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Carlton, Alissa Haight & Kristin Lejnieks. Block Party: The Modern Quilting Bee. Stash: C&T. 2011. c.128p, illus. ISBN 9781607051978. pap. $21.95. FIBER CRAFTS Twelve quilters, most from different parts of [...]

A leader of Big Brothers Big Sisters of America talks about how successful mentors help others see qualities in themselves that they might not otherwise see. We have a running average of 95 percent high-school graduation rates for kids supported by mentoring relationships, and they often attend schools whose graduation rates are half of that. [Extracted from the article]

The narrow-band imaging (NBI) International Colorectal Endoscopic (NICE) classification is based on narrow-band pictures of colon polyps viewed through a narrow-band spectrum. The categorisation utilises staining, surface structure, and vascular patterns to differentiate between hyperplastic and adenomatous colon polyps. It is known that accuracy of the NICE classification for colorectal polyps varies depending on the localisation in the colon.The aim of this study was to compare the diagnostic accuracy of the NICE classification and the gold standard — morphological analysis for the determination of the type of colorectal lesions depending on localisation in colon. A prospective study was performed in an outpatient clinic. 1214 colonoscopies were performed by two expert endoscopists and 475 polyps were found in 291 patients. The overall diagnostic accuracy of the NICE classification was 80.3%. Optical verification was better in ascending colon — 93.9%, followed by sigmoid colon — 82.1%. Inferior results were found for the descending colon — 64.0%. The results of this study showed that the NICE classification could be a helpful instrument in daily practice for the ascending and sigmoid colon. For better results, proper training should be considered. The NICE system could have a role in the replacement of morphological analysis if appropriate results of verification could be achieved.

AbstractEthylene glycol is a sweet-tasting toxic alcohol contained in a variety of chemical preparations. In patients poisoned with ethylene glycol, diagnosis is often based upon clinical suspicion and nonspecific tests. Hypocalcemia is often present due to calcium oxalate crystals formed by oxalic acid metabolite complexation. This retrospective study involved a review of clinical records of patients with a diagnosis of ethylene glycol poisoning. Results of blood gas samples, lactate, ionized calcium, and serum creatinine were documented and compared between various groups. The ionized calcium concentration was below the normal range in 59% of cases at the time of presentation and more commonly associated with a blood pH of <7.3 in 79% of cases. The number of patients with a low ionized calcium concentration increased over time. A low ionized calcium concentration was a common finding in cases of severe ethylene glycol poisoning and was more commonly associated with patients exhibiting metabolic acidosis or developing acute kidney injury or death. Ionized calcium concentration on presentation may be an additional marker in concert with blood pH that can be used in the risk assessment and stratification of severity and complications of ethylene glycol poisoning.

It was concluded that depression (D) is an independent risk factor for cardiovascular diseases (CVD), and is not related to other previously determined cardiac risk factors. Compared with non-depressed patients, the risk of cardiac arrest increased in less severely depressed patients. D worsens the CVD prognosis by significantly increasing the risk of recurrent coronary heart disease (CHD). Some studies suggest that OS directly increases the risk of D in patients with CVD. Oxidative stress (OS) is considered an emergency mechanism that relates to both CVD and D pathophysiology. The common risk factors increase the production of OS and reduce antioxidant defences, thereby promoting the occurrence and development of interacted ischaemic CVD and D. At present, there is insufficient evidence that routine screening of D in patients with CHD will ultimately help improve the patient’s condition. This review reiterates the need for a multidisciplinary approach, which is necessary to understand, diagnose and then treat this frequent co-morbid condition of CHD and D. Assessment of OS markers could modify risk stratification, diagnosis and prevention and treatment of patients with both CHD and D, in patients with and without previous cardiac history.

Patients with rheumatoid arthritis (RA) typically have many permanently inflamed joints. The inflammation inside the body can lead to general physical weakness, exhaustion, and drowsiness. This feeling of extreme tiredness is also called “fatigue”. Some people find this to be the worst symptom of the disease. However, the clinical significance of fatigue and its pathogenesis have not been recognised. This study aimed to determine the development of fatigue depending on activity and aggressiveness of RA. To achieve the goal, patients were interviewed and indicators of disease activity and aggressiveness were determined: rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), immunoglobulins IgA RF, IgM RF, IgG RF and anti-carbamylated protein antibodies (anti-CarP). Based on the results of the survey, RA patients were divided into two groups — with and without fatigue. In the group of RA patients with fatigue, statistically more often an increase in IgA RF, IgM RF, and IgG RF levels was observed in those with elevated RF level, higher IgM RF and IgG RF levels were associated with increase in IgA RF level, and increase in the IgG RF and anti-CarP levels with elevation in the IgM RF level. A higher IgG RF level contributed to a higher anti-CarP level increase. Significant differences in the levels of clinical and laboratory inflammatory markers were not observed between the RA patients with and without fatigue. The obtained data suggest that the aggressive course of RA, more than inflammation, may contribute to the development of fatigue in RA patients.

