The utility of B-type natriuretic peptide in predicting postoperative cardiac events and mortality in patients undergoing major emergency non-cardiac surgery

B-type natriuretic peptide (BNP) levels predict cardiovascular risk in several settings. We hypothesized that they would identify individuals at increased risk of complications and mortality following major emergency non-cardiac surgery.Forty patients were studied with a primary end-point of a new post-operative cardiac event, and/or development of significant ECG changes, and/or cardiac death. The main secondary outcome was all cause mortality at 6 months. Preoperative BNP levels were higher in 11 patients who suffered a new postoperative cardiac event (p=0.001) and predicted this outcome with an area under the receiver operating characteristic curve of 0.85 (CI=0.72-0.98,p=0.001). A pre-operative BNP value >170pg.ml-1 has a sensitivity of 82% and a specificity of 79% for the primary end-point. In this small study, pre-operative BNP levels identify patients undergoing major emergency non-cardiac surgery who are at increased risk of early post-operative cardiac events. Larger studies are required to confirm these data.Peer reviewedPreprin

2MASS J03105986+1648155AB - A new binary at the L/T transition

The transition from the L to the T spectral type of brown dwarfs is marked by a very rapid transition phase, remarkable brightening in the J-band and a higher binary frequency. Despite being an active area of inquiry, this transition regime still remains one of the most poorly understood phases of brown dwarf evolution. We resolved the L dwarf 2MASS J03105986+1648155 for the first time into two almost equally bright components straddling the L/T transition. Since such a co-eval system with common age and composition provides crucial information of this special transition phase, we monitored the system over 3 years to derive first orbital parameters and dynamical mass estimates, as well as a spectral type determination. We obtained resolved high angular resolution, near-IR images with HST and the adaptive optics instrument NACO at the VLT including the laser guide star system PARSEC. Based on two epochs of astrometric data we derive a minimum semi-major axis of 5.2 +- 0.8 AU. The assumption of a face-on circular orbit yields an orbital period of 72 +- 4 years and a total system mass of 30-60 Mjup. This places the masses of the individual components of the system at the lower end of the mass regime of brown dwarfs. The achieved photometry allowed a first spectral type determination of L9 +- 1 for each component. In addition, this seems to be only the fifth resolved L/T transition binary with a flux reversal. While ultimate explanations for this effect are still owing, the 2MASS J03105986+1648155 system adds an important benchmark object for improving our understanding of this remarkable evolutionary phase of brown dwarfs. Additionally, the observational results of 2MASS J03105986+1648155 AB derived with the new PARSEC AO system at the VLT show the importance of this technical capability. The updated AO system allows us to significantly extend the sample of brown dwarfs observable with high-resolution from the ground and hence to reveal more of their physical properties.Comment: 6 pages, 2 figures, 3 tables, accepted for publication by A&

Five supernova survey galaxies in the southern hemisphere. I. Optical and near-infrared database

The determination of the supernova (SN) rate is based not only on the number of detected events, but also on the properties of the parent galaxy population. This is the first paper of a series aimed at obtaining new, refined, SN rates from a set of five SN surveys, by making use of a joint analysis of near-infrared (NIR) data. We describe the properties of the 3838 galaxies that were monitored for SNe events, including newly determined morphologies and their DENIS and POSS-II/UKST I, 2MASS and DENIS J and Ks and 2MASS H magnitudes. We have compared 2MASS, DENIS and POSS-II/UKST IJK magnitudes in order to find possible systematic photometric shifts in the measurements. The DENIS and POSS-II/UKST I band magnitudes show large discrepancies (mean absolute difference of 0.4 mag), mostly due to different spectral responses of the two instruments, with an important contribution (0.33 mag rms) from the large uncertainties in the photometric calibration of the POSS-II and UKST photographic plates. In the other wavebands, the limiting near infrared magnitude, morphology and inclination of the galaxies are the most influential factors which affect the determination of photometry of the galaxies. Nevertheless, no significant systematic differences have been found between of any pair of NIR magnitude measurements, except for a few percent of galaxies showing large discrepancies. This allows us to combine DENIS and 2MASS data for the J and Ks filters.Comment: 17 pages, 3 figures, 5 tables, published in Astrophysics, Vol. 52, No. 1, 2009 (English translation of Astrofizika

