Silent myocardial infarction in women with impaired glucose tolerance: The Northern Sweden MONICA study

BACKGROUND: Patients with impaired glucose tolerance (IGT) have an increased risk of cardiovascular disease (CVD) that is independent of traditional risk factors. Hence, slightly elevated glucose levels, even in the non-diabetic range, might be associated with increased macrovascular disease. METHODS: Within the Northern Sweden MONICA project a population survey was performed in 1986. Electrocardiograms (ECG's) were recorded for half of the survey (n = 790) and oral glucose test was carried out in 78 % of those. The association between subjects with ECG's indicating previously unknown myocardial infarction (ukMI), IGT and conventional risk factors were analyzed by logistic regression for men and women separately, adjusting for age, smoking, hypercholesterolemia and hypertension. RESULTS: Impaired glucose tolerance was significantly more common among women with ukMI, but not in men, compared to the group with normal ECG. In men, no variable was significantly associated with ukMI although the odds ratio (OR) for hypercholesterolemia was of borderline significance, 3.2 (95% confidence interval (CI) 0.9 to 11). The OR of having ukMI was 4.1 (CI 1.1 to 15) in women with IGT compared to women with normal glucose tolerance after multiple adjustment. The OR for hypertension was of borderline significance; 3.3 (CI 0.97 to 11). CONCLUSION: We found that IGT was associated with ECG findings indicating silent myocardial infarction in women in a middle-aged general population in northern Sweden. The results persisted even after adjusting for known risk factors

Gender differences in trends of acute myocardial infarction events: The Northern Sweden MONICA study 1985 – 2004

<p>Abstract</p> <p>Background</p> <p>The registration of non-fatal and fatal MI events initiated 1985 in the WHO MONICA project has been ongoing in northern Sweden since the end of the WHO project in 1995. The purpose of the present study was to analyze gender differences in first and recurrent events, case fatality and mortality in myocardial infarction (MI) in Northern Sweden during the 20-year period 1985 – 2004.</p> <p>Methods</p> <p>Diagnosed MI events in subjects aged 25–64 years in the Counties of Norrbotten and Västerbotten were validated according to the MONICA protocol. The total number of events registered up to January 1, 2005 was 11,763: 9,387 in men and 2,376 in women.</p> <p>Results</p> <p>The proportion of male/female events has decreased from 5.5:1 to 3:1. For males the reductions were 30% and 70% for first and recurrent MI, respectively, and for women 0% and 40% in the 55–64 year group. For both sexes a 50% reduction in 28-day case fatality was seen in the 25–64 year-group. Mortality was reduced by 69% and 45% in men and women, respectively.</p> <p>Conclusion</p> <p>First and recurrent events of myocardial infarction was markedly reduced in men over the 20-year observation period, but for women the reduction was seen only for recurrent infarctions. Case fatality, on the other hand, was markedly reduced for both sexes. As a result of the positive effects on incidence and case fatality a substantial reduction was seen in total mortality, most pronounced for men.</p

Better long-term survival in young and middle-aged women than in men after a first myocardial infarction between 1985 and 2006. an analysis of 8630 patients in the Northern Sweden MONICA Study

<p>Abstract</p> <p>Background</p> <p>There is conflicting and only scant evidence on the effect of gender on long-term survival after a myocardial infarction (MI). Our aim was to analyse sex-specific survival of patients for up to 23 years after a first MI in northern Sweden and to describe time trends.</p> <p>Methods</p> <p>The Northern Sweden MONICA Myocardial Infarction Registry was linked to The Swedish National Cause of Death Registry for a total of 8630 patients, 25 to 64 years of age, 6762 men and 1868 women, with a first MI during 1985-2006. Also deaths before admission to hospital were included. Follow-up ended on August 30, 2008.</p> <p>Results</p> <p>Median follow-up was 7.1 years, maximum 23 years and the study included 70 072 patient-years. During the follow-up 45.3% of the men and 43.7% of the women had died. Median survival for men was 187 months (95% confidence interval (CI) 179-194) and for women 200 months (95% CI 186-214). The hazard ratio (HR) for all cause mortality after adjustment for age group was 1.092 (1.010-1.18, <it>P </it>= 0.025) for females compared to males, <it>i.e</it>. 9 percent higher survival in women. After excluding subjects who died before reaching hospital HR declined to 1.017 (95%CI 0.93-1.11, <it>P </it>= 0.7). For any duration of follow-up a higher proportion of women were alive, irrespective of age group. The 5-year survivals were 75.3% and 77.5%, in younger (<57 years) men and women and were 65.5% and 66.3% in older (57-64 years) men and women, respectively. For each of four successive cohorts survival improved. Survival time was longer for women than for men in all age groups.</p> <p>Conclusions</p> <p>Age-adjusted survival was higher among women than men after a first MI and has improved markedly and equally in both men and women over a 23-year period. This difference was due to lower risk for women to die before reaching hospital.</p

