Antihypertensive drug class and dyslipidemia: risk association among Chinese patients with uncomplicated hypertension

Factors associated with dyslipidemia in Chinese patients with uncomplicated hypertension were investigated in 1,139 patients newly prescribed a single antihypertensive drug in the public primary healthcare setting in Hong Kong, where their fasting lipid profiles were measured 4 to 16 weeks after the first prescription. Multivariate logistic regression showed that thiazide users were more likely (OR 3.67, 95% C.I. 1.13, 11.88, p=0.030) to have adverse (> 6.2mmol/l) total cholesterol (TC) compared with drugs acting on the renin angiotensin system (RAS), but the absolute difference in mean TC between thiazide users and all patients was small ( 0.14 mmol/l), while advanced age and male gender were also associated with some aspects of dyslipidemia. Clinicians should be aware of the increased risk of dyslipidemia in these groups, but the mild dyslipidemic profile associated with thiazides should not in itself deter its use as a possible first-line antihypertensive agent among Chinese patients

Global Trends and Gaps in Research Related to Latent Tuberculosis Infection

Background There is a global commitment to eliminating tuberculosis (TB). It is critical to detect and treat cases of latent TB infection (LTBI), the reservoir of new TB cases. Our study assesses trends in publication of LTBI-related research. Methods We used the keywords (“latent tuberculosis” OR “LTBI” OR “latent TB”) to search the Web of Science for LTBI-related articles published 1995–2018, then classified the results into three research areas: laboratory sciences, clinical research, and public health. We calculated the proportions of LTBI-related articles in each area to three areas combined, the average rates of LTBI-related to all scientific and TB-related articles, and the average annual percent changes (AAPC) in rates for all countries and for the top 13 countries individually and combined publishing LTBI research. Results The proportion of LTBI-related articles increased over time in all research areas, with the highest AAPC in laboratory (38.2%/yr), followed by public health (22.9%/yr) and clinical (15.1%/yr). South Africa (rate ratio [RR] = 8.28, 95% CI 5.68 to 12.08) and India (RR = 2.53, 95% CI 1.74 to 3.69) had higher RRs of overall TB-related articles to all articles, but did not outperform the average of the top 13 countries in the RRs of LTBI-related articles to TB-related articles. Italy (RR = 1.95, 95% CI 1.45 to 2.63), Canada (RR = 1.73, 95% CI 1.28 to 2.34), and Spain (RR = 1.53, 95% CI 1.13 to 2.07) had higher RRs of LTBI-related articles to TB-related articles. Conclusions High TB burden countries (TB incidence \u3e 100 per 100,000 population) published more overall TB-related research, whereas low TB burden countries showed greater focus on LTBI. Given the potential benefits, high TB burden countries should consider increasing their emphasis on LTBI-related research

Do clinical guidelines reduce clinician dependent costs?

Clinician dependent costs are the costs of care that are under the discretion of the healthcare provider. These costs include the costs of drugs, tests and investigations, and discretionary outpatient visits and impatient stays. The purpose of this review was to summarize recent evidence, relevant to both developed and developing countries on whether evidence based clinical guidelines can change hospitals variable costs which are clinician dependent, and the degree of financial savings achieved at hospital level. Potential studies for inclusion were identified using structured searches of Econlit, J-Stor, and Pubmed databases. Two reviewers independently evaluated retrieved studies for inclusion. The methodological quality of the selected articles was assessed using the Oxford Centre for Evidence- Based Medicine (CEBM) levels of evidence. The results suggest that 10 of the 11 interventions were successful reducing financial costs. Most of the interventions, either in modeling studies or real interventions generate significant financial saving, although the former reported higher savings because the studies assumed 100 percent compliance

Local mean-field study of capillary condensation in silica aerogels

We apply local mean-field (i.e. density functional) theory to a lattice model of a fluid in contact with a dilute, disordered gel network. The gel structure is described by a diffusion-limited cluster aggregation model. We focus on the influence of porosity on both the hysteretic and the equilibrium behavior of the fluid as one varies the chemical potential at low temperature. We show that the shape of the hysteresis loop changes from smooth to rectangular as the porosity increases and that this change is associated to disorder-induced out-of-equilibrium phase transitions that differ on adsorption and on desorption. Our results provide insight in the behavior of $^4$He in silica aerogels.Comment: 19 figure

Preoperative and Postoperative Evaluation of Multiple Giant Coronary Aneurysms by the Use of Coronary CT Angiography with 64-MDCT: A Case of Multiple Giant Coronary Aneurysms Treated with Aneurysmectomy and Coronary Artery Bypass Surgery

