Patients with chronic kidney disease (CKD) have an increased risk of premature mortality, mainly due to cardiovascular causes. The association between hemodialysis and accelerated atherosclerosis has ...long been described. The ankle-brachial index (ABI) is a surrogate marker of atherosclerosis and recent studies indicate its utility as a predictor of future cardiovascular disease and all-cause mortality. The clinical implications of ABI cut-points are not well defined in patients with CKD. Echocardiography is the most widely used imaging method for cardiac evaluation. Structural and functional myocardial abnormalities are common in patients with CKD due to pressure and volume overload as well as non-hemodynamic factors associated with CKD. Our study aimed to identify markers of subclinical cardiovascular risk assessed using ABI and 2D and 3D echocardiographic parameters evaluating left ventricular (LV) structure and function in patients with end-stage renal disease (ESRD) (patients undergoing dialysis), patients after kidney transplantation and non-ESRD patients (control). In ESRD, particularly in hemodialysis patients, changes in cardiac structure, rather than function, seems to be more pronounced. 3D echocardiography appears to be more sensitive than 2D echocardiography in the assessment of myocardial structure and function in CKD patients. Particularly 3D derived end-diastolic volume and 3D derived LV mass indexed for body surface appears to deteriorate in dialyzed and transplanted patients. In 2D echocardiography, myocardial mass represented by left ventricular mass/body surface area index (LVMI) appears to be a more sensitive marker of cardiac structural changes, compared to relative wall thickness (RWT), left ventricle and diastolic diameter index (LVEDDI) and left atrial volume index (LAVI). We observed a generally favorable impact of kidney transplantation on cardiac structure and function; however, the differences were non-significant. The improvement seems to be more pronounced in cardiac function parameters, peak early diastolic velocity/average peak early diastolic velocity of mitral valve annulus (E/e´), 3D left ventricle ejection fraction (LV EF) and global longitudinal strain (GLS). We conclude that ABI is not an appropriate screening test to determine the cardiovascular risk in patients with ESRD.
This report examines trends in public opinion since mid-1980. The first section describes the evolution of public perceptions concerning the terrorist threat at home and recounts Americans' ...predictions of future terrorist violence. The second section explores whether individuals have felt personally threatened by terrorism in their daily lives. The third reports the public's confidence in the government's ability to deal with the terrorist threat. The final section addresses the perceived trade-off between security and liberty since the Oklahoma City bombing and reports on public support for several governmental initiatives designed to combat such terrorism.
Growth hormone deficiency (GHD) is associated with reduced bone mineral content and increased risk of osteoporotic fractures. Reduced peak bone mass might explain the low bone mineral density (BMD) ...among patients with childhood onset GHD (CO-GHD) whilst the cause of osteopenia in adult-onset GHD (AO-GHD) is not fully understood.
Prospective multicentric study to asses bone status in GHD adults after two years of recombinant growth hormone replacement treatment.
In 94 GHD adults (49 men; Ø 34.5 yrs) we have measured BMD and bone markers (CTX, osteocalcin) during two years of rhGH treatment (at baseline, after 3 and 6 months, and after 1 and 2 years). Patients were adequately substituted for GHD and other pituitary deficiencies.
We have observed an increase in BMD-lumbar spine: n=42, 0.8155 →0.9418 g/cm2, p<0.0001; femoral neck n=41; 0.8468 →0.9031; p= 0.0004; BMD-whole body 1.0179 →1.0774; p=0.0003. We have compared gender difference: BMD-L-spine by 15.8 % in men (n=21) and by 5.6 % in women (n=19) (p= 0.008); BMD-femoral neck increased by 11.03 % in men and by about 3.0 % in women (p=0.032). In women, the initial decrease in BMD was recorded after 3 months. CO-GHD adults yielded a higher increase in BMD -L-spine (16.6 %, p=0.022). A correlation exists between IGF-I levels and BMD in lumbar spine (1st year: R=0.348, p=0.026; 2nd year: R= 0.33, p=0.0081) and between IGF-I and osteocalcin (1st year: R=0.383; p=0.0038).
Two-year therapy with recombinant human growth hormone improved bone status. IGF-I appears to be a good indicator of rhGH effect on bone (Tab. 3, Fig. 9, Ref. 36). Text in PDF www.elis.sk.
•Two new hg and one new mn complexes with the N'-(1-(pyridin-2-yl)ethylidene)isonicotinohydrazide ligand have been synthesized and characterized.•The importance of spodium bonding in the solid state ...of hg complexes has been demonstrated both experimentaly and theoretically.•Hirshfeld surface data analysis show a great importance of spodium bonds and metal–halogen···halogen–metal interactions.•Supramolecular assemblies and σ- -hole interactions have been studied by means of DFT calculations.
