OBJECTIVE:Left atrial (LA) enlargement (LAE) is associated to an increased risk of cardiovascular complications, and in particular of atrial fibrillation. The 2018 ESH/ESC Hypertension guidelines ...suggested the use of LA volume instead of linear dimensions, and for the first time proposed the indexation to height2(h2)The aim of our study was to assess the prevalence of left atrial dilatation in a large sample of patients undergoing an echocardiogram for cardiovascular risk stratification at an ESH excellence centre in Italy.
DESIGN AND METHOD:3872 subjects undergoing a diagnostic work-up for arterial hypertension (known or suspect) were analysed. The mean age was 56 ± 15 years, BMI 26 ± 5, 44% normal weight, 39% overweight, 17% obese, 53% males. Left atrial volume was measured by the area-length method using the apical 4-chamber and 2-chamber views.
RESULTS:The prevalence of left ventricular hypertrophy (LVH) was 11% when indexing for BSA and 12% when indexing for height2.7. LAE was observed in 30% of subjects when indexing for h2 and in 9% when indexing for BSA. In obese or overweight subjects the prevalence of LAE was 38% of subjects when indexing for h2 and in 11% when indexing for BSA. The different prevalence of LAE was particularly evident in extremely obese patients.LAE was very common in patients with LVH62% and 26% when indexing for h2 and for BSA, respectively. Interestingly, it was frequent also in patients without LVH, in particular when the indexation for h2 was used (25% as compared to 7% when indexing for BSA).
CONCLUSIONS:In a large sample of subjects undergoing a diagnostic work-up for arterial hypertension LAE was frequently observed, particularly when the new indexation proposed by the 2018 ESH/ESC hypertension guidelines was used. Even in the absence of clear-cut LVH, LAE was observed in one quarter of subjects. The indexation to BSA leads to an under-recognition of LAE, in particular in patients with overweight and/or obesity.
OBJECTIVE:It has been suggested that measurement of “unattended” or “automated oscillatory(AOBP)” blood pressure values may provide advantages over conventional BP measurement and some hypertension ...guidelines now suggest this approach as the preferred one for measuring office BP. Data on the strength of the relationship between AOBP and cardiovascular events are limited as compared to those obtained with the standard BP measurement; conflicting data are available on the relationship between hypertensive organ damage and “attended” and “unattended” BP.The aim of our study was to evaluate the relationship between “attended” or “unattended” BP values and arterial stiffness in 108 subjects undergoing a visit and assessment of arterial stiffness at an ESH Excellence Centre.
DESIGN AND METHOD:Both “unattended” BP (patient alone in the room, an oscillometric device programmed to perform 3 BP measurements, at 1 minute intervals, after 5 minutes) and “attended” BP were measured with the same device, on the same day of arterial stiffness assessment, in random order.
RESULTS:Patientʼs mean age was 65 ± 15 yrs, mean BMI 26 ± 4, 43% female, 72 % had hypertension (59% treated). Systolic unattended BP was lower as compared to attended SBP (132.7 ± 17.7vs124.9 ± 15.3 mmHg). A similar correlation was observed between PWV and systolic unattended BP or attended SBP (r = 0.530 and r = 0.535, p < 0.0001, respectively) and between PWV and mean unattended and attended BP (r = 0.408 and r = 0.381, p < 0.0001, respectively). Similar correlations were also observed between PWV and unattended and attended pulse pressure (r = 0.459 and r = 0.480, p < 0.0001). The differences between correlations were not statistically significant (Steigerʼs Z test).No significant difference was observed between the ROC curves of attended and unattended SBP for the presence of increased arterial stiffness (AUC 0.706 vs. AUC 0.730, p for the comparison = ns).
CONCLUSIONS:Measurement of BP “unattended” or “unattended” provides different values, being unattended BP lower as compared to attended BP. Our results suggest that unattended measurement of BP values does not change the relationship with the gold standard measure of arterial stiffness.
Abstract
Background
Left atrial (LA) enlargement (LAE) is associated to an increased risk of cardiovascular complications, and in particular of atrial fibrillation. The 2018 ESH/ESC Hypertension ...guidelines suggested the use of LA volume instead of linear dimensions, and for the first time proposed the indexation to height2 (h2)
The aim of our study was to assess the prevalence of left atrial dilatation in a large sample of patients undergoing an echocardiogram for cardiovascular risk stratification at an ESH excellence centre in Italy.
Design and methods 3872 subjects undergoing a diagnostic work-up for arterial hypertension (known or suspect) were analysed. The mean age was 56±15 years, BMI 26±5 kg/m, 44% normal weight, 39% overweight, 17% obese, 53% males. Left atrial volume was measured by the area-length method using the apical 4-chamber and 2-chamber views.
