Background. Published data sustain the participation of vascular renin angiotensin system (RAS) on alteration of pulmonary vessels reactivity during the allergic airway inflammation. Ghrelin is a growth hormone-releasing peptide involved in modulation of immune function.Objective. This study aims to investigate the interaction between ghrelin and local RAS from rat pulmonary vessels during ovalbumin -induced allergic airway disease.Methods. The angiotensinogen (AGT) -induced contractions were assessed on isolated pulmonary artery and veins from ovalbumin sensitized rats receiving either saline (OSR) or ghrelin (OSG) by endotracheal instillation. Experiments were performed in the absence or the presence of losartan, D-ALA 7 , chymostatin and N ω -nitro-L-arginine methyl ester (L-NAME).Results. The angiotensinogen (AGT) contractile effects mediated by AT1 receptors were lower with at least 25% on vessels from OSG than from OSR. The D-ALA 7 and L-NAME significantly increases the AGT -induced contraction on OSG. The amount of nitric oxide released after stimulation with angiotensinogen (AGT) is higher on OSG and it is blocked by D-ALA 7 .Conclusion. Our results suggested that pulmonary delivery of ghrelin could modulate the local RAS from pulmonary vessels, probably by promoting the angiotensin 1-7 mediated effects. These data sustained the existence of another possible way for ghrelin's beneficial effects on the lung.
Background and Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, patients with chronic diseases suffering exacerbations have required acute medical care. The purpose of our study was to determine useful criteria for the differentiation of patients with acute clinical syndromes and suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials and Methods: This was an observational retrospective study, conducted in an internal medicine clinic from April to May 2020. We collected clinical, biological, and computed tomography (CT) data on patients with exacerbations of chronic diseases and clinical suspicion of SARS-CoV-2 infection. Patients with an already-positive real-time reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2 on presentation at the emergency department were excluded from our study. Results: Of 253 suspected cases, 20 were laboratory-confirmed as having SARS-CoV-2 infection by RT-PCR, whereas COVID-19 diagnosis was ruled out in the remaining 233. Venous thromboembolism (VTE) correlated significantly with COVID-19 diagnosis in suspected patients, while laboratory markers were not significantly different between the two groups. Of the suspected patients, significantly higher percentages of dry cough, fever, myalgias, sore throat, loss of smell and appetite, and ground-glass opacities (GGOs) on CT were found in SARS-CoV-2-positive individuals. Conclusions: The study demonstrated that, until receiving the result of an RT-PCR test for SARS-CoV-2 (usually 12–24 h), association with VTE as a comorbidity, fever, dry cough, and myalgia as clinical features, and GGO on CT are the main markers for the identification of COVID-19 patients among those suspected with acute clinical syndromes. Our results also provide evidence for doctors not to rely solely on biological markers in the case of suspected SARS-CoV-2 infection in patients with exacerbations of chronic diseases. These data are useful for faster decision-making with regard to suspected COVID-19 patients before receiving RT-PCR test results, thus avoiding keeping patients in crowded emergency departments.
Objective This study was performed to determine whether a dual-biomarker approach using N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and galectin-3 optimizes the diagnosis and risk stratification of acute cardiac dyspnea. Atypical clinical manifestations and overlapping pathologies require objective and effective diagnostic methods to avoid treatment delays. Methods This prospective observational study included 208 patients who presented to the emergency department for acute dyspnea. NT-proBNP and galectin-3 were measured upon admission. The patients were divided into two groups according to the etiology of their clinical manifestations: cardiac and non-cardiac dyspnea. The patients' New York Heart Association functional class, left ventricular ejection fraction, and discharge status were assessed. Results Diagnostic criteria for acute heart failure were fulfilled in 61.1% of the patients. NT-proBNP and galectin-3 were strongly and significantly correlated. Receiver operating characteristic analysis revealed similar areas under the curve for both markers in the entire group of patients as well as in the high-risk subsets of patients. Conclusions The diagnostic performance of NT-proBNP and galectin-3 is comparable for both the total population and high-risk subsets. Galectin-3 adds diagnostic value to the conventional NT-proBNP in patients with acute cardiac dyspnea, and its utility is of major interest in uncertain clinical situations.
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