.Conclusions In this TAK cohort from Turkey, we observed NVPI in 7.2% of patients, with parenchymal infiltrations being the most common, followed by pleural effusion. Notably, NVPI was more frequent in patients with PAH or PAI. Although not as common as PAI, NVPI should be kept in mind, especially in TAK patients with PAH or PAI.

The Impact of Apple Variety and the Production Methods on the Antibacterial Activity of Vinegar Samples

Apple vinegar is a natural product widely used in food and traditional medicine as it contains many bioactive compounds. The apple variety and production methods are two factors that play a major role in determining the quality of vinegar. Therefore, this study aims to determine the quality of apple vinegar samples from different varieties (Red Delicious, Gala, Golden Delicious, and Starking Delicious) prepared by three methods using small apple pieces, apple juice, and crushed apple, through determining the physicochemical properties and antibacterial activity of these samples. The antibacterial activity was studied against five pathogenic bacteria: Staphylococcus aureus, Klebsiella pneumonia, Escherichia coli (ATB: 57), Escherichia coli (ATB: 97), and Pseudomonas aeruginosa, using two methods, disk diffusion and microdilution, for determining the minimum inhibitory concentrations and the minimum bactericidal concentrations. The results of this study showed that the lowest pH value was 3.6 for Stark Delicious, obtained by liquid fermentation, and the highest acetic acid values were 4.7 and 4% for the vinegar of Red Delicious and Golden Delicious, prepared by solid fermentation, respectively. The results of the antibacterial activity showed considerable activity of apple vinegar on the tested strains. Generally, the Staphylococcus aureus strain appears less sensitive and Pseudomonas aeruginosa seems to be very sensitive against all samples, while the other strains have distinct sensitivities depending on the variety studied and the method used. A higher antibacterial activity was found in vinegar obtained by the apple pieces method and the Red Delicious variety, with a low MIC and MBC recorded, at 1.95 and 3.90 µL/mL, respectively. This study has shown that the choice of both apple variety and production method is therefore an essential step in determining and aiming for the desired quality of apple vinegar.

Letter to the Editor: Adjusting Anterior Thigh Muscle Measurements Using Ultrasound in Sarcopenia

We have read with great interest the recently published article by Tsukasaki et al (1). We congratulate the authors for drawing attention to regional muscle mass measurements for evaluating sarcopenia. As they highlighted, age-related muscle loss occurs initially in the anterior thigh muscles that predominantly contain fast-twitch (type II) fibers (2). Therefore, regional muscle mass and functional assessments are important for the early diagnosis and follow-up of sarcopenia (2). In this regard, computed tomography (CT), magnetic resonance imaging, ultrasound (US) and dual-energy X-ray absorptiometry (DXA) techniques give opportunity for regional muscle mass measurements. Likewise, the authors compared the relationships among regional/total muscle mass measurements, muscle power, strength and performance tests. Although we agree with them in general, we would like to add further.

Maternal and fetal outcomes of COVID-19, SARS, and MERS: a narrative review on the current knowledge

OBJECTIVE

Coronavirus infections, including SARS, MERS and COVID-19 have significant impact on global health as well as on pregnancies. The aim of this review was to enlighten and summarize the cumulative knowledge regarding the relationship between Coronavirus outbreaks and pregnancy.

MATERIALS AND METHODS

Literature search was commenced in order to analyze the maternofetal effects of Coronavirus outbreaks.

RESULTS

Fever and cough are the most common presenting symptoms of COVID-19 which mostly affects pregnant women in their 3rd trimester with a maternal mortality rate of  0-77%  and fetal and neonatal mortality rates of 1.2%. Fetal demise is common in critically ill pregnant. Pregnancy seems as a worsening factor for SARS and MERS epidemics and both infections affect prominently 3rd trimester pregnancies, although abortion (57%) is a significant risk for cases of early pregnancy. Clinical course of COVID-19, SARS and MERS may be rapid and worse in pregnant women than non-pregnant individuals. Cesarean section is the choice of delivery in most reported women due to mostly obstetrical reasons, although vaginal delivery seems not a worsening factor for the disease.

