Prognostic value of hypoxia-inducible factor-1 alpha gene polymorphism in patients with heart failure with preserved ejection fraction and obstructive sleep apnea

Aim. To study the associations of hypoxia-inducible factor-1 alpha (HIF-1α) gene polymorphism (rs11549465) with the clinical course of heart failure (HF) with reserved ejection fraction (HFpEF) in patients with obesity and moderate and severe obstructive sleep apnea (OSA).

Material and methods. The study included 76 men with HFpEF and OSAS. Patients underwent a polysomnography, echocardiography, and a 6-minute walk test. In addition, apnea/hypopnea index was calculated, and the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) was assessed. HIF1A gene polymorphisms (rs11549465) were analyzed using polymerase chain reaction. After 12-month follow-up, the clinical course of HF was assessed.

Results. The T/T genotype of the HIF1A gene was associated with a high risk of HF progression (p=0,004), development of supraventricular premature beats (p=0,004) and atrial fibrillation (p=0,039). Carrying the T/T genotype was associated with severe OSA (p=0,006) and increased NT-proBNP (p=0,044), and also correlated with certain echocardiographic characteristics of myocardial remodeling.

Conclusion. T/T genotype of the HIF1A gene is associated with OSA severity and increased NT-proBNP, as well as with the severity of left and right heart remodeling. The carriage of this genotype was associated with an unfavorable course of HF and an increased risk of atrial fibrillation in patients with HFpEF and OSA.

Proteomic-based genotyping in a mouse model of trait anxiety exposes disease-relevant pathways

In our biomarker identification efforts, we have reported earlier on a protein that differs in its electrophoretic mobility between mouse lines bred either for high or low trait anxiety. The altered electrophoretic behavior of enolase phosphatase (EP) is now identified to be caused by two single-nucleotide polymorphisms. In both cases, the genetic polymorphism introduces an amino acid change in the protein's sequence resulting in differential mobility on SDS gels. This was shown by recombinantly expressing the two EP isoforms. Functional studies indicate that the EP isoform from the high anxiety mouse line has a lower enzymatic activity than does its low anxiety mouse counterpart. EP is a member of the methionine salvage pathway that is responsible for the synthesis of S-adenosyl-L-methionine, a natural compound with potential antidepressant activities. In addition, it is linked to the polyamine pathway whose members have functions in anxiety/depression-related behaviors. In a freely-segregating F2 panel, both single-nucleotide polymorphisms were significantly associated with locomotion-independent trait anxiety, further supporting a functional role of EP for this phenotype. The study shows that proteomic analysis can reveal genotypic differences relevant for the phenotype. The identified protein alterations, in turn, can expose metabolic pathways pertinent to the behavioral phenotype.

Congenital Central Hypoventilation syndrome (Ondine's curse): prenatal diagnosis and fetal breathing characteristics

We report a case of Congenital Central Hypoventilation syndrome (CCHS), diagnosed in utero at 18 weeks' gestation analysis of repeats in the PHOX2b gene in fetal amniocytes and confirmed at delivery. Prenatal diagnosis allowed for serial detailed assessment of fetal breathing characteristics. Fetal breathing in this affected fetus was indistinguishable from breathing characteristics in the non-affected fetus.

Review of bronchopulmonary foregut malformations

The term bronchopulmonary foregut malformation (BFM) describes rare cases of pulmonary sequestrations that communicate with the upper gastrointestinal tract. An unusual type of BFM is described; it consisted of esophageal atresia, proximal and distal tracheoesophageal fistulae, and bilateral extralobar pulmonary sequestrations communicating with a common bronchial structure that replaced the distal esophagus. This case is related to other reported cases in the literature, and serves as the basis for a proposed theory of the embryonic development of BFM.

Increased safety and specificity in the thin-layer chromatographic identification of marihuana

We are reporting what we believe to be a safe, rapid TLC system and spray for the identification of marihuana. The use of Fast Blue 2B salt greatly enhances the specificity of the TLC analysis of suspected marihuana samples.

Emergency department key factor in hospital admissions

A significant proportion of a community hospital's inpatient population is admitted through the emergency department. Administrators who are aware of the frequency of this practice in their institutions can schedule and staff services more efficiently. A 1975 survey conducted by the American Hospital Association shows that the number of emergency department admissions depends on hospital size, location, ownership, and type of physician coverage in the emergency department.

More hospitals say 'yes' to physicians on boards

Physician membership on hospital boards of trustees is a growing practice. Although many hospitals agree on the practicality of this concept, they differ considerably in their methods of achieving physician participation. Data from three surveys conducted by the American Hospital Association on physician trustees in nongovernmental not-for-profit hospitals are compared to illustrate this diversity.