Early and One-Year Stroke Case Fatality in Sao Paulo, Brazil: Applying the World Health Organization's Stroke STEPS

Case fatality rate is considered a main determinant of stroke mortality trends. We applied the World Health Organization's Stroke STEPS to identify case fatality rates in a community hospital in Brazil. We evaluated all patients with first-ever stroke seeking acute care at the hospital's emergency ward between April 2006 and December 2008 to verify early and late case fatality according to stroke subtype. We used years of formal education as a surrogate for socioeconomic status. Of 430 first-ever stroke events, 365 (84.9%) were ischemic and 65 (15.1%) were intracerebral hemorrhage. After 1 year, we adjudicated 108 deaths (86 ischemic; 22 hemorrhagic). Age-adjusted case fatality rates for ischemic stroke and intracerebral hemorrhage were 6.0% v 19.8% at 10 days, 10.6% v 22.1% at 28 days, 17.6% v 29.1% at 6 months, and 21.0% v 31.5% at 1 year. Illiteracy or no formal education was a predictor of death at 6 months (odds ratio [OR], 4.31; 95% confidence interval [CI] 1.34-13.91) and 1 year (OR, 4.21; 95% CI, 1.45-12.28) in patients with ischemic stroke, as well as at 6 months (OR, 3.19; 95% CI, 1.17-8.70) and 1 year (OR, 3.30; 95% CI, 1.30-8.45) for all stroke patients. Other variables, including previous cardiovascular risk factors and acute medical care, did not change this association to a statistically significant degree. In conclusion, case fatality, particularly up to 6 months, was higher in hemorrhagic stroke, and lack of formal education was associated with increased stroke mortality.

How far can we go in simplifying biomonitoring assessments? An integrated analysis of taxonomic surrogacy, taxonomic sufficiency and numerical resolution in a megadiverse region

The need for biodiversity conservation is increasing at a rate much faster than the acquisition of knowledge of biodiversity, such as descriptions of new species and mapping species distributions. As global changes are winning the race against the acquisition of knowledge, many researchers resort to the use of surrogate groups to aid in conservation decisions. Reductions in taxonomic and numerical resolution are also desirable, because they could allow more rapid the acquisition of knowledge while requiring less effort, if little important information is lost. In this study, we evaluated the congruence among 22 taxonomic groups sampled in a tropical forest in the Amazon basin. Our aim was to evaluate if any of these groups could be used as surrogates for the others in monitoring programs. We also evaluated if the taxonomic or numerical resolution of possible surrogates could be reduced without greatly reducing the overall congruence. Congruence among plant groups was high, whereas the congruence among most animal groups was very low, except for anurans in which congruence values were only slightly lower than for plants. Liana (Bignoniaceae) was the group with highest congruence, even using genera presence-absence data. The congruence among groups was related to environmental factors, specifically the clay and phosphorous contents of soil. Several groups showed strong spatial clumping, but this was unrelated to the congruence among groups. The high degree of congruence of lianas with the other groups suggests that it may be a reasonable surrogate group, mainly for the other plant groups analyzed, if soil data are not available. Although lianas are difficult to count and identify, the number of studies on the ecology of lianas is increasing. Most of these studies have concluded that lianas are increasing in abundance in tropical forests. In addition to the high congruence, lianas are worth monitoring in their own right because they are sensitive to global warming and the increasing frequency and severity of droughts in tropical regions. Our findings suggest that the use of data on surrogate groups with relatively low taxonomic and numerical resolutions can be a reliable shortcut for biodiversity assessments, especially in megadiverse areas with high rates of habitat conversion, where the lack of biodiversity knowledge is pervasive. (c) 2012 Elsevier Ltd. All rights reserved.

