Topographic Changes in SARS Coronavirus–infected Cells at Late Stages of Infection

Scanning electron and atomic force microscopy was used for the first time to view the maturation of SARS-CoV at the cell surface

292P Erectile dysfunction among male lymphoma survivors in a developing country

Background: Although erectile dysfunction (ED) is one of the known long-term complications among male cancer survivors, it is not commonly reported particularly in South East Asian region. This study aims to determine the prevalence of ED in lymphoma survivors in Malaysia and to determine its association with anxiety and depression, and its effects on patients’ quality of life (QOL). Methods: This was a cross-sectional study conducted in an outpatient haematology clinic at a tertiary hospital inMalaysia. Patients were allmale lymphoma survivors who were age 18 years old and above. The International Index of Erectile Function (IIEF-5) Questionnairewere used to screen for ED.Hospital Anxiety and Depression Score (HADS) questionnaire were used to assess for anxiety and depression.Quality of life were assessed using EORTC QLQ-C30. Bio-demographic datawas analysed using descriptive analysis. The association of EDwith the bio-demographics was assessed using Chi square test. The correlation between ED and anxiety/depression scores andQOL scores were measured using Pearson correlation. P value of<0.05 is statistically significant. Results: A total of 106 male patients were recruited (response rate of 79.6%). The mean age of the participants was 55.7 years old (range from 18-85 years). More than half (61%) of the patients were above 50 years old and 50.7% had other comorbidities. Thirty-five percent of patients were not sexually active at the time of interview and the most common reason provided were ‘feeling too tired’ (48.1%). Among those who were sexually active patients, 81.7% reported presence of ED. However, 4.2% had severe ED. The prevalence of ED among younger age group (< 40 years old) was 61.5%. Age was the only factor found to be associated with ED and the severity of EDincreased with age (p value ¼ 0.002). There was no association between ED with symptoms of anxiety or depression. Quality of life was also not found to be significantly associated with ED. Conclusions: ED is more prevalent in the older population and this is consistent with many studies. However, the relatively high prevalence of ED in younger patients is of concerns. This should remind the treating clinicians to be more mindful of the sexual dysfunction of these groups of patients and perhaps intervention may offer some help

Plasma Desmosine for Prediction of Outcomes after Actue Myocardial Infarction

BACKGROUND: Elastin degradation is implicated in the pathology of vulnerable plaque. Recent studies show promising results for plasma desmosine (pDES), an elastin-specific degradation product, as a marker of cardiovascular disease (CVD) outcomes. The aim of this study was to investigate the potential role of pDES as a marker of clinical outcome in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: In this case-control study, we studied 236 AMI patients: 79 patients who had death and/or myocardial infarction (MI) at 2 years, and 157 patients who did not have an event at 2 years. pDES was measured using a validated liquid chromatography-tandem mass spectrometry method. Association of pDES with adverse outcomes, and the incremental value of pDES to global registry of acute coronary events (GRACE) score for risk stratification was assessed. RESULTS: pDES levels were elevated in patients with the composite outcome of death/MI at 2 years (p = 0.002). Logistic regression analyses showed pDES to be associated with death/MI at 2 years [Odds ratio (OR) 5.99 (95% CI 1.81–19.86) p = 0.003]. pDES remained a significant predictor of death/MI at 2 years even after adjustment for age, sex, history of CVD, revascularisation, blood pressure, medications on discharge, Troponin I, and NT-proBNP levels.[OR 5.60 (95% CI 1.04–30.04) p = 0.044]. In another multivariable model including adjustment for eGFR, pDES was significantly associated with the composite outcome at 6 months, but not at 2 years follow up. DES was also able to reclassify risk stratification for death/MI at 6 months, when added to the GRACE risk model [Net Reclassification Index (NRI) 41.2 (95% CI 12.0–70.4) p = 0.006]. CONCLUSION: pDES concentrations predict clinical outcomes in patients with AMI, demonstrating its potential role as a prognostic marker in AMI

Clinical Determinants and Prognostic Implications of Renin and Aldosterone in Patients with Symptomatic Heart Failure

Aims Activation of the renin-angiotensin-aldosterone system plays an important role in the pathophysiology of heart failure (HF) and has been associated with poor prognosis. There are limited data on the associations of renin and aldosterone levels with clinical profiles, treatment response, and study outcomes in patients with HF. Methods and results We analysed 2,039 patients with available baseline renin and aldosterone levels in BIOSTAT-CHF (a systems BIOlogy study to Tailored Treatment in Chronic Heart Failure). The primary outcome was the composite of all-cause mortality or HF hospitalization. We also investigated changes in renin and aldosterone levels after administration of mineralocorticoid receptor antagonists (MRAs) in a subset of the EPHESUS trial and in an acute HF cohort (PORTO). In BIOSTAT-CHF study, median renin and aldosterone levels were 85.3 (percentile(25-75) = 28-247) mu IU/mL and 9.4 (percentile(25-75) = 4.4-19.8) ng/dL, respectively. Prior HF admission, lower blood pressure, sodium, poorer renal function, and MRA treatment were associated with higher renin and aldosterone. Higher renin was associated with an increased rate of the primary outcome [highest vs. lowest renin tertile: adjusted-HR (95% CI) = 1.47 (1.16-1.86), P = 0.002], whereas higher aldosterone was not [highest vs. lowest aldosterone tertile: adjusted-HR (95% CI) = 1.16 (0.93-1.44), P = 0.19]. Renin and/or aldosterone did not improve the BIOSTAT-CHF prognostic models. The rise in aldosterone with the use of MRAs was observed in EPHESUS and PORTO studies. Conclusions Circulating levels of renin and aldosterone were associated with both the disease severity and use of MRAs. By reflecting both the disease and its treatments, the prognostic discrimination of these biomarkers was poor. Our data suggest that the "point" measurement of renin and aldosterone in HF is of limited clinical utility

Geographical location affects the levels and association of trimethylamine N-oxide with heart failure mortality in BIOSTAT-CHF:a post-hoc analysis

No abstract available