A catalog of Kazarian galaxies

The entire Kazarian galaxies (KG) catalog is presented which combines extensive new measurements of their optical parameters with a literature and database search. The measurements were made using images extracted from the STScI Digitized Sky Survey (DSS) of Jpg(blue), Fpg(red) and Ipg(NIR) band photographic sky survey plates obtained by the Palomar and UK Schmidt telescopes. We provide accurate coordinates, morphological type, spectral and activity classes, blue apparent diameters, axial ratios, position angles, red, blue and NIR apparent magnitudes, as well as counts of neighboring objects in a circle of radius 50 kpc from centers of KG. Special attention was paid to the individual descriptions of the galaxies in the original Kazarian lists, which clarified many cases of misidentifications of the objects, particularly among interacting systems. The total number of individual Kazarian objects in the database is now 706. We also include the redshifts which are now available for 404 galaxies and the 2MASS infrared magnitudes for 598 KG. The database also includes extensive notes, which summarize information about the membership of KG in different systems of galaxies, and about revised activity classes and redshifts. An atlas of several interesting subclasses of KG is also presented.Comment: 15 pages, 5 figures, 1 table, Accepted in Astrophysics, Vol. 53, No. 1, 2010 (English translation of Astrofizika

Intermediate temperature dynamics of one-dimensional Heisenberg antiferromagnets

We present a general theory for the intermediate temperature (T) properties of Heisenberg antiferromagnets of spin-S ions on p-leg ladders, valid for 2Sp even or odd. Following an earlier proposal for 2Sp even (Damle and Sachdev, cond-mat/9711014), we argue that an integrable, classical, continuum model of a fixed-length, 3-vector applies over an intermediate temperature range; this range becomes very wide for moderate and large values of 2Sp. The coupling constants of the effective model are known exactly in terms of the energy gap above the ground state (for 2Sp even) or a crossover scale (for 2Sp odd). Analytic and numeric results for dynamic and transport properties are obtained, including some exact results for the spin-wave damping. Numerous quantitative predictions for neutron scattering and NMR experiments are made. A general discussion on the nature of T>0 transport in integrable systems is also presented: an exact solution of a toy model proves that diffusion can exist in integrable systems, provided proper care is taken in approaching the thermodynamic limit.Comment: 38 pages, including 12 figure

The properties of V838 Mon in 2002 November

We present the results of modelling the 0.45--1 micron spectral energy distribution of V838 Mon for 2002 November. Synthetic spectra were calculated using the NextGen model atmospheres of Hauschildt et al. (1999), which incorporate line lists for H2O, TiO, CrH, FeH, CO, and MgH, as well as the VALD atomic line list. Fits to the observed spectra show that, in 2002 November, the effective temperature of V838 Mon was approximately 2000 +/-100 K. Our theoretical spectra show a comparatively weak dependence on log g. Preliminary analysis of the hot star observed together with V838 Mon shows it to be a normal B3V dwarf.Comment: 7 pages, 4 figs, accepted by A&

A randomised trial into the effect of an isolated hip abductor strengthening programme and a functional motor control programme on knee kinematics and hip muscle strength

Background: Dynamic knee valgus and internal femoral rotation are proposed to be contributory risk factors for patellofemoral pain and anterior cruciate ligament injuries. Multimodal interventions including hip abductor strengthening or functional motor control programmes have a positive impact of pain, however their effect on knee kinematics and muscle strength is less clear. The aim of this study was to examine the effect of isolated hip abductor strengthening and a functional motor control exercise on knee kinematics and hip abductor strength. Methods: This prospective, randomised, repeated measures design included 29 asymptomatic volunteers presenting with increase knee valgus and femoral internal rotation. Participants completed either isolated hip abductor strengthening or a functional motor control exercise for 5 weeks. Knee kinematics were measured using inertial sensors during 2 functional activities and hip abductor strength measured using a load cell during isometric hip abduction. Results: There were no significant differences in dynamic knee valgus and internal rotation following the isolated hip abductor or functional motor control intervention, and no significant differences between the groups for knee angles. Despite this, the actual magnitude of reduction in valgus was 10° and 5° for the functional motor control group and strengthening group respectively. The actual magnitude of reduction in internal rotation was 9° and 18° for the functional motor control group and strengthening group respectively. Therefore there was a tendency towards clinically significant improvements in knee kinematics in both exercise groups. A statistically significant improvement in hip abductor strength was evident for the functional motor control group (27% increase; p = 0.008) and strengthening group (35% increase; p = 0.009) with no significant difference between the groups being identified (p = 0.475). Conclusions: Isolated hip strengthening and functional motor control exercises resulted in non-statistically significant changes in knee kinematics, however there was a clear trend towards clinically meaningful reductions in valgus and internal rotation. Both groups demonstrated similar significant gains in hip abductor strength suggesting\ud either approach could be used to strengthen the hip abductors

