Rat bile duct ligation (BDL) represents a useful method that mimics obstructive extrahepatic cholestasis, which is known to be a frequent disorder in humans. Polyamines (putrescine, spermidine, and spermine) are one of the key molecules regulating cell proliferation and differentiation. This work aimed to evaluate the potential beneficial properties of putrescine in rat BDL model by studying several biochemical parameters reflecting liver function and polyamine metabolism. Rats that were subjected to BDL were injected with putrescine (150 mg/kg) for 9 days, while in parallel another group with BDL remained untreated. Two control groups were included as well, sham-opened and putrescine-treated group. The following plasma parameters: ALT, AST, γ-GT, ALP, bilirubin, bile acids, as well as liver malondialdehyde and polyamine concentration and the activity of enzymes involved in polyamine metabolism were studied. After BDL, significant alterations in plasma biochemical parameters occurred, where a 9-day putrescine treatment significantly alleviated liver function deterioration. Putrescine also increased liver polyamines’ concentrations and polyamine and diamine oxidase activities in rats submitted to BDL. Our results demonstrated, for the first time, that putrescine plays an important role in preserving liver tissue function in rats with experimentally induced cholestasis.

Background: Post-operative atrial fibrillation (POAF) is a frequent complication after cardiac surgery. It is associated with prolonged hospital stay, increased morbidity, mortality rate and economic costs. The aim of the study was to determine the association between the values of Galectin3 and N-terminal pro-B-type natriuretic peptide (NTproBNP) with POAF after cardiac surgery. Methods: A prospective study enrolled patients aged 18-85 years old admitted due to elective coronary artery bypass graft surgery (CABG) or CABG + aortic valve replacement. The plasma Galectin-3 and NT-proBNP levels were measured one day before surgery postoperative days 1 and 7. Results: The study included a total of 103 patients. POAF was registered in 45 patients. The mean age of patients in whom POAF occurred was 68.8 years, while other patients' mean age was 65.5 years (p=0.028). Patients with POAF did not differ from the group without POAF in the values of Galectin-3 and NT-proBNP preoperatively as well as on the first and seventh postoperative days. Changes in Galectin-3 levels on the first postoperative day had statistically significant value for predicting POAF (AUC=0.627 0.509-0.745 , p<0.05). Decrease in Galectin-3 level con centration on the first postoperative day over 17% increases the risk of developing AF. Conclusions: Preoperative values of Galectin-3 and NTproBNP are not associated with POAF development after cardiac surgery.

Background and Objectives: Coronary artery bypass graft (CABG) surgery is the most common cardiac surgery. One of the main causes of postoperative complications and increased mortality after CABG is the inflammatory response. The aim of this study was to investigate whether continuous intraoperative dexmedetomidine can reduce the increase of IL-6 and other inflammatory markers after CABG surgery. Materials and Methods: The study is registered with ClinicalTrials.gov, NCT06378827, accessed on 23 April 2024. This prospective experimental study was conducted from April to December 2024 and included 100 patients undergoing CABG surgery. Patients in the experimental group (50 patients) received a continuous infusion of dexmedetomidine (0.5 μg/kg/h) from anesthesia induction until the end of surgery, while the patients in the control group (50 patients) received the same volume of saline. The primary outcomes were the changes in the values of interleukin-6 (IL-6), C-reactive protein (CRP), white blood cells (WBC), and fibrinogen on the first postoperative day (POD1) compared to the basal, preoperative values. Results: The patients in the control group were on average 65.26 years old, and the patients in the experimental group were 66.28 years old (p = 0.555). From the control group, 40 (80%) patients were male compared to 37 (74%) patients from the experimental group (p = 0.635). Median IL-6 before surgery was 2.0 pg/mL, while on POD 1 it was 76.2 pg/mL (p < 0.001). Median CRP before surgery was 2.5 mg/dL, while the POD1 value was 45.5 mg/dL (p < 0.001). Median WBC values were 6.7 × 10⁹/L before surgery and 13.6 × 10⁹/L on POD1 (p < 0.001). The average value of fibrinogen was 3.19 g/L before surgery, while on POD1 it was 3.37 g/L (p = 0.024). The increase in IL-6 on POD1 (ΔIL-6) was 72.4 pg/mL in the control group and 73.0 pg/mL in the experimental group (p = 0.427). ΔCRP was 41.2 mg/mL (control group) and 38.0 mg/mL (experimental group) (p = 0.725). ΔWBC was 7.45 × 10⁹/L (control group) and 6.81 × 10⁹/L (experimental group) (p = 0.407). Δfibrinogen was 0.16 g/L (control group) and 0.2 g/L (experimental group) (p = 0.771). Conclusions: Intraoperative administration of dexmedetodine during CABG surgery at a dose of 0.5 µg/kg/h without a loading dose does not lead to a decrease in the intensity of the inflammatory response after surgery.

