Patients with symptomatic idiopathic venous thromboembolism and apparently cancer-free have an approximate 10% incidence of subsequent cancer. Apparently cancer-free patients with acute idiopathic ...venous thromboembolism were randomized to either the strategy of extensive screening for occult cancer or to no further testing. Patients had a 2-year follow-up period. Of the 201 patients, 99 were allocated to the extensive screening group and 102 to the control group. In 13 (13.1%) patients, the extensive screening identified occult cancer. In the extensive screening group, a single (1.0%) malignancy became apparent during follow-up, whereas in the control group a total of 10 (9.8%) malignancies became symptomatic relative risk, 9.7 (95% CI, 1.3-36.8; P < 0.01. Overall, malignancies identified in the extensive screening group were at an earlier stage and the mean delay to diagnosis was reduced from 11.6 to 1.0 months (P < 0.001). Cancer-related mortality during the 2 years follow-up period occurred in two (2.0%) of the 99 patients of the extensive screening group vs. four (3.9%) of the 102 control patients absolute difference, 1.9% (95% CI, -5.5-10.9). Although early detection of occult cancers may be associated with improved treatment possibilities, it is uncertain whether this improves the prognosis.
Gilthead seabream is bred mainly in fish farms in the Mediterranean Sea. One important factor responsible for the deterioration of fish quality is lipid oxidation. Moringa oleifera leaves have been ...described as having high antioxidant content. This work investigates the effect of dietary supplementation with Moringa leaves on the antioxidant activity of seabream. Gilthead seabream specimens were divided into four groups, the control group (fed a commercial diet) and three other groups fed diets enriched with Moringa (5%, 10% and 15%). The antioxidant capacity was measured by assays of free radical scavenging (OH·, H2O2, lipoperoxyl and ABTS), Rancimat test and linoleic acid system in muscle and skin of gilthead seabream, commercial diet, enriched diet and Moringa. Finally, the polyphenol content of Moringa and the fatty acid composition of seabream fed diets with and without Moringa were determined. Results showed an increase in antioxidant activity in gilthead seabream fed with diets enriched with a higher percentage of Moringa; therefore, Moringa could be considered a functional ingredient in diets for fish bred in fish farms and. The antioxidant potential of Moringa leaves could be mainly attributed to the presence of polyphenolic compounds.
Chronic obstructive pulmonary disease (COPD) is a moderate risk factor for venous thromboembolism (VTE), but neither the clinical presentation nor the outcome of VTE in COPD patients is well known. ...The clinical presentation of VTE, namely pulmonary embolism (PE) or deep venous thrombosis (DVT), and the outcome at 3 months (death, recurrent VTE or bleeding) were compared between 2,984 COPD patients and 25,936 non-COPD patients included in the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry. This ongoing international, multi-centre registry includes patients with proven symptomatic PE or DVT. PE was the more frequent VTE presentation in COPD patients (n = 1,761, 59%). PE presentation was more significantly associated with COPD patients than non-COPD patients (OR 1.64, 95% CI 1.49-1.80). During the 3-month follow-up, mortality (10.8% versus 7.6%), minor bleeding (4.5% versus 2.3%) or first VTE recurrences as PE (1.5% versus 1.1%) were significantly higher in COPD patients than in non-COPD patients. PE was the most common cause of death. COPD patients presented more frequently with PE than DVT. It may explain the worse prognosis of COPD patients, with a higher risk of death, bleeding or VTE recurrences as PE compared with non-COPD patients. Further therapeutic options are needed.
The antioxidant activity of vegetables subjected to minimal processing (in MAP, and intended for cooking or for use in salads), dehydrated condiments and ready-to-eat vegetables such as soups and ...purees, was assessed by reference to their ability to scavenge lipoperoxyl and hydroxyl radicals and Trolox-equivalent antioxidant capacity. In the case, the MAP vegetables the measurements were repeated during eight days of storage in a domestic refrigerator and after cooking (boiling, microwaving, pressure cooking, griddling, frying and baking). MAP vegetables had a good or very good antioxidant capacity, and showed no significant loss of antioxidant activity or scavenging capacity compared with fresh vegetables. The cooking treatments that keep the antioxidant activity of MAP vegetables are microwaving, sautéing and baking. The most aggressive method of cooking were steaming, boiling and frying. The dehydrated condiments (tablets) showed higher antioxidant activity than the ready-to-eat soup. The enrichment of stews and casseroles, with dehydrated vegetable tablets, and the consumption of soup or vegetable purees represent an increased antioxidant intake in our diet. Also “ready-to-eat” vegetable soups show antioxidant activity after they have been submitted to heat treatment to increase their shelf-life. They can be recommended as alternatives in our non-stop “life style”.
An increased risk of ischemic stroke in patients with acute pulmonary embolism (PE) and patent foramen ovale (PFO) was reported but few data exist regarding prognostic outcomes of those patients.
...Using data in the RIETE registry, we compared the characteristics, therapeutic approaches and outcomes of patients with PE according to the presence or absence of PFO.
