Cooling curves for neutron stars with hadronic matter and quark matter

The thermal evolution of isothermal neutron stars is studied with matter both in the hadronic phase as well as in the mixed phase of hadronic matter and strange quark matter. In our models, the dominant early-stage cooling process is neutrino emission via the direct Urca process. As a consequence, the cooling curves fall too fast compared to observations. However, when superfluidity is included, the cooling of the neutron stars is significantly slowed down. Furthermore, we find that the cooling curves are not very sensitive to the precise details of the mixing between the hadronic phase and the quark phase and also of the pairing that leads to superfluidity.Comment: 19 pages, 25 figure

Synergistic effect of simvastatin and ezetimibe on lipid and pro-inflammatory profiles in pre-diabetic subjects

<p>Abstract</p> <p>Background</p> <p>Ezetimibe specifically blocks the absorption of dietary and biliary cholesterol and plant sterols. Synergism of ezetimibe-statin therapy on LDL-cholesterol has been demonstrated, but data concerning the pleiotropic effects of this combination are controversial.</p> <p>Objective</p> <p>This open-label trial evaluated whether the combination of simvastatin and ezetimibe also results in a synergistic effect that reduces the pro-inflammatory status of pre-diabetic subjects.</p> <p>Methods</p> <p>Fifty pre-diabetic subjects were randomly assigned to one of 2 groups, one receiving ezetimibe (10 mg/day), the other, simvastatin (20 mg/d) for 12 weeks, followed by an additional 12-week period of combined therapy. Blood samples were collected at baseline, 12 and 24 weeks. RESULTS: Total cholesterol, LDL-cholesterol and apolipoprotein B levels decreased in all the periods analyzed (p < 0.01), but triglycerides declined significantly only after combined therapy. Both drugs induced reductions in C-reactive protein, reaching statistical significance after combining ezetimibe with the simvastatin therapy (baseline 0.59 ± 0.14, simvastatin monotherapy 0.48 ± 0.12 mg/dL and 0.35 ± 0.12 mg/dL, p < 0.023). Such a reduction was independent of LDL-cholesterol change. However, mean levels of TNF-α and interleukin-6 and leukocyte count did not vary during the whole study.</p> <p>Conclusion</p> <p>Expected synergistic lowering effects of a simvastatin and ezetimibe combination on LDL-cholesterol, apolipoprotein B and triglycerides levels were confirmed in subjects with early disturbances of glucose metabolism. We suggest an additive effect of this combination also on inflammatory status based on the reduction of C-reactive protein. Attenuation of pro-inflammatory conditions may be relevant in reducing cardiometabolic risk.</p> <p>Title/ID of trial registration</p> <p>Effect of simvastatin and ezetimibe on lipid and inflammation/NCT01103648.</p

Identifying (subsurface) anthropogenic heat sources that influence temperature in the drinking water distribution system

The water temperature in the drinking water distribution system and at the customers’ taps approaches the surrounding soil temperature at ca. 1 meter depth. Water temperature is an important determinant of water quality, since it influences physical, chemical and biological processes, such as absorption of chemicals, microbial growth and chlorine decay. In the Netherlands drinking water is distributed without additional residual disinfectant and the temperature of drinking water at the customers’ tap is not allowed to exceed 25 ºC. Routine water quality samples at the tap in urban areas have shown locations with relatively high soil temperatures compared to the expected modelled soil temperatures, which indicate so called ‘underground hot-spots’. In the last decades, the urban sub-surface is getting more occupied with various types of sub-surface infrastructures and some of these can be heat sources. A few recent studies tackle the anthropogenic sources and their influence on the underground, at coarse spatial scales. Little is known about the urban shallow underground heat profile on small spatial scales, of the order of 10 m × 10 m. Our research focuses on developing a method to identify and to localise potential underground hot-spots at −1.0 m at a small spatial scale. In this article we describe a method to find anthropogenic heat sources that influence temperature in the drinking water distribution system through a combination of mapping urban anthropogenic heat sources, modelling the soil temperature and extensive measurements in Rotterdam