Our study was focused on identification and correction of early hyperglycaemia, with the aim to reduce the risk of developing post-transplant diabetes mellitus (PTDM) and its associated complications. In a single centre, the prospective study included adult kidney transplant recipients without diabetes mellitus whose pre-transplant glucometabolic data did not show signs of diabetes mellitus. Starting from the first day after kidney transplantation, patients were closely monitored for hyperglycaemia; glucose level measurements were started to obtain pre-prandial levels. If the blood glucose level exceeded 11.1 mmol/l, hyperglycaemia was corrected with short-acting insulin. A total of 14 patients completed a three-month follow-up. During the first post-transplant week, the blood glucose level exceeded 11.1 mmol/l in nine patients (63.9%). From those patients five (55.5%) did not develop PTDM. None of the patients who did not need insulin treatment developed PTDM. Higher pre-lunch glucose levels increased the risk of developing PTDM (p = 0.006). Patients with diabetes required a two times higher insulin dosage than other patients during the first post-transplantation week. We found that hyperglycaemia is a common problem in the early post-transplant period. Early recognition and correction of inpatient hyperglycaemia was associated with reduction of the prevalence of PTDM in more than a half of the patients in the studied group at three months post transplant.

Acinetobacter baumannii is an aerobic gram-negative opportunistic bacterial pathogen, an emerging cause of healthcare-associated infections, associated with increased morbidity, mortality and healthcare costs. It has been widely found in the hospital environment, exhibiting high resistance to antimicrobials, affecting the spread of healthcare-associated infections and preventing effective infection control. The role of virulence factors in the pathogenesis of A. baumannii related human infections remains unclear. Therefore, molecular testing of pathogenic bacteria is an important tool for improving infection control measures against A. baumannii with combined resistance. The aim of this study was to analyse A. baumannii infection cases, antimicrobial resistance profiles and to characterise the genetic heterogeneity of isolates. In general, outbreaks occurring in hospitals are presumed to be clonal, with patient-to-patient transmission of essentially identical strains. Treatment decisions are based on a combination of in vitro susceptibility assays and empirical results based on patient outcomes.

Right ventricle (RV) dysfunction in patients with ST elevation myocardial infarction (STEMI) is more common and important than previously considered. The aim of this study was to determine the incidence of RV involvement in acute STEMI by using advanced echocardiography (Echo) methods, such as RV longitudinal strain and three-dimensional (3D) ejection fraction, and to prove that RV involvement is not exclusive to right coronary artery damage in STEMI. The study group was formed of 73 patients aged 30 to 60 years with confirmed first-time acute STEMI and coronary angiography performed. Abnormality thresholds for standard and advanced Echo parameters in case of STEMI for predicted RV dysfunction were RV 3D ejection fraction < 49% and RV free wall longitudinal strain > –24.5 %. Using these abnormality thresholds it was possible to detect RV dysfunction in 60% of STEMI cases. The acquired results are close to the cardiac magnetic resonance data found in literature, which is the gold standard for determination of RV systolic function. RV involvement did not depend on the damaged coronary artery, as there was no association detected (p = 0.09); therefore, RV function should be assessed in every STEMI patient, and Echo is an effective method for this purpose.

Based on epidemiological data, osteoarthritis (OA) is the most common joint disease of populations of industrialised countries. The increasing prevalence of OA is closely related to an ageing population and a sedentary lifestyle. Load-bearing joints, such as hip, knee, and intervertebral joints, are the primary ones that are being subjected to the degenerative changes. The patho-physiology of the disease is based on progressive damage and gradual deterioration of the micro and macrostructure of hyaline cartilage. In today’s radiological practice, the first-line method for assessing the condition of articular cartilage is magnetic resonance imaging (MRI). However, the sensitivity of standard clinical MRI in articular cartilage assessment is limited. For this reason, for the last five years there has been a rapidly growing interest in developing advanced MRI techniques for cartilage structure evaluation. The purpose of this pilot study was to highlight the possibilities of Artificial Intelligence Computed Vision Analysis (MEDH 3.0 algorithm) in the evaluation of cartilage changes of the knee joint. The study was carried out at Rīga East Clinical University Hospital (RAKUS) and included 25 patients. After assessment by a rheumatologist, the participants were divided into two groups: 15 (60%) participants with OA and 10 (40%) healthy individuals. All patients underwent MRI examinations according to a unified RAKUS Gaiïezers Radiology clinic protocol. MRI data were analysed using the Computed Vision Analysis MEDH 3.0 algorithm. The results showed substantial differences in intensity variance (p < 0.01) parameters, as well as in pixel entropy and homogeneity values (p < 0.01). The results of the pilot study confirmed the potential use of Artificial Intelligence Computed Vision Analysis in further development and integration in the assessment of cartilage changes in the knee joint.

