The Role of Acu-TENS in Hemodynamic Recovery after Open-Heart Surgery

Increased heart rate (HR) and reduced blood pressure (BP) are common consequences of cardiac surgery. This study investigated the effect of transcutaneous electrical nervous stimulation applied over acupuncture points (Acu-TENS) on HR, BP, rate pressure product (RPP) and nausea and vomiting score after open-heart surgery. After open heart surgery, 40 patients were randomly allocated to either an Acu-TENS group, which received a 40-min session of TENS applied bilaterally over the acupuncture point PC6 on postoperative days 1–5, or a Placebo-TENS group, which received identical electrode placement but with no electrical output from the TENS unit, despite an output indicator light appearing activated. HR, systolic and diastolic BPs (SBP and DBP) were recorded and RPP computed. Nausea and vomiting symptoms were quantified using a 4-point Likert scale before and after TENS intervention. Daily HR, BP and antiemetic administration data were recorded from a further 20 consecutive subjects who received no intervention and formed the Control group. A trend of decreasing HR and increasing BP in the Acu-TENS group was observed over the five postoperative days, with all variables returning to preoperative values by Day 4 (P > .2). In the Placebo-TENS and Control groups the HR remained higher (P < .0001), BP lower (P < .05) and RPP higher (P = .01) than respective preoperative values at Day 4. The dose of Maxolon required was lowest in the Acu-TENS group (P = .038). We concluded that Acu-TENS facilitated an earlier return to preoperative BP, HR and RPP values in patients after acute heart surgery

Resequencing and Analysis of Variation in the TCF7L2 Gene in African Americans Suggests That SNP rs7903146 Is the Causal Diabetes Susceptibility Variant

OBJECTIVE—Variation in the transcription factor 7-like 2 (TCF7L2) locus is associated with type 2 diabetes across multiple ethnicities. The aim of this study was to elucidate which variant in TCF7L2 confers diabetes susceptibility in African Americans. RESEARCH DESIGN AND METHODS—Through the evalua-tion of tagging single nucleotide polymorphisms (SNPs), type 2 diabetes susceptibility was limited to a 4.3-kb interval, which contains the YRI (African) linkage disequilibrium (LD) block containing rs7903146. To better define the relationship between type 2 diabetes risk and genetic variation we resequenced this 4.3-kb region in 96 African American DNAs. Thirty-three novel and 13 known SNPs were identified: 20 with minor allele frequencies (MAF).0.05 and 12 with MAF.0.10. These poly-morphisms and the previously identified DG10S478 microsatellite were evaluated in African American type 2 diabetic cases (n

Analysis of whole exome sequencing with cardiometabolic traits using family-based linkage and association in the IRAS Family Study

Family-based methods are a potentially powerful tool to identify trait-defining genetic variants in extended families, particularly when used to complement conventional association analysis. We utilized two-point linkage analysis and single variant association analysis to evaluate whole exome sequencing (WES) data from 1,205 Hispanic Americans (78 families) from the Insulin Resistance Atherosclerosis Family Study. WES identified 211,612 variants above the minor allele frequency threshold of ≥0.005. These variants were tested for linkage and/or association with 50 cardiometabolic traits after quality control checks. Two-point linkage analysis yielded 10,580,600 LOD scores with 1,148 LOD scores ≥3, 183 LOD scores ≥4, and 29 LOD scores ≥5. The maximal novel LOD score was 5.50 for rs2289043:T\u3eC, in UNC5C with subcutaneous adipose tissue volume. Association analysis identified 13 variants attaining genome-wide significance (pT in APOA5, and triglyceride levels (p=3.67×10-10). Overall, there was a 5.2-fold increase in the number of informative variants detected by WES compared to exome chip analysis in this population, nearly 30% of which were novel variants relative to dbSNP build 138. Thus, integration of results from two-point linkage and single-variant association analysis from WES data enabled identification of novel signals potentially contributing to cardiometabolic traits

Implication of Genetic Variants Near TCF7L2, SLC30A8, HHEX, CDKAL1, CDKN2A/B, IGF2BP2, and FTO in Type 2 Diabetes and Obesity in 6,719 Asians

OBJECTIVE— Recent genome-wide association studies have identified six novel genes for type 2 diabetes and obesity and confirmed TCF7L2 as the major type 2 diabetes gene to date in Europeans. However, the implications of these genes in Asians are unclear

Genome-wide association study of primary open-angle glaucoma in continental and admixed African populations.

