3,995 research outputs found

    Metabolic Profile and Cardiovascular Risk in a Population of Renal transplant recipients

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    Introduction. Cardiovascular disease is more common in renal transplant recipients (RTRs) than in the general population, and is the major cause of both graft loss and patient death in RTRs. Objectives. This study aimed to characterize the cardiovascular risk factors, calculate the 7-year risk for major adverse cardiac events and the 7-year risk for death in a population of RTRs using a cardiovascular risk calculator, and determine the main cardiovascular risk factors associated with increased prediction of major adverse cardiac event (MACE) and death. Patients. This is a retrospective review of clinical data from 121 RTRs who are in follow-up programs at our institution, and who had a functioning and stable graft for longer than 6 months. Results. Among 121 adult patients followed at our institution (59.5% males, mean age of 49.6 13.8 years, mean times for functioning grafts were 105 73.5 mo), 86.8% had hypertension, 19.8% had diabetes, 24.8% were current or former smokers, 61.9% had increased body mass index, and 71% had dyslipidemia. The 7-year risk for MACE was more than 10% in 38 (31.4%) patients with age, diabetes, and smoke being independent risk predictors. The 7-year risk for death was more than 10% in 56 (46.3%) patients with age, diabetes, blood pressure, smoking, and male gender being independent risk predictors. Conclusion. There is a high prevalence of cardiovascular risk factors in a population of RTRs, and there is increased risk for MACE and death. Accurate risk prediction is important for physician decision support and patient education, promoting improved cardiovascular health of RTRs, and thus prolonging the survival of both patients and graft.info:eu-repo/semantics/publishedVersio

    Dynamic risk control by human nucleus accumbens

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    Real-world decisions about reward often involve a complex counterbalance of risk and value. Although the nucleus accumbens has been implicated in the underlying neural substrate, its criticality to human behaviour remains an open question, best addressed with interventional methodology that probes the behavioural consequences of focal neural modulation. Combining a psychometric index of risky decision-making with transient electrical modulation of the nucleus accumbens, here we reveal profound, highly dynamic alteration of the relation between probability of reward and choice during therapeutic deep brain stimulation in four patients with treatment-resistant psychiatric disease. Short-lived phasic electrical stimulation of the region of the nucleus accumbens dynamically altered risk behaviour, transiently shifting the psychometric function towards more risky decisions only for the duration of stimulation. A critical, on-line role of human nucleus accumbens in dynamic risk control is thereby established

    Population assessment of future trajectories in coronary heart disease mortality.

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    Background: Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends. Methods and findings: The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25–74. Calculations were based on combining: i) data on population numbers and projections (Statistics Iceland), ii) population risk factor levels and projections (Refine Reykjavik study), and iii) effectiveness of specific risk factor reductions (published meta-analyses). Projections for three contrasting scenarios were compared: 1) If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. 2) If recent trends in risk factors (past 5 years) continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3) Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040. Conclusions: The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future

    1H, 13C, and 15N resonance assignments for the tandem PHD finger motifs of human CHD4

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    The plant homeodomain (PHD) zinc finger is a structural motif of about 40–60 amino acid residues found in many eukaryotic proteins that are involved in chromatin-mediated gene regulation. The human chromodomain helicase DNA binding protein 4 (CHD4) is a multi-domain protein that harbours, at its N-terminal end, a pair of PHD finger motifs (dPHD) connected by a ~30 amino acid linker. This tandem PHD motif is thought to be involved in targeting CHD4 to chromatin via its interaction with histone tails. Here we report the 1H, 13C and 15N backbone and side-chain resonance assignment of the entire dPHD by heteronuclear multidimensional NMR spectroscopy. These assignments provide the starting point for the determination of the structure, dynamics and histone-binding properties of this tandem domain pair