Background: The lockdown and other measures for coronavirus disease 2019 (COVID-19) prevention have presented an enormous burden on healthcare systems, causing reorganization in work and lowering the number of elective hospitalizations, along with a consequent reduction in hospital-acquired infections and bacteremia. The aim of this study was to examine the influence of the COVID-19 pandemic on the diagnosis and management of infective endocarditis (IE). Methods: The study included 111 patients admitted for IE from 1 January 2017 to 31 December 2021. They were divided in two groups chronologically according to the COVID-19 pandemic: the first group consisted of patients before the pandemic (n = 85), while the second group consisted of patients during the pandemic (n = 26). Results: Before the pandemic there were 2.26 ± 1.41 cases/month with diagnosis of IE, while during the pandemic there were only 1.14 ± 1.15 cases/month (p = 0.004). IE patients during the pandemic were younger (53 [41–65] vs. 68 [52–74] years; p < 0.05). A similar number of patients underwent surgical treatment before and during COVID-19 (53% vs. 67%; p = 0.210) and 30-day mortality was comparable (28% vs. 22%; p = 0.539). Conclusion: The COVID-19 pandemic and lockdown measures have led to a reduction in the number of patients with IE, although this change did not influence management strategies and mortality.

Background / aim. Alcohol is the most common cause of fatty liver. Alcohol metabolism takes place in the liver by alcohol dehydrogenase, to the toxic acetaldehyde, and aldehyde dehydrogenase with the presence of acetyl coenzyme A, to the acetate. This produces hydrogen, which is accepted by nicotinamide adenine dinucleotide. Consequently, the fatty acids accumulate in the liver. By daily intake of the amount greater than 80g /day for men and 20g for women, there is a risk for develop alcoholic fatty liver (AFLD). Foods low in protein and antioxidants, but rich in unsaturated fatty acids, increases the risk of developing the disease. The aim of this study is to determine the profile of atherogenic factors in plasma of patients with AFLD compared to patients with non-alcoholic fatty liver (NAFLD) and determine its diagnostic significance. Methods. The study followed a total holesterol (TC), triglycerides (TG), HDL-C, LDL-C and apoliporoteins (apoA1 and apoB). The ratios TC/HDL-C, ApoB/ApoA1 and LDL-C/HDL-C were determined. Results. The study included 74 AFLD patients (21% of women and 79% of men), mean age 42.65±9.73 years, who consumed alcoholic beverages daily in amounts of 80g,or greter, during an average 2.31±0.96 years and 70 patients with NAFLD (37% of women and 63% of men) with average 41.3±4.1 years. There was no significant difference in gender distribution and average age between examined groups. Higher values of TG 9.94±2.94, TC 14.53±2.81, LDL-C 8.57±2.15 mmol/l and apolipoprotein B 3.97±0.28 g/l and lower values of HDL-C 0.43±0.11 mmol/l, apolipoprotein A1 0.49±0.09 g/l and apoB/apoA1 ratio 2.43±1.27 were registered in AFLD compared to NAFLD, TG 8.74±2.54 mmol/l TC 9.87±2.36, LDL-C 6.72±1.98 mmol/l, apolipoprotein B 2.38±0.16 g/l, HDL-C 0.78±0.09 mmol/l, apolipoprotein A1 0.98±0.04 g/l and apoB/apoA1 ratio 7.81±1.42. There were no differences in albumin concentration, INR and blood count parameters between groups. Conclusion. The lipids and apoB/apoA1 relation, besides markers of hepatocelular damage, can serve as a diagnostic criteria for the presence of AFLD, and as a better indicator of atherogenic risk.

Objective: The aim of this study was to evaluate the impact of chronic kidney disease (CKD) on clinical presentation, laboratory parameters, ECG, and echocardiographic features of patients with chronic heart failure (CHF). Methods: This retrospective cross-sectional study included 2227 patients hospitalized in a tertiary care center due to CHF. Patients were divided into two groups based on the presence of CKD, defined as eGFR < 60 mL/min/1.73 m². Demographic, clinical, laboratory, and echocardiographic data were collected for all patients. Comparative analyses were performed to assess differences in cardiovascular risk factors, comorbidities, laboratory parameters, and echocardiographic findings between the two groups. Results: The proportion of men was significantly higher in the non-CKD group, whereas women predominated in the CKD group (p < 0.001). Dyspnea, orthopnea, leg swelling, claudication, and expectoration were significantly more frequent in patients with CKD, while chest pain and palpitations were more common in the non-CKD group (all p < 0.05). A significant difference in the distribution of NYHA functional classes was observed between the groups (p < 0.001), with NYHA class IV being more prevalent in the CKD group and classes II and III more frequent in the non-CKD group. Levels of CRP and NT-proBNP were significantly higher in the CKD group (p < 0.001). In-hospital mortality was 2.5-fold higher in patients with CKD (28.6% vs. 11.1%; p < 0.001). Conclusions: Coexistence of CKD was associated with a more severe clinical presentation, advanced functional limitation, and a distinct laboratory and echocardiographic profile in CHF patients.