Atrial fibrillation (AF) conversion to sinus rhythm by electrical cardioversion (ECV) is followed by the challenge of preventing arrhythmia recurrence, especially in high-risk patients. The properties of class IC, class III and also class II antiarrhythmic medications have been established, but not all effects have been studied. The aim of the study was to compare efficacy of class IC and class III antiarrhythmic medications, and additionally medication with a class II mechanism of action, or taken concomitantly with a beta-blocker, for post-cardioversion sinus rhythm maintenance in patients with high-risk AF. A total of 112 patients who underwent successful ECV in Latvian Centre of Cardiology were included. Data was acquired by a face-to-face interview and 1-, 3-, 6-month follow-up interviews. Comparing class IC (used by 34.8%) and class III (used by 65.2%) drugs, there was no statistically significant difference between six-month sinus rhythm maintenance rates (53.8% vs. 63.0%, p = 0.346) and arrhythmia-free survival (p = 0.313). Comparing amiodarone (used by 57.1%) and ethacizine, concurrently with a beta-blocker (used by 25.9%), no statistically significant difference was found between six-month sinus rhythm maintenance (64.1% vs. 58.6%, p = 0.616) and arrhythmia-free survival (p = 0.706). The results showed that specific antiarrhythmic drug choice was not associated with superior effectiveness, highlighting that, if not contraindicated, ethacizine, concomitantly with a beta-blocker, could be used as a similarly effective alternative for amiodarone, which has adverse health effects.

The cardiac resynchronisation therapy (CRT) survey II is a joint initiative between the European Heart Rhythm Association and the Heart Failure Association. It compiles real world data about cardiac resynchronisation therapy in European Society of Cardiology member states. 11 088 patients assigned to implantation of CRT with pacemaker function (CRT-P) or CRT with an incorporated defibrillator (CRT-D) were enrolled in the survey starting 1 October 2015 till 31 December 2016 and for each patient, an electronic case report form (eCRF) was completed. Each participating country had each eCRF data-point benchmarked against the total cohort. In total, 79 patients were included from Latvia. The mean age of patients was 68.1, similar to the total cohort of other ESC member states, and 21.8% of patients were female. Latvian patients compared to other countries more often had permanent atrial fibrillation, NYHA class III and IV, ejection fraction 35 %. CRT-Ds and multipolar lead implantation rates were higher. Peri-procedural complication rates were similarly low in both groups. At discharge, prescribed medication rates were similar but more frequently MRAs, ivabradine and calcium channel blockers were prescribed and slightly less frequently ACE inhibitors/ARBs were prescribed. The CRT survey II is a valuable resource that describes ongoing practice of cardiac resynchronisation therapy around Europe and benchmarking against the total cohort is nationally significant for each participating country.

Research purpose.The purpose of this article is to investigate the most important risk factors in the assessment of the reliability and reputation of the Board Member for the implementation of responsible business activities in Latvia.

The mixed-ligand system consisting of tris(2-aminoethyl)amine (TREN) and tris(2-dimethylaminoethyl)amine (Me6-TREN) during the Cu(0) wire-catalyzed single electron transfer-living radical polymerization (SET-LRP) of methyl acrylate (MA) in “programmed” biphasic mixtures of the dipolar aprotic solvents NMP, DMF, and DMAc with H2O is reported. Kinetic and chain end analysis studies by NMR and MALDI-TOF before and after thio-bromo “click” reaction demonstrated that Me6-TREN complements and makes the less expensive TREN a very efficient ligand in the absence of externally added Cu(II)Br2. Statistical analysis of the kinetic data together with control experiments demonstrated that this mixed-ligand effect enhanced the apparent rate constant of propagation, monomer conversion, and molecular weight control. The most efficient effect was observed at a 1/1 molar ratio between these two ligands, suggesting that in addition to a fast exchange between the two ligands, a new single dynamic ligand generated by hydrogen bonding may be responsible for the mixed ligand observed.

Atrial fibrillation (AFib) is a disease that can influence the health related quality of life. Also oral anticoagulants can influence it both because of its therapeutic benefits or complications as well as how the anticoagulant usage influence the person's life style by regular laboratory test necessity or diet restrictions.

Electrical cardioversion is widely used to restore sinus rhythm in patients with atrial fibrillation. However, the long term clinical event and sinus rhythm maintenance rates following electrical cardioversion still remains unclear. This study evaluated one year incidence and risk factors for cardiovascular events and atrial fibrillation recurrence in a single center clinical practice.

This essay provides a brief overview of the history of architecture in Riga, Latvia. The 12th century saw German conquerors introduce stone buildings to replace the log fortresses of the tribes living in the area, which in turn was replaced in the 18th century during the rule of Russia. Buildings discussed include the 17th century St. Peter’s church in Riga designed by Rupert Bindenschu, the 18th century Rundale Palace designed by Bartolomeo Francesco Rastrelli, and the Latvian Red Cross building designed in the interwar period by Aleksandrs Klinklāvs.

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We evaluated a possible correlation between the clinical activities of rheumatoid arthritis (RA) and human parvovirus B19 (B19) infection using exploratory factor analysis (EFA).

