Platelet-activating factor receptor (PAF-R)-dependent pathways control tumour growth and tumour response to chemotherapy

Abstract Background Phagocytosis of apoptotic cells by macrophages induces a suppressor phenotype. Previous data from our group suggested that this occurs via Platelet-activating factor receptor (PAF-R)-mediated pathways. In the present study, we investigated the impact of apoptotic cell inoculation or induction by a chemotherapeutic agent (dacarbazine, DTIC) on tumour growth, microenvironmental parameters and survival, and the effect of treatment with a PAF-R antagonist (WEB2170). These studies were performed in murine tumours: Ehrlich Ascitis Tumour (EAT) and B16F10 melanoma. Methods Tumour growth was assessed by direct counting of EAT cells in the ascitis or by measuring the volume of the solid tumour. Parameters of the tumour microenvironment, such as the frequency of cells expressing cyclo-oxygenase-2 (COX-2), caspase-3 and galectin-3, and microvascular density, were determined by immunohistochemistry. Levels of vascular endothelium growth factor (VEGF) and prostaglandin E2 (PGE2) were determined by ELISA, and levels of nitric oxide (NO) by Griess reaction. PAF-R expression was analysed by immunohistochemistry and flow cytometry. Results Inoculation of apoptotic cells before EAT implantation stimulated tumour growth. This effect was reversed by in vivo pre-treatment with WEB2170. This treatment also reduced tumour growth and modified the microenvironment by reducing PGE2, VEGF and NO production. In B16F10 melanoma, WEB2170 alone or in association with DTIC significantly reduced tumour volume. Survival of the tumour-bearing mice was not affected by WEB2170 treatment but was significantly improved by the combination of DTIC with WEB2170. Tumour microenvironment elements were among the targets of the combination therapy since the relative frequency of COX-2 and galectin-3 positive cells and the microvascular density within the tumour mass were significantly reduced by treatment with WEB2170 or DTIC alone or in combination. Antibodies to PAF-R stained the cells from inside the tumour, but not the tumour cells grown in vitro. At the tissue level, a few cells (probably macrophages) stained positively with antibodies to PAF-R. Conclusions We suggest that PAF-R-dependent pathways are activated during experimental tumour growth, modifying the microenvironment and the phenotype of the tumour macrophages in such a way as to favour tumour growth. Combination therapy with a PAF-R antagonist and a chemotherapeutic drug may represent a new and promising strategy for the treatment of some tumours.

A new conceptual model of nitrification: A key factor in resolving the metabolic state of the ocean

Máster en Oceanografía

La radiación como factor determinante en la temperatura interior de los edificios en Canarias

Máster Universitario en Eficiencia Energética (SIANI)

Multi-pollutants impact on modern cement built heritage

It is well known that the deposition of gaseous pollutants and aerosols plays a major role in causing the deterioration of monuments and built cultural heritage in European cities. Despite of many studies dedicated to the environmental damage of cultural heritage, in case of cement mortars, commonly used in the 20th century architecture, the deterioration due to air multipollutants impact, especially the formation of black crusts, is still not well explored making this issue a challenging area of research. This work centers on cement mortars – environment interactions, focusing on the diagnosis of the damage on the modern built heritage due to air multi-pollutants. For this purpose three sites, exposed to different urban areas in Europe, were selected for sampling and subsequent laboratory analyses: Centennial Hall, Wroclaw (Poland), Chiesa dell'Autostrada del Sole, Florence (Italy), Casa Galleria Vichi, Florence (Italy). The sampling sessions were performed taking into account the height from the ground level and protection from rain run off (sheltered, partly sheltered and exposed areas). The complete characterization of collected damage layer and underlying materials was performed using a range of analytical techniques: optical and scanning electron microscopy, X ray diffractometry, differential and gravimetric thermal analysis, ion chromatography, flash combustion/gas chromatographic analysis, inductively coupled plasma-optical emission spectrometer. The data were elaborated using statistical methods (i.e. principal components analyses) and enrichment factor for cement mortars was calculated for the first time. The results obtained from the experimental activity performed on the damage layers indicate that gypsum, due to the deposition of atmospheric sulphur compounds, is the main damage product at surfaces sheltered from rain run-off at Centennial Hall and Casa Galleria Vichi. By contrast, gypsum has not been identified in the samples collected at Chiesa dell'Autostrada del Sole. This is connected to the restoration works, particularly surface cleaning, regularly performed for the maintenance of the building. Moreover, the results obtained demonstrated the correlation between the location of the building and the composition of the damage layer: Centennial Hall is mainly undergoing to the impact of pollutants emitted from the close coal power stations, whilst Casa Galleria Vichi is principally affected by pollutants from vehicular exhaust in front of the building.

