Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

OBJECTIVES: To correlate the importance of the ankle-brachial index in terms of cardiovascular morbimortalityand the extent of coronary arterial disease amongst elderly patients without clinical manifestations of lowerlimb peripheral arterial disease.METHODS: We analyzed prospective data from 100 patients over 65 years of age with coronary arterial disease,as confirmed by coronary angiography, and with over 70% stenosis of at least one sub-epicardial coronaryartery. We measured the ankle-brachial index immediately after coronary angiography, and a value of ,0.9was used to diagnose peripheral arterial disease.RESULTS: The patients’ average age was 77.4 years. The most prevalent risk factor was hypertension (96%), andthe median late follow-up appointment was 28.9 months. The ankle-brachial index was ,0.9 in 47% of thepatients, and a low index was more prevalent in patients with multiarterial coronary disease compared topatients with uniarterial disease in the same group. Using a bivariate analysis, only an ankle-brachial index of,0.9 was a strong predictive factor for cardiovascular events, thereby increasing all-cause deaths and fatal andnon-fatal acute myocardial infarctions two- to three-fold.CONCLUSION: In elderly patients with documented coronary disease, a low ankle-brachial index (,0.9) wasassociated with the severity and extent of coronary arterial disease, and in late follow-up appointments, a lowindex was correlated with an increase in the occurrence of major cardiovascular events

Ankle-brachial index as a predictor of coronary disease events in elderly patients submitted to coronary angiography

OBJECTIVES: To correlate the importance of the ankle-brachial index in terms of cardiovascular morbimortality and the extent of coronary arterial disease amongst elderly patients without clinical manifestations of lower limb peripheral arterial disease.METHODS: We analyzed prospective data from 100 patients over 65 years of age with coronary arterial disease, as confirmed by coronary angiography, and with over 70% stenosis of at least one sub-epicardial coronary artery. We measured the ankle-brachial index immediately after coronary angiography, and a value of <0.9 was used to diagnose peripheral arterial disease.RESULTS: the patients' average age was 77.4 years. the most prevalent risk factor was hypertension (96%), and the median late follow-up appointment was 28.9 months. the ankle-brachial index was <0.9 in 47% of the patients, and a low index was more prevalent in patients with multiarterial coronary disease compared to patients with uniarterial disease in the same group. Using a bivariate analysis, only an ankle-brachial index of,0.9 was a strong predictive factor for cardiovascular events, thereby increasing all-cause deaths and fatal and non-fatal acute myocardial infarctions two-to three-fold.CONCLUSION: in elderly patients with documented coronary disease, a low ankle-brachial index (<0.9) was associated with the severity and extent of coronary arterial disease, and in late follow-up appointments, a low index was correlated with an increase in the occurrence of major cardiovascular events.Univ Fed Estado São Paulo, Dept Cardiol, São Paulo, BrazilHosp Israelita Albert Einstein, Dept Cardiol, São Paulo, BrazilDuke Univ, Sch Med, Dept Med, Durham, NC 27706 USAUniv Fed Estado São Paulo, Dept Cardiol, São Paulo, BrazilWeb of Scienc

Azimuthal anisotropy of neutral pion production in Au+Au collisions at sqrt(s_NN) = 200 GeV: Path-length dependence of jet quenching and the role of initial geometry

We have measured the azimuthal anisotropy of pi0's for 1 < pT < 18 GeV/c for Au+Au collisions at sqrt s_NN = 200 GeV. The observed anisotropy shows a gradual decrease in 3 < pT < 7 - 10 GeV/c, but remains positive beyond 10 GeV/c. The magnitude of this anisotropy is under-predicted, up to at least 10 GeV/c, by current perturbative QCD (pQCD) energy-loss model calculations. An estimate of the increase in anisotropy expected from initial-geometry modification due to gluon saturation effects and initial-geometry fluctuations is insufficient to account for this discrepancy. Calculations which implement a path length dependence steeper than what is implied by current pQCD energy-loss models, show reasonable agreement with the data.Comment: 384 authors, 6 pages text, 3 figures. Submitted to Phys. Rev. Lett. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

(18O,16O) Two-neutron transfer reactions for spectroscopic studies.

A systematic study of the response of different nuclei to the (18O, 16O) two-neutron transfer reaction at 84 MeV incident energy was pursued at the INFN-LNS in Catania (Italy). The experiments were performed using several solid targets from light (9Bc, 11 B, 12,13C, 16O, 28Si) to heavier ones (58,64Ni, 120Sn, 208Pb). The 16O ejectiles were detected at forward angles by the MAGNEX magnetic spectrometer and identified without the need of time of flight measurements. Exploiting the large momentum (≈ 25%) and angular (50 msr) acceptance of the spectrometer, energy spectra were obtained with a relevant yield up to about 20 MeV excitation energy. A common feature of the light nuclei spectra is the strong population of states with well known configuration of two-particle over a core and the appearance of unknown resonant structures in the continuum. These latter can reveal the excitation of a collective mode connected with the transfer of a pair. For the heavier nuclei as 66Ni a completely different behaviour is observed indicating the presence of more dissipative processes in the reaction mechanisms that hide the spectroscopic information

Transverse momentum dependence of J/psi polarization at midrapidity in p+p collisions at sqrt(s)=200 GeV

We report the measurement of the transverse momentum dependence of inclusive J/psi polarization in p+p collisions at sqrt(s)=200 GeV performed by the PHENIX Experiment at RHIC. The polarization is studied in the helicity, Gottfried-Jackson, and Collins-Soper frames for p_T < 5 GeV/c and |y| < 0.35. The J/psi polarization in the helicity and Gottfried-Jackson frames is consistent with zero for all transverse momenta, with a slight (1.8 sigma) trend towards longitudinal polarization for transverse momenta above 2 GeV/c. No conclusion is allowed due to the limited acceptance in the Collins-Soper frame and the uncertainties of the current data. The results are compared to observations for other collision systems and center of mass energies and to different quarkonia production models.Comment: 384 authors from 62 institutions, 11 pages, 9 figures, 2 tables. v2 is expanded version submitted to Physical Review D. Plain text data tables for the points plotted in figures are available at http://www.phenix.bnl.gov/papers.htm

