Genetic Sharing with Cardiovascular Disease Risk Factors and Diabetes Reveals Novel Bone Mineral Density Loci.

Bone Mineral Density (BMD) is a highly heritable trait, but genome-wide association studies have identified few genetic risk factors. Epidemiological studies suggest associations between BMD and several traits and diseases, but the nature of the suggestive comorbidity is still unknown. We used a novel genetic pleiotropy-informed conditional False Discovery Rate (FDR) method to identify single nucleotide polymorphisms (SNPs) associated with BMD by leveraging cardiovascular disease (CVD) associated disorders and metabolic traits. By conditioning on SNPs associated with the CVD-related phenotypes, type 1 diabetes, type 2 diabetes, systolic blood pressure, diastolic blood pressure, high density lipoprotein, low density lipoprotein, triglycerides and waist hip ratio, we identified 65 novel independent BMD loci (26 with femoral neck BMD and 47 with lumbar spine BMD) at conditional FDR < 0.01. Many of the loci were confirmed in genetic expression studies. Genes validated at the mRNA levels were characteristic for the osteoblast/osteocyte lineage, Wnt signaling pathway and bone metabolism. The results provide new insight into genetic mechanisms of variability in BMD, and a better understanding of the genetic underpinnings of clinical comorbidity

Interaction between turbulence bursts and low-level jet in a nocturnal boundary layer \ufb02ow over complex terrain

Intermitted turbulent events in a nocturnal downvalley flow over complex terrain are investigated throughout boundary layer flow measurements made during the 2013 campaign of the Mountain Terrain Atmospheric Modeling and Observations (MATHERHORN) Program. Turbulent and meteorological data were continuously measured at five different heights of three different towers located in the north-north west direction along a wide, gently sloped valley of Dugway Proving Ground in Utah. A case study of intermittent turbulent events in a nocturnal downvalley flow was detected and analyzed for the night of the 12th of May 2013 when tethered balloon measurements were performed to support tower observations. The low-level jet behavior of the nocturnal downvalley flow follows somehow the inertial oscillation motion modeled by Wiel et al. (2010), which was developed for flat terrain low-level jet. Thermal stratification indeed confines the low-level jet in the lower portion of the boundary layer, while the gravity wave behavior of the flow modifies its structure with respect to a flat terrain jet. Gravity waves within the motion was found to have a period of 15 minutes. Gravity waves can develop in a nocturnal boundary layer motion as a result of a flow perturbation, which can be induced by a hydraulic jump, an intrusion of mass and momentum or an intermittent turbulent event. A gravity wave generation event can also perturb the inertial oscillation responsible of the mean motion behavior. In this study, we found a correlation between pulsed turbulent events, detected as turbulence bursts, and the appearance of a double nose shape in the low-level jet. The double nose shape was found to be the result of a mutual decrease of the speed of the low-level jet maximum and widening of the jet depth, and the development of a second jet at higher levels. This second jet is located at about 150-200 m as jets occurring over great US planes while the lower one occurring at about 50 m appears as a local feature. The impulsive increase of the momentum eddy diffusivity coefficient related to turbulence burst is supposed to be the mechanisms that induce the double nose formation, since a variation on the coefficient in time and space determines a shape and intensity modification of the jet behavior

Acute effects of peritoneovenous shunt (Le Veen) on the hemodinamics and gas exchange in patients with hepatyc intractable ascites

The acute effects of the peritoneovenous shunt (LeVeen) on hemodynamics and pulmonary gas exchange in 6 consecutive patients with intractable ascites and cirrhosis were evaluated. After opening the peritoneovenous shunt, there was a marked increase in cardiac index, (from 3.78 ± 0.4 to 5.86 ± 0.4 l/min. m2, p < 0.01), and mean pulmonary artery pressure (from 17.3 ± 1.9 to 23.3 ± 1.5 mmHg, p < 0.05), while a significant decrease in systemic vascular resistances (from 1086 ± 116 to 694 ± 52 dynes.sec. cm-5, p < 0.05) was observed. In all patients there was a drop in arterial oxygen tension (P(a)O2) (from 76 ± 3 to 67 ± 3 torr, p < 0.01) and an increase in venous admixture (QS(p)/Qt) from 13.1 ± 2 to 18.9 ± 2%, p < 0.01). The comparable increase in cardiac output and in venous admixture produced by opening the peritoneovenous shunt, might be related to the massive transfusion of ascitic fluid into the intravascular compartment. It is therefore concluded that this impairment of tas exchange further support discarding an appropriate amount of ascitic fluid at the time of shunt insertion

