93 research outputs found
QUAND RECHERCHER UNE HYPERTENSION ARTERIELLE PULMONAIRE AU COURS DâUNE MALADIE SYSTEMIQUE
Introduction: Pulmonary hypertension is a rare but well-known life-threatening complication of connective tissue diseases. The aim of this article is to analyse the available literature for diagnosis and treatment about this complication. Method: Scleroderma is the most common connective tissue disease affected by pulmonary hypertension. Dyspnea is the main symptom and is frequently severe. Echocardiography is an excellent exam to detect pulmonary hypertension. However, right heart catheterization is necessary to confirm the diagnosis of pulmonary hypertension and to test vasoreactivity with a potent vasodilator such as nitric oxide. Pulmonary hypertension is less severe in patients with connective tissue diseases perhaps because of an earlier diagnosis. A significantly lower proportion of patients present an acute vasodilator response, suggesting an early constitution of irreversible pulmonary vascular lesions. Continuous intravenous epoprostenol therapy seems to be less effective as compared with patients with primitive pulmonary hypertension and does not improve survival. Bosentan and Sildenafil are approved in idiopathique pulmonary hypertension. The role of immunosuppressive therapy in lupus erythematous has been reported. Conclusion: The WHO recommended annual detection of scleroderma pulmonary hypertension with echocardiography in asymptomatic patients. However, half of patients have dyspnea III or IV NYHA at the diagnosis. The prognostic is more severe than idiopathic pulmonary hypertension.Introduction : Lâhypertension artĂ©rielle pulmonaire est une complication rare mais bien connue des connectivites. Lâobjet de cet article est de faire le point sur les mĂ©thodes diagnostiques et les nouveautĂ©s thĂ©rapeutiques MĂ©thodes : La sclĂ©rodermie est la premiĂšre connectivite Ă se compliquer dâhypertension artĂ©rielle pulmonaire. La dyspnĂ©e dâeffort est le maĂźtre symptĂŽme et est souvent dâemblĂ©e sĂ©vĂšre. LâĂ©chocardiographie est un excellent examen de dĂ©pistage mais le cathĂ©tĂ©risme cardiaque droit demeure lâexamen de rĂ©fĂ©rence indispensable pour confirmer le diagnostic. Le traitement vasodilatateur par perfusion continue de prostacycline nâamĂ©liore pas la survie de ces patients contrairement Ă ce que lâon observe dans lâhypertension artĂ©rielle pulmonaire primitive. Le bosentan et le sildenafil ont approuvĂ© leurs efficacitĂ©s au cours de lâhypertention artĂ©rielle pulmonaires idiopathiques. LâHTAP du lupus Ă©rythĂ©mateux systĂ©mique peut ĂȘtre sensible Ă lâEndoxan et aux corticoĂŻdes. Conclusion : Les recommandations de lâOMS sont de dĂ©pister annuellement lâHTAP chez tout patient atteint de sclĂ©rodermie systĂ©mique mĂȘme en lâabsence de symptĂŽme clinique par Ă©chocardiographie. MalgrĂ© ces recommandations, plus de 50 % des patients dĂ©veloppant une HTAP sur sclĂ©rodermie sont en classe III ou IV NYHA au moment du diagnostic. Le pronostic reste plus sombre que celui de lâHTAP idiopathique
SYNDROME DES ANTISYNTHETASES
Introduction: The discovery in recent years, specific antibodies of idiopathic inflammatory myopathies, has opened new avenues in the understanding of their physiopathological mechanisms.We present the main clinical features and prognosis of syndromes associated with antibodies antisynthetase groupe, emphasizing the anti-Jo1.Method: The antisynthetase syndrome is a subgroup of idiopathic inflammatory myopathies, characterized by interstitial lung disease, arthritis, Raynaud's phenomenon and cutaneous "mechanics hands" associated with a specific antibody family of antisynthetases, anti-Jo1 and pulmonary life-threatening conditions. Treatment is not codified; corticosteroids are most effective on the fickle lung injury by discussing other immunosuppressive treatments.Conclusion: The antisynthetase syndrome is an entity to be known, because of the severity of interstitial lung disease, may occur in the absence of myopathy. Most authors recommend looking for the anti-Jo1 in any idiopathic interstitial pneumonia.Introduction : La dĂ©couverte ces derniĂšres annĂ©es, dâanticorps spĂ©cifiques des myopathies inflammatoires idiopathiques, a ouvert de nouvelles voies dans la comprĂ©hension de leurs mĂ©canismes physiopathogĂ©niques. Nous prĂ©sentons les principales caractĂ©ristiques cliniques et pronostiques des syndromes associĂ©s Ă la