943 research outputs found
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The Effect of Salsalate Therapy on Endothelial Function in a Broad Range of Subjects
Background: Inflammation is fundamental to the development of atherosclerosis. We examined the effect of antiâinflammatory doses of salicylate on endotheliumâdependent vasodilation, a biomarker of cardiovascular risk, in a broad range of subjects. Methods and Results: We performed a randomized, doubleâblind, placeboâcontrolled crossover trial evaluating the effects of 4 weeks of highâdose salsalate (disalicylate) therapy on endotheliumâdependent flowâmediated and endotheliumâindependent vasodilation. Fiftyâeight subjects, including 17 with metabolic syndrome, 13 with atherosclerosis, and 28 healthy controls, were studied. Among all subjects, endotheliumâdependent flowâmediated vasodilation decreased after salsalate compared with placebo therapy (P=0.01), whereas nitroglycerinâmediated, endotheliumâindependent vasodilation was unchanged (P=0.97). Endotheliumâdependent flowâmediated vasodilation after salsalate therapy was impaired compared with placebo therapy in subjects with therapeutic salicylate levels (n=31, P0.2). Conclusions: Salsalate therapy, particularly when therapeutic salicylate levels are achieved, impairs endotheliumâdependent vasodilation in a broad range of subjects. These data raise concern about the possible deleterious effects of antiâinflammatory doses of salsalate on cardiovascular risk. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique Identifiers: NCT00760019 and NCT00762827
Denial at the top table: status attributions and implications for marketing
Senior marketing management is seldom represented on the Board of Directors nowadays, reflecting a deteriorating status of the marketing profession. We examine some of the key reasons for marketingâs demise, and discuss how the status of marketing may be restored by demonstrating the value of marketing to the business community. We attribute marketingâs demise to several related key factors: narrow typecasting, marginalisation and limited involvement in product development, questionable marketing curricula, insensitivity toward environmental change, questionable professional standards and roles, and marketingâs apparent lack of accountability to CEOs. Each of these leads to failure to communicate, create, or deliver value within marketing. We argue that a continued inability to deal with marketingâs crisis of representation will further erode the status of the discipline both academically and professionally
Water and Sodium in Heart Failure: A Spotlight on Congestion.
Despite all available therapies, the rates of
hospitalization and death from heart failure (HF) remain
unacceptably high. The most common reasons for hospital
admission are symptoms related to congestion. During
hospitalization, most patients respond well to standard
therapy and are discharged with significantly improved
symptoms. Post-discharge, many patients receive diligent
and frequent follow-up. However, rehospitalization rates
remain high. One potential explanation is a persistent
failure by clinicians to adequately manage congestion in
the outpatient setting. The failure to successfully manage
these patients post-discharge may represent an unmet need
to improve the way congestion is both recognized and
treated. A primary aim of future HF management may be to
improve clinical surveillance to prevent and manage
chronic fluid overload while simultaneously maximizing
the use of evidence-based therapies with proven long-term
benefit. Improvement in cardiac function is the ultimate
goal and maintenance of a ââdryââ clinical profile is
important to prevent hospital admission and improve
prognosis. This paper focuses on methods for monitoring
congestion, and strategies for water and sodium management
in the context of the complex interplay between the cardiac
and renal systems. A rationale for improving recognition and
treatment of congestion is also proposed
Report of the 2016-2017 Student Affairs Standing Committee
The 2016-2017 AACP Student Affairs Standing Committee addressed charges related to recruitment to the profession of pharmacy and a national awareness campaign for pharmacy careers, as well as promotion of student wellness and stress management. The Committee report provides six recommendations to the American Association of Colleges of Pharmacy (AACP) and one proposed policy statement for the AACP House of Delegates related to recruitment to the pharmacy profession. The Committee report also provides three recommendations to AACP and one proposed policy statement for the AACP House of Delegates related to student wellness and stress management. In addition, this report provides recommendations for future AACP Student Affairs Standing Committee work
Percutaneous coronary revascularization in patients with formerly "refractory angina pectoris in end-stage coronary artery disease" â Not "end-stage" after all