In this work we report on crystal structures of a heteroleptic coordination polymer Hg2(HL)Cl4n (1) where the nitrogen atom of the peripheral pyridine fragment is linked to another HgCl2 molecule and two discrete mononuclear heteroleptic complexes Hg(HL)I2 (2) and Mn(HL)Cl2·MeOH (3·MeOH), which were obtained through self-assembling of N'-(1-(pyridin-2-yl)ethylidene)isonicotinohydrazide (HL) with HgCl2, HgI2 or MnCl2, respectively. HL coordinates the HgII salts in its keto-form, while MnCl2 is chelated by a zwitterionic form of HL confirmed by the solid state IR spectroscopy. The studied here ligand molecule has a tendency to involve the 4-pyridyl nitrogen atom in coordination bonding which is correlated with the ability to transfer the electric charge and production of a zwitterionic form. The crystal structure and Hirshfeld surface data analysis show a great importance of spodium bonds and metal–halogen⋯halogen–metal interactions. A prominent consequence of lack of σ- or π-hole interactions in case of MnII ion is the isolation of metal center from the external contacts. Apart form this in 3·MeOH the halogen⋯halogen interactions are absent. It seems that the σ- or π-hole regions formed at the HgII cation in 1 and 2 favor the participation of coordinated Cl or I atoms in the M–Hal⋯Hal'–M' halogen⋯halogen interactions, whereas in complex 3·MeOH there are no metal or halogen centered σ-hole interactions. Thus, the 1D coordination polymer in 1 is stabilized by the Hg⋯Cl spodium bonding. Additionally, the observed intermolecular halogen⋯halogen interactions in 1 provide cross-linking of the 1D coordination polymers, yielding a 2D supramolecular double-layered sheet. In 2 an additional contact between halogen and mercury atoms results in a dimeric unit. These dimers are linked into a 1D polymer by halogen⋯halogen interactions between metal bounded iodine atoms. The DFT theoretical studies were applied to analyze the Hg⋯X non-covalent spodium interactions that govern the formation of the 1D polymeric structure in 1 and self-assembled dimers in 2.
This work unveils indispensable role of spodium bonding and other non-covalent interactions in the HgII-derived complexes with N'-(1-(pyridin-2-yl)ethylidene)isonicotinohydrazide, which predominantly drive formation of extended architectures in comparison to the MnII-derivative. Display omitted
Since lung volume reduction surgery (LVRS) reduces end-expiratory lung volume, we hypothesized that it may improve diaphragm strength. We evaluated 37 patients for pulmonary rehabilitation and LVRS. ...Before and 8 wk after pulmonary rehabilitation, 24 patients had spirometry, lung volumes, diffusion capacity, incremental symptom limited maximum exercise test, 6-min walk test, maximal static inspiratory and expiratory mouth pressures, and transdiaphragmatic pressures during maximum static inspiratory efforts and bilateral supramaximal electrophrenic twitch stimulation measured. Twenty patients (including 7 patients who crossed over after completing pulmonary rehabilitation) had baseline measurements postrehabilitation, and 3 mo post-LVRS. Patients were 58 +/- 8 yr of age, with severe COPD and hyperinflation (FEV1, 0.69 +/- 0.21 L; RV, 4.7 +/- 1.4 L). Nineteen patients had bilateral LVRS performed via median sternotomy and stapling, and 1 patient had unilateral LVRS via thorascopy with stapling. After rehabilitation, spirometry and DL(CO)/VA were not different, and lung volumes showed a slight worsening in hyperinflation. Gas exchange, 6-min walk distance, maximum oxygen uptake (VO2max), and breathing pattern during maximum exercise did not change after rehabilitation, but total exercise time was significantly longer. Inspiratory muscle strength (PImax, Pdi(max combined), Pdi(max sniff), Pdi(max), Pdi(twitch)), was unchanged after rehabilitation. In contrast, after LVRS, FVC increased 21%, FEV1 increased 34%, TLC decreased 13%, FRC decreased 23%, and FRC(trapped gas) and RV decreased by 57 and 28%, respectively. PCO2 was lower (44 +/- 6 versus 48 +/- 6 mm Hg, p < 0.003) and 6-min walk distance increased (343 +/- 79 versus 250 +/- 89 m, p < 0.001), as did total exercise time during maximum exercise (9.2 +/- 1.9 versus 6.9 +/- 2.7 min, p < 0.01). Minute ventilation (29 +/- 8 versus 21 +/- 6 L/min, p < 0.001) and tidal volume (1.0 +/- 0.33 versus 0.84 +/- 0.25 L, p < 0.001) during maximum exercise increased whereas respiratory rate was lower (28 +/- 6 versus 32 +/- 7 breaths/min, p < 0.02). Measurements of respiratory muscle strength (PImax, 74 +/- 28 versus 50 +/- 18 cm H2O, p < 0.002; Pdi(max combined), 80 +/- 25 versus 56 +/- 29 cm H2O, p < 0.01; Pdi(max sniff), 71 +/- 7 versus 46 +/- 27 cm H2O, p < 0.01; Pdi(twitch), 15 +/- 5 versus 7 +/- 5 cm H2O, p < 0.01) were all greater post-LVRS. Inspiratory muscle workload as measured by Pdi TTI was lower following LVRS (0.07 +/- 0.02 versus 0.09 +/- 0.03, p < 0.03). On multiple regression analysis, increases in PImax correlated significantly with decreases in RV and FRC(trapped gas) after LVRS (r = 0.67, p < 0.03). We conclude that LVRS significantly improves diaphragm strength that is associated with a reduction in lung volumes and an improvement in exercise performance. Future studies are needed to determine the relationship and stability of these changes over time.
