ACTIVITY DEFINIZIONE ANTIHYPOXANTS IN DERIVATI DEL 2- BENZAMMIDE-2-(2-OKSOINDOLIN-3-ILIDENE)-VINEGARY ACIDO IN ACUTA IPOSSIA IPERBARICA

Questo articolo presenta i risultati dello screening di 2-benzammide- 2- (2-oksoindolin-3-ilidene)-vinegary attivitа antihypoxants acido. Scoperto che il composto al numero 15 per antihypoxants attivitа aumentato in modo significativo la durata totale di animali (tempo di simulazione dall'inizio alla nascita di ipossia respiri secondo agonico) 186% rispetto al controllo dei dati (r≤0,05). Contemporaneamente, il comparatore noto antihypoxants mexidol maggiore durata 197% (r≤0,05), che indica che il nuovo composto non cede mexidol confronto del farmaco. Inoltre, in termini di recupero di attivitа fisica degli animali che hanno soggiornato presso la "altopiano" Composto 15 mexidol effetto significativamente superiore.Кафедра фармакологі

EurA1c: the European HbA1c Trial to Investigate the Performance of HbA1c Assays in 2166 Laboratories across 17 Countries and 24 Manufacturers by Use of the IFCC Model for Quality Targets

Background: A major objective of the IFCC Committee on Education and Use of Biomarkers in Diabetes is to generate awareness and improvement of HbA1c assays through evaluation of the performance by countries and manufacturers. Methods: Fresh whole blood and lyophilized hemolysate specimens manufactured from the same pool were used by 17 external quality assessment organizers to evaluate analytical performance of 2166 laboratories. Results were evaluated per country, per manufacturer, and per manufacturer and country combined according to criteria of the IFCC model for quality targets. Results: At the country level with fresh whole blood specimens, 6 countries met the IFCC criterion, 2 did not, and 2 were borderline. With lyophilized hemolysates, 5 countries met the criterion, 2 did not, and 3 were borderline. At the manufacturer level using fresh whole blood specimens, 13 manufacturers met the criterion, 8 did not, and 3 were borderline. Using lyophilized hemolysates, 7 manufacturers met the criterion, 6 did not, and 3 were borderline. In both country and manufacturer groups, the major contribution to total error derived from between-laboratory variation. There were no substantial differences in performance between groups using fresh whole blood or lyophilized hemolysate samples. Conclusions: The state of the art is that 1 of 20 laboratories does not meet the IFCC criterion, but there are substantial differences between country and between manufacturer groups. Efforts to further improve quality should focus on reducing between-laboratory variation. With some limitations, fresh whole blood and well-defined lyophilized specimens are suitable for purpose

Value of minimum intensity projections for chest CT in COVID-19 patients

Purpose: To investigate whether minimum intensity projection (MinIP) reconstructions enable more accurate depiction of pulmonary ground-glass opacity (GGO) compared to standard transverse sections and multiplanar reformat (MPR) series in patients with suspected coronavirus disease 2019 (COVID-19). Method: In this multinational study, chest CT scans of 185 patients were retrospectively analyzed. Diagnostic accuracy, diagnostic confidence, image quality regarding the assessment of GGO, as well as subjective time-efficiency of MinIP and standard MPR series were analyzed based on the assessment of six radiologists. In addition, the suitability for COVID-19 evaluation, image quality regarding GGO and subjective time-efficiency in clinical routine was assessed by five clinicians. Results: The reference standard revealed a total of 149 CT scans with pulmonary GGO. MinIP reconstructions yielded significantly higher sensitivity (99.9 % vs 95.6 %), specificity (95.8 % vs 86.1 %) and accuracy (99.1 % vs 93.8 %) for assessing of GGO compared with standard MPR series. MinIP reconstructions achieved significantly higher ratings by radiologists concerning diagnostic confidence (medians, 5.00 vs 4.00), image quality (medians, 4.00 vs 4.00), contrast between GGO and unaffected lung parenchyma (medians, 5.00 vs 4.00) as well as subjective time-efficiency (medians, 5.00 vs 4.00) compared with MPR-series (all P <.001). Clinicians preferred MinIP reconstructions for COVID-19 assessment (medians, 5.00 vs 3.00), image quality regarding GGO (medians, 5.00 vs 3.00) and subjective time-efficiency in clinical routine (medians, 5.00 vs 3.00). Conclusions: MinIP reconstructions improve the assessment of COVID-19 in chest CT compared to standard images and may be suitable for routine application

Role of aldosterone on lung structural remodelling and right ventricular function in congestive heart failure

