Total Body Water and Intracellular Water Relationships with Muscle Strength,Frailty and Functional Performance in an Elderly Population. A Cross-Sectional Study

The journal of nutrition, health & aging - As a person ages, total body water (TBW), intracellular water (ICW), muscle mass and muscle strength tend to decline. The decline in ICW may reflect...     

Determinants of image quality of rotational angiography for on-line assessment of frame geometry after transcatheter aortic valve implantation

To study the determinants of image quality of rotational angiography using dedicated research prototype software for motion compensation without rapid ventricular pacing after the implantation of four commercially available catheter-based valves. Prospective observational study including 179 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with either the Medtronic CoreValve (MCS), Edward-SAPIEN Valve (ESV), Boston Sadra Lotus (BSL) or Saint-Jude Portico Valve (SJP) in whom rotational angiography (R-angio) with motion compensation 3D image reconstruction was performed. Image quality was evaluated from grade 1 (excellent image quality) to grade 5 (strongly degraded). Distinction was made between good (grades 1, 2) and poor image quality (grades 3–5). Clinical (gender, body mass index, Agatston score, heart rate and rhythm, artifacts), procedural (valve type) and technical variables (isocentricity) were related with the image quality assessment. Image quality was good in 128 (72?%) and poor in 51 (28?%) patients. By univariable analysis only valve type (BSL) and the presence of an artefact negatively affected image quality. By multivariate analysis (in which BMI was forced into the model) BSL valve (Odds 3.5, 95?% CI [1.3–9.6], p?=?0.02), presence of an artifact (Odds 2.5, 95?% CI [1.2–5.4], p?=?0.02) and BMI (Odds 1.1, 95?% CI [1.0–1.2], p?=?0.04) were independent predictors of poor image quality. Rotational angiography with motion compensation 3D image reconstruction using a dedicated research prototype software offers good image quality for the evaluation of frame geometry after TAVI in the majority of patients. Valve type, presence of artifacts and higher BMI negatively affect image quality.     

Fibrilación auricular en pacientes con COVID-19. Utilidad de la puntuación CHA2DS2-VASc: un análisis del registro internacional HOPE COVID-19

Introduction and objectivesCoronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. Atrial fibrillation (AF) is common in acute situations, where it is associated with more complications and higher mortality.MethodsAnalysis of the international HOPE registry (NCT04334291). The objective was to assess the prognostic information of AF in COVID-19 patients. A multivariate analysis and propensity score matching were performed to assess the relationship between AF and mortality. We also evaluated the impact on mortality and embolic events of the CHA₂DS₂-VASc score in these patients.ResultsAmong 6217 patients enrolled in the HOPE registry, 250 had AF (4.5%). AF patients had a higher prevalence of cardiovascular risk factors and comorbidities. After propensity score matching, these differences were attenuated. Despite this, patients with AF had a higher incidence of in-hospital complications such as heart failure (19.3% vs 11.6%, P = .021) and respiratory insufficiency (75.9% vs 62.3%, P = .002), as well as a higher 60-day mortality rate (43.4% vs 30.9%, P = .005). On multivariate analysis, AF was independently associated with higher 60-day mortality (hazard ratio, 1.234; 95%CI, 1.003-1.519). CHA₂DS₂-VASc score acceptably predicts 60-day mortality in COVID-19 patients (area ROC, 0.748; 95%CI, 0.733-0.764), but not its embolic risk (area ROC, 0.411; 95%CI, 0.147-0.675).ConclusionsAF in COVID-19 patients is associated with a higher number of complications and 60-day mortality. The CHA₂DS₂-VASc score may be a good risk marker in COVID patients but does not predict their embolic risk.     

Changes in hippocampal arc protein expression and synaptic plasticity by the presentation of contextual cues linked to drug experience

Contextual cues linked to drug experience have been frequently associated to craving and relapse, with this phenomenon being described in human and experimental animals. Hippocampal synaptic plasticity has been related to learning, memory, and adaptive processes developed during chronic administration of drug abuse. In this study, we investigated if the environmental context associated with withdrawal experience was able to evoke the same behavioral alteration observed after chronic benzodiazepine administration. Furthermore, we studied the hippocampal synaptic plasticity and anatomical expression of Arc protein during withdrawal and the re‐exposure to the context associated with anxiety expression (characteristic sign of benzodiazepines withdrawal). It was demonstrated that re‐exposure evoked on days 15 and 25 after the first exposure the same behavior. An increased hippocampal synaptic plasticity, expressed as a lower threshold to induce long‐term potentiation on dentate gyrus, was observed in animals dependent on diazepam and during retrieval, in the same group, until day 15. This plastic change disappeared 25 days after the first exposure. An overexpression of Arc protein in the dorsal dentate gyrus and CA1 on the first day of withdrawal in the dependent animals was observed. Synapse 64:39–46, 2010. © 2009 Wiley‐Liss, Inc.     

