71 research outputs found

    Behavior and Impact of Zirconium in the Soil–Plant System: Plant Uptake and Phytotoxicity

    Get PDF
    Because of the large number of sites they pollute, toxic metals that contaminate terrestrial ecosystems are increasingly of environmental and sanitary concern (Uzu et al. 2010, 2011; Shahid et al. 2011a, b, 2012a). Among such metals is zirconium (Zr), which has the atomic number 40 and is a transition metal that resembles titanium in physical and chemical properties (Zaccone et al. 2008). Zr is widely used in many chemical industry processes and in nuclear reactors (Sandoval et al. 2011; Kamal et al. 2011), owing to its useful properties like hardness, corrosion-resistance and permeable to neutrons (Mushtaq 2012). Hence, the recent increased use of Zr by industry, and the occurrence of the Chernobyl and Fukashima catastrophe have enhanced environmental levels in soil and waters (Yirchenko and Agapkina 1993; Mosulishvili et al. 1994 ; Kruglov et al. 1996)

    Continued Decline of Malaria in The Gambia with Implications for Elimination

    Get PDF
    BACKGROUND: A substantial decline in malaria was reported to have occurred over several years until 2007 in the western part of The Gambia, encouraging consideration of future elimination in this previously highly endemic region. Scale up of interventions has since increased with support from the Global Fund and other donors. METHODOLOGY/PRINCIPAL FINDINGS: We continued to examine laboratory records at four health facilities previously studied and investigated six additional facilities for a 7 year period, adding data from 243,707 slide examinations, to determine trends throughout the country until the end of 2009. We actively detected infections in a community cohort of 800 children living in rural villages throughout the 2008 malaria season, and assayed serological changes in another rural population between 2006 and 2009. Proportions of malaria positive slides declined significantly at all of the 10 health facilities between 2003 (annual mean across all sites, 38.7%) and 2009 (annual mean, 7.9%). Statistical modelling of trends confirmed significant seasonality and decline over time at each facility. Slide positivity was lowest in 2009 at all sites, except two where lowest levels were observed in 2006. Mapping households of cases presenting at the latter sites in 2007-2009 indicated that these were not restricted to a few residual foci. Only 2.8% (22/800) of a rural cohort of children had a malaria episode in the 2008 season, and there was substantial serological decline between 2006 and 2009 in a separate rural area. CONCLUSIONS: Malaria has continued to decline in The Gambia, as indicated by a downward trend in slide positivity at health facilities, and unprecedented low incidence and seroprevalence in community surveys. We recommend intensification of control interventions for several years to further reduce incidence, prior to considering an elimination programme

    Woodland Recovery after Suppression of Deer: Cascade effects for Small Mammals, Wood Mice (Apodemus sylvaticus) and Bank Voles (Myodes glareolus)

    Get PDF
    Over the past century, increases in both density and distribution of deer species in the Northern Hemisphere have resulted in major changes in ground flora and undergrowth vegetation of woodland habitats, and consequentially the animal communities that inhabit them. In this study, we tested whether recovery in the vegetative habitat of a woodland due to effective deer management (from a peak of 0.4–1.5 to <0.17 deer per ha) had translated to the small mammal community as an example of a higher order cascade effect. We compared deer-free exclosures with neighboring open woodland using capture-mark-recapture (CMR) methods to see if the significant difference in bank vole (Myodes glareolus) and wood mouse (Apodemus sylvaticus) numbers between these environments from 2001–2003 persisted in 2010. Using the multi-state Robust Design method in program MARK we found survival and abundance of both voles and mice to be equivalent between the open woodland and the experimental exclosures with no differences in various metrics of population structure (age structure, sex composition, reproductive activity) and individual fitness (weight), although the vole population showed variation both locally and temporally. This suggests that the vegetative habitat - having passed some threshold of complexity due to lowered deer density - has allowed recovery of the small mammal community, although patch dynamics associated with vegetation complexity still remain. We conclude that the response of small mammal communities to environmental disturbance such as intense browsing pressure can be rapidly reversed once the disturbing agent has been removed and the vegetative habitat is allowed to increase in density and complexity, although we encourage caution, as a source/sink dynamic may emerge between old growth patches and the recently disturbed habitat under harsh conditions

    A novel inhibitor of fatty acid synthase shows activity against HER2+ breast cancer xenografts and is active in anti-HER2 drug-resistant cell lines

