Cardiovascular-kidney-metabolic overlap in heart failure with mildly reduced or preserved ejection fraction a trial-level analysis

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Not AvailableAssessment of the stability of grain iron (Fe) and zinc (Zn) content across growing regions is a pre-requisite in breeding for micronutrient enrichment in grains. Grain Fe and Zn contents were estimated in a set of 10 sorghum genotypes grown at six locations. The Fe and Zn in grain ranged from 28.9-34.9 mg/kg and 20.4-25.7 mg/kg, respectively, across the locations. Significant genotype × environment (G × E) interactions were observed for both grain Fe and Zn, indicating differential nutrient accumulation by the genotypes. Additive main effects and multiplicative interaction (AMMI) analysis indicated that the first two principal components were significant and contributed more than 75% of G × E sum of squares. Though environment (linear) variance was significant indicating linear sensitivity, significant pooled deviation for both the traits suggested that expression in some of the genotypes fluctuated significantly from their respective linear path of response to environments. The study shows the necessity of multi-location as well as multi-season evaluation of genotypes for identifying stable donors that can be used in breeding programmes for micronutrient enrichment.Not Availabl

Implementation of a psychodermatology clinic at a major health system in Detroit

The association between psychiatric and dermatologic disorders has been well characterized in the present literature with estimates of up to 40% of dermatology patients having concomitant psychiatric problems that are often related to their skin condition. Here, we present our experience regarding the implementation of a psychodermatology clinic in Detroit, Michigan. The most commonly referred conditions were delusions of parasitosis, neurotic excoriations, and isotretinoin initiation for patients with a history of psychiatric conditions. Seventy-three percent of referred patients were female. By creating a monthly clinic for patients who are diagnosed with skin conditions and associated psychiatric disorders or psychological symptoms, we are able to meet the needs of these patients with a synergistic relationship between health care providers

Baseline characteristics of patients with heart failure with mildly reduced or preserved ejection fraction: The FINEARTS-HF trial

Aims: To describe the baseline characteristics of participants in the FINEARTS-HF trial, contextualized with prior trials including patients with heart failure (HF) with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF). The FINEARTS-HF trial is comparing the effects of the non-steroidal mineralocorticoid receptor antagonist finerenone with placebo in reducing cardiovascular death and total worsening HF events in patients with HFmrEF/HFpEF. Methods and results: Patients with symptomatic HF, left ventricular ejection fraction (LVEF) ≥40%, estimated glomerular filtration rate ≥ 25 ml/min/1.73 m2, elevated natriuretic peptide levels and evidence of structural heart disease were enrolled and randomized to finerenone titrated to a maximum of 40 mg once daily or matching placebo. We validly randomized 6001 patients to finerenone or placebo (mean age 72 ± 10 years, 46% women). The majority were New York Heart Association functional class II (69%). The baseline mean LVEF was 53 ± 8% (range 34–84%); 36% of participants had a LVEF <50% and 64% had a LVEF ≥50%. The median N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 1041 (interquartile range 449–1946) pg/ml. A total of 1219 (20%) patients were enrolled during or within 7 days of a worsening HF event, and 3247 (54%) patients were enrolled within 3 months of a worsening HF event. Compared with prior large-scale HFmrEF/HFpEF trials, FINEARTS-HF participants were more likely to have recent (within 6 months) HF hospitalization and greater symptoms and functional limitations. Further, concomitant medications included a larger percentage of sodium–glucose cotransporter 2 inhibitors and angiotensin receptor–neprilysin inhibitors than previous trials. Conclusions: FINEARTS-HF has enrolled a broad range of high-risk patients with HFmrEF and HFpEF. The trial will determine the safety and efficacy of finerenone in this population