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European Journal of Clinical Investigation

Manuel Luque-Ramírez, Lucía Jiménez-Mendiguchia, Ana García-Cano, Elena Fernández-Durán, Verónica de Dios Rosa, Lia Nattero-Chávez, Andrés E Ortiz-Flores, Héctor F Escobar-Morreale
BACKGROUND: Testosterone (T) measurement in women are problematic leading to initiatives aiming to improve laboratory standardization of commercial assays. We assessed the impact on the clinical diagnosis of functional hyperandrogenic disorders of a total T immunoassay recently certified by the Centers for Diseases Control and Prevention (CDC). METHODS: We conducted a cross-sectional study including 263 consecutive adult premenopausal women presenting with functional ovarian hyperandrogenism - including polycystic ovary syndrome (PCOS) - and 73 nonhyperandrogenic female volunteers who served to define reference ranges...
September 19, 2018: European Journal of Clinical Investigation
Cristina Alonso-Montes, María Martín, Laura Martínez-Arias, Eliecer Coto, Manuel Naves-Díaz, César Morís, Jorge B Cannata-Andía, Isabel Rodríguez
BACKGROUND: Bicuspid aortic valve (BAV) is a heterogeneous and still not fully understood condition, with diverse genetic etiology and associated phenotypes ranging from aortic stenosis or regurgitation to aneurysm and dissection. Several genes have been associated with the presence of BAV, notably some members of the GATA family of transcription factors that play important roles in cardiac embryogenesis. METHODS: A case-control study with 122 unrelated and ethnically matched patients with bicuspid and 154 with tricuspid aortic valve was performed...
September 19, 2018: European Journal of Clinical Investigation
Alexander Jt Wood, Arlette Vassallo, Charlotte Summers, Edwin R Chilvers, Andrew Conway Morris
Critical illness is an aetiologically and clinically heterogeneous syndrome that is characterised by organ failure and immune dysfunction. Mortality in critically ill patients is driven by inflammation-associated organ damage and a profound vulnerability to nosocomial infection. Both factors are influenced by the activated complement protein C5a, released by unbridled activation of the complement system during critical illness. C5a exerts deleterious effects on organ systems directly, and suppresses antimicrobial functions of key immune cells...
September 19, 2018: European Journal of Clinical Investigation
Christian Wallmüller, Alexander Spiel, Fritz Sterz, Andreas Schober, Pia Hubner, Peter Stratil, Christoph Testori
BACKGROUND: In elder patients after out-of-hospital cardiac arrest diminished neurologic function as well as reduced neuronal plasticity may cause a low response to targeted temperature management (TTM). Therefore, we investigated the association between TTM (32°C to 34°C) and neurologic outcome in cardiac arrest survivors with respect to age. MATERIAL AND METHODS: This retrospective cohort study included patients 18 years of age or older suffering a witnessed out-of-hospital cardiac arrest with presumed cardiac cause, which remained comatose after return of spontaneous circulation...
September 14, 2018: European Journal of Clinical Investigation
Daphne Hahn, Caroline S Stokes, Ralf Kaiser, Markus R Meyer, Frank Lammert, Frank Gruenhage
BACKGROUND AND AIMS: The new direct-acting antiviral agents (DAA) have revolutionized the treatment of patients with chronic hepatitis C virus (HCV) infection. This study investigates to which extent DAA affect fatigue and mood and, if so, whether this results from changes to tryptophan (TRP) metabolism, as reflected by two critical biosynthetic pathways, serotonin (SRT) generation from TRP and TRP degradation through kynurenines (KYN) via indoleamine 2,3-dioxygenase (IDO). METHODS: This study assessed 24 patients with chronic HCV infection, before (T1), during (T2: at 4 weeks) and 12 weeks post-treatment with DAA (T3) with respect to viral load, fatigue and depressive symptoms (BDI-II questionnaire), physical activity (actigraph) and plasma serotonin-tryptophan metabolites (LC/MS)...
September 2, 2018: European Journal of Clinical Investigation
Patricia Van der Niepen, Frank van Tussenbroek, Hannes Devos, Erik Debing, Silvia Di Monaco, Pierre Goffette, Parla Astarci, Alexandre Persu
Fibromuscular dysplasia (FMD) is an idiopathic, segmental, non-atherosclerotic and non-inflammatory disease of the musculature of arterial walls, leading to stenosis of small and medium-sized arteries, mostly involving renal and cervical arteries. As a result of better and more systematic screening, it appears that involvement of the splanchnic vascular bed is more frequent than originally assumed. We review epidemiology, pathogenesis, clinical picture as well as diagnosis and treatment of visceral artery (VA) FMD...
August 29, 2018: European Journal of Clinical Investigation
Aastha Malik, Rajesh Kumar Morya, Sanjay Kumar Bhadada, Satyavati Rana
BACKGROUND: Oxidative stress is risk factor in progression of diabetes. It can increase cytokine production via several different mechanisms. Inflammation can affect gut neural apparatus that may lead to dysmotility which may exaggerate occurrence of bacterial overgrowth in intestine. Thus, a study was planned to understand the complex interplay of oxidative stress, inflammatory cytokines, gut motility and small intestinal bacterial overgrowth in type 1 diabetes mellitus (T1DM) patients...