Response to zolendronic acid in children with type III osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a common genetic disorder that manifests with intrauterine or pre- or postnatal fractures, blue sclera, and deafness. Various treatments for the management of OI have been tried, of which bisphosphonates (BPs) seem to have the maximum benefit in reducing fracture rate and improving bone density. Zolendronic acid is a newer BP tried for several bone diseases, mainly in adults. The objective of our analysis was to study the response to zolendronic acid in children with type III OI. The case records of subjects with type III OI receiving zolendronic acid in the past 3 years between February 2006 and March 2009 were analyzed. Relevant details were recorded on a predesigned chart. Subjective improvement, reduction in number of fractures, and the DEXA scan Z-score were used to judge improvement. Five OI type III cases were followed up in the Genetic clinic. Presentation was from neonatal period to 7 years of age; M:F ratio was 3:2. Average duration of therapy given was 20.4 months. Improvement was noted in all patients, in the form of reduction in frequency of fractures (P = 0.002) and increase in bone density on DEXA scan (P = 0.01). Side effects noted were flu-like symptoms and myalgia. No clinical problems due to hypocalcemia were noted in any of the patients. Thus, zolendronic acid is seen as a safe and effective BP in type III OI children. The exact dose for optimal benefit is yet to be determined. The long-term effects of newer BPs need further long-term trials.     

Aortico-left ventricular tunnel: a rare congenital cardiac anomaly in an adult

Aortico Left Ventricular Tunnel (ALVT) is a rare congenital anomaly. It presents as an asymptomatic murmur to severe Aortic Regurgitation (AR) and heart failure. Most of the patients have heart failure in first year of life. Patient rarely present beyond second decade of life. Here we report a 42 year male with unusual type of ALVT, who presented with heart failure and conduction disturbances.     

Evaluation of the law of presumed consent after brain death by Spanish journalism students

Introduction

Information provided by journalists is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), wherein the participation of the general public is essential to obtain organs.

Objective

The objective of this study was to determine the knowledge of students taking a degree in journalism about the concept of brain death and the law of presumed consent.

Materials and Methods

The study involved 129 journalism degree students in the 2005-2006 academic year from a university in the south-east of Spain. Attitudes on the psychosocial aspects of ODT were evaluated using a validated questionnaire. The self-administered survey was completed anonymously in classes and compulsory practical sessions.

Results

The questionnaire completion rate was 98% (n = 126). Of the students surveyed, 43% (n = 54) understood the concept of brain death, 44% (n = 56) stated that they had doubts, whereas 13% (n = 16) believed that a person with brain death can recover and lead a normal life. Their knowledge was more accurate in the final than in the first year (54% vs 47%; P = .016). Most students 66% (n = 83) believed that it would be interesting to receive an informative talk about ODT. Concerning legislation, 75% of students were against the law of presumed consent, whereas 25% were in favor.

Conclusion

More than 50% of journalism students do not understand the concept of brain death. Furthermore, up to 75% do not accept the law of presumed consent that donation must be made.     

Substance Use in HIV-Infected Women During Pregnancy: Self-Report Versus Meconium Analysis

We evaluated prenatal substance use in a cohort of 480 HIV-infected women and their uninfected children. Substance use was reported by 29%; the most common substances reported were tobacco (18%), alcohol (10%), and marijuana (7.2%). Fewer than 4% of women reported cocaine or opiate use. Substance use was more common in the first trimester (25%) than the second (17%) and third (15%) (trend p-value <0.01), and was associated with race/ethnicity, education, birthplace, age and marital status. For 264 mother/infant pairs with meconium results, sensitivity of self-report was 86% for tobacco, 80% for marijuana and 67% for cocaine. Higher discordance between self-report and urine/blood toxicology was observed for cocaine, marijuana and opiates in a non-random subset of mothers/infants with these tests. Findings suggest reasonably complete self-reporting of substance use as confirmed by meconium analysis. Illicit substance use was low and substantially less than that reported in earlier studies of HIV-infected women, but alcohol and tobacco exposure was prevalent.     

Molecular characterization of <Emphasis Type="Italic">Histoplasma capsulatum</Emphasis> isolated from an outbreak in treasure hunters

Background  

In Mexico, primary pulmonary histoplasmosis is the most relevant clinical form of the disease. The geographical distribution of specific strains of Histoplasma capsulatum circulating in Mexico has not been fully established. Outbreaks must be reported in order to have current, updated information on this disease, identifying new endemic areas, manner of exposure to the fungi, and molecular characterization of the causative agents. We report a recent outbreak of histoplasmosis in treasure hunters and the molecular characterization of two isolates obtained from these patients.