Development of an experiment for ultrahigh-precision g-factor

Die vorliegende Arbeit befasst sich mit der Entwicklung und dem Aufbau eines Experiments zur hochpräzisen Bestimmung des g-Faktors gebundener Elektronen in hochgeladenen Ionen. Der g-Faktor eines Teilchens ist eine dimensionslose Konstante, die die Stärke der Wechselwirkung mit einem magnetischen Feld beschreibt. Im Falle eines an ein hochgeladenes Ion gebundenen Elektrons, dient es als einer der genausten Tests der Quantenelektrodynamik gebundener Zustande (BS-QED). Die Messung wird in einem dreifach Penning-Fallen System durchgeführt und basiert auf dem kontinuierlichen Stern-Gerlach-Effekt. Der erste Teil dieser Arbeit gibt den aktuellen Wissensstand über magnetische Momente wieder. Der hier gewählte experimentelle Aufbau wird begründet. Anschließend werden die experimentellen Anforderungen und die verwendeten Messtechniken erläutert. Das Ladungsbrüten der Ionen - einer der wichtigsten Aufgaben dieser Arbeit - ist dargestellt. Seine Realisierung basiert auf einer Feld-Emissions-Spitzen-Anordnung, die die Messung des Wirkungsquerschnitts für Elektronenstoßionisation ermöglicht. Der letzte Teil der Arbeit widmet sich der Entwicklung und dem Aufbau des Penning-Fallen Systems, sowie der Implementierung des Nachweisprozesses. Gegenwärtig ist der Aufbau zur Erzeugung hochgeladener Ionen und der dazugehörigen Messung des g-Faktors abgeschlossen, einschließlich des Steuerprogramms für die erste Datennahme. Die Ionenerzeugung und das Ladungsbrüten werden die nächsten Schritte sein.

The impact of polymorphisms in P-gp, DNA repair and folic acid metabolism genes in newly diagnosed multiple myeloma patients treated with thalidomide plus dexamethasone, with or without bortezomib

The principle aim of this study was to investigate biological predictors of response and resistance to multiple myeloma treatment. Two hypothesis had been proposed as responsible of responsiveness: SNPs in DNA repair and Folate pathway, and P-gp dependent efflux. As a first objective, panel of SNPs in DNA repair and Folate pathway genes, were analyzed. It was a retrospective study in a group of 454, previously untreated, MM patients enrolled in a randomized phase III open-label study. Results show that some SNPs in Folate pathway are correlated with response to MM treatment. MTR genotype was associated with favorable response in the overall population of MM patients. However, this relation, disappear after adjustment for treatment response. When poor responder includes very good partial response, partial response and stable/progressive disease MTFHR rs1801131 genotype was associated with poor response to therapy. This relation - unlike in MTR – was still significant after adjustment for treatment response. Identification of this genetic variant in MM patients could be used as an independent prognostic factor for therapeutic outcome in the clinical practice. In the second objective, basic disposition characteristics of bortezomib was investigated. We demonstrated that bortezomib is a P-gp substrate in a bi-directional transport study. We obtain apparent permeability rate values that together with solubility values can have a crucial implication in better understanding of bortezomib pharmacokinetics with respect to the importance of membrane transporters. Subsequently, in view of the importance of P-gp for bortezomib responsiveness a panel of SNPs in ABCB1 gene - coding for P-gp - were analyzed. In particular we analyzed five SNPs, none of them however correlated with treatment responsiveness. However, we found a significant association between ABCB1 variants and cytogenetic abnormalities. In particular, deletion of chromosome 17 and t(4;14) translocation were present in patients harboring rs60023214 and rs2038502 variants respectively.