Stem and progenitor cells provide a promising therapeutic strategy for amyotrophic lateral sclerosis (ALS). To comparatively evaluate the therapeutic potentials of human bone marrow-derived ...mesodermal stromal cells (hMSCs) and umbilical cord blood cells (hUBCs) in ALS, we transplanted hMSCs and hUBCs and their neuroectodermal derivatives (hMSC-NSCs and hUBC-NSCs) into the ALS mouse model over-expressing the G93A mutant of the human SOD1 gene. We used a standardized protocol similar to clinical studies by performing a power calculation to estimate sample size prior to transplantation, matching the treatment groups for gender and hSOD-G93A gene content, and applying a novel method for directly injecting 100,000 cells into the CSF (the cisterna magna). Ten days after transplantation we found many cells within the subarachnoidal space ranging from frontal basal cisterns back to the cisterna magna, but only a few cells around the spinal cord. hMSCs and hMSC-NSCs were also located within the Purkinje cell layer. Intrathecal cell application did not affect survival times of mice compared to controls. Consistently, time of disease onset and first pareses, death weight, and motor neuron count in lumbar spinal cord did not vary between treatment groups. Interestingly, transplantation of hMSCs led to an increase of pre-symptomatic motor performance compared to controls in female animals. The negative outcome of the present study is most likely due to insufficient cell numbers within the affected brain regions (mainly the spinal cord). Further experiments defining the optimal cell dose, time point and route of application and particularly strategies to improve the homing of transplanted cells towards the CNS region of interest are warranted to define the therapeutic potential of mesodermal stem cells for the treatment of ALS.
Progress in cell efficiency was designed by Si
n
+
p junction/organic layer hybrid. This design comprises the Si solar cell structure with patterned
n
+
p junction and heterocycleamine organic layer ...containing N, S, P, Cl, J atoms. The initial solar cell structure exhibited poor parameters with efficiency of about 4–7% at AM0. The organic layer was grown from aquatic solution at room temperature and appropriate contact time between the solution and the
n
+
p Si structure. After the layer deposition, the improvement in the solar cells performance was observed:
I
sc is doubled,
V
oc increased up to 50 mV, FF is increased by 20%, and 15% growth of the efficiency took place. Here we discuss factors resulting in these improvements of the solar cells properties.
Interaction of 2-furylvinyl- and 2-thienylvinyl-2,3-dihydroquinazolin-4(1H)-ones with maleic anhydride gives isoindolo2,1-aquinazoline-11(13)-carboxylic acids via the tandem acylation/intramolecular ...Diels-Alder reaction of vinylarenes (IMDAV). The reaction sequence involves three successive steps: the initial acylation of a quinazolinone nitrogen atom, the IMDAV reaction, and the final aromatization of the resulting five-member ring. The proposed exo-cycloaddition reaction allows to construct from four to five stereogenic centers and two new rings in one synthetic step. The target annelated isoindoloquinazolines were evaluated in vitro against common bacterial pathogens strains (Escherichia coli, Staphylococcus aureus, etc.). It was demonstrated that some of thienoisoindolequinazoline derivatives exibit a potent antibacterial activity at the level of MIC values of 16–32 μg mL−1. Selected 2,3-dihydroquinazolin-4(1H)-ones and isoindolo2,1-aquinazolinecarboxylic acids displayed antiviral activity (against the influenza virus A/Puerto Rico/8/34 – H1N1).
Display omitted
PDF