August 29, 2018: European Journal of Clinical Investigation
Julie Refardt, Bernadette Kling, Katharina Krausert, Martin Fassnacht, Stefanie von Felten, Mirjam Christ-Crain, Wiebke Fenske
BACKGROUND: Chronic hyponatremia is common and associated with increased morbidity and mortality. However, whether treatment improves outcome in patients without significant symptoms is unclear. We here assessed the therapeutic outcome on clinical symptoms, neurocognitive and neuromuscular function in patients with chronic non profound hyponatremia. MATERIAL AND METHODS: Prospective case-control study in 19 patients from the University Hospital Würzburg with chronic non profound hyponatremia without clinically apparent symptoms...
August 28, 2018: European Journal of Clinical Investigation
Denise Mafra, Eva-Karin Gidlund, Natália Alvarenga Borges, D'Angelo Carlo Magliano, Bengt Lindholm, Peter Stenvinkel, Ferdinand von Walden
Chronic kidney disease (CKD), which affects 10-15% of the population, associates with a range of complications - such as cardiovascular disease, frailty, infections, muscle and bone disorders and premature ageing - that could be related to alterations of mitochondrial number, distribution, structure and function. As mitochondrial biogenesis, bioenergetics and the dynamic mitochondrial networks directly or indirectly regulate numerous intra- and extracellular functions, the mitochondria have emerged as an important target for interventions aiming at preventing or improving the treatment of complications in CKD...
August 25, 2018: European Journal of Clinical Investigation
Kimberly D van der Willik, Sanne B Schagen, M Arfan Ikram
Noncentral nervous system cancer and the brain share an interesting and complex relation, with an emerging body of evidence showing that cancer patients are at an increased risk of developing cognitive problems. In contrast, population-based studies consistently find an inverse link between cancer and dementia, that is patients with dementia having a lower risk of subsequently developing cancer, and cancer patients being less often diagnosed with dementia. Different biological processes such as inversely activated cell proliferation and survival pathways have been suggested to have an important role underlying this inverse association...
August 15, 2018: European Journal of Clinical Investigation
Kálmán Bódis, Michael Roden
BACKGROUND: Insulin resistance occurs in obesity, but also in lipodystrophy. Although adipose tissue controls metabolic fluxes and participates in inter-organ crosstalk, the role of energy metabolism within white adipose tissue for insulin resistance is less clear. MATERIALS AND METHODS: A Medline search identified in vivo studies in humans on energy and lipid metabolism in subcutaneous (SAT) and visceral adipose tissue (VAT). Studies in adipocyte cultures and transgenic animal models were included for the better understanding of the link between abnormal energy metabolism in adipose tissue and insulin resistance...
August 14, 2018: European Journal of Clinical Investigation
Christopher Adlbrecht, Alejandro Blanco-Verea, María C Bouzas-Mosquera, María Brion, Martin Burtscher, Federico Carbone, Ting-Ting Chang, Evangelia Charmandari, Jaw-Wen Chen, Liane Correia-Costa, Robin P F Dullaart, Makarios Eleftheriades, Beatriz Fernandez-Fernandez, Georg Goliasch, Thomas Gremmel, Menno Evert Groeneveld, Alexandrino Henrique, Martin Huelsmann, Christian Jung, Michael Lichtenauer, Fabrizio Montecucco, Nicolas C Nicolaides, Alexander Niessner, Carlos Palmeira, Markus Pirklbauer, Maria Dolores Sanchez-Niño, Alexandros Sotiriadis, Teresa Sousa, Patrick Sulzgruber, André P van Beek, Nicola Veronese, Max-Paul Winter, Kak Khee Yeung
Following the publication of our study [1] no biochemical data derived from adolescent marathon runners have been made available. However, there are two potentially relevant investigations including adult runners. Shin and colleagues demonstrated different effects depending on the running distance, i.e. marathon, 100 km and 308 km [2]. Hepatic function was more impaired after completing 308 km (low intensity, long duration) compared to marathon or 100 km, but renal dysfunction was more pronounced after marathon and especially after 100 km (higher intensity and shorter duration)...
August 12, 2018: European Journal of Clinical Investigation
Felipe Gonzalez-Loyola, Rosa Abellana, José-Maria Verdú-Rotellar, Alejandro Bustamante Rangel, Josep Lluís Clua-Espuny, Miguel-Angel Muñoz
BACKGROUND: The impact of atrial fibrillation (AF) on mortality of patients with heart failure (HF) has been established. Nevertheless, the effect of some factors in mortality, such as digoxin or diuretic use, remains controversial. This study aims at assessing mortality in community-dwelling patients with stable HF related to AF and determines the relation of these drugs with prognosis. MATERIALS AND METHODS: Community-based cohort study of HF patients diagnosed between January 2010 and December 2014 attended at any one of the 279 primary healthcare centres of the Catalan Institute of Health (Spain)...