<p>Abstract</p> <p>Background</p> <p>The mechanisms of benefit of mineralocorticoid receptors antagonists in congestive heart failure (CHF) are still debated. We hypothesized that aldosterone contributes to pulmonary remodelling and right ventricular (RV) dysfunction associated with CHF by stimulation of lung myofibroblasts (MYFs) proliferation.</p> <p>Methods</p> <p>Rats with moderate to large myocardial infarcts (MI) and CHF were studied. Two weeks after MI, spironolactone 100 mg/kg/day (n = 21) or no treatment (n = 24) were given for 3 weeks and compared to sham (n = 8).</p> <p>Results</p> <p>Infarct size was similar by ultrasound and pathologic measures in both MI groups.</p> <p>The MI-untreated group developed important lung remodelling with nearly doubling of dry lung weight (p < 0.01), reduced left ventricular (LV) fractional shortening (16 ± 2% vs. 53 ± 1%; mean ± SEM, p < 0.0001), pulmonary hypertension (RV systolic pressure: 40 ± 3 mmHg vs. 27 ± 1 mmHg, p < 0.01) and RV hypertrophy (RV/(LV + septum): 38 ± 3% vs. 24 ± 1%, p < 0.05). Spironolactone had no effect on these parameters and did not improve LV or RV performance (tricuspid annular plane systolic excursion and RV myocardial performance index) measured by echocardiography. CHF induced a restrictive respiratory syndrome with histological lung fibrosis: this was also unaffected by spironolactone. Finally, isolated lung MYFs did not proliferate after exposure to aldosterone.</p> <p>Conclusion</p> <p>Aldosterone does not significantly contribute to pulmonary remodelling and RV dysfunction associated with CHF. Other mechanisms are responsible for the beneficial effects of spironolactone in CHF.</p

Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis

OBJECTIVES: Among patients with severe acute kidney injury (AKI) admitted to the ICU in high-income countries, regional practice variations for fluid balance (FB) management, timing, and choice of renal replacement therapy (RRT) modality may be significant. DESIGN: Secondary post hoc analysis of the STandard vs. Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial (ClinicalTrials.gov number NCT02568722). SETTING: One hundred-fifty-three ICUs in 13 countries. PATIENTS: Altogether 2693 critically ill patients with AKI, of whom 994 were North American, 1143 European, and 556 from Australia and New Zealand (ANZ). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Total mean FB to a maximum of 14 days was +7199 mL in North America, +5641 mL in Europe, and +2211 mL in ANZ (p &lt; 0.001). The median time to RRT initiation among patients allocated to the standard strategy was longest in Europe compared with North America and ANZ (p &lt; 0.001; p &lt; 0.001). Continuous RRT was the initial RRT modality in 60.8% of patients in North America and 56.8% of patients in Europe, compared with 96.4% of patients in ANZ (p &lt; 0.001). After adjustment for predefined baseline characteristics, compared with North American and European patients, those in ANZ were more likely to survive to ICU (p &lt; 0.001) and hospital discharge (p &lt; 0.001) and to 90 days (for ANZ vs. Europe: risk difference [RD], -11.3%; 95% CI, -17.7% to -4.8%; p &lt; 0.001 and for ANZ vs. North America: RD, -10.3%; 95% CI, -17.5% to -3.1%; p = 0.007). CONCLUSIONS: Among STARRT-AKI trial centers, significant regional practice variation exists regarding FB, timing of initiation of RRT, and initial use of continuous RRT. After adjustment, such practice variation was associated with lower ICU and hospital stay and 90-day mortality among ANZ patients compared with other regions

An Assessment of The Efficacy of National Cohesion and Integration Commission (Ncic) in Violence and Conflict Prevention During Electoral Processes in Kenya: A Case Study of Nairobi County (2012-2022)

Masters ThesisIn Kenya, elections are based on a zero-sum model that predisposes the country to electoral related ethnic conflicts. In response to these conflicts and violent conflicts, Kenya has instituted several measures including the establishment of the NCIC. Despite establishment and operationalization of NCIC, conflicts continue to riddle electoral processes in the country. This study therefore, assessed the efficacy of NCIC investigations on electoral related hate speech and ethnic contempt; evaluated NCIC efforts in sensitizing the public on electoral related hate speech and ethnic contempt; and analyzed the level of public confidence in NCIC in prevention of electoral related conflicts and violence in Kenya. The study is based on the conflict transformation theory and the Rational Choice Theory. Methodologically, the study was based on a case study research design targeting CSOs, citizens in Nairobi County - Mlango Kubwa and Nairobi Central Wards; institutions including NCIC, NSC, the DCI, and KNCHR. Respondents were sampled through purposive and simple random sampling. The researcher gathered data from 200 residents using questionnaires and also interviewed 5 key informants. Descriptive statistics for quantitative data was conducted using SPSS while qualitative data was analyzed using content analysis. Data was presented using narratives, tables and diagrams. The findings show that: electoral-related violence is manifested in a myriad of forms such as psychological abuse; viral attacks; and voter intimidation. It also found that curbing hate speech and preventing electoral related violence in Kenya by the NCIC faces internal and external challenges that limit the effectiveness of the NCIC. On sensitization strategies, the study showed NCIC used strategies including media campaigns, sensitization of election stakeholders, public engagement and awareness. Other impactful strategies were introduction of Amani clubs in schools; conducting peace caravans across Counties; influencing themes in National drama and music festivals; and conducting online and social media initiatives focused on responsible online behavior and digital citizenship. On the public’s confidence in the NCIC, there is lack of trust in the NCIC to deliver competent output. Contrary to this, there is a positive but modest belief that the decision-making process and outputs of the NCIC are achieved through values of transparency and accountability. And lastly, there is also a modest agreement that the NCIC is responsive to public demand on issues of hate speech and ethnic contempt in Kenya. To effectively prevent electoral related conflict and violence in Kenya, the study recommends increased budgetary allocation to NCIC to reinforce its activities and programs, improvement of the Commission’s early warning and rapid response capabilities, the representation of youth amongst the Commissioners, the engagement of stakeholders particularly those in the private sector to complement the Commission’s mandate, the use of ‘a whole -of-community approach in the coming up of integration policies and importantly an update of the laws around hate speech while concurrently addressing the issues around freedom of expression.Daystar Universit