Comparative effects of glucose and water drinks on blood pressure and cardiac function in older subjects with and without postprandial hypotension

Postprandial hypotension (PPH) occurs frequently and is thought to reflect an inadequate increase in cardiac output to compensate for the rise in splanchnic blood flow after a meal. Gastric distension by water attenuates the postprandial fall in blood pressure (BP). Cardiac hemodynamics (stroke volume (SV), cardiac output (CO), and global longitudinal strain (GLS)) have hitherto not been measured in PPH We sought to determine the comparative effects of water and glucose drinks on cardiac hemodynamics in healthy older subjects and individuals with PPH Eight healthy older subjects (age 71.0 ± 1.7 years) and eight subjects with PPH (age 75.5 ± 1.0 years) consumed a 300 mL drink of either water or 75 g glucose (including 150 mg 13C-acetate) in randomized order. BP and heart rate (HR) were measured using an automatic device, SV, CO, and GLS by transthoracic echocardiography and gastric emptying by measurement of 13CO2 In both groups, glucose decreased systolic BP (P < 0.001) and increased HR, SV, and CO (P < 0.05 for all). The fall in systolic BP was greater (P < 0.05), and increase in HR less (P < 0.05), in the PPH group, with no difference in SV or CO Water increased systolic BP (P < 0.05) in subjects with PPH and, in both groups, decreased HR (P < 0.05) without affecting SV, CO, or GLS In subjects with PPH, the hypotensive response to glucose and the pressor response to water were related (R = -0.75, P < 0.05). These observations indicate that, in PPH, the hypotensive response to oral glucose is associated with inadequate compensatory increases in CO and HR, whereas the pressor response to water ingestion is maintained and, possibly, exaggerated.Laurence G. Trahair, Sharmalar Rajendran, Renuka Visvanathan, Matthew Chapman, Daniel Stadler, Michael Horowitz and Karen L. Jone

Markers of inflammation and bone remodelling associated with improvement in clinical response measures in psoriatic arthritis patients treated with golimumab

&lt;p&gt;Objective To determine serum biomarker associations with clinical response to golimumab treatment in patients with psoriatic arthritis (PsA).&lt;/p&gt; &lt;p&gt;Methods GO–REVEAL was a randomised, placebo-controlled study of golimumab in patients with active PsA. Samples were collected from 100 patients at baseline, week 4 and week 14, and analysed for serum-based biomarkers and protein profiling (total 92 markers); data were correlated with clinical measures at week 14.&lt;/p&gt; &lt;p&gt;Results Serum levels of a subset of proteins (apolipoprotein C III, ENRAGE, IL-16, myeloperoxidase, vascular endothelial growth factor, pyridinoline, matrix metalloproteinase 3, C-reactive protein (CRP), carcinoembryonic antigen, intercellular adhesion molecule 1 and macrophage inflammatory protein 1α) at baseline or week 4 were strongly associated with American College of Rheumatology 20% improvement (ACR20) response and/or disease activity score in 28 joints (DAS28) at week 14. A smaller subset of proteins was significantly associated with a 75% improvement in the psoriasis area and severity index score (PASI75) at week 14, (adiponectin, apolipoprotein CIII, serum glutamic oxaloacetic transaminase, and tumour necrosis factor α). Subsets of proteins were identified as potentially predictive of clinical response for each of the clinical measures, and the power of these biomarker panels to predict clinical response to golimumab treatment was stronger than for CRP alone.&lt;/p&gt; &lt;p&gt;Conclusions This analysis provides insight into several panels of markers that may have utility in identifying PsA patients likely to have ACR20, DAS28, or PASI75 responses following golimumab treatment.&lt;/p&gt

Clinical screening tools for sarcopenia and Its management

Sarcopenia, an age-related decline in muscle mass and function, is affecting the older population worldwide. Sarcopenia is associated with poor health outcomes, such as falls, disability, loss of independence, and mortality; however it is potentially treatable if recognized and intervened early. Over the last two decades, there has been significant expansion of research in this area. Currently there is international recognition of a need to identify the condition early for intervention and prevention of the disastrous consequences of sarcopenia if left untreated. There are currently various screening tools proposed. As yet, there is no consensus on the best tool. Effective interventions of sarcopenia include physical exercise and nutrition supplementation. This review paper examined the screening tools and interventions for sarcopenia.Solomon C.Y. Yu, Kareeann S.F. Khow, Agathe D. Jadczak and Renuka Visvanatha

The Red-Sequence Luminosity Function in Galaxy Clusters since z~1

We use a statistical sample of ~500 rich clusters taken from 72 square degrees of the Red-Sequence Cluster Survey (RCS-1) to study the evolution of ~30,000 red-sequence galaxies in clusters over the redshift range 0.35<z<0.95. We construct red-sequence luminosity functions (RSLFs) for a well-defined, homogeneously selected, richness limited sample. The RSLF at higher redshifts shows a deficit of faint red galaxies (to M_V=> -19.7) with their numbers increasing towards the present epoch. This is consistent with the `down-sizing` picture in which star-formation ended at earlier times for the most massive (luminous) galaxies and more recently for less massive (fainter) galaxies. We observe a richness dependence to the down-sizing effect in the sense that, at a given redshift, the drop-off of faint red galaxies is greater for poorer (less massive) clusters, suggesting that star-formation ended earlier for galaxies in more massive clusters. The decrease in faint red-sequence galaxies is accompanied by an increase in faint blue galaxies, implying that the process responsible for this evolution of faint galaxies is the termination of star-formation, possibly with little or no need for merging. At the bright end, we also see an increase in the number of blue galaxies with increasing redshift, suggesting that termination of star-formation in higher mass galaxies may also be an important formation mechanism for higher mass ellipticals. By comparing with a low-redshift Abell Cluster sample, we find that the down-sizing trend seen within RCS-1 has continued to the local universe.Comment: ApJ accepted. 11 pages, 5 figure