Prognostic value of adenosine stress cardiovascular magnetic resonance in patients with low-risk chest pain

<p>Abstract</p> <p>Background</p> <p>Approximately 5% of patients with an acute coronary syndrome are discharged from the emergency room with an erroneous diagnosis of non-cardiac chest pain. Highly accurate non-invasive stress imaging is valuable for assessment of low-risk chest pain patients to prevent these errors. Adenosine stress cardiovascular magnetic resonance (AS-CMR) is an imaging modality with increasing application. The goal of this study was to evaluate the negative prognostic value of AS-CMR among low-risk acute chest pain patients.</p> <p>Methods</p> <p>We studied 103 patients, mean 56.7 ± 12.3 years of age, with chest pain and no electrocardiographic evidence of ischemia and negative cardiac biomarkers of necrosis, who were admitted to the Cardiac Decision Unit of our institution. All patients underwent AS-CMR. A negative AS-CMR was defined as absence of all the following: regional wall motion abnormalities at rest; perfusion defects during stress (adenosine) and rest; and myocardial scar on late gadolinium enhancement images. The patients were followed for a mean of 277 (range 161-462) days. The primary end point was defined as the combination of cardiac death, nonfatal acute myocardial infarction, re-hospitalization for chest pain, obstructive coronary artery disease (>50% coronary stenosis on invasive angiography) and coronary revascularization.</p> <p>Results</p> <p>In 14 patients (13.6%), AS-CMR was positive. The remaining 89 patients (86.4%), who had negative AS-CMR, were discharged. No patient with negative AS-CMR reached the primary end-point during follow-up. The negative predictive value of AS-CMR was 100%.</p> <p>Conclusion</p> <p>AS-CMR holds promise as a useful tool to rule out significant coronary artery disease in patients with low-risk chest pain. Patients with negative AS-CMR have an excellent short and mid-term prognosis.</p

Visual impairment is associated with physical and mental comorbidities in older adults:a cross-sectional study

Background&lt;p&gt;&lt;/p&gt; Visual impairment is common in older people and the presence of additional health conditions can compromise health and rehabilitation outcomes. A small number of studies have suggested that comorbities are common in visual impairment; however, those studies have relied on self-report and have assessed a relatively limited number of comorbid conditions.&lt;p&gt;&lt;/p&gt; Methods&lt;p&gt;&lt;/p&gt; We conducted a cross-sectional analysis of a dataset of 291,169 registered patients (65-years-old and over) within 314 primary care practices in Scotland, UK. Visual impairment was identified using Read Code ever recorded for blindness and/or low vision (within electronic medical records). Prevalence, odds ratios (from prevalence rates standardised by stratifying individuals by age groups (65 to 69 years; 70 to 74; 75 to 79; 80 to 84; and 85 and over), gender and deprivation quintiles) and 95% confidence intervals (95% CI) of 37 individual chronic physical/mental health conditions and total number of conditions were calculated and compared for those with visual impairment to those without.&lt;p&gt;&lt;/p&gt; Results&lt;p&gt;&lt;/p&gt; Twenty seven of the 29 physical health conditions and all eight mental health conditions were significantly more likely to be recorded for individuals with visual impairment compared to individuals without visual impairment, after standardising for age, gender and social deprivation. Individuals with visual impairment were also significantly more likely to have more comorbidities (for example, five or more conditions (odds ratio (OR) 2.05 95% CI 1.94 to 2.18)).&lt;p&gt;&lt;/p&gt; Conclusions&lt;p&gt;&lt;/p&gt; Patients aged 65 years and older with visual impairment have a broad range of physical and mental health comorbidities compared to those of the same age without visual impairment, and are more likely to have multiple comorbidities. This has important implications for clinical practice and for the future design of integrated services to meet the complex needs of patients with visual impairment, for example, embedding depression and hearing screening within eye care services