Sex-specific cardiovascular remodeling leads to a divergent sex-dependent development of heart failure in aged hypertensive rats

INTRODUCTION

The prevalence of heart failure with preserved ejection fraction (HFpEF) is continuously rising and predominantly affects older women often hypertensive and/or obese or diabetic. Indeed, there is evidence on sex differences in the development of HF. Hence, we studied cardiovascular performance dependent on sex and age as well as pathomechanisms on a cellular and molecular level.

METHODS

We studied 15-week- and 1-year-old female and male hypertensive transgenic rats carrying the mouse Ren-2 renin gene (TG) and compared them to wild-type (WT) controls at the same age. We tracked blood pressure and cardiac function via echocardiography. After sacrificing the 1-year survivors we studied vascular smooth muscle and endothelial function. Isolated single skinned cardiomyocytes were used to determine passive stiffness and Ca2+-dependent force. In addition, Western blots were applied to analyse the phosphorylation status of sarcomeric regulatory proteins, titin and of protein kinases AMPK, PKG, CaMKII as well as their expression. Protein kinase activity assays were used to measure activities of CaMKII, PKG and angiotensin-converting enzyme (ACE).

RESULTS

TG male rats showed significantly higher mortality at 1 year than females or WT male rats. Left ventricular (LV) ejection fraction was specifically reduced in male, but not in female TG rats, while LV diastolic dysfunction was evident in both TG sexes, but LV hypertrophy, increased LV ACE activity, and reduced AMPK activity as evident from AMPK hypophosphorylation were specific to male rats. Sex differences were also observed in vascular and cardiomyocyte function showing different response to acetylcholine and Ca2+-sensitivity of force production, respectively cardiomyocyte functional changes were associated with altered phosphorylation states of cardiac myosin binding protein C and cardiac troponin I phosphorylation in TG males only. Cardiomyocyte passive stiffness was increased in TG animals. On a molecular level titin phosphorylation pattern was altered, though alterations were sex-specific. Thus, also the reduction of PKG expression and activity was more pronounced in TG females. However, cardiomyocyte passive stiffness was restored by PKG and CaMKII treatments in both TG sexes.

CONCLUSION

Here we demonstrated divergent sex-specific cardiovascular adaptation to the over-activation of the renin-angiotensin system in the rat. Higher mortality of male TG rats in contrast to female TG rats was observed as well as reduced LV systolic function, whereas females mainly developed HFpEF. Though both sexes developed increased myocardial stiffness to which an impaired titin function contributes to a sex-specific molecular mechanism. The functional derangements of titin are due to a sex-specific divergent regulation of PKG and CaMKII systems.

Evaluation of Forced Expiratory Volume in One Second and Forced Vital Capacity from Age and Height for Pulmonary Function Test

BACKGROUND

Lung function tests (LFTs) are a collection of clinical examinations used to assess lung function and monitor potential declines in the lungs, respiratory muscles, and chest wall's mechanical performance. This cross-sectional study aimed to identify the relation of age and height to lung function.

MATERIAL AND METHODS

The study was conducted at AlHussein Medical City, 70 adult male subjects were enrolled in the study. All subjects were screened physically to ensure that they were normal and there were no respiratory disorders that could affect the lung function. Age and height were taken for these subjects, forced vital capacity (FVC), FEV1 (Forced expiratory volume in first second) as well as FEV1 /FVC ratio were measured.

RESULTS

The results of the study showed that the average values of FVC and FEV1 were 4.75 and 3.88 respectively. There was a significant negative correlation observed between age and FVC (r=0.48), FEV1 (r= 0.6). Also there was a significant positive correlation noticed between Height and FVC (r = 0.62), FEV1 (r =0.69). There was a very high correlation evidenced between FEV1 and FVC, the relation between FEV1 and FVC is practically height and age-independent.

CONCLUSION

Our study highlights a great interest in the study of the relation between age, height, and lung function. The study also creates simple and convenience equations that can be used for reference standards in clinical practice to give reasonable theoretical values for a large sector of the population.

