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Objective/Background To investigate the prevalence of bovine arch (BA) among patients with type A and B aortic dissection, and to provide insight into the implication of this variation on the outcome of patients with acute or subacute type B aortic dissection (a/sTBAD). Methods This retrospective cohort analysis includes patients with a/sTBAD admitted between January 2006 and December 2016. Computed tomographic angiograms (CTAs) of patients referred because of type A aortic dissection were also re-evaluated with regard to the presence of BA. As a control group, 110 oncological patients who had undergone a chest CTA for disease staging during the study period were enrolled. A total of 154 patients with a/sTBAD and 168 with type A aortic dissection were identified during the study period. Results An overall prevalence of 17.6% for BA variants was revealed. The comparison between patients with aortic dissection and the control group showed no statistically significant difference in BA prevalence (17.7% vs. 17.3%; p = 1.0). No statistically significant difference in BA prevalence was observed when comparing patients with type A aortic dissection with those with type B aortic dissection (16.6% vs. 18.8%; p = .66). During a median follow-up period of 27.8 months, 30 patients died. The mortality rate among patients presenting a BA variant was 34.5%, whereas among patients without, it was 16.0% (p = .04). Multivariate analysis revealed the presence of a BA as an independent predictor of mortality (adjusted odds ratio 3.4, 95% confidence interval 1.2–9.8). Conclusion The BA should be considered as a predictor of the outcome for patients with type B aortic dissection.

Summary: Background: The aim of this study is to evaluate perioperative as well as long-term outcomes in patients operated with carotid endarterectomy (CEA) or stenting (CAS) due to symptomatic or asymptomatic high-grade restenosis of the internal carotid artery (ICA). Patients and methods: In a retrospective analysis of our electronic database including 2980 patients who underwent carotid endarterectomy or stenting due to a symptomatic or asymptomatic high-grade stenosis of the ICA, between 2000 and 2016, we enrolled 111 patients with recurrent ICA stenosis. Results: An ipsilateral 2nd time restenosis (> 80 % in the asymptomatic and > 50 % in the symptomatic patients according to NASCET criteria) of ICA was detected in 13 patients (12 %); 3 of them were symptomatic. These patients were managed with either CEA (n = 5/38 %) or CAS (n = 8/62 %) with no perioperative stroke or death. The stroke-free survival rates at 2 and 8 years for CEA were 98 % and 98 % versus 100 % and 100 % for CAS respectively (P = .271). The type of the initial procedure (patch, CAS or interposition) did not play any significant role for the development of a 2nd time restenosis (P = .841). Conclusions: Redo-CEA/CAS seem to have similar results as primary procedures (as reported in the literature) with favorable periprocedural and long-term outcomes.

Greek Orthodox fasting (OF), which involves 180-200 days of fasting per year, is dictated by the Christian Orthodox religion. For the first time, this cross-sectional study examines the characteristics and the effects of OF on anthropometry, cardiometabolic markers and calcium homeostasis in Athonian monks (AMs).Daily intakes of energy, macro- and micronutrients of a day during a weekend of Nativity Fast, defined as non-restrictive day (NRD), and a weekday during Great Lent, labeled as restrictive day (RD) were recorded.The daily energy intake of 70 AM (age=38.8±9.7 years) was low during both RD and NRD (1265.9±84.5 vs 1660±81 kcal, respectively, P0.001). Paired samples t-test showed statistically significant difference between daily intakes in RD and NRD: carbohydrates (159.6±21.8 vs 294.3±23.4 g, P0.0001) and saturated fat (12.7±0.0 vs 16.4±0.0 g, P0.0001) were lower, whereas protein (89.2±1.3 vs 72.35±1.3 g, P0.001) was higher during RD. A subsample of 50 monks (age=38.7±10.6 years) formed a study cohort for cardiometabolic and calcium homeostasis assessment. Body weight (74.3±12.9 kg) and body mass index (BMI; 23.8±4.1 kg/mUnaffected by variation in lifestyle factors, the results of this unique study offers clear evidence for the health benefits of the strict Athonian OF through optimal lipid and glucose homeostasis.

In the work, the temperature field model is developed for the absorber of a round-pipe collector. As distinguished from previous models when the temperature of liquid was assumed to be constant over the entire pipe crosssection, the results obtained clearly show the temperature variations in the absorber’s cross-section. In the work, optimal values are found in the work for geometrical parameters of the collector (i.e. the plate thickness and the pipe diameter) that allow the highest possible temperature of liquid to be achieved.

