2,132 research outputs found
The association of microalbuminuria with mortality in patients with acute myocardial infarction. A ten-year follow-up study
Our study evaluates the long-term effect of microalbuminuria on mortality among patients with acute myocardial infarction. We followed 151 patients from 1996 to 2007 to investigate if microalbuminuria is a risk factor in coronary heart disease. All patients admitted with acute myocardial infarction in 1996 were included. At baseline, we recorded urinary albumin/creatinine concentration ratio, body mass index, blood pressure, left ventricle ejection fraction by echocardiography, smoking status, medication, diabetes, age, and gender. Deaths were traced in 2007 by means of the Danish Personal Identification Register. Microalbuminuria, defined as a urinary albumin/creatinine concentration ratio above 0.65 mg/mmoL, occurred in 50% of the patients and was associated with increased all-cause mortality. Thus, 68% of the patients with microalbuminuria versus 48% of the patients without microalbuminuria had died during the 10 years of follow-up (P=0.04). The crude hazard ratio for death associated with microalbuminuria was 1.78 (CI: 1.18â2.68) (P=0.006), whereas the gender- and age-adjusted hazard ratio was 1.71 (CI: 1.03â2.83) (P=0.04). We concluded that microalbuminuria in hospitalized patients with acute myocardial infarction is prognostic for increased long-term mortality. We recommend measurement of microalbuminuria to be included as a baseline risk factor in patients with acute myocardial infarction and in future trials in patients with coronary heart disease
Neuroscience and architecture:modulating behavior through sensorimotor responses to the built environment
Changing micronutrient intake through (voluntary) behaviour change. The case of folate.
The objective of this study was to relate behaviour change mechanisms to nutritionally relevant behaviour and demonstrate how the different mechanisms can affect attempts to change these behaviours. Folate was used as an example to illuminate the possibilities and challenges in inducing behaviour change. The behaviours affecting folate intake were recognised and categorised. Behaviour change mechanisms from "rational model of man", behavioural economics, health psychology and social psychology were identified and aligned against folate-related behaviours. The folate example demonstrated the complexity of mechanisms influencing possible behavioural changes, even though this only targets the intake of a single micronutrient. When considering possible options to promote folate intake, the feasibility of producing the desired outcome should be related to the mechanisms of required changes in behaviour and the possible alternatives that require no or only minor changes in behaviour. Dissecting the theories provides new approaches to food-related behaviour that will aid the development of batteries of policy options when targeting nutritional problems
Long-Term Clinical Impact of Coronary CT Angiography in Patients With Recent Acute-Onset Chest Pain The Randomized Controlled CATCH Trial
AbstractObjectivesThe aim of the CATCH (CArdiac cT in the treatment of acute CHest pain) trial was to investigate the long-term clinical impact of a coronary computed tomographic angiography (CTA)-guided treatment strategy in patients with recent acute-onset chest pain compared to standard care.BackgroundThe prognostic implications of a coronary CTA-guided treatment strategy have not been compared in a randomized fashion to standard care in patients referred for acute-onset chest pain.MethodsPatients with acute chest pain but normal electrocardiograms and troponin values were randomized to treatment guided by either coronary CTA or standard care (bicycle exercise electrocardiogram or myocardial perfusion imaging). In the coronary CTA-guided group, a functional test was included in cases of nondiagnostic coronary CTA images or coronary stenoses of borderline severity. The primary endpoint was a composite of cardiac death, myocardial infarction (MI), hospitalization for unstable angina pectoris (UAP), late symptom-driven revascularizations, and readmission for chest pain.ResultsWe randomized 299 patients to coronary CTA-guided strategy and 301 to standard care. After inclusion, 24 patients withdrew their consent. The median (interquartile range) follow-up duration was 18.7 (range 16.8 to 20.1) months. In the coronary CTA-guided group, 30 patients (11%) had a primary endpoint versus 47 patients (16%) in the standard care group (p = 0.04; hazard ratio [HR]: 0.62 [95% confidence interval: 0.40 to 0.98]). A major adverse cardiac event (cardiac death, MI, hospitalization for UAP, and late symptom-driven revascularization) was observed in 5 patients (2 MIs, 3 UAPs) in the coronary CTA-guided group versus 14 patients (1 cardiac death, 7 MIs, 5 UAPs, 1 late symptom-driven revascularization) in the standard care group (p = 0.04; HR: 0.36 [95% CI: 0.16 to 0.95]). Differences in cardiac death and MI (8 vs. 2) were insignificant (p = 0.06).ConclusionsA coronary CTA-guided treatment strategy appears to improve clinical outcome in patients with recent acute-onset chest pain and normal electrocardiograms and troponin values compared to standard care with a functional test. (Cardiac-CT in the Treatment of Acute Chest Pain [CATCH]; NCT01534000
Iron Oxide Nanoparticles as a Contrast Agent for Synchrotron Imaging of Sperm
Fast phase-contrast imaging offered by modern synchrotron facilities opens
the possibility of imaging dynamic processes of biological material such as
cells. Cells are mainly composed of carbon and hydrogen, which have low X-ray
attenuation, making cell studies with X-ray tomography challenging. At specific
low energies, cells provide contrast, but cryo-conditions are required to
protect the sample from radiation damage. Thus, non-toxic labelling methods are
needed to prepare living cells for X-ray tomography at higher energies. We
propose using iron oxide nanoparticles due to their proven compatibility in
other biomedical applications. We show how to synthesize and attach iron oxide
nanoparticles and demonstrate that cell-penetrating peptides facilitate iron
oxide nanoparticle uptake into sperm cells. We show results from the TOMCAT
Nanoscope (Swiss Light Source), showing that iron oxide nanoparticles allow the
heads and midpiece of fixed sperm samples to be reconstructed from X-ray
projections taken at 10 keV.Comment: 21 pages, 6 figure
Adiabatic Pair Creation
We give here the proof that pair creation in a time dependent potentials is
possible. It happens with probability one if the potential changes
adiabatically in time and becomes overcritical, that is when an eigenvalue
enters the upper spectral continuum. The potential may be assumed to be zero at
large negative and positive times. The rigorous treatment of this effect has
been lacking since the pioneering work of Beck, Steinwedel and Suessmann in
1963 and Gershtein and Zeldovich in 1970.Comment: 53 pages, 1 figure. Editorial changes on page 22 f
A high-affinity, bivalent PDZ domain inhibitor complexes PICK1 to alleviate neuropathic pain
Maladaptive plasticity involving increased expression of AMPAâtype glutamate receptors is involved in several pathologies, including neuropathic pain, but direct inhibition of AMPARs is associated with side effects. As an alternative, we developed a cellâpermeable, highâaffinity (~2 nM) peptide inhibitor, TatâPâ(C5), of the PDZ domain protein PICK1 to interfere with increased AMPAR expression. The affinity is obtained partly from the Tat peptide and partly from the bivalency of the PDZ motif, engaging PDZ domains from two separate PICK1 dimers to form a tetrameric complex. Bivalent TatâPâ(C5) disrupts PICK1 interaction with membrane proteins on supported cell membrane sheets and reduce the interaction of AMPARs with PICK1 and AMPAâreceptor surface expression in vivo. Moreover, TatâPâ(C5) administration reduces spinal cord transmission and alleviates mechanical hyperalgesia in the spared nerve injury model of neuropathic pain. Taken together, our data reveal TatâPâ(C5) as a novel promising lead for neuropathic pain treatment and expand the therapeutic potential of bivalent inhibitors to nonâtandem proteinâprotein interaction domains
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