Cross-taxon congruence of alpha and beta diversity among five leaf litter arthropod groups in Colombia

In this study alpha and beta diversity patterns of five leaf litter arthropod groups (ants, predatory ants, oribatid mites, spiders and other arachnids) were described and compared in 39 sampling patches of a transformed landscape in southwestern Colombia, that represented five vegetation types: secondary forest, riparian forest, giant bamboo forest, pasture and sugarcane crop. It was also assessed whether some taxa could be used as diversity surrogates. A total of 6,765 individuals grouped in 290 morphospecies were collected. Species richness in all groups was lower in highly transformed vegetation types (pasture, sugarcane crop) than in native ones (forests). In contrast, there were no clear tendencies of beta diversity among vegetation types. Considering sampling patches, 0.1-42% of the variation in alpha diversity of one taxonomic group could be explained from the alpha diversity of another, and 0.2-33% of the variation of beta diversity of a given taxon was explained by that in other groups. Contrary to recent findings, we concluded that patterns of alpha diversity are more congruent than patterns of beta diversity. This fact could be attributed to a sampling effect that promotes congruence in alpha diversity and to a lack of a clear regional ecological gradient that could promote congruent patterns of beta diversity. We did not find evidence for an ideal diversity surrogate although diversity patterns of predatory ants had the greatest congruencies. These results support earlier multi-taxon evaluations in that conservation planning should not be based on only one leaf litter arthropod group.

Blood transfusion in cardiac surgery is a risk factor for increased hospital length of stay in adult patients

Abstract Background Allogeneic red blood cell (RBC) transfusion has been proposed as a negative indicator of quality in cardiac surgery. Hospital length of stay (LOS) may be a surrogate of poor outcome in transfused patients. Methods Data from 502 patients included in Transfusion Requirements After Cardiac Surgery (TRACS) study were analyzed to assess the relationship between RBC transfusion and hospital LOS in patients undergoing cardiac surgery and enrolled in the TRACS study. Results According to the status of RBC transfusion, patients were categorized into the following three groups: 1) 199 patients (40%) who did not receive RBC, 2) 241 patients (48%) who received 3 RBC units or fewer (low transfusion requirement group), and 3) 62 patients (12%) who received more than 3 RBC units (high transfusion requirement group). In a multivariable Cox proportional hazards model, the following factors were predictive of a prolonged hospital length of stay: age higher than 65 years, EuroSCORE, valvular surgery, combined procedure, LVEF lower than 40% and RBC transfusion of > 3 units. Conclusion RBC transfusion is an independent risk factor for increased LOS in patients undergoing cardiac surgery. This finding highlights the adequacy of a restrictive transfusion therapy in patients undergoing cardiac surgery. Trial registration Clinicaltrials.gov identifier: http://NCT01021631.

Hierarquias reprodutivas: maternidade e desigualdades no exercício de direitos humanos pelas mulheres

A partir da concepção contemporânea de direitos humanos, o texto discute os direitos reprodutivos e o exercício da maternidade. Após histórico e definição dos direitos reprodutivos e dos direitos sexuais, o artigo trata da maternidade voluntária, segura, socialmente amparada e prazerosa, para propor uma reflexão sobre 'hierarquias reprodutivas'. Defende-se que diferentes aspectos das mães - tal como raça, classe social, idade e parceria sexual - determinam a legitimidade e aceitação social destas maternidades, e, portanto, suas vivências. Quanto maior o número de aspectos 'negativos' presentes na mulher (ou casal) ao exercitar a maternidade e/ou a reprodução e cuidado com os filhos, mais próxima da base da pirâmide hierárquica estará e, ainda, maior dificuldade encontrará no exercício de seus direitos humanos. O texto conclui que são necessárias políticas públicas de suporte social à maternidade para as mulheres que assim escolham, indistintamente, visando promover o exercício de seus direitos humanos.

