Antimicrobial lock therapy has been widely utilized internationally for the prevention and management of intravascular catheter-related bloodstream infections. One of the agents commonly utilized for ...lock therapy is ethanol. However, a systematic review of adverse events associated with ethanol locks has not been published.
PubMed was searched to collect articles published from May 2003 through March 2014. The bibliographies of relevant articles were also reviewed.
In vitro studies of the mechanical properties of catheters after ethanol immersion have revealed changes predominantly in polyurethane catheters and to a lesser extent in silicone and Carbothane catheters. An elution of polymers from polyurethane and Carbothane catheters has been observed at the ethanol concentrations used in ethanol lock therapy. Ethanol above a concentration of 28% leads to plasma protein precipitation. Ethanol locks were associated with catheter occlusion in 11 studies and independently increased the risk of thrombosis compared with heparin lock in a randomized trial. Six studies noted abnormalities in catheter integrity, including one case leading to catheter embolization. Of note, five of these studies involved silicone catheters. Ethanol lock use was associated with systemic side effects in 10 studies and possible side effects in one additional study. Four studies noted liver function test abnormalities, predominantly transaminase elevation, related to ethanol lock use. However, a prospective study did not find any difference in the risk of doubling the transaminase level above the normal range during use of ethanol locks compared with not using an ethanol lock.
The use of ethanol locks has been associated with structural changes in catheters, as well as the elution of molecules from the catheter polymers. Clinical studies have revealed systemic toxicity, increased catheter occlusion and breaches in catheter integrity.
Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates ...attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association’s 2020 goals.
The hypoxia signalling pathway enables adaptation of cells to decreased oxygen availability. When oxygen becomes limiting, the central transcription factors of the pathway, hypoxia-inducible factors ...(HIFs), are stabilised and activated to induce the expression of hypoxia-regulated genes, thereby maintaining cellular homeostasis. Whilst hydroxylation has been thoroughly described as the major and canonical modification of the HIF-α subunits, regulating both HIF stability and activity, a range of other post-translational modifications decorating the entire protein play also a crucial role in altering HIF localisation, stability, and activity. These modifications, their conservation throughout evolution, and their effects on HIF-dependent signalling are discussed in this review.
This study reveals a new feature of many solar jets: a group height, which links their acceleration and velocity.
The acceleration and velocity (
a
,
V
) for jets such as spicules, often displayed as ...scattergraphs, show a strong correlation. This can be represented empirically by the equation,
V
=
p
a
+
q
, where
p
and
q
are two arbitrary non-zero constants.
This study reanalyses the (
a
,
V
) data for nine different groups of jets, in order to test an alternative proposal that a simpler relationship directly links (
a
,
V
) to the mean height for the group of jets, without needing the empirical constants
p
and
q
. A standard mathematical test – plotting
log
(
a
) against
log
(
V
), tests whether
V
∼
a
n
and if so, gives the value of n. When this is done for a wide range of jets the index
n
is consistently found to be close to 0.5
The nine groups of jets include spicules, macrospicules and dynamic fibrils. The result,
V
∼
a
0.5
, or equivalently
V
2
=
k
a
, with only one constant, provides as close a match to the data as the equation
V
=
p
a
+
q
, which requires two unknown constants. It is found that the constant
k
, is a known quantity: just twice the mean height,
s
‾
, of the group of jets being analysed. This then gives the equation
V
2
=
2
a
s
‾
, for the jets in the group. This more succinct relationship links the acceleration and maximum velocity of every jet in the group to a well-defined quantity – the mean height of the group of spicules, without needing extra constants
The importance of cardiorespiratory fitness (CRF) is well established. This report provides newly developed standards for CRF reference values derived from cardiopulmonary exercise testing (CPX) ...using cycle ergometry in the United States. Ten laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the "Fitness Registry and the Importance of Exercise: A National Database" (FRIEND) Registry from April 2014 through May 2016. Data from 4494 maximal (respiratory exchange ratio, ≥1.1) cycle ergometer tests from men and women (20-79 years) from 27 states, without cardiovascular disease, were used to develop these references values. Percentiles of maximum oxygen consumption (VO
) for men and women were determined for each decade from age 20 years through age 79 years. Comparisons of VO
were made to reference data established with CPX data from treadmill data in the FRIEND Registry and previously published reports. As expected, there were significant differences between sex and age groups for VO
(P<.01). For cycle tests within the FRIEND Registry, the 50th percentile VO
of men and women aged 20 to 29 years declined from 41.9 and 31.0 mLO
/kg/min to 19.5 and 14.8 mLO
/kg/min for ages 70 to 79 years, respectively. The rate of decline in this cohort was approximately 10% per decade. The FRIEND Registry reference data will be useful in providing more accurate interpretations for the US population of CPX-measured VO
from exercise tests using cycle ergometry compared with previous approaches based on estimations of standard differences from treadmill testing reference values.
Abstract Cardiorespiratory fitness (CRF) has been one of the most widely examined physiological variables, particularly as it relates to functional capacity and human performance. Over the past three ...decades, CRF has emerged as a strong, independent predictor of all-cause and disease-specific mortality. The evidence supporting the prognostic use of CRF is so powerful that the American Heart Association recently advocated for the routine assessment of CRF as a clinical vital sign. Interestingly, the continuity of evidence of the inverse relationship between CRF and mortality over the past decade exists despite a wide variation of methods used to assess CRF in these studies, ranging from the gold-standard method of directly measured maximal oxygen uptake (VO2max ) during cardiopulmonary exercise testing to estimation from exercise tests and non-exercise prediction equations. This review highlights new knowledge and the primary advances since 2009, with specific reference to the impact variations in CRF have on all-cause and disease-specific mortality.
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