Prognostic significance of endogenous erythropoietin in long-term outcome of patients with acute decompensated heart failure

Aims Although previous reports suggest that an elevated endogenous erythropoietin (EPO) level is associated with worse clinical outcomes in chronic heart failure (HF) patients, the prognostic implication of EPO in patients with acute decompensated HF (ADHF) and underlying mechanisms of the high EPO level in severe HF patients who have a poor prognosis remain unclear. Methods and results We examined 539 consecutive ADHF patients with EPO measurement on admission from our registry. During a median follow-up period of 329 days, a higher EPO level on admission was independently associated with worse clinical outcomes [hazard ratio (HR) 1.25, 95% confidence interval (CI) 1.06–1.48, P = 0.008], and haemoglobin level was the strongest determinant of EPO level (P < 0.001), whereas estimated glomerular filtration rate (eGFR) was not significant in multivariate regression analysis. In the anaemic subgroup of 318 patients, a higher EPO level than expected on the basis of their haemoglobin level was related to increased adverse events (HR 1.63, 95% CI 1.05–2.49, P = 0.028). Moreover, estimated plasma volume excess rate was positively associated with EPO level (P = 0.003), and anaemic patients with a higher than expected EPO level tended to have a higher estimated plasma volume excess rate and plasma lactate level, and lower systemic oxygen saturation level with the preservation of the reticulocyte production index than those with a lower than expected EPO level. Conclusion A high EPO level predicts long-term worse clinical outcomes in ADHF patients, independent of anaemia and impaired renal function. Anaemia and hypoxia due to severe congestion may synergistically contribute to a high EPO level in high-risk HF patients

Normal values for ionized calcium in the plasma of normal lactating ewes and suckling lambs: relation to plasma total calcium, inorganic phosphate, magnesium and total proteins

No Abstrac

An investigation into possible methods of assessing the intake of calcium and phosphorus by grazing sheep

A study was made, over a period of 29 weeks, of the interrelationship between calcium (Ca) and phosphorus (P) levels while monitoring those of magnesium (Mg) in ovine bone, soft tissues, faeces, urine and rumen fluid as well as blood plasma, where the P was determined as inorganic P (Pi) in order to determine whether the results reflected the dietary intake of P and Ca. Three groups of 6-month-old South African Mutton Merino x Merino wethers were fed 3 different rations containing, respectively, approximately the same amounts of crude protein (7, 28; 7, 67; 7, 53%) and Mg (0, 12; 0, 13; 0, 11 %), but increasing amounts of P (0, 05; 0, 27; 0, 63 %) and varying amounts of Ca (0, 22; 0,62; 0,20%). A comparison of the results for these Low, Medium and High phosphate (P) groups of animals showed that plasma Ca did not reflect dietary intake and, although the plasma Pi levels of the Low P group were low, those of the Medium and High groups rarely differed. Thus, in the assessment of the dietary intake of Ca and P by grazing sheep, plasma Ca and Pi levels must be viewed with extreme caution. On the other hand, the mean faecal Ca and P levels did reflect the dietary levels of these 2 elements. The Ca content of small faecal grab samples was closely correlated with the Ca content of 4-day pooled samples from the same animal (P< 0,01, r = 0,927). A similar finding was true for P (P<0,01, r = 0 ,963). Thus, taking rectal faeces from a number of sheep in a flock for individual or pooled analyses for Ca and P appears to be the best method for assessing the dietary intake of these elements. The Ca percentage in bone increased as dietary Ca increased but was influenced by the availability of P since the ratio of P to Ca in bone remained virtually constant. There was a significant correlation between the ash percentage and the midshaft width of the cortex of the femur (P< 0,01, r = 0,879). Significant negative correlations (P< 0,01) were also found between whole dry bone fat and ash percentage in cervical vertebrae (r = - 0,963), ribs (r= -0,903) and femurs (r= -0, 885). Thus ash analyses on whole dry bone will probably suffice to indicate the mineral status of the animals. Body composition estimated from tritiated water space was of little value as total body ash percentage was the reverse of the ash percentage actually found in the bones. Bone turnover as measured by urinary hydroxyproline excretion was significantly lower (P < 0,01) in the Low P group. The concentration of Ca and/or P in soft tissues did not reflect dietary intake. Similarly the Ca concentration in the case of urine and ruminal fluid did not reflect dietary intake whereas P concentrations did. Although the dietary intake of Ca and P was reflected in the mean daily urinary excretion, this measurement is unpractical in grazing animals. Although dietary Mg was almost equal in the 3 groups, faecal Mg was the lowest and plasma Mg the highest in the Low P group. Bone Mg was significantly lower (P< 0,01) in the Low P group than in the other 2 groups in respect of all 3 types of bone analysed.The articles have been scanned in colour with a HP Scanjet 5590; 300dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-format

Books

Neurobiology Neurobiology: 2 ed. Ed. by Gordon M. Shepherd. Pp. xiv + 689. Illustrared. R74,50. Oxford: Oxford Universiry Press. 1988.Medical physiology Textbook of Medical Physiology. Ed. by A. C. Guyton. Pp. xli + 1014. Illustrated. Kent: Harcourt, Brace, Jovanovich. 1991.Bilingual heart and stress booklets The Healthy HeartlDie Gesonde Hart. Ed. by G. Jackson. Coping with Stress/Oorwin Stres. Ed. by T. Trauer. pp. 77. Illustrated. RI9,95. Cape Town: Tafelberg. 1990

Anatomical studies, no. 41 : prenatal death in the Merino ewe, associated with deformity of the cervix uteri

Attention is drawn to the somewhat frequent occurrence of prenatal death in the pregnant Merino ewe, and to a case of unusual cervical dilatation.The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.mn201

Effect on the fertility of "barren" or early post-partum Karakul ewes of oestrus synchronization and various levels of PMSG within and outside the normal breeding season

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Anatomical studies No. 53. Local thickening of the vascular system in a horse

The articles have been scanned in colour with a HP Scanjet 5590; 600dpi. Adobe Acrobat XI Pro was used to OCR the text and also for the merging and conversion to the final presentation PDF-format.No abstract available

Adaptation to protein deficiency: cortisol, thyroxine, insulin and glucose in young pigs

No Abstrac