Gender dimorphism in skeletal muscle leptin receptors, serum leptin and insulin sensitivity

[EN] To determine if there is a gender dimorphism in the expression of leptin receptors (OB-R170, OB-R128 and OB-R98) and the protein suppressor of cytokine signaling 3 (SOCS3) in human skeletal muscle, the protein expression of OB-R, perilipin A, SOCS3 and alpha-tubulin was assessed by Western blot in muscle biopsies obtained from the m. vastus lateralis in thirty-four men (age = 27.1+/-6.8 yr) and thirty-three women (age = 26.7+/-6.7 yr). Basal serum insulin concentration and HOMA were similar in both genders. Serum leptin concentration was 3.4 times higher in women compared to men (P<0.05) and this difference remained significant after accounting for the differences in percentage of body fat or soluble leptin receptor. OB-R protein was 41% (OB-R170, P<0.05) and 163% (OB-R128, P<0.05) greater in women than men. There was no relationship between OB-R expression and the serum concentrations of leptin or 17beta-estradiol. In men, muscle OB-R128 protein was inversely related to serum free testosterone. In women, OB-R98 and OB-R128 were inversely related to total serum testosterone concentration, and OB-R128 to serum free testosterone concentration. SOCS3 protein expression was similar in men and women and was not related to OB-R. In women, there was an inverse relationship between the logarithm of free testosterone and SCOS3 protein content in skeletal muscle (r = -0.46, P<0.05). In summary, there is a gender dimorphism in skeletal muscle leptin receptors expression, which can be partly explained by the influence of testosterone. SOCS3 expression in skeletal muscle is not up-regulated in women, despite very high serum leptin concentrations compared to men. The circulating form of the leptin receptor can not be used as a surrogate measure of the amount of leptin receptors expressed in skeletal muscles.

Assessment of the initial state of two reserves, Micro áreas Ecoturísticas Litorales (MAEL), in Gran Canaria, Canary Islands

Máster en Oceanografía

Studio e sviluppo di un motore a 2 tempi diesel veloce di nuova concezione per applicazioni automobilistiche

The Department of Mechanical and Civil Engineering (DIMeC) of the University of Modena and Reggio Emilia is developing a new type of small capacity HSDI 2-Stroke Diesel engine (called HSD2), featuring a specifically designed combustion system, aimed to reduce weight, size and manufacturing costs, and improving pollutant emissions at partial load. The present work is focused on the analysis of the combustion and the scavenging process, investigated by means of a version of the KIVA-3V code customized by the University of Chalmers and modified by DIMeC. The customization of the KIVA-3V code includes a detailed combustion chemistry approach, coupled with a comprehensive oxidation mechanism for diesel oil surrogate and the modeling of turbulence/chemistry interaction through the PaSR (Partially Stirred Reactor) model. A four stroke automobile Diesel engine featuring a very close bore size is taken as a reference, for both the numerical models calibration and for a comparison with the 2-Stroke engine. Analysis is carried out trough a comparison between HSD2 and FIAT 1300 MultiJet in several operating conditions, at full and partial load. Such a comparison clearly demonstrates the effectiveness of the two stroke concept in terms of emissions reduction and high power density. However, HSD2 is still a virtual engine, and experimental results are needed to assume the reliability of numerical results.

Beiträge zur Steuerung und Analyse von technischen Bearbeitungssystemen mit Methoden der nichtlinearen Zeitreihenanalyse