Transverse momentum and centrality dependence of dihadron correlations in Au+Au collisions at sqrt(s_NN)=200 GeV: Jet-quenching and the response of partonic matter

Azimuthal angle \Delta\phi correlations are presented for charged hadrons from dijets for 0.4 < p_T < 10 GeV/c in Au+Au collisions at sqrt(s_NN) = 200 GeV. With increasing p_T, the away-side distribution evolves from a broad to a concave shape, then to a convex shape. Comparisons to p+p data suggest that the away-side can be divided into a partially suppressed "head" region centered at Delta\phi ~ \pi, and an enhanced "shoulder" region centered at Delta\phi ~ \pi +/- 1.1. The p_T spectrum for the "head" region softens toward central collisions, consistent with the onset of jet quenching. The spectral slope for the "shoulder" region is independent of centrality and trigger p_T, which offers constraints on energy transport mechanisms and suggests that the "shoulder" region contains the medium response to energetic jets.Comment: 420 authors from 58 institutions, 6 pages, 4 figures. Submitted to Physical Review Letters. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

High p_T Direct Photon and pi^0 Triggered Azimuthal Jet Correlations in sqrt(s)=200 GeV p+p Collisions

Correlations of charged hadrons of 1 < pT < 10 GeV/c with high pT direct photons and pi^ 0 mesons in the range 5 <pT < 15 GeV/c are used to study jet fragmentation in the photon+jet and di-jet channels, respectively. The magnitude of the partonic transverse momentum, kT, is obtained by comparing to a model incorporating a Gaussian kT smearing. The sensitivity of the associated charged hadron spectra to the underlying fragmentation function is tested and the data are compared to calculations using recent global fit results. The shape of the direct photon-associated hadron spectrum as well as its charge asymmetry are found to be consistent with a sample dominated by quark-gluon Compton scattering. No significant evidence of fragmentation photon correlated production is observed within experimental uncertainties.Comment: 431 authors, 18 pages, 18 figures, 4 tables, RevTeX-4. Submitted to Physical Review D. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Immunity to Lutzomyia intermedia Saliva Modulates the Inflammatory Environment Induced by Leishmania braziliensis

Transmission of Leishmania parasites occurs during blood feeding, when infected female sand flies inject humans with parasites and saliva. Chemokines and cytokines are secreted proteins that regulate the initial immune responses and have the potential of attracting and activating cells. Herein, we studied the expression of such molecules and the cellular recruitment induced by salivary proteins of the Lutzomyia intermedia sand fly. Of note, Lutzomyia intermedia is the main vector of Leishmania braziliensis, a parasite species that causes cutaneous leishmaniasis, a disease associated with the development of destructive skin lesions that can be fatal if left untreated. We observed that L. intermedia salivary proteins induce a potent cellular recruitment and modify the expression profile of chemokines and cytokines in mice. More importantly, in mice previously immunized with L. intermedia saliva, the alteration in the initial inflammatory response was even more pronounced, in terms of the number of cells recruited and in terms of gene expression pattern. These findings indicate that an existing immunity to L. intermedia sand fly induces an important modulation in the initial immune response that may, in turn, promote parasite multiplication, leading to the development of cutaneous leishmaniasis

Skin color and severe maternal outcomes: evidence from the brazilian network for surveillance of severe maternal morbidity

Taking into account the probable role that race/skin color may have for determining outcomes in maternal health, the objective of this study was to assess whether maternal race/skin color is a predictor of severe maternal morbidity. This is a secondary analysis of the Brazilian Network for Surveillance of Severe Maternal Morbidity, a national multicenter cross-sectional study of 27 Brazilian referral maternity hospitals. A prospective surveillance was performed to identify cases of maternal death (MD), maternal near miss (MNM) events, and potentially life-threatening conditions (PLTC), according to standard WHO definition and criteria. Among 9,555 women with severe maternal morbidity, data on race/skin color was available for 7,139 women, who were further divided into two groups: 4,108 nonwhite women (2,253 black and 1,855 from other races/skin color) and 3,031 white women. Indicators of severe maternal morbidity according to WHO definition are shown by skin color group. Adjusted Prevalence Ratios (PRadj - 95%CI) for Severe Maternal Outcome (SMO=MNM+MD) were estimated according to sociodemographic/obstetric characteristics, pregnancy outcomes, and perinatal results considering race. Results. Among 7,139 women with severe maternal morbidity evaluated, 90.5% were classified as PLTC, 8.5% as MNM, and 1.6% as MD. There was a significantly higher prevalence of MNM and MD among white women. MNMR (maternal near miss ratio) was 9.37 per thousand live births (LB). SMOR (severe maternal outcome ratio) was 11.08 per 1000 LB, and MMR (maternal mortality ratio) was 170.4 per 100,000 LB. Maternal mortality to maternal near miss ratio was 1 to 5.2, irrespective of maternal skin color. Hypertension, the main cause of maternal complications, affected mostly nonwhite women. Hemorrhage, the second more common cause of maternal complication, predominated among white women. Nonwhite skin color was associated with a reduced risk of SMO in multivariate analysis. Nonwhite skin color was associated with a lower risk for severe maternal outcomes. This result could be due to confounding factors linked to a high rate of Brazilian miscegenation.2019CNPQ - Conselho Nacional de Desenvolvimento Científico e Tecnológico402702/2008-