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Purpose: To determine the effect of inspiratory muscle training (IMT) on respiratory and peripheral muscle strength, functional exercise capacity, health-related quality of life (HRQoL), fatigue, depression, and cardiac functions in patients with stable angina. Methods: A randomized, controlled, single-blinded study. Twenty patients (59.95 ± 7.35 y, LVEF - 58.77 ± 7.49) with stable angina received IMT at the lowest load (10 cmH2O), and 20 patients (55.85 ± 7.60 y, LVEF - 62.26 ± 7.75) received training at 30% of maximal inspiratory pressure (MIP) seven days/8 weeks. Respiratory muscle strength (MIP; maximal expiratory pressure, MEP), peripheral muscle strength, pulmonary functions, functional exercise capacity (6-min walking test; exercise test), fatigue, HRQoL, depression, and cardiac functions were evaluated before and after. Results: A statistical difference was found between groups in terms of respiratory and peripheral muscle strength, pulmonary functions, functional exercise capacity (p<0.05). The results of fatigue, depression, HRQoL, and cardiac functions were similar between the groups (p>0.05). Conclusions: This study is the first to demonstrate the positive effects of IMT in patients with stable angina. IMT is a safe and effective method and is recommended to be added to cardiopulmonary rehabilitation programs and guidelines, as it results in increased peripheral muscle strength and functional exercise capacity in stable angina patients. [ABSTRACT FROM AUTHOR]

Background and Objectives : The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may cause acute respiratory failure, but also remains responsible for many other pathologies, including electrolyte disorders. SARS-CoV-2 infection causes disorders in many systems and can disrupt water homeostasis with thirst and appetite abnormalities. Dysnatremia affects prognosis, and may be associated with mortality in patients admitted to an intensive care unit (ICU) diagnosed with SARS-CoV-2. Materials and Methods : The study included 209 patients admitted to the ICU between 12 April 2021 and 1 March 2022 who were over 18 years old and diagnosed with SARS-CoV-2 infection by clinical and thoracic tomography findings or with a positive reverse transcription polymerase chain reaction (RT-PCR) test result. The laboratory markers, treatment modalities, nutritional, and respiratory support also for outcome evaluation, length of stay in the ICU, total hospitalization duration, and mortality in the ICU were recorded. The laboratory marker comparison was made using admission with the final assessment performed before the time of mortality in the ICU or after discharge. Results : Inotropic requirements among patients were high, which reflected mortality in the ICU. Hypernatremia presence was associated with an increase in enteral support, the inotropic support requirement, and mortality. Hypernatremia was correlated with diabetes mellitus, chronic renal failure, and a longer duration under mechanical ventilation. Conclusions : Hypernatremia was an important risk factor in ICU patients hospitalized for SARS-CoV-2 infection, which was also affected by the treatment regimens given themselves. This complex relationship underlies the importance of proper electrolyte management, especially in patients who were under severe stress and organ failure.

Hodgkin-Reed-Sternberg cells (HRSCs) in classic Hodgkin Lymphoma (HL) frequently lack expression of human leukocyte antigen class I (HLA-I), considered to hamper activation of cytotoxic T cells in the tumor microenvironment (TME). Here, we demonstrate HLA-I expression on HRSCs to be a strong determinant of TME composition whereas expression of HLA-II was associated with only minor differential gene expression in the TME. In HLA-I-positive HL the HRSC content and expression of CCL17/TARC in HRSCs are low, independent of the presence of Epstein-Barr virus in HRSCs. Additionally, HLA-I-positive HL shows a high content of CD8+ cytotoxic T cells. However, an increased expression of the inhibitory immune checkpoint LAG3 on CD8+ T cells in close proximity to HRSCs is observed. Suggesting interference with cytotoxic activity, we observed an absence of clonally expanded T cells in the TME. While HLA-I-positive HL is not associated with an unfavorable clinical course in our cohorts, they share features with the recently described H2 subtype of HL. Given the major differences in TME composition, immune checkpoint inhibitors may differ in their mechanism of action in HLA-I-positive compared to HLA-I-negative HL., Competing Interests: Dr von Tresckow is an advisor or consultant for Allogene, BMS/Celgene, Cerus, Incyte, IQVIA, Gilead Kite, Lilly, Miltenyi, Novartis, Noscendo, Pentixapharm, Roche, Amgen, Pfizer, Takeda, Merck Sharp & Dohme, and Gilead Kite; has received honoraria from AstraZeneca, BMS, Incyte, Lilly, Novartis, Roche Pharma AG, Takeda, and Merck Sharp & Dohme; reports research funding from Novartis (Inst), Merck Sharp & Dohme (Inst), and Takeda (Inst); and reports travel support from AbbVie, AstraZeneca, Gilead Kite, Lilly, Merck Sharp & Dohme, Pierre Fabre, Roche, Takeda, and Novartis all outside the submitted work. Dr P. Borchmann reports grants from BMS during the conduct of the study. Dr Engert reports grants and nonfinancial support from BMS during the conduct of the study, and personal fees from Takeda, BMS, and MSD outside the submitted work. Dr Bröckelmann is an advisor or consultant for BeiGene, BMS, MSD, Stemline, and Takeda, received honoraria from BeiGene, BMS, MSD, Stemline, and Takeda, received travel support from BeiGene, Celgene, and Takeda, and reports research funding from BeiGene (Inst), BMS (Inst), MSD (Inst) and Takeda (Inst). Dr Klapper reports grants from Roche, Amgen, Takeda, Incyte, and Regeneron paid to his institution outside the submitted work. The remaining authors declare no conflicts of interest., (© 2024 The Authors. HemaSphere published by John Wiley & Sons Ltd on behalf of European Hematology Association.)