BrushFire made the following promotion and hires in its public relations and media departments. Candice Georgi was promoted to an account supervisor; she will manage events and public relations related [...]

An accelerated modular synthesis of six libraries containing 29 amphiphilic Janus dendrimers, employed to discover and predict functions viaprimary structures, is reported. These dendrimers were constructed from a single hydrophobic and a single hydrophilic dendron, interconnected with l-Ala to form two constitutional isomeric libraries, with Gly to produce one library, and with l-propanediol ester to generate two additional constitutional isomeric libraries. They are denoted “single–single” amphiphilic Janus dendrimers. Assemblies obtained by injection of their ethanol solution into water were analyzed by dynamic light scattering and cryogenic transmission electron microscopy. A diversity of complex structures including soft and hard dendrimersomes, cubosomes, solid lamellae, and rod-like micelles were obtained in water. It was discovered that the “single–single” amphiphilic Janus dendrimers containing three triethylene glycol groups in the hydrophilic dendron favored the formation of dendrimersomes. Assemblies in bulk analyzed by differential scanning calorimetry and powder X-ray diffraction revealed that the amphiphilic Janus dendrimers with melting point or glass transition below room temperature self-assemble into soft dendrimersomes in water, while those with higher temperature transitions produce hard assemblies. In the range of concentrations where their size distribution is narrow, the diameter of the dendrimersomes is predictable by the d-spacing of their assemblies in bulk. These results suggested the synthesis of Library 6 containing two simpler constitutional isomeric benzyl ester based amphiphilic Janus dendrimers that self-assemble in water into soft dendrimersomes and multidendrimersome dendrimersomes with predictable dimensions.

Pepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pyloriinfection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pyloriantibodies in confirming successful eradication.

A nationwide survey of schoolchildren was conducted to detect regional differences in urinary iodine excretion in Latvia and to compare the results with data from the newborn thyroid-stimulating hormone (TSH) screening database as well with the results of a similar study performed in Latvia 10 years ago.

Renal anaemia: the role of haemoglobin control in patients with chronic kidney diseaseChronic kidney disease (CKD) is a significant and prevalent health problem in the world. Anaemia is one of the most common manifestations in patients with CKD. The correction of anaemia with erythropoietin normalises haemoglobin level and improves quality of life. Many aspects of the impact of anaemia treatment with erythropoiesis-stimulating agents on the progression of CKD remain unresolved and disputable. The present study is a retrospective chart review of 1654 outpatients with CKD. The data were collected from the Centre of Nephrology between 1 January 2002 and 31 December 2006. The aims of the study were to assess the causes of CKD; the prevalence of anaemia based on the current guidelines for anaemia management in CKD (Kidney Disease Dialysis Outcomes Quality Initiative; K/DOQI); to evaluate haemoglobin (Hb), systolic and diastolic blood pressure (SBP and DBP), glomerular filtration rate (GFR) at the first referral to a nephrologist and at the start of renal replacement therapy (RRT). The most common causes of CKD were arterial hypertension (17.2%), chronic glomerulonephritis (17.2%), chronic intersticial nephritis (13.3%), and diabetes (12.8%). Twenty-three percent of end-stage renal disease (ESRD) patients had diabetes mellitus. At the first visit in the renal department, 16% of the patients had an advanced degree of CKD (GFR <30 ml/min). The proportion of patients under an observation in the kidney centre for a period of six months and more was only 34% (554 of 1654). Hypertension was recorded in 72% of study subjects. The blood pressure (BP) values in patients at the first visit (n = 1633) vs. at the start of RRT (n = 154) were: mean SBP 147.4 ± 24.8 mm Hg vs. 152.2 ± 23.0 mm Hg (P < 0.05); mean DBP 88.8 ± 13.6 mm Hg vs. 88.4 ± 12.0 mm Hg (P 0.05). Anaemia was recorded in 41% of study subjects, estimated using K/DOQI recommendations. The prevalence of anaemia was increased from 30.2% to 44.8% of study patients with a rise of BP (from normal BP to hypertension; P < 0.05). The mean Hb level at the start of RRT was 9.8 ± 2.1 g/dl. Only 18% of patients with renal anaemia had used erythropoiesis-stimulating agents before RRT (28 of 155). Anaemia is the prevalent condition at moderate degrees of CKD. The severity of anaemia in the CKD population is determined by evidence of diabetes, cardiovascular disease, and renal function. Anaemia may often be unrecognised or untreated.

