Oxidative stress has been suggested to play a main role in the pathogenesis of type 2 diabetes mellitus and its complications. As a consequence of this increased oxidative status a cellular adaptive ...response occurs requiring functional chaperones, antioxidant production and protein degradation. This study was designed to evaluate systemic oxidative stress and cellular stress response in patients suffering from type 2 diabetes and in age-matched healthy subjects. Systemic oxidative stress has been evaluated by measuring plasma reduced and oxidized glutathione, as well as pentosidine, protein carbonyls lipid oxidation products 4-hydroxy-2-nonenal and F2-isoprostanes in plasma, and lymphocytes, whereas the lymphocyte levels of the heat shock proteins (HSP) HO-1, Hsp72, Sirtuin-1, Sirtuin-2 and thioredoxin reductase-1 (TrxR-1) have been measured to evaluate the systemic cellular stress response. Plasma GSH/GSSG showed a significant decrease in type 2 diabetes as compared to control group, associated with increased pentosidine, F2-isoprostanes, carbonyls and HNE levels. In addition, lymphocyte levels of HO-1, Hsp70, Trx and TrxR-1 (P<0.05 and P<0.01) in diabetic patients were higher than in normal subjects, while sirtuin-1 and sirtuin-2 protein was significantly decreased (p<0.05). In conclusion, patients affected by type 2 diabetes are under condition of systemic oxidative stress and, although the relevance of downregulation in sirtuin signal has to be fully understood, however induction of HSPs and thioredoxin protein system represent a maintained response in counteracting systemic pro-oxidant status. This article is part of a Special Issue entitled: Antioxidants and Antioxidant Treatment in Disease.
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► Oxidative stress plays a key role in diabetes mellitus and its complications. ► This study evaluates oxidative stress and stress response in diabetic patients. ► Sirtuin and Hsp signals counteract systemic oxidant status.
Angiogenesis is a process stimulated in inflamed synovium of patients with osteoarthritis (OA), and contributes to the progression of the disease. Synovial fibroblasts secrete angiogenic factors, ...such as vascular endothelial growth factor (VEGF), an up-regulator of angiogenesis, and this ability is increased by interleukin (IL)-1β. The purpose of this study was to verify whether IL-17 contributes and/or synergizes with IL-1β and tumor necrosis factor (TNF)-α in vessel development in articular tissues by stimulating the secretion of proangiogenic factors by synovial fibroblasts.
We stimulated
in vitro synovial fibroblasts isolated from OA, rheumatoid arthritis (RA) and fractured patients (FP) with IL-17 and IL-1β and from OA patients with IL-17, IL-1β and TNF-α. In the supernatants from the cultures, we assayed the amount of VEGF by immunoassay and other angiogenic factors (keratinocyte growth factor, KGF; hepatocyte growth factor, HGF; heparin-binding endothelial growth factor, HB-EGF; angiopoietin-2, Ang-2; platelet-derived growth factor B, PDGF-BB; thrombopoietin, TPO) by chemiluminescence; semiquantitative RT-PCR was used to state mRNA expression of nonreleased angiogenic factors (Ang-2 and PDGF-BB) and tissue inhibitors of metalloproteinase (TIMP)-1.
IL-17, TNF-α and IL-1β increased VEGF secretion by synovial fibroblasts from OA patients. IL-17 and IL-1β also increased VEGF secretion in RA and FP. Besides, IL-17 increased KGF and HGF secretions in OA, RA and FP; in OA and RA, IL-17 also increased the HB-EGF secretion and the expression of TIMP-1 as protein and mRNA. In OA patients IL-17 had an additive effect on TNF-α-stimulated VEGF secretion.
These results suggest that IL-17 is an
in vitro stimulator of angiogenic factor release, both by its own action and by cooperating with TNF-α.
