Psoriasis-Associated Vascular Disease: the Role of HDL

Psoriasis is a chronic inflammatory systemic disease with a prevalence of 2-3%. Overwhelming evidence show an epidemiological association between psoriasis, cardiovascular disease and atherosclerosis. Cardiovascular disease is the most frequent cause of death in patients with severe psoriasis. Several cardiovascular disease classical risk factors are also increased in psoriasis but the psoriasis-associated risk persists after adjusting for other risk factors.Investigation has focused on finding explanations for these epidemiological data. Several studies have demonstrated significant lipid metabolism and HDL composition and function alterations in psoriatic patients. Altered HDL function is clearly one of the mechanisms involved, as these particles are of the utmost importance in atherosclerosis defense. Recent data indicate that biologic therapy can reverse both structural and functional HDL alterations in psoriasis, reinforcing their therapeutic potential.info:eu-repo/semantics/publishedVersio

Homogenization on multi-materials' elements: application to printed circuit boards and warpage analysis

Multi-material domains are often found in industrial applications. Modelling them can be computationally very expensive due to meshing requirements. The finite element properties comprising different materials are hardly accurate. In this work, a new homogenization method that simplifies the computation of the homogenized Young modulus, Poisson ratio and thermal expansion coefficient is proposed, and applied to composite-like material on a printed circuit board. The results show a good properties correspondence between the homogenized domain and the real geometry simulation.This research is sponsored: - by the Portugal Incentive System for Research and Technological Development. Project in co - promotion nº 36265/2013 (Project HMIExcel - 2013 - 2015), and - by FCT with the reference project UID/EEA/04436/2013, by FEDER funds through the COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) with the reference project POCI - 01 - 0145 - FEDER - 006941info:eu-repo/semantics/publishedVersio

Stress-Related Mucosal Disease: Incidence of Bleeding and the Role of Omeprazole in its Prophylaxis

BACKGROUND: Upper gastrointestinal bleeding is the severe complication of stress-related mucosal disease in hospitalized patients. In intensive care units (ICU), risk factors are well defined and only mechanical ventilation and coagulopathy proved to be relevant for significant bleeding. On the contrary, in non-ICU settings there is no consensus about this issue. Nevertheless, omeprazole is still widely used in prophylaxis of bleeding. The objective of our study was to evaluate the relevance of stress-related mucosal disease bleeding in patients admitted to an internal medicine ward, and the role of omeprazole in its prophylaxis. METHODS: We conducted a retrospective study in which we analysed consecutive patients who were admitted to our ward over a year. We recorded demographic characteristics of the patients, potential risk factors for stress-related mucosal disease (clinical data, laboratory, and medication), administration of prophylactic omeprazole, and total cost of this prophylaxis. Patients with active gastrointestinal bleeding on the admission were excluded. We recorded every upper gastrointestinal bleeding event with clinical relevance. RESULTS: Five hundred and thirty-five patients, mean age 70 years, mean length of stay 9.6+/-7.7 days; 140 (26.2%) patients were treated with 40 mg of omeprazole intravenously, 193 (36.1%) with 20mg of omeprazole orally, and 202 (37.8%) patients had no prophylaxis. There was only one episode (0.2%) of clinically relevant bleeding. CONCLUSION: In patients admitted to an internal medicine ward, incidence of upper gastrointestinal bleeding as a complication of stress-related mucosal disease is low. We found that there is no advantage in prophylaxis with omeprazole

Antiphospholipid antibodies and renal transplant: a systematic review and meta-analysis

Objective: To evaluate the effect of antiphospholipid antibodies (aPL) on renal allograft outcome after kidney transplantation. Methods: A systematic search of EMBASE and PubMed databases from inception to July 2018 was run according to PRISMA guidelines; Peto's odds ratio (OR) for rare events was used for the meta-analysis. Results: Our inclusion/exclusion criteria were met by 22 cohort studies having different outcomes: allograft thrombosis (n = 9) and thromboprophylaxis (n = 3), allograft loss from any cause (n = 9), allograft malfunction (n = 3), duration (n = 2), glomerular filtration rate at 1 year (n = 3) and allograft rejection (n = 5). The pooled prevalence of allograft thrombosis and of thrombotic microangiopathy was greater in aPL+ve than negative recipients (10.4% vs 1.7%, p < 0.0001 and 10.2% vs 0%, p = 0.005, respectively). The pooled prevalence of allograft thrombosis was 75% in patients not taking anticoagulation whereas none of the anticoagulated recipients developed thrombosis (p < 0.0001). The pooled prevalence of allograft loss was greater in aPL+ve recipients (28% vs 18% respectively, p < 0.0001); the pooled prevalence of aPL was greater in allograft loss recipients compared to those who did not lose it (51% vs 33%, p < 0.0001). The pooled prevalence of allograft malfunction and rejection was similar in aPL−ve and aPL+ve recipients (32.2% vs 40.3% and 14.9% vs 14.4%, respectively) but graft duration was shorter in aPL+ve than aPL−ve recipients (p = 0.001) and glomerular filtration rate at 1 year was lower in aPL + ve than aPL−ve recipients (p < 0.0001). Conclusion: APL relate strongly to allograft thrombosis, loss and duration but not to allograft malfunction and rejection. Oral antivitamin K anticoagulants effectively prevent allograft thrombosis in aPL recipients. The debate on the role of aPL in renal transplant is limited by the expression of data as percentage of recipients positive for aPL rather than aPL titres in many studies

