Fibromuscular dysplasia (FMD), a noninflammatory disease of medium-size arteries, may lead to stenosis, occlusion, dissection, and/or aneurysm. There has been little progress in understanding the ...epidemiology, pathogenesis, and outcomes since its first description in 1938.
Clinical features, presenting symptoms, and vascular events are reviewed for the first 447 patients enrolled in a national FMD registry from 9 US sites. Vascular beds were imaged selectively based on clinical presentation and local practice. The majority of patients were female (91%) with a mean age at diagnosis of 51.9 (SD 13.4 years; range, 5-83 years). Hypertension, headache, and pulsatile tinnitus were the most common presenting symptoms of the disease. Self-reported family history of stroke (53.5%), aneurysm (23.5%), and sudden death (19.8%) were common, but FMD in first- or second-degree relatives was reported only in 7.3%. FMD was identified in the renal artery in 294 patients, extracranial carotid arteries in 251 patients, and vertebral arteries in 82 patients. A past or presenting history of vascular events were common: 19.2% of patients had a transient ischemic attack or stroke, 19.7% had experienced arterial dissection(s), and 17% of patients had an aneurysm(s). The most frequent indications for therapy were hypertension, aneurysm, and dissection.
In this registry, FMD occurred primarily in middle-aged women, although it presents across the lifespan. Cerebrovascular FMD occurred as frequently as renal FMD. Although a significant proportion of FMD patients may present with a serious vascular event, many present with nonspecific symptoms and a subsequent delay in diagnosis.
Vibrio parahaemolyticus
is a significant seafood-borne pathogen, leading to serious acute gastrointestinal diseases worldwide. In this study, a reliable 4-plex droplet digital PCR (ddPCR) was ...successfully established and evaluated for the simultaneous detection of
V. parahaemolyticus
based on
tlh
,
tdh
,
ureR
, and
orf8
in food samples using single intact cells. The targets
tlh
and
ureR
were labeled with 6-Carboxyfluorescein (FAM), and the targets
tdh
and
orf8
were labeled with 5’-Hexachlorofluorescein (HEX). Due to reasonable proration of primers and probes corresponding into the two fluorescence channels of the ddPCR detecting platforms, the clearly separated 16 (2
4
) clusters based on fluorescence amplitude were obtained. For better results, the sample hot lysis time and the cycle number were optimized. The results showed that the minimum number of “rain” and maximum fluorescence amplification were presented for precise detection in the condition of 25 min of the sample hot lysis time and 55 cycles. The sensitivity of this 4-plex ddPCR assay was 39 CFU/mL, which was in accordance with that of the conventional plate counting and was 10-fold sensitive than that of qPCR. In conclusion, the 4-plex ddPCR assay presented in this paper was a rapid, specific, sensitive, and accurate tool for the detection of
V. parahaemolyticus
including pandemic group strains and could be applied in the differentiation of
V. parahaemolyticus
in a wide variety of samples.
Heat Shock Protein 90 (Hsp90) is essential for tumor progression in humans and drug resistance in fungi. However, the roles of its many co-chaperones in antifungal resistance are unknown. In this ...study, by susceptibility test of
mutants lacking each of 18 Hsp90/Calcineurin system member genes (including 8 Hsp90 co-chaperone genes) to antifungal drugs and other stresses, we demonstrate that the Hsp90 co-chaperones Sti1 (Hop1 in yeast), Aha1, and P23 (Sba1 in yeast) were required for the basal resistance to antifungal azoles and heat stress. Deletion of any of them resulted in hypersensitivity to azoles and heat. Liquid chromatography-mass spectrometry (LC-MS) analysis showed that the toxic sterols eburicol and 14α-methyl-3,6-diol were significantly accumulated in the
and
deletion mutants after ketoconazole treatment, which has been shown before to led to cell membrane stress. At the transcriptional level, Aha1, Sti1, and P23 positively regulate responses to ketoconazole stress by
and
, key genes in the ergosterol biosynthetic pathway. Aha1, Sti1, and P23 are highly conserved in fungi, and
and
deletion also increased the susceptibility to azoles in
. These results indicate that Hsp90-cochaperones Aha1, Sti1, and P23 are critical for the basal azole resistance and could be potential targets for developing new antifungal agents.
Smoking and Adverse Outcomes in Fibromuscular Dysplasia O’Connor, Sarah, MD; Gornik, Heather L., MD, MHS; Froehlich, James B., MD, MPH ...
