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Csaba Melczer, László Melczer, András Oláh, Mónika Sélleyné-Gyúró, Zsanett Welker and Pongrác Ács

Abstract

Measurement of physical activity among patients with heart failure typically requires a special approach due to the patients’ physical status. Nowadays, a technology is already available that can measure the kinematic movements in 3-D by a pacemaker and implantable defibrillator giving an assessment on software. The telemetry data can be transmitted to a central system. The research aims to elaborate the methods that help to compare of the data concerning physical activity both built-in an accelerometer in Cardiac Resychrinisation Therapy (CRT) devices and data obtained from an external Actigraph GT3XE-Plus Triaxial Activity Monitor. 5 persons participated in the pilot study (n=5); mean age: 57+- 13.37; BMI: 90.6+- 7.63. The Actigraph data from CRT device were examined in a 6-day-interval, between February 28 and March 5, 2014. The investigation started conducting a 6-minute walking test and continued with the measurement of daily physical activity. For data analysis descriptive statistics and linear regression analysis were used. It is clear from the data obtained from Actigraph that the MET values (mean: 1.17 ± 0.096) of the patients in the sample were extremely low due to their disease. However, some patients with higher physical activity than average (1.26; 1.28) seemed to be noteworthy, but they showed lower performance than healthy people. The physical activity of the patients during the 6-minute walking test corresponded to 1.9-2.48 MET. The physical activity of patients was found typically in the “light or moderate range” classifying the physical activity by Actigraph. Data from Actigraph are accurate and detailed making the physical activity of the patients measurable and appreciable. The results of the 6-minute walking test were in the category from moderate to very vigorous for individualized moderate physical performance based on Actigraph. It indicates the individual performance differences among patients. However, the daily physical performance is even lower than that of the 6- minute walking. We can conclude from the data related to the percentage of the average activity in CRT system to the average energy consumption and the improvement in the patients’ physical condition. Due to the limitations of the sampling frequency the different time intervals cannot be isolated in the different intensity ranges. Therefore, the percentage of the data of physical activity provided by the device may have a limited use.

Open access

Joanne Pascale, Angela Fertig and Kathleen Call

Survey. Available at: https://www.researchgate.net/publication/267196753_Estimates_of_Health_Insurance_Coverage_in_the_Community_Tracking_Study_and_the_Current_Population_Survey (accessed March 2019). Swartz, K. 1986. “Interpreting the Estimates from Four National Surveys of the Number of People Without Health Insurance.” Journal of Economic and Social Measurement 14(3): 233–242. Doi: https://doi.org/10.3233/JEM-1986-14306 . U.S. Census Bureau. 2016a. Table DP05 ACS Demographic and Housing Estimates. Available at: http

Open access

Anca Bălănescu, Paul Bălănescu, Valentina Comănici, Iustina Stan, Beata Acs, Laura Prisăcariu, Florin Brezan, Tatiana Ciomârtan and Ioan Gherghina

Abstract

Background and aims. The aim of this study is to assess the lipid profile pattern of pediatric overweight and/or obese patients with Non-Alcoholic Fatty Liver Disease (NAFLD) in relation to IDF Consensus Criteria for Metabolic Syndrome (MetS).

Material and Methods. We conducted a cross-sectional preliminary study on 45 consecutive pediatric patients. Overweight or obese children aged from 3 to 18 years were included. Standardized measurement of blood pressure and anthropometric parameters were performed. Biological evaluation included inflammatory status, lipid profile, glycemic profile, full blood count and liver function tests. Abdominal ultrasound was performed in all patients.

Results. Prevalence of MetS was 44.4%. A number of 21 patients (46.7%) had NAFLD. MetS patients had higher risk for NAFLD (OR = 9.5, 95% CI = 2.42-37.24). Also patients with positive familial history of type 2 diabetes had a 6.61 fold higher risk for NAFLD (OR = 6.61, 95% CI = 1.74-25.1). We performed a subgroup analysis in patients under ten years old. Patients under the age of ten which had both NAFLD and MetS met more frequently the hypertriglyceride criterion. After adjusting for age and MetS presence, triglyceride levels independently associated with NAFLD (adjusted R square = 0.46, unstandardized B coefficient = 34.51, 95% CI = 4.01-65.02, p = 0.02).

Conclusion. NAFLD obese patients had higher prevalence of MetS, higher BMI and particular lipid profile pattern. Triglyceride levels independently associated with NAFLD after adjusting for age and MetS presence. According to our findings we suggest early triglyceride testing (even below the age of ten) in selected patients.

Open access

Erzsébet Lázár, Marius Găzdac, Szende Jakab, István Benedek, Judit-Beáta Köpeczi, Annamária Pakucs, János Ács and István Benedek

Abstract

Multiple myeloma represents a challenge for hematologists because it has become more frequent at a young age in recent years. This is why autologous stem cell transplantation is included in the standard treatment of myeloma patients. We present the case of a 39-year-old patient who was diagnosed with non-secretory myeloma with double autologous transplantation and underwent neurosurgery for spinal cord compression caused by a plasmocytoma at D5 level. We present the evolution and complexity of this very difficult case.

