The relation among myocardial iron load and the severity of heart failure

 

Heart failure (HF) symptoms are related to reduced circulatory perfusion, peripheral congestion, also impaired peripheral muscle strength & oxygen utilization due to iron deficiency. Despite many premises, the correlation between myocardial iron load and failing heart function was not proved.

The purpose of this study was to assess iron itself and iron-related proteins in human failing (FH) vs non-failing (NFH) myocardium.

The study group consisted of 58 explanted FHs vs the control consisted of 31 NFHs unsuitable for transplantation. HF study group presented with LV dilatation (LVDD 67±8 mm; LVSD 59±13 mm), reduced contraction (LVEF 20±7.5%), RV enlargement (RVD 42±6.5 mm), pulmonary hypertension (2.21±0.93 Wu) and elevated NTproBNP (3955.5±2250.5pg/ml).

We assessed iron serum markers: ferritin (FR), transferrin/saturation (TSAT), transferrin receptor (soluble sTfR), sTFR/log FR; myocardial iron homeostasis assessment: M-Iron (Instrumental Neutron Activation Analysis, μg/g) and iron gathering proteins (by ELISA): divalent metal transporter (DMT-1); L-type calcium channel (L-CH), TfR-1/TfR-2; ferritins: heavy (FT-H), light (FT-L) chain, mitochondrial (FT-MT); ferroportin (FPN) and oxidative stress marker: 4-hydroxynonenal (4-HNE).

In FH vs NFH, M-Iron was reduced (164.6±25.2 vs 182.3±23.9; p=0.0358) however, did not apply to the entire group. Therefore we divvied the FH group into two subgroups (based on M-Iron concentration in NFH controls). Average iron concertation in non-iron-deficient (NIDM) subgroup was 172.5±19.1 (n=35) and in iron-deficient (IDM) subgroup wad 127.0±16.5; (n=23, p=0.0001).

Regardless M-Iron load in FH vs NFH myocardial proteins expressions were reduced: L-CH (NIDM vs IDM vs NFH: 49.2±9.2; 42.5±4.2; 67.3±23.0, p=0.0022); FT-L (16.4±7.3; 11.6±4.8; 26.3±7.5, p= <0.0001, respectively); FT-MT (41.2±7.6; 38.7±4.1; 59.3±10.4 p≤0,0001, respectively). With regard to M-Iron load, only in DMT-1 expression was changed (NIDM vs IDM vs NFH 4.8±0.7; 4.0±0.5; 5.8±0.8; p≤0.0001). 4-HNE levels in FH vs NFH were increased, regardless M-Iron load (NIDM-Iron vs IDM-Iron vs NFH; 55.7±29.2; 57.2±47.8; 9.9±8.1 p≤0.0001).

Interestingly, the iron load (NIDM-Iron vs IDM-Iron) did not modify the assessed clinical parameters.

With regard to commonly used systemic iron markers only sTFR/log FR proved M-Iron load difference (NIDM-Iron vs IDM-Iron 0.6±0.2; 0.7±0.3; p=0.047910)

In FH, we observed, the subgroup with the reduced M-Iron load. The observed reduction of iron gathering proteins were independent on M-Iron load, except DMT-1 the main iron transportation protein into the cell. The results showed that the HF degree and concertation of iron proteins are unlikely to be affected by the M-Iron load, except DMT-1 protein. The oxidative stress was also regardless from M-Iron load, and increased in the whole FH group. Commonly used systemic iron markers except sTFR/log FR did not define M-Iron load.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): The Cardinal Stefan Wyszyński National Institute of Cardiology

Immunoaffinity Column Cleanup with Liquid Chromatography Using Post-Column Bromination for Determination of Aflatoxin B1 in Cattle Feed: Collaborative Study

