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1.
J Microsc ; 279(3): 265-273, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32400899

RESUMEN

The image contrast of sheared needle-like ß ' ' precipitates in the Al-Mg-Si alloy system is investigated with respect to shear-plane positions, the number of shear-planes, and the active matrix slip systems through multislice transmission electron microscopy image simulations and the frozen phonon approximation. It is found that annular dark field scanning transmission electron microscopy (ADF STEM) images are mostly affected by shear-planes within a distance ∼6-18 unit cells from the specimen surface, whereas about 5-10 equidistant shear-planes are required to produce clear differences in HRTEM images. The contrast of the images is affected by the Burgers vector of the slip, but not the slip plane. The simulation results are discussed and compared to experimental data. LAY DESCRIPTION: Pure aluminium is too soft to be viable in most structural applications, but this may be remedied by alloying the metal with various elements. Adding small amounts of silicon and magnesium to pure aluminium allows small particles to precipitate during heat treatment. These precipitates resist plastic deformation and can increase the strength of the alloy and make it viable for a range of industrial applications, such as automotive door panels and load-bearing profiles. However, if subjected to large loads, the precipitates are sheared and the strength of the alloy changes dynamically. Designing safe products such as cars or buildings require physically based predictions on this dynamical change. Developing models that can provide such predictions depend in turn on experimental observations of the shearing process. Because the precipitates are nm long, experimental observations must be done by transmission electron microscopy. However, understanding these results sometimes require computer simulations of atomic models. In this work, we have performed image simulations of various models of sheared precipitates and compared the results with earlier experiments. The simulations indicate that certain conditions must be met for the sheared precipitates to appear different from unsheared precipitates. These conditions are most likely to be met if precipitates are sheared several times in a relatively homogeneous manner. This is important for two reasons. First, a localized shearing process would lead to large dynamical changes in precipitate strength during deformation, and in turn drastically reduce the work hardening of the alloy. Secondly, a localized shearing process would have promoted earlier fracture and failure of the alloy during deformation. Finally, our results also show how different slip directions influences the images of precipitates. In the future, these influences can be used to further understand the shearing process of these precipitates. Hence, our results can be used to improve model predictions of strength, work hardening, and fracture. In turn, this may improve alloy design and reduce the use of prototype testing in, e.g. the automotive industry.

2.
Allergy ; 73(3): 602-614, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-28960325

RESUMEN

BACKGROUND: Cross-sectional studies suggested that allergy prevalence in childhood is higher in boys compared to girls, but it remains unclear whether this inequality changes after puberty. We examined the sex-specific prevalence of asthma and rhinitis as single and as multimorbid diseases before and after puberty onset in longitudinal cohort data. METHODS: In six European population-based birth cohorts of MeDALL, we assessed the outcomes: current rhinitis, current asthma, current allergic multimorbidity (ie, concurrent asthma and rhinitis), puberty status and allergic sensitization by specific serum antibodies (immunoglobulin E) against aero-allergens. With generalized estimating equations, we analysed the effects of sex, age, puberty (yes/no) and possible confounders on the prevalence of asthma and rhinitis, and allergic multimorbidity in each cohort separately and performed individual participant data meta-analysis. FINDINGS: We included data from 19 013 participants from birth to age 14-20 years. Current rhinitis only affected girls less often than boys before and after puberty onset: adjusted odds ratio for females vs males 0.79 (95%-confidence interval 0.73-0.86) and 0.86 (0.79-0.94), respectively (sex-puberty interaction P = .089). Similarly, for current asthma only, females were less often affected than boys both before and after puberty onset: 0.71, 0.63-0.81 and 0.81, 0.64-1.02, respectively (sex-puberty interaction P = .327). The prevalence of allergic multimorbidity showed the strongest sex effect before puberty onset (female-male-OR 0.55, 0.46-0.64) and a considerable shift towards a sex-balanced prevalence after puberty onset (0.89, 0.74-1.04); sex-puberty interaction: P < .001. INTERPRETATION: The male predominance in prevalence before puberty and the "sex-shift" towards females after puberty onset were strongest in multimorbid patients who had asthma and rhinitis concurrently.