Open access

Joanna Marchewka, Ina Beltrán de Heredia, Xavier Averós, Roberto Ruiz, Adroaldo J. Zanella, Julia Adriana Calderón Díaz and Inma Estevez

be reported in a separate manuscript. Behavioural changes observed in the current study were very frequent and had short durations; therefore, we considered them as events. The behavioural sequences were also video-recorded (Panasonic HDC-HS80, Osaka, Japan) as a precaution in case behavioural changes would occur too fast to be accurately recorded. Due to unexpected behaviours occurring during tests (i.e. exploratory climbs [ECs] and abrupt climbs (ACs) on the walls, defined as a climb on the pen walls requiring at least both front legs to be off the ground), and

Open access

Grazyna Sypniewska, Katarzyna Bergmann, Magdalena Krintus, Marek Kozinski and Jacek Kubica

References Ogolnopolski Rejestr Ostrych Zespolow Wiencowych PL-ACS http://www.rejestrozw.pl Torres M, Moayedi S. Evaluation of the acutely dyspneic elderly patient. Clin Geriatr Med 2007; 23: 307-25. Davidson MH. Apolipoprotein measurements: is more widespread use clinically indicated? Clin Cardiol 2009; 32: 9: 482-6. Barter PJ, Ballantyne CM, Carmena R, et al. Apo B versus cholesterol in estimating cardiovascular risk and in guiding therapy: report of the

Open access

Pascal Meier, Alexandra J. Lansky and Andreas Baumbach

Summary

Unstable coronary artery plaque is the most common underlying cause of acute coronary syndromes (ACS) and can manifest as unstable angina, non-ST segment elevation infarction (NSTE-ACS), and ST elevation myocardial infarction (STEMI), but can also manifest as sudden cardiac arrest due to ischaemia induced tachyarrhythmias. ACS mortality has decreased significantly over the last few years, especially from the more extreme manifestations of ACS, STEMI, and cardiac arrest. This trend is likely to continue based on recent therapeutic progress which includes novel antiplatelet agents such as prasugrel, ticagrelor and cangrelor.

Open access

Kanok Preativatanyou and Sittisak Honsawek

Abstract

Background: Recombinant human bone morphogenetic proteins (rhBMPs) have been characterized especially chondrogenic and osteogenic activity both in vitro and in vivo studies. However, delivery of more than one growth factor by sustained release carrier to orthopedic site has yet been questionable in terms of efficacy and synergism.

Objective: Evaluate osteoinductivity and synergistic effect of rhBMP-2 and -7 using absorbable collagen sponge (ACS) carrier system in vivo.

Methods: cDNA of BMP-2 and -7 active domains were cloned and expressed in Escherichia coli BL21 StarTM (DE3) using pRSETc expression system. Then, the purified rhBMPs were loaded onto ACS and evaluated by in vivo rat subcutaneous bioassay. Two and eight weeks postoperatively, all treated groups were histologically verified for evidence of new bone formation and neovascularization by hematoxylin-eosin staining and light microscopy.

Results: The Wistar rat treated with rhBMP-2 or -7/ACS exhibited new bone formation, compared to ACS control. The group treated with ACS supplemented with both rhBMP-2 and -7 significantly showed the osteoid matrix very well-organized into trabeculae-like structure with significant blood vessel invasion.

Conclusion: The osteogenic induction of rhBMPs was combined with ACS carrier in the in vivo bioassay. In addition, the combination of both two potent recombinant osteoinductive cytokines, rhBMP-2 and -7, with ACS carrier demonstrated synergistic effect and might be a more promising and effective choice for therapeutic applications.

Open access

Jorgo Kostov, Jelka Davceva-Pavlovska and Sasko Kedev

-2165. 14. Fox KA, Eagle KA, Gore JM, et al. The Global Registry of Acute Coronary Events, 1999 to 2009 - GRACE. Heart. 2010; 96: 1095-1101. 15. Savonitto S, Ardissino D, Granger CB, et al. Prognostic value of the admission electrocardiogram in acute coronary syndromes. JAMA. 1999; 281: 707-713. 16. Mandelzweig L, Battler A, Boyko V, et al. The second Euro Heart Survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004. Eur Heart J. 2006; 27: 2285

Open access

Andrey V. Grek, Lyudmyla N. Prystupa and Tatiana V. Sytnik

Summary

Cardiovascular diseases (CVD) of atherosclerotic origin and accompanying complications are a major cause of mortality in the world and Ukraine, in particular. Endothelial dysfunction is the key cause of atherosclerosis and atherothrombosis. One of the causes of endothelial dysfunction is hyperhomocysteinemia that may occur on the background of MTHFR (methylenetetrahydrofolate reductase) mutation.

Thus, the goal of the study was to investigate the interrelation between homocysteine (Hc) level and MTHFR polymorphism in patients with acute coronary syndrome (ACS).

161 patients with ischemic heart disease and ACS have been examined. The control group comprised 87 healthy individuals. Homocysteine level was the highest in the patients having ACS with ST-segment elevation and complicated course, and was 1.8 times higher than Hc level in the control group. The patients with the most severe ACS course comprised 27 % of homozygotes for the major allele C and 41 % of homozygotes for the minor allele T. Comparing the distribution of MTHFR gene C677T polymorphism in patients with ACS that were stratified by plasma Hc level, we observed a statistically significant association, P < 0.030 by chi-square test. We confirmed that these patients had a high T/T genotype frequency of MTHFR C677T polymorphism. The obtained data proved the association of T/T genotype of MTHFR C677T polymorphism with increased Hc level as well as ACS severity.