Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Peripartum cardiomyopathy is a rare form of cardiomyopathy, with heterogeneous presentation occurring in women between one-month antepartum and six months postpartum. It carries a poor prognosis and a high risk of mortality.</p> <p>Case presentation</p> <p>We report the development of peripartum cardiomyopathy in two sisters, 27- and 35-year-old African women, one of whom presented with a large left ventricular thrombus. Subsequently, both patients were treated with bromocriptine, heparin and standard therapy for heart failure (angiotensin converting enzyme inhibitors, beta-blockers and diuretics). During follow-up, the left ventricular thrombus observed in one patient degraded. Neither patient experienced a thrombotic event, and both experienced continuous improvements in cardiac function and New York Heart Association stage.</p> <p>Conclusion</p> <p>The development of peripartum cardiomyopathy in two sisters indicates that there may be a genetic basis for this type of cardiomyopathy, and that women with a positive family history for peripartum cardiomyopathy may have an increased risk of developing the disease. This is also the first report of a patient experiencing degradation of a large left ventricular thrombus under standard therapy for heart failure with bromocriptine. It suggests that the use of bromocriptine in association with adequate anti-coagulation and heart failure therapy may be beneficial and safe.</p

Clara cell protein and surfactant proteinB in garbage collectors and in wastewater workers exposed to bioaerosols

Objectives: Inhalation of bioaerosols has been hypothesised to cause "toxic pneumonitis” that should increase lung epithelial permeability at the bronchioloalveolar level. Serum Clara cell protein (CC16) and serum surfactant proteinB (SPB) have been proposed as sensitive markers of lung epithelial injury. This study was aimed at looking for increased lung epithelial permeability by determining CC16 and SPB in workers exposed to bioaerosols from wastewater or garbage. Methods: Subjects (778 wastewater, garbage and control workers; participation 61%) underwent a medical examination, lung function tests [American Thoracic Society (ATS) criteria], and determination of CC16 and SPB. Symptoms of endotoxin exposure and several potential confounders (age, gender, smoking, kidney function, obesity) were looked for. Results were examined with multiple linear or logistic regression. Results: Exposure to bioaerosols increased CC16 concentration in the wastewater workers. No effect of exposure on SPB was found. No clue to work-related respiratory diseases was found. Conclusions: The increase in CC16 in serum supports the hypothesis that bioaerosols cause subclinical "toxic pneumonitis”, even at low exposur

Skilling up for training : a feasibility study investigating acute effects of stochastic resonance whole-body vibration on postural control of older adults

The present pilot study investigated the feasibility of applying a single bout stochastic resonance whole-body vibration in deconditioned elderly individuals and the effects on static and dynamic balance and reaction time. We report the results of a non-blinded randomized control trial with a pre-test/post-test design. Twenty elderly individuals were randomized into either single bout stochastic resonance whole-body vibration (SR-WBV) (n=10, frequency 5 Hz, Noise 4) or control (n=10). SR-WBV received 5 sets of 1 min stochastic whole-body vibration (5 Hz, Noise 4: vibration with a randomly varying frequency, 1=low, 4=high) with 1 min rest in between. The control group rested for 10 min without any intervention. Functional reach test (FRT), semi-tandem stand (STS), Expanded Timed Get Up-and-Go Test (ETGUG), single task- (ST) and dual task walking time (DT), chair rising (CR), and foot (RTF) and hand reaction time (RTH) were measured before and after the intervention. Within- and between group differences were analyzed using repeated measures. In order to assess the meaningfulness of pre-training to post-training changes, the effect size (ES) was calculated according to Cohen’s d. All participants in the study accepted and adhered to the WBV session and performed scheduled follow-up measurements. There were no adverse events. Change values for dynamic balance showed a strong trend towards improvement for FRT of about 4.5% (ES=0.52, P=0.161). Change values for RTF (5.9%; ES=0.55; P =0.169) showed a trend towards improvement in the SR-WBV only. The results suggest that stochastic resonance WBV is both safe and well accepted by elderly individuals in assisted living institutions, and might have beneficial effects on balance in these adults. Further research is warranted to determine whether this device might be of use in the skilling-up phase of an exercise program when training is initiated in strongly deconditioned and/or frail elderly. The new training protocol is expected to allow for safe skilling-up training of deconditioned older adults in assisted living institutions

Comparison of risk factors predicting return to work between patients with subacute and chronic non-specific low back pain: systematic review

