Determination and Correlation of Anticardiolipin Antibody with High Sensitivity C- reactive Proteins and its Role in Predicting Short Term Outcome in Patients with Acute Coronary Syndrome

Anticardiolipin antibody (aCL) is considered to be an independent risk factor while high sensitivity C reactive protein (hsCRP) is an established marker for coronary artery disease. This study was conducted to determine levels of aCL antibodies and hsCRP, their correlation and role in predicting recurrence of events in patients presenting with Acute Coronary Syndrome (ACS). Sixty patients admitted with Acute Coronary Syndrome were followed up for 7 days or until discharge. Patients were classified into two groups as those having experienced an ischemic event needing intervention within 7 days (Group I) and other having an event free recovery (Group II). aCL antibody and hsCRP levels were estimated and compared in these two groups. Twenty age and sex matched disease free persons served as controls. The levels of aCL were significantly higher in patients with ACS as compared to the controls (p=0.020). However the levels of aCL in Group I (13.39±9.46 GPL-U/ml) and Group II (13.51±9.93 GPL-U/ml) were not significantly different (p =0.838). The mean hsCRP levels were higher in cases with an event (23.30±10.68 mg/dl) than in cases without an event (20.60±11.45mg/dl) though it was not significant statistically (p=0.389). aCL and CRP were not found to be significantly correlated in causing the recurrence of events(p=0.178). Therefore anticardiolipin antibody is an independent risk factor which could be implicated in the pathogenesis of ACS. However it is not significantly associated with recurrence of short-term events in patients with ACS. Also, aCL antibody does not have significant correlation with hSCRP in causing recurrence of events in the patients of acute coronary syndrome

Psoriasis and comorbid diseases: Implications for management.

: As summarized in the first article in this continuing medical education series, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel disease, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis. The clinical implications of the comorbid diseases that are associated with psoriasis and recommendations for clinical management are reviewed in this article.<br/

Psoriasis and comorbid diseases: Epidemiology.

Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis

Recent studies of cements and concretes by synchrotron radiation crystallographic and cognate methods

The portfolio of available synchrotron radiation techniques is increasing notably for cements and pastes. Furthermore, sometimes the terminology is confusing and an overall picture highlighting similarities and differences of related techniques was lacking. Therefore, the main objective of this work is to review recent advances in synchrotron techniques providing a comprehensive overview. This work is not intended to gather all publications in cement chemistry but to give a unified picture through selected examples. Crystallographic techniques are used for structure determination, quantitative phase analyses and microstructure characterization. These studies are not only carried out in standard conditions but synchrotron techniques are especially suited to non-ambient conditions: high temperatures and pressures, hydration, etc., and combinations. Related crystallographic techniques, like Pair Distribution Function, are being used for the analysis of ill-crystalline phase(s). Furthermore, crystallographic tools are also employed in imaging techniques including scanning diffraction microscopy and tomography and coherent diffraction imaging. Other synchrotron techniques are also reviewed including X-rays absorption spectroscopy for local structure and speciation characterizations; small angle X-ray scattering for microstructure analysis and several imaging techniques for microstructure quantification: full-field soft and hard X-ray nano-tomographies; scanning infrared spectro-microscopy; scanning transmission and fluorescence X-ray tomographies. Finally, a personal outlook is provided.I am grateful to all my coauthors, collaborators, colleagues and PhD students, for all our work together during more than two decades. I thank the University of Malaga and ALBA Synchrotron Light Source for the support and the stirring environments. I acknowledge the Spanish science funding agencies (they change the name quite often) for funding my studentship, to do the PhD and the three summer research stays at Oxford University, to the last ongoing research project. To all synchrotrons I have been allowed to enjoy carrying out experiments: SRS, ESRF, Max-Lab, DLS, APS, SLS and ALBA. Finally, this work has been supported by the Spanish MINECO through the BIA2014-57658-C2-1-R research grant

Do acute elevations of serum creatinine in primary care engender an increased mortality risk?

Background: The significant impact Acute Kidney Injury (AKI) has on patient morbidity and mortality emphasizes the need for early recognition and effective treatment. AKI presenting to or occurring during hospitalisation has been widely studied but little is known about the incidence and outcomes of patients experiencing acute elevations in serum creatinine in the primary care setting where people are not subsequently admitted to hospital. The aim of this study was to define this incidence and explore its impact on mortality. Methods: The study cohort was identified by using hospital data bases over a six month period. Inclusion criteria: People with a serum creatinine request during the study period, 18 or over and not on renal replacement therapy. The patients were stratified by a rise in serum creatinine corresponding to the Acute Kidney Injury Network (AKIN) criteria for comparison purposes. Descriptive and survival data were then analysed. Ethical approval was granted from National Research Ethics Service (NRES) Committee South East Coast and from the National Information Governance Board. Results: The total study population was 61,432. 57,300 subjects with ‘no AKI’, mean age 64.The number (mean age) of acute serum creatinine rises overall were, ‘AKI 1’ 3,798 (72), ‘AKI 2’ 232 (73), and ‘AKI 3’ 102 (68) which equates to an overall incidence of 14,192 pmp/year (adult). Unadjusted 30 day survival was 99.9% in subjects with ‘no AKI’, compared to 98.6%, 90.1% and 82.3% in those with ‘AKI 1’, ‘AKI 2’ and ‘AKI 3’ respectively. After multivariable analysis adjusting for age, gender, baseline kidney function and co-morbidity the odds ratio of 30 day mortality was 5.3 (95% CI 3.6, 7.7), 36.8 (95% CI 21.6, 62.7) and 123 (95% CI 64.8, 235) respectively, compared to those without acute serum creatinine rises as defined. Conclusions: People who develop acute elevations of serum creatinine in primary care without being admitted to hospital have significantly worse outcomes than those with stable kidney function

