There is an extraordinary flood of new technologies in medicine nowadays. Sophisticated diagnostics based on genome assays, mass spectrometry and cell sorting platforms are driving the technological ...transfer and promote the entrance of individualized patient management in clinical practice. Mass spectrometry (MS) could be viewed as one of the major tools that promote the development of precision medicine (PM), which employs a patient's genotype and phenotype investigation to establish individually tailored drug treatment. While genetic testing allows the physician to choose appropriate medicine, MS assays provide the patient's actual phenotype, with all of the environmental, pharmacological and pathological variables. Therefore, MS is an essential technology for personalized patient management, and high-resolution MS systems are employed to resolve challenging analytical demands. The great technological advance of MS resulted in the introduction of methods with unprecedented identification power, extreme sensitivity, specificity and extended linearity range, which are simpler to use in the medical laboratories, and are based on the current reference analytical principles. Further, the ability to perform panel profiling with simultaneous measurement of bioactive compounds, their precursors and metabolites in a single sample, enormously amplifies the informative value of results, with ultimate improvement of patient care. Typical examples include newborn screening, therapeutic drug management, toxicology, endocrinology, microbiology, clinical omics assays and others. It should be specially emphasized that clinical MS integrates chemical and anatomical pathology: MS imaging and iKnife-MS guidance in surgery, although still in the research phase, open new horizons for personalized treatment and individualized patient care.
Carotid stenting is used with an expanding indications. The neurotrophins are a family of proteins that induce the survival, development, and function of neurons. Carotid stenting alters cerebral ...blood flow and can affect neurotrophins' levels.
We included 78 people: 39 with significant carotid stenoses (CS) referred for carotid stenting (mean age 67.79 ± 10.53 years) and relatively healthy control group of 39 people without carotid and vertebral artery disease (mean age 57.42 ± 15.77 years). Brain derived reurotrophic factor (BDNF) and neuronal growth factor (NGF) concentrations were evaluated with ELISA method from venous blood - once for the control group; and for the carotid stenting group: before (n33), 24 h after (n22) and at least 1 month after (n18) carotid stenting.
There was a difference between the mean neurotrophins' concentration of patients with significant carotid stenoses and the group without: BDNF p = 0.001, CI (-5.11 to −1.44) (3.10 ± 3.10 ng/ml in CS vs. 6.37 ± 4.67 ng/ml in controls); NGF p = 0.049, CI (0.64-347.75), 195.67 ± 495.34 pg/ml in CS vs. 21.48 ± 52.81 pg/ml in controls. BDNF levels before carotid stenting (3.10 ± 3.10 ng/ml) were significantly lower than the postprocedural (4.99 ± 2.57 ng/ml) - p < 0.0001, CI (-2.86 to −0.99). For NGF there was a tendency for lower values after stenting: 195.67 ± 495.34 pg/ml before vs. 94.92 ± 120.06 pg/ml after, but the result did not reach statistical significance. The neurotrophins levels one month after carotid stenting and controls' were not significantly different p < 0.01 (BDNF 5.03 ± 4.75 ng/ml vs. 6.37 ± 4.67 ng/min; NGF 47.89 ± 54.68 pg/ml vs. 21.48 pg/ml).
Periprocedural and mid-term concentrations of neurotrophins after carotid stenting change in non-linear model. This may be due to changes in cerebral perfusion and also might be involved in neuronal recovery and reparation after reperfusion.
KEY MESSAGES
Periprocedural and mid-term concentrations of neurotrophins after carotid stenting change in non-linear model.
As the majority of them are not specific, their periprocedural change can be used as a clinical correlate to guide changes or even success in carotid stenting.
Changes in neutrophins' concentrations may be due to changes in cerebral perfusion and also might be involved in neuronal recovery and reparation after reperfusion.
This goes in analogy with cardiac high-sensitive troponin, used as procedural guidance in coronary interventions.
In this prospective study, we assessed biomarkers of inflammation (IL-6 and SAA) from the serum of 120 COVID-19 patients, of whom 70 had chronic kidney disease. All the samples were taken at ...emergency-department (ED) admission. Our goal was to relate the biomarkers to the results of death and acute kidney injury. All the patients underwent chest computer tomography to estimate the severity score (0-5), which was performed at hospital admission. Finally, biomarkers were also evaluated in a healthy control group and in non-COVID-19-CKD patients. IL-6 and SAA were statistically different between the subgroups, i.e., they were significantly increased in patients with COVID-19. Both of the biomarkers (IL-6 and SAA) were independently associated with mortality, AKI and a higher grade of pathological changes in the lung's parenchyma. Both high baseline levels of IL-6 and SAA on hospital admission were highly correlated with a later ventilatory requirement and mortality, independent of hospital stay. Mortality was found to be significantly higher when the chest CT severity score was 3-4, compared with a severity score of 0-2 (
< 0.0001). Conclusions: at the admission stage, IL-6 and SAA are useful markers for COVID-19 patients with CKD.