The objective of the study was to provide an inventory of predictive instruments and their constituting parameters associated with return to work in patients with subacute (2-10weeks pain duration) and chronic (10-24weeks pain duration) non-specific low back pain (NSLBP). Data sources included systematic review in Medline, Embase, Cinahl, Central, PEDro, Psyndex, PsychInfo/PsycLit, and Sociofile up to September 2008, in reference lists of systematic reviews on risk factors, and of included studies. For the systematic review, two reviewers independently assessed study eligibility and quality, and extracted data. Disagreements were resolved by consensus. Risk factors were inventorised and grouped into a somatic and psychosocial domain. 23 studies reporting on subacute and 16 studies reporting on chronic patients were included. The studies on subacute patients reported on a total of 56 biomedical factors out of which 35 (63%) were modifiable and 61 psychosocial factors out of which 51 (84%) were modifiable. The corresponding values in studies on chronic patients were 44 biomedical [27 (62%) modifiable] and 61 [40 (66%) modifiable] respectively. Our data suggest that the interdisciplinary approach in patients at risk to develop persistent NSLBP is justified in both, the subacute and chronic disease stages. Psychosocial interventions might be more effective in subacute stages since a higher proportion of modifiable risk factors were identified in that grou

Fine particle pH and the partitioning of nitric acid during winter in the northeastern United States

Particle pH is a critical but poorly constrained quantity that affects many aerosol processes and properties, including aerosol composition, concentrations, and toxicity. We assess PM1 pH as a function of geographical location and altitude, focusing on the northeastern U.S., based on aircraft measurements from the Wintertime Investigation of Transport, Emissions, and Reactivity campaign (1 February to 15 March 2015). Particle pH and water were predicted with the ISORROPIA-II thermodynamic model and validated by comparing predicted to observed partitioning of inorganic nitrate between the gas and particle phases. Good agreement was found for relative humidity (RH) above 40%; at lower RH observed particle nitrate was higher than predicted, possibly due to organic-inorganic phase separations or nitrate measurement uncertainties associated with low concentrations (nitrate \u3c 1 µg m−3). Including refractory ions in the pH calculations did not improve model predictions, suggesting they were externally mixed with PM1 sulfate, nitrate, and ammonium. Sample line volatilization artifacts were found to be minimal. Overall, particle pH for altitudes up to 5000 m ranged between −0.51 and 1.9 (10th and 90th percentiles) with a study mean of 0.77 ± 0.96, similar to those reported for the southeastern U.S. and eastern Mediterranean. This expansive aircraft data set is used to investigate causes in variability in pH and pH-dependent aerosol components, such as PM1 nitrate, over a wide range of temperatures (−21 to 19°C), RH (20 to 95%), inorganic gas, and particle concentrations and also provides further evidence that particles with low pH are ubiquitous

Small-scale spatial variation in infection risk shapes the evolution of a Borrelia resistance gene in wild rodents

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordSpatial variation in pathogen-mediated selection is predicted to influence the evolutionary trajectory of host populations and lead to spatial variation in their immunogenetic composition. However, to date few studies have been able to directly link small-scale spatial variation in infection risk to host immune gene evolutionin natural,non-human populations. Here we use a natural rodent-Borrelia system to test for associations between landscape-level spatial variation in Borrelia infection risk along replicated elevational gradients in the Swiss Alps and Toll-like receptor 2(TLR2) evolution, a candidate gene for Borrelia resistance, across bank vole (Myodes glareolus) populations.We found that Borrelia infection risk (i.e. the product of Borrelia prevalence in questing ticks and the average tick load of voles at a sampling site) was spatially variable and significantly negatively associated with elevation. Across sampling sites, Borrelia prevalence in bank voles was significantly positively associated with Borrelia infection risk along the elevational clines. We observed a significant association between naturally occurring TLR2 polymorphisms in hosts and their Borrelia infection status. The TLR2 variant associated with a reduced likelihood of Borrelia infection was most common in rodent populations at lower elevations that face a high Borreliainfection risk, and its frequency changed in accordance with the change in Borrelia infection risk along the elevational clines. These results suggest that small-scale spatial variation in parasite-mediated selection affects the immunogenetic composition of natural host populations, providing a striking example that the microbial environment shapes the evolution of the host’s immune system in the wild.Swiss National Science FoundationStiftung für wissenschaftliche Forschung an der Universität ZürichFaculty of Science of the University of ZurichBaugarten StiftungGeorges und Antoine Claraz‐Schenkun

Optical and magneto-optical properties of MnPt\u3csub\u3e3\u3c/sub\u3e films (abstract)