CONCLUSIONS

COVID-19, SARS and MERS have significant detrimental effect on pregnancy. Rapid intervention, treatment, and intensive care support are essential for infected pregnant. Timely delivery is important in order to avoid intrauterine fetal death.

Preliminary report of in vitro and in vivo effectiveness of dornase alfa on SARS-CoV-2 infection

Dornase alfa, the recombinant form of the human DNase I enzyme, breaks down neutrophil extracellular traps (NET) that include a vast amount of DNA fragments, histones, microbicidal proteins and oxidant enzymes released from necrotic neutrophils in the highly viscous mucus of cystic fibrosis patients. Dornase alfa has been used for decades in patients with cystic fibrosis to reduce the viscoelasticity of respiratory tract secretions, to decrease the severity of respiratory tract infections, and to improve lung function. Previous studies have linked abnormal NET formations to lung diseases, especially to acute respiratory distress syndrome (ARDS). It is well known that novel coronavirus disease 2019 (COVID-19) pneumonia progresses to ARDS and even multiple organ failure. High blood neutrophil levels are an early indicator of COVID-19 and predict severe respiratory diseases. Also it is reported that mucus structure in COVID-19 is very similar to that in cystic fibrosis due to the accumulation of excessive NET in the lungs. In this study, we showed the recovery of three individuals with COVID-19 after including dornase alfa in their treatment. We followed clinical improvement in the radiological analysis (two of three cases), oxygen saturation (Spo₂), respiratory rate, disappearance of dyspnoea, coughing and a decrease in NET formation and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load after the treatment. Also here, we share our preliminary results suggesting that dornase alfa has an anti-viral effect against SARS-CoV-2 infection in a green monkey kidney cell line, Vero, and a bovine kidney cell line, MDBK, without determined cytotoxicity on healthy peripheral blood mononuclear cells.

Occurrence, loadings and removal of EU-priority polycyclic aromatic hydrocarbons (PAHs) in wastewater and sludge by advanced biological treatment, stabilization pond and constructed wetland

Eight polycyclic aromatic hydrocarbon (PAH) compounds which have been accepted as priority micropollutants by European Union (EU) were analyzed both in wastewater and sludge lines throughout three full scale (located in city, sub-province and village) WWTPs during 12-month sampling period. Investigated WWTPs have different treatment types including advanced biological treatment, stabilization pond (SP) and constructed wetland (CW). Removal efficiencies for total PAH compounds varied from 48% in CW to 85% in advanced biological treatment plant. The maximum concentrations of 360-2282 ng/L observed for naphthalene in raw wastewater were decreased to 103-370 ng/L by treatment processes. Minimum concentration were detected for benzo(k)fluoranthene (B[k]F) and benzo(g,h,i)perylene (B[g,h,i]P) ranged between 8 and 12 ng/L and 19-33 ng/L, respectively. While minimum removal efficiencies were obtained for B[k]F and B[g,h,i]P maximum removal efficiencies were obtained for naphthalene in all WWTPs. PAHs present in minimum and maximum levels in the sludge samples were detected as 54 and 6826 ng/g for the B[g,h,I]P and naphthalene, respectively. Considering the removal mechanisms, PAHs have been determined to be removed by biodegradation or vaporization up to 84% and by settling (adsorption onto sludge) up to 2%. The greatest portion (99%) of naphthalene and anthracene were determined to be biodegraded or vaporized in biological treatment due to their low molecular weights. On the other hand, mechanism of adsorption onto sludge was determined as negligible for these two compounds. In addition, approximately 14% of PAHs were discharged to the receiving environment. Among the different WWTP types investigated, advanced biological treatment was found to be the most efficient plant for the removal of PAH compounds.

SAT0613-HPR EFFECT OF CERVICAL STABILIZATION EXERCISES ON CERVICAL POSITION ERROR IN PATIENTS WITH SPONDYLOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL

Background:

Proprioception sense might be deteriorated due to joint related diseases. Different exercise programs were shown beneficial for improving proprioception sense. However, the effect of exercise on cervical position error was not investigated in patients with axial spondyloarthritis (axSpA).

Objectives:

To investigate the effect of cervical stabilization exercises on cervical position error in patients with axSpA.