    Get PDF
    Introduction: Inhibiting the enzyme Fatty Acid Synthase (FASN) leads to apoptosis of breast carcinoma cells, and this is linked to human epidermal growth factor receptor 2 (HER2) signaling pathways in models of simultaneous expression of FASN and HER2. Methods: In a xenograft model of breast carcinoma cells that are FASN+ and HER2+, we have characterised the anticancer activity and the toxicity profile of G28UCM, the lead compound of a novel family of synthetic FASN inhibitors. In vitro, we analysed the cellular and molecular interactions of combining G28UCM with anti-HER drugs. Finally, we tested the cytotoxic ability of G28UCM on breast cancer cells resistant to trastuzumab or lapatinib, that we developed in our laboratory. Results: In vivo, G28UCM reduced the size of 5 out of 14 established xenografts. In the responding tumours, we observed inhibition of FASN activity, cleavage of poly-ADPribose polymerase (PARP) and a decrease of p-HER2, p- protein kinase B (AKT) and p-ERK1/2, which were not observed in the nonresponding tumours. In the G28UCM-treated animals, no significant toxicities occurred, and weight loss was not observed. In vitro, G28UCM showed marked synergistic interactions with trastuzumab, lapatinib, erlotinib or gefitinib (but not with cetuximab), which correlated with increases in apoptosis and with decreases in the activation of HER2, extracellular signal-regulated kinase (ERK)1/2 and AKT. In trastuzumab-resistant and in lapatinib-resistant breast cancer cells, in which trastuzumab and lapatinib were not effective, G28UCM retained the anticancer activity observed in the parental cells. Conclusions: G28UCM inhibits fatty acid synthase (FASN) activity and the growth of breast carcinoma xenografts in vivo, and is active in cells with acquired resistance to anti-HER2 drugs, which make it a candidate for further pre-clinical development

    Composition, potential emissions and agricultural value of pig slurry from Spanish commercial farms

