162 research outputs found

    Prognostic utility of erectile dysfunction for cardiovascular disease in younger men and those with diabetes

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    Multiple published studies have established erectile dysfunction (ED) as an independent risk marker for cardiovascular disease (CVD). In fact, incident ED has a similar or greater predictive value for cardiovascular events than traditional risk factors including smoking, hyperlipidemia, and family history of myocardial infarction. Here, we review evidence that supports ED as a particularly significant harbinger of CVD in 2 populations: men <60 years of age and those with diabetes. Although addition of ED to the Framingham Risk Score only modestly improved the 10-year predictive capacity of the Framingham Risk Score for myocardial infarction or coronary death data in men enrolled in the Massachusetts Male Aging Study, other epidemiologic studies suggest that the predictive value of ED is quite strong in younger men. Indeed, in the Olmstead County Study, men 40 to 49 years of age with ED had a 50-fold higher incidence of new-incident coronary artery disease than those without ED. However, ED had less predictive value (5-fold increased risk) for coronary artery disease in men 70 years and older. Several studies, including a large analysis of more than 6300 men enrolled in the ADVANCE study, suggest that ED is a particularly powerful predictor of CVD in diabetic men as well. Based on the literature reviewed here, we encourage physicians to inquire about ED symptoms in all men more than 30 years of age with cardiovascular risk factors. Identification of ED, particularly in men <60 years old and those with diabetes, represents an important first step toward CVD risk detection and reduction

    The midwife factor in obstetric procedures and neonatal outcome

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    Aims. In the face of major tendency towards midwiferyled-care it was our purpose to investigate the extent of the influence of the midwife on the rates of obstetric procedures and perinatal outcome. Methods. 5384 consecutive deliveries at the Department of Obstetrics and Gynecology. University of Graz, were enrolled in the study. The following data were collected: mode of delivery, pH of umbilical artery, Apgar score. Firstly, data were investigated for interindividual differences and, secondly, for relationship with age of the midwife as a measure of experience. Results. Interindividual differences were significant for episiotomy rates (minimum: 31.6%; maximum 76.9%; p&lt;0.001), forceps rates (minimum: 1.7%; maximum 11.1%;p=0.002) and pH of umbilical arteries (minimum: 7.21:maxinium: 7.28 p=0.001) but not for cesarean section rates and Apgar scores. Linear regression analysis was significant between age of midwives and pH of umbilical arteries (p&lt;0.001: r=0.055) and for one-minute Apgar score (p=0.009; r=0.050) but not for episiotomy rates, cesarean section rates, forceps rates and five-minutes Apgar score. Conclusions. There are large interindividual differences in obstetric intervention rates which cannot be explained by the midwives' age. Provision of health care should be primarily determined by need and not by the personal characteristics of the health care provider, thus interindividual differences should be reduced and more often taken into account when analyzing any kind of data

    1,2,3-Triazoles of 8Hydroxyquinoline and HBT: Synthesis and Studies (DNA Binding, Antimicrobial, Molecular Docking ADME, and DFT)

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    A new series of 1,2,3-triazole hybrids containing either 2- or 4-hydroxyphenyl benzothiazole (2- or 4-HBT) and naphthalen-1-ol or 8-hydroxyquinoline (8-HQ) was synthesized in high yields and fully characterized. In vitro DNA binding studies with herring fish sperm DNA (hs-DNA) showed that quinoline- and 2-HBT-linked 1,2,3-triazoles of shorter alkyl linkers such as 6a are better with a high binding affinity (3.90 × 105 L mol–1) with hs-DNA as compared to naphthol- and 4-HBT-linked 1,2,3-triazoles bound to longer alkyl linkers. Molecular docking of most active 1,2,3-triazoles 6a–f showed high binding energy of 6a (−8.7 kcal mol–1). Also, compound 6a displayed considerable antibacterial activity and superior antifungal activity with reference to ciprofloxacin and fluconazole, respectively. The docking results of the fungal enzyme lanosterol 14-α-demethylase showed high binding energy for 6a (−9.7 kcal mol–1) involving dominating H-bonds, electrostatic interaction, and hydrophobic interaction. The absorption, distribution, metabolism, and excretion (ADME) parameter, Molinspiration bioactivity score, and the PreADMET properties revealed that most of the synthesized 1,2,3-triazole molecules possess desirable physicochemical properties for drug-likeness and may be considered as orally active potential drugs. The electrophilicity index and chemical hardness properties were also studied by density functional theory (DFT) using the B3LYP/6-311G­(d,p) level/basis set

    Improving the Performance of Routing Protocol Using Neighbor Coverage Based Probabilistic Rebroadcast in Mobile Ad Hoc Network

