Læknablaðið : fylgirit - 05.01.2015, Page 86

Læknablaðið : fylgirit - 05.01.2015, Page 86
X V I I V Í S I N D A R Á Ð S T E F N A H Í F Y L G I R I T 8 2 86 LÆKNAblaðið/Fylgirit 82 2015/101 og alvarlegra æðakalkana í hálsslagæðum var 41, 59 og 83% hjá sjúk- lingum með eðlilegan sykurbúskap, skert sykurþol og SS2. Í fjölþátta aðhvarfsgreiningu var gagnalíkindahlutfall 2,56 (95% Cl 1,07-6,37) fyrir meðal- til alvarlega æðakölkun í hálsslagæðum hjá sjúklingum með skert sykurþol og 5,56 (95% Cl 1,50-24,89) hjá sjúklingum með SS2. Ályktanir: Æðakölkun í hálsæðum var til staðar í nær öllum sjúklingum með BKH. Magn æðakölkunar var aukin hjá sjúklingum með nýgreinda truflun á sykurbúskap. Nýgreint skert sykurþol og SS2 er sjálfstæður áhættuþáttur fyrir í meðallagi til alvarlega æðakölkun í hálslagæðum hjá sjúklingum með BKH. Þessar niðurstöður styðja markvissa grein- ingu á truflaðri sykurstjórnun hjá sjúklingum með BKH. V 92 Blóðeitrun meðal fullburða nýbura á Landspítala árin 2010- 2011: Algengi, einkenni og áhættuþættir Lóa Rún Björnsdóttir1, Lilja Björk Sigmundsdóttir1, Guðrún Kristjánsdóttir1, 2 1Hjúkrunarfræðideild Háskóla Íslands, 2barna- og kvennasviði Landspítala gkrist@hi.is Inngangur: Rannsóknir sýna að mikilvægt sé að vera næmur fyrir ein- kennum og aðstæðum nýfæddra til að uppgötva í tæka tíð blóðeitranir. Tilgangur rannsóknarinnar upplýsa um algengi skráðra tilfella blóðeitr- unar af völdum baktería meðal fullburða nýbura á Íslandi árin 2010- 2011, skoða algengustu áhættuþætti hjá móður og barni og algengustu skráðu einkenni nýburans. Efniviður og aðferðir: Með afturskyggnu lýsandi rannsóknarsniði var upplýsinga aflað úr sjúkraskrám fullburða nýbura (>37 vikur) fæddra á árunum 2010 og 2011 sjúkdómsgreind með blóðeitrun á nýbura- skeiði (≤ 28 dagar). Upplýsingar um áhættuþætti mæðra og þekkt einkenni og áhættuþætti hjá nýburunum voru fengnar úr mæðraskrám. Endanlegt úrtak var 88 nýburar fædda á Landspítala af 9383 lifandi fæddra á Íslandi á tímabilinu, ekki náðist í 7 sjúkraskrár og þeim sleppt. Niðurstöður: Algengi blóðeitrunar meðal fullburða nýbura á þessu tímabili var 10 börn á 1000 lifandi fæddum. Ekkert barnanna lést vegna blóðeitrunar. Öll börn nema eitt voru blóðræktuð og 39,8% voru mænuræktuð. Aðeins 7 börn (7,95%) voru með staðfesta blóðræktun og voru kóagúlasa neikvæðir stafýlókokkar algengasta bakterían. Í engu sýni greindust bakteríur í mænuvökva. Algengustu áhættuþættirnir hjá móður voru grænt legvatn (39,8%), hiti fyrir eða í fæðingu (25,0%), offita (19,3%) og snemmrof á belgjum (18,2%). Algengustu áhættuþættirnir hjá nýbura voru karlkyn (58%), fósturköfnun. Öndunarerfiðleikar (89,9%) voru algengustu skráðu einkennin meðal nýburanna, svo erfiðleikar við fæðugjöf (51,1%), slappleiki (45,5%), fölur húðlitur (25,0%) og pirringur (21,6%). Ályktanir: Blóðeitrun meðal fullburða nýbura á Íslandi er sjaldgæf samanborið við önnur lönd. Þörf er á framskyggnum rannsóknum á blóðeitrunum nýbura hér á landi. V 93 Effects of protolichesterinic acid on fatty acid synthase and lipid composition cancer cells Margrét Bessadóttir1,2, Finnur F. Eiríksson1,2,4, Sharon Gowan3, Suzanne Eccles3, Sesselja Ómarsdóttir2, Margrét Þorsteinsdóttir2,4, Helga M. Ögmundsdóttir1 1Faculty of Medicine, University of Iceland, 2Faculty of Pharmaceutical Science, University of Iceland, 3Cancer Research UK Cancer Therapeutics Unit, The Institute of Cancer Research London, 4ArcticMass mab24@hi.is Introduction: (+)-Protolichesterinic acid (PA) is a lichen secondary me- tabolite. PA has anti-proliferative effects on several types of cancer cells, but no effect on normal skin fibroblasts. Fatty acid synthase (FASN) is highly