Methods:

Thirty-nine patients with axSpA were randomly allocated into two groups as exercise group (n: 20, 11 males) and control group (n: 19, 12 males). All patients were evaluated regarding to physical characteristics (age, body-mass index), disease activity (Bath Ankylosing Spondylitis Disease Activity Index), functional status (Bath Ankylosing Spondylitis Functional Index), and spinal mobility (Bath Ankylosing Spondylitis Metrology Index). Cervical position error was evaluated in flexion, extension, rotation and lateral flexion directions and was calculated using a special formula (1). All evaluations were performed at baseline and after six weeks. Exercise group performed a progressive home-based cervical stabilization exercise program, while the control group did not receive any exercise intervention. Exercise adherence control and exercise progression was delivered by sending messages and video instructions via a freeware and cross-platform messaging service (WhatsApp Messenger) in a weekly basis.

Results:

Baseline physical and disease related characteristics were similar between groups (p>0.05, table 1). Exercise group showed significant improvements in all directions related to cervical proprioception following six weeks (p<0.05, Table 2), however, no improvements were observed in the control group (p>0.05, Table 2).

Table 1.

Comparison of the Groups at Baseline

Exercise Group (n: 20)Median (IQR 25/75)Control Group (n: 19)Median (IQR 25/75)p*Physical CharacteristicsAge (years)40.5 (36.0/52.5)44.0 (39.0/49.5)0.496Body-Mass Index (kg/m2)27.5 (24.5/30.2)26.8 (23.6/29.3)0.569Disease Related CharacteristicsBASDAI (score)2.0 (1.0/3.3)1.8 (1.3/2.5)0.687BASMI Total (score)2.9 (1.7/4.1)2.3 (1.8/3.1)0.127BASFI (score)1.8 (0.6/2.9)1.2 (1.0/2.2)0.496

*Mann-Whitney U Test, IQR 25/75: Interquartile range 25/75, BASDAI: Bath Ankylosing Spondylitis Disease Activity Index, BASMI: Bath Ankylosing Spondylitis Metrology Index, BASFI: Bath Ankylosing Spondylitis Functional Index, p<0.05.

Table 2.

In-Group Comparison of Cervical Position Sense Error

BeforeMedian (IQR 25/75)AfterMedian (IQR 25/75)p*Exercise Group (n: 20)Flexion(o)4.9 (2.2/7.0)2.8 (1.7/3.8)0.033Extension(o)4.5 (3.3/6.4)3.1 (1.8/4.8)0.040Right Rotation(o)5.2 (3.0/8.9)3.7 (1.9/4.7)0.006Left Rotation(o)4.3 (2.5/5.0)2.8 (2.2/3.3)0.017Right Lateral Flexion(o)4.9 (3.3/6.8)2.3 (1.8/3.7)0.009Left Lateral Flexion(o)4.3 (2.1/6.7)2.0 (1.5/3.4)0.010Control Group (n: 19)Flexion(o)6.3 (3.5/7.3)5.2 (3.8/7.0)0.856Extension(o)5.5 (4.5/7.3)4.1 (3.3/8.2)0.809Right Rotation(o)6.4 (4.3/9.0)5.5 (3.0/8.5)0.472Left Rotation(o)5.4 (3.5/7.9)5.0 (3.5/7.2)0.778Right Lateral Flexion(o)5.9 (3.6/8.4)4.3 (2.7/7.7)0.717Left Lateral Flexion(o)3.8 (2.4/5.6)4.9 (2.9/5.7)0.904

*Wilcoxon Signed Rank Test, IQR 25/75: Interquartile range 25/75,o: degree, p<0.05.

Conclusion:

A six-week cervical stabilization exercise program is beneficial for impaired cervical proprioception sense in patients with axSpA.

References:

[1]Dugailly P-M, De Santis R, Tits M, Sobczak S, Vigne A, Feipel V. Head repositioning accuracy in patients with neck pain and asymptomatic subjects: concurrent validity, influence of motion speed, motion direction and target distance. European Spine Journal. 2015;24:2885-2891.

Disclosure of Interests:

None declared

The utility of TNF-α, IL-6 and IL-10 in the diagnosis and/or follow-up food allergy

BACKGROUND

Several pro-inflammatory and anti-inflammatory mediators play a role in the immunopathogenesis of food allergy (FA). The aim of this study was to investigate the utility of serum biomarkers like interleukin (IL)-10, TNF-α, and IL-6 in the diagnosis and/or follow-up of FA.

