Re: Lipoprotein(a) and SYNTAX Score Association with Severity of Coronary Artery Atherosclerosis in North India

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Direct Test for Determining Sensitivity of M. Tuberculosis To Streptomycin

For a total of 400 sputum specimens, the sensitivity of M. tuberculosis to streptomycin was determined by direct inoculation of the sputum sediment on to drug-free and drugcontaining slopes of Lowenstein-Jensen medium, and also by a standard indirect test. Agreement between the two methods in the classification of strains as sensitive or resistant was of the order of 90%. The optimal time for reading the direct test is 6 weeks

Lysosomal acid lipase deficiency – An under-recognized cause of dyslipidaemia and liver dysfunction

AbstractLysosomal acid lipase deficiency (LAL-D) is a rare autosomal recessive lysosomal storage disease caused by deleterious mutations in the LIPA gene. The age at onset and rate of progression vary greatly and this may relate to the nature of the underlying mutations. Patients presenting in infancy have the most rapidly progressive disease, developing signs and symptoms in the first weeks of life and rarely surviving beyond 6 months of age. Children and adults typically present with some combination of dyslipidaemia, hepatomegaly, elevated transaminases, and microvesicular hepatosteatosis on biopsy. Liver damage with progression to fibrosis, cirrhosis and liver failure occurs in a large proportion of patients. Elevated low-density lipoprotein cholesterol levels and decreased high-density lipoprotein cholesterol levels are common features, and cardiovascular disease may manifest as early as childhood. Given that these clinical manifestations are shared with other cardiovascular, liver and metabolic diseases, it is not surprising that LAL-D is under-recognized in clinical practice. This article provides practical guidance to lipidologists, endocrinologists, cardiologists and hepatologists on how to recognize individuals with this life-limiting disease. A diagnostic algorithm is proposed with a view to achieving definitive diagnosis using a recently developed blood test for lysosomal acid lipase. Finally, current management options are reviewed in light of the ongoing development of enzyme replacement therapy with sebelipase alfa (Synageva BioPharma Corp., Lexington, MA, USA), a recombinant human lysosomal acid lipase enzyme

Operations management and the resource based view: another view

This paper evaluates the usefulness of the resource-based view (RBV) to the field of operations management. Based on the seminal RBV articles, we argue that using the RBV does not align with the objectives and activities of operations management researchers in several ways. First, the dependent variable in the RBV is sustained competitive advantage. Using sustained competitive advantage as a dependent variable implies that scholars focus on explaining the differences between the relatively few firms with sustained competitive advantage and all the other firms, ignoring performance variations within the great mass of firms. In addition, competitive advantage exists at the level of the business or the firm and does not directly translate into the normal level of operations management research. Measuring sustained competitive advantage also presents difficulties. Second, the explanatory variables in the RBV are resources that must be rare, valuable and hard or impossible to imitate. Measuring valuable resources or factors firms cannot imitate poses serious problems both in demonstrating value independent of the factor's impact on performance (i.e., avoiding tautology) and in measuring unique or nearly unique entities. Third, under the RBV, prescription is problematic; you cannot prescribe things that firms can readily implement because such things can be imitated. We present the practice-based view (PBV) as a simpler and better alternative for operations management where scholars attempt to explain the entire range of firm and unit performance based on transferable practices

Telomeres are shorter in myocardial infarction patients compared to healthy subjects: correlation with environmental risk factors

Shorter telomeres have been reported in premature myocardial infarction (MI) patients. Our work aimed at confirming the association of shorter telomere with MI in two case–control studies and in familial hypercholesterolemia (FH) patients with coronary heart disease (CHD). The HIFMECH study compared 598 white male patients (<60 years) who survived a first MI and 653 age-matched controls from North and South Europe. Additionally, from the UK, 413 coronary artery bypass graft (CABG) patients and two groups of 367 and 94 FH patients, of whom 145 and 17 respectively had premature CHD, were recruited. Leukocyte telomere length (LTL) was measured using a real-time polymerase chain reaction-based method. In HIFMECH, LTL was significantly shorter in subjects from the North (7.99 kb, SD 4.51) compared to the South (8.27 kb, SD 4.14; p = 0.02) and in cases (7.85 kb, SD 4.01) compared to controls (8.04 kb, SD 4.46; p = 0.04). In the CABG study, LTL was significantly shorter (6.89 kb, SD 4.14) compared to the HIFMECH UK controls (7.53, SD 5.29; p = 0.007). In both samples of FH patients, LTL was shorter in those with CHD (overall 8.68 kb, SD 4.65) compared to the non-CHD subjects (9.23 kb, SD 4.83; p = 0.012). Apart from a consistent negative correlation with age, LTL was not associated across studies with any measured CHD risk factors. The present data confirms that subjects with CHD have shorter telomeres than controls and extends this to those with monogenic and polygenic forms of CHD