Optically thick films of MnPt3 were prepared by magnetron sputtering onto quartz substrates. Postdeposition annealing at 850 °C resulted in highly textured (111) films with the L12 (Cu3Au) structure. MnPt3 films are ferromagnetic with a Curie temperature of 380 °C, and they show large magneto-optical effects in the visible.1,2 These films also show a high degree of long-range order. The diagonal components of the dielectric tensor were determined using variable angle spectroscopic ellipsometry measurements over the spectral range 1.2–2.4 eV. Magneto-optic Kerr rotation and ellipticity measurements were made at near normal incidence over the spectral range 1.4–3.6 eV to determine the off-diagonal components of the MnPt3 dielectric tensor. First-principles electronic structure calculations were carried out for the ordered MnPt3 structure, and from these the components of the dielectric tensor were calculated. We find excellent agreement between the measured and calculated diagonal components, but only fair agreement for the off-diagonal components

Global simulations of monoterpene-derived peroxy radical fates and the distributions of highly oxygenated organic molecules (HOMs) and accretion products

We evaluate monoterpene-derived peroxy radical (MT-RO2) unimolecular autoxidation and self- and cross-reactions with other RO2 species in the GEOS-Chem global chemical transport model. The formation of associated highly oxygenated organic molecules (HOMs) and accretion products are tracked in competition with other bimolecular reactions. Autoxidation is the dominant fate up to 6-8 km for first-generation MT-RO2, which can undergo unimolecular H shifts. Reaction with NO can be a more common fate for H-shift rate constants < 0.1 s(-1) or at altitudes higher than 8 km due to the imposed Arrhenius temperature dependence of unimolecular H shifts. For MT-derived HOM-RO2, generated by multistep autoxidation of first-generation MT-RO2, reaction with other RO2 species is predicted to be the major fate throughout most of the boreal and tropical forest regions, whereas reaction with NO dominates in the temperate and subtropical forests of the Northern Hemisphere. The newly added reactions result in an approximate 4 % global average decrease in HO2 and RO2, mainly due to faster self-/cross-reactions of MT-RO2, but the impact upon HO2, OH, and NOx abundances is only important in the planetary boundary layer (PBL) over portions of tropical forests. Predicted HOM concentrations in MT-rich regions and seasons can exceed total organic aerosol predicted by the standard version of the GEOS-Chem model depending on the parameters used. Comparisons to observations reveal that large uncertainties remain for key reaction parameters and processes, especially with respect to the photochemical lifetime and volatility of HOMs as well as the rates and branching of associated RO2 accretion products. Further observations and laboratory studies related to MT-RO2-derived HOMs and gas-phase RO2 accretion product formation kinetics - especially their atmospheric fate, such as gas-particle partitioning, multiphase chemistry, and net secondary organic aerosol formation - are needed.Peer reviewe

Effects of whole-body vibration on proxies of muscle strength in old adults: a systematic review and meta-analysis on the role of physical capacity level

Forest plot overview of Classification No-Go, outcome: all strength outcomes (IMVC, DS, Power, RFD, FS). (PPTX 75 kb

Decadal changes in summertime reactive oxidized nitrogen and surface ozone over the Southeast United States

Widespread efforts to abate ozone (O3) smog have significantly reduced emissions of nitrogen oxides (NOx) over the past 2 decades in the Southeast US, a place heavily influenced by both anthropogenic and biogenic emissions. How reactive nitrogen speciation responds to the reduction in NOx emissions in this region remains to be elucidated. Here we exploit aircraft measurements from ICARTT (July–August 2004), SENEX (June–July 2013), and SEAC4RS (August–September 2013) and long-term ground measurement networks alongside a global chemistry–climate model to examine decadal changes in summertime reactive oxidized nitrogen (RON) and ozone over the Southeast US. We show that our model can reproduce the mean vertical profiles of major RON species and the total (NOy) in both 2004 and 2013. Among the major RON species, nitric acid (HNO3) is dominant (∼ 42–45%), followed by NOx (31%), total peroxy nitrates (ΣPNs; 14%), and total alkyl nitrates (ΣANs; 9–12%) on a regional scale. We find that most RON species, including NOx, ΣPNs, and HNO3, decline proportionally with decreasing NOx emissions in this region, leading to a similar decline in NOy. This linear response might be in part due to the nearly constant summertime supply of biogenic VOC emissions in this region. Our model captures the observed relative change in RON and surface ozone from 2004 to 2013. Model sensitivity tests indicate that further reductions of NOxemissions will lead to a continued decline in surface ozone and less frequent high-ozone events