Analysis of the Slow Food movement impact on the farmers and rural areas’ sustainable development

The evaluation of the farmers’ communities’ approach to the Slow Food vision, their perception of the Slow Food role in supporting their activity and their appreciation and expectations from participating in the event of Mother Earth were studied. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was adopted in an agro-food sector context. A survey was conducted, 120 questionnaires from farmers attending the Mother Earth in Turin in 2010 were collected. The descriptive statistical analysis showed that both Slow Food membership and participation to Mother Earth Meeting were much appreciated for the support provided to their business and the contribution to a more sustainable and fair development. A positive social, environmental and psychological impact on farmers also resulted. Results showed also an interesting perspective on the possible universality of the Slow Food and Mother Earth values. Farmers declared that Slow Food is supporting them by preserving the biodiversity and orienting them to the use of local resources and reducing the chemical inputs. Many farmers mentioned the language/culture and administration/bureaucratic issues as an obstacle to be a member in the movement and to participate to the event. Participation to Mother Earth gives an opportunity to exchange information with other farmers’ communities and to participate to seminars and debates, helpful for their business development. The absolute majority of positive answers associated to the farmers’ willingness to relate to Slow Food and participate to the next Mother Earth editions negatively influenced the UTAUT model results. A factor analysis showed that the variables associated to the UTAUT model constructs Performance Expectancy and Effort Expectancy were consistent, able to explain the construct variability, and their measurement reliable. Their inclusion in a simplest Technology Acceptance Model could be considered in future researches.

The impact of cardiac rehabilitation on lifestyles, psychological correlates and the clinical course of cardiac disease

Objectives: The aim of this research was to evaluate the impact of Cardiac Rehabilitation (CR) on risky lifestyles, quality of life, psychopathology, psychological distress and well-being, considering the potential moderating role of depression, anxiety and psychosomatic syndromes on lifestyles modification. The influence of CR on cardiac morbidity and mortality was also evaluated. Methods: The experimental group (N=108), undergoing CR, was compared to a control group (N=85) of patients affected by cardiovascular diseases, not undergoing CR, at baseline and at 1-month, 6- and 12-months follow-ups. The assessment included: the Structured Clinical Interview for DSM-IV, the structured interview based on Diagnostic Criteria for Psychosomatic Research (DCPR), GOSPEL questionnaire on lifestyles, Pittsburgh Sleep Quality Index, Morisky Medication Adherence Scale, MOS 36-Item Short Form Health Survey, Symptom Questionnaire, Psychological Well-Being Scale and 14-items Type D Scale. Results: Compared to the control group, CR was associated to: maintenance of the level of physical activity, improvement of correct dietary behaviors and stress management, enhancement of quality of life and sleep; reduction of the most frequently observed psychiatric diagnoses and psychosomatic syndromes at baseline. On the contrary, CR was not found to be associated with: healthy dietary habits, weight loss and improvement on medications adherence. In addition, there were no relevant effects on sub-clinical psychological distress and well-being, except for personal growth and purpose in life (PWB). Also, CR did not seem to play a protective role against cardiac recurrences. The presence of psychosomatic syndromes and depressive disorders was a mediating factor on the modification of specific lifestyles. Conclusions: The findings highlight the need of a psychosomatic assessment and an evaluation of psychological sub-clinical symptomatology in cardiac rehabilitation, in order to identify and address specific factors potentially associated with the clinical course of the heart disease.

An interferon regulatory factor element controls the major immune modulator of murine cytomegalovirus

Immune modulation by herpesviruses, such as cytomegalovirus, is critical for the establishment of acute and persistent infection confronting a vigorous antiviral immune response of the host. Therefore, the action of immune-modulatory proteins has long been the subject of research, with the final goal to identify new strategies for antiviral therapy.rnIn the case of murine cytomegalovirus (mCMV), the viral m152 protein has been identified to play a major role in targeting components of both the innate and the adaptive immune system in terms of infected host-cell recognition in the effector phase of the antiviral immune response. On the one hand, it inhibits cell surface expression of RAE-1 and thereby prevents ligation of the activating natural killer (NK)-cell receptor NKG2D. On the other hand, it decreases cell surface expression of peptide-loaded MHC class I molecules thereby preventing antigen presentation to CD8 T cells. Ultimately, the outcome of CMV infection is determined by the interplay between viral and cellular factors.rnIn this context, the work presented here has revealed a novel and intriguing connection between viral m152 and cellular interferon (IFN), a key cytokine of the immune system: rnthe m152 promoter region contains an interferon regulatory factor element (IRFE) perfectly matching the consensus sequence of cellular IRFEs.rnThe biological relevance of this regulatory element was first suggested by sequence comparisons revealing its evolutionary conservation among various established laboratory strains of mCMV and more recent low-passage wild-derived virus isolates. Moreover, search of the mCMV genome revealed only three IRFE sites in the complete sequence. Importantly, the functionality of the IRFE in the m152 promoter was confirmed with the use of a mutant virus, representing a functional deletion of the IRFE, and its corresponding revertant virus. In particular, m152 gene expression was found to be inhibited in an IRFE-dependent manner in infected cells. Essentially, this inhibition proved to have a severe impact on the immune-modulatory function of m152, first demonstrated by a restored direct antigen presentation on infected cells for CD8 T-cell activation. Even more importantly, this effect of IRFE-mediated IFN signaling was validated in vivo by showing that the protective antiviral capacity of adoptively-transferred, antigen-specific CD8 T cells is also significantly restored by the IRFE-dependent inhibition of m152. Somewhat curious and surprising, the decrease in m152 protein simultaneously prevented an enhanced activation of NK cells in acute-infected mice, apparently independent of the RAE-1/NKG2D ligand/receptor interaction but rather due to reduced ‘missing-self’ recognition.rnTaken together, this work presents a so far unknown mechanism of IFN signaling to control mCMV immune modulation in acute infection.rnrn