The matrix model version of AGT conjecture and CIV-DV prepotential

Recently exact formulas were provided for partition function of conformal (multi-Penner) beta-ensemble in the Dijkgraaf-Vafa phase, which, if interpreted as Dotsenko-Fateev correlator of screenings and analytically continued in the number of screening insertions, represents generic Virasoro conformal blocks. Actually these formulas describe the lowest terms of the q_a-expansion, where q_a parameterize the shape of the Penner potential, and are exact in the filling numbers N_a. At the same time, the older theory of CIV-DV prepotential, straightforwardly extended to arbitrary beta and to non-polynomial potentials, provides an alternative expansion: in powers of N_a and exact in q_a. We check that the two expansions coincide in the overlapping region, i.e. for the lowest terms of expansions in both q_a and N_a. This coincidence is somewhat non-trivial, since the two methods use different integration contours: integrals in one case are of the B-function (Euler-Selberg) type, while in the other case they are Gaussian integrals.Comment: 27 pages, 1 figur

Ocular inflammatory disease and ocular tuberculosis in a cohort of patients co-infected with HIV and multidrug-resistant tuberculosis in Mumbai, India: a cross-sectional study.

The prevalence and the patterns of ocular inflammatory disease and ocular tuberculosis (TB) are largely undocumented among Multidrug Resistant TB (MDR-TB) patients co-infected with Human Immunodeficiency Virus (HIV) and on antituberculosis and antiretroviral therapy (ART)

Psilocybin and MDMA reduce costly punishment in the Ultimatum Game

Disruptions in social decision-making are becoming evident in many psychiatric conditions. These are studied using paradigms investigating the psychological mechanisms underlying interpersonal interactions, such as the Ultimatum Game (UG). Rejection behaviour in the UG represents altruistic punishment – the costly punishment of norm violators – but the mechanisms underlying it require clarification. To investigate the psychopharmacology of UG behaviour, we carried out two studies with healthy participants, employing serotonergic agonists: psilocybin (open-label, within-participant design, N = 19) and 3,4-methylenedioxymethamphetamine (MDMA; placebo-controlled, double-blind, crossover design, N = 20). We found that both MDMA and psilocybin reduced rejection of unfair offers (odds ratio: 0.57 and 0.42, respectively). The reduction in rejection rate following MDMA was associated with increased prosociality (R2 = 0.26, p = 0.025). In the MDMA study, we investigated third-party decision-making and proposer behaviour. MDMA did not reduce rejection in the third-party condition, but produced an increase in the amount offered to others (Cohen’s d = 0.82). We argue that these compounds altered participants’ conceptualisation of ‘social reward’, placing more emphasis on the direct relationship with interacting partners. With these compounds showing efficacy in drug-assisted psychotherapy, these studies are an important step in the further characterisation of their psychological effects

Prevalence of Malaria and Anaemia among HIV Infected Pregnant women Receiving Co-trimoxazole Prophylaxis in Tanzania: A Cross Sectional Study in Kinondoni Municipality.

HIV-infected pregnant women are particularly more susceptible to the deleterious effects of malaria infection particularly anaemia. In order to prevent opportunistic infections and malaria, a policy of daily co-trimoxazole prophylaxis without the standard Suphadoxine-Pyrimethamine intermittent preventive treatment (SP-IPT) was introduced to all HIV infected pregnant women in the year 2011. However, there is limited information about the effectiveness of this policy. This was a cross sectional study conducted among HIV-infected pregnant women receiving co-trimoxazole prophylaxis in eight public health facilities in Kinondoni Municipality from February to April 2013. Blood was tested for malaria infection and anaemia (haemoglobin <11 g/dl). Data were collected on the adherence to co-trimoxazole prophylaxis and other risk factors for malaria infection and anaemia. Pearson chi-square test, Fischer's exact test and multivariate logistic regression were used in the statistical analysis. This study enrolled 420 HIV infected pregnant women. The prevalence of malaria infection was 4.5%, while that of anaemia was 54%. The proportion of subjects with poor adherence to co-trimoxazole was 50.5%. As compared to HIV infected pregnant women with good adherence to co-trimoxazole prophylaxis, the poor adherents were more likely to have a malaria infection (Adjusted Odds Ratio, AOR = 6.81, 95%CI = 1.35-34.43, P = 0.02) or anaemia (AOR = 1.75, 95%CI = 1.03-2.98, P = 0.039). Other risk factors associated with anaemia were advanced WHO clinical stages, current malaria infection and history of episodes of malaria illness during the index pregnancy. The prevalence of malaria was low; however, a significant proportion of subjects had anaemia. Good adherence to co-trimoxazole prophylaxis was associated with reduction of both malaria infection and anaemia among HIV infected pregnant women

Effect of mixture proportions on the drying shrinkage and permeation properties of high strength concrete containing class F fly ash

Sustainability of concrete can be improved by using large volume of fly ash as a replacement of cement and by ensuring improved durability of concrete. Durability of concrete containing large volume of class F fly ash is dependent on the design of mixture proportions. This paper presents an experimental study on the effect of mixture proportions on the drying shrinkage and permeation properties of high strength concrete containing large volume local class F fly ash. Concrete mixtures were designed with and without adjustments in the water to binder ratio (w/b) and the total binder content to take into account the incorporation of fly ash up to 40% of total binder. Concretes, in which the mixture proportions were adjusted for fly ash inclusion achieved equivalent strength of the control concrete and showed enhanced properties of drying shrinkage, sorptivity, water permeability and chloride penetration as compared to the control concrete. The improvement of durability properties was less significant when no adjustments were made to the w/b ratio and total binder content. The results show the necessity of the adjustments in mixture proportions of concrete to achieve improved durability properties when using class F fly ash as a cement replacement