RESUMEN
The relationship between blood pressure (BP) and kidney function among individuals with chronic kidney disease (CKD) remains controversial. This study evaluated the association between BP and estimated glomerular filtration rate (eGFR) decline among adults with nondiabetic stage 3 CKD. The Multi-Ethnic Study of Atherosclerosis participants with an eGFR 30-59 ml min(-1) per 1.73 m2 at baseline without diabetes were included. Participants were followed over a 5-year period. Kidney function change was determined by annualizing the change in eGFR using cystatin C, creatinine and a combined equation. Risk factors for progression of CKD (defined as a decrease in annualized eGFR>2.5 ml min(-1) per 1.73 m2) were identified using univariate analyses and sequential logistic regression models. There were 220 participants with stage 3 CKD at baseline using cystatin C, 483 participants using creatinine and 381 participants using the combined equation. The median (interquartile range) age of the sample was 74 (68-79) years. The incidence of progression of CKD was 16.8% using cystatin C and 8.9% using creatinine (P=0.002). Systolic BP>140 mm Hg or diastolic BP>90 mm Hg was significantly associated with progression using a cystatin C-based (odds ratio (OR), 2.49; 95% confidence interval (CI), 1.12-5.52) or the combined equation (OR, 2.07; 95% CI, 1.16-3.69), but not when using creatinine after adjustment for covariates. In conclusion, with the inclusion of cystatin C in the eGFR assessment hypertension was an important predictor of CKD progression in a multi-ethnic cohort with stage 3 CKD.
Asunto(s)
Presión Sanguínea , Hipertensión/fisiopatología , Riñón/fisiopatología , Insuficiencia Renal Crónica/fisiopatología , Negro o Afroamericano , Anciano , Anciano de 80 o más Años , Asiático , Biomarcadores/sangre , Distribución de Chi-Cuadrado , Creatinina/sangre , Cistatina C/sangre , Progresión de la Enfermedad , Femenino , Tasa de Filtración Glomerular , Hispánicos o Latinos , Humanos , Hipertensión/diagnóstico , Hipertensión/etnología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Modelos Biológicos , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Prevalencia , Pronóstico , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/etnología , Factores de Riesgo , Factores de Tiempo , Estados Unidos/epidemiología , Población BlancaRESUMEN
Apidaecins, short proline-arginine-rich peptides from insects, are highly bactericidal through a mechanism that includes stereoselective elements but is completely devoid of any pore-forming activity. The spectrum of antibacterial activity, always limited to Gram-negatives, is further dependent on a small number of variable residues and can be manipulated. We show here that mutations in the evolutionary conserved regions result in a more general loss of function, and we have used such analogs to probe molecular interactions in Escherichia coli. First, an assay was developed to measure selectively chiral association with cellular targets. By using this method, we find that apidaecin uptake is energy-driven and irreversible and yet can be partially competed by proline in a stereospecific fashion, results upholding a model of a permease/transporter-mediated mechanism. This putative transporter is not the end point of apidaecin action, for failure of certain peptide analogs to kill cells after entering indicates the existence of another downstream target. Tetracycline-induced loss of bactericidal activity and dose-dependent in vivo inhibition of translation by apidaecin point at components of the protein synthesis machinery as likely candidates. These findings provide new insights into the antibacterial mechanism of a unique group of peptides and perhaps, by extension, for distant mammalian relatives such as PR-39.
Asunto(s)
Péptidos Catiónicos Antimicrobianos , Escherichia coli/efectos de los fármacos , Péptidos/farmacología , Antibacterianos/farmacología , División Celular/efectos de los fármacos , Secuencia Conservada , Metabolismo Energético , Conformación Molecular , Péptidos/genética , Mutación Puntual , Prolina/farmacología , Biosíntesis de Proteínas/efectos de los fármacos , Inhibidores de la Síntesis de la Proteína/farmacología , Rhizobium/efectos de los fármacos , Sales (Química)/farmacología , Tetraciclinas/farmacologíaRESUMEN
A theoretical investigation of oblique plane-wave electromagnetic scattering in an active dielectric cylinder predicted the existence of anomalous resonances at discrete plane-wave angles of incidence. These resonances may be understood as being due to a leaky-wave phase-matching boundary condition. Experiments were performed with active dielectric cylinders to confirm the existence of discrete resonances. Cross coupling between TE and TM modes was clearly detected for both active and passive scattering. Enhancement of active scattered field intensities was observed in experiments with finite-diameter pump and probe laser beams. Optical pumping of a dye solution was used to provide the gain.
RESUMEN
A simple method is demonstrated to determine the diameters of dielectric spheres from 0.2 to 1.0 mm by observing the scattering of visible light. Theoretical calculations show that there is an approximately linear relationship between the size of the scattering sphere and the number of maxima and minima in the scattered field as a function of angle when the radius in the 200-1000-wavelength region.