Agreement between the SCORE and D’Agostino Scales for the Classification of High Cardiovascular Risk in Sedentary Spanish Patients

Background: To evaluate agreement between cardiovascular risk in sedentary patients as estimated by the new Framingham-D’Agostino scale and by the SCORE chart, and to describe the patient characteristics associated with the observed disagreement between the scales. Design: A cross-sectional study was undertaken involving a systematic sample of 2,295 sedentary individuals between 40–65 years of age seen for any reason in 56 primary care offices. An estimation was made of the Pearson correlation coefficient and kappa statistic for the classification of high risk subjects (≥20% according to the Framingham-D’Agostino scale, and ≥5% according to SCORE). Polytomous logistic regression models were fitted to identify the variables associated with the discordance between the two scales. Results: The mean risk in males (35%) was 19.5% ± 13% with D’Agostino scale, and 3.2% ± 3.3% with SCORE. Among females, they were 8.1% ± 6.8% and 1.2% ± 2.2%, respectively. The correlation between the two scales was 0.874 in males (95% CI: 0.857–0.889) and 0.818 in females (95% CI: 0.800–0.834), while the kappa index was 0.50 in males (95% CI: 0.44%–0.56%) and 0.61 in females (95% CI: 0.52%–0.71%). The most frequent disagreement, characterized by high risk according to D’Agostino scale but not according to SCORE, was much more prevalent among males and proved more probable with increasing age and increased LDL-cholesterol, triglyceride and systolic blood pressure values, as well as among those who used antihypertensive drugs and smokers. Conclusions: The quantitative correlation between the two scales is very high. Patient categorization as corresponding to high risk generates disagreements, mainly among males, where agreement between the two classifications is only moderate

Effect of repetitiveness on the immunogenicity and antigenicity of Trypanosoma cruzi FRA protein

Repetitive proteins (RP) of Trypanosoma cruzi are highly present in the parasite and are strongly recognized by sera from Chagas' disease patients. Flagelar Repetitive Antigen (FRA), which is expressed in all steps of the parasite life cycle, is the RP that displays the greatest number of aminoacids per repeat and has been indicated as one of the most suitable candidate for diagnostic test because of its high performance in immunoassays. Here we analyzed the influence of the number of repeats on the immunogenic and antigenic properties of the antigen. Recombinant proteins containing one, two, and four tandem repeats of FRA (FRA1, FRA2, and FRA4, respectively) were obtained and the immune response induced by an equal amount of repeats was evaluated in a mouse model. The reactivity of specific antibodies present in sera from patients naturally infected with T. cruzi was also assessed against FRA1, FRA2, and FRA4 proteins, and the relative avidity was analyzed. We determined that the number of repeats did not increase the humoral response against the antigen and this result was reproduced when the repeated motifs were alone or fused to a non-repetitive protein. By contrast, the binding affinity of specific human antibodies increases with the number of repeated motifs in FRA antigen. We then concluded that the high ability of FRA to be recognized by specific antibodies from infected individuals is mainly due to a favorable polyvalent interaction between the antigen and the antibodies. In accordance with experimental results, a 3D model was proposed and B epitope in FRA1, FRA2, and FRA4 were predicted

Erbium spectroscopy and 1.5-micrometre emission in KGd(WO4)2: Er,Yb single crystals

We grew good-optical-quality KGd(WO/sub 4/)/sub 2/ single crystals doped with erbium and ytterbium ions at several concentrations of dopants using the top-seeded-solution growth slow-cooling method (TSSG). We performed the spectroscopic characterization of this material related to the 1.5-mm infrared emission of erbium which is interesting for laser applications. To do this, we carried out polarized optical absorption at room temperature (RT) and at low temperature (6 K) and performed luminescence studies of the emission and lifetime. We obtained the 1.5-mm emission of erbium after selective laser pump excitation of the ytterbium ion and energy transfer between the two ions. The maximum emission cross section for 1.5 mm was about 2.56/spl times/10/sup -20/ cm/sup 2/ for the polarization of light with the electric field parallel to the N/sub m/ principal optical direction. This value was higher than for other erbium-doped materials with application in solid-state lasers such as LiYF/sub 4/:Er(YLF:Er), Y/sub 3/Al/sub 5/O/sub 12/:Er(YAG:Er), YAlO/sub 3/:Er, and Al/sub 2/O/sub 3/:Er

Erbium spectroscopy and 1.5-micrometre emission in KGd(WO4)2: Er,Yb single crystals

We grew good-optical-quality KGd(WO/sub 4/)/sub 2/ single crystals doped with erbium and ytterbium ions at several concentrations of dopants using the top-seeded-solution growth slow-cooling method (TSSG). We performed the spectroscopic characterization of this material related to the 1.5-mm infrared emission of erbium which is interesting for laser applications. To do this, we carried out polarized optical absorption at room temperature (RT) and at low temperature (6 K) and performed luminescence studies of the emission and lifetime. We obtained the 1.5-mm emission of erbium after selective laser pump excitation of the ytterbium ion and energy transfer between the two ions. The maximum emission cross section for 1.5 mm was about 2.56/spl times/10/sup -20/ cm/sup 2/ for the polarization of light with the electric field parallel to the N/sub m/ principal optical direction. This value was higher than for other erbium-doped materials with application in solid-state lasers such as LiYF/sub 4/:Er(YLF:Er), Y/sub 3/Al/sub 5/O/sub 12/:Er(YAG:Er), YAlO/sub 3/:Er, and Al/sub 2/O/sub 3/:Er

Impact of the MIC of piperacillin/tazobactam on the outcome for patients with bacteraemia due to Enterobacteriaceae: the Bacteraemia-MIC project

Our objective was to evaluate the impact of low versus borderline MIC of piperacillin/tazobactam on the clinical outcomes of patients with bacteraemia caused by Enterobacteriaceae who were treated with that antimicrobial