Chirurgia degli aneurismi dell'aorta addominale (in elezione e in urgenza) complicanze e mortalita' post-operatoria

Año 2, No. 4El tema central de este número está relacionado al Sistema jurídico y animales, reflexiones que se realizan a propósito de haber pasado más de un año de la publicación de la ley Nº 30407, ley de protección y bienestar animal

Application of the Perme Score to assess mobility in patients with COVID-19 in inpatient units

# Objective To evaluate the ability of the Perme Score to detect changes in the level of mobility of patients with COVID-19 outside the intensive care unit. # Method A retrospective cohort study was conducted in inpatient units of a private hospital. Patients older than 18, diagnosed with COVID-19, who were discharged from the intensive care unit and remained in the inpatient units were included. The variables collected included demographic characterization data, length of hospital stay, respiratory support, Perme Score values at admission to the inpatient unit and at hospital discharge and the mobilization phases performed during physical therapy. # Result A total of 69 patients were included, 80% male and with a mean age of 61.9 years (SD=12.5 years). The comparison of the Perme Score between the times of admission to the inpatient unit and at hospital discharge shows significant variation, with a mean increase of 7.3 points (95%CI:5.7-8.8; *p*\<0.001), with estimated mean values of Perme Score at admission of 17.5 (15.8; 19.3) and hospital discharge of 24.8 (23.3; 26.3). There was no association between Perme Score values and length of hospital stay (measure of effect and 95%CI 0.929 (0.861; 1.002; *p*=0.058)). # Conclusion The Perme Score proved effective for assessing mobility in patients diagnosed with COVID-19 with prolonged hospitalization outside the intensive care setting. In addition, we demonstrated by the value of the Perme Score that the level of mobility increases significantly from the time of admission to inpatient units until hospital discharge. There was no association between the Perme Score value and length of hospital stay

PREVALENCE OF CHRONIC LIVER-DISEASE IN THE GENERAL-POPULATION OF NORTHERN ITALY - THE DIONYSOS STUDY

Data on the prevalence of chronic liver disease, derived from selected series of hospitalized patients or from mortality registers, underestimate the prevalence of chronic liver disease. The Dionysos Study is a cohort study that investigated for the first time the prevalence of chronic liver disease in a general population. All the citizens of two towns in northern Italy, Campogalliano and Cormons, aged 12 to 65 yr were contacted by letter. From March 1991 through March 1993, 6,917 of a total of 10,150 citizens were enrolled (compliance, 69%). The standardized protocol for each enrollee included (a) a color-illustrated food questionnaire on dietary habits and alcohol intake; (b) a detailed medical history, including questions on risk factors for chronic liver disease; (c) a physical examination; and (d) blood tests for AST, ALT, \u3b3-glutamyl-transpeptidase, mean cell volume, platelet count and hepatitis B virus and hepatitis C virus markers. Signs suggestive of chronic liver disease were seen in 21.3% of the subjects, and who then underwent further liver function tests, upper abdominal ultrasonography and, when necessary, liver biopsy. Persistent signs of chronic liver disease were present in 17.5% of the subjects, including 1.1% with cirrhosis and 0.07% with hepatocellular carcinoma. The prevalence rates of hepatitis B virus and hepatitis C virus positivity (second-generation enzyme-linked immunosorbent assay) were 1.3% and 3.2%, respectively. Alcohol abuse was the etiological agent in 23%. Other factors which predisposed subjects to chronic liver disease were age older than 35 yr, male sex, body mass index higher than 27, history of blood transfusion, drug addiction and presence of chronic liver disease in the subject's family. Cirrhosis was due to hepatitis B virus or hepatitis C virus in 37%, and alcohol was the cause in 26%. In those subjects with alcohol abuse, viral infection, especially hepatitis C virus, played an important role in the deterioration of chronic liver disease and its progression to hepatocellular carcinoma. We conclude that the Dionysos study, the first study of the prevalence of chronic liver disease in a general population of northern Italy, found a much higher prevalence of chronic liver disease than reported previously in selected populations from Western countries. Hepatitis viral infections and alcoholism were the most important causative agents