Die Nichtlineare Zeitreihenanalyse konnte in den letzten Jahren im Rahmen von Laborexperimenten ihre prinzipelle Brauchbarkeit beweisen. Allerdings handelte es sich in der Regel um ausgewählte oder speziell konstruierte nichtlineare Systeme. Sieht man einmal von der Überwachung von Prozessen und Produkten ab, so sind Anwendungen auf konkrete, vorgegebene dynamische Probleme im industriellen Bereich kaum bekannt geworden. Ziel dieser Arbeit war es, an Hand von zwei Problemen aus der technischen Praxis zu untersuchen, ob die Anwendung des kanonischen Schemas der Nichtlinearen Zeitreihenanalyse auch dort zu brauchbaren Resultaten führt oder ob Modifikationen (Vereinfachungen oder Erweiterungen) notwendig werden. Am Beispiel der Herstellung von optischen Oberflächen durch Hochpräzisionsdrehbearbeitung konnte gezeigt werden, daß eine aktive Störungskompensation in Echtzeit mit einem speziell entwickelten nichtlinearen Vorhersagealgorithmus möglich ist. Standardverfahren der Nichtlinearen Zeitreihenanalyse beschreiten hier den allgemeinen, aber sehr aufwendigen Weg über eine möglichst vollständige Phasenraumrekonstruktion. Das neue Verfahren verzichtet auf viele der kanonischen Zwischenschritte. Dies führt zu einererheblichen Rechenzeitersparnis und zusätzlich zu einer wesentlich höheren Stabilität gegenüber additivem Meßrauschen. Mit den berechneten Vorhersagen der unerwünschten Maschinenschwingungen wurde eine Störungskompensation realisiert, die die Oberflächengüte des bearbeiteten Werkstücks um 20-30% verbesserte. Das zweite Beispiel betrifft die Klassifikation von Körperschallsignalen, die zur Überwachung von Zerspansprozessen gemessen werden. Diese Signale zeigen, wie auch viele andere Prozesse im Bereich der Produktion, ein hochgradig nichtstationäres Verhalten. Hier versagen die Standardverfahren der Nichtlinearen Datenanalyse, die FT- bzw. AAFT-Surrogate benutzen. Daher wurde eine neue Klasse von Surrogatdaten zum Testen der Nullhypothese nichtstationärer linearer stochastischer Prozesse entwickelt, die in der Lage ist, zwischen deterministischen nichtlinear chaotischen und stochastischen linearen nichtstationären Zeitreihen mit change points zu unterscheiden. Damit konnte gezeigt werden, daß die untersuchten Köperschallsignale sich statistisch signifikant einer nichtstationären stochastischen Folge von einfachen linearen Prozessen zuordnen lassen und eine Interpretation als nichtlineare chaotische Zeitreihe nicht erforderlich ist.

Tecniche avanzate per l'analisi di sensitività globale: applicazione alla contaminazione delle acque sotterranee.

The thesis is framed within the field of the stochastic approach to flow and transport themes of solutes in natural porous materials. The methodology used to characterise the uncertainty associated with the modular predictions is completely general and can be reproduced in various contexts. The theme of the research includes the following among its main objectives: (a) the development of a Global Sensitivity Analysis on contaminant transport models in the subsoil to research the effects of the uncertainty of the most important parameters; (b) the application of advanced techniques, such as Polynomial Chaos Expansion (PCE), for obtaining surrogate models starting from those which conduct traditionally developed analyses in the context of Monte Carlo simulations, characterised by an often not negligible computational burden; (c) the analyses and the understanding of the key processes at the basis of the transport of solutes in natural porous materials using the aforementioned technical and analysis resources. In the complete picture, the thesis looks at the application of a Continuous Injection transport model of contaminants, of the PCE technique which has already been developed and applied by the thesis supervisors, by way of numerical code, to a Slug Injection model. The methodology was applied to the aforementioned model with original contribution deriving from surrogate models with various degrees of approximation and developing a Global Sensitivity Analysis aimed at the determination of Sobol’ indices.

