Genetic Basis of Myocarditis: Myth or Reality?

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Is body mass index before middle age related to coronary heart disease risk in later life?

Objective: Although obesity beginning early in life is becoming more common, its implications for coronary heart disease (CHD) risk in later life remain uncertain. We examined the relationship of body mass index (BMI) before 30 years of age to CHD risk in later life.Design: Systematic review of published studies relating BMI between age 2 and 30 years to later CHD risk. Studies were identified using Medline (1950 onwards), Embase (1980 onwards) and Web of Science (1970 onwards) databases (to November 2007).Measurements: Relative risks (RR) of CHD associated with a 1 standard deviation (s.d.) higher BMI (most based on a narrow age range at measurement) were extracted by two authors independently, and combined using random-effect models.Results: A total of 15 studies provided 17 estimates (731 337 participants, 23 894 CHD events) of the association of early BMI to later CHD outcome. BMI in early childhood (2–6 years, 3 estimates) showed a weak inverse association with CHD risk (RR 0.94, 95% CI 0.82–1.07). BMI in later childhood (7 to o18 years, 7 estimates) and BMI in early adult life (18–30 years, 7 estimates) were both positively related to later CHD risk (RR 1.09, 95% CI 1.00–1.20; RR 1.19, 95% CI 1.11–1.29 respectively). However, there was considerable statistical heterogeneity between study estimates. Results were unaffected by adjustment for social class and/or cigarette smoking, blood pressure and/or total cholesterol, in studies with available data. Gender and year of birth (1900–1976) had little effect on the association.Conclusions: BMI is positively related to CHD risk from childhood onwards; the associations in young adults are consistent with those observed in middle age. Long-term control of BMI from childhood may be important to reduce the risk of CHD

Immune cell profiling to guide therapeutic decisions in rheumatic diseases.

Biomarkers are needed to guide treatment decisions for patients with rheumatic diseases. Although the phenotypic and functional analysis of immune cells is an appealing strategy for understanding immune-mediated disease processes, immune cell profiling currently has no role in clinical rheumatology. New technologies, including mass cytometry, gene expression profiling by RNA sequencing (RNA-seq) and multiplexed functional assays, enable the analysis of immune cell function with unprecedented detail and promise not only a deeper understanding of pathogenesis, but also the discovery of novel biomarkers. The large and complex data sets generated by these technologies—big data—require specialized approaches for analysis and visualization of results. Standardization of assays and definition of the range of normal values are additional challenges when translating these novel approaches into clinical practice. In this Review, we discuss technological advances in the high-dimensional analysis of immune cells and consider how these developments might support the discovery of predictive biomarkers to benefit the practice of rheumatology and improve patient care

The Battle for a Sustainable Food Supply

Since the time that Homo sapiens took up farming, a battle has been waged against pests and diseases which can cause significant losses in crop yield and threaten a sustainable food supply. Initially, early control techniques included religious practices or folk magic, hand removal of weeds and insects, and “chemical” techniques such as smokes, easily available minerals, oils and plant extracts known to have pesticidal activity. But it was not until the early twentieth century that real progress was made when a large number of compounds became available for testing as pesticides due to the upsurge in organic chemistry. The period after the 1940s saw the introduction of important families of chemicals, such as the phenoxy acid herbicides, the organochlorine insecticides and the dithiocarbamate fungicides. The introduction of new pesticides led to significant yield increases, but concern arose over their possible negative effects on human health and the environment. In time, resistance started to occur, making these pesticides less effective. This led agrochemical companies putting in place research looking for new modes of action and giving less toxic and more environmentally friendly products. These research programmes gave rise to new pesticide families, such as the sulfonylurea herbicides, the strobilurin fungicides and the neonicotinoid insecticide classes