31 research outputs found

    CA125-Guided Diuretic Treatment Versus Usual Care in Patients With Acute Heart Failure and Renal Dysfunction

    Get PDF
    Background: The optimal diuretic treatment strategy for patients with acute heart failure and renal dysfunction remains unclear. Plasma carbohydrate antigen 125 (CA125) is a surrogate of fluid overload and a potentially valuable tool for guiding decongestion therapy. The aim of this study was to determine if a CA125-guided diuretic strategy is superior to usual care in terms of short-term renal function in patients with acute heart failure and renal dysfunction at presentation. Methods: This multicenter, open-label study randomized 160 patients with acute heart failure and renal dysfunction into 2 groups (1:1). Loop diuretics doses were established according to CA125 levels in the CA125-guided group (n = 79) and in clinical evaluation in the usual-care group (n = 81). Changes in estimated glomerular filtration rate (eGFR) at 72 and 24 hours were the co-primary endpoints, respectively. Results: The mean age was 78 ± 8 years, the median amino-terminal pro-brain natriuretic peptide was 7765 pg/mL, and the mean eGFR was 33.7 ± 11.3 mL/min/1.73m2. Over 72 hours, the CA125-guided group received higher furosemide equivalent dose compared to usual care (P = 0.011), which translated into higher urine volume (P = 0.042). Moreover, patients in the active arm with CA125 >35 U/mL received the highest furosemide equivalent dose (P <0.001) and had higher diuresis (P = 0.013). At 72 hours, eGFR (mL/min/1.73m2) significantly improved in the CA125-guided group (37.5 vs 34.8, P = 0.036), with no significant changes at 24 hours (35.8 vs 39.5, P = 0.391). Conclusion: A CA125-guided diuretic strategy significantly improved eGFR and other renal function parameters at 72 hours in patients with acute heart failure and renal dysfunction

    ThePlasmodiumClass XIV Myosin, MyoB, Has a Distinct Subcellular Location in Invasive and Motile Stages of the Malaria Parasite and an Unusual Light Chain

    Get PDF
    Myosin B (MyoB) is one of the two short class XIV myosins encoded in the Plasmodium genome. Class XIV myosins are characterized by a catalytic “head,” a modified “neck,” and the absence of a “tail” region. Myosin A (MyoA), the other class XIV myosin in Plasmodium, has been established as a component of the glideosome complex important in motility and cell invasion, but MyoB is not well characterized. We analyzed the properties of MyoB using three parasite species as follows: Plasmodium falciparum, Plasmodium berghei, and Plasmodium knowlesi. MyoB is expressed in all invasive stages (merozoites, ookinetes, and sporozoites) of the life cycle, and the protein is found in a discrete apical location in these polarized cells. In P. falciparum, MyoB is synthesized very late in schizogony/merogony, and its location in merozoites is distinct from, and anterior to, that of a range of known proteins present in the rhoptries, rhoptry neck or micronemes. Unlike MyoA, MyoB is not associated with glideosome complex proteins, including the MyoA light chain, myosin A tail domain-interacting protein (MTIP). A unique MyoB light chain (MLC-B) was identified that contains a calmodulin-like domain at the C terminus and an extended N-terminal region. MLC-B localizes to the same extreme apical pole in the cell as MyoB, and the two proteins form a complex. We propose that MLC-B is a MyoB-specific light chain, and for the short class XIV myosins that lack a tail region, the atypical myosin light chains may fulfill that role

    Prospective study into the value of the automated Elecsys antimüllerian hormone assay for the assessment of the ovarian growing follicle pool

    Get PDF
    ObjectiveTo evaluate a new fully automated assay measuring antimüllerian hormone (AMH; Roche Elecsys) against antral follicle count in women of reproductive age.DesignProspective cohort study.SettingHospital infertility clinics and academic centers.Patient(s)Four hundred fifty-one women aged 18 to 44 years, with regular menstrual cycles.Intervention(s)None.Main Outcome Measure(s)AMH and antral follicle count (AFC) determined at a single visit on day 2–4 of the menstrual cycle.Result(s)There was a statistically significant variance in AFC but not in AMH between centers. Both AFC and AMH varied by age (overall Spearman rho −0.50 for AFC and −0.47 for AMH), but there was also significant between-center variation in the relationship between AFC and age but not for AMH. There was a strong positive correlation between AMH and AFC (overall spearman rho 0.68), which varied from 0.49 to 0.87 between centers. An agreement table using AFC cutoffs of 7 and 15 showed classification agreement in 63.2%, 56.9% and 74.5% of women for low, medium, and high groups, respectively.Conclusion(s)The novel fully automated Elecsys AMH assay shows good correlations with age and AFC in women of reproductive age, providing a reproducible measure of the growing follicle pool

    Resources assessment of a small karstic mediterranean aquifer (South-Eastern, Spain)

    Get PDF
    Groundwater from small aquifer systems is frequently used for urban supply in southeastern Spain. Aquifers such as the Ventos system, located in Mediterranean semiarid environments, are sensitive to climatic and anthropogenic changes. Many of them have been severely depleted due to intensive pumping. Drawdowns in the Ventos aquifer amount to approximately 80m over the last three decades. Adequate knowledge of groundwater resources is necessary for water planners and managers to guarantee suitable abstraction. This paper presents a methodology to estimate groundwater recharge in these kinds of quick-response semiarid karst aquifers. A distributed model has been used to evaluate the fraction of rainfall that ultimately results in aquifer recharge, as well as the correlation between the magnitude of rainfall events and infiltration rates. Modelling results are then compared with direct observations of the recharge processes and discussed to evaluate the implications of time scales

    Hydrogeologie characterization of the Sierra de la Horna (Alicante)

    No full text
    In this paper we present the preliminary results ofthe'study of Sierra de Horna aquifer. There is a conection between Horna aquifer and the detritical aquifer of Rambla del Tarafa deduced from the piezometric data: The hydrochemistry results have shown .that most saline waters lie in the deepest parts of the aquifer, while those of lowest mineralization occupy the area of the saturated zone closest to the surfac
    corecore