Prognostic impact of systemic inflammatory diseases in elderly patients with congestive heart failure

Background and aims: Inflammation is part of the pathophysiology of congestive heart failure (CHF). However, little is known about the impact of the presence of systemic inflammatory disease (SID), defined as inflammatory syndrome with constitutional symptoms and involvement of at least two organs as co-morbidity on the clinical course and prognosis of patients with CHF. Methods and results: This is an analysis of all 622 patients included in TIME-CHF. After an 18 months follow-up, outcomes of patients with and without SID were compared. Primary endpoint was all-cause hospitalization free survival. Secondary endpoints were overall survival and CHF hospitalization free survival. At baseline, 38 patients had history of SID (6.1%). These patients had higher N-terminal pro brain natriuretic peptide and worse renal function than patients without SID. SID was a risk factor for adverse outcome [primary endpoint: hazard ratio (HR) = 1.73 (95% confidence interval: 1.18-2.55, P = 0.005); survival: HR = 2.60 (1.49-4.55, P = 0.001); CHF hospitalization free survival: HR = 2.3 (1.45-3.65, P < 0.001)]. In multivariate models, SID remained the strongest independent risk factor for survival and CHF hospitalization free survival. Conclusions: In elderly patients with CHF, SID is independently accompanied with adverse outcome. Given the increasing prevalence of SID in the elderly population, these findings are clinically important for both risk stratification and patient managemen

The large-scale ionised outflow of CH Cygni

HST and ground-based [OII} and [NII] images obtained from 1996 to 1999 reveal the existence of a ionised optical nebula around the symbiotic binary CH Cyg extending out to 5000 A.U. from the central stars. The observed velocity range of the nebula, derived from long-slit echelle spectra, is of 130 km/s. In spite of its complex appearence, the velocity data show that the basic morphology of the inner regions of the optical nebula is that of a bipolar (or conical) outflow extending nearly along the plane of the sky out to some 2000 A.U. from the centre. Even if the extension of this bipolar outflow and its position angle are consistent with those of the radio jet produced in 1984 (extrapolated to the time of our optical imagery), no obvious counterpart is visible of the original, dense radio bullets ejected by the system. We speculate that the optical bipolar outflow might be the remannt of the interaction of the bullets with a relatively dense circumstellar medium.Comment: 8 text pages + 3 figures (jpeg). ApJ in press. For a full PostScript version with figures inline see ftp://ftp.ll.iac.es/pub/research/preprints/PP252001.ps.g

V496 Scuti: An Fe II nova with dust shell accompanied by CO emission

We present near-infrared and optical observations of the nova V496 Scuti 2009 covering various phases - pre-maximum, early decline and nebular - during the first 10 months of its discovery followed by limited observations in early part of 2011 April. The spectra follow the evolution of the nova when the lines had strong P Cygni profiles to a phase dominated by prominent emission lines. The notable feature of the near-IR spectra in the early decline phase is the rare presence of first overtone bands of carbon monoxide in emission. Later about 150 days after the peak brightness the IR spectra show clear dust formation in the expanding ejecta. Dust formation in V496 Sct is consistent with the presence of lines of elements with low ionization potentials like Na and Mg in the early spectra and the detection of CO bands in emission. The light curve shows a slow rise to the maximum and a slow decline indicating a prolonged mass loss. This is corroborated by the strengthening of P Cygni profiles during the first 30 days. In the spectra taken close to the optical maximum brightness, the broad and single absorption component seen at the time of discovery is replaced by two sharper components. During the early decline phase two sharp dips that show increasing outflow velocities are seen in the P Cygni absorption components of Fe II and H I lines. The spectra in 2010 March showed the onset of the nebular phase. Several emission lines display saddle-like profiles during the nebular phase. In the nebular stage the observed fluxes of [O III] and H-beta lines are used to estimate the electron number densities and the mass of the ejecta. The optical spectra show that the nova evolved in the P_fe A_o spectral sequence. The physical conditions in the ejecta are estimated. The absolute magnitude and the distance to the nova are estimated to be M_V = -7.0 +/- 0.2 and d = 2.9 +/- 0.3 kpc respectively.Comment: 14 pages, 9 figures and 6 Tables, Accepted for Publication in MNRA

Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement : systematic review and meta-analysis

Background: Several types of Magnetic resonance imaging (MRI) are commonly used in imaging of femoroacetabular impingement (FAI), however till now there are no clear protocols and recommendations for each type. The aim of this meta-analysis is to detect the accuracy of conventional magnetic resonance imaging (cMRI), direct magnetic resonance arthrography (dMRA) and indirect magnetic resonance arthrography (iMRA) in the diagnosis of chondral and labral lesions in femoroacetabular impingement (FAI). Methods: A literature search was finalized on the 17th of May 2016 to collect all studies identifying the accuracy of cMRI, dMRA and iMRA in diagnosing chondral and labral lesions associated with FAI using surgical results (arthroscopic or open) as a reference test. Pooled sensitivity and specificity with 95% confidence intervals using a random-effects meta-analysis for MRI, dMRA and iMRA were calculated also area under receiver operating characteristic (ROC) curve (AUC) was retrieved whenever possible where AUC is equivocal to diagnostic accuracy. Results: The search yielded 192 publications which were reviewed according inclusion and exclusion criteria then 21 studies fulfilled the eligibility criteria for the qualitative analysis with a total number of 828 cases, lastly 12 studies were included in the quantitative meta-analysis. Meta-analysis showed that as regard labral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.864, 0.833 and 0.88 and for dMRA were 0.91, 0.58 and 0.92. While in chondral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.76, 0.72 and 0.75 and for dMRA were 0.75, 0.79 and 0.83, while for iMRA were sensitivity of 0.722 and specificity of 0.917. Conclusions: The present meta-analysis showed that the diagnostic test accuracy was superior for dMRA when compared with cMRI for detection of labral and chondral lesions. The diagnostic test accuracy was superior for labral lesions when compared with chondral lesions in both cMRI and dMRA. Promising results are obtained concerning iMRA but further studies still needed to fully assess its diagnostic accuracy