O Efeito da Monitorização Remota em Eventos Cardíacos Adversos numa Amostra Emparelhada por Propensity-Score Matching

AIMS: There are conflicting data regarding the clinical benefits of device-based remote monitoring (RM). We sought to assess the effect of device-based RM on long-term clinical outcomes in recipients of implantable cardioverter-defibrillators (ICDs). METHODS: We assessed the incidence of adverse cardiac events, overall mortality and device therapy efficacy and safety in a propensity score-matched cohort of patients under RM compared to patients under conventional follow-up. Data on hospitalizations, mortality and cause of death were systematically assessed using a nationwide healthcare platform. The primary outcome was time to a composite outcome of first hospital admission for heart failure or cardiovascular death. RESULTS: Of a total of 923 implantable device recipients, 164 matched patients were identified (84 under RM, 84 under conventional follow-up). The mean follow-up was 44 months (range 1-123). There were no significant differences regarding baseline characteristics in the matched cohorts. Patients under RM had a significantly lower incidence of the primary outcome (hazard ratio [HR] 0.42, confidence interval [CI] 0.20-0.88, p=0.022); there was a non-significant trend towards lower overall mortality (HR 0.53, CI 0.27-1.04, p=0.066). No significant differences between cohorts were found regarding appropriate therapies (RM vs. conventional follow-up, 8.1 vs. 8.2%, p=NS) or inappropriate therapies (6.8 vs. 5.0%, p=NS). CONCLUSION: In a propensity score-matched cohort of ICD recipients with long-term follow-up, RM was associated with a lower rate of a combined endpoint of hospital admission for heart failure or cardiovascular death.info:eu-repo/semantics/publishedVersio

Antibodies Against β2-Glycoprotein I Complexed With an Oxidised Lipoprotein Relate to Intima Thickening of Carotid Arteries in Primary Antiphospholipid Syndrome

To explore whether antibodies against β2-glycoprotein I (β2GPI) complexed to 7-ketocholesteryl-9-carboxynonanoate (oxLig-1) and to oxidised low-density lipoproteins (oxLDL) relate to paraoxonase activity (PONa) and/or intima media thickness (IMT) of carotid arteries in primary antiphospholipid syndrome (PAPS). As many as 29 thrombotic patients with PAPS, 10 subjects with idiopathic antiphospholipid antibodies (aPL) without thrombosis, 17 thrombotic patients with inherited thrombophilia and 23 healthy controls were investigated. The following were measured in all participants: β2GPI−oxLDL complexes, IgG anti-β2GPI−oxLig-1, IgG anti-β2GPI−oxLDL antibodies (ELISA), PONa, (para-nitrophenol method), IMT of common carotid (CC) artery, carotid bifurcation (B), internal carotid (IC) by high resolution sonography. β2GPI−oxLDL complex was highest in the control group (p < 0.01), whereas, IgG anti-β2GPI−oxLig1 and IgG anti-β2GPI−oxLDL were highest in PAPS (p < 0.0001). In healthy controls, β2GPI−oxLDL complexes positively correlated to IMT of the IC (p = 0.007) and negatively to PONa after correction for age (p < 0.03). PONa inversely correlated with age (p = 0.008). In PAPS, IgG anti-2GPI−oxLig-1 independently predicted PONa (p = 0.02) and IMT of B (p = 0.003), CC, (p = 0.03) and of IC (p = 0.04). In PAPS, PONa inversely correlated to the IMT of B, CC and IC (p = 0.01, 0.02 and 0.003, respectively). IgG anti-2GPI−oxLig-1 may be involved in PAPS related atherogenesis via decreased PON activity

Influence of Remote Monitoring on Long-Term Cardiovascular Outcomes after Cardioverter-Defibrillator Implantation

AIMS: Device-based remote monitoring (RM) has been linked to improved clinical outcomes at short to medium-term follow-up. Whether this benefit extends to long-term follow-up is unknown. We sought to assess the effect of device-based RM on long-term clinical outcomes in recipients of implantable cardioverter-defibrillators (ICD). METHODS: We performed a retrospective cohort study of consecutive patients who underwent ICD implantation for primary prevention. RM was initiated with patient consent according to availability of RM hardware at implantation. Patients with concomitant cardiac resynchronization therapy were excluded. Data on hospitalizations, mortality and cause of death were systematically assessed using a nationwide healthcare platform. A Cox proportional hazards model was employed to estimate the effect of RM on mortality and a composite endpoint of cardiovascular mortality and hospital admission due to heart failure (HF). RESULTS: 312 patients were included with a median follow-up of 37.7months (range 1 to 146). 121 patients (38.2%) were under RM since the first outpatient visit post-ICD and 191 were in conventional follow-up. No differences were found regarding age, left ventricular ejection fraction, heart failure etiology or NYHA class at implantation. Patients under RM had higher long-term survival (hazard ratio [HR] 0.50, CI 0.27-0.93, p=0.029) and lower incidence of the composite outcome (HR 0.47, CI 0.27-0.82, p=0.008). After multivariate survival analysis, overall survival was independently associated with younger age, higher LVEF, NYHA class lower than 3 and RM. CONCLUSION: RM was independently associated with increased long-term survival and a lower incidence of a composite endpoint of hospitalization for HF or cardiovascular mortality