famille des anticorps antisynthĂ©tases, en insistant sur lâanticorps anti-Jo1.MĂ©thode : Le syndrome des anti-synthĂ©tases constitue un sous-groupe de myopathies inflammatoires idiopathiques, caractĂ©risĂ© par une atteinte interstitielle pulmonaire, une polyarthrite, un phĂ©nomĂšne de Raynaud et une atteinte cutanĂ©e de type « mains de mĂ©caniciens », associĂ©s Ă un anticorps spĂ©cifique de la famille des anticorps anti-synthĂ©tases, lâanti-Jo1. Lâatteinte pulmonaire conditionne le pronostic vital. Le traitement nâest pas codifiĂ© ; les corticostĂ©roĂŻdes ont une efficacitĂ© inconstante sur les lĂ©sions pulmonaires, faisant discuter dâautres traitements immunosuppresseurs.Conclusion : Le syndrome des antisynthĂ©tases est une entitĂ© Ă connaĂźtre, du faite de la gravitĂ© de la pneumopathie interstitielle, pouvant survenir en lâabsence dâatteinte musculaire. La plupart des auteurs recommendes la recherche de lâanticorps anti-jo1 lors de toute pneumopathie interstitielle idiopathique
European survey on criteria of aesthetics for periodontal evaluation: The ESCAPE study
Objective:
The ESCAPE multicentre survey was designed to (a) compare the agreement of three relevant aesthetic scoring systems among different centres, and (b) evaluate the reproducibility of each question of the questionnaires. /
Materials and Methods:
EFP centres (n = 14) were involved in an eâsurvey. Fortyâtwo participants (28 teachers, 14 postgraduate students) were asked to score the oneâyear aesthetic outcomes of photographs using the BeforeâAfter Scoring System (BASS), the Pink Esthetic Score (PES) and the Root coverage Esthetic Score (RES). Mean values of kappa statistics performed on each question were provided to resume global agreement of each method. /
Results:
Between teachers, a difference of kappa â„ 0.41 (p = .01) was found for BASS (75%) and PES (57%). Similarly, RES (84%) and PES (57%) were different (p < .001). No difference was found between BASS (75%) and RES (84%). No difference was found between students, whatever the scoring system. Questions of each scoring system showed differences in their reproducibility. /
Conclusions:
The outcomes of this study indicate that BASS and RES scoring systems are reproducible tools to evaluate aesthetic after root coverage therapies between different centres. Among the various variables, lack of scar, degree of root coverage, colour match and gingival margin that follows the CEJ show the best reliability
Association Between Interstitial Lung Abnormalities and All-Cause Mortality.
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This article is open access.Interstitial lung abnormalities have been associated with lower 6-minute walk distance, diffusion capacity for carbon monoxide, and total lung capacity. However, to our knowledge, an association with mortality has not been previously investigated.To investigate whether interstitial lung abnormalities are associated with increased mortality.Prospective cohort studies of 2633 participants from the FHS (Framingham Heart Study; computed tomographic [CT] scans obtained September 2008-March 2011), 5320 from the AGES-Reykjavik Study (Age Gene/Environment Susceptibility; recruited January 2002-February 2006), 2068 from the COPDGene Study (Chronic Obstructive Pulmonary Disease; recruited November 2007-April 2010), and 1670 from ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; between December 2005-December 2006).Interstitial lung abnormality status as determined by chest CT evaluation.All-cause mortality over an approximate 3- to 9-year median follow-up time. Cause-of-death information was also examined in the AGES-Reykjavik cohort.Interstitial lung abnormalities were present in 177 (7%) of the 2633 participants from FHS, 378 (7%) of 5320 from AGES-Reykjavik, 156 (8%) of 2068 from COPDGene, and in 157 (9%) of 1670 from ECLIPSE. Over median follow-up times of approximately 3 to 9 years, there were more deaths (and a greater absolute rate of mortality) among participants with interstitial lung abnormalities when compared with those who did not have interstitial lung abnormalities in the following cohorts: 7% vs 1% in FHS (6% difference [95% CI, 2% to 10%]), 56% vs 33% in AGES-Reykjavik (23% difference [95% CI, 18% to 28%]), and 11% vs 5% in ECLIPSE (6% difference [95% CI, 1% to 11%]). After adjustment for covariates, interstitial lung abnormalities were associated with a higher risk of death in the FHS (hazard ratio [HR], 2.7 [95% CI, 1.1 to 6.5]; Pâ=â.03), AGES-Reykjavik (HR, 1.3 [95% CI, 1.2 to 1.4]; Pâ<â.001), COPDGene (HR, 1.8 [95% CI, 1.1 to 2.8]; Pâ=â.01), and ECLIPSE (HR, 1.4 [95% CI, 1.1 to 2.0]; Pâ=â.02) cohorts. In the AGES-Reykjavik cohort, the higher rate of mortality could be explained by a higher rate of death due to respiratory disease, specifically pulmonary fibrosis.In 4 separate research cohorts, interstitial lung abnormalities were associated with a greater risk of all-cause mortality. The clinical implications of this association require further investigation.National Institutes of Health (NIH)