•A shorter BTD is associated with a higher incidence of unplanned obstetrical intervention due to labor dystocia.•There is an inverse correlation between the BTD and the length of the second stage of ...labor.•Antenatal identification of women at risk for labor dystocia might trigger some specific interventions during the second stage of labor.•Antenatal identification of women at higher risk for labor dystocia might prompt a referral of the patient to a district hospital.
The aim our study was to evaluate the association between the antepartum clinical measurement of the Bituberous Diameter (BTD) and the occurrence of unplanned obstetrical intervention (UOI) due to labor dystocia, including either operative vaginal delivery or caesarean section in a cohort of low-risk, nulliparous at term.
Retrospective analysis of prospectively collected data.
Tertiary maternity care.
With the women lying in lithotomic the distance between two ischial tuberosities was assessed using a tape measure during the routine antenatal booking between 37 and 38 weeks of gestation.
Overall, 116 patient were included, and of these 23(19.8%) were submitted to an UOI due to labor dystocia. Compared to women that had a spontaneous vaginal delivery, women submitted to an UOI had a shorter BTD (8.25 + 0.843 vs 9.60 + 1.12, p < 0.001), a higher frequency of epidural analgesia (21/23 or 91.3% vs 50/93 or 53.8%; p = 0.002) and of augmentation of labor (14/23 or 60.9% vs 19/93 or 20.4%; p < 0.001) as well as a longer first 455 (IQR 142–455 min vs 293 (IQR 142–455) min and second stages of labor 129 (IQR 85–155) min vs 51 (IQR 27–78) min. Multivariable logistic regression showed that the BTD (aOR 0.16, 95% CI 0.04–0.60; p = 0.007) and the length of the second stage of labor (aOR 6.83, 95% CI 2.10–22.23; p = 0.001) were independently associated with UOI. When evaluating the diagnostic accuracy of the BTD for the prediction of UOI due to labor dystocia, the BTD showed an AUC of 0.82 (95 %CI 0.73–0.91; p < 0.001) with an optimal cut-off value of 8.6 cm (78.3% (95 %CI 56.3–92.5) sensitivity, 77.4% (95 %CI 67.6–85.4) specificity, 46.2% (95% CI 30.1–62.8) PPV, 93.5% (95% CI 85.5–97.9) NPV, 3.5 (95% CI 2.3–5.4) positive LR, and 0.28 (95% CI 0.13–0.61) negative LR. A significant inverse correlation between the length of the second stage of labour and the BTD in patients that had a vaginal delivery was also demonstrated (Spearman’s rho = -0.24, p = 0.01).
Our study suggests that antepartum clinical assessment of the BTD might be used as a reliable predictor of UOI due to labor dystocia in low-risk, nulliparous women at term gestation.
Antenatal identification of women at higher risk for labor dystocia might trigger some interventions during the second stage of labor, such as maternal position shifting, to increase the pelvic capacity and potentially improve outcomes or might prompt a referral of the patient to a district hospital prior to the onset of labor.
Moringa oleifera seeds were used as a biosorbent for the selective extraction of inorganic arsenic in water and detection by furnace graphite atomic absorption spectrometry. The behavior of the ...As(III) and As(V) adsorption onto the biosorbent was evaluated at pH 1.0–9.0 in batch studies. The results indicated that As(III) was adsorbed at pH 7.0 while As(V) was poorly retained. So much, in a sample contained As(III) and As(V), the As(III) is going to be retained while most pentavalent species remained free in solution, allowing their determination by GF AAS. The operational variables of the separation method were optimized, the adsorbent mass of 1.0g was found to be sufficient to retain the As(III) present in the solutions with a stirring time of 1h. The limit of detection for As(V) determination is 6.3μgL−1 and the precision was below 1.23%. Results for recovery tests using different water samples were higher than 92% As(V). The accuracy of the method was proven through the analysis of a certified water sample (APS 1071).