Sublethal effects of a common neonicotinoid pesticide, thiamethoxam, on honey bees: impact on locomotion and thermoregulation

Neonicotinoids have been pointed to as a factor responsible for the increased honey bee colony losses in the last decades. Many studies have investigated the effects of the first marketed neonicotinoid, imidacloprid, while fewer have focused on thiamethoxam. One recent study showed that sublethal doses of thiamethoxam lead to colony failure by decreasing forager homing flight success. We thus decided to investigate the mechanism which caused this phenomenon. Our hypothesis was that this effect was caused by impairment of forager locomotion abilities. Therefore we tested the effects of sublethal acute and chronic exposures to thiamethoxam on forager walking (Chapter 2) and flight (Chapter 3) performances. The acute treatment (1.34 ng/bee) affected walking locomotion firstly triggering hyperactivity (30 min post-treatment) and then impairing motor functioning (60 min post-treatment). 2-day continuous exposures to thiamethoxam (32.5, 45 ppb) elicited fewer effects on walking locomotion, however both exposure modes elicited an increased positive phototaxis. Similarly, in flight experiments, the single dose (1.34 ng/bee) elicited hyperactivity shortly after intoxication (increased flight duration and distance), while longer and continuous exposures (32.5, 45 ppb) impaired forager motor functions (decreased flight duration, distance, velocity). It is known that flight muscles temperature needs to be precisely regulated by bees during flight. Therefore, we further hypothesized that the impaired flight performances of neonicotinoid intoxicated bees were caused also by thermoregulation anomalies. We tested the effects that acute thiamethoxam exposures (0.2, 1, 2 ng/bee) elicit on forager thorax temperature (Chapter 4). Foragers treated with high doses exhibited hyperthermia or hypothermia when respectively exposed to high or low environmental temperatures. In summary, we show that sublethal doses of thiamethoxam affected forager walking and flight locomotion, phototaxis and thermoregulation. We also display the intricate mode of action of thiamethoxam which triggered, at different extents, inverse sublethal effects in relation to time and dose.

Die Rolle von Chemokinrezeptor CXCR4 und Connective Tissue Growth Factor innerhalb der Tumor-Stroma-Interaktion in der akuten myeloischen Leukämie