METHODS

Sixty (25 females, 41.6%) newly diagnosed FA patients [IgE mediated (group-1, n=37), non-IgE (group-2, n=23)] with a median age of nine (1-33) months were enrolled. Twenty-four healthy children with a median age of eight (1-36) months constituted the control group (CG). In all the subjects, serum TNF-α, IL-6 and IL-10 levels were evaluated at the time of diagnosis and reassessed four weeks after therapeutic elimination diet (TED).

RESULTS

The mean white blood cell count and median absolute eosinophile count of the CG were significantly lower than group-1 (p values were 0.019 and 0.006, respectively). The mean absolute neutrophile count and the median IL-6 were significantly higher in group-1 when compared with group-2 (p values were 0.005 and 0.032, respectively. Median TNF-α and IL-6 levels were significantly higher in the pre-TED among all patients (p values were 0.005 and 0.018, respectively). In group-1, median TNF-α and IL-6 levels decreased significantly after TED (p values were 0.01 and 0.029, respectively).

CONCLUSIONS

Our findings support the role of inflammation in the pathogenesis of FA. Serum TNF-α and IL-6 levels may be useful markers for follow-up in FA, especially among IgE-mediated FA patients. Evaluation of IL-10 results was not sufficient for an interpretation of clinical tolerance.

P371 Right ventricle end-systolic remodeling index in patients with atrial septal defect and severe pulmonary arterial hypertension

Background Outcome of patients with atrial septal defect (ASD) and severe pulmonary arterial hypertension (PAH) relates to right ventricular (RV) function.

Magnetic resonance imaging (MRI) remains the gold standard for evaluating the RV function but it is not used routinely. We investigated the relationship between MRI and multiple echocardiography parameters, including the Right Ventricle End-Systolic Remodeling Index (RVESRI), a new prognostic marker in patients with PAH.

Methods 23 patients with ASD and severe PAH (median age 49y.o.[39-59], Sp0 2 92% [90-95], WHO functional class II or III, mean pulmonary artery pressure 51mmHg [40-59]) were included between 2014 and 2018. All patients underwent MRI and echocardiography assessment. Echocardiographic measurements of RV remodeling and function included TAPSE, RV fractional area change (RVFAC), peak systolic velocity of the tricuspid valve (S’TV), right atrial (RA) area, RV strain, Systolic to diastolic ratio, eccentricity index and RVESRI, defined by septum length divided by lateral wall length (Figure 1). Pericardial effusion was noted.

Results Median RV ejection fraction (EF) evaluated with MRI was 46 % [34-59]. RV dysfunction (RVEF &lt; 45%) was observed in 43% of patients. Median RVFAC and

RVESRI were 29.6%[23-34] and 1.6[1.4-1.7] respectively. By spearman correlation, RVFAC and RVESRI were significantly correlated to RVEF (Rho 0.62, p &lt; 0.007 and

Rho -0.51,p &lt; 0.02 respectively). By linear regression, RVFAC and RVESRI were also correlated to RVEF (R 2 =0.36, p &lt; 0.003 and R 2 =0.34, p &lt; 0.08). Pericardial effusion was associated with RV dysfunction (p&lt; 0.008) and a lower RVFAC (p &lt; 0.01). TAPSE, S’TV and RV strain were not correlated with RVEF.

Conclusion RVFAC, RVESRI and pericardial effusion were markers of RV dysfunction in patients with ASD and severe PAH. RVESRI appears as a simple and reliable parameter for follow-up. Its prognostic value in patients with CHD remains to be demonstrated.

Evaluation of pentraxin-3 in familial Mediterranean fever patients during attack and attack-free periods

INTRODUCTION

Pentraxin-3 (PTX-3) is a prototype of pentraxin proteins that have been shown to be involved in acute phase response. In this study, we aimed to investigate the relationship between PTX-3 levels and familial Mediterranean fever (FMF) disease, and to evaluate PTX-3 as a novel diagnostic marker of FMF.

METHOD

Forty-three male patients diagnosed with FMF and 42 healthy individuals were included in the study. Patients with other inflammatory diseases and patients who used drugs having anti-inflammatory properties were excluded from the research. Blood samples were obtained during both attack and attack-free periods.

