High incidence of Angina pectoris in patients treated with 5-fluorouracil - A planned surveillance study with 102 patients

Objective: Angina pectoris, arrhythmic sudden death and myocardial infarction, all these cardiac events have occasionally been reported during 5-fluorouracil (5-FU) chemotherapy. Underlying mechanisms leading to these events are unknown; damage to the myocytes or vasospasms have been discussed. Methods: 102 consecutive and unselected patients were monitored with 12-lead ECG, echocardiography and radionuclide ventriculography prior to the first cycle of 5-FU chemotherapy and 3 months from baseline. Results: 19% of the patients developed reversible symptoms of angina pectoris during treatment which lasted up to 12 h after cessation of the infusion. Most of the 19 patients showed corresponding ECG changes. 6 out of the 19 patients with severe angina pectoris had subsequent coronary angiography. In none of these patients the coronary angiography showed coronary artery disease, but it showed low ventricular function (ejection fraction <50%) in 2 patients. The ejection fraction did not increase overtime. Arrhythmias were screened for with Holter monitoring during 5-FU chemotherapy. The frequency of bradycardia and ventricular extrasystoles increased significantly (p < 0.05) during treatment compared to arrhythmias in Holter monitoring 3 months later. Furthermore the Qtc time in the ECG 3 months later was significantly prolonged (p < 0.05) compared to baseline values. Conclusions:The incidence of angina pectoris in patients during 5-FU treatment seems higher than previously suspected. As myocardial ischemia can be fatal, attentiveness to these symptoms and immediate treatment are crucial. Copyright (C) 2003 S. Karger AG, Basel

Allan Sandage and the distance scale

Allan Sandage returned to the distance scale and the calibration of the Hubble constant again and again during his active life, experimenting with different distance indicators. In 1952 his proof of the high luminosity of Cepheids confirmed Baade's revision of the distance scale (H0 ~ 250 km s−1 Mpc−1). During the next 25 years, he lowered the value to 75 and 55. Upon the arrival of the Hubble Space Telescope, he observed Cepheids to calibrate the mean luminosity of nearby Type Ia supernovae (SNe Ia) which, used as standard candles, led to the cosmic value of H0 = 62.3 ± 1.3 ± 5.0 km s−1 Mpc−1. Eventually he turned to the tip of the red giant branch (TRGB) as a very powerful distance indicator. A compilation of 176 TRGB distances yielded a mean, very local value of H0 = 62.9 ± 1.6 km s−1 Mpc−1 and shed light on the streaming velocities in the Local Supercluster. Moreover, TRGB distances are now available for six SNe Ia; if their mean luminosity is applied to distant SNe Ia, one obtains H0 = 64.6 ± 1.6 ± 2.0 km s−1 Mpc−1. The weighted mean of the two independent large-scale calibrations yields H0 = 64.1 km s−1 Mpc−1 within 3.6

The expansion field: the value of H 0

Any calibration of the present value of the Hubble constant (H 0) requires recession velocities and distances of galaxies. While the conversion of observed velocities into true recession velocities has only a small effect on the result, the derivation of unbiased distances which rest on a solid zero point and cover a useful range of about 4-30Mpc is crucial. A list of 279 such galaxy distances within v4.5 Mpc. RRLyr star-calibrated TRGB distances of 78 galaxies above this limit give H 0=63.0±1.6 at an effective distance of 6Mpc. They compensate the effect of peculiar motions by their large number. Support for this result comes from 28 independently calibrated Cepheids that give H 0=63.4±1.7 at 15Mpc. This agrees also with the large-scale value of H 0=61.2±0.5 from the distant, Cepheid-calibrated SNeIa. A mean value of H 0=62.3±1.3 is adopted. Because the value depends on two independent zero points of the distance scale its systematic error is estimated to be 6%. Other determinations of H 0 are discussed. They either conform with the quoted value (e.g. line width data of spirals or the D n −σ method of E galaxies) or are judged to be inconclusive. Typical errors of H 0 come from the use of a universal, yet unjustified P-L relation of Cepheids, the neglect of selection bias in magnitude-limited samples, or they are inherent to the adopted model

The rapid evolution of the exciting star of the Stingray Nebula

SAO244567, the exciting star of the Stingray nebula, is rapidly evolving. Previous analyses suggested that it has heated up from an effective temperature of about 21kK in 1971 to over 50kK in the 1990s. Canonical post-asymptotic giant branch evolution suggests a relatively high mass while previous analyses indicate a low-mass star. Fitting line profiles from static and expanding non-LTE model atmospheres to the observed UV and optical spectra, taken during 1988-2013, allowed us to study the temporal change of effective temperature, surface gravity, mass-loss rate, and terminal wind velocity. In addition, we determined the chemical composition of the atmosphere. We find that the central star has steadily increased its effective temperature from 38kK in 1988 to a peak value of 60kK in 2002. During the same time, the star was contracting, as concluded from an increase in surface gravity from log g = 4.8 to 6.0 and a drop in luminosity. Simultaneously, the mass-loss rate declined from log (dM/dt/Msun/yr)=-9.0 to -11.6 and the terminal wind velocity increased from 1800km/s to 2800km/s. Since around 2002, the star stopped heating and has cooled down again to 55kK by 2006. It has a largely solar surface composition with the exception of slightly subsolar carbon, phosphorus, and sulfur. By comparison with stellar-evolution calculations, we confirm that SAO244567 must be a low-mass star (M < 0.55 Msun). However, the slow evolution of the respective stellar evolutionary models is in strong contrast to the observed fast evolution and the young planetary nebula with a kinematical age of only about 1000 years. We speculate that the star could be a late He-shell flash object. Alternatively, it could be the outcome of close-binary evolution. Then SAO244567 would be a low-mass (0.354 Msun) helium prewhite dwarf after the common-envelope phase, during which the planetary nebula was ejected.Comment: 16 pages, 13 figures, accepted for publication in A&