<p>Abstract</p> <p>Background</p> <p>Patients with refractory angina pectoris in end-stage coronary artery disease represent a severe condition with a higher reduction of life-expectancy and quality of life as compared to patients with stable coronary artery disease. It was the purpose of this study to invasively re-evaluate highly symptomatic patients with formerly diagnosed refractory angina pectoris in end-stage coronary artery disease for feasible options of myocardial revascularization.</p> <p>Methods</p> <p>Thirty-four Patients formerly characterized as having end stage coronary artery disease with refractory angina pectoris were retrospectively followed for coronary interventions.</p> <p>Results</p> <p>Of those 34 patients 21 (61.8%) were eventually revascularized with percutaneous interventional revascularization (PCI). Due to complex coronary morphology (angulation, chronic total occlusion) PCI demanded an above-average amount of time (66 ± 42 minutes, range 25â206 minutes) and materials (contrast media 247 ± 209 ml, range 50â750 ml; PCI guiding wires 2.0 ± 1.4, range 1â6 wires). Of PCI patients 7 (33.3%) showed a new lesion as a sign of progression of atherosclerosis. Clinical success rate with a reduction to angina class II or lower was 71.4% at 30 days. Surgery was performed in a total of8 (23.5%) patients with a clinical success rate of 62.5%. Based on an intention-to-treat 2 patients of originally 8 (25%) demonstrated clinical success. Mortality during follow-up (1â18 months) was 4.8% in patients who underwent PCI, 25% in patients treated surgically and 25% in those only treated medically.</p> <p>Conclusion</p> <p>The majority of patients with end-stage coronary artery disease can be treated effectively with conventional invasive treatment modalities. Therefore even though it is challenging and demanding PCI should be considered as a first choice before experimental interventions are considered.</p
Electrocardiographic features of immune checkpoint inhibitor associated myocarditis
Background Myocarditis is a highly morbid complication of immune checkpoint inhibitor (ICI) use that remains inadequately characterized. The QRS duration and the QTc interval are standardized electrocardiographic measures that are prolonged in other cardiac conditions; however, there are no data on their utility in ICI myocarditis. Methods From an international registry, ECG parameters were compared between 140 myocarditis cases and 179 controls across multiple time points (pre-ICI, on ICI prior to myocarditis, and at the time of myocarditis). The association between ECG values and major adverse cardiac events (MACE) was also tested. Results Both the QRS duration and QTc interval were similar between cases and controls prior to myocarditis. When compared with controls on an ICI (93±19 ms) or to baseline prior to myocarditis (97±19 ms), the QRS duration prolonged with myocarditis (110±22 ms, p<0.001 and p=0.009, respectively). In contrast, the QTc interval at the time of myocarditis (435±39 ms) was not increased compared with pre-myocarditis baseline (422±27 ms, p=0.42). A prolonged QRS duration conferred an increased risk of subsequent MACE (HR 3.28, 95% CI 1.98 to 5.62, p<0.001). After adjustment, each 10 ms increase in the QRS duration conferred a 1.3-fold increase in the odds of MACE (95% CI 1.07 to 1.61, p=0.011). Conversely, there was no association between the QTc interval and MACE among men (HR 1.33, 95% CI 0.70 to 2.53, p=0.38) or women (HR 1.48, 95% CI 0.61 to 3.58, p=0.39). Conclusions The QRS duration is increased in ICI myocarditis and is associated with increased MACE risk. Use of this widely available ECG parameter may aid in ICI myocarditis diagnosis and risk-stratification
Cigarette Smoke Upregulates Rat Coronary Artery Endothelin Receptors In Vivo
Background: Cigarette smoking is a strong cardiovascular risk factor and endothelin (ET) receptors are related to coronary artery diseases. The present study established an in vivo secondhand smoke (SHS) exposure model and investigated the hypothesis that cigarette smoke induces ET receptor upregulation in rat coronary arteries and its possible underlying mechanisms. Methodology/Principal Findings: Rats were exposed to SHS for 200 min daily for 8 weeks. The coronary arteries were isolated and examined. The vasoconstriction was studied by a sensitive myograph. The expression of mRNA and protein for receptors was examined by real-time PCR, Western blot and immunofluorescence. Compared to fresh air exposure, SHS increased contractile responses mediated by endothelin type A (ETA) and type B (ETB) receptors in coronary arteries. In parallel, the expression of mRNA and protein for ETA and ETB receptors of smoke exposed rats were higher than that of animals exposed to fresh air, suggesting that SHS upregulates ET A and ET B receptors in coronary arteries in vivo. Immunofluorescence staining showed that the enhanced receptor expression was localized to the smooth muscle cells of coronary arteries. The protein levels of phosphorylated (p)-Raf-1 and p-ERK1/2 in smoke exposed rats were significantly higher than in control rats, demonstrating that SHS induces the activation of the Raf/ERK/MAPK pathway. Treatment with Raf-1 inhibitor GW5074 suppressed SHS-induced enhanced contraction mediated by ET A receptors, and inhibited th
Measuring personal networks and their relationship with scientific production
The analysis of social networks has remained a crucial and yet understudied aspect of the efforts to measure Triple Helix linkages. The Triple Helix model aims to explain, among other aspects of knowledge-based societies, Âżthe current research system in its social context. This paper develops a novel approach to study the research system from the perspective of the individual, through the analysis of the relationships among researchers, and between them and other social actors. We develop a new set of techniques and show how they can be applied to the study of a specific case (a group of academics within a university department). We analyse their informal social networks and show how a relationship exists between the characteristics of an individualÂżs network of social links and his or her research output
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