MASTR-MS: A web-based collaborative laboratory information management system (LIMS) for metabolomics

Background An increasing number of research laboratories and core analytical facilities around the world are developing high throughput metabolomic analytical and data processing pipelines that are capable of handling hundreds to thousands of individual samples per year, often over multiple projects, collaborations and sample types. At present, there are no Laboratory Information Management Systems (LIMS) that are specifically tailored for metabolomics laboratories that are capable of tracking samples and associated metadata from the beginning to the end of an experiment, including data processing and archiving, and which are also suitable for use in large institutional core facilities or multi-laboratory consortia as well as single laboratory environments. Results Here we present MASTR-MS, a downloadable and installable LIMS solution that can be deployed either within a single laboratory or used to link workflows across a multisite network. It comprises a Node Management System that can be used to link and manage projects across one or multiple collaborating laboratories; a User Management System which defines different user groups and privileges of users; a Quote Management System where client quotes are managed; a Project Management System in which metadata is stored and all aspects of project management, including experimental setup, sample tracking and instrument analysis, are defined, and a Data Management System that allows the automatic capture and storage of raw and processed data from the analytical instruments to the LIMS. Conclusion MASTR-MS is a comprehensive LIMS solution specifically designed for metabolomics. It captures the entire lifecycle of a sample starting from project and experiment design to sample analysis, data capture and storage. It acts as an electronic notebook, facilitating project management within a single laboratory or a multi-node collaborative environment. This software is being developed in close consultation with members of the metabolomics research community

Intercomparison of the northern hemisphere winter mid-latitude atmospheric variability of the IPCC models

We compare, for the overlapping time frame 1962-2000, the estimate of the northern hemisphere (NH) mid-latitude winter atmospheric variability within the XX century simulations of 17 global climate models (GCMs) included in the IPCC-4AR with the NCEP and ECMWF reanalyses. We compute the Hayashi spectra of the 500hPa geopotential height fields and introduce an integral measure of the variability observed in the NH on different spectral sub-domains. Only two high-resolution GCMs have a good agreement with reanalyses. Large biases, in most cases larger than 20%, are found between the wave climatologies of most GCMs and the reanalyses, with a relative span of around 50%. The travelling baroclinic waves are usually overestimated, while the planetary waves are usually underestimated, in agreement with previous studies performed on global weather forecasting models. When comparing the results of various versions of similar GCMs, it is clear that in some cases the vertical resolution of the atmosphere and, somewhat unexpectedly, of the adopted ocean model seem to be critical in determining the agreement with the reanalyses. The GCMs ensemble is biased with respect to the reanalyses but is comparable to the best 5 GCMs. This study suggests serious caveats with respect to the ability of most of the presently available GCMs in representing the statistics of the global scale atmospheric dynamics of the present climate and, a fortiori, in the perspective of modelling climate change.Comment: 39 pages, 8 figures, 2 table

Growth of a cohort of very low birth weight infants in Johannesburg, South Africa

<p>Abstract</p> <p>Background</p> <p>Little is known about the growth of VLBW infants in South Africa. The aim of this study was to assess the growth of a cohort of VLBW infants in Johannesburg.</p> <p>Methods</p> <p>A secondary analysis of a prospective cohort was conducted on 139 VLBW infants (birth weight ≤1500 g) admitted to Charlotte Maxeke Johannesburg Academic Hospital. Growth measurements were obtained from patient files and compared with the World Health Organization Child Growth Standards (WHO-CGS) and with a previous cohort of South African VLBW infants. The sample size per analysis ranged from 11 to 81 infants.</p> <p>Results</p> <p>Comparison with the WHO-CGS showed initial poor growth followed by gradual catch up growth with mean Z scores of 0.0 at 20 months postmenstrual age for weight, -0.8 at 20 months postmenstrual age for length and 0.0 at 3 months postmenstrual age for head circumference. Growth was comparable with that of a previous cohort of South African VLBW infants in all parameters.</p> <p>Conclusions</p> <p>Initial poor growth in the study sample was followed by gradual catch up growth but with persistent deficits in length for age at 20 months postmenstrual age relative to healthy term infants.</p

Case report: The management of advanced oral cancer in a Jehovah's Witness using the Ultracision Harmonic Scalpel

We present the first case of a head and neck oncological procedure accomplished in a Jehovah's Witness using the Ultracision Harmonic Scalpel (Ethicon, Cincinnati, OH). Jehovah's Witnesses present a serious challenge to the head and neck cancer surgeon due to their refusal to accept transfusion of any blood products. However, our experience reinforces the view that surgical management of head and neck cancer is possible in these patients. We show the Harmonic Scalpel, an ultrasonic tissue dissector, to be a useful surgical tool in obviating the need for blood transfusion. Preoperative optimisation, intra-operative surgical and anaesthetic techniques are also fully discussed