Severe sudden sensorineural hearing loss related to risk of stroke and atherosclerosis

The cause of idiopathic sudden sensorineural hearing loss (idiopathic SSNHL)—diagnosed after excluding other causes of hearing loss, such as SSNHL associated with vestibular schwannoma (VS)—is unknown. The presumed pathogenesis of idiopathic SSNHL includes circulatory disorders (e.g., cochlear infarction). We tested the hypothesis that patients with SSNHL who are at high stroke risk will have a lower rate of VS compared to those with low stroke risk. The rationale is that the primary cause of SSNHL in patients with high stroke risk might be a circulatory disturbance. We conducted a retrospective study in six hospitals. Our sampling of SSNHL patients included those diagnosed with idiopathic SSNHL and VS-associated SSNHL. SSNHL patients who had a head MRI were stratified by severity of hearing loss and evaluated for differences in the detection rate of VS between the high-scoring CHADS2 (CHADS2-H-), an index of stroke risk, and low-scoring CHADS2 (CHADS2-L-) groups. We identified 916 patients who met the inclusion criteria. For severe hearing loss, the CHADS2-H group had a significantly lower rate of VS than the CHADS2-L group (OR 0 [95% CI 0.00–0.612]; P = 0.007). These results indirectly support the hypothesis that a primary cause of severe idiopathic SSNHL in those at high risk of stroke might be a circulatory disorder.

Bile Acids, Liver Cirrhosis, and Extrahepatic Vascular Dysfunction

The bile acid pool with its individual bile acids (BA) is modulated in the enterohepatic circulation by the liver as the primary site of synthesis, the motility of the gallbladder and of the intestinal tract, as well as by bacterial enzymes in the intestine. The nuclear receptor farnesoid X receptor (FXR) and Gpbar1 (TGR5) are important set screws in this process. Bile acids have a vasodilatory effect, at least according to in vitro studies. The present review examines the question of the extent to which the increase in bile acids in plasma could be responsible for the hyperdynamic circulatory disturbance of liver cirrhosis and whether modulation of the bile acid pool, for example, via administration of ursodeoxycholic acid (UDCA) or via modulation of the dysbiosis present in liver cirrhosis could influence the hemodynamic disorder of liver cirrhosis. According to our analysis, the evidence for this is limited. Long-term studies on this question are lacking.

microRNA-30c attenuates fibrosis progression and vascular dysfunction in systemic sclerosis model mice

Systemic sclerosis (SSc) is characterized by the fibrosis of skin and visceral organs, and peripheral circulatory disturbance. We recently demonstrated that α2-antiplasmin (α2AP) is elevated in SSc dermal fibroblasts and SSc model mice, and is associated with fibrosis progression and vascular dysfunction. In the present study, we predicted that α2AP could be a target of microRNA-30c (miR-30c) using TargetScan online database, and investigated the effect of miR-30c on the pathogenesis of SSc using a bleomycin-induced SSc model mice. miR-30c attenuated α2AP expression, and prevented the pro-fibrotic changes (increased dermal thickness, collagen deposition, myofibroblast accmulation) and the vascular dysfunction (the reduction of vascular endothelial cells (ECs) and blood flow) in the skin of SSc model mice. Furthermore, miR-30c suppressed pulmonary fibrosis progression in the SSc model mice. These findings suggest that miR-30c exerts the anti-fibrotic and anti-angiopathy effects on SSc model mice, and might provide a basis for clinical strategies for SSc.

MiR-223-3p in Cardiovascular Diseases: A Biomarker and Potential Therapeutic Target

Cardiovascular diseases, involving vasculopathy, cardiac dysfunction, or circulatory disturbance, have become the major cause of death globally and brought heavy social burdens. The complexity and diversity of the pathogenic factors add difficulties to diagnosis and treatment, as well as lead to poor prognosis of these diseases. MicroRNAs are short non-coding RNAs to modulate gene expression through directly binding to the 3′-untranslated regions of mRNAs of target genes and thereby to downregulate the protein levels post-transcriptionally. The multiple regulatory effects of microRNAs have been investigated extensively in cardiovascular diseases. MiR-223-3p, expressed in multiple cells such as macrophages, platelets, hepatocytes, and cardiomyocytes to modulate their cellular activities through targeting a variety of genes, is involved in the pathological progression of many cardiovascular diseases. It participates in regulation of several crucial signaling pathways such as phosphatidylinositol 3-kinase/protein kinase B, insulin-like growth factor 1, nuclear factor kappa B, mitogen-activated protein kinase, NOD-like receptor family pyrin domain containing 3 inflammasome, and ribosomal protein S6 kinase B1/hypoxia inducible factor 1 α pathways to affect cell proliferation, migration, apoptosis, hypertrophy, and polarization, as well as electrophysiology, resulting in dysfunction of cardiovascular system. Here, in this review, we will discuss the role of miR-223-3p in cardiovascular diseases, involving its verified targets, influenced signaling pathways, and regulation of cell function. In addition, the potential of miR-223-3p as therapeutic target and biomarker for diagnosis and prediction of cardiovascular diseases will be further discussed, providing clues for clinicians.

