Cardiotoxicity (CTox) is a major side effect of cancer therapies, but uniform diagnostic criteria to guide clinical and research practices are lacking.
We prospectively studied 865 patients, aged ...54.7 ± 13.9; 16.3% men, scheduled for anticancer therapy related with moderate/high CTox risk. Four groups of progressive myocardial damage/dysfunction were considered according to current guidelines: normal, normal biomarkers (high-sensitivity troponin T and N-terminal natriuretic pro-peptide), and left ventricular (LV) function; mild, abnormal biomarkers, and/or LV dysfunction (LVD) maintaining an LV ejection fraction (LVEF) ≥50%; moderate, LVD with LVEF 40-49%; and severe, LVD with LVEF ≤40% or symptomatic heart failure. Cardiotoxicity was defined as new or worsening of myocardial damage/ventricular function from baseline during follow-up. Patients were followed for a median of 24 months. Cardiotoxicity was identified in 37.5% patients during follow-up 95% confidence interval (CI) 34.22-40.8%, 31.6% with mild, 2.8% moderate, and 3.1% with severe myocardial damage/dysfunction. The mortality rate in the severe CTox group was 22.9 deaths per 100 patients-year vs. 2.3 deaths per 100 patients-year in the rest of groups, hazard ratio of 10.2 (95% CI 5.5-19.2) (P < 0.001).
The majority of patients present objective data of myocardial injury/dysfunction during or after cancer therapy. Nevertheless, severe CTox, with a strong prognostic relationship, was comparatively rare. This should be reflected in protocols for clinical and research practices.
Aims
To examine the association of alcohol consumption patterns with growth differentiation factor 15 (GDF‐15) in older drinkers, separately among individuals with cardiovascular disease ...(CVD)/diabetes and those without them, as GDF‐15 is a strong biomarker of chronic disease burden.
Design
Cross‐sectional study.
Setting
Population‐based study in Madrid (Spain).
Participants
A total of 2051 life‐time drinkers aged 65+ years included in the Seniors‐ENRICA‐2 study in 2015–17. Participants’ mean age was 71.4 years and 55.4% were men.
Measurements
According to their average life‐time alcohol intake, participants were classified as occasional (≤ 1.43 g/day), low‐risk (men: > 1.43–20 g/day; women: > 1.43–10 g/day), moderate‐risk (men: > 20–40 g/day; women: > 10–20 g/day) and high‐risk drinkers (men: > 40 g/day; women: > 20 g/day; or binge drinkers). We also ascertained wine preference (> 80% of alcohol derived from wine), drinking with meals and adherence to a Mediterranean drinking pattern (MDP) defined as low‐risk drinking, wine preference and one of the following: drinking only with meals; higher adherence to the Mediterranean diet; or any of these.
Findings
In participants without CVD/diabetes, GDF‐15 increased by 0.27% 95% confidence interval (CI) = 0.06%, 0.48% per 1 g/day increment in alcohol among high‐risk drinkers, but there was no clear evidence of association in those with lower intakes or in the overall group, or across categories of alcohol consumption status. Conversely, among those with CVD/diabetes, GDF‐15 rose by 0.19% (95% CI = 0.05%, 0.33%) per 1 g/day increment in the overall group and GDF‐15 was 26.89% (95% CI = 12.93%, 42.58%) higher in high‐risk versus low‐risk drinkers. Drinking with meals did not appear to be related to GDF‐15, but among those without CVD/diabetes, wine preference and adherence to the MDP were associated with lower GDF‐15, especially when combined with high adherence to the Mediterranean diet.
Conclusions
Among older life‐time drinkers in Madrid, Spain, high‐risk drinking was positively associated with growth differentiation factor 15 (a biomarker of chronic disease burden). There was inconclusive evidence of a beneficial association for low‐risk consumption.
Celiac disease (CeD) is an autoimmune condition triggered by gluten in genetically predisposed individuals, affecting all ages. Intestinal permeability (IP) is crucial in the pathogenesis of CeD and ...it is primarily governed by tight junctions (TJs) that uphold the intestinal barrier's integrity. The protein zonulin plays a critical role in modulating the permeability of TJs having emerged as a potential non-invasive biomarker to study IP. The importance of this study lies in providing evidence for the usefulness of a non-invasive tool in the study of IP both at baseline and in the follow-up of paediatric patients with CeD. In this single-centre prospective observational study, we explored the correlation between faecal zonulin levels and others faecal and serum biomarkers for monitoring IP in CeD within the paediatric population. We also aimed to establish reference values for faecal zonulin in the paediatric population. We found that faecal zonulin and calprotectin values are higher at the onset of CeD compared with the control population. Specifically, the zonulin levels were 347.5 ng/mL as opposed to 177.7 ng/mL in the control population (
= 0.001), while calprotectin levels were 29.8 μg/g stool compared to 13.9 μg/g stool (
= 0.029). As the duration without gluten consumption increased, a significant reduction in faecal zonulin levels was observed in patients with CeD (348.5 ng/mL vs. 157.1 ng/mL;
= 0.002), along with a decrease in the prevalence of patients with vitamin D insufficiency (88.9% vs. 77.8%). We conclude that faecal zonulin concentrations were higher in the patients with active CeD compared with healthy individuals or those following a gluten-free diet (GFD). The significant decrease in their values over the duration of the GFD suggests the potential use of zonulin as an additional tool in monitoring adherence to a GFD.
This study aimed to evaluate discrepancies in potassium measurements between point-of-care testing (POCT) and central laboratory (CL) methods, focusing on the impact of hemolysis on these ...measurements and its impact in the clinical practice in the emergency department (ED).
