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  • Author: Irina Todor x
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Luminița Vida-Simiti, Irina Todor, Mirela Stoia, Claudia Gherman and Cerasela Goidescu

Abstract

Background: A number of cytokines and adipokines secreted by adipose tissue may influence vessel wall directly. Adiponectin exhibits anti-inflammatory and atheroprotective actions. Resistin is expressed at higher levels in inflammatory cells. Resistin directly activates the endothelium through upreglation of adhesion molecules, induces production of TNF-α by macrophages, effects that are antagonized by adiponectin. Leptin has multiple effects on cells of artery walls, many similar to those of resistin. The prognostic role of adipokines in atherosclerosis is not well established. Methods: We compared the baseline plasma levels of adiponectin, resistin, leptin and TNF-α (ELISA assays) in 59 patients with coronary artery disease (CAD) and 32 patients with peripheral artery disease (PAD). Also, we investigated the impact of baseline plasma levels of adiponectin, resistin, leptin and TNF-α on the incidence of the new ischemic cardiovascular events. Results: In patients with CAD, as compared with PAD, baseline plasma levels of leptin were significantly increased (2882.02 ± 368.57pg/ml vs 1025.56 ± 232.28 pg/ml; p<0.001), plasma levels of resistin were significantly decreased (13.15 ± 0.83ng/ml vs 17.76 ± 2.13 ng/ml; p = 0.02) and no differences in plasma levels of adiponectin and TNF-α were found. A significant correlation between BMI and plasma levels was found only for leptin, irrespective of group. 45 patients (49.5%) were re-hospitalized in a 2 years period of follow-up. In a backward stepwise multivariable Cox regression analysis only resistin ≥ 15 ng/ ml, HR =1.8829, 95% CI 1.0490- 3.3797, p = 0.034 and diastolic blood pressure ≥ 85 mmHg, HR =2.0927, 95%CI 1.0782- 4.0616, p=0.0299 were associated with new cardiovascular events. Conclussion: In patients with clinical atherosclerosis plasma levels of resistin predict new ischemc events.

Open access

Atanaska P. Petrova, Irina D. Stanimirova, Ivan N. Ivanov, Michael M. Petrov, Tsonka M. Miteva-Katrandzhieva, Vasil I. Grivnev, Velichka S. Kardjeva, Todor V. Kantardzhiev and Mariana A. Murdjeva

Abstract

Background: Production of Bla OXA-23, OXA-24, OXA-58 and hyperexpression of OXA-51 due to ISAba1 insertion sequence are the leading causes of carbapenem resistance in Acinetobacter baumannii. The loss of OprD transmembrane protein and the overexpression of some effl ux pumps are considered to be the main factors for carbapenem resistance in Pseudomonas aeruginosa whereas metallo-enzymes’ production has a secondary role. Aim: Тo examine the carbapenem resistance due to carbapenemase production among clinically signifi cant Gram-negative non-fermenters from St George University hospital, Plovdiv: A. baumannii and P. aeruginosa. Materials and methods: Forty three A. baumannii and 43 P. aeruginosa isolates, resistant or with intermediate resistance to imipenem and/or meropenem were included in the study. They were collected from patients admitted in 14 various hospital wards between 2010 and 2014. Both phenotypic and genetic methods were used for identifi cation and antimicrobial susceptibility testing. Results: All A. baumannii demonstrated carbapenemase production determined by a modifi ed Hodge test whereas P. aeruginosa isolates did not show this phenomenon. OXA-23 genes were determined in 97.7% (42 out of 43) of A. baumannii isolates indistinguishable from the sequence of the classical ARI-1 gene. OXA-24, OXA-58 and overexpression of OXA-51 were not registered in any of the isolates. All P. aeruginosa were negative for blaVIM and blaIMP genes. Conclusion: The leading cause of carbapenem resistance in A. baumannii isolates from our hospital is the carbapenemase production due to the expression of OXA- 23 gene, whereas in P. aeruginosa - the loss of transmembrane OprD protein and the effl ux pumps’ hyperexpression are suspected to be the main mechanisms.