High Prevalence of Associated Birth Defects in Congenital Hypothyroidism

Aim. To identify dysmorphic features and cardiac, skeletal, and urogenital anomalies in patients with congenital hypothyroidism. Patients and Methods. Seventeen children with congenital primary hypothyroidism were recruited. Cause for congenital hypothyroidism was established using ultrasound of thyroid and 99mTc radionuclide thyroid scintigraphy. Malformations were identified by clinical examination, echocardiography, X-ray of lumbar spine, and ultrasonography of abdomen. Results. Ten (59%) patients (6 males and 4 females) had congenital malformations. Two had more than one congenital malformation (both spina bifida and ostium secundum atrial septal defect). Five (29%) had cardiac malformations, of whom three had only osteum secundum atrial septal defect (ASD), one had only patent ductus arteriosus (PDA), and one patient had both ASD and PDA. Seven patients (41%) had neural tube defects in the form of spina bifida occulta. Conclusion. Our study indicates the need for routine echocardiography in all patients with congenital hypothyroidism

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Grain size characteristics of beach sediments of north coastal Andhra Pradesh

283-286The grain size parameters of different environments viz., dunes, backshore, upper and lower foreshore of nine beaches were calculated. The two-way Analysis of Variance (ANOVA) reveals that the sediment texture variations among different beaches are not statistically significant and the grain size variations of different environments within a given beach are statistically significant. The one-way ANOVA has revealed that the north to south spatial variation in grain size within a particular environment is not significant. The Students' t-test revealed that there are significant variations in the mean size of the sediments between two adjacent environments of a beach except between backshore and upper foreshore. These variations are: attributed to different agents of deposition and their energy levels

Research article STUDY ON CROSSING ABILITY OF ANNUAL CHRYSANTHEMUM GENOTYPES

viability, in-vitro pollen germination, stigma receptivity and crossed seed set percentage to find out the crossing ability of genotypes. The present experiment was laid out at the experimental field of Horticulture Section, College of Agriculture, Nagpur, during 2010-11. Pollen viability of six genotypes of annual chrysanthemum showed a range of 69.69 % to 86.66 % viability, Percentage of germination on the day of anthesis ranged from 22.72 % (NAC-06-10) to 66.66 % (NAC-01-10). First day pollen pollinated on first day stigma showed 100 % stigma receptivity in all six genotypes and the crossed seed set ranged from 61.60 % (NAC-04-10 × NAC-05-10) to 92.00% (NAC-01-10 × NAC-04-10) among direct crosses whereas, the percentage ranged from 42.00 % (NAC-04-10 × NAC-02-10) to 90.00 % (NAC-05-10 × NAC-01-10) among the reciprocal crosses. All the six genotypes are highly suitable for their use as parents in crossing program. Key words: Annual Chrysanthemum, pollen viability, pollen germination, stigma receptivit

Computed tomographic coronary angiography as a tool in diagnosis of coronary artery disease in patients with negative exercise stress test

L’A. s’intéresse à l’utilisation des animaux par Rūmī soit dans des contes moraux, philosophiques ou mystiques, soit dans des comparaisons, métaphores et autres figures de style. Elle établit un lexique d’une centaine de mots en listant à chaque fois les différentes occurrences dans le Maṯnavī, les contes concernés et la symbolique liée à tel animal. Voilà qui pourra servir de base à une réflexion sur l’imagerie animale en poésie persane