858 research outputs found
Paratanaoidea Lang 1949
No full textSuperfamily Paratanaoidea Lang, 1949 Family incertae sedisPublished as part of Chim, C. K. & Tong, Samantha J. W., 2020, Two new species of paratanaoid tanaidaceans of the family incertae sedis (Crustacea: Peracarida) from polymetallic nodule fields in the eastern Clarion-Clipperton Fracture Zone, pp. 461-485 in Zootaxa 4758 (3) on page 464, DOI: 10.11646/zootaxa.4758.3.3, http://zenodo.org/record/373467
Agathotanaidae Lang 1971
No full textFamily Agathotanaidae Lang, 1971 Diagnosis. See Larsen (2005).Published as part of Chim, C. K. & Tong, Samantha J. W., 2021, Three new species of agathotanaids (Tanaidacea: Paratanaoidea: Tanaidomorpha) from the lower bathyal zone off southwestern Java, Indonesia, Indian Ocean with notes on the global distribution and diversity of Agathotanaidae, pp. 67-106 in Zootaxa 5004 (1) on page 70, DOI: 10.11646/zootaxa.5004.1.3, http://zenodo.org/record/512030
Congestion and use of diuretics in heart failure and cardiomyopathies: a practical guide
Full text linkPurpose of Review:
Heart failure is a highly prevalent condition caused by many different aetiologies and characterised by cardiac dysfunction and congestion. Once developed, congestion leads to signs (peripheral oedema) and symptoms (breathlessness on exertion), adverse cardiac remodelling, and an increased risk of hospitalisation and premature death. This review summarises strategies that could enable early identification and a more objective management of congestion in patients with heart failure.
Recent Findings:
For patients with suspected or diagnosed heart failure, combining an echocardiogram with assessment of great veins, lungs, and kidneys by ultrasound might facilitate recognition and quantification of congestion, the management of which is still difficult and highly subjective.
Summary:
Congestion is a one of the key drivers of morbidity and mortality in patients with heart failure and is often under-recognised. The use of ultrasound allows for a timely, simultaneous identification of cardiac dysfunction and multiorgan congestion; ongoing and future studies will clarify how to tailor diuretic treatments in those with or at risk of heart failure
Prognostic significance and measurement of exercise-derived hemodynamic variables in patients with heart failure
No full textThe peak VO2 is an important prognostic measurement in the evaluation of patients with heart failure and is used to monitor the progress of the condition, especially in selecting patients for cardiac transplantation. However, peak VO2 may be influenced by noncardiac factors such as age, sex, motivation, anemia, and muscle deconditioning. These confounding factors may diminish somewhat the prognostic power of peak VO2 Several groups have looked at exercise-derived variables beyond peak VO2 to assess whether a more direct assessment of cardiac function, using exercise-derived hemodynamic variables, may yield more precise prognostic information than standard cardiopulmonary-derived data. This article reviews the evidence that cardiac work related to exercise may enhance the prognostic value of peak VO2 in the evaluation of patients with heart failure and briefly discusses the available methods for measuring these parameters.</p
Inflammation and endothelial function: Direct vascular effects of human C-reactive protein on nitric oxide bioavailability
No full textBackground - Circulating concentrations of the sensitive inflammatory marker C-reactive protein (CRP) predict future cardiovascular events, and CRP is elevated during sepsis and inflammation, when vascular reactivity may be modulated. We therefore investigated the direct effect of CRP on vascular reactivity. Methods and Results - The effects of isolated, pure human CRP on vasoreactivity and protein expression were studied in vascular rings and cells in vitro, and effects on blood pressure were studied in rats in vivo. The temporal relationship between changes in CRP concentration and brachial flow-mediated dilation was also studied in humans after vaccination with Salmonella typhi capsular polysaccharide, a model of inflammatory endothelial dysfunction. In contrast to some previous reports, highly purified and well-characterized human CRP specifically induced hyporeactivity to phenylephrine in rings of human internal mammary artery and rat aorta that was mediated through physiological antagonism by nitric oxide (NO). CRP did not alter endothelial NO synthase protein expression but increased protein expression of GTP cyclohydrolase-1, the rate-limiting enzyme in the synthesis of tetrahydrobiopterin, the NO synthase cofactor. In the vaccine model of inflammatory endothelial dysfunction in humans, increased CRP concentration coincided with the resolution rather than the development of endothelial dysfunction, consistent with the vitro findings; however, administration of human CRP to rats had no effect on blood pressure. Conclusions - Pure human CRP has specific, direct effects on vascular function in vitro via increased NO production; however, further clarification of the effect, if any, of CRP on vascular reactivity in humans in vivo will require clinical studies using specific inhibitors of CRP. © 2005 American Heart Association, Inc
Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients
