Waarde van lichte en intensieve begeleiding van patienten met hartfalen; resultaten van het COACH-onderzoek.

OBJECTIVE: To determine the efficacy of 2 nurse-directed programmes of different intensity for the counselling and follow-up of patients hospitalised for heart failure, compared with standard care by a cardiologist. DESIGN: Multicentre randomised clinical trial (www.trialregister.nl: NCT 98675639). METHOD: A total of 1023 patients were randomized after hospitalisation for heart failure to 1 of 3 treatment strategies: standard care provided by a cardiologist, follow-up care from a cardiologist with basic counselling and support by a nurse specialising in heart failure, or follow-up care from a cardiologist with intensive counselling and support by a nurse specialising in heart failure. Primary end points were the time to rehospitalisation due to heart failure or death and the number of days lost to rehospitalisation or death during the 18-month study period. Data were analysed on an intent-to-treat basis. RESULTS: Mean patient age was 71 years, 38% were women, 50% had mild heart failure and 50% had severe heart failure. During the study, 411 patients (40%) were rehospitalised due to heart failure or died from any cause: 42% in the control group, and 41% and 38% in the basic and intensive support groups, respectively (differences not significant). The time to rehospitalisation or death was similar in the 3 groups: hazard ratios for the basic and intensive support groups versus the control group were 0.96 (95% CI: 0.76-1.21; p = 0.73) and 0.93 (95% CI: 0.73-1.17; p = 0.53), respectively. The number of days lost to rehospitalisation or death was 39,960 in the control group; this number was 15% less in the intervention groups, but the difference was not significant. However, there was a trend toward lower mortality in the intervention groups. In all 3 groups, more visits occurred than planned, which may have had a considerable effect on care, notably in the control group. CONCLUSION: The results of this study indicated that the provision of additional counselling and support by a nurse specialising in heart failure as an adjuvant to intensive follow-up care provided by a cardiologist does not always lead to a reduction in rehospitalisation frequenc

Measurement of the Bottom-Strange Meson Mixing Phase in the Full CDF Data Set

We report a measurement of the bottom-strange meson mixing phase \beta_s using the time evolution of B0_s -> J/\psi (->\mu+\mu-) \phi (-> K+ K-) decays in which the quark-flavor content of the bottom-strange meson is identified at production. This measurement uses the full data set of proton-antiproton collisions at sqrt(s)= 1.96 TeV collected by the Collider Detector experiment at the Fermilab Tevatron, corresponding to 9.6 fb-1 of integrated luminosity. We report confidence regions in the two-dimensional space of \beta_s and the B0_s decay-width difference \Delta\Gamma_s, and measure \beta_s in [-\pi/2, -1.51] U [-0.06, 0.30] U [1.26, \pi/2] at the 68% confidence level, in agreement with the standard model expectation. Assuming the standard model value of \beta_s, we also determine \Delta\Gamma_s = 0.068 +- 0.026 (stat) +- 0.009 (syst) ps-1 and the mean B0_s lifetime, \tau_s = 1.528 +- 0.019 (stat) +- 0.009 (syst) ps, which are consistent and competitive with determinations by other experiments.Comment: 8 pages, 2 figures, Phys. Rev. Lett 109, 171802 (2012

Implications of serial measurements of natriuretic peptides in heart failure: insights from BIOSTAT‐CHF

No abstract available

Chiral 1,2-diacylglycerols in the haemolymph of the locust, Locusta migratoria

A 1H-NMR method using chiral shift reagents was applied in the stereochemical analysis of the haemolymph 1,2-diacylglycerols of Locusta migratoria. Conversion of the 1,2-diacylglycerols into 1,2-diacetyl-3-tritylglycerols allowed the accurate determination of the enantiomeric purity, whereas direct trimethylsilylation of the unmodified or hydrogenated haemolymph 1,2-diacylglycerols proved to be less suitable because of signal broadening. In the haemolymph of Locusta, sn-1,2-mdiacylglycerols with a remarkably high optical purity were found to be present. In the resting locust, at least 96% of the haemolymph 1,2-diacylglycerols have the sn-1,2-configuration; in locusts in which the haemolymph diacylglycerol concentration was elevated by fat body triacylglycerol mobilization induced by flight activity or injection of adipokinetic hormone, over 97% of the 1,2-diacylglycerols is the sn-1,2-enantiomer. The few percent sn-2,3-menantiomer may not have been present initially. Positional distribution of the fatty acids in the fat body triacylglycerols and in the haemolymph sn-1,2-diacylglycerols obtained from locusts after a 2 h flight revealed nearly identical occupation of the sn-2-positions in both acylglycerols. The distribution patterns in the sn-1-position of the 1,2-diacylglycerols and the combined sn-1 and sn-3 positions of the triacylglycerols are compatible with the possible existence of a stereospecific sn-3-triacylglycerol lipase