A collaborative study was conducted to evaluate the effectiveness of an immunoaffinity column cleanup liquid chromatography (LC) method for determination of aflatoxin B1 in cattle feed at a possible future European regulatory limit (1 ng/g). The test portion was extracted with acetone–water (85 + 15), filtered, diluted with water, and applied to an immunoaffinity column. The column was washed with water to remove interfering compounds, and the purified aflatoxin B1 was eluted with methanol. Aflatoxin B1 was separated and determined by reversed-phase liquid chromatography (RP–LC) and detected by fluorescence after post column derivatization (PCD) involving bromination. PCD was achieved with either pyridinium hydrobromide perbromide (PBPB), used by 14 laboratories, or an electrochemical cell and addition of bromide to the mobile phase, used by 7 laboratories. Both derivatization techniques were not significantly different when compared by the t-test; the method was statistically evaluated for all laboratories together (bromination and PBPB). The cattle feed samples, both spiked and naturally contaminatedwithaflatoxinB1, were sent to 21 laboratories in 14 different countries (United States, Japan, and Europe). Test portions were spiked at levels of 1.2 and 3.6 ng/g for aflatoxin B1. Recoveries ranged from 74 to 157%. Based on results for spiked samples (blind pairs at 2 levels) as well as naturally con-taminated samples (blind pairs at 3 levels), the relative standard deviation for repeatability (RSDr) ranged from 5.9 to 8.7%. The relative standard deviation for reproducibility (RSDR) ranged from 17.5 to 19.6%. The method showed acceptable within-and between-laboratory precision for this matrix, as evidenced by HORRAT values, at the target levels of determination for aflatoxin B1. No major differences in RSD were observed, showing that the composition of the feeds was not a factor for the samples tested and that the method was applicable for all materials used.

Determination of Aflatoxin B1 in Baby Food (Infant Formula) by Immunoaffinity Column Cleanup Liquid Chromatography with Postcolumn Bromination: Collaborative Study

A collaborative study was conducted to evaluate the effectiveness of an immunoaffinity column cleanup liquid chromatography (LC) method for determination of aflatoxin B1 in a milk powder based infant formula at a possible future European regulatory limit (0.1 ng/g). The test portion was extracted with methanol–water (8 + 2 [v + v]), filtered, diluted with water, and applied to an immunoaffinity column. The column was washed with water to remove interfering compounds, and the purified aflatoxin B1 was eluted with methanol. The separation and determination of the aflatoxin B1 was performed by reversed-phase LC and detected by fluorescence after postcolumn derivatization (PCD) involving bromination. PCD was achieved with either pyridinum hydrobromide perbromide (PBPB) or an electrochemical (Kobra) cell by addition of bromide to the mobile phase. The baby food (infant formula) test samples, both spiked and naturally contaminated with aflatoxin B1, were sent to 14 laboratories in 13 different European countries. Test portions were spiked at levels of 0.1 and 0.2 ng/g for aflatoxin B1. Recoveries ranged from 101 to 92%. Based on results for spiked test samples (blind pairs at 2 levels) and naturally contaminated test samples (blind pairs at 3 levels), the relative standard deviation for repeatability (RSDr) ranged from 3.5 to 14%. The relative standard deviation for reproducibility (RSDR) ranged from 9 to 23%. Nine participants used PBPB derivatization, and 5 particpants used the Kobra cell. There was no evidence of method performance depending on the derivatization method used. The method showed acceptable within- and between-laboratory precision for baby food matrix, as evidenced by HORRAT values, at the target levels of determination for aflatoxin B1.

Training of child and adolescent psychiatry fellows in autism and intellectual disability

Patients with autism spectrum disorders and intellectual disability can be clinically complex and often have limited access to psychiatric care. Because little is known about post-graduate clinical education in autism spectrum disorder and intellectual disability, we surveyed training directors of child and adolescent psychiatry fellowship programs. On average, child and adolescent psychiatry directors reported lectures of 3 and 4 h per year in autism spectrum disorder and intellectual disability, respectively. Training directors commonly reported that trainees see 1-5 patients with autism spectrum disorder or intellectual disability per year for outpatient pharmacological management and inpatient treatment. Overall, 43% of directors endorsed the need for additional resources for training in autism spectrum disorder and intellectual disability, which, coupled with low didactic and clinical exposure, suggests that current training is inadequate.