Association between Inflammatory Markers and Clinical and Metabolic Risk Factors for Cardiovascular DiseasesThe inflammatory reaction plays an important role in the development of atherosclerosis. The clinical significance of the main inflammatory markers — C-reactive protein (CRP), interleukin 6 (IL6), tumour necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1 (PAI1), etc. — has not been fully established. CRP, IL6, TNF-α, and PAI1 were assessed in 100 patients in terms of certain clinical indicators (sex, obesity indicators, blood pressure, and heart rate), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG), glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), adiponectin, and leptin levels. CRP and PAI1 levels were elevated in subjects with increased body mass index (BMI) and waist circumference. CRP correlated positively with indicators of carbohydrate metabolism and negatively with TC, HDL-C, and adiponectin. PAI1 correlated positively with insulin levels, HOMA-IR, leptin, and TG, but negatively with HDL-C. IL6 correlated negatively with TC, but TNF-α correlated negatively with HDL-C. Both IL6 and TNF-α correlated positively with leptin levels. TNF-α correlated with TG levels and the indicators of carbohydrate metabolism only in women. CRP and PAI1 are the most sensitive inflammatory markers; their levels were higher in adipose subjects.

Relation of Endothelial Dysfunction and Adipokines Levels to Insulin Resistance in Metabolic Syndrome PatientsObese metabolic syndrome (MS) patients were categorised into three groups: 44 with type 2 diabetes mellitus (T2DM)(D); 20 with T2DM and coronary artery disease (CAD) (DC), and 26 with MS alone (M). Eighteen healthy subjects were selected as controls (C). Insulin resistance (IR) was assessed by HOMA-IR. Adiponectin, tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and interleukin-8 (IL-8) concentrations were measured by xMAP technology. Endothelin-1 (ET-1) was determined by ELISA. We used laser Doppler imaging for evaluating cutaneous endothelium-dependent vasodilatation in the hand. D and DC groups had significantly elevated IR compared with M or C group (P < 0.01). TNF-α, IL-6, IL-8, MCP-1 and ET-1 levels in DC were significantly elevated compared with other groups (P < 0.001). IL-6, IL-8, MCP-1 and ET-1 in D group were higher than those in C group (P < 0.05). TNF-α, IL-6, IL-8, MCP-1 and ET-1 concentrations were correlated with HOMA-IR indexes and adiponectin levels. All patients had lower adiponectin concentrations than controls (P < 0.001), but there were no differences between the patient groups. Only D and DC groups demonstrated a significant and similar decrease in LDI-Ach marker compared to C group (P < 0.001). LDI-Ach values were significantly correlated with HOMA-IR indexes and adiponectin levels (P < 0.001). Our findings show that obese MS patients have significantly increased HOMA-IR, TNF-α, IL-6, MCP-1 and IL-8 levels, decreased adiponectin concentration, and endothelial dysfunction, but the presence of T2DM and CAD in these patients is associated with more pronounced endothelial dysfunction and increased production of inflammatory cytokines and chemokines.

Characteristics of Cardiovascular Risk Factors and Their Correlation with the Sex and Age of Patients in the Latvian PopulationVarious cardiovascular risk factors (RFs) were determined in 773 out-patients (mean age 55.8 ± 14.5 years). Male individuals had a larger waist circumference (WC) than did female patients (99.1 ± 13.6 cm vs 93.3 ± 15.2 cm), higher diastolic blood pressure (DBP) (83.6 ± 9.6 mmHg vs 81.8 ± 9.6 mmHg), and higher levels of blood glucose (5.73 ± 1.4 mmol/L vs 5.49 ± 1.3 mmol/L) and triglycerides (TG) (1.89 ± 1.3 mmol/L vs 1.60 ± 1.0 mmol/L), but lower levels of total cholesterol (TC) (5.54 ± 1.2 mmol/L vs 5.79 ± 1.2 mmol/L) and high-density lipoprotein cholesterol (HDL-C) (1.21 ± 0.4 mmol/L vs 1.44 ± 0.4 mmol/L). Compared with the younger age group (i.e., males, < 7 years; females, < 65 years), patients in the older age group had a larger WC (98.4 ± 14.2 cm vs 92.8 ± 15.1 cm), higher systolic blood pressure (SBP) (144.2 ± 19.2 mmHg vs 131.6 ± 18.5 mmHg), higher DBP (84.5 ± 8.8 mmHg vs 80.9 ± 9.8 mmHg), higher blood glucose level (5.74 ± 1.3 mmol/L vs 5.46 ± 1.3 mmol/L), and higher low-density lipoprotein cholesterol level (LDL-C) (3.68 ± 1.0 mmol/L vs 3.52 ± 1.0 mmol/L), but lower HDL-C level (1.3 ± 0.4 mmol/L vs 1.41 ± 0.4 mmol/L). Age was significantly correlated with all RFs, with the exception of the level of C-reactive protein. In conclusion, analysis of cardiovascular RFs in different age subgroups of both sexes clearly showed individual peculiarities of risk profile. This conclusion challenges the usual way of risk calculation using "universal" markers like adiposity or dyslipidemia in all population. The new approach requires individual attention depending on sex and age also in management of risk.