The Bose-Einstein Condensate and Cold Atom Laboratory

Microgravity eases several constraints limiting experiments with ultracold andcondensed atoms on ground. It enables extended times of flight withoutsuspension and eliminates the gravitational sag for trapped atoms. Theseadvantages motivated numerous initiatives to adapt and operate experimentalsetups on microgravity platforms. We describe the design of the payload,motivations for design choices, and capabilities of the Bose-Einstein Condensateand Cold Atom Laboratory (BECCAL), a NASA-DLR collaboration. BECCALbuilds on the heritage of previous devices operated in microgravity, featuresrubidium and potassium, multiple options for magnetic and optical trapping,different methods for coherent manipulation, and will offer new perspectives forexperiments on quantum optics, atom optics, and atom interferometry in theunique microgravity environment on board the International Space Station

Studies on the antiproliferative action of interferon : effects on proteins synthesized in the G1 and S phase of the cell cycle in 2 anchorage-dependent cell lines

Interferons (IFNs) are a class of structurally related proteins first discovered to be produced by virus-infected cells. By now, several other inducing agents have been described. IFNs exert multiple effects on cells exemplified by the establishment of an antiviral state, inhibition of cell proliferation and alteration of different immune reactions. In the present thesis the inhibition of cellular growth concentrated on effects in the early cell cycle have been studied. The human glioma cell line 251 MG was found to be blocked in the S phase of the cell cycle upon addition of IFN both to exponentially growing and growth-factor depleted, synchronized cells. Thymidine kinase and DNA-polymerase activities were reduced in parallel with the S phase effect. 2-5 oligo Anucleotides transfected into glioma cells lead to inhibition of cell growth, exponentially growing cells being blocked in the S phase as during IFN treatment. In contrast, synchronized, restimulated cells were blocked in the cellcycle phase where they resided at the time of transfection. As 2-5 oligo A synthetase activity was induced in the middle of the Gl phase, these results might indicate that the kinetics of expression of oligonucleotides after IFN additiondetermines the type of cell cycle block obtained in differenttumor cells. IFN inhibited preferentially proteins originating from newly synthesized mRNA in Sw 3T3 cells, c-mvc did not seem to be included among these proteins. In both cell systems c-myc expression was unaltered after IFN treatment. In clone T1 selected from the the Sw 3T3 cell line , c-mvc expression was uncoupled to growth and seemed to be growth factor independent. The change in c-myc expression in clone T1 compared to SW 3T3 cells did not render the cells sensitive to IFN. Hence, c-myc regulation does not seem to be the mechanism by which IFN regulates cell growth in this system. The proliferation marker KI-67 antigen was shown not to be causatively involved in growth inhibition of IFN. The reduced levels of the antigen was proposed to be a secondary effect caused by the G0/G1 arrest.Diss. (sammanfattning) Umeå : Umeå universitet, 1991, härtill 6 uppsatserdigitalisering@um

Injury incidence in male elite youth football players is associated with preceding levels and changes in training load

Objectives Elite youth football players miss out on a large part of seasonal training due to injury. Limited research suggests an association between external and internal training load (TL) and injury incidence in elite youth football. This study analysed external and internal TL variables and their association with injury incidence in a group of male elite youth football players over four seasons.Methods Measures of external and internal TL and injury incidence of 56 male elite youth football players (age 17–19 years) were collected throughout four seasons. Heart rate, session rating of perceived exertion andGlobal Positioning System (GPS) variables were analysed. Individual players’ TL during the 30 days leading up to injury was compared with 30-day injury-free control periods. Change in TL through the periods was also analysed.Results Eighty-five injuries were included for analysis, showing that for most TL variables, the average levels were significantly lower during the period leading up to injury. Significant increases for the majority of TL variables were also found during the periods leading up to injury, while the control periods did not show any significant change.Conclusion A lower and/or increasing average TL volume over 30 days might increase the risk of injury in male elite youth football players. Avoiding long-term drops in TL and balance increases in TL might be beneficial to reduce injury risk

Prodromal symptoms and health care consumption prior to out-of-hospital cardiac arrest in patients without previously known ischaemic heart disease

Aims: To describe prodromal symptoms and health care consumption prior to an out-of-hospital cardiac arrest (OHCA) in patients without previously known ischaemic heart disease (IHD). Background: The most common lethal event of cardiovascular disease is sudden cardiac death, and the majority occur outside hospital. Little is known about prodromal symptoms and health care consumption associated with OHCAs. Design: Case-crossover study. Methods: Medical records of 403 OHCA cases without previously known IHD, age 25-74 years in the MONICA myocardial registry in Norrbotten County 2000-2008, were reviewed. Presenting symptoms and emergency visits at public primary care facilities and internal medicine clinics in Norrbotten County were analyzed from the week prior to the OHCA and from the same week one year previously, which served as a control week. Unlike most studies we included unwitnessed arrests and those where no cardiopulmonary resuscitation (CPR) was attempted. Results: Emergency visits were more common during the week prior to the OHCA than during the control week, both for visits to primary care (29 vs. 6, p &lt; 0.001) and to internal medicine clinics (16 vs. 0, p &lt; 0.001). Symptoms were more prevalent during the week prior to the OHCA (36.7 vs. 6.7%, p &lt; 0.001). The most prevalent symptoms were chest pain (14.6 vs. 0%, p &lt; 0.001), gastrointestinal symptoms (7.7 vs. 1.2%, p &lt; 0.001) and dyspnoea/peripheral oedema (6.9 vs. 0.2%, p &lt; 0.001). Conclusions: Patients who suffer an OHCA seek health care and present prodromal symptoms significantly more often the week prior to the event than the same week one year earlier