Synthesis, characterization, anti-mycobacterial activity and in silico study of new 2,5-disubstituted-1,3,4-oxadiazole derivatives

A series of new 2,5-disubstituted-1,3,4-oxadiazole derivatives (5a-j and 6a-j) have been designed and synthesized in four-steps. Sixteen compounds among the twenty compounds are reported for the first time. The compounds were characterized and confirmed by the FTIR, 1D- and 2D-NMR and HRMS analyses, and were tested against Mycobacterium smegmatis and Mycobacterium tuberculosis H37Ra. Compound 5d was the most active against M. smegmatis with MIC value of 25 µM, and exhibited cidal activity with MBC of 68 µM, respectively. The time-kill assay showed the good killing rate at 77% with the combination of isoniazid (INH). In addition, checkboard assay confirmed the interaction of compound 5d was categorised as additive. Docking simulation has been performed to position 5d into the pantothenate synthetase active site with binding free energy value -8.6 kcal mol-1. It also occupied the same active site as that of standard native ligand with similar interactions, which clearly indicate their potential as pantothenate synthetase inhibitor.

United Arab Emirates National Newborn Screening Programme:an evaluation 1998-2000

To evaluate the United Arab Emirate National Newborn Screening Programme we compared coverage, timeliness of programme indicators [age at sampling, recall and treatment initiation, timing of specimen delivery and laboratory results] and specimen quality with international st and ards. Recall rate, sensitivity, specificity, positive predictive values and relative incidence rates for phenylketonuria [PKU] and congenital hypothyroidism [CH] were calculated. Investigations for hypothyroidism included thyroid function studies [T3, T4, fT4 and TSH], technetium-99m thyroid scan when possible and thyroglobulin and thyroid antibodies when indicated. PKU investigations included plasma amino acids and measurement of biopterin defects. In the 6 years before December 2000, 138, 718 neonates were screened. Relative incidences for CH and for classic PKU were 1: 1570 and 1: 20, 050 respectively

Six-year experience of detection and investigation of possible Middle East Respiratory Syndrome coronavirus cases, England, 2012-2018

OBJECTIVES

Surveillance for Middle East Respiratory Syndrome (MERS) has been undertaken in the UK since September 2012. This study describes the surveillance outcomes in England from 2012 to 2018.

STUDY DESIGN

This was a descriptive study using surveillance data.

METHODS

Local health protection teams in England report possible MERS cases to the National Infection Service with clinical and laboratory data.

RESULTS

A total of 1301 possible MERS cases were identified in the study period. Five cases were laboratory-confirmed MERS. The majority of cases had travelled to Saudi Arabia (56.7%) and United Arab Emirates (25.9%). Fifty-four percent of cases were men and 43.7% were women. The majority of cases (65.1%) were aged 45 years or older. The number of tests increased in the period after Hajj each year. Laboratory-confirmed alternative diagnoses were available for 513 (39.4%) cases; influenza was the most common virus detected (n = 255, 52.4%).

CONCLUSIONS

Our study highlights the importance of differential diagnosis of influenza and other respiratory pathogens and early influenza antiviral treatment.

A European multicentre evaluation of detection and typing methods for human enteroviruses and parechoviruses using RNA transcripts

Polymerase chain reaction (PCR) detection has become the gold standard for diagnosis and typing of enterovirus (EV) and human parechovirus (HPeV) infections. Its effectiveness depends critically on using the appropriate sample types and high assay sensitivity as viral loads in cerebrospinal fluid samples from meningitis and sepsis clinical presentation can be extremely low. This study evaluated the sensitivity and specificity of currently used commercial and in-house diagnostic and typing assays. Accurately quantified RNA transcript controls were distributed to 27 diagnostic and 12 reference laboratories in 17 European countries for blinded testing. Transcripts represented the four human EV species (EV-A71, echovirus 30, coxsackie A virus 21, and EV-D68), HPeV3, and specificity controls. Reported results from 48 in-house and 15 commercial assays showed 98% detection frequencies of high copy (1000 RNA copies/5 µL) transcripts. In-house assays showed significantly greater detection frequencies of the low copy (10 copies/5 µL) EV and HPeV transcripts (81% and 86%, respectively) compared with commercial assays (56%, 50%; P = 7 × 10-5 ). EV-specific PCRs showed low cross-reactivity with human rhinovirus C (3 of 42 tests) and infrequent positivity in the negative control (2 of 63 tests). Most or all high copy EV and HPeV controls were successfully typed (88%, 100%) by reference laboratories, but showed reduced effectiveness for low copy controls (41%, 67%). Stabilized RNA transcripts provide an effective, logistically simple and inexpensive reagent for evaluation of diagnostic assay performance. The study provides reassurance of the performance of the many in-house assay formats used across Europe. However, it identified often substantially reduced sensitivities of commercial assays often used as point-of-care tests.