Colloid and Interfacial Chemistry at Stuttgart University

The research work carried out in our group can be referred to as “Colloid and Interfacial Chemistry”. We subdivide this rather broad research area into four main topics which are covered by the projects presented in this overview. The surfaces we study are surfactant-loaden water-air surfaces, the films are mainly free-standing thin foam films of less than 100 nm thickness, and the foams are 3D aqueous foams whose stability and drainage we investigate. As regards the topic “Complex Fluids” we study lyotropic liquid crystalline phases and microemulsions. In the past, we were able to establish two new tuning parameters for the formation and destruction of lyotropic liquid crystals, while current research focuses on the lyotropic mesomorphism of new surfactants and of surfactant mixtures. Apart from lyotropic liquid crystals microemulsions are a central theme in the group. Due to their unique properties and fascinating structure variety microemulsions offer a great potential as templates for the synthesis of new functional materials, which is a further research topic in our group. These studies involve the gelation of and the polymerisation in microemulsions preserving their nanostructure to create high surface area polymers. Currently, we also use microemulsions as tailor-made nano-compartmented reaction media. The studied reactions are either enzyme-catalysed conversions of substrates or the reduction of metal salts to synthesize mono- or bimetallic nanoparticles. In this context we focus on bicontinuous and water-in-oil droplet microemulsions. Last but not least we also synthesize new surfactant structures such as inositol-based surfactants and explore the properties.

Aromatase knockout mice show normal steroid-induced activation of gonadotrophin-releasing hormone neurones and luteinising hormone surges with a reduced population of kisspeptin neurones in the rostral hypothalamus

We recently reported that female aromatase knockout (ArKO) mice show deficits in sexual behaviour and a decreased population of kisspeptin-immunoreactive neurones in the rostral periventricular area of the third ventricle (RP3V), resurrecting the question of whether oestradiol actively contributes to female-typical sexual differentiation. To further address this question, we assessed the capacity of ArKO mice to generate a steroid-induced luteinising hormone (LH) surge. Adult, gonadectomised wild-type (WT) and ArKO mice were given silastic oestradiol implants s.c. and, 1 week later, received s.c. injections of either oestradiol benzoate (EB) followed by progesterone, EB alone, or no additional steroids to activate gonadotrophin-releasing hormone (GnRH) neurones and generate an LH surge. Treatment with EB and progesterone induced significant Fos/GnRH double-labelling and, consequently, an LH surge in female WT and in ArKO mice of both sexes but not in male WT mice. ArKO mice of both sexes had fewer cells expressing Kiss-1 mRNA in the RP3V compared to female WT mice but had more Kiss-1 mRNA-expressing cells compared to WT males, reflecting an incomplete sexual differentiation of this system. To determine the number of cells expressing kisspeptin, the same experimental design was repeated in Experiment 2 with the addition of groups of WT and ArKO mice that were given EB + progesterone and sacrificed 2 h before the expected LH surge. No differences were observed in the number of kisspeptin-immunoreactive cells 2 h before and at the time of the LH surge. The finding that ArKO mice of both sexes have a competent LH surge system suggests that oestradiol has predominantly defeminising actions on the GnRH/LH surge system in males and that the steroid-induced LH surge can occur in females even with a greatly reduced population of kisspeptin neurones in the RP3V.

Metabolic signals, hormones and neuropeptides involved in control of energy balance and reproductive success in hamsters

