Rotational atherectomy (RA) is an advanced coronary debulking technique, often used in cases, where traditional percutaneous coronary intervention (PCI) methods (e.g. balloon predilatation, use of cutting balloons, direct stenting etc.) are inadequate. We report a case of a male patient, who previously underwent PCI of the right coronary artery (RCA) and was free of chest pain for several weeks, but his clinical symptoms have developed again. Angiography showed a “de novo”, highly calcified left anterior descending (LAD) lesion that, after high-pressure balloon inflation, failed to dilate, thus the intervention was suspended. RA was scheduled for the patient within one month. As a complication of the previous LAD dilatation attempt, a chronic dissection of the target lesion occurred. Problems arose during the direct wiring attempt of the main vessel and the true lumen was only found via plaque modification, after accessing a small septal branch. Accessing the true lumen was only possible by using a conventional cross-wire. This was exchanged to a RA wire, with the help of an over-the-wire (OTW) balloon catheter. RA and debulking of the target lesion was performed. An everolimus-eluting stent (BioMatrix, Biosensors Europe, Morges, Switzerland) was implanted, with excellent results. The patient is free of clinical symptoms since the intervention, which took place 14 months ago.
The glomerular filtration barrier is a highly specialized tri-layer structure with unique functional properties. Podocyte dysfunction and cytoskeletal disorganization leads to disruption of the slit diaphragma, and proteinuria. Inflammatory diseases involving the kidney as well as inherited podocytopathies or diabetic nephropathy cause injury of the podocyte network. Focal segmental glomerulosclerosis (FSGS) is a pathologic entity that is a common cause of nephrotic syndrome with severe proteinuria in both adults and children. Several causative genes have been identified in the pathogenesis of FSGS. Mutations of the transient receptor potential canonical-6 (TRPC6), a non-selective cation channel that is directly activated by diacylglycerol (DAG), cause a particularly aggressive form of FSGS. Angiotensin II, acting through its AT1 receptor, plays a critical role in generation of proteinuria and progression of kidney injury in a number of kidney diseases, including FSGS. Mounting evidence suggest the central role of TRPC6 and perhaps other TRPC channels in the pathogenesis of FSGS as well as of acquired forms of proteinuria such as diabetic nephropathy or hypertension. Identification of signaling pathways downstream of TRPC6 may provide novel targets for the treatment of proteinuria and prevent progression of podocyte injury.
Blood serum clinical biochemical parameters of fasted BUT Big 8 male turkeys were determined at the ages of 3 days, 4, 8, 12, 16 and 20 weeks, for a follow-up of the developmental changes of some serum metabolites, enzymes and ions. The serum protein content (total protein, albumin, globulin) increased with age, indicating also the moulting-associated metabolic changes in the age interval from the 8th to the 12th weeks. Creatinine was shown to have a peak at 3 days of age (role of muscle activity in thermogenesis), while urate concentration sensitively reflected the dietary protein amount. Serum triglycerides peaked at the time of yolk catabolism, while cholesterol was shown to indicate the moulting, as was serum malondialdehyde. Serum sodium content increased throughout the study. Alanine aminotransferase and aspartate aminotransferase activities increased along the ontogeny, while alkaline phosphatase activity decreased in parallel with the growth. Serum creatine kinase activity showed an over one-magnitude increase. General metabolic and enzymatic alterations were characteristic and applicable for the description of the ontogenetic development of a precocial (post-hatch triglyceride peak), large bodied, meat-type (lactate dehydrogenase, continuously increasing creatine kinase) bird species.
A nem szteroid gyulladásgátló készítmények jótékony hatásaik mellett számos, az alkalmazott gyógyszer típusától és dózisától is függő mellékhatással rendelkeznek. A leggyakoribb gastrointestinalis mellékhatások a terápia megkezdését követően már rövid időn belül jelentkezhetnek, de más nem kívánt hatások, mint a cardiovascularis események kockázatának fokozódása (amelyek a gastrointestinalis mellékhatásokhoz képest lényegesen ritkábbak) is előfordulhatnak a gyógyszerek alkalmazásának megkezdését követően, latenciaperiódus nélkül. Fontos megemlíteni, hogy fájdalomcsillapítás céljából nem szteroid gyulladásgátló kezelést leggyakrabban az idősebb, cardiovascularis szempontból fokozott kockázatú populáción alkalmazzák hosszabb ideig, ahol más gyógyszerek – például a kis dózisú acetilszalicilsav – kölcsönhatásba léphetnek az alkalmazott fájdalomcsillapító készítményekkel; ebben a tekintetben a diclofenac alkalmazása kevesebb kockázatot rejthet magában. Összefoglaló közleményükben a szerzők a nem szteroid gyulladásgátlók cardiovascularis mellékhatásainak előfordulását, azok kialakulását befolyásoló tényezőket és terápiás konzekvenciáit, valamint e készítmények acetilszalicilsavval történő interakcióit elemzik. Orv. Hetil., 2015, 156(13), 516–520.
The energy imbalance related predisposition to mastitis was studied in group-fed postpartum dairy cows (n = 333) kept in 4 large-scale units and producing milk of low somatic cell count (SCC). Blood samples were taken on Days 1-3 after calving for assaying some metabolites and hormones related to the negative energy balance (NEB). If mastitis was diagnosed later, aseptic milk samples were taken to identify the pathogens. Considering pathogen types [contagious pathogens: Staphylococcus (S.) aureus, Gram-positive (GP) environmental pathogens, and Gram-negative (GN) environmental pathogens + mastitis with no detectable pathogens (NDP)] separately, stepwise logistic regression was used to analyse the relation between the potential prognostic value of hormones and metabolites and mastitis outbreak. Only the elevated (= 1.00 mmol/l) serum ß-hydroxybutyrate (BHB) levels predisposed the cows to mastitis in the subsequent 4 weeks. This prognostic value of BHB was significant only in GN + NDP mastitis and in cases caused by GP environmental pathogens, but not in S. aureus mastitis (odds ratio: 5.333, 3.600 and 1.333, respectively).