    Full text link
    [EN] Pig slurry is a valuable fertilizer for crop production but at the same time its management may pose environmental risks. Slurry samples were collected from 77 commercial farms of four animal categories (gestating and lactating sows, nursery piglets and growing pigs) and analyzed for macronutrients, micronutrients, heavy metals and volatile fatty acids. Emissions of ammonia (NH3) and biochemical methane potential (BMP) were quantified. Slurry electrical conductivity, pH, dry matter content and ash content were also determined. Data analysis included an analysis of correlations among variables, the development of predictionmodels for gaseousemissions and the analysis of nutritional content of slurries for crop production. Descriptive information is provided in this work and shows a wide range of variability in all studied variables. Animal category affected some physicochemical parameters, probably as a consequence of different slurry management and use of cleaning water. Slurries from gestating sows and growing pigs tended to be more concentrated in nutrients, whereas the slurry from lactating sows and nursery piglets tended to be more diluted. Relevant relationships were found among slurry characteristics expressed in fresh basis and gas emissions. Predictivemodels using on-farmmeasurable parameterswere obtained forNH3 (R2 = 0.51) andCH4 (R2 = 0.76), which suggests that BMP may be estimated in commercial farms from easily determined slurry characteristics. Finally, slurry nutrient composition was highly variable. Therefore, complete analyses of slurries should be performed for an effective and environmental friendly land application.This project was funded by the Spanish Ministry of Science and Innovation (AGL2011-30023) and the Valencian Government (ACOMP/2013/118). We thank the BABEL Project, Building Academic Bonds between Europe and Latin America. Erasmus Mundus Programme Action 2 for PhD fellowships. The translation of this paper was funded by the Universitat Politecnica de Valencia, Spain.Antezana-Julian, WO.; Blas, CD.; García-Rebollar, P.; Rodríguez, C.; Beccaccia, A.; Ferrer Riera, P.; Cerisuelo, A.... (2016). Composition, potential emissions and agricultural value of pig slurry from Spanish commercial farms. Nutrient Cycling in Agroecosystems. 104(2):159-173. https://doi.org/10.1007/s10705-016-9764-3S1591731042Aarnink AJA, Verstegen MWA (2007) Nutrition, key factor to reduce environmental load from pig production. Livest Sci 109(1–3):194–203Abubaker J, Risberg K, Jönsson E, Dahlin A S, Cederlund H, Pell M (2015) Short-term effects of biogas digestates and pig slurry application on soil microbial activity. Appl Environ Soil Sci. Article ID 658542: 1–15Adekunle KF, Okolie JA (2015) A review of biochemical process of anaerobic digestion. Adv Biosci Biotechnol 6:205–212Angelidaki I, Alves M, Bolzonella D, Borzacconi L, Campos JL, Guwy J, Kalyuzhnyi S, Jenicek P, Van Lier JB (2009) Defining the biomethane potential (BMP) of solid organic wastes and energy crops: a proposed protocol for batch assays. Water Sci Technol 59(5):927–934Antezana W, Calvet S, Beccaccia A, Ferrer P, De Blas C, García-Rebollar P, Cerisuelo A (2015) Effects of nutrition on digestion efficiency and gaseous emissions from slurry in growing pigs: III. Influence of varying the dietary level of calcium soap of palm fatty acids distillate with or without orange pulp supplementation. Anim Feed Sci Technol 209:128–136APHA (2005) Standard methods for the examination of water and wastewater. Centennial, BaltimoreBai ZH, Qin W, Chen Q, Oenema O, Zhang FS (2014) Changes in pig production in china and their effects on nitrogen and phosphorus use and losses. Environ Sci Technol 48:12742–12749Beccaccia A, Ferrer P, Ibáñez MA, Estellés F, Rodríguez C, Moset V, De Blas C, Calvet S, García-rebollar P (2015) Relationships among slurry characteristics and gaseous emissions at different types of commercial spanish pig farms. Span J Agric Res 13(1):1–15Conn KL, Topp E, Lazarovits G (2007) Factors influencing the concentration of volatile fatty acids, ammonia, and other nutrients in stored liquid pig manure. J Environ Qual 36(2):440–447Diacono M, Montemurro F (2010) Long-term effects of organic amendments on soil fertility. A review. Agron Sustain Dev 30:401–422. doi: 10.1051/agro/2009040Díez JA, Hernaiz P, Muñoz MJ, Torre A, Vallejo A (2006) Impact of pig slurry on soil properties, water salinization, nitrate leaching and crop yield in a four-year experiment in Central Spain. Soil Use Manag 20(4):444–450Dourmad J-Y, Jondreville C (2007) Impact of nutrition on nitrogen, phosphorus, Cu and Zn in pig manure, and on emissions of ammonia and odours. Livest Sci 112(3):192–198EUROSTAT (2015) Pig farming sector—statistical portrait. Pig Farming in the European Union: considerable variations from one member state to another. Statistics in Focus 15/2014. Author: Pol Marquer, Teresa Rabade, Roberta Forti ISSN:2314-9647, Catalogue number: KS-SF-14-015-EN-NFangueiro D, Lopes C, Surgy S, Vasconcelos E (2012a) Effect of the pig slurry separation techniques on the characteristics and potential availability of N to plants in the resulting liquid and solid fractions. Biosyst Eng 113(2):187–194Fangueiro D, Ribeiro H, Vasconcelos E, Coutinho J, Cabral F (2012b) Influence of animal slurries composition and relative particle size fractions on the C and N mineralization following soil incorporation. Biomass Bioenergy 47:50–51Ferrer P, Cambra-López M, Cerisuelo A, Peñaranda D, Moset V (2014) The use of agricultural substrates to improve methane yield in anaerobic co-digestion with pig slurry: effect of substrate type and inclusion level. Waste Manag 34:196–203Galassi G, Colombini S, Malagutti L, Crovetto GM, Rapetti L (2010) Effects of high fibre and low protein diets on performance, digestibility, nitrogen excretion and ammonia emission in the heavy pig. Anim Feed Sci Technol 161:3–4Gopalan P, Jensen PD, Batstone DJ (2013) Anaerobic digestion of swine effluent: impact of production stages. Biomass Bioenergy 48:121–129Hernández D, Fernández JM, Plaza C, Polo A (2007) Water-soluble organic matter and biological activity of a degraded soil amended with pig slurry. Sci Total Environ 378:101–103Hernández D, Polo A, Plaza C (2013) Long-term effects of pig slurry on barley yield and N use efficiency under semiarid mediterranean conditions. Eur J Agron 44:47–86Hristov AN, Oh J, Lee C, Meinen R, Montes F, Ott T, Firkins J, Rotz A, Dell C, Adesogan A, Yang W, Tricarico J, Kebreab E, Waghorn G, Dijkstra J, Oosting S (2013) Mitigation of greenhouse gas emissions in livestock production—A review of technical options for non-CO2 emissions. In: Gerber PJ, Henderson B, Makkar HPS (eds) FAO Animal Production and Health Paper No. 177. FAO, RomeIguácel F, Yagüe MR, Betrán J, Orús F (2011) Ensayos de Fertilización Con Purín Porcino, En Cereales de Invierno de Secano, Dirección General de Desarrollo Rural, Centro de Transferencia Agroalimentaria, Gobierno de Aragón. Informe