expressed in human carcinomas and appears to be required for proliferation and survival. The products of FASN are generally incor- porated into phospholipids. The chemical structure of PA is very similar to a known FASN inhibitor, C75. Methods and data: The effects of PA on FASN and HER2 expression in two breast cancer cell lines, SK-BR-3 (overexpresses FASN and HER2) and T-47D, were estimated by Immunofluorescence staining. Effects on major signalling pathways, ERK1/2 and AKT were measured by Meso Scale Discovery (MSD)® assay. Lipid composition in cancer cells was evaluated by electrospray quadrupole traveling wave ion mobility time- of-flight (Q-ToF) mass spectrometry utilizing a lipidomic approach. Results: Treatment with PA induced FASN expression in SK-BR-3 cells and a decrease in HER2 expression was observed at the same time along with reduced signalling through ERK1/2 and AKT. No effects were seen in T-47D cells. Lipidomics indicated differences in lipid composition between SK-BR-3 and T-47D. Conclusions: Results suggest that PA inhibits FASN activity which then leads to a compensatory effect on FASN expression in SK-BR-3 cancer cells. Transcriptional repression is the likely cause of decreased in HER2 expression leading to the inhibitory effects of PA on ERK1/2 and AKT signalling pathways. Targeting lipid metabolism may be a treatment option in breast cancer patients, particularly for HER2-positive tumours. V 94 Obesity and risk of monoclonal gammopathy of undetermined significance: A population-based study Maríanna Þórðardóttir1, Sigrún Helga Lund1, Ebba K. Lindqvist2, Rene Costello3, Debra Burton3, Neha Korde4, Sham Mailankody3, Guðný Eiríksdóttir5, Lenore J. Launer6, Vilmundur Guðnason1,5, Tamara B. Harris6, Ola Landgren2,4, Sigurður Y. Kristinsson1,2 1Faculty of Medicine, University of Iceland, 2Department of Medicine, Karolinska University Hospital and Karolinska Institutet, 3Multiple Myeloma Section, National Cancer Institute, National Institutes of Health, Bethesda, 4Myeloma Service, Division of Hematologic Oncology, Memorial Sloan-Kettering Cancer Center, 5Icelandic Heart Association, 6National Institute on Aging, National Institute of Health, Bethesda mthordar@hi.is Introduction: All multiple myeloma (MM) cases are preceded by an asymptomatic condition, monoclonal gammopathy of undetermined significance (MGUS). The etiology of MM and MGUS is to a large extent unknown. Two studies on the association between obesity and MGUS have been conducted with conflicting results, despite reported associa- tion between obesity and MM. The aim of this study was to determine if obesity is associated with an increased risk of conventional MGUS and light-chain MGUS (LC-MGUS). Methods and data: This study was based on participants from the AGES-Reykjavik Study (n=5,764). Serum protein electrophoresis (SPEP) and serum free light-chain assay were performed on all subjects to identify conventional MGUS and LC-MGUS. Various obesity measures were used for assessment. The association was analyzed using logistic regression. Cox proportional-hazard regression was performed to test whether progression to MM was affected by obesity. Results: A total of 299 (5.2%) conventional MGUS cases and 33 (0.6%) LC-MGUS cases were identified. No association was found between any of the obesity markers and conventional MGUS (ORBMI = 0.94; 95% CI 0.74-1.24) or LC-MGUS (ORBMI = 0.8; 95% CI 0.35-1.80). The risk of progression from MGUS to MM was not affected by obesity (HRBMI = 1.03; 95% CI 0.93-1.15). Conclusions: In this large population-based study we did not find an
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