Introduction
Objectives
Our aim was to analyze the link between hyperandrogenism and early clinical manifestations of osteoarthritis (OA), knee cartilage thickness, and serum cartilage oligomeric ...matrix protein (sCOMP) levels in patients with polycystic ovary syndrome (PCOS) and to compare them with healthy volunteers.
Methods
Fifty-four PCOS patients who met the Rotterdam criteria with phenotypes A, B, and C were included. They were compared with 26 age- and body mass index (BMI)-matched controls. Detailed anthropometric measurements and clinical evaluation for hyperandrogenism were performed for all participants who also filled in the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Furthermore, laboratory tests including sCOMP and hormone quantification were performed in a fasting stage. Finally, an ultrasound assessment was carried out in randomly selected 56 study participants.
Results
PCOS women reported more prominent knee-related symptoms (
p
= 0.035) and more impaired activities of daily living (ADL) (
p
= 0.001) than controls. Cartilage thickness of the left and right medial condyle and left lateral condyle was significantly greater in PCOS group (
n
= 41) than in control group (
n
= 15) (
p
= 0.05,
p
= 0.006, and
p
= 0.036, respectively). COMP correlated significantly and negatively with testosterone levels (
p
= 0.029,
r
= − 0.297) in women with PCOS and the correlation remained significant after controlling for BMI.
Conclusions
Women with PCOS may experience knee-related symptoms and impaired ADL. They had greater knee femoral cartilage thickness. Although sCOMP levels did not significantly differ between the groups, lower levels of sCOMP may be inherent to PCOS patients with higher testosterone levels.
Key Points
•
Although PCOS patients may experience more prominent knee related symptoms, their femoral cartilage of the knee joint is found thicker than controls.
• PCOS patients did not have significantly elevated levels of sCOMP.
• Lower sCOMP levels were related to higher testosterone levels.
Micro- and macrovascular consequences of atherosclerosis, arterial hypertension, dyslipidemia, and smoking can affect neurotransmission and markers for neuronal activity. The potential direction and ...specifics are under study. It is also known that optimal control of hypertension, diabetes, and dyslipidemia in midlife may positively affect cognitive functioning later in life. However, the role of hemodynamically significant carotid stenoses in neuronal activity markers and cognitive functioning is still being debated. With the increased use of interventional treatment for extracranial carotid disease, the question of whether it might affect neuronal activity indicators and whether we can stop or even reverse the path of cognitive deterioration in patients with hemodynamically severe carotid stenoses naturally emerges. The existing state of knowledge provides us with ambiguous answers. We sought the literature for possible markers of neuronal activity that can explain any potential difference in cognitive outcomes and guide us in the assessment of patients throughout carotid stenting. The combination of biochemical markers for neuronal activity with neuropsychological assessment and neuroimaging may be important from practical point of view and may provide the answer to the question for the consequences of carotid stenting for long-term cognitive prognosis.
The skin manifestations in hypothyroidism are common but their advanced forms do not have adequate therapy. Along with achievement of euthyroidism, thyroid-associated dermatopathy (TAD) needs an ...inhibition of the proliferation and activation of fibroblasts, and of the glycosaminoglycans synthesis. Pentoxifylline (PTX) exerts multifaceted effects and has shown properties to inhibit certain constitutive activities of dermal fibroblasts. The aim of this study was to determine the histopathological changes and to establish the amount and distribution of mucin in hypothyroid skin, with or without treatment with PTX. Hypothyroid skin showed abundant diffuse mucin deposition in all dermal compartments in comparison with euthyroid skin. After administration of PTX in dose 100 mg/kg daily, there was a significant decreased amount of mucin in the dermis. The improvement of the dermal histological manifestations, in general demonstrated by narrowing between the dermal collagen fibers and by a decrease in mucin deposition, might be explained with dose-dependent PTX inhibition of the synthesis and accumulation of glycosaminoglycans. The histological results of this study confirmed several clinical observations about the beneficial effect of PTX on clinical skin manifestations in hypothyroid state. Therefore, we may propose PTX as a new potential therapeutic agent for TAD treatment. Further studies are needed to fully establish the effect of PTX on dermal fibroblasts after continuous administration.