Técnico 226:15Jarret G, Cerisuelo A, Peu P, Martinez J, Dourmad JY (2012) Impact of pig diets with different fibre contents on the composition of excreta and their gaseous emissions and anaerobic digestion. Agric Ecosyst Environ 160:51–58Jouany JP (1982) Volatile fatty acid and alcohol determination in digestive contents, silage juices, bacterial cultures and anaerobic fermentor contents. Sci Alimen 2:131–144Krupa SV (2003) Effects of atmospheric ammonia (NH3) on terrestrial vegetation: a review. Environ Pollut 124(2):179–221Mantovi P, Fumagalli L, Beretta GP, Guermandi M (2006) Nitrate leaching through the unsaturated zone following pig slurry applications. J Hydrol 316:1–4Martínez-Suller L, Azzellino A, Provolo G (2008) Analysis of livestock slurries from farms across Northern Italy: relationship between indicators and nutrient content. Biosyst Eng 99(4):540–552Moral R, Moreno-Caselles J, Perez-Murcia MD, Perez-Espinosa A, Rufete B, Paredes C (2005a) Characterisation of the organic matter pool in manures. Bioresour Technol 96(2):153–158Moral R, Perez-Murcia MD, Perez-Espinosa A, Moreno-Caselles J, Paredes C (2005b) Estimation of nutrient values of pig slurries in Southeast Spain using easily determined properties. Waste Manag 25(7):719–725Moral R, Perez-Murcia MD, Perez-Espinosa A, Moreno-Caselles J, Paredes C, Rufete B (2008) Salinity, organic content, micronutrients and heavy metals in pig slurries from South-Eastern Spain. Waste Manag 28(2):367–371Morazán H, Alvarez-Rodriguez J, Seradj AR, Balcells J, Babot D (2015) Trade-offs among growth performance, nutrient digestion and carcass traits when feeding low protein and/or high neutral-detergent fiber diets to growing-finishing pigs. Anim Feed Sci Technol 207:168–180Moset V, Cambra-López M, Estellés F, Torres AG, Cerisuelo A (2012) Evolution of chemical composition and gas emissions from aged pig slurry during outdoor storage with and without prior solid separation. Biosyst Eng 111(1):2–10Ndegwa PM, Vaddella VK, Hristov N, Joo HS (2009) Measuring concentrations of ammonia in ambient air or exhaust air stream using acid traps.  J Environ Qual 38(2):647–653Nicholson FA, Chambers BJ, Williams JR, Unwin RJ (1999) Heavy metal contents of livestock feeds and animal manures in England and Wales. Bioresour Technol 70(1):23–31Olusegun OS (2014) Influence of NPK 15-15-15 Fertilizer and Pig Manure on Nutrient Dynamics and Production of Cowpea, Vigna unguiculata L. Walp. Am J Agric For 2(6):267Parera i Pous J, Olivé D, Mallol Nabot C, Torrijos NC (2010) Adaptación Del Uso de La Conductividad Eléctrica (CE) Para Determinar de Forma Rápida El Contenido En Nutrientes Del Purín Porcino En Catalunya. International Workshop on Anaerobic Digestion of Slaughterhouse Waste, pp 67–76Patience JF, Gould SA, Koehler D, Corrigan B, Elsbernd A, Holloway CL (2015) Super-dosed phytase improves rate and efficiency of gain in nursery pigs. Anim Ind Rep AS 661:98Penha HG, Menezes JF, Silva CA, Lopes G, Carvalho CA, Ramos SJ, Guilherme LRG (2015) Nutrient accumulation and availability and crop yields following long-term application of pig slurry in a Brazilian Cerrado soil. Nutr Cycl Agroecosyst 101(2):259–269Popovic O, Jensen LS (2012) Storage temperature affects distribution of carbon, VFA, ammonia, phosphorus, copper and zinc in raw pig slurry and its separated liquid fraction. Water Res 46(12):3849–3858Provolo G, Martínez-Suller L (2007) In situ determination of slurry nutrient content by electrical conductivity. Bioresour Technol 98(17):3235–3242Sánchez M, González JL (2005) The fertilizer value of pig slurry. I. Values depending on the type of operation. Bioresour Technol 96(10):1117–1123SAS Institute (2008) SAS/STAT User´s guide, v 9.3. SAS Institute Inc., CarySchoumans OF, Chardon WJ, Bechmann ME, Gascuel-Odoux C, Hofman G, Kronvang B, Rubæk HG, Ulén B, Dorioz JM (2014) Mitigation options to reduce phosphorus losses from the agricultural sector and improve surface water quality: a review. Sci Total Environ 468–469:1255–1266Schröder JJ, Cordell D, Smit AL, Rosemarin A (2010) Sustainable use of phosphorus. Plant Research International Wageningen UR. Report 357Scotford IM, Cumby TR, White RP, Carton OT, Lorenz F, Hatterman U, Provolo G (1998) Estimation of the nutrient value of agricultural slurries by measurement of physical and chemical properties. J Agric Eng Res 71(3):291–305Snoek DJW, Johannes DS, Ogink NWM, Koerkamp PWGG (2014) Sensitivity analysis of mechanistic models for estimating ammonia emission from dairy cow urine puddles. Biosyst Eng 121:12–24Suresh A, Choi HL, Oh DI, Moon OK (2009) Prediction of the nutrients value and biochemical characteristics of swine slurry by measurement of EC—electrical conductivity. Bioresour Technol 100:4683–4689Thygesen O, Triolo JM, Sommer SG (2012) Indicators of physical properties and plant nutrient content of animal slurry and separated slurry. Biol Eng Trans 5(3):123–135Triolo JM, Sommer SG, Møller HB, Weisbjerg MR, Jiang XY (2011) A new algorithm to characterize biodegradability of biomass during anaerobic digestion: influence of lignin concentration on methane production potential. Bioresour Technol 102:9395–9402Van Duivenbooden N, de Wit CT, Van Keulen H (1996) Nitrogen, phosphorus and potassium relations in five major cereals reviewed in respect to fertilizer recommendations using simulation modelling. Fertil Res Wagening 44:37–49Viguria M, Sanz-Cobeña A, López DM, Arriaga H, Merino P (2015) Ammonia and greenhouse gases emission from impermeable covered storage and land application of cattle slurry to bare soil. Agric Ecosyst Environ 199:261–271Villamar CA, Canuta T, Belmonte M, Vidal G (2012) Characterization of swine wastewater by toxicity identification evaluation methodology (TIE). Water Air Soil Pollut 223(1):363–369Villamar CA, Rodríguez DC, López D, Peñuela G, Vidal G (2013) Effect of the generation and physical–chemical characterization of swine and dairy cattle slurries on treatment technologies. Waste Manage Res 31(8):820–828Villar MC, Petrikova V, Díaz-Raviña M, Carballas T (2004) Recycling of organic wastes in burnt soils: combined application of poultry manure and plant cultivation. Waste Manage 24(4):365–370Webb J, Menzi H, Pain BF, Misselbrook TH, Dämmgen U, Hendriks H, Döhler H (2005) Managing ammonia emissions from livestock production in Europe. Environ Pollut 135:399–406Webb J, Broomfield M, Jones S, Donovan B (2014) Ammonia and odour emissions from UK pig farms and nitrogen leaching from outdoor pig production. Sci Total Environ 470:865–875Weiland P (2010) Biogas production: current state and perspectives. Appl Microbiol Biotechnol 85:849–860Yagüe MR, Bosch-Serra AD, Boixadera J (2012) Measurement and estimation of the fertiliser value of pig slurry by physicochemical models: usefulness and constraints. Biosyst Eng 111(2):206–216Zhang W, Wei Q, Wu S, Qi D, Li W, Zuo Z, Dong R (2014) Batch anaerobic co-digestion of pig manure with dewatered sewage sludge under mesophilic conditions. Appl Energy 128:175–18