Journal of the American College of Cardiology,
04/2016, Letnik:
67, Številka:
14
Journal Article
Background Fibromuscular dysplasia (FMD) is a nonatherosclerotic arterial disease that has a variable presentation including pulsatile tinnitus (PT). The frequency and characteristics of PT in FMD ...are not well understood. The objective of this study was to evaluate the frequency of PT in FMD and compare characteristics between patients with and without PT. Methods and Results Data were queried from the US Registry for FMD from 2009 to 2020. The primary outcomes were frequency of PT among the FMD population and prevalence of baseline characteristics, signs/symptoms, and vascular bed involvement in patients with and without PT. Of 2613 patients with FMD who were included in the analysis, 972 (37.2%) reported PT. Univariable analysis and multivariable logistic regression were performed to explore factors associated with PT. Compared with those without PT, patients with PT were more likely to have involvement of the extracranial carotid artery (90.0% versus 78.6%; odds ratio, 1.49;
=0.005) and to have higher prevalence of other neurovascular signs/symptoms including headache (82.5% versus 62.7%; odds ratio, 1.82;
<0.001), dizziness (44.9% versus 22.9%; odds ratio, 2.01;
<0.001), and cervical bruit (37.5% versus 15.8%; odds ratio, 2.73;
<0.001) compared with those without PT. Conclusions PT is common among patients with FMD. Patients with FMD who present with PT have higher rates of neurovascular signs/symptoms, cervical bruit, and involvement of the extracranial carotid arteries. The coexistence of the 2 conditions should be recognized, and providers who evaluate patients with PT should be aware of FMD as a potential cause.
Vibrio parahaemolyticus, a marine food-borne pathogen, has been proved to be a significant cause of human gastrointestinal disorders worldwide. In this study, a method of multiplex droplet digital ...PCR (ddPCR) based on primer and probe sequences of the tlh, tdh and ureR genes were developed and evaluated for the reliable quantification of V. parahaemolyticus cells in seafoods. The specificities of all primers and probes used in this study were validated on three standard strains of V. parahaemolyticus, 10 strains of Vibrio spp., and 22 strains of other bacteria by ddPCR and quantitative PCR (qPCR). Then the ddPCR system, primers, probe concentration and amplification procedures were optimized, and the templates with cell and genomic DNA (gDNA) were compared. The results showed that using cell as template could benefit for multiplex ddPCR, which performed higher linkage among three genes. This method improved sensitivity, specificity, accuracy, convenience, and reproducibility for the detection of V. parahaemolyticus, and the limit of detection (LOD) was 15 CFU/mL. In addition, the applicability of this method was compared with plate count and qPCR, and then verified to detect artificially contaminated seafood samples containing different concentrations of V. parahaemolyticus. The results indicated that the established method is stable, accurate, sensitive, range-wide, and has the potential to detect the three different genes of V. parahaemolyticus in food samples.
•Multiplex ddPCR was developed and evaluated to directly quantify V. parahaemolyticus.•The assay exhibited significant specificity, sensitivity and accuracy.•The method was used to monitor three genes and distinguish different V. parahaemolyticus.•The multiplex ddPCR based on single intact cell is better than that of gDNA.•The applicability of the assay was verified to detect spiked seafood samples.
Abstract Background Fibromuscular dysplasia (FMD) is a noninflammatory arterial disease that predominantly affects women. The arterial manifestations may include beading, stenosis, aneurysm, ...dissection, or tortuosity. Objectives This study compared the frequency, location, and outcomes of FMD patients with aneurysm and/or dissection to those of patients without. Methods The U.S. Registry for FMD involves 12 clinical centers. This analysis included clinical history, diagnostic, and therapeutic procedure results for 921 FMD patients enrolled in the registry as of October 17, 2014. Results Aneurysm occurred in 200 patients (21.7%) and dissection in 237 patients (25.7%); in total, 384 patients (41.7%) had an aneurysm and/or a dissection by the time of FMD diagnosis. The extracranial carotid, renal, and intracranial arteries were the most common sites of aneurysm; dissection most often occurred in the extracranial carotid, vertebral, renal, and coronary arteries. FMD patients with dissection were younger at presentation (48.4 vs. 53.5 years of age, respectively; p < 0.0001) and experienced more neurological symptoms and other end-organ ischemic events than those without dissection. One-third of aneurysm patients (63 of 200) underwent therapeutic intervention for aneurysm repair. Conclusions Patients with FMD have a high prevalence of aneurysm and/or dissection prior to or at the time of FMD diagnosis. Patients with dissection were more likely to experience ischemic events, and a significant number of patients with dissection or aneurysm underwent therapeutic procedures for these vascular events. Because of the high prevalence and associated morbidity in patients with FMD who have an aneurysm and/or dissection, it is recommended that every patient with FMD undergo one-time cross-sectional imaging from head to pelvis with computed tomographic angiography or magnetic resonance angiography.
Specifics of this registry are described in detail elsewhere (1). Since the publication of the first registry report (1), one additional clinical center has been added and an additional 168 patients ...have been enrolled as of September 11, 2012. ...there are important sex-related differences in the family history, presentation, and arterial involvement of FMD.
PDF