    Detection of Massive Forming Galaxies at Redshifts Greater than One

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    The complex problem of when and how galaxies formed has not until recently been susceptible of direct attack. It has been known for some time that the excessive number of blue galaxies counted at faint magnitudes implies that a considerable fraction of the massive star formation in the universe occurred at z < 3, but, surprisingly, spectroscopic studies of galaxies down to a B magnitude of 24 found little sign of the expected high-z progenitors of current massive galaxies, but rather, in large part, small blue galaxies at modest redshifts z \sim 0.3. This unexpected population has diverted attention from the possibility that early massive star-forming galaxies might also be found in the faint blue excess. From KECK spectroscopic observations deep enough to encompass a large population of z > 1 field galaxies, we can now show directly that in fact these forming galaxies are present in substantial numbers at B \sim 24, and that the era from redshifts 1 to 2 was clearly a major period of galaxy formation. These z > 1 galaxies have very unusual morphologies as seen in deep HST WFPC2 images.Comment: 10 pages LaTeX + 5 PostScript figures in uuencoded gzipped tar file; aasms4.sty, flushrt.sty, overcite.sty (the two aastex4.0 and overcite.sty macros are available from xxx.lanl.gov) Also available (along with style files) via anonymous ftp to ftp://hubble.ifa.hawaii.edu/pub/preprints . E-print version of paper adds citation cross-references to other archived e-prints, where available. To appear in Nature October 19, 199

    Determination and Validation of Nimesulide in Pharmaceutical Formulation by Near Infrared Spectroscopy

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    Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)The determination of nimesulide in pharmaceutical formulation in the range of 10.38 to 39.47% m/m using near infrared spectroscopy and multivariate calibration based on partial least squares (PLS) and net analyte signal (NAS) was studied and validated by establishing its figures of merit. Suitable results were obtained, with limit of detection of 0.61%, limit quantification of 2.03%, accuracy estimated as root mean square error of prediction (RMSEP) of 1.05%, mean selectivity of 0.006, sensitivity of 0.004%, inverse analytical sensitivity of (0.20%)(-1) and signal-to-noise ratio of 181. In addition, it was obtained relative errors lower than 10% that are acceptable values for quality control of this drug. These results indicate that the proposed method can be used in pharmaceutical industries as an alternative to standard analytical procedures.211019291936Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)International Institute of Pharmaceutical Researches (IIPF)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

    Utilidade do Strain Bidimensional por Speckle Tracking da Aurícula e Ventrículo Direito para Predizer Arritmias Tardias em Doentes Adultos com Tetralogia de Fallot Corrigida

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    OBJECTIVE: To determine whether right ventricular and/or atrial speckle tracking strain is associated with previous arrhythmic events in patients with repaired tetralogy of Fallot. METHODS AND RESULTS: We studied right ventricular and atrial strain in 100 consecutive patients with repaired tetralogy of Fallot referred for routine echocardiographic evaluation. Patients were divided into two groups, one with previous documentation of arrhythmias (n=26) and one without arrhythmias, in a median follow-up of 22 years. Patients with arrhythmias were older (p<0.001) and had surgical repair at an older age (p=0.001). They also had significantly reduced right ventricular strain (-14.7±5.5 vs. -16.9±4.0%, p=0.029) and right atrial strain (19.1±7.7% vs. 25.8±11.4%, p=0.001). Neither right ventricular nor right atrial strain were independent predictors of the presence of a history of documented arrhythmias, which was associated with age at correction and with the presence of residual defects. In a subanalysis after excluding 23 patients who had had more than one corrective surgery, right ventricular strain was an independent predictor of the presence of previous arrhythmic events (OR 1.19, 95% CI 1.02-1.38, p=0.025). Right atrial strain was also an independent predictor after adjustment (OR 0.93, 95% CI 0.87-0.99, p=0.029). The ideal cut-off for right ventricular strain was -15.3% and for right atrial strain 23.0%. CONCLUSIONS: Compared with conventional echocardiographic parameters, strain measures of the right heart are associated with the presence of arrhythmic events, and may be useful for risk stratification of patients with repaired tetralogy of Fallot, although a prospective study is required.info:eu-repo/semantics/publishedVersio
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