    Oxygen dependence of metabolic fluxes and energy generation of Saccharomyces cerevisiae CEN.PK113-1A

    Get PDF
    <p>Abstract</p> <p>Background</p> <p>The yeast <it>Saccharomyces cerevisiae </it>is able to adjust to external oxygen availability by utilizing both respirative and fermentative metabolic modes. Adjusting the metabolic mode involves alteration of the intracellular metabolic fluxes that are determined by the cell's multilevel regulatory network. Oxygen is a major determinant of the physiology of <it>S. cerevisiae </it>but understanding of the oxygen dependence of intracellular flux distributions is still scarce.</p> <p>Results</p> <p>Metabolic flux distributions of <it>S. cerevisiae </it>CEN.PK113-1A growing in glucose-limited chemostat cultures at a dilution rate of 0.1 h<sup>-1 </sup>with 20.9%, 2.8%, 1.0%, 0.5% or 0.0% O<sub>2 </sub>in the inlet gas were quantified by <sup>13</sup>C-MFA. Metabolic flux ratios from fractional [U-<sup>13</sup>C]glucose labelling experiments were used to solve the underdetermined MFA system of central carbon metabolism of <it>S. cerevisiae</it>.</p> <p>While ethanol production was observed already in 2.8% oxygen, only minor differences in the flux distribution were observed, compared to fully aerobic conditions. However, in 1.0% and 0.5% oxygen the respiratory rate was severely restricted, resulting in progressively reduced fluxes through the TCA cycle and the direction of major fluxes to the fermentative pathway. A redistribution of fluxes was observed in all branching points of central carbon metabolism. Yet only when oxygen provision was reduced to 0.5%, was the biomass yield exceeded by the yields of ethanol and CO<sub>2</sub>. Respirative ATP generation provided 59% of the ATP demand in fully aerobic conditions and still a substantial 25% in 0.5% oxygenation. An extensive redistribution of fluxes was observed in anaerobic conditions compared to all the aerobic conditions. Positive correlation between the transcriptional levels of metabolic enzymes and the corresponding fluxes in the different oxygenation conditions was found only in the respirative pathway.</p> <p>Conclusion</p> <p><sup>13</sup>C-constrained MFA enabled quantitative determination of intracellular fluxes in conditions of different redox challenges without including redox cofactors in metabolite mass balances. A redistribution of fluxes was observed not only for respirative, respiro-fermentative and fermentative metabolisms, but also for cells grown with 2.8%, 1.0% and 0.5% oxygen. Although the cellular metabolism was respiro-fermentative in each of these low oxygen conditions, the actual amount of oxygen available resulted in different contributions through respirative and fermentative pathways.</p