From August 2016 to January 2020, 4148 patients with acute PE were enrolled. Of these, 2775 (67%) had no transthoracic echocardiogram (TTE), 993 (24%) underwent TTE but had no reported results on PFO. Among the remaining 380 patients, 287 (74%) did not have PFO and 93 (26%) had PFO. Patients with PFO were more likely to have chronic heart failure, prior myocardial infarction or ischemic stroke than those without PFO. Patients with PFO had a higher rate of subsequent ischemic stroke than those without PFO (hazard ratio (HR): 9.28; 95% CI: 1.83–69.1), than those with TTE but no data on PFO (HR: 10.1; 95% CI: 2.56–42.4) or without TTE (HR: 9.78; 95% CI: 3.02–28.4). On multivariable analysis, patients with PFO were at increased risk for subsequent ischemic stroke than those without PFO (HR: 8.96; 95% CI: 1.68–47.7).
PFO was searched in a minority of patients with an acute PE in real life setting. Subject to possible selection and measurement biases, our results confirmed a higher risk of ischemic stroke in PE patients with PFO compared to those without PFO. This association warrants further investigation before determining the best therapeutic option in patients with acute PE and concomitant PFO.
•In real life setting, patent foramen ovale (PFO) was searched in a minority of patients with acute pulmonary embolism (PE)•When PFO was searched, PFO was present in one in every four patients•Patients with PFO were at a 9-fold higher risk to develop ischemic stroke early in the course of anticoagulation•They also had a higher rate of PE recurrences than those without PFO•These results confirmed the poor prognosis of patients with acute PE and PFO
In recent years alternative farming practices have received considerable attention from Canadian producers as a means to improve their net return from grain and oilseed production. Enhancing the ...efficiency of nitrogen fertilizer use, including a pulse crop in the rotation, reducing tillage and pesticide use are seen as viable options to reduce reliance on fossil fuel, lower input costs and decrease the risk of soil, air and water degradation. The objective of this study was to determine the effects of 16 alternative management practices for a 2-year spring wheat (
Triticum aestivum L.)–field pea (
Pisum sativum L.) rotation on economic returns, non-renewable energy use efficiency, and greenhouse gas emissions. The alternative management methods for wheat consisted of a factorial combination of high vs. low soil disturbance one pass seeding, four nitrogen (N) fertilizer rates (20
kg
N
ha
−1, 40
kg
N
ha
−1, 60
kg
N
ha
−1 and 80
kg
N
ha
−1), and recommended vs. reduced rates of in-crop herbicide application. Alternative management practices for field pea were high vs. low soil disturbance one pass seeding. The resulting 16 cropping systems were evaluated at the whole farm level based on 4 years (two rotation cycles) of data from field experiments conducted on two Orthic Black Chernozem soils (clay loam and loam textures) in Manitoba, Canada. The highest net returns on the clay loam soil were for the high disturbance system with 60
kg
N
ha
−1 applied to wheat and the recommended rates of in-crop herbicides. The lowest application rate of N, together with low disturbance seeding, provided the highest economic returns on the loam soil. Energy use efficiency was highest for the lowest rate of N application for both tillage systems. The highest rate of N fertilizer and recommended rates of in-crop herbicide produced little additional yield response, lower net returns, and higher GHG emissions. An increase in N fertilizer application from 20
kg
ha
−1 to 80
kg
ha
−1 increased whole farm energy requirements by about 40%, while reducing herbicide rates had negligible effects on grain yields and total energy input. Overall, as N fertilizer rate increased, the associated GHG emissions were not offset by an increase in carbon retained in the above-ground crop biomass. Moderate to high soil test NO
3-N levels at experimental sites reduced the potential for positive yield responses to N fertilizer in this study, thus minimizing the economic benefits derived from N fertilizer application.
One in every three patients with deep vein thrombosis (DVT) in the lower limbs may have silent pulmonary embolism (PE), but its clinical relevance has not been thoroughly studied.
We used the RIETE ...Registry data to study patients with proximal DVT and no PE symptoms, but with a systematic search for PE. We compared the outcome of DVT patients with silent PE and those with no PE.
Of 2375 patients with DVT, 842 (35%) had silent PE and 1533 had no PE. During the first 15 days of anticoagulation, patients presenting with silent PE had a higher incidence of symptomatic PE events than those with no PE (0.95% vs. 0.13%; P = 0.015), with a similar incidence of major bleeding (0.95% vs. 1.63%; P = 0.09). In patients with silent PE, the incidence of PE events during the first 15 days was equal to the incidence of major bleeding (eight events each), but in those with no PE the incidence of PE events was eight times lower (3 vs. 25 bleeding events). Multivariate analysis confirmed that DVT patients with silent PE had a higher incidence of symptomatic PE events during the first 15 days than those with no PE (odds ratio, 4.80; 95% CI, 1.27-18.1), with no differences in bleeding.
DVT patients with silent PE at baseline had an increased incidence of symptomatic PE events during the first 15 days of anticoagulant therapy. This effect disappeared after 3 months of anticoagulation.
