With the development of progressive right ventricular dysfunction, pulmonary arterial hypertension (PAH) is one of the causes of type 2 cardiohepatic syndrome (CHS). Risk assessment, timely and effective management are crucial to improve survival in PAH. Thus, we aimed to evaluate the presence of CHS at diagnosis and its association with prognosis in patients with PAH. One hundred and eighteen consecutive incident patients with PAH between January 2013 and June 2021 were retrospectively included. The presence of CHS was assessed from blood tests taken during diagnostic evaluation and was defined as elevation of at least two of three cholestatic liver parameters; total bilirubin, alkaline phosphatase and gamma-glutamyl transferase. The primary endpoint was all-cause mortality. Patients were followed for a median period of 58 (32-96) months. 23.7% of the patients had CHS at diagnosis. Significantly more patients in CHS (+) group were in intermediate and high-risk categories according to 2015 ESC/ERS guideline, REVEAL 2.0 and REVEAL Lite 2 risk assessment methods (p = .02, .03 and <.001, respectively). The presence of CHS was identified as an independent predictor of mortality (HR: 2.17, 95% CI: 1.03-4.65, p = .03) along with older age (HR: 2.89, 95% CI: 1.50-5.56, p = .001) and higher WHO functional class (HR: 2.57, 95% CI: 1.07-6.22, p = .03). To conclude, presence of CHS at diagnosis in patients with PAH was associated with severe disease and poor prognosis independent of other well known risk factors. As a simple and easy parameter to assess from routinely taken blood tests, CHS should be evaluated in patients with PAH.
Determination of arsenic is possible by various methods such as spectrophotometry, atomic absorption (as arsine), atomic emission, and neutron activation analysis are common. High levels of interference and the high costs of these methods are major drawbacks. Anodic stripping voltammetry (ASV) has proved to be a sensitive, precise, and cost-effective electroanalytical technique for determining trace metals. It is routinely used for detecting Pb (II) and Cd (II). The general procedure of this technique involves depositing metal(s) at a reductive potential into Hg electrodes for a certain time and stripping them back into the solution by scanning the potential in the oxidative direction. In this work, the analysis of As (III) by ASV has been investigated using solid and Screen Printed Gold electrodes. Improved detection limits up to 10 ppb could be achieved with relative ease. A highly optimized procedure has been presented for the BASi Epsilon users that automatically provides electrochemical pretreatment in automated fashion along with the built-in differential pulse stripping voltammetry in the next step.
The accurate determination of hexavalent chromium in environmental matrices such as natural and waste waters is crucial for the safety of both human and wildlife populations. The United States Environmental Protection Agency (U.S.EPA) has put forth SW-846, Method 7198, using differential pulse polarography for determination of Cr (VI) in both, the natural as well as waste waters. In Method 7198, the cathodic peak current resulting from the reduction of Cr (VI) to Cr (III) is measured and the concentration range for this method is listed as 10 ppb to 5 ppm Cr (VI). Using BASi Epsilon Potentiostat that is specifically made for measuring ultra-low current resolutions and a controlled growth mercury electrode (CGME) set-up, the US EPA method 7198 has been successfully optimized in this work for higher detection limits. It is observed that a detection limit of up to 7 ppb can be easily obtained by efficiently managing the interference of iron and Sulphur through a combination of various supporting electrolytes. This work may also become a valuable source of reference information on the behavior of wide variety of electrolytes and their control parameters needed to achieve extremely low detection limits. Figure 1
OBJECTIVEIn this study, the effect of high-risk pregnancies on pregnant women's perception of anxiety and traumatic birth was examined.DESIGN AND METHODSData in a comparative descriptive study involving 156 pregnant women, collected by pregnant information form, State and Trait Anxiety, and Traumatic Birth Perception Scale.RESULTSIt was found that 44.9% of the pregnant women in the study were between the ages of 24-29, 79.5% wanted to give birth normally, and 62.8% feared vaginal delivery. There was a low level of positive correlation between traumatic anxiety and perception of traumatic delivery in high-risk pregnant women, and a moderate positive relationship between traumatic anxiety and traumatic delivery perception in low risk pregnant women (p < 0.05).PRACTICE IMPLICATIONSIt is recommended to determine the risk factors that will create a perception of traumatic birth in pregnant women and to plan holistic care aimed at preventing traumatic births.
Infection with wild-type (WT) measles virus (MeV) is an important cause of childhood mortality that leads to lifelong protective immunity in survivors. WT MeV and the live-attenuated MeV used in the measles vaccine (LAMV) are antigenically similar, but the determinants of attenuation are unknown, and protective immunity induced by LAMV is less robust than that induced by WT MeV. To identify factors that contribute to these differences, we compared virologic and immunologic responses after respiratory infection of rhesus macaques with WT MeV or LAMV. In infected macaques, WT MeV replicated efficiently in B and T lymphocytes with spreading throughout lymphoid tissues resulting in prolonged persistence of viral RNA. In contrast, LAMV replicated efficiently in the respiratory tract but displayed limited spread to lymphoid tissue or peripheral blood mononuclear cells. In vitro, WT MeV and LAMV replicated similarly in macaque primary respiratory epithelial cells and human lymphocytes, but LAMV-infected lymphocytes produced little virus. Plasma concentrations of interleukin-1β (IL-1β), IL-12, interferon-γ (IFN-γ), CCL2, CCL11, CXCL9, and CXCL11 increased in macaques after WT MeV but not LAMV infection. WT MeV infection induced more protective neutralizing, hemagglutinin-specific antibodies and bone marrow plasma cells than did LAMV infection, although numbers of MeV-specific IFN-γ- and IL-4-producing T cells were comparable. Therefore, MeV attenuation may involve altered viral replication in lymphoid tissue that limited spread and decreased the host antibody response, suggesting a link between lifelong protective immunity and the ability of WT MeV, but not LAMV, to spread in lymphocytes.