    Natural History of MYH7-Related Dilated Cardiomyopathy

    Get PDF
    BACKGROUND: Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVE: We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS: We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 ± 19.2 years) recruited from 29 international centers. RESULTS: At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% ± 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of ≤35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS: MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare

    Association of follow-up infarct volume with functional outcome in acute ischemic stroke: a pooled analysis of seven randomized trials.

    Get PDF
    BACKGROUND: Follow-up infarct volume (FIV) has been recommended as an early indicator of treatment efficacy in patients with acute ischemic stroke. Questions remain about the optimal imaging approach for FIV measurement. OBJECTIVE: To examine the association of FIV with 90-day modified Rankin Scale (mRS) score and investigate its dependency on acquisition time and modality. METHODS: Data of seven trials were pooled. FIV was assessed on follow-up (12 hours to 2 weeks) CT or MRI. Infarct location was defined as laterality and involvement of the Alberta Stroke Program Early CT Score regions. Relative quality and strength of multivariable regression models of the association between FIV and functional outcome were assessed. Dependency of imaging modality and acquisition time (≤48 hours vs >48 hours) was evaluated. RESULTS: Of 1665 included patients, 83% were imaged with CT. Median FIV was 41 mL (IQR 14-120). A large FIV was associated with worse functional outcome (OR=0.88(95% CI 0.87 to 0.89) per 10 mL) in adjusted analysis. A model including FIV, location, and hemorrhage type best predicted mRS score. FIV of ≥133 mL was highly specific for unfavorable outcome. FIV was equally strongly associated with mRS score for assessment on CT and MRI, even though large differences in volume were present (48 mL (IQR 15-131) vs 22 mL (IQR 8-71), respectively). Associations of both early and late FIV assessments with outcome were similar in strength (ρ=0.60(95% CI 0.56 to 0.64) and ρ=0.55(95% CI 0.50 to 0.60), respectively). CONCLUSIONS: In patients with an acute ischemic stroke due to a proximal intracranial occlusion of the anterior circulation, FIV is a strong independent predictor of functional outcome and can be assessed before 48 hours, oneither CT or MRI
    corecore