August 9, 2018: European Journal of Clinical Investigation
Florenzo Iannone, Fausto Salaffi, Marco Fornaro, Marco Di Carlo, Stefano Gentileschi, Luca Cantarini, Giuseppe Lopalco
AIM: To assess the impact of baseline modified Rheumatic Disease Comorbidity Index (mRDCI) a simple comorbidity count, on overall survival of treatments with biological drugs in patients affected with Rheumatoid Arthritis (RA), Spondyloarthritis (SpA) and Psoriatic Arthritis (PsA) in real-world settings. METHODS: Patients (nr. 635) with RA (nr. 214), SpA (nr. 213) and PsA (nr. 208) starting a first biological drug were retrospectively analysed. mRDCI was scored at baseline, and disease characteristics were recorded at entry and at last observation...
August 5, 2018: European Journal of Clinical Investigation
Yalan Xu, Yijun Song, Jiazhen Chang, Xiya Zhou, Qingwei Qi, Xinping Tian, Mengtao Li, Xiaofeng Zeng, Mengnan Xu, Wenjuan Zhang, David S Cram, Juntao Liu
BACKGROUND: High levels of circulating cell-free DNA (cfDNA) have been reported in patients with inflammatory conditions. The aim of the study was to investigate the levels of cfDNA in patients with systemic lupus erythematosus (SLE). MATERIALS AND METHODS: Comparative groups comprised 22 nonpregnant and 36 pregnant women with SLE (test groups) and 60 nonpregnant and 199 pregnant women with no history of SLE (control groups). The levels of cfDNA in plasma were quantitated by a fluorometric dsDNA assay...
August 5, 2018: European Journal of Clinical Investigation
Min Chen, Xiaoqi Chen, Qianqian Wan
BACKGROUND: T helper 17 (Th17) and regulatory T (Treg) cells play an important role in pathogenesis of systemic lupus erythematosus (SLE). Their imbalance was reported in treated SLE patients, while very little is known about the relationship between Th17 and Treg cells in new-onset untreated SLE patients. AIM: To assess the role of Th17/Treg cells in the pathogenesis of new-onset SLE. MATERIALS AND METHODS: Thirty-nine new-onset SLE patients and 33 age-matched healthy adults were enrolled...
August 5, 2018: European Journal of Clinical Investigation
Ásthildur Árnadóttir, Kirstine Roll Vestergaard, György Sölétormos, Rolf Steffensen, Jens P Goetze, Kasper Iversen
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is a good prognostic marker for mortality. However, it is uncertain if hs-cTnT can be used to detect sub-clinical cardiac disease. METHOD: Pilot study in patients without known heart disease and elevated hs-cTnT measured at presentation to the emergency department. Hs-cTnT was measure with Roche Diagnostics. Echocardiography was used to assess structural heart disease and the participants underwent computed tomography angiography for assessment of coronary artery disease and agatston score...
July 30, 2018: European Journal of Clinical Investigation
María Correa-Rodríguez, Jacqueline Schmidt-RioValle, Blanca Rueda-Medina
BACKGROUND: SOX6 has been recently proposed as a pleiotropic gene for obesity and osteoporosis. The aim of this study was to investigate whether the rs7117858 genetic variant in SOX6 was associated with bone mass assessed by quantitative ultrasound (QUS) and obesity-related measures in a population of young adults. METHODS: A cross-sectional study was conducted in 550 unrelated healthy individuals of Caucasian ancestry (381 (69.3%) female and 169 (30.7%) male; mean age 20...
July 30, 2018: European Journal of Clinical Investigation
Fariborz Mobarrez, Elisabet Svenungsson, David S Pisetsky
Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease characterized by the production of antibodies to components of the cell nucleus (antinuclear antibodies or ANAs) and the formation of immune complexes with nuclear antigens. These complexes can drive pathogenesis by depositing in the tissue to incite inflammation or induce cytokine production by cells of the innate immune system. While ANAs can bind to purified nuclear molecules, nuclear autoantigens in vivo most likely exist attached to other molecules or embedded in larger structures...
July 30, 2018: European Journal of Clinical Investigation
Max-Paul Winter, Franz Wiesbauer, Hermann Blessberger, Noemi Pavo, Patrick Sulzgruber, Kurt Huber, Johann Wojta, Klaus Distelmaier, Irene M Lang, Georg Goliasch
BACKGROUND: Premature myocardial infarction (≤40 years) represents a rare disease with a distinct risk factor profile and a lipid phenotype that is characterized by a predominance of elevated triglyceride-rich lipoproteins. So far high-density and low-density lipoproteins remain the primary targets for risk stratification and treatment evaluation in coronary artery disease, but this strategy might be insensitive in patients with premature myocardial infarction. AIM: Aim of this study was to investigate the predictive value of different lipid fractions on long-term cardiovascular outcome in patients with premature myocardial infarction...
July 30, 2018: European Journal of Clinical Investigation
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