Transdisciplinary unifying implications of circadian findings in the 1950s

A few puzzles relating to a small fraction of my endeavors in the 1950s are summarized herein, with answers to a few questions of the Editor-in-Chief, to suggest that the rules of variability in time complement the rules of genetics as a biological variability in space. I advocate to replace truisms such as a relative constancy or homeostasis, that have served bioscience very well for very long. They were never intended, however, to lower a curtain of ignorance over everyday physiology. In raising these curtains, we unveil a range of dynamics, resolvable in the data collection and as-one-goes analysis by computers built into smaller and smaller devices, for a continued self-surveillance of the normal and for an individualized detection of the abnormal. The current medical art based on spotchecks interpreted by reference to a time-unqualified normal range can become a science of time series with tests relating to the individual in inferential statistical terms. This is already doable for the case of blood pressure, but eventually should become possible for many other variables interpreted today only based on the quicksand of clinical trials on groups. These ignore individual differences and hence the individual's needs. Chronomics (mapping time structures) with the major aim of quantifying normalcy by dynamic reference values for detecting earliest risk elevation, also yields the dividend of allowing molecular biology to focus on the normal as well as on the grossly abnormal

Potential Chonobiological Triggering Factors of Acute Heart Attack

Abstract: The immediate triggers of acute heart attack or acute coronary syndrome (ACS) are not known exactly. There is a marked increase in sympathetic activity, neuroendocrino-logical dysfunction, oxidative stress and deficiency of 3 fatty acids, vitamins, minerals, as well as antioxidants during ACS. Energy intake and expenditure have diurnal variation throughout 24-hour cycle and any disturbance in this cycle may result into disruption of the endogenous clock and neurohumoral dysfunctions. Clinical studies have reported an increased incidence of reinfarction, sudden death, coronary constriction, myocardial ischaemia, vascular variability disorders and angina, during second quarter of the 24 hour cycle, at the point where there is rapid withdrawal of vagal activity and increase in sympathetic tone. In several studies, among patients with heart attack, there was a significant 2-3 fold increase in cardiac events in the second quarter of the day (6-12 hours) compared to other quarters respectively. Triggers of heart attack were noted in up to 80.0% of patients in various studies. Brain related and psychological mechanisms, i.e., emotional stress, sleep deprivation, cold climate, hot climate, large meals and physical exertion were observed among 30-50% of patients. Such triggers have also been reported in Europe, North America and Asia. These triggering factors are known to enhance sympathetic activity and decrease vagal tone, resulting into increased secretion of plasma cortisol, noradrenaline, aldosterone, angiotensin converting enzyme, interleukin-1, 2, 6, 18 and tumor necrosis factor-alpha, that are proinflammatory. There is also a deficiency in the serum levels of 3 fatty acids, vitamin A, E, C, coenzyme Q10, magnesium, potassium, melatonin, interleukin-10 (antiinflammatory) and increase in TBARS, MDA, diene conjugates, TNF-alpha and IL-6, which are indicators of oxidative damage and inflammation, respectively. It is not clear whether the predisposition of ACS is due to size of the meals or other proinflammatory factors of meals

Usefulness of left ventricular peak filling rate measurement by cardiac MR imaging in heart transplant recipients with cardiac allograft vasculopathy

Oral presentation13th Annual SCMR Scientific Sessions / Phoenix, AZ, USA. / 21-24 January 201

Prevalence of hypertension at high altitude: cross-sectional survey in Ladakh, Northern India 2007-2011

Objective: Prevalence of hypertension was examined in a widely dispersed (45 110 km2) representative group of Ladakhi in Northern India. The influence of hypoxic environment of wide-ranged altitude (2600–4900 m) and lifestyle change on hypertension was studied. Methods: 2800 participants (age 20–94 years) were enrolled. Systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure of ≥90 mm Hg and/or taking current anti-hypertensive medicine was defined as hypertension. Height and weight for body mass index and SpO2 were examined. The rural population comprised six subdivisions with a distinct altitude, dietary and occupational pattern. Participants in the urban area of Leh consist of two groups, that is, migrants settled in Leh from the Changthang nomadic area, and dwellers born in Leh. The prevalence of hypertension in the two groups was compared with that in the farmers and nomads in rural areas. The effects of ageing, hypoxia, dwelling at high altitude, obesity, modernised occupation, dwelling in an urban area, and rural-to-urban migration to hypertension were analysed by multiple logistic regression. Results: The prevalence of hypertension was 37.0% in all participants and highest in migrants settled in Leh (48.3%), followed by dwellers born in Leh town (41.1%) compared with those in rural areas (33.5). The prevalence of hypertension in nomads (all: 27.7%, Tibetan/Ladakhi: 19.7/31.9%)) living at higher altitude (4000–4900 m) was relatively low. The associated factors with hypertension were ageing, overweight, dwelling at higher altitude, engagement in modernised sedentary occupations, dwelling in urban areas, and rural-to-urban migration. The effects of lifestyle change and dwelling at high altitude were independently associated with hypertension by multivariate analysis adjusted with confounding factors. Conclusions: Socioeconomic and cultural factors play a big role with the effect of high altitude itself on high prevalence of hypertension in highlanders in Ladakh

Relationship between cardiac allograft vasculopathy and left ventricular diastolic dysfunction assessed by cardiac magnetic resonance imaging in heart transplant recipients

POSTER PRESENTATION12th Annual SCMR Scientific Sessions – 2009 / Orlando, FL, USA / 29 January–1 February 200