T32 HL007633
Icelandic Research Fund
141513-051
Landspitali Scientific Fund
A-2015-030
National Cancer Institute grant
1K23CA157631
NIH
K08 HL097029
R01 HL113264
R21 HL119902
K25 HL104085
R01 HL116931
R01 HL116473
K01 HL118714
R01 HL089897
R01 HL089856
N01-AG-1-2100
HHSN27120120022C
P01 HL105339
P01 HL114501
R01 HL107246
R01 HL122464
R01 HL111024
National Heart, Lung, and Blood Institute's Framingham Heart Study contract
N01-HC-2519.5
GlaxoSmithKline
NCT00292552
5C0104960
National Institute on Aging (NIA) grant
27120120022C
NIA Intramural Research Program, Hjartavernd (the Icelandic Heart Association)
Althingi (the Icelandic Parliament)
NIA
27120120022
Validity and reliability of an adapted arabic version of the long international physical activity questionnaire
Risk Prediction for Acute Kidney Injury in Acute Medical Admissions in the UK
Background Acute Kidney Injury (AKI) is associated with adverse outcomes; identifying patients who are at risk of developing AKI in hospital may lead to targeted prevention. This approach is advocated in national guidelines but is not well studied in acutely unwell medical patients. We therefore aimed to undertake a UK-wide study in acute medical units (AMUs) with the following aims: to define the proportion of acutely unwell medical patients who develop hospital-acquired AKI (hAKI); to determine risk factors associated with the development of hAKI; and to assess the feasibility of using these risk factors to develop an AKI risk prediction score. Methods In September 2016, a prospective multicentre cohort study across 72 UK AMUs was undertaken. Data were collected from all patients who presented over a 24-hour period. Chronic dialysis, community-acquired AKI (cAKI) and those with fewer than two creatinine measurements were subsequently excluded. The primary outcome was the development of h-AKI. Results 2,446 individuals were admitted to the AMUs of the 72 participating centres. 384 patients (16%) sustained AKI of whom 287 (75%) were cAKI and 97 (25%) were hAKI. After exclusions, 1,235 participants remained in whom chronic kidney disease (OR 3.08, 95% CI 1.96-4.83), diuretic prescription (OR 2.33, 95% CI 1.5-3.65), a lower haemoglobin concentration and an elevated serum bilirubin were independently associated with development of hAKI. Multivariable model discrimination was moderate (c-statistic 0.75), and this did not support the development of a robust clinical risk prediction score. Mortality was higher in those with hAKI (adjusted OR 5.22; 95% CI 2.23-12.20). Conclusion AKI in AMUs is common and associated with worse outcomes, with the majority of cases community acquired. The smaller proportion of hAKI cases, only moderate discrimination of prognostic risk factor modelling and the resource implications of widespread application of an AKI clinical risk score across all AMU admissions suggests that this approach is not currently justified. More targeted risk assessment or automated methods of calculating individual risk may be more appropriate alternatives
-Stabilization of Integrator Chains Subject to Input Saturation Using Lyapunov-Based Homogeneous Design
MECHANICAL DAMPING AT HIGH TEMPERATURES IN ALUMINIDES
Measurements of the internal friction Q-1 and Young's Modulus E of alternative materials for high temperature service are reported. The technique used is the PUCOT, where E and Q-1 for the ordered 82 FeAl were measured as a function of temperature T and strain amplitude Δ , respectively. It is shown that the Granato-Luecke theory predicts low mobile dislocation densities. E decreases linearly with T such that 0.080 †dE/dT †0.095 GPa/K in the temperature range 300-998 K
Temperature and composition dependence of young's modulus for ordered B2 polycrystalline CoAl and FeAl
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