Asunto(s)
Asma/epidemiología , Pubertad/inmunología , Rinitis Alérgica/epidemiología , Caracteres Sexuales , Adolescente , Estudios de Cohortes , Comorbilidad , Femenino , Humanos , Masculino , Prevalencia , Maduración Sexual/inmunología , Adulto Joven
3.
J Vet Pharmacol Ther ; 41(2): 340-348, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29057479

RESUMEN

Ketoprofen is a nonsteroidal anti-inflammatory and analgesic agent that nonselectively inhibits cyclooxygenase, with both COX-1 and COX-2 inhibition. Recent studies on COX receptor expression in reptiles suggest that nonselective COX inhibitors may be more appropriate than more selective inhibitors in some reptiles, but few pharmacokinetic studies are available. The goal of this study was to determine single- and multidose (three consecutive days) pharmacokinetics of racemic ketoprofen administered intravenously and intramuscularly at 2 mg/kg in healthy juvenile loggerhead turtles (Caretta caretta). The S-isomer is the predominant isomer in loggerhead sea turtles, similar to most mammals, despite administration of a 50:50 racemic mixture. Multidose ketoprofen administration demonstrated no bioaccumulation; therefore, once-daily dosing will not require dose adjustment over time. S-isomer pharmacokinetic parameters determined in this study were Cmax of 10.1 µg/ml by IM injection, C0 of 13.4 µg/ml by IV injection, AUC of 44.7 or 69.4 µg*hr/ml by IM or IV injection, respectively, and T½ of 2.8 or 3.6 hr by IM or IV injection, respectively. Total ketoprofen plasma concentrations were maintained for at least 12 hr above concentrations determined to be effective for rats and humans. A dose of 2 mg/kg either IM or IV every 24 hr is likely appropriate for loggerhead turtles.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacocinética , Cetoprofeno/farmacocinética , Tortugas/metabolismo , Animales , Antiinflamatorios no Esteroideos/administración & dosificación , Esquema de Medicación/veterinaria , Femenino , Inyecciones Intramusculares/veterinaria , Inyecciones Intravenosas/veterinaria , Cetoprofeno/administración & dosificación
4.
J Fish Dis ; 39(3): 277-83, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25864868

RESUMEN

Monogenean parasite infestations are common in captive marine teleosts, and are generally found on the skin and gills. This report describes an unusual pathological presentation of exuberant granulation tissue of the gills, suspected to be related to Neobenedenia infestation in two cobia housed together at a North Carolina aquarium.


Asunto(s)
Animales de Zoológico/parasitología , Enfermedades de los Peces/parasitología , Tejido de Granulación/parasitología , Trematodos/fisiología , Infecciones por Trematodos/veterinaria , Animales , Branquias/parasitología , Perciformes/parasitología , Infecciones por Trematodos/parasitología
5.
Diabetes Obes Metab ; 17(8): 742-50, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25855340

RESUMEN

AIMS: To investigate the effect of glucagon-like peptide 1 receptor agonist liraglutide on the counter-regulatory hormone response to hypoglycaemia in type 1 diabetes. METHODS: We conducted a randomized, double-blind, placebo-controlled, single-centre trial, in which a total of 45 adults with type 1 diabetes [mean ± standard deviation age 34.5 ± 11.2 years, BMI 23.9 ± 2.4 kg/m(2) , glycated haemoglobin (HbA1c) 7.6 ± 0.8%, diabetes duration 16.6 ± 9.4 years] underwent a hypoglycaemic clamp after 4 weeks' crossover treatment with once-daily liraglutide/placebo added to insulin in one of three liraglutide dose groups: 0.6 mg (n = 15); 1.2 mg (n = 14); and 1.8 mg (n = 16). The main outcome measure was glucagon concentration at nadir plasma glucose (2.5 mmol/l). Clinical outcomes were also evaluated. Five participants were withdrawn from the trial; three because of adverse events. All participants were included in the analysis. RESULTS: Glucagon concentration at nadir plasma glucose was modest, trending towards lower concentrations at increasing liraglutide dose versus placebo: 34.7 versus 38.1 pg/ml, p = 0.555 (0.6 mg); 28.8 versus 37.2 pg/ml, p = 0.126 (1.2 mg); and 28.4 versus 37.5 pg/ml, p = 0.092 (1.8 mg). There was no difference, however, between liraglutide and placebo in incremental change in glucagon during hypoglycaemia. Other counter-regulatory hormone levels increased during hypoglycaemia with no systematic differences between groups. Glucose infusion rates were significantly lower with liraglutide versus placebo during the clamp. After 4 weeks' treatment, HbA1c remained unchanged in the liraglutide and placebo groups. Greater reductions in insulin dose and body weight were seen with liraglutide versus placebo. CONCLUSIONS: Liraglutide did not compromise hypoglycaemic responses in type 1 diabetes after 4 weeks' treatment.