Asthma-COPD overlap (ACO) is a disorder that combines clinical signs of bronchial asthma and COPD - fixed airways obstruction and/or significant reversibility of the bronchial obstruction, rapid ...progression, poor quality of life, higher mortality, frequent and severe exacerbations compared to COPD and asthma alone. The aim of our study is to determine the neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-6 (IL-6) plasma levels and to analyze their association with peripheral eosinophilia and exacerbations of patients with asthma-COPD overlap (ACO), Chronic obstructive pulmonary disease (COPD) and asthma. Our results, based on 81 patients, indicate that the plasma levels of NGAL and IL-6 are significantly elevated in ACO and are associated with blood eosinophilia and exacerbations. NGAL and IL-6 may be useful biomarkers for differentiation of patients with frequent exacerbations and ACO.
In a prospective, observational, non-interventional, single-center study, we assessed various plasma and urinary biomarkers of kidney injury (neutrophil gelatinase-associated Lipocain NGAL, ...kidney-injury molecule-1 KIM-1, and interleukin-18 IL-18); inflammation (IL-6, C-reactive protein CRP); plus angiotensin converting enzyme 2 (ACE2) in 120 COVID-19 patients (of whom 70 had chronic kidney disease (CKD) at emergency-department (ED) admission). Our aim was to correlate the biomarkers with the outcomes (death, acute kidney injury AKI). All patients had received a chest-CT scan at admission to calculate the severity score (0-5). Biomarkers were also assessed in healthy volunteers and non-COVID-19-CKD patients. These biomarkers statistically differed across subgroups, i.e., they were significantly increased in COVID-19 patients, except for urinary (u)KIM1 and uIL-18. Amongst the biomarkers, only IL-6 was independently associated with mortality, along with AKI and not using remdesivir. Regarding the prediction of AKI, only IL-6 and uKIM1 were significantly elevated in patients presenting with AKI. However, AKI could not be predicted. Having high baseline IL-6 levels was associated with subsequent ventilation requirement and death. The mortality rate was almost 90% when the chest CT-scan severity score was 3 or 4 vs. 6.8% when the severity score was 0-2 (
< 0.0001).
Post-acute sequelae of SARS-CoV-2 (PASC) is a significant health concern, particularly for patients with chronic kidney disease (CKD). This study investigates the long-term outcomes of individuals ...with CKD who were infected with COVID-19, focusing on their health status over a three-year period post-infection. Data were collected from both CKD and non-CKD patients who survived SARS-CoV-2 infection and were followed for three years as part of a research study on the impact, prognosis, and consequences of COVID-19 infection in CKD patients. In this prospective cohort study, we analyzed clinical records, laboratory findings, and patient-reported outcomes assessed at intervals during follow-up. The results indicated no permanent changes in renal function in any of the groups analyzed, although patients without CKD exhibited faster recovery over time. Furthermore, we examined the effect of RAAS-blocker therapy over time, finding no influence on PASC symptoms or renal function recovery. Regarding PASC symptoms, most patients recovered within a short period, but some required prolonged follow-up and specialized post-recovery management. Following up with patients in the post-COVID-19 period is crucial, as there is still insufficient information and evidence regarding the long-term effects, particularly in relation to CKD.
Background: Obesity and diabetes are related to a chronic low-grade inflammation. As a pro-inflammatory cytokine, IL-18 stimulates various cell types and has pleiotropic functions. Objective: To ...assess the levels of IL-18 in subjects from the entire spectrum of glycemic disorders. Methods: This study included 387 Caucasians divided into four groups: healthy controls, obese subjects without carbohydrate issues, prediabetic patients, and recently discovered type 2 diabetics. Results: Subject with body mass index ≥30kg/m2 and glycemic disorders showed significantly higher levels of IL-18 (249.77 ± 89.96 pg/ml; 259.01 ± 95.70 pg/ml; and 340.98 ± 127.65 pg/ml) compared with that of the control group (219.47 ± 110.53 pg/ml, p < 0.05). IL-18 also had significant positive associations with some anthropometric parameters, liver enzymes, fasting, post-load glucose, insulin, uric acid, and triglycerides while negative with HDL. The circulating IL-18 levels for differentiating subjects with carbohydrate disturbances and those with metabolic syndrome were determined by ROC analysis. The AUC for the disturbances of the carbohydrate metabolism was 0.597 (p = 0.001; 95% CI = 0.539 - 0.654) and for MS AUC was 0.581 (p = 0.021; 95 % CI = 0.516 - 0.647). Conclusion: Our data indicate that as the levels of IL-18 are increased the carbohydrate tolerance is deteriorated. However, the significance of IL-18 in the progression of diabetes mellitus and subsequent consequences requires further exploration.