From fall-risk assessment to fall detection: inertial sensors in the clinical routine and daily life

Falls are caused by complex interaction between multiple risk factors which may be modified by age, disease and environment. A variety of methods and tools for fall risk assessment have been proposed, but none of which is universally accepted. Existing tools are generally not capable of providing a quantitative predictive assessment of fall risk. The need for objective, cost-effective and clinically applicable methods would enable quantitative assessment of fall risk on a subject-specific basis. Tracking objectively falls risk could provide timely feedback about the effectiveness of administered interventions enabling intervention strategies to be modified or changed if found to be ineffective. Moreover, some of the fundamental factors leading to falls and what actually happens during a fall remain unclear. Objectively documented and measured falls are needed to improve knowledge of fall in order to develop more effective prevention strategies and prolong independent living. In the last decade, several research groups have developed sensor-based automatic or semi-automatic fall risk assessment tools using wearable inertial sensors. This approach may also serve to detect falls. At the moment, i) several fall-risk assessment studies based on inertial sensors, even if promising, lack of a biomechanical model-based approach which could provide accurate and more detailed measurements of interests (e.g., joint moments, forces) and ii) the number of published real-world fall data of older people in a real-world environment is minimal since most authors have used simulations with healthy volunteers as a surrogate for real-world falls. With these limitations in mind, this thesis aims i) to suggest a novel method for the kinematics and dynamics evaluation of functional motor tasks, often used in clinics for the fall-risk evaluation, through a body sensor network and a biomechanical approach and ii) to define the guidelines for a fall detection algorithm based on a real-world fall database availability.

Oxidation and pyrolysis of methane and methyl formate in a plug flow reactor: computational and experimenal studies

Biodiesel represents a possible substitute to the fossil fuels; for this reason a good comprehension of the kinetics involved is important. Due to the complexity of the biodiesel mixture a common practice is the use of surrogate molecules to study its reactivity. In this work are presented the experimental and computational results obtained for the oxidation and pyrolysis of methane and methyl formate conducted in a plug flow reactor. The work was divided into two parts: the first one was the setup assembly whilst, in the second one, was realized a comparison between the experimental and model results; these last was obtained using models available in literature. It was started studying the methane since, a validate model was available, in this way was possible to verify the reliability of the experimental results. After this first study the attention was focused on the methyl formate investigation. All the analysis were conducted at different temperatures, pressures and, for the oxidation, at different equivalence ratios. The results shown that, a good comprehension of the kinetics is reach but efforts are necessary to better evaluate kinetics parameters such as activation energy. The results even point out that the realized setup is adapt to study the oxidation and pyrolysis and, for this reason, it will be employed to study a longer chain esters with the aim to better understand the kinetic of the molecules that are part of the biodiesel mixture.

Development of strategies for vascular damage repair in Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a progressive and rare disease with so far unclear pathogenesis, limited treatment options and poor prognosis. Unbalance of proliferation and migration in pulmonary arterial smooth muscle cells (PASMCs) is an important hallmark of PAH. In this research Sodium butyrate (BU) has been evaluated in vitro and in vivo models of PAH. This histone deacetylase inhibitor (HDACi) counteracted platelet-derived growth factor (PDGF)-induced ki67 expression in PASMCs, and arrested cell cycle mainly at G0/G1 phases. Furthermore, BU reduced the transcription of PDGFRbeta, and that of Ednra and Ednrb, two major receptors in PAH progression. Wound healing and pulmonary artery ring assays indicated that BU inhibited PDGF-induced PASMC migration. BU strongly inhibited PDGF-induced Akt phosphorylation, an effect reversed by the phosphatase inhibitor calyculinA. In vivo, BU showed efficacy in monocrotaline-induced PAH in rats. Indeed, the HDACi reduced both thickness of distal pulmonary arteries and right ventricular hypertrophy. Besides these studies, Serial Analysis of Gene Expression (SAGE) has be used to obtain complete transcriptional profiles of peripheral blood mononuclear cells (PBMCs) isolated from PAH and Healthy subjects. SAGE allows quantitative analysis of thousands transcripts, relying on the principle that a short oligonucleotide (tag) can uniquely identify mRNA transcripts. Tag frequency reflects transcript abundance. We enrolled patients naïve for a specific PAH therapy (4 IPAH non-responder, 3 IPAH responder, 6 HeritablePAH), and 8 healthy subjects. Comparative analysis revealed that significant differential expression was only restricted to a hundred of down- or up-regulated genes. Interestingly, these genes can be clustered into functional networks, sharing a number of crucial features in cellular homeostasis and signaling. SAGE can provide affordable analysis of genes amenable for molecular dissection of PAH using PBMCs as a sentinel, surrogate tissue. Altogether, these findings may disclose novel perspectives in the use of HDACi in PAH and potential biomarkers.

