212 research outputs found

    Endothelin-1 Predicts Hemodynamically Assessed Pulmonary Arterial Hypertension in HIV Infection.

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    BackgroundHIV infection is an independent risk factor for PAH, but the underlying pathogenesis remains unclear. ET-1 is a robust vasoconstrictor and key mediator of pulmonary vascular homeostasis. Higher levels of ET-1 predict disease severity and mortality in other forms of PAH, and endothelin receptor antagonists are central to treatment, including in HIV-associated PAH. The direct relationship between ET-1 and PAH in HIV-infected individuals is not well described.MethodsWe measured ET-1 and estimated pulmonary artery systolic pressure (PASP) with transthoracic echocardiography (TTE) in 106 HIV-infected individuals. Participants with a PASP ≥ 30 mmHg (n = 65) underwent right heart catheterization (RHC) to definitively diagnose PAH. We conducted multivariable analysis to identify factors associated with PAH.ResultsAmong 106 HIV-infected participants, 80% were male, the median age was 52 years and 77% were on antiretroviral therapy. ET-1 was significantly associated with higher values of PASP [14% per 0.1 pg/mL increase in ET-1, p = 0.05] and PASP ≥ 30 mmHg [PR (prevalence ratio) = 1.24, p = 0.012] on TTE after multivariable adjustment for PAH risk factors. Similarly, among the 65 individuals who underwent RHC, ET-1 was significantly associated with higher values of mean pulmonary artery pressure and PAH (34%, p = 0.003 and PR = 2.43, p = 0.032, respectively) in the multivariable analyses.ConclusionsHigher levels of ET-1 are independently associated with HIV-associated PAH as hemodynamically assessed by RHC. Our findings suggest that excessive ET-1 production in the setting of HIV infection impairs pulmonary endothelial function and contributes to the development of PAH

    Connected Green function approach to ground state symmetry breaking in Φ1+14\Phi^4_{1+1}-theory

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    Using the cluster expansions for n-point Green functions we derive a closed set of dynamical equations of motion for connected equal-time Green functions by neglecting all connected functions higher than 4th4^{th} order for the λΦ4\lambda \Phi^4-theory in 1+11+1 dimensions. We apply the equations to the investigation of spontaneous ground state symmetry breaking, i.e. to the evaluation of the effective potential at temperature T=0T=0. Within our momentum space discretization we obtain a second order phase transition (in agreement with the Simon-Griffith theorem) and a critical coupling of λcrit/4m2=2.446\lambda_{crit}/4m^2=2.446 as compared to a first order phase transition and λcrit/4m2=2.568\lambda_{crit}/4m^2=2.568 from the Gaussian effective potential approach.Comment: 25 Revtex pages, 5 figures available via fpt from the directory ugi-94-11 of [email protected] as one postscript file (there was a bug in our calculations, all numerical results and figures have changed significantly), ugi-94-1

    Sigma model approach to string theory effective actions with tachyons

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    Motivated by recent discussions of actions for tachyon and vector fields related to tachyon condensation in open string theory we review and clarify some aspects of their derivation within sigma model approach. In particular, we demonstrate that the renormalized partition function Z(T,A)Z(T,A) of boundary sigma model gives the effective action for massless vectors which is consistent with string S-matrix and beta function, resolving an old problem with this suggestion in bosonic string case at the level of the leading F2(dF)2F^2 (dF)^2 derivative corrections to Born-Infeld action. We give manifestly gauge invariant definition of Z(T,A)Z(T,A) in non-abelian NSR open string theory and check that its derivative reproduces the tachyon beta function in a particular scheme. We also discuss derivation of similar actions for tachyon and massless modes in closed bosonic and NSR (type 0) string theories.Comment: 26 pages, harvmac. To appear in the special issue of J. Math. Phys. on Strings, Branes and M-theory. v4: minor editorial changes, version to appear in JM

    Renormalization of Hamiltonian Field Theory; a non-perturbative and non-unitarity approach

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    Renormalization of Hamiltonian field theory is usually a rather painful algebraic or numerical exercise. By combining a method based on the coupled cluster method, analysed in detail by Suzuki and Okamoto, with a Wilsonian approach to renormalization, we show that a powerful and elegant method exist to solve such problems. The method is in principle non-perturbative, and is not necessarily unitary.Comment: 16 pages, version shortened and improved, references added. To appear in JHE

    The Impact of HAART on the Respiratory Complications of HIV Infection: Longitudinal Trends in the MACS and WIHS Cohorts

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    Objective: To review the incidence of respiratory conditions and their effect on mortality in HIV-infected and uninfected individuals prior to and during the era of highly active antiretroviral therapy (HAART). Design: Two large observational cohorts of HIV-infected and HIV-uninfected men (Multicenter AIDS Cohort Study [MACS]) and women (Women's Interagency HIV Study [WIHS]), followed since 1984 and 1994, respectively. Methods: Adjusted odds or hazards ratios for incident respiratory infections or non-infectious respiratory diagnoses, respectively, in HIV-infected compared to HIV-uninfected individuals in both the pre-HAART (MACS only) and HAART eras; and adjusted Cox proportional hazard ratios for mortality in HIV-infected persons with lung disease during the HAART era. Results: Compared to HIV-uninfected participants, HIV-infected individuals had more incident respiratory infections both pre-HAART (MACS, odds ratio [adjusted-OR], 2.4; 95% confidence interval [CI], 2.2-2.7; p<0.001) and after HAART availability (MACS, adjusted-OR, 1.5; 95%CI 1.3-1.7; p<0.001; WIHS adjusted-OR, 2.2; 95%CI 1.8-2.7; p<0.001). Chronic obstructive pulmonary disease was more common in MACS HIV-infected vs. HIV-uninfected participants pre-HAART (hazard ratio [adjusted-HR] 2.9; 95%CI, 1.02-8.4; p = 0.046). After HAART availability, non-infectious lung diseases were not significantly more common in HIV-infected participants in either MACS or WIHS participants. HIV-infected participants in the HAART era with respiratory infections had an increased risk of death compared to those without infections (MACS adjusted-HR, 1.5; 95%CI, 1.3-1.7; p<0.001; WIHS adjusted-HR, 1.9; 95%CI, 1.5-2.4; p<0.001). Conclusion: HIV infection remained a significant risk for infectious respiratory diseases after the introduction of HAART, and infectious respiratory diseases were associated with an increased risk of mortality. © 2013 Gingo et al
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