Sub-optimal diets are widely known to be associated with disease. This study investigated two questions: first, whether a Western affluent diet affects long-term health in the rat, and second, whether, and to what extent, early changes in blood biomarkers can predict specific pathologies. A rat model was used in which animals were fed from weaning either a control diet or a high fat, low protein, energy dense Western affluent diet. Rats were harvested at either 12 or 18 months, and at these time points blood samples were taken and various clinical biomarkers measured using a hospital analyser or by ELISA. Predictive biomarkers should show small changes at early time points and larger changes at later time-points, and be associated with disease(s). Tissues were examined for overt pathology, and data were mined to establish links between pathologies and specific blood markers that might be used predictively. Results showed that the Western affluent diet is associated with ill-health, with a relative risk of developing disease 4.5 times higher than for the control diet. Furthermore we conclude that triacylglycerol, HDL cholesterol, the ratio of total cholesterol to HDL cholesterol, creatinine and alanine aminotransferase were good predictors of disease as across the cohorts they showed altered levels before the clinical development of pathologies, in agreement with our hypothesis.

Background Both transforming growth factor (TGF)-β 1 and activin-A have been implicated in airway remodeling in asthma, but the modulation of their specific signaling pathways after disease activation remains undefined. Objective To define the expression kinetics of TGF-β 1 , activin-A ligands, and follistatin (a natural activin inhibitor), their type I and type II receptors (activin-like kinase[ALK]–1, ALK-5, ALK-4, TβRII, and ActRIIA/RIIB) and activation of signaling (via phosphorylated (p) Smad2), in the asthmatic airway after allergen challenge. Methods Immunohistochemistry was performed on bronchial biopsies from 15 mild atopic patients with asthma (median age, 25 years; median FEV 1 % predicted, 97%) at baseline and 24 hours after allergen inhalation. Functional effects of activin-A were evaluated by using cultured normal human bronchial epithelial (NHBE) cells. Results pSmad2 + epithelial cells increased at 24 hours ( P = .03), and pSmad2 was detected in submucosal cells. No modulation of activin-A, follistatin, or TGF-β 1 expression was demonstrated. Activin receptor + cells increased after allergen challenge: ALK-4 in epithelium ( P = .04) and submucosa ( P = .04), and ActRIIA in epithelium ( P = .01). The TGF-β receptor ALK-5 expression was minimal in the submucosa at baseline and after challenge and was downregulated in the epithelium after challenge ( P = .02), whereas ALK-1 and TβRII expression in the submucosa increased after allergen challenge ( P = .03 and P = .004, respectively). ALK-1 and ALK-4 expression by T cells was increased after allergen challenge. Activin-A induced NHBE cell proliferation, was produced by NHBE cells in response to TNF-α, and downregulated TNF-α and IL-13–induced chemokine production by NHBE cells. Conclusion Both TGF-β and activin signaling pathways are activated on allergen provocation in asthma. Activin-A may contribute to resolution of inflammation.

Background Anti-IgE (omalizumab) inhibited early and late asthmatic reactions and infiltration of inflammatory cells in asthmatic bronchial biopsies at baseline. The effect of chronic allergen exposure on these outcomes is unknown. Repeat allergen challenge in human skin represents a suitable model to address this question. Objective To study the effect of anti-IgE (omalizumab) on early-phase (EPR) and late-phase (LPR) skin reactions and cellular infiltration by using a repeat skin allergen challenge designed to imitate chronic allergen exposure. Methods Twenty-four atopic allergic volunteers received omalizumab or placebo for 12 weeks. Paired intradermal challenges of allergen (30 biological units) and diluent control were administered on 9 occasions at 2-week intervals. Early-phase and late-phase skin reactions and cellular infiltration in skin biopsies (using immunohistochemistry and in situ hybridization) were measured at intervals. Results Compared with placebo, omalizumab-treated patients had a progressive reduction in the LPR that was significantly greater than its effect on the EPR (median, −63% vs −24% respectively; P =.009). In addition, significant reduction of the LPR was reached within 2 weeks of commencing treatment, compared with 8 weeks for the EPR. There was a priming effect of repeated allergen challenge on infiltration of eosinophil, neutrophil, T H 2 (CD3 + /IL-4 + ), and total FcɛRI + cells in patients on placebo that was abrogated in those receiving omalizumab. Conclusion The more marked effect of omalizumab on the LPR and prevention of the repeat-dose priming effect on several inflammatory cell types support a role for anti-IgE treatment in conditions associated with chronic allergic inflammation.