Asunto(s)
Diabetes Mellitus Tipo 1/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Liraglutida/uso terapéutico , Adulto , Peso Corporal , Estudios Cruzados , Diabetes Mellitus Tipo 1/sangre , Método Doble Ciego , Quimioterapia Combinada/métodos , Femenino , Glucagón/metabolismo , Péptido 1 Similar al Glucagón/uso terapéutico , Glucosa/administración & dosificación , Técnica de Clampeo de la Glucosa , Hemoglobina Glucada/efectos de los fármacos , Hemoglobina Glucada/metabolismo , Humanos , Hipoglucemia/tratamiento farmacológico , Hipoglucemia/metabolismo , Masculino , Persona de Mediana Edad
6.
Vet Pathol ; 52(4): 712-5, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25239052

RESUMEN

Leatherback sea turtles are globally distributed and endangered throughout their range. There are limited data available on disease in this species. Initial observations of solitary large intestinal diverticulitis in multiple leatherbacks led to a multi-institutional review of cases. Of 31 subadult and adult turtles for which complete records were available, all had a single exudate-filled diverticulum, as large as 9.0 cm in diameter, arising from the large intestine immediately distal to the ileocecal junction. All lesions were chronic and characterized by ongoing inflammation, numerous intralesional bacteria, marked attenuation of the muscularis, ulceration, and secondary mucosal changes. In three cases, Morganella morganii was isolated from lesions. Diverticulitis was unrelated to the cause of death in all cases, although risk of perforation and other complications are possible.


Asunto(s)
Diverticulitis/veterinaria , Divertículo/veterinaria , Enfermedades Intestinales/veterinaria , Tortugas , Animales , Diverticulitis/patología , Especies en Peligro de Extinción , Femenino , Enfermedades Intestinales/patología , Masculino
7.
Br J Anaesth ; 112(1): 79-88, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24009267

RESUMEN

BACKGROUND: The association between preoperative blood glucose (BG) concentration and outcomes after non-cardiac surgery and the impact of the diabetes diagnosis status remain unclear. We tested two hypotheses: that preoperative BG is related to surgical outcomes; and that this relationship depends on the diabetes diagnosis status of the patient. METHODS: We retrospectively analysed data on 61 536 consecutive elective non-cardiac surgery patients treated at our tertiary care facility. Logistic regression models were used to test the hypotheses before and after adjustment for baseline patient characteristics. Our primary outcome was a composite of in-hospital serious complications and mortality. A second primary outcome was 1 yr mortality. RESULTS: The crude incidence of the composite in-hospital outcome was significantly related to preoperative BG (P<0.001), but not after covariable adjustment (P=0.40). This relationship did not significantly differ between patients with and without diagnosed diabetes (P=0.09). One year mortality was significantly related to preoperative BG, both univariably (P<0.001) and after covariable-adjustment (P<0.001). Patients with diagnosed diabetes and preoperative euglycaemia generally had worse 1 yr mortality than those without diabetes at the same BG {e.g. odds ratio (OR) [95% confidence interval (CI)] of 1.27 (1.06, 1.53) at 6 mmol litre(-1) (108 mg dl(-1)), P=0.003}. Conversely, hyperglycaemic patients with diagnosed diabetes displayed a significantly lower 1 yr mortality than hyperglycaemic patients without diabetes [OR (95% CI) of 0.58 (0.44, 0.77) at 12 mmol litre(-1) (216 mg dl(-1)), P<0.001]. CONCLUSIONS: For elective non-cardiac surgery, preoperative hyperglycaemia should be given greater consideration in patients without diabetes than in those with diagnosed diabetes.