Numerical and experimental studies of water disinfection in UV reactors

Performance of UV reactors for water disinfection is investigated in this paper. Both experimental and numerical studies are performed on base reactor LP24. Enterobacteria phage MS2 is chosen as the challenge microorganism in the experiments. Experiments are conducted to evaluate the effect of different parameters, i.e. flow rate and UV transmission, on the reactor performance. Simulation is carried out based on the commercial software ANSYS FLUENT with user defined functions (UDFs) implemented. The UDF is programmed to calculate UV dose absorbed by different microorganisms along their flow trajectories. The effect with boundary layer mesh and without boundary layer mesh for LP24 is studied. The results show that the inclusion of boundary layer mesh does not have much effect on the reactor performance in terms of reduction equivalent dose (RED). The numerical results agree well with the experimental measurements, hence validating the numerical model. With this achieved, the numerical model is applied to study other scaled reactors: LP12, LP40, LP60 and LP80. Comparisons show that LP40 has the highest RED and log inactivation among all the reactors while LP80 has the lowest RED and log inactivation.

New Anti-Infective Preparations of Naphthyloxypropargylpiperidine Series

1-alkyl-4-(3-naphthyloxyprop-1-ynyl)piperidine-4-ols have been obtained by the condensation of 1-alkyl-pipieridin-4-ones with 1- and 2-naphthoxypropines by the Favorsky method in absolute diethylether, in the presence of powered technical KОН, under atmospheric pressure. Acylation of tertiary naphthoxypropynyl piperidols by cyclopropanecarbonylchloride has been carried out in order to introduce a cyclopropanecarbonyl fragment into the structures of naphthoxypropargylpiperidines. The obtained esters of cyclopropanecarboxylic acid represent crystalline substances with the definite melting temperature, very soluble in water, ethanol, acetone. The composition and structure of the synthesized compounds have been confirmed by the data of elemental analysis, IR-spectroscopy, NMR-spectroscopy, the identity has been confirmed by thin-layer chromatography. The compounds under the code AIP (anti-infective preparation) have been studied for an antimicrobial activity in relation to museum microbial strains. The effects of these preparations have been assessed in vitro in relation to Bacillus subtilis ATCC 6633, Escherichia coli ATCC 25922, Salmonella enterica ATCC 14028 and Staphylococcus aureus ATCC 6538- P. It has been found that the compounds AIP-30 and AIP-31 possess an antimicrobial activity in relation to all strains of microorganisms, engaged in the experiment. AIP- 30 and AIP-31 have antimicrobial effects to different extents, AIP-30 has displayed the highest activity in relation to the museum strain Bacillus subtilis ATCC 6633 in the concentration of 250 μg/ml. It has been established that AIP-32 displays a selective antimicrobial activity towards one type, and AIP-33 ‒ towards two types of the museum strains, engaged in the experiment.

Greatly reduced risk of EBV reactivation in rituximab-experienced recipients of alemtuzumab-conditioned allogeneic HSCT

EBV-associated post-transplant lymphoproliferative disease (PTLD) remains an important complication of allogeneic haematopoietic stem cell transplantation (allo-HSCT). We retrospectively analysed the incidence and risk factors for EBV reactivation in 186 adult patients undergoing consecutive allo-HSCT with alemtuzumab T-cell depletion at a single centre. The cumulative incidence of EBV reactivation was 48% (confidence interval (CI) 41-55%) by 1 year, with an incidence of high-level EBV reactivation of 18% (CI 13-24%); 8 patients were concurrently diagnosed with PTLD. Amongst patients with high-level reactivation 31/38 (82%) developed this within only 2 weeks of first EBV qPCR positivity. In univariate analysis age⩾50 years was associated with significantly increased risk of EBV reactivation (hazard ratio (HR) 1.54, CI 1.02-2.31; P=0.039). Furthermore, a diagnosis of non-Hodgkin lymphoma (NHL) was associated with greatly reduced risk of reactivation (HR 0.10, CI 0.03-0.33; P=0.0001) and this was confirmed in multivariate testing. Importantly, rituximab therapy within 6 months prior to allo-HSCT was also highly predictive for lack of EBV reactivation (HR 0.18, CI 0.07-0.48; P=0.001) although confounding with NHL was apparent. Our data emphasise the risk of PTLD associated with alemtuzumab. Furthermore, we report the clinically important observation that rituximab, administered in the peri-transplant period, may provide effective prophylaxis for PTLD.