Die akute myeloische Leukämie (AML) ist eine heterogene Erkrankung der hämatopoetischen Vorläuferzelle, die durch unkontrollierte Vermehrung und ein reduziertes Differenzierungsverhalten gekennzeichnet ist. Aufgrund von Therapieresistenzen und häufig vorkommenden Rückfällen ist die AML mit einer schlechten Langzeitprognose verbunden. Neue Studienergebnisse zeigen, dass leukämische Zellen einer hierarchischen Ordnung unterliegen, an deren Spitze die leukämische Stammzelle (LSC) steht, welche den Tumor speist und ähnliche Charakteristika besitzt wie die hämatopoetische Stammzelle. Die LSC nutzt den Kontakt zu Zellen der hämatopoetischen Nische des Knochenmarks, um die erste Therapie zu überdauern und Resistenzen zu erwerben. Neue Therapieansätze versuchen diese Interaktion zwischen leukämischen Zellen und supportiv wirkenden Stromazellen anzugreifen. rnrnIn dieser Arbeit sollte die Bedeutung des CXC-Motiv Chemokinrezeptors Typ 4 (CXCR4) und des Connective Tissue Growth Factors (CTGF) innerhalb der AML-Stroma-Interaktion untersucht werden. CXCR4, der in vivo dafür sorgt, dass AML-Zellen in der Nische gehalten und geschützt werden, wurde durch den neuwertigen humanen CXCR4-spezifischen Antikörper BMS-936564/MDX-1338 in AML-Zelllinien und Patientenzellen in Zellkulturversuchen blockiert. Dies induzierte Apoptose sowie Differenzierung und führte in Kokulturversuchen zu einer Aufhebung des Stroma-vermittelten Schutzes gegenüber der Chemotherapie. Für diese Effekte musste teilweise ein sekundärer Antikörper verwendet werden, der die CXCR4-Moleküle miteinander kreuzvernetzt.rnDie Auswertung eines quantitativen Real time PCR (qPCR)-Arrays ergab, dass CTGF in der AML-Zelllinie Molm-14 nach Kontakt zu Stromazellen hochreguliert wird. Diese Hochregulation konnte in insgesamt drei AML-Zelllinien sowie in drei Patientenproben in qPCR- und Western Blot-Versuchen bestätigt werden. Weitere Untersuchungen zeigten, dass diese Hochregulation (i) unabhängig von der Stromazelllinie ist, (ii) den direkten Kontakt zum Stroma benötigt und (iii) auch unter hypoxischen Bedingungen, wie sie innerhalb des Knochenmarks vorherrschen, stattfindet. Der durch Zell-Zell- oder Zell-Matrix-Kontakt gesteuerte Hippo-Signalweg konnte aus folgenden Gründen als möglicher upstream-Regulationsmechanismus identifiziert werden: (i) Dessen zentraler Transkriptions-Kofaktor TAZ wurde in kokultivierten Molm-14-Zellen stabilisiert, (ii) der shRNA-gesteuerte Knockdown von TAZ führte zu einer reduzierten CTGF-Hochregulation, (iii) CTGF wurde in Abhängigkeit von der Zelldichte reguliert, (iv) Cysteine-rich angiogenic inducer 61 (Cyr61), ein weiteres Zielgen von TAZ, wurde in kokultivierten AML-Zellen ebenfalls verstärkt exprimiert. Der Knockdown von CTGF führte in vitro zu einer partiellen Aufhebung der Stroma-vermittelten Resistenz und die Blockierung von CTGF durch den Antikörper FG-3019 wirkte im AML-Mausmodell lebensverlängernd. rn rnDie Rolle von CTGF in der AML ist bisher nicht untersucht. Die vorliegenden Ergebnisse zeigen, dass CTGF ein interessantes Therapieziel in der AML darstellt. Es bedarf weiterer Untersuchungen, um die Bedeutung von CTGF in der Tumor-Stroma-Interaktion näher zu charakterisieren und nachgeschaltete Signalwege zu identifizieren.

Investigations on DNA methylation by Dnmt2 and impact of tRNA modifications on TLR7 stimulation

The incorporation of modified nucleotides into ribonucleic acids (RNAs) is important for their structure and proper function. These modifications are inserted by distinct catalytic macromolecules one of them being Dnmt2. It methylates the Cytidine (C) at position 38 in tRNA to 5-methylcytidine (m5C). Dnmt2 has been a paradigm in this respect, because all of its nearest neighbors in evolution are DNA-cytosine C5-methyltransferases and methylate DNA, while its (own) DNA methyltransferase activity is the subject of controversial reports with rates varying between zero and very weak. This work determines whether the biochemical potential for DNA methylation is present in the enzyme. It was discovered that DNA fragments, when presented as covalent RNA:DNA hybrids in the structural context of a tRNA, can be more efficiently methylated than the corresponding natural tRNA substrate. Additional minor deviations from a native tRNA structure that were seen to be tolerated by Dnmt2 were used for a stepwise development of a composite system of guide RNAs that enable the enzyme to perform cytidine methylation on single stranded DNA in vitro. Furthermore, a proof-of-principle is presented for utilizing the S-adenosyl methionine-analog cofactor SeAdoYn with Dnmt2 to search for new possible substrates in a SELEX-like approach.rnIn innate immunity, nucleic acids can function as pathogen associated molecular patterns (PAMPs) recognized by pattern recognition receptors (PRRs). The modification pattern of RNA is the discriminating factor for toll-like receptor 7 (TLR7) to distinguish between self and non-self RNA of invading pathogens. It was found that a 2'-O-methylated guanosine (Gm) at position18, naturally occurring at this position in some tRNAs, antagonizes recognition by TLR7. In the second part of this work it is pointed out, that recognition extends to the next downstream nucleotide and the effectively recognized molecular detail is actually a methylated dinucleotide. The immune silencing effect of the ribose methylation is most pronounced if the dinucleotide motif is composed of purin nucleobases whereas pyrimidines diminish the effect. Similar results were obtained when the Gm modification was transposed into other tRNA domains. Point mutations abolishing base pairings important for a proper tertiary structure had no effect on the immune stimulatory potential of a Gm modified tRNA. Taken together these results suggest a processive type of RNA inspection by TLR7.rn