Assessment of the Reproductive Health Status of Clarias Gariepinus (Burchell, 1822) in a River Impacted by Mercury from Clandestine Gold Mining: A Case Study of Bagoue River, Côte d’Ivoire

Pollution of aquatic ecosystems often results in adverse environmental disturbances, including individual and/or sub-individual changes in fish. The aim of the present study was to examine possible reproductive health effects in male and female, based on a histological assessment of Clarias gariepinus sampled in Bagoue River impacted by mercury from the artisanal gold mining. Fish were collected between August 2018 and April 2019 during two seasons from four stations differently impacted. A histological assessment was done on three target fish organs (liver, ovary and testis). Water and sediment samples were analysed for total mercury (T-Hg) concentration. Histological alterations were semi-quantitatively assessed, and the results were classified according to the severity of the histological response identified. Microscopic assessment revealed alterations of the gonads and liver tissues. A higher incidence of reaction pattern (Regressive changes, Inflammation and Circulatory disturbance) was found in liver tissues than in gonads tissues (Regressive changes). T-Hg levels were higher upstream than downstream in ovaries and testis tissues. Paradoxically, the lesions observed in these organs were more pronounced downstream than those found in fish from upstream during rainy season. According to total index, the organs examined downstream suffered severe damage unlike upstream sites. Also, comparison of degree of alteration between testes and ovaries indicates a greater impact of ovarian structures especially on downstream sites. The effect of anthropogenic impact appears to be visible downstream as the concentration of chemical pollutants and exposure time determine the severity of the damage. Alterations in ovarian follicles, spermatogenic cells and liver tissues may reflect damage to the process of gametogenesis, which may reduce the reproductive capacity of individuals over the long term.

Prehospital lactate improves prediction of the need for immediate interventions for hemorrhage after trauma

The blood lactate level is used to guide the management of trauma patients with circulatory disturbance. We hypothesized that blood lactate levels at the scene (Lac scene) could improve the prediction for immediate interventions for hemorrhage. We prospectively measured blood lactate levels and assessed retrospectively in 435 trauma patients both at the scene and on arrival at the emergency room (ER) of a level I trauma center. Primary outcome was immediate intervention for hemorrhage defined as surgical/radiological intervention and/or blood transfusion within 24 h. Physiological variables plus Lac scene significantly increased the predictive value for immediate intervention (area under the curve [AUC] 0.882, 95% confidence interval [CI] 0.839–0.925) compared to that using physiological variables only (AUC 0.837, 95% CI 0.787–0.887, P = 0.0073), replicated in the validation cohort (n = 85). There was no significant improvement in predicting value of physiological variables plus Lac scene for massive transfusion compared to physiological variables (AUC 0.903 vs 0.895, P = 0.32). The increased blood lactate level per minute from scene to ER was associated with increased probability for immediate intervention (P < 0.0001). Both adding Lac scene to physiological variables and the temporal elevation of blood lactate levels from scene to ER could improve the prediction of the immediate intervention.

Effect of the Dried Flowers of Campsis grandiflora on Stagnant Blood Syndrome

Dried flower of Campsis grandiflora ( Bignoniaceae), known as ryoushouka in Japanese, is a traditional Chinese medicine used to treat stagnant blood, contusion, pruritus, and gynecopathy such as menstrual and menopausal disorders. In the present study, we evaluated the stagnant blood flow (BF) improvement effect of the methanol extract (CG) of dried flowers of C. grandiflora using an in vivo assay, in a continuing effort to improve peripheral circulatory disturbance using natural sources. We used the assay system to monitor a decrease in BF in the tail vein microcirculation of mice subjected to sensitization with hen-egg white lysozyme. Bioassay-guided fractionation of the CG led to the isolation of apigenin (1), acteoside (2), cleroindicin B (3), rengyol (4), and isorengyol (5). Apigenin (1) and acteoside (2) were identified as active compounds as they exhibited significant stagnant BF improvement effect in the peripheral circulation. This study proved the positive effect of ryoushouka against stagnant blood syndrome.

Instrumental Assessment of the Face Skin Aging in Women

The aim of this study is to conduct several non-invasive methods for assessing the level of circulatory disturbance, elasticity and aging of skin in patients of different age groups in order to expand the diagnostic capabilities and evaluate the effectiveness of current research in aesthetic medicine. Clinical and instrumental exploration of 160 women aged 17 to 75 years with varying degrees of involutional skin changes was carried out. To objectify the assessment of skin condition, in all group of patients modern instrumental methods were used, such as: elastometry, ultrasound examination of the skin, laser Doppler flowmetry, transcutaneous oxygen tension. Concurrent implementation of several non-invasive methods for assessing the level of circulatory disturbance, elasticity and aging of the skin, allowed us to find new possibilities for studying the functional state of the skin. These methods extend the possibilities of ultrasonic research methods used today in aesthetic cosmetology. The obtained comparative data of elastometry, ultrasonography, laser Doppler flowmetry and transcutaneous oximetry in patients of different age groups showed the presence of elasticity and structure defect, skin thickness and subcutaneous fat, as well as microcirculation changes since 25 years and marked changes after 40 years.