Síndrome de Cushing na gravidez: uma visão geral

Cushing's syndrome (CS) during pregnancy is a rare condition with fewer than 150 cases reported in the literature. Adrenal adenomas were found to be the commonest cause, followed by Cushing's disease. The gestation dramatically affects the maternal hypothalamic-pituitary-adrenal axis, resulting in increased hepatic production of corticosteroid-binding globulin (CBG), increased levels of serum, salivary and urinary free cortisol, lack of suppression of cortisol levels after dexamethasone administration and placental production of CRH and ACTH. Moreover, a blunted response of ACTH and cortisol to exogenous CRH may also occur. Therefore, the diagnosis of CS during pregnancy is much more difficult. Misdiagnosis of CS is also common, as the syndrome may be easily confused with preeclampsia or gestational diabetes. Because CS during pregnancy is usually associated with severe maternal and fetal complications, its early diagnosis and treatment are critical. Surgery is the treatment of choice for CS in pregnancy, except perhaps in the late third trimester, with medical therapy being a second choice. There does not seem to be a rationale for supportive treatment alone.A ocorrência de síndrome de Cushing (SC) durante a gravidez é rara, com menos de 150 casos reportados na literatura. Os adenomas adrenais parecem ser a causa mais comum seguidos da doença de Cushing. A gestação afeta de maneira dramática o eixo hipotálamo-hipófise-adrenal materno resultando em aumento da produção hepática da globulina ligadora de corticosteróides (CBG), aumento dos níveis séricos, salivares e livres urinários de cortisol, falta de supressão do cortisol após administração de dexametasona e produção placentária de CRH e ACTH. Além disso, pode também ocorrer bloqueio da resposta do ACTH e do cortisol ao CRH exógeno. Assim, o diagnóstico de SC durante a gravidez torna-se muito mais difícil. A falha em diagnosticar SC é também comum, já que a síndrome pode ser facilmente confundida com pré-eclampsia ou diabetes gestacional. Uma vez que a SC de ocorrência na gravidez é usualmente associada com graves complicações materno-fetais, seu diagnóstico e tratamento precoces tornam-se críticos. A cirurgia é o tratamento de escolha para a SC na gravidez, exceto, talvez, no final do 3º trimestre, sendo o tratamento medicamentoso a segunda escolha. Não parece haver nenhum arrazoado para o tratamento de suporte isoladamente.Federal University of Pernambuco Hospital das Clínicas Division of Endocrinology and MetabolismHospital Getúlio Vargas Pernambuco University Medical School Division of Endocrinology and MetabolismFederal University of São Paulo Department of Medicine Division of Endocrinology and MetabolismUNIFESP, Department of Medicine Division of Endocrinology and MetabolismSciEL

Deficiência combinada de 17α-hidroxilase/17,20 liase devido à mutação p.R96W no gene CYP17 em um paciente brasileiro

Congenital adrenal hyperplasia (CAH) resulting from 17α-hydroxylase/17,20-lyase deficiency is a rare autosomal recessive disease and the second most common form of CAH in Brazil. We describe the case of a Brazilian patient with CYP17 deficiency (17α-hydroxylase/17,20-lyase deficiency) caused by a homozygous p.R96W mutation on exon 1 of the CYP17 gene, an unusual genotype in Brazilian patients with this form of CAH. The patient, raised as a normal female, sought medical care for lack of pubertal signs and primary amenorrhea at the age of 16 years. At evaluation, the presence of a 46,XY karyotype, hypertension and hypokalemia were observed. We emphasize the recognition of CYP17 deficiency in the differential diagnosis of cases of hypergonadotrophic hypogonadism and hypertension in young patients who need specific treatment for both situations.A hiperplasia adrenal congênita (HAC), em razão da deficiência de 17α-hidroxilase/17,20-liase, é uma doença autossômica recessiva rara e a segunda causa mais comum de HAC no Brasil. Descrevemos o caso de um paciente brasileiro portador da deficiência 17α-hidroxilase/17,20- liase (CYP17) em homozigose para a mutação p.R96W no éxon 1 do gene da CYP17A1, uma mutação incomum entre os casos brasileiros descritos com essa forma de HAC. Esse paciente, criado como um indivíduo normal do sexo feminino, procurou atendimento por ausência de sinais puberais e amenorreia primária aos 16 anos de idade. Durante a avaliação, constataram-se um cariótipo 46,XY e a presença de hipertensão e hipocalemia. Enfatizamos o reconhecimento da deficiência da CYP17 dentre os possíveis diagnósticos em um paciente jovem com hipogonadismo hipergonadotrófico e hipertensão, os quais necessitam de tratamento particularizado para ambas as situações.Universidade Federal do Rio Grande do Sul Hospital de Clínicas de Porto AlegreUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of MedicineUniversity of Texas Southwestern Medical Center Department of Internal MedicineUNIFESP, EPM, Department of MedicineSciEL