Compactness and existence results in weighted Sobolev spaces of radial functions. Part II: Existence

We prove existence and multiplicity results for finite energy solutions to the nonlinear elliptic equation $$-\triangle u+V\left( \left| x\right| \right) u=g\left( \left| x\right| ,u\right) \quad \textrm{in }\Omega \subseteq \mathbb{R}^{N},\ N\geq 3,$$ where $\Omega$ is a radial domain (bounded or unbounded) and $u$ satisfies $u=0$ on $\partial \Omega$ if $\Omega \neq \mathbb{R}^{N}$ and $u\rightarrow 0$ as $\left| x\right| \rightarrow \infty$ if $\Omega$ is unbounded. The potential $V$ may be vanishing or unbounded at zero or at infinity and the nonlinearity $g$ may be superlinear or sublinear. If $g$ is sublinear, the case with $g\left( \left| \cdot \right| ,0\right) \neq 0$ is also considered.Comment: 29 pages, 8 figure

Atrial fibrillation subtypes, risk of stroke, and antithrombotic therapy

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On a functional satisfying a weak Palais-Smale condition

In this paper we study a quasilinear elliptic problem whose functional satisfies a weak version of the well known Palais-Smale condition. An existence result is proved under general assumptions on the nonlinearities.Comment: 18 page

Current Strategies to Diminish the Impact of Cardiovascular Diseases in Women

The European Society of Cardiology (ESC) has recently promoted the "Women at Heart" program in order to organize initiatives targeted at promoting research and education in the field of cardiovascular diseases in women. Comparisons of the gender differences in specific disease and treatment trends across Europe are provided by analyzing data from the Euro Heart Surveys. A Policy Conference has been organized with the objective to summarize the state of the art from an European perspective, to identify the scientific gaps and to delineate the strategies for changing the misperception of cardiovascular diseases in women, improving risk stratification, diagnosis, and therapy from a gender perspective and increasing women representation in clinical trials. A Statement from the Policy Conference has been provided and published in the European Heart Journal. Synergic activities should be undertaken at European level with the support of national scientific societies, European institutions, national health care authorities, patients' associations, and foundations. The commitment of the Board of the ESC is that these initiatives contribute to increase the awareness across Europe that cardiovascular disease is the primary cause of death in women and to improve the knowledge of risk factors, presentation and treatment of cardiovascular diseases in women

Increased prevalence of prolonged QT interval in males with primary or secondary hypogonadism : a pilot study

P>Symptoms and signs of male hypogonadism span all organ systems, including the cardiovascular apparatus. The electrocardiographic QT interval reflects cardiac ventricular repolarization and, if prolonged, increases the risk of malignant arrhythmias. QT interval duration is similar in boys and girls during childhood, but shortens in males after puberty and experimental studies suggest that testosterone is a major contributor to shortening of QT interval in men. The aim of the present pilot study was to assess the duration of ventricular repolarization in adult males with primary or secondary hypogonadism. Standard ECG recordings were performed in 26 men (mean age 39.2 +/- 2.17 years) with pituitary or testicular hypogonadism and repeated in 15 patients during testosterone replacement. Twenty-six age-matched control men were also analysed. Measured QT intervals were corrected for heart rate according to Bazzett's formula (QTc = QT/root RR interval). The prevalence of prolonged QTc was considerably higher in hypogonadal patients (four of 26 men) than in control men (none, p < 0.05) and in the general, healthy population (< 2.5%). QTc interval normalized on hormone replacement therapy in the four patients presenting prolonged QTc in the hypogonadal state. Heart rate and left ventricular mass did not differ among the two groups and no known QT-prolonging factor was apparent in patients with abnormal QTc interval. In conclusion, a high number prolonged QT interval measurements was observed in hypogonadal men who may therefore be at increased risk for cardiac arrhythmias. This observation reveals an additional feature of male hypogonadism, which may benefit from testosterone replacement therapy

Hormone replacement therapy and cardioprotection. A new dawn? A statement of the \u27Gruppo di studio sulle malattie cardiovascolari nella donna\u27 of the societ? italiana di cardiologia on hormone replacement therapy in postmenopausal women

Cardiovascular disease is the leading cause of death in women in western countries. Despite preventive strategies, in the past decades, the incidence of cardiovascular events has shown a decline in men but a rise in women, matching the growth of the population of postmenopausal women. Several epidemiological findings suggest the causative pathophysiological role of ovarian hormone deficiency in the development of cardiovascular disease in women. Observational and randomized studies have suggested that hormone replacement therapy in early postmenopause could be beneficial from a cardiovascular point of view. Conversely, aging, time since menopause and presence of cardiovascular risk factors or cardiovascular disease may decrease its efficacy and increase the risk of cardiovascular events. It is plausible that the unfavorable effects of the estrogen/progestin combination used in the randomized studies are not related to the hormone preparation per se but rather to the use of hormones in the less receptive group of women, older and with cardiovascular risk factors. Clinical judgment, choice of the right dose and estrogen/ progestin combination are of pivotal importance to maximize the beneficial effect of estrogen replacement therapy/hormone replacement therapy, especially if given within a reasonable time after the menopause to the women who need the therapy for the relief of menopausal symptoms