OBJECTIVE: To determine the prevalence and clinical significance of human parvovirus B19 (B19) infection in patients with rheumatoid arthritis (RA). METHODS: One hundred patients with RA and 94 apparently healthy blood donor controls were enrolled for study. Plasma samples of patients and controls were examined for the presence of anti-B19-specific antibodies by ELISA. B19 DNA was detected in plasma and peripheral blood leukocyte (PBL) samples of all patients and controls as well as in synovial fluid cells of 38 RA patients by nested polymerase chain reaction. Disease activity and clinical manifestations were determined in RA patients with and without markers of B19 infection. RESULTS: IgM anti-B19-specific antibodies were detected in 24.0% of RA patients; B19 DNA was found in plasma and/or PBL, synovial fluid cells in 34.0% (34 patients); in 14.0% of the cases (14 patients) both markers were found. In blood donor controls, anti-B19 IgM antibodies were observed in 16.0% (15 donors) and B19 DNA in 6.4% (6 donors); all donors with detectable B19 genomic DNA were IgM-positive. The disease activity in patients with and without B19 infection was similar, while the frequency of clinical complications was significantly higher in the patients with anti-B19 IgM antibodies. Moreover, liver failure and sicca syndrome were observed in the viremic patients only. CONCLUSION: Our study confirms observations regarding a high prevalence of B19 DNA in patients with RA, and a possible role of this viral infection in the pathogenesis of RA.

Regional Lung Blood Perfusion Measured With Laser Doppler Method During Body Position Change, Valsalva Manoeuvre and Cardiopulmonary BypassMethodological approaches to investigate local regulatory mechanisms of lung blood supply in humans are restricted. We tried a new approach using laser Doppler technique. During bronchoscopy, an angled laser Doppler flow probe was introduced through a biopsy channel and wedged into small bronchus. Laser light penetrated the wall of small bronchus and was reflected from blood cells running through neighbouring capillaries. Regional blood perfusion changes were recorded during body position change from vertical to supine and back to vertical, while performing Valsalva maneuver and during cardiac bypass surgery. Body position change and Valsalva maneuver markedly influenced the blood perfusion signal. During cardiac bypass when lungs were supplied with blood only through bronchial arteries regional blood perfusion dropped substantially on average from 93 ± 42 to 7.3 ± 4.3 perfusion units. We conclude that blood perfusion measured with this method reflect mainly the pulmonary vascular bed and may be used for investigation of its local regulatory mechanisms.

The unfolded protein response (UPR) is an intracellular signaling pathway that regulates the protein folding and processing capacity of the endoplasmic reticulum (ER). The UPR is induced by the pharmacological agents that perturb ER functions but is also activated upon excessive accumulation of the mutant secretory proteins that are unable to attain correct three-dimensional structure and are thus retained in the ER. Such defects in intracellular protein transport underlie the development of a number of phenotypically diverse inherited pathologies, termed endoplasmic reticulum storage diseases (ERSD). We have studied UPR development in two similar ERSDs, human congenital goiter caused by the C1264R and C1996S mutations in the thyroglobulin (Tg) gene and non-goitrous congenital hypothyroidism in rdw dwarf rats determined by the G2320R Tg mutation. In both cases, these mutations rendered Tg incapable of leaving the ER. A major ER chaperone immunoglobulin-binding protein (BiP), and a novel putative escort chaperone endoplasmic reticulum protein 29 KDa (ERp29) were found to be associated with Tg, which might be interpreted as the contribution of the quality control machinery to the previously shown retention of Tg in the ER. We have extended our earlier observations of ER chaperone induction with the identification of the additional ER (ERp29, ERp72, calreticulin, protein disulfide isomerase (PDI)), cytoplasmic (heat shock protein (HSP)70, HSP90) and mitochondrial (mtHSP70) upregulated chaperones and folding enzymes. Activation of the transcriptional arm of UPR, as judged by the appearance of the spliced (active) form of X-box binding protein (XBP1) and processed activating transcription factor 6 (ATF6) transcription factors was suggested to contribute to the overexpression of the ER chaperones. The processing of ATF6 was observed in both human and rat tissues with Tg mutations. Whereas, in human tissues, weak splicing of XBP1 mRNA was detected only in the C1264R mutant, all rat thyroids including wild-type contained significant amounts of the spliced form of XBP1 as opposed to human liver and rat brain tissues, implying the existence of a previously unknown tissue-specific regulation of XBP1 processing.

The effect of the amount of absorbed water on the physicomechanical indices (tensile modulus, tensile strength, and ultimate strain) of composites based on secondary polyethylene (SPE) of two trademarks and linen yarn production waste (LW), both with and without a coupling agent (diphenylmetane diisocyanate - DIC), is evaluated. It is shown that the strength properties considerably depend on the time of water sorption and on the blend composition. The tensile strength decreases with increased amount of absorbed water (with increased time of exposure to distilled water) and with increased content of LW in the composites. This can be explained by the plasticizing effect of water molecules, which is confirmed by the increase in the ultimate strain of specimens after their exposure to water. The slight increase in the strength observed for the systems modified with DIC is probably caused by cross-linking of the free diisocyanate in the system under the action of moisture. The diisocyanate intensifies the interfacial interaction and retards the water-sorption process. Therefore, the resulting strength indices of these systems are higher than those of the unmodified compositions.