Asunto(s)
Glucemia/análisis , Procedimientos Quirúrgicos Electivos/mortalidad , Complicaciones Posoperatorias/epidemiología , Cuidados Preoperatorios , Diabetes Mellitus/sangre , Diabetes Mellitus/mortalidad , Procedimientos Quirúrgicos Electivos/efectos adversos , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Modelos Logísticos , Estudios Retrospectivos , Resultado del Tratamiento
8.
Scand J Med Sci Sports ; 24(2): 447-53, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22882175

RESUMEN

Exercise addiction is characterized by excessive exercise behavior with potential negative consequences. The symptoms consist of salience, mood modification, tolerance, withdrawal symptoms, conflicts, and relapse. The purpose of this study was to test the psychometric properties of the exercise addiction inventory (EAI) and to estimate the prevalence of exercise addiction in a Danish normal weight sport population. A sample of 780 habitual fitness and football exercisers were contacted and 590 completed the EAI and an in-house questionnaire containing questions about variables related to exercise addiction: (a) exercise frequency; (b) continuance despite injuries; and (c) personal perception of addiction. The results demonstrated an overall prevalence of exercise addiction of 5.8%. There was no significant difference between fitness and football prevalences. The internal reliability of EAI was acceptable with a Cronbach's α of 0.66. The criterion validity was tested toward the three variables related to exercise addiction. The dependent group had significantly higher scores on the three variables than the non-dependent group. Exercise addiction seems to exist in both fitness and football. The EAI is a useful screening tool and might be applicable in future screening and prevention of exercise addiction. However, further investigation about the population is needed to understand the phenomenon and to identify the risk group.


Asunto(s)
Conducta Adictiva/psicología , Ejercicio Físico/psicología , Aptitud Física/psicología , Escalas de Valoración Psiquiátrica , Adolescente , Adulto , Anciano , Conducta Adictiva/epidemiología , Dinamarca/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Psicometría , Fútbol/psicología , Adulto Joven
9.
Int J Cardiol ; 405: 131865, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38365013

RESUMEN

BACKGROUND: Finding patients with chronic coronary syndromes (CCS) whom revascularization could benefit, is complicated. Myocardial flow reserve (MFR), a measurement of myocardial perfusion, has proven prognostic value on survival and risk of major adverse cardiac events (MACE). We investigated if MFR identifies who may benefit from revascularization. METHODS: Among 7462 patients from Danish hospitals examined with 82Rb PET between January 2018 and August 2020, patients with ≥5% reversible perfusion defects were followed for MACE and all-cause mortality. Associations between revascularisation (within 90 days) and outcomes according to MFR (< and ≥ 2) was assessed by Cox regression adjusted by inverse probability weighting for demographics, cardiovascular risk factors, comorbidities, and 82Rb PET variables. RESULTS: Of 1806 patients with ≥5% reversible perfusion defect, 893 (49%) had MFR < 2 and 491 underwent revascularisation (36.6% in MFR < 2 versus 17.9% MFR ≥ 2, p < 0.001). During a median follow-up of 37.0 [31.0-45.8 IQR] months, 251 experienced a MACE and 173 died. Revascularisation was associated with lower adjusted risk of all-cause mortality (hazard ratio [HR], 0.51 [95% CI, 0.30-0.88], p = 0.015) and MACE (HR, 0.54 [0.33-0.87], p = 0.012) in patients with MFR < 2 but not MFR ≥ 2 for all-cause mortality (HR 1.33 [0.52-3.40], p = 0.542) and MACE (HR 1.50 [0.79-2.84], p = 0.211). MFR significantly modified the association between revascularisation and MACE, but not all-cause mortality (interaction p-value 0.021 and 0.094, respectively). CONCLUSIONS: Revascularization was associated with improved prognosis among patients with impaired MFR. No association was seen in patients with normal MFR. In patients with regional ischemia, MFR may identify patients with a prognostic benefit from revascularization.