Tumor-associated microglia and blood-derived macrophages (TAMs) play a central role in modulating the immune suppressive microenvironment in glioma. Here, we show that GPNMB is predominantly expressed by TAMs in human glioblastoma multiforme and the murine RCAS-PDGFb high grade glioma model. Loss of GPNMB in the in vivo tumor microenvironment results in significantly smaller tumor volumes and generates a pro-inflammatory innate and adaptive immune cell microenvironment. The impact of host-derived GPNMB on tumor growth was confirmed in two distinct murine glioma cell lines in organotypic brain slices from GPNMB-KO and control mice. Using published data bases of human glioma, the elevated levels in TAMs could be confirmed and the GPNMB expression correlated with a poorer survival., (© 2024. The Author(s).)

Background: Primary lymphoma of the central nervous system (PCNSL) encompasses a variety of lymphoma subtypes, with the majority being diffuse large B-cell lymphomas, which require aggressive systemic treatment. In contrast, low-grade lymphomas are reported infrequently and are mostly limited to dural manifestations. Very rarely, parenchymal low-grade PCNSL is diagnosed, and the cases documented in the literature show a wide variety of treatment approaches., Methods: We screened all cases of PCNSL treated at our department (a tertiary hematooncology and neurooncology center) in the last 15 years and conducted a comprehensive literature research in the PubMed database., Results: Overall, two cases of low-grade primary parenchymal PCNSL treated with irradiation were identified. The dose prescriptions ranged from 30.6 to 36 Gy for the involved site, with sparing of the hippocampal structures. Both patients had an excellent response to the treatment with a mean follow-up of 20 months. No clinical or radiological signs of treatment toxicity were detected., Conclusions: Our analysis corroborates the results from the literature and demonstrates that parenchymal low-grade PCNSL shows a good response to localized radiation treatment, enabling a favorable outcome while avoiding long-term treatment toxicity.

Background: Chronic coronary syndrome (CCS) is one of the most life-restricting coronary artery diseases, and symptom relief is the main goal in CCS patients who suffer from angina., Objectives: To assess the potential benefits of device-guided breathing in CCS patients with angina in this randomized, controlled, single-blinded study., Methods: Fifty-one patients with CCS received device-guided breathing for 7 days/8 weeks. Exercise capacity [exercise stress test], cardiac function [transthoracic echocardiography], and angina severity [Canadian Cardiovascular Society Classification] were evaluated initially and after the training. Device-guided breathing was performed at the lowest resistance of the device (POWERbreathe® Classic LR) for the control group (n = 17). The low load training group (LLTG; n = 18) and high load training group (HLTG; n = 16) were trained at 30% and 50% of maximal inspiratory pressure. Baseline characteristics were compared using one-way ANOVA and Kruskal-Wallis test. Categorical data were compared using the chi-square test. ANCOVA was performed to compare changes between three groups. A p value < 0.05 was considered statistically significant., Results: Metabolic equivalent values were significantly improved in both HLTG and LLTG groups (p < 0.001, p = 0.003). The Duke treadmill score significantly improved and shifted to low-risk both in the HLTG (p < 0.001) and LLTG (p < 0.001) groups. Angina severity significantly alleviated after the training in both HLTG and LLTG groups (p < 0.001, p = 0.002)., Conclusions: An 8-week long program of short-term respiratory muscle training provided positive gains in exercise capacity and angina severity in CCS patients with angina. The effects of long-term training programs on CCS patients should be investigated clinically because of the possibility of helping to decrease the need for invasive treatments., Competing Interests: The authors stated that there is no conflict of interest.

