Dynamic changes in biochemical markers of renal function with thyroid status- A study in Indian population

Thyroid dysfunction is known to cause significant changes in glomerular filtration rate. The present cross-sectional study was performed to evaluate the changes in biochemical markers of renal function in hypothyroid subjects before and after treatment. Thyroid function tests (T3, T4 and TSH levels) were assayed in 385 subjects. Based on TSH levels, subjects were classified as euthyroid (n=198), sub-clinical hypothyroid (n=98; TSH 6.1 to 19.9 μIU/ml) and overt hypothyroid (n=89; TSH ≥ 20 μIU/ml, abnormally low T4 levels). Forty-eight hypothyroid patients were re-evaluated after 3 months of thyroxine replacement therapy. Renal function tests were carried out in all subjects and statistically analyzed. Serum creatinine was significantly increased in subclinical and overt hypothyroid groups as compared to euthyroid subjects. Serum creatinine showed a significant negative correlation with T3 &T4 levels in overt group(r = -0.372 and r = - 0.371), whereas a positive correlation was observed with TSH (r=0.283). Uric acid levels were significantly increased in the overt group as compared to euthyroid subjects. Uric acid levels showed a significant negative correlation with T3 levels in the overt group (r= -0.298). After 3 months of thyroxine replacement therapy, creatinine and uric acids levels decreased significantly and were comparable to euthyroid levels. Hypothyroidism leads to reversible changes in renal function

Titin truncating variants affect heart function in disease cohorts and the general population

Titin-truncating variants (TTNtv) commonly cause dilated cardiomyopathy (DCM). TTNtv are also encountered in ~1% of the general population, where they may be silent, perhaps reflecting allelic factors. To better understand TTNtv, we integrated TTN allelic series, cardiac imaging and genomic data in humans and studied rat models with disparate TTNtv. In patients with DCM, TTNtv throughout titin were significantly associated with DCM. Ribosomal profiling in rat showed the translational footprint of premature stop codons in Ttn, TTNtv-position-independent nonsense-mediated degradation of the mutant allele and a signature of perturbed cardiac metabolism. Heart physiology in rats with TTNtv was unremarkable at baseline but became impaired during cardiac stress. In healthy humans, machine-learning-based analysis of high-resolution cardiac imaging showed TTNtv to be associated with eccentric cardiac remodeling. These data show that TTNtv have molecular and physiological effects on the heart across species, with a continuum of expressivity in health and disease

An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience

A review of the development and implementation of a 4-year medical student integrated ultrasound curriculum is presented. Multiple teaching and assessment modalities are discussed as well as results from testing and student surveys. Lessons learned while establishing the curriculum are summarized. It is concluded that ultrasound is a well received, valuable teaching tool across all 4 years of medical school, and students learn ultrasound well, and they feel their ultrasound experience enhances their medical education

SHINING, A Survey of Far-infrared Lines in Nearby Galaxies. I. Survey Description, Observational Trends, and Line Diagnostics

We use the Herschel/PACS spectrometer to study the global and spatially resolved far-infrared (FIR) fine-structure line emission in a sample of 52 galaxies that constitute the SHINING survey. These galaxies include star-forming, active-galactic nuclei (AGN), and luminous infrared galaxies (LIRGs). We find an increasing number of galaxies (and kiloparsec size regions within galaxies) with low line-to-FIR continuum ratios as a function of increasing FIR luminosity ($L_{\mathrm{FIR}}$), dust infrared color, $L_{\mathrm{FIR}}$ to molecular gas mass ratio ($L_{\mathrm{FIR}}/M_{\mathrm{mol}}$), and FIR surface brightness ($\Sigma_{\mathrm{FIR}}$). The correlations between the [CII]/FIR or [OI]/FIR ratios with $\Sigma_{\mathrm{FIR}}$ are remarkably tight ($\sim0.3$ dex scatter over almost four orders of magnitude in $\Sigma_{\mathrm{FIR}}$). We observe that galaxies with $L_{\mathrm{FIR}}/M_{\mathrm{mol}} \gtrsim 80\,L_{\odot}\,M_{\odot}^{-1}$ and $\Sigma_{\mathrm{FIR}}\gtrsim10^{11}$ $L_{\odot}$ kpc$^{-2}$ tend to have weak fine-structure line-to-FIR continuum ratios, and that LIRGs with infrared sizes $\gtrsim1$ kpc have line-to-FIR ratios comparable to those observed in typical star-forming galaxies. We analyze the physical mechanisms driving these trends in Paper II (Herrera-Camus et al. 2018). The combined analysis of the [CII], [NII], and [OIII] lines reveals that the fraction of the [CII] line emission that arises from neutral gas increases from 60% to 90% in the most active star-forming regions and that the emission originating in the ionized gas is associated with low-ionization, diffuse gas rather than with dense gas in HII regions. Finally, we report the global and spatially resolved line fluxes of the SHINING galaxies to enable the comparison and planning of future local and high-$z$ studies

Titin-truncating variants affect heart function in disease cohorts and the general population

Titin-truncating variants (TTNtv) commonly cause dilated cardiomyopathy (DCM). TTNtv are also encountered in ~1% of the general population, where they may be silent, perhaps reflecting allelic factors. To better understand TTNtv, we integrated TTN allelic series, cardiac imaging and genomic data in humans and studied rat models with disparate TTNtv. In patients with DCM, TTNtv throughout titin were significantly associated with DCM. Ribosomal profiling in rat showed the translational footprint of premature stop codons in Ttn, TTNtv-position-independent nonsense-mediated degradation of the mutant allele and a signature of perturbed cardiac metabolism. Heart physiology in rats with TTNtv was unremarkable at baseline but became impaired during cardiac stress. In healthy humans, machine-learning-based analysis of high-resolution cardiac imaging showed TTNtv to be associated with eccentric cardiac remodeling. These data show that TTNtv have molecular and physiological effects on the heart across species, with a continuum of expressivity in health and disease

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3 years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0 years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013