Estimating Mean Pulmonary Wedge Pressure in Patients With Chronic Atrial Fibrillation From Transthoracic Doppler Indexes of Mitral and Pulmonary Venous Flow Velocity

AbstractObjectives. We sought to obtain a noninvasive estimation of mean pulmonary wedge pressure (MPWP) in patients with chronic atrial fibrillation (AF).Background. It has previously been demonstrated that MPWP can be reliably estimated from Doppler indexes of mitral and pulmonary venous flow (PVF) in patients with sinus rhythm. Doppler estimation of MPWP has not been validated in patients with AF.Methods. MPWP was correlated with variables of mitral and pulmonary venous flow velocity as assessed by Doppler transthoracic echocardiography in 35 consecutive patients. The derived algorithm was prospectively tested in 23 additional patients.Results. In all patients the mitral flow pattern showed only a diastolic forward component. A significant but relatively weak correlation (r = −0.50) was observed between MPWP and mitral deceleration time. In 12 (34%) of 35 patients, the pulmonary vein flow tracing demonstrated only a diastolic forward component; a diastolic and late systolic forward flow was noted in the remaining 23 patients (66%). A strong negative correlation was observed between MPWP and the normalized duration of the diastolic flow (r = −0.80) and its initial deceleration slope time (r = −0.91). Deceleration time >220 ms predicted MPWP ≤12 mm Hg with 100% sensitivity and 100% specificity. When estimating MPWP by using the equation MPWP= −94.261 PVF deceleration time− 9.831 Interval QRS to onset of diastolic PVF− 16.337 Duration of PVF+ 44.261, the measured and predicted MPWP closely agreed with a mean difference of −0.85 mm Hg. The 95% confidence limits were 4.8 and −6.1 mm Hg.Conclusions. In patients with chronic AF, MPWP can be estimated from transthoracic Doppler study of PVF velocity signals.(J Am Coll Cardiol 1997;30:19–26

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Safety and Efficacy of Subcutaneous Rituximab in Previously Untreated Patients with CD20+ Diffuse Large B-Cell Lymphoma or Follicular Lymphoma: Results from an Italian Phase IIIb Study

Subcutaneous (SC) rituximab may be beneficial in terms of convenience and tolerability, with potentially fewer and less severe administration-related reactions (ARRs) compared to the intravenous (IV) form. This report presents the results of a phase IIIb study conducted in Italy. The study included adult patients with CD20+ DLBCL or FL having received at least one full dose of IV RTX 375 mg/m2 during induction or maintenance. Patients on induction received ≥4 cycles of RTX SC 1400 mg plus standard chemotherapy and FL patients on maintenance received ≥6 cycles of RTX SC. Overall, 159 patients (73 DLBCL, 86 FL) were enrolled: 103 (54 DLBCL, 49 FL) completed induction and 42 patients with FL completed 12 maintenance cycles. ARRs were reported in 10 patients (6.3%), 3 (4.2%) with DLBCL and 7 (8.1%) with FL, all of mild severity, and resolved without dose delay/discontinuation. Treatment-emergent adverse events (TEAEs) and serious adverse events occurred in 41 (25.9%) and 14 patients (8.9%), respectively. Two patients with DLBCL had fatal events: Klebsiella infection (related to rituximab) and septic shock (related to chemotherapy). Neutropenia (14 patients, 8.9%) was the most common treatment-related TEAE. Two patients with DLBCL (2.8%) and 6 with FL (7.0%) discontinued rituximab due to TEAEs. 65.2% and 69.7% of patients with DLBCL and 67.9% and 73.6% of patients with FL had complete response (CR) and CR unconfirmed, respectively. The median time to events (EFS, PFS, and OS) was not estimable due to the low rate of events. At a median follow-up of 29.5 and 47.8 months in patients with DLBCL and FL, respectively, EFS, PFS, and OS were 70.8%, 70.8%, and 80.6% in patients with DLBCL and 77.9%, 77.9%, and 95.3% in patients with FL, respectively. The switch from IV to SC rituximab in patients with DLBCL and FL was associated with low risk of ARRs and satisfactory response in both groups. This trial was registered with NCT01987505

Empleo del radar meteorológico argentino RMA1 para la detección de un evento severo