The study was conducted in a remote sputum sample collection sites and GeneXpert® MTB/RIF testing centers to detect Mycobacterium tuberculosis in Malawi. The main purpose of the study was to evaluate ...whether sputum samples stored and transported with OMNIgene®•SPUTUM (OM-S) medium perform comparably to the routine cold-chain stored and transported samples for GeneXpert testing to detect Mycobacterium tuberculosis.
Two sputum samples from each of 362 tuberculosis suspects were randomly assigned to the OMNIgene treated (OM-S group) or the standard-of-care group (SOC; transported via cold chain). All specimens were tested at regional GeneXpert testing sites using the expectorated (raw) sputum protocol. Demographic, clinical, transport/storage and Xpert data were recorded for each specimen pair. Agreement between the SOC and OM-S groups' Xpert results was evaluated using Cohen's kappa analysis.
Mean patient age was 42.3 years (range 2-79 years), 77% of patients were female, and 80% were HIV-positive. Mean transport/storage time was 6.7 days (range, 0-29 days). The rates of MTB positivity for the OM-S and SOC groups were comparable (11.8 and 11.2%, respectively), inter-test agreement was "very good" (κ = 0.97), and overall percent agreement was 99%. Two specimen pairs (both mucoid, one 13 days transport, one 1 day transport) had discordant Xpert results.
OM-S-treated sputum specimens can undergo multi-day ambient-temperature storage as well as transport and yield Xpert results comparable to those of cold-chain-transported samples in Malawi.
Convergence spasm is a clinical condition characterized by transient episodes of convergence, miosis and accommodation with strabismus and diplopia and it is usually a manifestation of a functional ...neurological disorder. We describe a patient with a challenging diagnosis of convergence spasm in the setting of occipital lobe epilepsy.
A 52-year-old woman came for the assessment of focal epilepsy due to left occipital cortical dysplasia. During ocular motility tests, she presented with episodes of short duration (~10-30 seconds) of convergent strabismus. Neuropsychological evaluation showed a severe mixed anxiety-depressive disorder with a tendency toward somatization.
Convergence spasm was recorded during video-EEG examination and no ictal activity was present.
To our knowledge, no other report of functional convergence spasm in the context of focal epilepsy associated with cortical dysplasia has been described in literature.
Objectives
The aim of the study was to describe chronic lung disease in HIV‐infected never‐smokers by looking at clinical, structural and functional abnormalities.
Methods
This comparative ...cross‐sectional study included 159 HIV‐infected never‐smoking patients mean (± standard deviation) age 54.6 ± 9.1 years; 13.2% female; 98.1% with undetectable viral load and 75 nonmatched never‐smoking controls mean (± standard deviation) age 52.6 ± 6.9 years; 46.7% female. We examined calcium scoring computer tomography (CT) scans or chest CT scans, all with a lung‐dedicated algorithm reconstruction, to assess emphysema and airway disease (respiratory bronchiolitis and/or bronchial wall thickening), tested pulmonary function using spirometry, lung volumes and the diffusion lung capacity of carbon monoxide (DLCO), and assessed respiratory symptoms using the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT).
Results
Twenty‐five (17.2%) of the HIV‐infected patients versus two (2.7%) of the controls had a CAT score > 10. Only 5% of the HIV‐infected patients showed FEV1% < 80%, and 25% had DLCO < 75% of the predicted value. Based on the CT scans, they had increased prevalences, compared with the controls, of airway disease (37% versus 7.9%, respectively) and emphysema (18% versus 4%, respectively), with more severe and more frequent centrilobular disease. After correction for age, sex and clinical factors, HIV infection was significantly associated with CAT > 10 odds ratio (OR) 7.7, emphysema (OR 4), airway disease (OR 4.5) and DLCO < 75% of predicted (OR 4).
Conclusions
Although comparisons were limited by the different enrolment methods used for HIV‐infected patients and controls, the results suggest that never‐smoking HIV‐infected patients may present with chronic lung damage characterized by CT evidence of airway disease. A minority of them showed respiratory symptoms, without significant functional abnormalities.
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