Hepatoprotective effect of tumour necrosis factor alpha blockade in psoriatic arthritis: a cross-sectional study

Objective To evaluate the impact of tumour necrosis factor α (TNFα) blockers on the presence of liver fibrosis in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) treated with methotrexate (MTX). Methods Participants were consecutive patients with RA and PsA who had undergone MTX treatment for at least 1 year ± TNF blockade for over 6 months. Liver fibrosis was assessed using non-invasive transient elastography (FibroScan). Regression models were used to compare FibroScan values of patients with RA and patients with PsA receiving TNFα blockers with those who were not. Results FibroScan assessments were performed on 51 patients with RA and 43 patients with PsA. Compared to patients with RA, those with PsA were predominantly young men, received lower cumulative dosages of MTX and exhibited a higher incidence of liver steatosis and hyperlipidaemia. An abnormal result was observed in 7.1% of the anti-TNFα-naïve and in 13% of the anti-TNFα-treated patients in the RA group and in 30% of the anti-TNFα-naïve and 4.3% of the anti-TNFα-treated patients in the PsA group (OR=0.11, 95% CI 0.02 to 0.98). Results of the PsA group were robust when adjusted for baseline characteristics. Conclusion The results suggest a protective effect of TNFα inhibitors against the development of liver fibrosis in patients with PsA.

Impact of long-term corticosteroid therapy on the distribution pattern of lower limb atherosclerosis

OBJECTIVE: Ectopic calcification and mediacalcinosis can be promoted by corticosteroid use. Aim of the present investigation is to describe macrovascular disease features in patients with long-term corticosteroid therapy and symptomatic lower limb peripheral arterial occlusive disease (PAD). METHODS: A consecutive series of 2783 patients undergoing clinical and angiographic work-up of PAD were screened for long-term (>5 years) corticosteroid use (group A). Comparison was performed to a randomly selected age-, sex- and risk factor-matched PAD control cohort from the same series without corticosteroid use (group B). Patients with diabetes mellitus or severe renal failure were excluded. Arterial calcification was evaluated by qualitative assessment on radiographic images. Severity of atherosclerotic lesions was analysed from angiographic images using a semi-quantitative score (Bollinger score). RESULTS: In general, 12 patients (5 males, mean age 78.5 +/- 9.0 years) with 15 ischaemic limbs qualified to be enrolled in group A and were compared to 23 matching control patients (6 2 males, mean age 79.5 +/- 6 years) with 32 ischaemic limbs. Incompressibility of ankle arteries determined by measurement of the ankle-brachial index was seen in 12 limbs (80%) in group A compared to 3 limbs (9%) in group B (p = 0.0009). No significant difference was found comparing group A and B for segmental calcification, whereas comparison of the atherosclerotic burden using the angiographic severity score showed a significantly higher score at the infragenicular arterial level in group A (p = 0.001). CONCLUSION: Findings suggest that the long-term corticosteroid therapy is associated with a distally accentuated, calcifying peripheral atherosclerosis inducing arterial incompressibility. This occlusion pattern is comparable to patients with renal failure or diabetes. Further research is required to support our observations.

Impact of obesity on venous hemodynamics of the lower limbs

Obesity is a risk factor for chronic venous insufficiency and venous thromboembolism. The aim of this study was to compare venous flow parameters of the lower limbs assessed by duplex ultrasound scanning in obese and nonobese individuals according to body mass index (BMI).