Ponencia presentada en el XXVII Congreso Latinoamericano de Hidráulica. Lima, Perú del 28 al 30 de septiembre de 2016.Fil: Comes, Raúl Alberto. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina.Fil: Ingaramo, Ricardo Daniel. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Ingaramo, Ricardo Daniel. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Hidráulica. Laboratorio de Hidráulica; Argentina.Fil: Poffo, Denis Alexander. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina.Fil: Furbatto, Celina Grisel. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Saffe, Jorge Nicolás. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Vicario, Leticia del Valle. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Vicario, Leticia del Valle. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Dasso, Clarita María. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Dasso, Clarita María. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Rodríguez, Andrés. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Rodríguez, Andrés. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Hidráulica. Laboratorio de Hidráulica; Argentina.Fil: Bertoni, Juan Carlos. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Caranti, Giorgio Mario. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina.Fil: Catalini, Carlos Gastón. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Martina, Agustín. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Menajovsky Barbiero, Sergio Aníbal Natalio. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Montamat, Ignacio Adolfo. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Rico, Andrea. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Rodríguez González, Santiago. Ministerio de Defensa. Fuerza Aérea Argentina. Centro de Investigaciones Aplicadas; Argentina.Fil: Serra, Juan José. Universidad Nacional de la Patagonia San Juan Bosco; Argentina.Fil: Villa Uría, Alberto Rafael. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Hidráulica. Laboratorio de Hidráulica; Argentina.Los radares meteorológicos permiten la elaboración de pronósticos con una buena definición tanto espacial como temporal, pero como contrapartida producen estimaciones muy poco precisas de la intensidad de lluvia caída en un punto. Por eso es necesario integrar los datos del radar con registros pluviométricos de superficie, para ajustar los algoritmos que permiten realizar la transformación de los ecos medidos por el radar en precipitación u otras variables meteorológicas de interés. En este trabajo se presenta el análisis de un evento pluviométrico de gran intensidad registrado en la Provincia de Córdoba (Argentina), que fue monitoreado por el radar RMA1, instalado en la ciudad de Córdoba y perteneciente al Sistema Nacional de Radares Meteorológicos, y por una estación meteorológica de superficie perteneciente al Instituto Nacional del Agua.Fil: Comes, Raúl Alberto. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina.Fil: Ingaramo, Ricardo Daniel. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Ingaramo, Ricardo Daniel. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Hidráulica. Laboratorio de Hidráulica; Argentina.Fil: Poffo, Denis Alexander. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina.Fil: Furbatto, Celina Grisel. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Saffe, Jorge Nicolás. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Vicario, Leticia del Valle. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Vicario, Leticia del Valle. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Dasso, Clarita María. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Dasso, Clarita María. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Rodríguez, Andrés. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Rodríguez, Andrés. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Hidráulica. Laboratorio de Hidráulica; Argentina.Fil: Bertoni, Juan Carlos. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Caranti, Giorgio Mario. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina.Fil: Catalini, Carlos Gastón. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Martina, Agustín. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Menajovsky Barbiero, Sergio Aníbal Natalio. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Montamat, Ignacio Adolfo. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; Argentina.Fil: Rico, Andrea. Instituto Nacional del Agua. Centro de la Región Semiárida; Argentina.Fil: Rodríguez González, Santiago. Ministerio de Defensa. Fuerza Aérea Argentina. Centro de Investigaciones Aplicadas; Argentina.Fil: Serra, Juan José. Universidad Nacional de la Patagonia San Juan Bosco; Argentina.Fil: Villa Uría, Alberto Rafael. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Hidráulica. Laboratorio de Hidráulica; Argentina.Meteorología y Ciencias Atmosférica

Spontaneous Peierls dimerization and emergent bond order in one-dimensional dipolar gases

info:eu-repo/semantics/publishe

Comparison of Cortisol, Androstenedione and Metanephrines to Assess Selectivity and Lateralization of Adrenal Vein Sampling in Primary Aldosteronism

Success of adrenal vein sampling (AVS) is verified by the selectivity index (SI), i.e., by a step-up of cortisol levels between the adrenal vein and the infrarenal inferior vena cava samples, beyond a given cut-off. We tested the hypothesis that androstenedione, metanephrine, and normetanephrine, which have higher gradients than cortisol, could increase the rate of AVS studies judged to be bilaterally successful and usable for the clinical decision making. We prospectively compared within-patient, head-to-head, the selectivity index of androstenedione (SIA), metanephrine (SIM), and normetanephrine (SINM), and cortisol (SIC) in consecutive hypertensive patients with primary aldosteronism submitted to AVS. Main outcome measures were rate of bilateral success, SI values, and identification of unilateral PA. We recruited 136 patients (55 + 10 years, 35% women). Compared to the SIC, the SIA values were 3.5-fold higher bilaterally, and the SIM values were 7-fold and 4.4-fold higher on the right and the left side, respectively. With the SIA and the SIM the rate of bilaterally successful AVS increased by 14% and 15%, respectively without impairing the identification of unilateral PA. We concluded that androstenedione and metanephrine outperformed cortisol for ascertaining AVS success, thus increasing the AVS studies useable for the clinical decision making