The effect of the amount of absorbed water on the physicomechanical indices (tensile modulus and tensile strength) of composites based on low-density polyethylene (LDPE) and linen yarn production waste (LW), both with and without coupling agents (stearic acid - SA and diphenylmetane diisocyanate - DIC), is studied. It is shown that the strength properties depend considerably on the time of water sorption and on the blend composition. The tensile strength decreases with increased amount of absorbed water (with increased time of exposure to distilled water) and with increased content of LW in the composite. Somewhat different results are obtained for systems containing SA and DIC modifiers. The modifiers, intensifying the interfacial interaction, retard the process of water sorption, therefore the drop in the strength indices is not so significant. Of special interest is the behavior of systems with DIC. In some cases, a slight increase in strength (after a two to five day exposure to water) is observed, which is probably caused by cross-linking of the free diisocyanate in the system under the action of moisture.

Retroviral vectors encoding glucose-responsive promoters driving furin expression may provide an amplified, glucose-regulated secretion of insulin. We constructed LhI*TFSN virus to encode a glucose-regulatable transforming growth factor α promoter controlling furin expression with a viral LTR promoter driving constitutive expression of furin-cleavable human proinsulin. Autologous BB rat vascular smooth muscle cells transduced with LhI*TFSN virus and cultured in 1.7 and 16.7 mM glucose secreted 50.7 ± 3.2 and 136.0 ± 11.0 μU (mean ± SD) of insulin per 106 cells per day, respectively. After the onset of diabetes spontaneously diabetic congenic DR lyp/lyp BB rats received stomach implants containing 2 × 106 LhI*TFSN-transduced primary rat vascular smooth muscle cells. In eight treated rats there was a major reduction in insulin requirement to as low as 25% of pretreatment level for up to 3 months and one rat became insulin free without hypoglycemia. Intraperitoneal glucose tolerance tests (IPGTTs) in diabetic rats receiving control implants did not show the characteristic decline in blood glucose of normal rats after glucose administration. In contrast, diabetic rats receiving LhI*TFSN-transduced cells showed significant clearances of blood glucose. These data suggest clinically significant levels of glucose-regulated insulin delivery from implanted vascular smooth muscle cells transduced with LhI*TFSN vector.

To approach the goal of consistent long-term erythropoietin (Epo) expression in vivo, we developed an implantation procedure in which transduced autologous vascular smooth muscle was introduced into rats in a chamber created from a polytetrafluoroethylene (PTFE) ring placed under the serosa of the stomach. The implant became vascularized and permitted the long-term survival of smooth muscle cells expressing Epo. Hematocrits of treated animals increased rapidly and monitored over 12 months gave a mean value of 56.0 ± 4.0% (P < .001; n = 9), increased from a presurgery mean of 42.3 ± 1.6%. Hemoglobin levels rose from a presurgery mean of 15.2 ± 0.4 g/dL and for 12 months were significantly elevated with a mean value of 19.5 ± 1.3 g/dL (P < .001; n = 9). The hematocrit and hemoglobin levels of control animals receiving human adenosine deaminase (ADA)–expressing cells were not significantly different from baseline (P > .05; n = 5). In response to tissue oxygenation, kidney, and (to a lesser extent) liver are specific organs that synthesize Epo. Treated animals showed downregulation of endogenous Epo mRNA in kidney over a 12-month period. The PTFE implant provides sustained gene delivery, is safe, and is minimally invasive. It allows easy engraftment of transduced cells and may be applied generally to the systemic delivery of therapeutic proteins such as hormones and clotting factors. © 1998 by The American Society of Hematology.

ABSTRACTGranulocyte colony-stimulating factor (G-CSF) regulates granulocyte precursor cell proliferation, neutrophil survival, and activation. Cyclic hematopoiesis, a disease that occurs both in humans and grey collie dogs is characterized by cyclical variations in blood neutrophils. Although the underlying molecular defect is not known, long-term daily administration of recombinant G-CSF eliminates the severe recurrent neutropenia, indicating that expression of G-CSF by gene therapy would be beneficial. As a prelude to preclinical studies in affected collie dogs, we monitored hematopoiesis in rats receiving vascular smooth muscle cells transduced to express G-CSF. Cells transduced with LrGSN, a retrovirus expressing rat G-CSF, were implanted in the carotid artery and control animals received cells transduced with LASN, a retrovirus expressing human adenosine deaminase (ADA). Test animals showed significant increases in neutrophil counts for at least 7 weeks, with mean values of 3,670 740 cells/l in comparison to 1,870 460 cells/l in controls (p< 0.001). Thus, in rats G-CSF gene transfer targeted at vascular smooth muscle cells initiated sustained production of 1,800 neutrophils/l, a cell number that would provide clinical benefit to patients. Lymphocytes, red cells and platelets were not different between control and test animals (p> 0.05). These studies indicate that retrovirally transduced vascular smooth muscle cells can provide sustained clinically useful levels of neutrophils in vivo.