In the 'postgenome era', most research on the neuroendocrine control of energy homeostasis has focused on hormonal and neuropeptide control of food intake (i.e. the amount of food eaten) in rats and mice. The amount of food consumed is influenced by both the motivation to procure food and the consummatory act of ingestion. In some species, the rate of food intake remains relatively constant, while survival is maintained via changes in food procurement, external storage and internal expenditure. For example, in hamsters, metabolic signals, peripheral hormones and central neuropeptides influence hunger motivation, food hoarding and changes in energy expenditure without necessarily influencing the amount of food ingested. A similar suite of metabolic signals, hormones and neuropeptides is involved in optimizing reproductive success under fluctuating energetic conditions. Reproductive processes are inhibited or delayed when energy expenditure outstrips energy intake and mobilization from storage. Estrous cyclicity in Syrian hamsters is sensitive to the availability of oxidizable glucose, but the presence of central glucose alone is not sufficient for normal estrous cycles. Food deprivation-induced anestrus does not depend upon food deprivation-induced increases in concentrations of adrenal hormones such as glucocorticoids. If hormones such as insulin and leptin play a role, they might do so by modulating the availability of glucose detected at extra-hypothalamic sites, instead of or in addition to direct effects on the mechanisms that control gonadotropin releasing hormone secretion. Despite our ability to measure and manipulate gene transcription, understanding of fuel homeostasis requires examination of indirect effects of hormones and neuropeptides on peripheral metabolism, attention to the motivational as well as consummatory aspects of ingestion, and the study of behaviour in a natural or seminatural context.

Practice parameters for the assessment and treatment of children, adolescents, and adults with mental retardation and comorbid mental disorders. American Academy of Child and Adolescent Psychiatry Working Group on Quality Issues

Mental retardation (MR) is a heterogeneous condition defined by significantly subaverage intellectual and adaptive functioning and onset before age 18 years. With an approach underscored by principles of normalization and the availability of appropriate education and habilitation, persons with MR generally live, are educated, and work in the community. Mental disorders occur more commonly in persons with MR than in the general population. However, the disorders themselves are essentially the same. Clinical presentations can be modified by poor language skills and by life circumstances, so a diagnosis might hinge more heavily on observable behavioral symptoms. The diagnostic assessment considers and synthesizes the biological, psychological, and psychosocial context of mental disorders. Comprehensive treatment integrating various approaches, including family counseling, pharmacological, educational, habilitative, and milieu interventions is the rule.

Summary of the Practice Parameters for the Assessment and Treatment of Children, Adolescents, and Adults with Mental Retardation and Comorbid Mental Disorders. American Academy of Child and Adolescent Psychiatry

This summary provides an overview of the assessment and treatment recommendations contained in the Practice Parameters for the Assessment and Treatment of Children, Adolescents, and Adults With Mental Retardation and Comorbid Mental Disorders. The parameters were written to aid clinicians in the assessment and treatment of children, adolescents, and adults with symptoms of mental retardation (MR) and comorbid mental disorders. MR is a heterogeneous condition defined by significantly subaverage intellectual and adaptive functioning and onset before age 18 years. With an approach underscored by principles of normalization and the availability of appropriate education and habilitation, persons with MR generally live, are educated, and work in the community. Mental disorders occur more commonly in persons with MR than in the general population. However, the disorders themselves are essentially the same. Clinical presentations can be modified by poor language skills and by life circumstances, so a diagnosis might hinge more heavily on observable behavioral symptoms. The diagnostic assessment considers and synthesizes the biological, psychological, and psychosocial context of mental disorders. Comprehensive treatment integrating various approaches, including family counseling, pharmacological, educational, habilitative, and milieu interventions is the rule.

Changes in self-efficacy and decisional balance for exercise among obese women in a weight management program

OBJECTIVE

To assess changes in eating and exercise self-efficacy and decisional balance for exercise in an obese population enrolled in a multi-disciplinary weight management program.

RESEARCH METHOD AND PROCEDURES

Thirty-two obese women were assessed at entry and after 12 weeks of treatment.

RESULTS

Participants showed 15% mean weight loss after 12 weeks of treatment. Mean minutes of self-reported exercise increased by 229%. Participants demonstrated significant improvements in self-efficacy for both eating and exercise and health parameters but not in decisional balance for exercise adoption.

DISCUSSION

These results may have implications for the practitioner in that self-efficacy changes occur during successful weight loss, but decisional balance for exercise may not change until individuals enter maintenance. These results imply that practitioners may be advised to shift from confidence building to relapse prevention early on in treatment, and that focusing on strengthening the pros of exercise and reducing the cons of exercise may need to remain constant during treatment.