A retrospective analysis was conducted using data from three European university hospitals: Technische Universitat Munchen (Germany), Hospital Universitario La Paz (Spain), and Erasmus University Medical Center (The Netherlands). The study compared POCT potassium measurements in EDs with CL measurements. Data normalization was performed in categories for potassium levels (kalemia) and hemolysis. The severity of discrepancies between POCT and CL potassium measurements was assessed using the reference change value (RCV).
The study identified significant discrepancies in potassium between POCT and CL methods. In comparing POCT normo- and mild hypokalemia against CL results, differences of -4.20 % and +4.88 % were noted respectively. The largest variance in the CL was a +4.14 % difference in the mild hyperkalemia category. Additionally, the RCV was calculated to quantify the severity of discrepancies between paired potassium measurements from POCT and CL methods. The overall hemolysis characteristics, as defined by the hemolysis gradient, showed considerable variation between the testing sites, significantly affecting the reliability of potassium measurements in POCT.
The study highlighted the challenges in achieving consistent potassium measurement results between POCT and CL methods, particularly in the presence of hemolysis. It emphasised the need for integrated hemolysis detection systems in future blood gas analysis devices to minimise discrepancies and ensure accurate POCT results.
The synovial fluid (SF) analysis involves a series of chemical and physical studies that allow opportune diagnosing of septic, inflammatory, non-inflammatory, and other pathologies in joints. Among ...the variety of analyses to be performed on the synovial fluid, the study of viscosity can help distinguish between these conditions, since this property is affected in pathological cases. The problem with viscosity measurement is that it usually requires a large sample volume, or the necessary instrumentation is bulky and expensive. This study compares the viscosity of normal synovial fluid samples with samples with infectious and inflammatory pathologies and classifies them using an ANN (Artificial Neural Network). For this purpose, a low-cost, portable QCR-based sensor (10 MHz) was used to measure the viscous responses of the samples by obtaining three parameters: Δf, ΔΓ (parameters associated with the viscoelastic properties of the fluid), and viscosity calculation. These values were used to train the algorithm. Different versions of the ANN were compared, along with other models, such as SVM and random forest. Thirty-three samples of SF were analyzed. Our study suggests that the viscosity characterized by our sensor can help distinguish infectious synovial fluid, and that implementation of ANN improves the accuracy of synovial fluid classification.
Background
Growth differentiation factor 15 (GDF‐15) is a biomarker for chronic disease burden that might explain the health effects of sedentary behaviours (SBs) and physical activity (PA). We ...examined associations of device‐measured sleep, SB and PA, and time reallocations among them, with GDF‐15 in older adults.
Methods
We used data from 2245 older adults participating in the Seniors‐ENRICA‐2 study. Wrist‐worn accelerometers were employed to ascertain total time in sleep, SB, light PA (LPA) and moderate‐to vigorous PA (MVPA). Associations between these activities and serum GDF‐15 levels were analysed using linear regression, including isotemporal substitution models for time reallocations among activities, and adjusted for potential confounders. Analyses were conducted separately in two groups (less active and more active individuals) according to the median total PA time.
Results
In the less active participants, 30 min/day more of MVPA were related to lower levels of GDF‐15 when replacing sleep (fully adjusted mean percentage differences 95% confidence interval in GDF‐15 of −9.2% −13.2, −5.0), SB (−9.8% −13.6, −5.8) and LPA (−5.8% −11.1, −0.3), whereas 30 min/day more of LPA were related to lower GDF‐15 when replacing both sleep (−3.6% −6.1, −1.0) and SB (−4.2% −6.7, −1.7). In the more active participants, 30 min/day more of MVPA were also associated with lower GDF‐15 when replacing sleep (−2.9% −5.3, −0.3), SB (−2.4% −4.6, −0.2) and LPA (−3.5% −6.6, −0.3), but no associations were found for more time in LPA. Spending more time in SB was associated with higher GDF‐15 levels only among those less active (1.9% 0.9, 2.9 per 30 min/day increment). Sleep time did not appear to be associated with GDF‐15.
Conclusions
The MVPA was inversely associated with GDF‐15, with stronger associations at lower PA volumes. Also, more LPA and less SB time were linked to lower GDF‐15 in the less active individuals. This suggests that simply moving more and sitting less may reduce chronic disease burden in older adults.
When using biological variation (BV) data, BV estimates need to be robust and representative. High-endurance athletes represent a population under special physiological conditions, which could ...influence BV estimates. Our study aimed to estimate BV in athletes for metabolism and growth-related biomarkers involved in the Athlete Biological Passport (ABP), by 2 different statistical models.
Thirty triathletes were sampled monthly for 11 months. The samples were analyzed for human growth hormone (hGH), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), insulin, and N-terminal propeptide of type III procollagen (P-III-NP) by immunoassay. Bayesian and ANOVA methods were applied to estimate within-subject (CVI) and between-subject BV.
CVI estimates ranged from 7.8% for IGFBP-3 to 27.0% for insulin, when derived by the Bayesian method. The 2 models gave similar results, except for P-III-NP. Data were heterogeneously distributed for P-III-NP for the overall population and in females for IGF-1 and IGFBP-3. BV components were not estimated for hGH due to lack of steady state. The index of individuality was below 0.6 for all measurands, except for insulin.
In an athlete population, to apply a common CVI for insulin would be appropriate, but for IGF-1 and IGFBP-3 gender-specific estimates should be applied. P-III-NP data were heterogeneously distributed and using a mean CVI may not be representative for the population. The high degree of individuality for IGF-1, IGFBP-3, and P-III-NP makes them good candidates to be interpreted through reference change values and the ABP.
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