Potent sirtuin inhibition with 1,2,5-trisubstituted benzimidazoles

Benzimidazole analogs were previously shown to inhibit sirtuin activity. Novel compound 5i was found to be a potent SIRT2 inhibitor with an IC50 value of 2.92 μM.

Transfusion in CMV seronegative T-depleted allogeneic stem cell transplant recipients with CMV-unselected blood components results in zero CMV transmissions in the era of universal leukocyte reduction: a U.K. dual centre experience

OBJECTIVES

To establish rates of cytomegalovirus (CMV) transmission with use of CMV-unselected (CMV-U), leukocyte-reduced blood components transfused to CMV-seronegative patient/CMV-seronegative donor (CMV neg/neg) allogeneic stem cell transplantation (SCT) recipients including those receiving T-depleted grafts.

BACKGROUND

CMV infection remains a major cause of morbidity following SCT. CMV-seronegative SCT recipients are particularly at risk of transfusion transmitted CMV (TT-CMV) and until recently they have received blood components from CMV-seronegative donors with significant resource implications. Although leukocyte reduction of blood components is reported to minimise risk of TT-CMV, its efficacy in high-risk situations, such as in T-depleted transplant recipients, is unknown.

METHODS

We retrospectively analysed the incidence of TT-CMV in CMV neg/neg allogeneic SCT recipients transfused with CMV-U, leukocyte-reduced blood components in two transplantation centres in the UK. Patients were monitored for CMV infection by weekly CMV polymerase chain reaction testing. Leukocyte reduction of blood components was in accordance with current UK standards.

RESULTS

Among 76 patients, including 59 receiving in vivo T-depletion, no episodes of CMV infection were detected. Patients were transfused with 1442 CMV-unselected, leukocyte-reduced components, equating to 1862 donor exposures.

CONCLUSIONS

Our findings confirm the safety of leukocyte reduction as a strategy in preventing TT-CMV in high-risk allogeneic SCT recipients.

Evaluation of occupational and patient radiation doses in orthopedic surgery

This study intends to measure the radiation dose to patients and staff during (i) Dynamic Hip Screw (DHS) and (ii) Dynamic Cannula Screw (DCS) and to evaluate entrance surface Air kerma (ESAK) dose and organ doses and effective doses. Calibrated Thermoluminescence dosimeters (TLD-GR200A) were used. The mean patients' doses were 0.46mGy and 0.07mGy for DHS and DCS procedures, respectively. The mean staff doses at the thyroid and chest were 4.69mGy and 1.21mGy per procedure. The mean organ and effective dose for patients and staff were higher in DHS compared to DCS. Orthopedic surgeons were exposed to unnecessary radiation doses due to the lack of protection measures. The radiation dose per hip procedure is within the safety limit and less than the previous studies.

Atypical blood and bone marrow lymphocytes in ALK-positive anaplastic T-cell lymphoma: important lessons

A 42-year-old man presented with a short history of fever, significant weight loss and bilateral neck swelling. A CT scan revealed widespread lymphadenopathy and hepatosplenomegaly. Lymph node morphology and immunohistochemistry confirmed a diagnosis of anaplastic lymphoma kinase (ALK)-positive anaplastic T-cell non-Hodgkin's lymphoma. Both the peripheral blood (PB) and bone marrow (BM) revealed atypical lymphocytes with cleaved nuclei, vacuolation and granulation, suggestive of disease involvement at both sites. However, BM and PB immunophenotyping and immunohistochemistry did not reveal typical markers (ALK and CD30) at either site. All features resolved with a short remission after conventional chemotherapy. Despite salvage chemotherapy and an autologous stem cell transplant, a relapse of the PB and BM features with stable radiological findings was noted. Rapid decline followed with pancytopenia resulting in death 12 months after the initial diagnosis.