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    Mobile Ad Hoc Networks provides important control and route establishment functionality for a number of unicast an d multicast protocols. To discover an effective and an efficient routing protocol for transmit information from source to destination across whole network topology. This is a main issue in networking research. Broadcasting is important in MANET for routing infor mation discovery, protocols such as ad hoc on demand distance vector (AODV), dynamic source routing (DSR), and location aided routing use broadcasting to establish routes. Broadcasting in MANETs poses more challenging problems because of the variable and unpredictable characteristics of its medium as well as the fluctuation of the signal strength and propagation with respect to time and environment such as bandwidth congestion, channel contention problem, and packet collision problem. To overcome the se and reducing routing overhead we did study about neighbor coverage based probabilistic rebroadcast protocol in MANETs. In order to effectively exploit the neighbor coverage knowledge, we also discuss a connectivity factor to provide the node density ada ptation. Our approach combines the advantages of the neighbor coverage knowledge and the probabilistic mechanism, which can significantly, optimizes the routing mechanism in comparison to the AODV protocol. We just complete our dissertation work by compari ng AODV protocol with the new concept of rebroadcasting is NCPR in point of many performance metrics. The performance results and comparisons are done by using NS - 2 simulator

    Revisiting the genotypes of Theileria equi based on the V4 hypervariable region of the 18S rRNA gene

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    IntroductionEquine theileriosis, an economically important disease that affects horses and other equids worldwide, is caused by a tick-borne intracellular apicomplexan protozoa Theileria equi. Genotyping of T. equi based on the 18S rRNA gene revealed the presence of two, three, four or five genotypes. In previous published reports, these genotypes have been labelled either alphabetically or numerically, and there is no uniformity in naming of these genotypes. The present study was aimed to revisit the phylogeny, genetic diversity and geographical distribution of T. equi based on the nucleotide sequences of the V4 hypervariable region of the 18S rRNA gene available in the nucleotide databases.MethodsOut of 14792 nucleotide sequences of T. equi available in the GenBank™, only 736 sequences of T. equi containing the complete V4 hypervariable region of the 18S rRNA gene (&gt;207 bp) were used in multiple sequence alignment. Subsequently, a maximum likelihood phylogenetic tree was constructed based on the Kimura 2-parameter model (K2+I).ResultsThe phylogenetic tree placed all the sequences into four distinct clades with high bootstrap values which were designated as T. equi clades/ genotypes A, B, C and D. Our results indicated that the genotype B of Nagore et al. and genotype E of Qablan et al. together formed the clade B with a high bootstrap value (95%). Furthermore, all the genotypes probably originated from clade B, which was the most dominant genotype (52.85%) followed by clades A (27.58%), and C (9.78%) and D (9.78%). Genotype C manifested a comparatively higher genetic diversity (91.0-100% identity) followed by genotypes A (93.2-99.5%), and B and D (95.7-100%). The alignment report of the consensus nucleotide sequences of the V4 hypervariable region of the 18S rRNA gene of four T. equi genotypes (A-D) revealed significant variations in one region, between nucleotide positions 113-183, and 41 molecular signatures were recognized. As far as geographical distribution is concerned, genotypes A and C exhibited far-extending geographical distribution involving 31 and 13 countries of the Asian, African, European, North American and South American continents, respectively. On the contrary, the genotypes B and D exemplified limited distribution with confinement to 21 and 12 countries of Asian, African and European continents, respectively. Interestingly, genotypes A and C have been reported from only two continents, viz., North and South America. It was observed that genotypes A and C, and B and D exhibit similar geographical distribution.DiscussionThe present study indicated the presence of only four previously described T. equi genotypes (A, B, C and D) after performing the molecular analyses of all available sequences of the complete V4 hypervariable region of the 18S rRNA gene of T. equi isolates in the GenBank™

    Diagnosis and Treatment of Erectile Dysfunction for Reduction of Cardiovascular Risk

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    PURPOSE: Here, we 1) establish erectile dysfunction (ED) as an often neglected but valuable marker of cardiovascular risk, particularly in younger and diabetic men; and 2) review evidence that lifestyle change, combined with informed prescribing of pharmacotherapies used to mitigate cardiovascular risk, can improve overall vascular health and sexual functioning in men with ED. MATERIALS AND METHODS: A PubMed search for articles and guidelines pertinent to relationships between ED and cardiovascular disease (CVD), cardiovascular and all-cause mortality, and pharmacotherapies for dyslipidemia and hypertension was performed. The clinical guidance presented incorporates the current literature and the expertise of the multi-specialty author group. RESULTS: Numerous cardiovascular risk assessment tools exist, but risk stratification remains challenging, particularly for those patients at low or intermediate short-term risk. ED has a predictive value for cardiovascular events that is comparable to or better than traditional risk factors. Interventional studies support lifestyle changes as means of improving overall vascular health as well as sexual functioning. Statins, diuretics, beta blockers, and renin-angiotensin system modifiers may positively or negatively affect erectile function. Furthermore, phosphodiesterase type 5 (PDE5) inhibitors used to treat ED may have systemic vascular benefits. CONCLUSIONS: Treatment of ED should be considered secondary to cardiovascular risk reduction, but informed prescribing may prevent worsening of sexual function in men receiving pharmacotherapy for dyslipidemia and hypertension. As the first point of medical contact for men with ED symptoms, the primary care physician or urologist has a unique opportunity to identify patients who require early intervention to prevent cardiovascular disease
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