Entwicklung eines Tests zur Ablösung von Tierversuchen beim Nachweis von Pertussis-Toxin

Weltweit existiert keine zum Tierversuch alternative Methode, um adsorbierte Pertussis-Impfstoffe auf restliche Toxin-Aktivität hin zu untersuchen. Der im Europäischen Arzneibuch vorgeschriebene Tierversuch besitzt nach Erfahrungen der Industrie, internationaler Prüfbehörden sowie des Paul-Ehrlich-Institutes eine schlechte Aussagekraft. Er ist wenig standardisierbar und weist häufig ein zweifelhaftes Ergebnis auf, so dass Wiederholungen und damit einhergehend ein hoher Verbrauch an Versuchstieren unumgänglich sind. Enthält der Impfstoff Reste von nicht-inaktiviertem Pertussis-Toxin (PTx), muss mit schweren und schwersten Nebenwirkungen bei den Impflingen gerechnet werden. In dieser Arbeit wurde ein In vitro-Nachweis für aktives PTx entwickelt. rnAngeregt durch Publikationen, wonach Pertussis-Toxin humane Monozyten aktiviert, wurde zunächst versucht, diesen Effekt zum Toxin-Nachweis auszunutzen. Die vorliegende Arbeit zeigt jedoch eindeutig, dass Pertussis-Toxin selbst nicht zur Stimulation humaner Monozyten führt. Vielmehr konnte nachgewiesen werden, dass die Aktivierung dieser Immunzellen auf Kontaminationen durch Lipopolysaccharide zurückzuführen ist. Damit wurden die Aussagen in den oben erwähnten Veröffentlichungen widerlegt. Dieses Ergebnis wurde bereits zur Publikation eingereicht.rnNunmehr wurden verschiedene Ansätze zum Nachweis von Pertussis-Toxin entwickelt, welche seine enzymatischen Aktivitäten als NAD-Glycohydrolase und ADP-Ribosyltransferase ausnutzen. Zunächst wurde versucht, die Hydrolyse von NAD zu ADP-Ribose und Nicotinamid photometrisch nachzuweisen. Wegen unbefriedigender Sensitivität wurde dieses Verfahren zu einem fluorometrischen Nachweis weiterentwickelt. Verwendet wurde hier fluorogenes etheno-NAD, welches von Pertussis-Toxin als Substrat akzeptiert wird. Letzteres Prinzip ist zum In vitro-Nachweis von Pertussis-Toxin geeignet, wird jedoch durch das in Impfstoffen häufig verwendete Adsorbens Aluminiumhydroxid gestört. Deshalb wurde dieser Ansatz aufgegeben und ein neuer Weg verfolgt, welcher am Energiestoffwechsel von humanen Zellen ansetzt. Eine Konsequenz des Angriffs von Pertussis-Toxin auf seine Zielzellen im Respirationstrakt besteht – nach komplexen Reaktionen des Signaltransduktionsweges – im Absenken des ATP-Gehaltes. Als menschliche Surrogat-Zellen wurden frisch isolierte periphere mononukleäre Zellen (PBMCs) sowie die permanente Lymphozyten-Zelllinie Jurkat eingesetzt und deren ATP-Gehalt mittels Luziferin-Luziferase-Lumineszenz gemessen. Der Test wird nicht durch Lipopolysaccharid gestört und auch Aluminiumhydroxid übt erst nach mehreren Stunden Inkubation einen interferierenden Einfluss aus. Ebenso konnte aktives Pertussis-Toxin mit Hilfe kryokonservierter PBMCs detektiert werden, auch in orientierenden Versuchen mit komplexen Impfstoffen. Der Pertussis-ATP-Test kommt der In vivo-Situation in der Zelle sehr nahe, weil beide Untereinheiten des Toxins in einem Test überprüft werden. Demnach soll er Bestandteil einer geplanten internationalen Studie zu alternativen Pertussis-Toxin-Testungen sein.