The high-resolution analysis of radiolarians and silicoflagellates in sediments from Holes U1545A and U1549A drilled during IODP Expedition 385 in the Guaymas Basin, in the Gulf of California ...provides detailed insights into the evolution of ocean circulation and water masses, and its relation to Eastern Tropical Pacific Ocean climate conditions, over the past 31,000 cal years BP (based on AMS radiocarbon dates). In the pre-Last Glacial Maximum, the Guaymas Basin experienced alternating circulation patterns of California Current Water (CCW) and Gulf of California Water (GCW), with an extended presence of the Pacific Intermediate Water (PIW) owing to: amplified jet streams; southern movement of the California Current System (CCS) and the incursion of CCW into the gulf; and increased North Pacific Intermediate Water (NPIW) formation. The Last Glacial Maximum witnessed the incursion of CCW due to the stronger CCS. The dominance of the PIW indicates the expansion and formation of NPIW. The Heinrich-I event as manifested in the core record, displays two distinct patterns, one suggesting GCW-like dominance and the other, the occurrence of CCW. The Bølling-Ållerød interstadial featured the entry of Tropical Surface Water (TSW), GCW, and CCW, linked with the northward migration of the Intertropical Convergence Zone. In the Younger Dryas, CCW dominated, transitioning to GCW as colder climatic conditions and more intense CCS. The Holocene displayed alternating periods of TSW and GCW, with a modern monsoon regime from 7,600 to 1,000 cal years BP. From 1,000 cal years BP to the present the ITCZ shifted to the south.
To examine the clinical characteristics and outcomes of cancer patients with venous thromboembolism (VTE) in order to identify factors that place these patients at an increased risk for fatal ...pulmonary embolism (PE) or fatal bleeding.
Registro Informatizado de la Enfermedad Trombo Embólica (RIETE) is a prospective registry of consecutive patients with symptomatic, objectively confirmed, acute VTE.
Up to January 2006, a total of 14 391 patients with symptomatic acute VTE were enrolled in RIETE, of whom 2945 (20%) had cancer. During the 3-month follow-up period the frequency of fatal PE in cancer patients was 2.6%, and that of fatal bleeding 1.0%. These frequencies were significantly higher than in VTE patients without cancer (1.4% and 0.3%, respectively). In patients with cancer, abnormal renal function, metastatic disease, recent major bleeding and recent immobility for >or= 4 days (42% of the 108 patients who died from PE or bleeding had recent immobility) were factors independently associated with an increased risk for both fatal PE and fatal bleeding. In addition, PE diagnosis on admission was an independent risk factor for fatal PE, while body weight < 60 kg was an independent risk factor for fatal bleeding.
Both fatal PE and fatal bleeding are more common in cancer patients with VTE than in those patients without cancer. In cancer patients, abnormal renal function, metastatic disease, recent major bleeding and recent immobility for >or= 4 days are associated with an increased risk for both fatal PE and fatal bleeding.
Deep-vein thrombosis (DVT) forms a major healthcare burden in Europe, but exact estimates concerning the economic burden on society are lacking. This study reports results from the PREFER in VTE ...study concerning resource utilization and absence from work in DVT patients.
The PREFER in VTE registry was a prospective, observational, multicenter study carried out in Europe (France, Italy, Spain, the UK, and DACH Germany, Switzerland and Austria), designed to provide data concerning treatment patterns, resource utilization, mortality and quality of life. Patients with a first-time and/or recurrent DVT, were recruited and followed for 12 months. Data about resource utilization concerns resource utilization related to DVT. Specifically, treatment pattern, re-hospitalization rate, length of hospital stay, ambulatory/office visit, and proportion of patients returning to work, were analyzed and presented. Subgroup analysis by country and active cancer were also conducted. The length of hospital stay was analyzed as a function of demographics, previous events and co-morbidities using zero-inflated binomial negative regression. Similarly, time until return to work was analyzed using Cox regression.
A total of 2056 patients with DVT were recruited, with an average age of 60 years. Patients with active cancer were mostly treated with heparin (83.9%), while patients without active cancer were treated with combinations of heparin, VKA and DOACs. DOACs were less often used in Spain and Italy (<7.0%). Following the management of their initial DVT 20.5% of the patients with and 12.2% of patients without active cancer (n = 88; n = 1462) were hospitalized for on average 8.2 and 10.1 days, respectively. The hospitalization-rate was highest in Italy (16.7%) and lowest in France (7.7%). Furthermore, the average length of stay was highest in Italy (16.6 days) and lowest in DACH (5.2 days). Physician visits were highest in DACH (9.3), lowest in the UK (2.6). Of those working, 50% returned to work at 1 month; >30% did not return to work within the year.
Medical treatment of DVT differed between patients with active cancer and those without. Post-VTE or VTE-related resource utilization differs remarkably between countries. Work-loss seems high, but questions may be raised concerning the causality due to the presence of co-morbidities.
•Medication use significantly differed for active cancer patients.•Post-VTE re-hospitalization rate and length of stay varied between countries.•30% of employed patients had still not returned to work after one year.•Active cancer plays a significant role in healthcare utilization and return to work.
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