Structure–electrical conductivity of polyvinylidene fluoride/graphite composites

Graphite powder was introduced into polyvinylidene fluoride via the solution mixing technique. The composites were then subjected to hot compression molding. The effect of dispersion of graphite particles and electrical conductivity of the composites were investigated. Solution mixing enabled homogeneous dispersion of graphite powder within the polyvinylidene fluoride matrix as revealed by transmission electron microscopy. X-ray diffraction and Fourier transform infrared spectroscopy analysis revealed that graphite incorporation induced the α-phase of polyvinylidene fluoride. The DC conductivity results showed that the conductivity increased with an increase in graphite content. Beyond a critical concentration of graphite, percolation threshold, (Φ c = 2.3 vol%) the conductivity increases by five orders of magnitude at 3.9 vol% of graphite powder composite. The electrical conductivity was approximately constant for the composites with the higher graphite loading. Consequently, adding more graphite powder did not significantly alter the electrical conductivity. The correlation between the dispersion of graphite particles and electrical conductivity was discussed. The AC conductivity of composites was investigated in a wide range of frequencies from 50 Hz to 5 MHz and at temperatures ranging from room temperature to 180°C. The conductivity of the composites exhibited strong frequency dependence particularly in the vicinity of the electrical percolation threshold. σAC obeyed the power law of the form: [Formula: see text], where ω is the angular frequency and s and A the characteristic parameters. The values of the exponent ( s) were found to decrease with increasing temperature which is consistent with the correlated barrier-hopping model.

Respiratory viral infections during the 2009-2010 winter season in Central England, UK: incidence and patterns of multiple virus co-infections

Acute viral respiratory infections are the most common infections in humans. Co-infection with different respiratory viruses is well documented but not necessarily well understood. The aim of this study was to utilise laboratory data from the winter season following the 2009 influenza A(H1N1) outbreak to investigate rates of respiratory virus co-infections, virus prevalence in different age groups and temporal variations in virus detection. The Health Protection Agency Public Health Laboratory (HPA PHL) Birmingham, UK, routinely uses polymerase chain reaction (PCR) to detect common respiratory viruses. The results from specimens received for respiratory virus investigations from late September 2009 to April 2010 were analysed. A total of 4,821 specimen results were analysed. Of these, 323 (13.2 %) had co-detections of two viruses, 22 (0.9 %) had three viruses and four (0.2 %) had four viruses. Reciprocal patterns of positive or negative associations between different virus pairs were found. Statistical analysis confirmed the significance of negative associations between influenza A and human metapneumovirus (HMPV), and influenza A and rhinovirus. Positive associations between parainfluenza with rhinovirus, rhinovirus with respiratory syncytial virus (RSV) and adenovirus with rhinovirus, parainfluenza and RSV were also significant. Age and temporal distributions of the different viruses were typical. This study found that the co-detection of different respiratory viruses is not random and most associations are reciprocal, either positively or negatively. The pandemic strain of influenza A(H1N1) was notable in that it was the least likely to be co-detected with another respiratory virus.

Surgical excision for B3 breast lesions diagnosed by vacuum-assisted core biopsy

The aim of this retrospective study was to assess whether open surgical excision is required following a B3 diagnosis on 11-gauge vacuum-assisted core biopsy (VACB) of radiologically indeterminate breast lesions.

PATIENTS AND METHODS

Twenty-four women with a histological diagnosis of the B3 category on VACB of radiologically indeterminate breast lesions were identified over a 3-year period. The VACB procedure was performed under stereotactic (n=21), ultrasound (n=2) or magnetic resonance imaging (MRI) (n=1) guidance using the Suros system. Nineteen patients underwent open surgical excision. The remaining 5 patients who had 'complete' removal of the radiological abnormality using VACB under ultrasound (n=2, papilloma) or stereotactic (n=4, atypical ductal hyperplasia) guidance were followed up clinically and radiologically.

RESULTS

The median patient age was 49 years. The disease status in three patients was upgraded to ductal carcinoma in situ at open surgical excision. The VACB showed atypical lobular hyperplasia in these 3 patients, associated with microcalcification (n=2) or mass lesion (n=1). No single case of upgrading to invasive breast cancer was identified in our series. The remaining patients (16 out of 19) had a benign biopsy. The upgrade to malignancy was significantly associated with the presence of atypical lobular hyperplasia, a BI-RADS category of 4 and incomplete removal of the radiological abnormality by VACB. After a mean follow-up of 18 months, no malignancy was detected in the 5 patients who did not undergo open surgical biopsy.

