Patients with coronary artery disease were randomly assigned to either methotrexate (15 to 20 mg weekly) or placebo. At a median of 2.3 years, there was no difference between the two groups in the ...rate of myocardial infarction, stroke, or cardiovascular death.
The article presents information on the treatment of inflammation related to atherothrombosis with canakinumab through neutralization of interleukin-1, resulting in the decreasing rates of ...cardiovascular diseases. It discusses the outcomes of the randomized controlled trials of low-dosage methotrexate, possibility of myocardial infarction, and the elevation of liver-enzyme levels with reduced leukocyte count.
We reviewed the echocardiograms of 35 patients with intracardiac myxomas. Patient data were combined from two geographically distant laboratories. No significant variations in the patient profiles ...were encountered. Most patients were white (33 of 35) with a mean age of 45 years. The diagnosis was suspected on clinical grounds alone in only six of 35 patients before the echocardiogram was done. M-mode recordings were the primary echocardiographic modality available in the first 16 patients, whereas two-dimensional studies were also done in the others. Continuous and pulsed wave Doppler echocardiography were added in eight of the most recent studies. In one patient color flow imaging from both transthoracic and esophageal approaches was possible to better visualize a large left atrial tumor. Thirty-three patients had solitary tumors (29 left atrial, three right atrial, and one left ventricular), and two had multiple tumors. The most characteristic finding, as expected, was the demonstration of abnormal mass echoes produced by the myxoma tissue. Several interesting features not previously emphasized in the literature included abnormal notching of the interventricular septum and posterior left ventricular wall probably produced by displacement from the larger mobile left atrial tumors dropping into the mitral sleeve. This was best appreciated by the M-mode recordings. In one patient with an associated atrial septal defect, movement of the tumor into the defect appeared to alter the expected downward displacement into the mitral orifice. In the patients who were studied by two-dimensional, Doppler, or color flow imaging, tumor movement was evidenced by abnormal frequency shifts, and dispersion of flow around the tumor mass was readily appreciated. Surgical removal was performed in all patients. Follow-up echocardiograms were done postoperatively ranging up to 17 years. Recurrent tumors occurred in two patients, both of whom had congenital myxomas. Echocardiography is proving to be an unparalleled tool in the diagnosis of intracardiac tumors.
We have reported a case of left atrial myxoma in association with an atrial septal defect in a patient followed up over a number of years for recurrent sterile pleural effusions and chronic ...obstructive lung disease of undetermined cause. During hospitalization for pneumonia, an intracardiac mass and atrial septal defect were found by echocardiography, and verified at operation to be a left atrial myxoma.
The roles of edaphic characteristics and grazing in regulating nitrogen cycling and belowground processes were simulated for the shortgrass and tallgrass regions of the Serengeti National Park, ...Tanzania, by coupling a model of grassland productivity with a model of belowground decomposition processes. Grasslands of each region were simulated under ungrazed and observed grazing intensities to establish reference points for sensitivity analyses using a wide range of grazing intensities and different microbial biomasses. The consequences of patchy carbon and nitrogen deposition were also simulated. Results indicate that nitrogen cycling processes are affected differentially by grazing in the shortgrass and tallgrass regions. Net nitrogen mineralized by the microbial biomass in the shortgrass simulations declined from the ungrazed condition at low grazing intensities, and proceeded to increase from moderate to high grazing intensities. Plant nitrogen uptake was significantly correlated with net mineralization, and soil mineral nitrogen levels were greatest at moderate grazing intensities. In tallgrass simulations, soil mineral nitrogen increased with grazing intensity; net nitrogen immobilization occurred over much of the grazing intensity range because of low decomposition substrate quality. Tallgrass plant nitrogen uptake responded to urine nitrogen input to the soil and was uncorrelated with net mineralization. The potential for nitrogen competition between grasses and microbes was greater in the tallgrass than in the shortgrass because of lower total system nitrogen and lower grazing intensity in the tallgrass. The ecosystem-wide soil nitrogen gradient of the Serengeti governs most properties of nitrogen cycling, while within-region edaphic conditions and grazing create significant variation in local ecosystem processes.
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