A coronary artery aneurysm is an uncommon disorder and is seen as a characteristic dilatation of a localized portion of the coronary artery. Clinical manifestation of a coronary artery aneurysm varies from an asymptomatic presentation to sudden death of a patient. Although coronary aneurysms are typically diagnosed by the use of coronary angiography, a new generation of coronary 64-slice multidetector computed tomography (64-MDCT) scanners have successfully been used for evaluating this abnormality in a noninvasive manner. In the present case, we performed coronary 64-MDCT scanning preoperatively and postoperatively on a patient with multiple giant coronary aneurysms. The use of coronary 64-MDCT may provide an evaluation technique not only for diagnosis but also for follow-up after surgery for this condition

Bimodal crystallization at polymer-fullerene interfaces

The growth-kinetics of [6,6]-phenyl C61-butyric acid methyl ester (PCBM) crystals, on two different length-scales, is shown to be controlled by the thickness of the polymer layer within a PCBM-polymer bilayer. Using a model amorphous polymer we present evidence, from in situ optical microscopy and grazing-incidence X-ray diffraction (GIXD), that an increased growth-rate of nanoscale crystals impedes the growth of micron-sized, needle-like PCBM crystals. A combination of neutron reflectivity and GIXD measurements, also allows us to observe the establishment of a liquid-liquid equilibrium composition-profile between the PCBM layer and a polymer-rich layer, before crystallization occurs. While the interfacial composition-profile is independent of polymer-film-thickness, the growth-rate of nanoscale PCBM crystals is significantly larger for thinner polymer films. A similar thickness-dependent behavior is observed for different molecular weights of entangled polymer. We suggest that the behavior may be related to enhanced local-polymer-chain-mobility in nanocomposite thin-films

Analysis of factors influencing the ultrasonic fetal weight estimation

Objective: The aim of our study was the evaluation of sonographic fetal weight estimation taking into consideration 9 of the most important factors of influence on the precision of the estimation. Methods: We analyzed 820 singleton pregnancies from 22 to 42 weeks of gestational age. We evaluated 9 different factors that potentially influence the precision of sonographic weight estimation ( time interval between estimation and delivery, experts vs. less experienced investigator, fetal gender, gestational age, fetal weight, maternal BMI, amniotic fluid index, presentation of the fetus, location of the placenta). Finally, we compared the results of the fetal weight estimation of the fetuses with poor scanning conditions to those presenting good scanning conditions. Results: Of the 9 evaluated factors that may influence accuracy of fetal weight estimation, only a short interval between sonographic weight estimation and delivery (0-7 vs. 8-14 days) had a statistically significant impact. Conclusion: Of all known factors of influence, only a time interval of more than 7 days between estimation and delivery had a negative impact on the estimation

Radial distribution of stars, gas and dust in SINGS galaxies. I. Surface photometry and morphology

We present ultraviolet through far-infrared surface brightness profiles for the 75 galaxies in the Spitzer Infrared Nearby Galaxies Survey (SINGS). The imagery used to measure the profiles includes GALEX UV data, optical images from KPNO, CTIO and SDSS, near-IR data from 2MASS, and mid- and far-infrared images from Spitzer. Along with the radial profiles, we also provide multi-wavelength asymptotic magnitudes and several non-parametric indicators of galaxy morphology: the concentration index (C_42), the asymmetry (A), the Gini coefficient (G) and the normalized second-order moment of the brightest 20% of the galaxy's flux (M_20). Our radial profiles show a wide range of morphologies and multiple components (bulges, exponential disks, inner and outer disk truncations, etc.) that vary not only from galaxy to galaxy but also with wavelength for a given object. In the optical and near-IR, the SINGS galaxies occupy the same regions in the C_42-A-G-M_20 parameter space as other normal galaxies in previous studies. However, they appear much less centrally concentrated, more asymmetric and with larger values of G when viewed in the UV (due to star-forming clumps scattered across the disk) and in the mid-IR (due to the emission of Polycyclic Aromatic Hydrocarbons at 8.0 microns and very hot dust at 24 microns).Comment: 66 pages in preprint format, 14 figures, published in ApJ. The definitive publisher authenticated version is available online at http://dx.doi.org/10.1088/0004-637X/703/2/156

Differences in Bone Mineral Density between the Right and Left Hips in Postmenopausal Women

Bone mineral density (BMD) using dual energy radiography absorptiometry are commonly used for the diagnosis of osteoporosis. It is usually measured at the spine and also at one hip joint. Controversy still exists regarding the use of bilateral hip scanning. We analyzed the difference of BMD at bilateral hips in 384 postmenopausal women, retrospectively. The concordance and discordance rates of the lowest T-score and BMD between both hips were evaluated. The BMDs of the femoral neck and trochanter were significantly different between both hips (P < 0.05). There were also discrepancies between the lowest T-scores of both hips (P < 0.05). The discordance rates were about 30%. Due to significant differences in BMD between both hips at the femoral neck and trochanter and high discordance rate, bilateral hip measurements using DEXA are recommended to avoid underestimating osteoporosis