Primary open angle glaucoma (POAG) is a complex disease with a major genetic contribution. Its prevalence varies greatly among ethnic groups, and is up to five times more frequent in black African populations compared to Europeans. So far, worldwide efforts to elucidate the genetic complexity of POAG in African populations has been limited. We conducted a genome-wide association study in 1113 POAG cases and 1826 controls from Tanzanian, South African and African American study samples. Apart from confirming evidence of association at TXNRD2 (rs16984299; OR[T] 1.20; P = 0.003), we found that a genetic risk score combining the effects of the 15 previously reported POAG loci was significantly associated with POAG in our samples (OR 1.56; 95% CI 1.26-1.93; P = 4.79 × 10-5). By genome-wide association testing we identified a novel candidate locus, rs141186647, harboring EXOC4 (OR[A] 0.48; P = 3.75 × 10-8), a gene transcribing a component of the exocyst complex involved in vesicle transport. The low frequency and high degree of genetic heterogeneity at this region hampered validation of this finding in predominantly West-African replication sets. Our results suggest that established genetic risk factors play a role in African POAG, however, they do not explain the higher disease load. The high heterogeneity within Africans remains a challenge to identify the genetic commonalities for POAG in this ethnicity, and demands studies of extremely large size

Influência do regime alimentar sobre os parâmetros de crescimento de borregas merinas.

O presente trabalho teve por objetivo avaliar o efeito que três suplementos alimentares (alimento composto comercial (CP), farinha forrageira de milho (FM) e cladódios de Opuntia ficus-indica (OFI)) tiveram sobre os indicadores de crescimento de borregas de substituição de raça Merino Branco alimentadas com feno de consociação (F), como alimento forrageiro base em regime ad libitum controlado, assim como a ingestão de água. Os 24 animais selecionados foram organizados em grupos de 8 borregas cada um, homogéneos em relação ao peso vivo, à idade e ao ganho de peso médio diário do nascimento até ao início do ensaio. Cada grupo de 8 borregas foi organizado em quatro subgrupos de 2 borregas cada um e o controlo da ingestão alimentar foi feito para cada um destes subgrupos. Para cada tratamento avaliou-se os seguintes parâmetros de crescimento e de consumo de alimentos: peso vivo; ganho de peso diário; consumo de feno (MS); consumo de cada um dos suplementos alimentares (MS); consumo de MS/kg0,75; consumo de PB/kg0,75; consumo de EM/kg0,75; consumo de NDF/kg0,75; consumo de NFC/kg0,75; índice de conversão alimentar (kg MS/kg PVG); consumo de água; ingestão total de água. Durante os 63 dias de ensaio, verificou-se que as borregas submetidas ao regime alimentar CP+F (T1) apresentaram maior ingestão (p≤0,05) de MS, MS/kg PV0,75, C, NDF, ADF, PB, PB/kg PV0,75, GB, EM e H2O e menor ingestão (p≤0,05) de NFC e de NFC/kg PV0,75. No regime alimentar FM+F (T2), verificou-se maior ingestão (p≤0,05) de NFC/kg PV0,75 e menor ingestão (p≤0,05) de C. No regime alimentar OFI+FM+F (T3) as borregas ingeriram menos (p≤0,05) NDF, PB/kg PV0,75 e H2O. Não se encontraram diferenças estatísticas significativas entre os tratamentos T2 e T3 relativamente à ingestão média diária de MS, de EM, de PB, de NDF e de ADF (p≤0,05). O maior consumo de H2O foi apresentado no T1 (2,037 kg/dia) (p≤0,05), seguido das borregas do T2 (1,459 kg/dia). O menor consumo médio diário de H2O de bebida ocorreu nas borregas do T3 (0,277 kg/dia ±0,038) (p≤0,05), no entanto as borregas do T3 apresentaram o maior CTH2O (3,900 kg/dia) (p≤0,05). As borregas do T1 apresentaram GPD significativamente mais elevado (0,180 kg/dia ±0,009) (p≤0,05) do que as borregas do T2 e T3 (0,110 kg/dia ±0,020 e 0,131 kg/dia 0,006 respetivamente). No final do ensaio, as borregas do T3 alimentadas com OFI+FM+F apresentaram PV semelhante (29,5 kg; p≤0,05) às borregas do T2 alimentadas com FM+F (27,94 kg), porém inferiores (p≤0,05) às borregas do T1 alimentadas com CP+F (33,01 kg). Considera-se que a baixa concentração proteica dos 2 regimes alimentares OFI+FM+F (85,54 g PB/kg MS ±0,560) e FM+F (84,76 g PB/kg MS ±0,367) terá afetado o crescimento dos animais relativamente aos animais alimentados com CP+F (148,62 g PB/kg MS ±2,914).The objective of this study was to evaluate the effect of three feed supplements (commercial compound (CC), corn flour (CF) and Opuntia ficus-indica (OFI) cladodes) on the growth indicators of Merino Branco female lambs, fed as forage with hay (H) of association based on controlled ad libitum regime, as well water intake. The 24 animals selected were organized in groups of 8 lambs each, homogeneous in relation to live weight, age and average daily weight gain from birth until the beginning of the test. Each group of 8 lambs was organized in four subgroups of 2 lambs each and the food intake control was done for each of these subgroups. For each treatment the following growth and food consumption parameters were evaluated: live weight; daily weight gain; hay consumption (DM); consumption of each dietary supplements (DM); consumption of DM/kg0,75; consumption of CP/kg0,75; consumption of ME/kg0,75; consumption of NDF/kg0,75; consumption of NFC/kg0,75; feed conversion index (kg DM/kg DWG); water consumption; total water intake. During the 63 test days, it has been found that lambs submitted on the diet CC+H (T1) presented the highest intake (p≤0.05) of DM, DM/kg LW0,75, A, NDF, ADF, CP, CP/kg LW0,75, CF, ME and H2O, and the lowest intake (p≤0.05) of NFC and NFC/kg LW0,75. In the CF+H diet (T2), it was verified the highest intake (p≤0.05) of NFC/kg LW0,75 and the lowest intake (p≤0.05) of A. In the OFI+CF+H diet (T3) the lambs ingested less (p≤0.05) NDF, CP/kg LW0,75 and H2O. No statistically significant differences were found between treatments T2 and T3 in relation to the mean daily intake of DM, ME, CP, NDF and ADF (p≤0.05). The T1 showed the highest H2O intake (2.037 kg/day) (p≤0.05), followed by the lambs of T2 (1.459 kg/day). The lowest daily H2O intake occurred in the lambs of T3 (0.277 kg/day ±0.038) (p≤0.05), however the lambs of T3 showed the highest TH2OI (3.900 kg/day) (p≤0.05). The lambs of T1 presented significantly higher DWG (0.180 kg/day ±0.009) (p≤0.05) than lambs of T2 and T3 (0.110 kg/day ±0.020 and 0.131 kg/day 0.006 respectively). At the end of the test, the lambs fed with OFI+CF+H (T3) showed a LW similar (29.5 kg; p≤0.05) to the lambs fed with CF+H (T2) (27.94 kg) but lower (p≤0.05) than the animals fed with CC+H (T1) (33.01 kg). It was considered that the low protein concentration of the 2 feed treatments OFI+CF+H (85.54 g CP/kg DM ±0,560) and CF+H (84.76 g CP/kg DM ±0,367) will have affected the growth of the animals compared to animals feed with CC+H (148.62 g CP/kg DM ±2.914)