No full textBackground: Cardiovascular–kidney–metabolic (CKM) syndrome, recently defined by the American Heart Association, encompasses the interplay between obesity, diabetes, chronic kidney disease, and cardiovascular disease. This study aimed to investigate the impact of CKM syndrome severity on outcomes in patients with acute myocardial infarction (AMI). Methods: A retrospective analysis was conducted using the National Inpatient Sample database from 2016 to 2019. Adult patients hospitalized with AMI were stratified into CKM Stages 0–4 based on ICD-10 codes. Multivariable logistic regression models were used to examine associations between CKM stages and in-hospital procedures and outcomes. Results: The study analyzed 2,768,154 AMI cases. Advanced CKM stages were associated with older age and a higher proportion of males. Patients with severe CKM were more likely to undergo invasive procedures. Coronary angiography showed the strongest association in CKM Stage 4A (aOR: 6.86, 95% CI: 6.73–6.99, p-value < 0.001) and Stage 4B (aOR: 3.87, 95% CI: 3.80–3.95, p-value < 0.001). Similarly, the likelihood of PCI was highest in Stage 4A (aOR: 5.93, 95% CI: 5.79–6.08, p-value < 0.001) and Stage 4B (aOR: 4.14, 95% CI: 4.04–4.24, p-value < 0.001). Notably, patients with CKM Stage 0 demonstrated higher odds of adverse outcomes compared to other stages. Conclusions: This study reveals a complex relationship between CKM syndrome severity and AMI outcomes. Patients with advanced CKM stages were more likely to undergo invasive procedures, and those without CKM risk factors unexpectedly showed worse outcomes. Among Stages 1–4B, no consistently graded association emerged between the CKM stage and adverse outcomes. These findings warrant further investigation into underlying mechanisms and long-term prognosis
Implementing HLA-B*58:01 testing prior to allopurinol initiation in Malaysian primary care setting: A qualitative study from doctors’ and patients’ perspective
Full text linkIntroduction Allopurinol, the first-line treatment for chronic gout, is a common causative drug for severe cutaneous adverse reactions (SCAR). HLA-B*58:01 allele was strongly associated with allopurinol-induced SCAR in Asian countries such as Taiwan, Japan, Thailand and Malaysia. HLA-B*58:01 screening before allopurinol initiation is conditionally recommended in the Southeast-Asian population, but the uptake of this screening is slow in primary care settings, including Malaysia. This study aimed to explore the views and experiences of primary care doctors and patients with gout on implementing HLA-B*58:01 testing in Malaysia as part of a more extensive study exploring the feasibility of implementing it routinely. Methods This qualitative study used in-depth interviews and focus group discussions to obtain information from patients with gout under follow-up in primary care and doctors who cared for them. Patients and doctors shared their gout management experiences and views on implementing HLA-B*58:01 screening in primary care. Data were coded and analysed using thematic analysis. Results 18 patients and 18 doctors from three different healthcare settings (university hospital, public health clinics, private general practitioner clinics) participated. The acceptability to HLA-B*58:01 screening was good among the doctors and patients. We discovered inadequate disclosure of severe side effects of allopurinol by doctors due to concerns about medication refusal by patients, which could potentially be improved by introducing HLA-B*58:01 testing. Barriers to implementation included out-of-pocket costs for patients, the cost-effectiveness of this implementation, lack of established alternative treatment pathway besides allopurinol, counselling burden and concern about genetic data security. Our participants preferred targeted screening for high-risk populations instead of universal screening. Conclusion Implementing HLA-B*58:01 testing in primary care is potentially feasible if a cost-effective, targeted screening policy on high-risk groups can be developed. A clear treatment pathway for patients who test positive should be made available
Synthesis and applications of Palladium complexes Part I. The synthesis, single crystal structures and liquid crystalline phase behavior of Alkoxy substituted Tolans. Part II. Palladium-Complexes of Thioureas and phosphine sulfides
Full text linkThree series of alkoxy substituted tolans p-X-C(_6)H(_4)-C≡C-C(_6)H(_4)-p-OC(_n)H(_2n+1) [X = H (series 1), CH(_3) (series 2), OCH(_3) (series 3)] with varying chain length were synthesized by Pd/Cu-catalysed Sonogashira cross-coupling reactions of terminal alkynes and iodoarenes, crystal structures and phase behavior of three series of tolans. Twenty-eight of the tolans were structurally characterised by single-crystal X-ray diffraction. Their phase behavior was characterised by tplm; only the tolans in series 3 show liquid crystalline phases. The melting points of the tolans decrease with increasing chain length due to a higher degree of flexibility of the terminal chain. An odd-even effect is clearly observed for the clearing point of the nematic phase upon both heating and cooling, with the higher temperature for even and low temperature for odd number carbon chains for series 3.Monomeric and dimeric palladium dichloride