Longitudinal changes in college students' exercise participation

A 4-page questionnaire was mailed to 708 randomly selected 1st-year university students to assess changes in the students' exercise behavior from the 1st year of college to the 2nd year. The questionnaire assessed student demographics and participation in vigorous and moderate exercise over the preceding 7 days. Three hundred thirty-two students responded. A year later, a similar questionnaire was mailed to the same 332 students; responses were obtained from 242 students. Although no changes in reported exercise participation were found in the group as a whole, subgroups of students who either increased or decreased exercise participation were identified. Implications for exercise intervention programs among college students are presented.

Exercise in weight management

Exercise is integral to successful weight loss and maintenance. When talking to patients about exercise, consider their readiness, and address the barriers that prevent exercise. Physicians can help those patients who already exercise by encouraging them to continue and helping them anticipate, and recover from, lapses. Providing resource material to patients on behavioral strategies for exercise adoption and weight management can supplement the physician's efforts. Overall, patients need to hear that any regular exercise, be it step-aerobics, walking, or taking the stairs, will benefit them.

Services for people with mental retardation and psychiatric disorders: US-UK comparative overview

Mental health services for people with mental retardation have been receiving greater attention over recent years following a long period of inactivity. The main policy factors which influenced the developments of services were in the USA, the emphasis on deinstitutionalisation and normalisation, and in the UK the focus on social care. Progress in the assessment of psychiatric disorders and improved diagnostic techniques have stimulated the development of a wide range of mental health services for people with mental retardation, compatible with current ideology of community care on both sides of the Atlantic. Specialist multidisciplinary, community based and easily accessible mental health services should be available for people with mental retardation. Economic cost, quality of care, and training of professionals and direct care staff, remain some of the challenges faced by purchasers and providers of mental retardation and mental health services in both countries.

A comparison of questionnaire and physiological data in predicting future chronic disease risk factor status in an employee population

BACKGROUND

The ideal screening tool for worksite health screening programs has not yet been identified, and the effectiveness of screening programs in predicting future chronic disease risk factors status is not well understood. This study compared two commonly used screening tools, health-related questionnaires and measurement of physiological parameters, in terms of their ability to predict future chronic disease risk factor status in an employee population.

METHODS

Data were collected over a 10-year period from Liberty Corporation employees (N = 723). Baseline evaluation included the administration of questionnaires and measurement of physiological data. Follow-up evaluation measured physiological data only. Regression analyses identified the statistically significant predictors of future risk factor status using 1) baseline questionnaire data; 2) baseline physiological data; and 3) both questionnaire and physiological data as predictor variables.

RESULTS

Although both screening methods were able to predict future risk factor status, R 2 values were higher in models including baseline physiological measures than models including questionnaire data only. Adding questionnaire data to physiological data provided little or no additional predictive ability.

DISCUSSION

These results suggest that physiological data, particularly baseline measures of a risk factor, are more predictive of future risk factor status than questionnaire data.

[Relationship between evaluation of the duration and loudness of short sounds]

The relation between loudness and duration judgments of short tones was investigated. Sounds (15 to 120 ms, 2500 Hz, about dB SPL), were exposed in pairs; one tone of the pair, the first or the second one, was twice as long as the other. Subjects had to compare the loudness of the tones, or the duration, or the loudness and the duration at the same time. Results show that the loudness judgments are independent of experiences with duration judgments and of immediate duration judgments, but duration judgments were less precise when loudness judged at the same time.

[Variations in the loudness of a brief sound compared to another brief sound as a function of the duration of both sounds]

Loudness equalizations between two short 2500 Hz tones (15 to 120 ms, about 50 dB SPL) were made. One tone, either the first or the second one, was twice as long as the other. The intensity level differences between tones of the same loudness were calculated. Results show that the relations between duration and loudness of the tones differ for different subjects. Nevertheless the calculated differences diminished with subject experience. Subject evaluations in accordance with the intensity levels of tones, i.e. independently of the duration, were quite often obtained even for the pairs 15 ms-30 ms.