Aperture effects on the oxygen abundance determinations from CALIFA data

This paper aims at providing aperture corrections for emission lines in a sample of spiral galaxies from the Calar Alto Legacy Integral Field Area Survey (CALIFA) database. In particular, we explore the behavior of the log([OIII]5007/Hbeta)/([NII]6583/Halpha) (O3N2) and log[NII]6583/Halpha (N2) flux ratios since they are closely connected to different empirical calibrations of the oxygen abundances in star forming galaxies. We compute median growth curves of Halpha, Halpha/Hbeta, O3N2 and N2 up to 2.5R_50 and 1.5 disk R_eff. The growth curves simulate the effect of observing galaxies through apertures of varying radii. The median growth curve of the Halpha/Hbeta ratio monotonically decreases from the center towards larger radii, showing for small apertures a maximum value of ~10% larger than the integrated one. The median growth curve of N2 shows a similar behavior, decreasing from the center towards larger radii. No strong dependence is seen with the inclination, morphological type and stellar mass for these growth curves. Finally, the median growth curve of O3N2 increases monotonically with radius. However, at small radii it shows systematically higher values for galaxies of earlier morphological types and for high stellar mass galaxies. Applying our aperture corrections to a sample of galaxies from the SDSS survey at 0.02<=z<=0.3 shows that the average difference between fiber-based and aperture corrected oxygen abundances, for different galaxy stellar mass and redshift ranges, reaches typically to ~11%, depending on the abundance calibration used. This average difference is found to be systematically biased, though still within the typical uncertainties of oxygen abundances derived from empirical calibrations. Caution must be exercised when using observations of galaxies for small radii (e.g. below 0.5R_eff) given the high dispersion shown around the median growth curves.Comment: Accepted for publication in Ap

Impact of Ionic Liquid Structure and Loading on Gas Sorption and Permeation for ZIF-8-Based Composites and Mixed Matrix Membranes

Carbon dioxide (CO2) capture has become of great importance for industrial processes due to the adverse environmental effects of gas emissions. Mixed matrix membranes (MMMs) have been studied as an alternative to traditional technologies, especially due to their potential to overcome the practical limitations of conventional polymeric and inorganic membranes. In this work, the effect of using different ionic liquids (ILs) with the stable metal–organic framework (MOF) ZIF-8 was evaluated. Several IL@ZIF-8 composites and IL@ZIF-8 MMMs were prepared to improve the selective CO2 sorption and permeation over other gases such as methane (CH4) and nitrogen (N2). Different ILs and two distinct loadings were prepared to study not only the effect of IL concentration, but also the impact of the IL structure and affinity towards a specific gas mixture separation. Single gas sorption studies showed an improvement in CO2/CH4 and CO2/N2 selectivities, compared with the ones for the pristine ZIF-8, increasing with IL loading. In addition, the prepared IL@ZIF-8 MMMs showed improved CO2 selective behavior and mechanical strength with respect to ZIF-8 MMMs, with a strong dependence on the intrinsic IL CO2 selectivity. Therefore, the selection of high affinity ILs can lead to the improvement of CO2 selective separation for IL@ZIF-8 MMMsinfo:eu-repo/semantics/publishedVersio

Insights on the stellar mass-metallicity relation from the CALIFA survey

We use spatially and temporally resolved maps of stellar population properties of 300 galaxies from the CALIFA integral field survey to investigate how the stellar metallicity (Z*) relates to the total stellar mass (M*) and the local mass surface density ($\mu$*) in both spheroidal and disk dominated galaxies. The galaxies are shown to follow a clear stellar mass-metallicity relation (MZR) over the whole 10$^9$ to 10$^{12}$ M$_{\odot}$ range. This relation is steeper than the one derived from nebular abundances, which is similar to the flatter stellar MZR derived when we consider only young stars. We also find a strong relation between the local values of $\mu$* and Z* (the $\mu$ZR), betraying the influence of local factors in determining Z*. This shows that both local ($\mu$*-driven) and global (M*-driven) processes are important in determining the metallicity in galaxies. We find that the overall balance between local and global effects varies with the location within a galaxy. In disks, $\mu$* regulates Z*, producing a strong $\mu$ZR whose amplitude is modulated by M*. In spheroids it is M* who dominates the physics of star formation and chemical enrichment, with $\mu$* playing a minor, secondary role. These findings agree with our previous analysis of the star formation histories of CALIFA galaxies, which showed that mean stellar ages are mainly governed by surface density in galaxy disks and by total mass in spheroids.Comment: 6 pages, 3 figures, accepted for publication in ApJ