complexes containing the monodentate thioureas, tetramethyl thiourea (tmtu) and a chiral C(_2) symmetric thiourea were synthesized. Their structures were obtained from single-crystal X-ray diffraction. The structures of the mono-palladium complexes are the trans-isomers, whereas the dimer complexes present cis-configurations, and are also the first examples of palladium complexes with sulfur-bridging thiourea ligands. NMR studies of the monomeric and dimeric complexes with tmtu reveal that, in solution, the dimeric complexes are interconverting with mono-palladium complexes, which suggests that the systems are labile. A dynamic equilibrium in solution was also observed between the rac- and meso-dipalladium complexes with the C(_2)-symmetric ligand. The energy barrier to exchange was obtained from a variable temperature NMR study. It is proposed that this equilibrium results from the monomer-dimer interconversion. S,N-bidentate ß-dimethyl and ß-monomethyl oxazoline thiourea ligands and α-isoquinoline thiourea ligands and their palladium complexes have been obtained. Single-crystal X-ray diffraction analyses allow us to distinguish between some of their atropoisomers and diastereomers. Most of the Pd complexes were shown to be monomers in the solid state, although one ligand with a cyclohexyl group formed exclusively dimers, and one formed a trimer, as well as a monomer, depending on the solvent mixture that the crystals were grown from. The ligands were found to coordinate through their S and N atoms. All of the mono-palladium complexes and most of the dimers have cis-configurations at the Pd centers; however, we also found a trans-configuration in the trimer and the dimer of one of the palladium complex of the ß-monomethyl ligands. The structures show that the ß- monomethyl oxazoline and a-isoquinoline thiourea complexes appear to be more weakly coordinated than the ß-dimethyl oxazoline ones which may be responsible for their lower stabilities in solution. The structure of the ligands (in particular the 'up' or 'down' conformation of the atropoisomers) is intimately related to their enatioselectivities in bis(methoxycarbonylation) reactions of styrene using palladium complexes. The ß-dimethyl ligands were, in general, found to be more selective in this reaction than the ß -monomethyl oxazoline ones, with palladium complexes of the latter generally found to be less stable in NMR studies. Several bis(phosphine) monosulfide and disulfide ligands and their palladium complexes have been synthesized and analyzed by single-crystal X-ray diffraction. The reaction with 1:1 molar ratios of Pd source to monosulfide ligands were found to produce monomeric palladium complexes with chelating ligands, apart from the reaction with is(diphenylphosphino)butane monosulfide, which was found to result in a dimer being formed. The reactions with 1:2 molar ratios of Pd source to monosulfide ligand gave complexes which were coordinated only through the phosphine groups, except for that with bis(diphenylphosphino)methane monosulfides which formed cafionic palladium complexes with two chelating ligands. Analogous reactions with the disulfide ligands and the Pd source [Pd(CH(_3)CN)(_4)](BF(_4))(_2) also resulted in cationic Pd complexes incorporating two chelating ligands. In some cases, in solution, the complexes showed dynamic equilibria between cis- and trans- isomers which suggests that the phosphine sulfide ligands are labile. The Pd-S-P angles in the complexes were found to be variable but, since there are none less than 90, it is unlikely that there is any ƞ(^2)-π bonding involving the P=S bond. Preliminary results show that the activities of phosphine sulfide palladium complexes in the oxidative homo-coupling of phenylacetylene are comparable to that of the commonly used pre-catalyst, PdCl(_2)(PPh(_3))(_2)
Dependence of TIMP-1 plasma levels on preanalytical specimen handling
Full text linkBackground: Tissue inhibitor of metalloproteinases-1 (TIMP-1) in blood might be a helpful biomarker in various diseases. However, various authors report that TIMP-1 is dependent on preanalytical procedures. Our study was performed to determine how storage conditions and time to centrifugation influence TIMP-1. Materials and Methods: Twenty-six blood specimens were collected from each of 20 volunteers. Two specimens from each person were centrifuged/measured within 1 h after venipuncture and frozen at -80 degrees C. They were thawed once or twice within 72 h. Eight specimens were stored at 20 degrees C in daylight, 8 at 20 degrees C covered and 8 at 4 C in daylight. Four of each of these 8 specimens were mixed once a day until centrifugation. A mixed and an unmixed specimen of each group was centrifuged/measured after 3, 6, 24 and 72 h. Results: TIMP-1 increased after freeze/ thaw (p < 0.001). Mixing blood specimens more than once caused increased TIMP-1 (p < 0.001). TIMP-1 increased within 3 h of storage (p < 0.001). The increase was lower in specimens covered and refrigerated (p < 0.001). Conclusion: TIMP-1 is unstable and has to be evaluated carefully. Blood should be centrifuged directly after venipuncture. For routine application, specimen handling must be standardized and carefully followed. Research should be done on specimens handled identically. Copyright (C) 2008 S. Karger AG, Basel
- …