Onset and evolution of dysphagia in Huntington’s Disease

Background Huntington's disease (HD) is a neurodegenerative disorder characterized by motor disturbances, cognitive decline and behaviour changes. Dysphagia is a well-recognized feature in advanced HD stage that leads to malnutrition and aspiration pneumonia, the latter representing the first causes of death in HD. However, no data are available about the onset of dysphagia during the disease course and the correlation between dysphagia severity and disease progression. Aim The aim of the study was to characterize dysphagia in patients with HD from early to advanced stages of the disease. Methods Dysphagia was investigated in 43 patients with HD by fiberoptic endoscopic examination of swallowing (FEES). FEES recordings were de-identified and assessed by a blinded judge. Dysphagia Outcome and Severity Scale (DOSS), Penetration-Aspiration Scale (PAS), and Yale Pharyngeal Residue Severity Rating Scale (YALE) were used to rate dysphagia severity, swallowing safety, and swallowing efficacy, respectively. For disease severity, all patients were assessed with the Unified Huntington's Disease Rating Scale (UHDRS) and were classi\ufb01ed as early-stage, moderate-stage or advanced stage HD based on Shoulson-Fahn stages. Results FEES was well tolerated in all the subjects. Data showed that 30% of early-stage patients with HD already exhibit dysphagia (DOSS 645). Prevalence of dysphagia noticeably increased to 90% in the moderate stage of the disease, while reached 100% in the advanced stage. PAS scores progressively worsened with the disease stage. On the contrary, YALE scores remained stable in the various stages of disease and showed a greater amount of residue in the valleculae compared to pyriform sinus. A Total Motor Score of the UHDRS >37 correctly identified patients with dysphagia with 82% sensitivity and 73% specificity. Conclusion This study provides a better understanding of dysphagia onset and development in HD and may guide the definition of clinical care standard for dysphagia recognition and management, aimed at reducing nutritional and pulmonary complications

An Australian longitudinal pilot study examining health determinants of cardiac outcomes 12 months post percutaneous coronary intervention

Background Percutaneous coronary intervention (PCI) is a very common revascularisation procedure for coronary artery disease (CAD). The purpose of this study was to evaluate cardiac outcomes, health related quality of life (HRQoL), resilience and adherence behaviours in patients who have undergone a PCI at two time points (6 and 12 months) following their procedure. Methods A longitudinal pilot study was conducted to observe the cardiac outcomes across a cohort of patients who had undergone a percutaneous coronary intervention (PCI). Participants who had undergone PCI 6 months prior were invited. Those participants who met the inclusion criteria and provided consent then completed a telephone survey (time point 1). These participants were then contacted 6 months later (i.e. 12 months post-intervention, time point 2) and the measures were repeated. Results All patients (n = 51) were recorded as being alive at time point 1. The multiple model indicated that controlling for other factors, gender was significantly associated with a linear combination of outcome measures (p = 0.004). The effect was moderate in magnitude (partial-η2 = 0.303), where males performed significantly better than females 6 months after the PCI procedure physically and with mood. Follow-up univariate ANOVAs indicated that gender differences were grounded in the scale measuring depression (PHQ9) (p = 0.005) and the physical component score of the short form measuring HRQoL (SF12-PCS) (p = 0.003). Thirteen patients were lost to follow-up between time points 1 and 2. One patient was confirmed to have passed away. The pattern of correlations between outcome measures at time point 2 revealed statistically significant negative correlation between the PHQ instrument and the resilience scale (CD-RISC) (r = -0.611; p < 0.001); and the physical component score of the SF-12 instrument (r = -0.437; p = 0.054). Conclusions Men were performing better than women in the 6 months post-PCI, particularly in the areas of mood (depression) and physical health. This pilot results indicate gender-sensitive practices are recommended particularly up to 6 months post-PCI. Any gender differences observed at 6 month appear to disappear at 12 months post-PCI. Further research into the management of mood particularly for women post-PCI is warranted. A more detailed inquiry related to access/attendance to secondary prevention is also warranted

CENP-A binding domains and recombination patterns in horse spermatocytes

Centromeres exert an inhibitory effect on meiotic recombination, but the possible contribution of satellite DNA to this "centromere effect" is under debate. In the horse, satellite DNA is present at all centromeres with the exception of the one from chromosome 11. This organization of centromeres allowed us to investigate the role of satellite DNA on recombination suppression in horse spermatocytes at the stage of pachytene. To this aim we analysed the distribution of the MLH1 protein, marker of recombination foci, relative to CENP-A, marker of centromeric function. We demonstrated that the satellite-less centromere of chromosome 11 causes crossover suppression, similarly to satellite-based centromeres. These results suggest that the centromere effect does not depend on satellite DNA. During this analysis, we observed a peculiar phenomenon: while, as expected, the centromere of the majority of meiotic bivalent chromosomes was labelled with a single immunofluorescence centromeric signal, double-spotted or extended signals were also detected. Their number varied from 0 to 7 in different cells. This observation can be explained by positional variation of the centromeric domain on the two homologs and/or misalignment of pericentromeric satellite DNA arrays during homolog pairing confirming the great plasticity of equine centromeres