Einfluss der AMPK-Aktivität auf Endothelfunktion, oxidativen Stress und vaskuläre Inflammation

Die AMPK ist ein ubiquitär exprimiertes, heterotrimeres Enzym, das bei Energiemangel das Überleben der Zelle sichert. Um diese Funktion ausüben zu können fungiert die AMPK als sogenannter „Energie-Sensor“, der durch steigende AMP Mengen aktiviert wird. In diesem Zustand werden ATP verbrauchende Reaktionen inhibiert und gleichzeitig ATP generierende Vorgänge induziert. Im vaskulären System konnte gezeigt werden, dass die endotheliale NOSynthase durch die AMPK aktiviert, die Angiogenese stimuliert, die Endothelzellapoptose und das Wachstum von Gefäßmuskelzellen inhibiert wird. All diese Prozesse sind fundamental in der Entwicklung von kardiovaskulären Krankheiten, was auf eine protektive Funktion der AMPK im vaskulären System hindeutet. In der vorliegenden Arbeit sollten die Effekte der in vivo Modulation der AMPK Aktivität auf Endothelfunktion, oxidativen Stress und Inflammation untersucht werden. Dazu wurden zwei unterschiedliche Mausmodelle genutzt: Einerseits wurde die AMPK Aktivität durch den pharmakologischen AMPK-Aktivator AICAR stimuliert und andererseits die vaskulär vorherrschende AMPK-Isoform durch knock out ausgeschaltet. Zur Induktion von oxidativem Stress wurde ein bereits charakterisiertes Angiotensin II-Modell angewandt. Zur Untersuchung gehörten neben den Superoxid-Messungen auch die Bestimmung der Stickstoffmonoxid-Mengen in Serum und Aortengewebe, die Relaxationsmessungen in isometrischen Tonusstudien sowie HPLC-basierte Assays. Es konnte gezeigt werden, dass durch die Aktivierung der AMPK mittels AICAR die Angiotensin II induzierte Endotheldysfunktion, der oxidative Stress und auch die vaskuläre Inflammation verbessert werden konnte. Weiterhin zeigte sich dass der knock out der vaskulären Isoform (α1) im Angiotensin II Modell eine signifikant verstärkte Endotheldysfunktion, oxidativen Stress und Inflammation nach sich zog. Anhand der erhobenen Daten konnte die NADPH-Oxidase als Hauptquelle des Angiotensin II induzierten oxidativen Stresses identifiziert werden, wobei sich diese Quelle als AMPK sensitiv erwies. Durch die Aktivierung konnte die Aktivität der NADPH-Oxidase verringert und durch die α1AMPK Defizienz signifikant erhöht werden. Auch die mitochondriale Superoxidproduktion konnte durch die Modulation der AMPK Aktivität beeinflusst werden. Die vaskuläre Inflammation, die anhand der Surrogaten VCAM-1, COX-2 und iNOS untersucht wurde, konnte durch Aktivierung der AMPK verringert werden, der knock out der α1AMPK führte so einer sehr starken Expressionssteigerung der induzierbaren NO-Synthase, was in einem starken Anstieg der NO-Produktion und somit der Peroxynitritbildung resultierte.Die dargestellten Daten deuten stark auf eine protektive Funktion der AMPK im vaskulären System hin und sollte als therapeutisches Ziel, nicht nur in Bezug auf diabetische Patienten, in Betracht gezogen werden.