Postextubation pulmonary edema: A case series and review

SummaryWe report a series of patients with postextubation pulmonary edema who had no obvious risk factors for the development of this syndrome.MethodsPatients identified by the pulmonary consultation service at an academic medical center were reviewed.ResultsFourteen cases were collected and analyzed. The average age was 34.5 years; 12 patients were male. The average BMI was 25.5. None had documented previous lung disease. Most operations were scheduled as outpatient procedures, and the type of surgery ranged from an incision and drainage of a bite wound to an open reduction- internal fixation of the radius. None of the patients had upper airway surgery. The length of surgeries ranged from 27 to 335min. Laryngospasm was the most commonly identified obstructing event postextubation. Treatment involved airway support when needed, supplemental oxygen, and diuretics.ConclusionsIt would appear that all patients, especially young men, are at risk for the development of this syndrome and that the pathogenesis remains uncertain in many cases

Semi-Analytical Models for the Formation of Disk Galaxies II. Dark Matter versus Modified Newtonian Dynamics

We present detailed semi-analytical models for the formation of disk galaxies both in a Universe dominated by dark matter (DM), and in one for which the force law is given by modified Newtonian dynamics (MOND). We tune the models to fit the observed near-infrared Tully-Fisher (TF) relation, and compare numerous predictions of the resulting models with observations. The DM and MOND models are almost indistinguishable. They both yield gas mass fractions and dynamical mass-to-light ratios which are in good agreement with observations. Both models reproduce the narrow relation between global mass-to-light ratio and central surface brightness, and reveal a characteristic acceleration, contrary to claims that these relations are not predicted by DM models. Both models require SN feedback in order to reproduce the lack of high surface brightness dwarf galaxies. However, the introduction of feedback to the MOND models steepens the TF relation and increases the scatter, making MOND only marginally consistent with observations. The most serious problem for the DM models is their prediction of steep central rotation curves. However, the DM rotation curves are only slightly steeper than those of MOND, and are only marginally inconsistent with the poor resolution data on LSB galaxies.Comment: 26 pages, 11 figures. Accepted for publication in Ap

Infrared Properties of Cataclysmic Variables from 2MASS: Results from the 2nd Incremental Data Release

Because accretion-generated luminosity dominates the radiated energy of most cataclysmic variables, they have been ``traditionally'' observed primarily at short wavelengths. Infrared observations of cataclysmic variables contribute to the understanding of key system components that are expected to radiate at these wavelengths, such as the cool outer disk, accretion stream, and secondary star. We have compiled the J, H, and Ks photometry of all cataclysmic variables located in the sky coverage of the 2 Micron All Sky Survey (2MASS) 2nd Incremental Data Release. This data comprises 251 systems with reliably identified near-IR counterparts and S/N > 10 photometry in one or more of the three near-IR bands.Comment: 2 pages, including 1 figure. To appear in the proceedings of The Physics of Cataclysmic Variables and Related Objects, Goettingen, Germany. For our followup ApJ paper (in press), also see http://www.ctio.noao.edu/~hoard/research/2mass/index.htm

Food services using energy- and protein-fortified meals to assist vulnerable community-residing older adults meet their dietary requirements and maintain good health and quality of life: findings from a pilot study

The effects of "standard (STD)" vs. "protein- and energy-enriched (HEHP)" food-service meals on the nutrient intake, nutritional status, functional capacity, and wellbeing of older adults was investigated using a 12 week, double-blinded, parallel group design. All participants received dietetics counseling and either an STD (2.3 MJ and 30 g protein per meal) or a HEHP (4.6 MJ and 60 g protein) hot lunchtime meal for at least 3 days/week; those who did not want food-service meals were included in the control group (CON). Twenty-nine participants completed the study (STD = 7; HEHP = 12; CON = 10). From baseline to week 12, the HEHP subjects increased their mean daily energy intake from 6151 ± 376 kJ to 8228 ± 642 kJ (p = 0.002 for effect of time) and protein intake from 67 ± 4 g to 86 ± 8 g (p = 0.014 for effect of time). The MNA (Mini Nutritional Assessment) score was increased significantly in HEHP by 4.0 ± 1.1 points (p = 0.001), but not in the STD and CON groups (2.8 ± 2.1 points and 1.8 ± 1.1 points, p > 0.05). No difference was found for other clinical outcomes between the groups. The findings indicate that provision of HEHP-fortified food-service meals can increase energy and protein intake and improve the nutritional status of nutritionally at-risk older people.Tony Arjuna, Michelle Miller, Tomoko Ueno, Renuka Visvanathan, Kylie Lange, Stijn Soenen, Ian Chapman and Natalie Luscombe-Mars