Background: Coronary microvascular dysfunction (CMD) and hypertension (HTN) occur frequently in hypertrophic cardiomyopathy (HCM), but whether blood pressure (BP) influences CMD and outcomes is unknown., Objective: The purpose of this study was to test the hypothesis that HTN is associated with worse CMD and outcomes., Methods: This retrospective study included 690 HCM patients. All patients underwent cardiac magnetic resonance imaging, echocardiography, and rhythm monitoring; 127 patients also underwent rest/vasodilator stress 13 NH 3 positron emission tomography myocardial perfusion imaging. Patients were divided into 3 groups based on their rest systolic blood pressure (SBP) (group 1 ≤110 mm Hg; group 2 111-140; group 3 >140 mm Hg) and were followed for development of ventricular tachycardia (VT)/ventricular fibrillation (VF), heart failure (HF), death, and composite outcome., Results: Group 1 patients had the lowest age and left ventricular (LV) mass but the highest prevalence of nonobstructive hemodynamics and restrictive diastolic filling. LV scar was similar in the 3 groups. Group 1 had the lowest rest and stress myocardial blood flow (MBF) and highest SDS (summed difference score). Rest SBP was positively correlated with stress MBF and negatively correlated with SDS. Group 1 had the highest incidence of VT/VF, whereas the incidences of HF, death, and composite outcome were similar among the 3 groups. In multivariate analysis, rest SBP ≤110 mm Hg was independently associated with VT/VF (hazard ratio 2.6; 95% confidence interval 1.0-6.7; P = .04)., Conclusion: SBP ≤110 mm Hg is associated with greater severity of CMD and coronary microvascular ischemia and higher incidence of ventricular arrhythmias in HCM., (© 2023 Published by Elsevier Inc. on behalf of Heart Rhythm Society.)

Background and Objective: To compare oxidative stress (OS) markers in the saliva, gingival crevicular fluid (GCF), and serum samples of pregnant women with gestational diabetes (GDM) and healthy pregnant women and to investigate the association between periodontal health/diseases and OS and GDM., Method: Eighty women with GDM and 80 healthy pregnant women were included in the study. Medical and clinical anamnesis was obtained from all the pregnant women included in the study, and their plaque index (PI), gingival index (GI), bleeding on probing (BoP), probing pocket depth (PPD), and clinical attachment level (CAL) measurements were performed. GCF, saliva, and serum samples were collected for the measurements of the local and systemic total antioxidant status (TAS) and total oxidant status (TOS)., Results: Clinical periodontal parameters were found to be significantly higher in the GDM group compared to the control group. The serum and saliva TAS, TOS, and TAS/TOS values were significantly lower in the GDM group than in the control group. In the analysis of the GCF samples, the mean TAS and TAS/TOS values were significantly lower and the TOS value was significantly higher in the GDM group than in the control group. The multivariate reduced model indicated that gravidity, salivary TAS/TOS, and GCF TAS were significant independent variables in the development of GDM (p < .05)., Conclusion: Our results indicated that the OS of serum, saliva, and GCF samples increased in patients with GDM compared to healthy pregnant women. The role of local OS parameters in GDM may be associated with elevated clinical periodontal parameters., (© 2023 John Wiley & Sons Ltd.)

The study aims to determine the chemical contents of the surface water of the Duger Creek and the sediments of the Duger basin, which feeds the Burdur Lake, the correlation between these contents, the potential ecological risks of these contents, the toxic heavy metal contents, and their spatial distribution by using X-ray fluorescence (XRF) spectroscopy method. The Duger basin, which has been selected as the study area, is located on the streams feeding the Burdur Lake, which has been determined as the Ramsar area in Turkey. Burdur Lake has a key role in the ecological balance due to its biological diversity, characteristic animal/plant fauna since it provides a suitable area for seasonal migration of waterfowl. Considering all these functions, the surface water and sediment quality of the Duger basin, which is located in the streams feeding Burdur Lake, is critical. In this study, elemental compositions of 20 water and 20 sediment samples collected from the Duger basin were determined by using the XRF spectroscopy method. Many elements that may have toxicological characteristics in terms of human and environmental health have been detected in the surface water and sediment samples from the Duger basin. These elements were found to have the following average values: Al (60.09 mg/L), Co (3.35 mg/L), Zn (3.35 mg/L), Cu (2.21 mg/L), Cr (0.14 mg/L). It is interpreted that they may be toxic because they exceed the limits specified in WHO 2004. In this context, the surface water in the Duger basin, which feeds the Burdur Lake, must be filtered before using it as drinking water or for agricultural and livestock purposes. New strategic planning is suggested to ensure the sustainability of the basin's surface water quality., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Colorectal cancer (CRC) is the third most common cancer worldwide with a high mortality rate. Dietary fibers, both soluble and insoluble, are essential for reducing the risk of CRC. In this study, a meta-analysis was performed to examine the relationship between the soluble and insoluble dietary fiber consumption and CRC risk. The highest vs. lowest fiber concentrations were compared by using PRISMA guidelines. To determine publishing bias, the Egger test; assess study heterogeneity I 2 statistics were used. Studies that reported adjusted relative risk estimates with 95% confidence intervals (Cl) for the associations of interest were included. The results reveal that the relationship between soluble and insoluble fiber intake and the risk of CRC is almost equal [The total fiber ES = 0.75 (95% CI = 0.66-0.86), soluble fiber ES = 0.78 (95% CI = 0.66-0.92), insoluble fiber ES = 0.77 (95% CI = 0.67-0.88)]. Funnel plot and Egger's linear regression tests demonstrated that there was no publication bias. Both soluble and insoluble fiber consumption appear to be protective against CRC, with a clinically significant reduction in CRC risk. It is critical to identify preventive steps to avoid the CRC development, especially by leading a healthier lifestyle that includes healthy diet.