Results
The prevalence of left ventricular hypertrophy (LVH) was 11% when indexing for BSA and 12% when indexing for height2.7. LAE was observed in 30% of subjects when indexing for h2 and in 9% when indexing for BSA. In obese or overweight subjects the prevalence of LAE was 38% of subjects when indexing for h2 and in 11% when indexing for BSA. The different prevalence of LAE was particularly evident in extremely obese patients.
LAE was very common in patients with LVH: 62% and 26% when indexing for h2 and for BSA, respectively. Interestingly, it was frequent also in patients without LVH, in particular when the indexation for h2 was used (25% as compared to 7% when indexing for BSA).
Conclusions
In a large sample of subjects undergoing a diagnostic work-up for arterial hypertension LAE was frequently observed, particularly when the new indexation proposed by the 2018 ESH/ESC hypertension guidelines was used. Even in the absence of clear-cut LVH, LAE was observed in one quarter of subjects. The indexation to BSA leads to an under-recognition of LAE, in particular in patients with overweight and/or obesity
This study evaluated two cases of Apert's syndrome, through phonological, cognitive, and neuropsychological instruments and correlated the results to complementary exams. In short, this study reveals ...the necessity of application of neuropsychological, cognitive and phonological evaluation and correlation of the results with complementary testings because significant differences can be present in the Apert's syndrome.
To evaluate and to compare the findings of oral and pharyngeal phases of swallowing in children with both spastic tetraparetic cerebral palsy (STCP) and with athetosic cerebral palsy (ACP).
11 ...children were evaluated, with their ages ranging from 10 months to 8 years old, through both clinical assessment and videofluoroscopic evaluation.
The children with STCP were more involved at the neurologic, clinical and speech-language and hearing aspects. At the oral phases all the children had presented some involvement. At the pharyngeal phases the clinical signs of aspiration were identified in 10 children. It was observed aspirations in 80% of children with STCP and in 67% with ACP. The changes on swallowing were similar in both cerebral palsy groups, but the performance of the children with STCP was inferior.
The videofluoroscopy was an important method which makes possible the verification of aspirations, helping the professionals at the therapeutical program for these children.
Children who enter kindergarten with low oral language skills are at great risk for reading problems, especially in the areas of vocabulary and comprehension. The purpose of this study was to ...evaluate the effectiveness of two instructional vocabulary methods of storybook reading with children who exhibit typically developing language skills and those that exhibit low language skills. Children with low language skills have difficulty understanding, remembering, and retrieving novel vocabulary words, thus helping them find effective ways to acquire vocabulary is essential. Two types of vocabulary instruction, embedded vocabulary instruction and explicit vocabulary instruction, were compared. Embedded vocabulary instruction is a method in which the storybook reader provides a simple definition of a vocabulary word within the context of the story while explicit vocabulary instruction provides the direct teaching of targeted words with contextual and definitional information, multiple exposures to targeted words in varied contexts, and the discussion of words related to students' experiences. Researcher- developed vocabulary assessment methods are more sensitive to vocabulary growth than standardized assessments (National Reading Panel, 2000), so participants' knowledge of targeted vocabulary words were assessed through the use of a Researcher Developed Vocabulary Assessment (RDVA). Results showed that students with typically developing language skills acquire more vocabulary than students with low language skills across both instructional conditions (embedded method and explicit method). Students with typically developing language skills and low language skills both acquired more words taught with the explicit method of vocabulary instruction than the words taught with the embedded method of vocabulary instruction. Students in both groups were able to demonstrate similar receptive vocabulary knowledge on the RDVA. Students with typically developing language skills were better able to demonstrate their knowledge expressively. This investigation addressed questions that may assist teachers in planning vocabulary instruction for students with low language skills. The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.
Prolonged human interactions and artificial selection have influenced the genotypic and phenotypic diversity among dog breeds. Because humans and dogs occupy diverse habitats, ecological contexts ...have likely contributed to breed-specific positive selection. Prior to the advent of modern dog-feeding practices, there was likely substantial variation in dietary landscapes among disparate dog breeds. As such, we investigated one type of genetic variant, copy number variation, in three metabolic genes: glucokinase regulatory protein (GCKR), phytanol-CoA 2-hydroxylase (PHYH), and pancreatic α-amylase 2B (AMY2B). These genes code for proteins that are responsible for metabolizing dietary products that originate from distinctly different food types: sugar, meat, and starch, respectively. After surveying copy number variation among dogs with diverse dietary histories, we found no correlation between diet and positive selection in either GCKR or PHYH. Although it has been previously demonstrated that dogs experienced a copy number increase in AMY2B relative to wolves during or after the dog domestication process, we demonstrate that positive selection continued to act on amylase copy number in dog breeds that consumed starch-rich diets in time periods after domestication. Furthermore, we found that introgression with wolves is not responsible for deterioration of positive selection on AMY2B among diverse dog breeds. Together, this supports the hypothesis that the amylase copy number expansion is found universally in dogs.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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