CONCLUSION

Open surgical excision is strongly recommended for atypical lobular hyperplasia identified in VACB specimens. VACB can be a safe alternative to surgery in the treatment of B3 lesions in selected cases, providing thorough multidisciplinary discussion has taken place.

A case study of delayed HIV-1 seroconversion highlights the need for Combo assays

Summary

This report describes a case in which a patient took at least four months to seroconvert to anti-HIV positivity. A concomitant CMV infection probably contributed to the profound immune suppression observed. It is essential that fourth generation HIV antigen/antibody combo assays be used to ensure that such cases are not missed.

Outcome in elderly acute myeloid leukaemia

We reviewed the reports of 79 newly diagnosed acute myeloid leukaemia patients admitted to our department between 1996 and 2005. Patients' characteristics and outcome were analysed. The acute myeloid leukaemia rate for all patients who received intensive chemotherapy, i.e. age > or = 60 years was 52.9%; in the age group (60-69) and > or = 70 years it was 62.5% and 44.4%, respectively. The acute myeloid leukaemia rate difference between the diagnosis periods (1996-2000) and (2001-2005) are statistically significant only in the age group (60-69) years (P = 0.018). For patients who received intensive chemotherapy and treatment other than intensive chemotherapy, the median overall survival was 9.73 and 3.6 months, respectively (P < 0.0001). There was no significant difference in overall survival between the age groups for the two diagnosis periods, except in patients aged > or = 80 years 3.0 and 0.63 month, respectively (P = 0.023). This study improved knowledge of characteristics and outcome of elderly acute myeloid leukaemia patients in our department.

Ante-natal screening and post-natal follow-up of hepatitis B in the West Midlands of England

BACKGROUND

We established at Queen Elizabeth Hospital in Birmingham a post-natal follow-up care service for hepatitis B virus (HBV) positive women diagnosed through ante-natal screening.

AIM

Virological and clinical follow-up of HBsAg positive mothers detected through ante-natal screening in Birmingham.

DESIGN

Retrospective observational study.

METHOD

We evaluated 117 post-natal mothers with chronic HBV infection between April 2003 and December 2006. Patients were first seen at least 3 months post-delivery and followed up.

RESULTS

Most of the women were of Asian or African origin (107 of 117 patients). Five out of 117 (4%) patients had undergone serum HBsAg clearance by the time of post-natal review, and 112 patients had persisting HBsAg-positivity (seven HBeAg positive and 105 HBeAg negative). HBeAg positive women were younger than HBeAg negative patients (median 21 vs 30-years old). Fifty percent of HBeAg negative women had detectable serum HBV DNA at the time of initial review. HBeAg positive women had higher serum HBV DNA titres than those negative for HBeAg (median 40 million copies/ml vs 4323 copies/ml). The majority of patients had normal serum transaminases. A single case of clinically significant liver disease was identified in a woman with HBV and delta virus infection.

CONCLUSION

Very few women who were diagnosed with chronic HBV infection at ante-natal screening have clinical evidence of liver disease. However, many have high levels of virus replication and remain at risk for the future development of liver disease.

Effect of thermal processing of palm sap on the physico-chemical composition of traditional palm sugar

During the production of palm sugar, the palm sap (Arenga pinnata) is heated up to 150 degrees C. Besides the hydrolysis of carbohydrate to generate reducing sugars and degradation of amino acid, many physicochemical changes produced at all these temperatures, having a significant impact on the overall quality of palm sugar. In this study, changes in physico-chemical properties of the palm sap due to heat processing were investigated. Analysis of colour, soluble solid, pH, temperature, sugar and amino acid concentration was determinant. The results showed clearly that the heating process at these high temperatures was necessary to create an environment which was rich in essential precursors for subsequent reactions such as Maillard reaction. Chemical compounds that showed drastic changes in concentration were polar side chain amino acids especially glutamine, asparagine and arginine as well as sucrose and pH value. Other quality characteristics of palm sugar based on colour and soluble solids (Brix) shared an increase in concentration as a function of time.