A genome-wide association study for diabetic nephropathy genes in African Americans

A genome-wide association study was performed using the Affymetrix 6.0 chip to identify genes associated with diabetic nephropathy in African Americans. Association analysis was performed adjusting for admixture in 965 type 2 diabetic African American patients with end-stage renal disease (ESRD) and in 1029 African Americans without type 2 diabetes or kidney disease as controls. The top 724 single nucleotide polymorphisms (SNPs) with evidence of association to diabetic nephropathy were then genotyped in a replication sample of an additional 709 type 2 diabetes-ESRD patients and 690 controls. SNPs with evidence of association in both the original and replication studies were tested in additional African American cohorts consisting of 1246 patients with type 2 diabetes without kidney disease and 1216 with non-diabetic ESRD to differentiate candidate loci for type 2 diabetes-ESRD, type 2 diabetes, and/or all-cause ESRD. Twenty-five SNPs were significantly associated with type 2 diabetes-ESRD in the genome-wide association and initial replication. Although genome-wide significance with type 2 diabetes was not found for any of these 25 SNPs, several genes, including RPS12, LIMK2, and SFI1 are strong candidates for diabetic nephropathy. A combined analysis of all 2890 patients with ESRD showed significant association SNPs in LIMK2 and SFI1 suggesting that they also contribute to all-cause ESRD. Thus, our results suggest that multiple loci underlie susceptibility to kidney disease in African Americans with type 2 diabetes and some may also contribute to all-cause ESRD