RESULTS

Patient attack periods were confirmed by combining physical examination and elevation of acute phase reactants. Acute phase reactants were significantly higher in attack versus attack-free periods (p < 0.01), however PTX-3 levels were not significantly different between the two periods. Additionally, PTX-3 levels in FMF patients were higher than in controls in both attack (917.29 ± 725.29 vs 451.83 ± 291.95, p < 0.01) and attack-free periods (748.23 ± 487.53 vs 451.83 ± 291.95, p < 0.01).

CONCLUSION

In this study, we showed that PTX-3 levels, in both FMF attack and attack-free periods, were significantly higher than in the control group. Finally, PTX-3 may be a promising biomarker for FMF diagnosis and may predict FMF attacks (Tab. 2, Fig. 2, Ref. 18).

Evaluation of Mediterranean diet adherence in patients with a history of coronary revascularization

INTRODUCTION

Lifestyle modification is an important component of the secondary prevention strategies; and a healthy diet is one of the cornerstones in management of the coronary heart disease. We aimed to investigate the dietary habits of the patients with history of coronary revascularization, characteristics of the ones with good adherence by using alternate MedDiet questionnaire.

METHODS

We included outpatients who had a history of coronary revascularization at least 6 months prior to enrollment. Each participant filled out a questionnaire to collect the data of demographics and clinical characteristics. Alternate MedDiet score was calculated to evaluate the Mediterranean style dietary adherence. Alternate MedDiet was originally based on 14-item questionnaire; we adjusted it to our population (max 13 points).

RESULTS

We enrolled 226 consecutive outpatients (age 61.7±10.9 years, 72% males). The median duration after revascularization was 60 months. A total of 112 (49.6%) patients had previous percutaneous coronary intervention (PCI), 77 (34.1%) had coronary by-pass graft surgery (CABG), and 36 (15.9%) had both revascularization procedures. The median MedDiet score was 6. Patients were stratified into two subgroups (MedDiet score ≥7 vs. <7). A total of 61 (26.9%) patients had MedDiet score ≥7. By univariate analysis, good MedDiet scores were associated with older age, waist circumference, body mass index, high education level, regular follow-up, duration after first revascularization and revascularization with CABG+PCI. In the multivariate analysis, high education level (P=.002, OR=8.212, 95%CI: 2.155-31.291) and duration after revascularization (P=.034, OR=1.007, 95%CI: 1.001-1.013) were independent predictors of good MedDiet scores.

CONCLUSION

The adherence rate to a healthy diet was low in patients with previous coronary revascularization. MedDiet score seems to be practical and useful item to evaluate the dietary habits in outpatient setting. Mediterranean diet adherence rates were associated with high education level, and duration after revascularization.

The ameliorative effects of Ginkgo biloba on apoptosis, LH-R expression and sperm morphology anomaly in testicular torsion and detorsion

Torsion/detorsion (T/D) induces testicular damages in both germinal epithelial and interstitial tissues. Ginkgo biloba extract (GbE) exerts antioxidant and free radical scavenger. We investigated the effect of GbE on testicular tissues, Leydig and sperm cells in rats injured with T/D. Twenty-eight Wistar albino rats were randomly assigned into four groups (Control, GbE, Treatment: T/D+GbE, T/D). T/D performed to the rats in torsion, treatment received GbE (50 mg/kg) 1 hr before T/D, GbE group received only GbE (50 mg/kg) and control was defined as sham group. After T/D, the testes along with epididymis were removed and processed. LH-R expression, apoptosis, sperm morphology and histopathological damage scores were determined for each group. Testicular T/D caused significant increases in apoptosis and sperm morphology anomaly, and a significant decrease in Johnsen's testicular biopsy scores, LH-R expression of Leydig cell and normal sperm cell count. GbE ameliorated testicular histopathology and caused significant increases in LH-R expression, normal sperm cell count in the treated and particularly GbE group. Consequently, GbE may prevent testicular injury and enhance Leydig and sperm cell activity following both T/D and normal situation owing to its antioxidant, anti-apoptotic, free radical scavenger and anti-inflammatory effects.