A technique is described which measures the adhesion of platelets to connective tissue fragments in platelet-rich plasma (PRP). The principle of the method is measurement of OD in EDTA–PRP to which connective tissue fragments have been added. A fall in OD occurs as the platelets line up on connective tissue fibers. Aspirintreated platelets adhere normally, although they show reduced aggregation with collagen in citrated PRP. An additional observation is that in the presence of sufficient connective tissue, all platelets participate in the adhesion reaction.

Rabbit blood vessel cells were labeled with tritiated thymidine. Labeled cells were seen in all layers of all vessels of normal, adult animals, although the incidence was low. Following chemical or physical injury, increased mitotic activity developed after a latent period of 2 days. Injection of isotope prior to vascular injury was unaccompanied by the appearance of labeled cells in the vessel wall.

Platelets from three consecutive patients with essential thrombocythemia were studied. In each case there were characteristic abnormalities. These included absent aggregation in response to epinephrine and reduced aggregation by adenosine diphosphate. The platelets were aggregated normally by collagen. Uptake by platelets of serotonin labeled with radioactive carbon 14C was reduced, and there was possibly reduced platelet adenosine diphosphatase activity. The platelets supported normal clot retraction, and gave normal platelet factor 3 availability. The abnormality appears to be specific for the disease rather than a nonspecific reflection of thrombocythemia.

Nonprofits should prioritize donor acknowledgment programs, according to Jen Shang, co-founder of the Institute for Sustainable Philanthropy. Shang's research shows that thanking donors not only keeps them engaged but also motivates greater giving. To improve donor thank-yous, nonprofits should provide excellent customer service, go beyond standard practices, and think about how they want donors to feel. Other tips include leading with stories, knowing donors' motivations, being specific about the impact, sending unexpected thank-yous, respecting communication preferences, building a culture of gratitude, sending handwritten notes, timing thank-yous well, and thanking donors for simply visiting the donation page. [Extracted from the article]

A study conducted at Pauls Stradins Clinical University Hospital in Riga, Latvia, explored the use of balloon pulmonary angioplasty (BPA) as a treatment for chronic thromboembolic pulmonary hypertension (CTEPH). The researchers analyzed the outcomes of nine CTEPH patients who underwent BPA sessions and found that BPA resulted in improvements in functional capacity, pulmonary hemodynamics, and right ventricular function. The study concluded that BPA is an effective and safe interventional treatment for CTEPH, improving both pulmonary hemodynamics and functional status. Further research is needed to validate these findings. [Extracted from the article]

Patient registries are a valuable tool in the research of rare conditions such as pulmonary hypertension (PH). We report comprehensive hemodynamic and survival data of 174 patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), included in the prospective Latvian PH registry over a period of > 9 years. In total, 130 adult PAH patients (75%) and 44 adult CTEPH patients (25%) were enrolled. The median follow-up period was 33 months for PAH and 18 months for CTEPH, P= 0.001. Latvian CTEPH patients had significantly higher plasma levels of B-type natriuretic peptide, higher pulmonary vascular resistance, and lower cardiac index than Latvian PAH patients. Calculated incidence of PAH and CTEPH in Latvia in 2016 was 13.7 and 5.1 cases per million inhabitants, calculated prevalence was 45.7 and 15.7 cases per million inhabitants, respectively. Survival rates at one, three, and five years for PAH patients was 88.0%, 73.3%, and 58.1%, and 83.8%, 59.0%, and 44.2% for CTEPH patients, respectively. We compared our study results with data from European adult PH registries. Latvian PAH patients had the fourth lowest and CTEPH patients the lowest one-year survival rate among European adult PH registries. As most PH registries in Europe are small, yet with equivalent patient inclusion criteria, it would be desirable to combine these registries to produce more reliable and high-quality study results.

A recent study conducted by researchers at the University of Latvia examined the differences in tumorigenic pathology and manifestations of colon cancer between early-onset colorectal cancer (EOCRC) and late-onset colorectal cancer (LOCRC). The study analyzed colonoscopy-based screening data from 1653 patients, dividing them into two groups based on age. The findings revealed that the <50-year age group had a lower polyp detection rate compared to the 50-year age group, with a higher prevalence of hyperplastic polyps in the rectum and sigmoid colon. The study emphasizes the importance of age stratification in colonoscopy-based screening for effective evaluation of colorectal cancer. [Extracted from the article]

Biomedicine, Cardiology, Cardiovascular, Cardiovascular Research, Health and Medicine, Kidney, Nephrology Keywords: Biomedicine; Cardiology; Cardiovascular; Cardiovascular Research; Health and Medicine; Kidney; Nephrology EN Biomedicine Cardiology Cardiovascular Cardiovascular Research Health and Medicine Kidney Nephrology 963 963 1 09/11/23 20230911 NES 230911 2023 SEP 11 (NewsRx) -- By a News Reporter-Staff News Editor at Cardiovascular Week -- Investigators publish new report on biomedicine. [Extracted from the article]