Uncharted waters: rare and unclassified cardiomyopathies characterized on cardiac magnetic resonance imaging

Cardiac magnetic resonance imaging (CMR) has undergone considerable technology advances in recent years, so that it is now entering into mainstream cardiac imaging practice. In particular, CMR is proving to be a valuable imaging tool in the detection, morphological assessment and functional assessment of cardiomyopathies. Although our understanding of this broad group of heart disorders continues to expand, it is an evolving group of entities, with the rarer cardiomyopathies remaining poorly understood or even unclassified. In this review, we describe the clinical and pathophysiological aspects of several of the rare/unclassified cardiomyopathies and their appearance on CMR

Application of a plant bioassay for the evaluation of ecotoxicological risks of heavy metals in sediments affected by mining activities

Purpose. The objective of this work was to evaluate the effectiveness of a plant bioassay (Phytotoxkit®) for screening ecotoxicological risks in sediments affected by mining activities. Materials and methods A total of 42 sediment samples affected by mining activities were studied, including 39 sediment samples fromthe Sierra Minera, Spain, an area affected by old extraction procedures, and three sediments from an area affected by opencast mining. These three samples were then mixed with limestone filler at 10, 20 and 30 %, providing nine stabilised samples. The total and soluble metal(loid) content (As, Cd, Cu, Fe, Pb and Zn) was determined in all samples, and the Phytotoxkit® bioassay was applied to determine the ecotoxicological effect of this procedure. Results and discussion The stabilised material had a neutral pH and low soluble metal(loid) concentration, similar to that of samples in which a natural attenuation process had taken place because of mixing with surrounding carbonate-rich materials. An ecotoxicological survey identified the low toxicity levels of the stabilised samples

Serum 25-hydroxy-vitamin D and the risk of fractures in the teriparatide versus risedronate VERO clinical trial

PurposeUsing data from the 2-year, randomized, double-dummy VERO trial, we examined the changes in 25-hydroxy-vitamin D (25[OH]D) concentrations over time, and whether the fracture risk reduction of teriparatide versus risedronate varies by baseline 25(OH)D sufficiency category.MethodsPostmenopausal women with established osteoporosis received subcutaneous daily teriparatide 20g or oral weekly risedronate 35mg, with concomitant 500-1000mg of elemental calcium and 400-800IU/day of vitamin D supplements. Fracture endpoints were analyzed by predefined subgroups of 25(OH)D insufficient and sufficient patients. Heterogeneity of the treatment effect on fractures was investigated by logistic and Cox proportional hazards regression models.ResultsAt baseline, mean serum 25(OH)D was 31.9ng/mL in the teriparatide group and 31.5ng/mL in the risedronate group, and 16.8% and 17.9% of patients, respectively, were 25(OH)D insufficient. At month 6, the mean serum 25(OH)D concentration decreased in teriparatide-treated patients to 24.5ng/mL (by approximately 23%) but remained relatively constant in risedronate-treated patients (32.2ng/mL) (p0.1) treatment-by-25(OH)D interactions in all fracture analyses.ConclusionsSerum 25(OH)D concentration decreases during teriparatide treatment. Fracture risk reduction with teriparatide versus risedronate did not significantly differ between the two groups of patients defined by baseline 25(OH)D.Trial registrationClinicalTrials.gov Identifier: NCT01709110EudraCT Number: 2012-000123-4