Asunto(s)
Reserva del Flujo Fraccional Miocárdico , Revascularización Miocárdica , Tomografía de Emisión de Positrones , Sistema de Registros , Radioisótopos de Rubidio , Humanos , Masculino , Femenino , Anciano , Revascularización Miocárdica/métodos , Revascularización Miocárdica/estadística & datos numéricos , Persona de Mediana Edad , Tomografía de Emisión de Positrones/métodos , Reserva del Flujo Fraccional Miocárdico/fisiología , Dinamarca/epidemiología , Estudios de Seguimiento , Resultado del Tratamiento , Enfermedad de la Arteria Coronaria/cirugía , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/fisiopatología , Enfermedad de la Arteria Coronaria/mortalidad
10.
Psychol Med ; 41(2): 313-9, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20406526

RESUMEN

BACKGROUND: There is a lack of specific knowledge about the dose-response effect of multiple parental risk factors for suicide attempts among children and adolescents. The aim of this study was to determine the dose-response effect of multiple parental risk factors on an offspring's risk for suicide attempt. METHOD: We designed a population-based two-generation nested case-control study and used Danish register data. A population of 403 431 individuals born between 1983 and 1989 was sampled. Among these, 3465 (0.8%) were registered as having had a suicide attempt. Twenty controls were matched to each case and a link to the offspring's biological parents was established. RESULTS: There was a dose-response relationship between the number of exposures and the risk of suicide attempts, with the increased risk seeming to be a multiplicative effect. Parental suicide, suicide attempt, psychiatric illness and low level of income were all significant independent risk factors for offspring's suicide attempts. CONCLUSIONS: Knowledge of the effect of multiple risk factors on the likelihood of suicide attempts in children and adolescents is important for risk assessment. Dose-response effects of multiple parental risk factors are multiplicative, but it is rare for children and adolescents to be exposed to multiple parental risk factors simultaneously. Nevertheless, they should be considered along with the offspring's own multiple risk factors in determining the overall risk of a suicide attempt. Further research incorporating both parental and offspring's risk factors is indicated to determine the overall dose-response effect of multiple risk factors.


Asunto(s)
Depresión/epidemiología , Salud de la Familia , Inteligencia , Intento de Suicidio/psicología , Adolescente , Niño , Inglaterra/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Análisis Multivariante , Padres , Distribución de Poisson , Pubertad/psicología , Análisis de Regresión , Factores de Riesgo
11.
Catheter Cardiovasc Interv ; 74(5): 710-7, 2009 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-19496145

RESUMEN

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) that associates with a high acute-phase mortality rate, whereas long-term outcome is less well described. OBJECTIVE: To describe the incidence, predictors, and prognosis of SCAD. DESIGN: Retrospective case-identification study from the Western Denmark Heart Registry and the database of the Forensic Institute at Aarhus University from 1999 through 2007. RESULTS: SCAD was documented in 22 of 32,869 (0.7 per thousand) angiograms in the angiographic registry. The SCAD incidence among cases of ACS was 22 of 11,175 (2.0 per thousand). None was seen in the forensic database. The mean age was 48.7 +/- 8.9 years (range: 37-71 years). Females constituted 17 of 22 (77%) patients and all had undergone one or more pregnancies; two cases occurred in the postpartum period. The left descending artery (LAD) was the predominant site of entry. The age distribution, prevalence of the cardiovascular risk factors, presence of coronary atherosclerosis, and entry of the dissection were comparable among genders. Treatment was percutaneous coronary intervention in 13 of 22 (59%), coronary artery bypass operation in 2 of 22 (9%), and medical treatment in 7 of 22 (32%) patients. The mean follow-up period was 3.6 +/- 2.9 years. One patient suffered from recurrent SCAD; another patient died suddenly. The MACE- (cardiac death, nonfatal myocardial infarction, and new revascularization) free survival was 81% after 24 months. CONCLUSION: SCAD is a rare disease that mainly affects younger women. Compared with earlier reports, the prognosis seems to be improved by early diagnosis and interventional treatment.


Asunto(s)
Síndrome Coronario Agudo/epidemiología , Disección Aórtica/epidemiología , Aneurisma Coronario/epidemiología , Síndrome Coronario Agudo/etiología , Síndrome Coronario Agudo/mortalidad , Síndrome Coronario Agudo/terapia , Adulto , Factores de Edad , Anciano , Disección Aórtica/complicaciones , Disección Aórtica/diagnóstico , Disección Aórtica/mortalidad , Disección Aórtica/terapia , Angioplastia Coronaria con Balón , Fármacos Cardiovasculares/uso terapéutico , Aneurisma Coronario/complicaciones , Aneurisma Coronario/diagnóstico , Aneurisma Coronario/mortalidad , Aneurisma Coronario/terapia , Angiografía Coronaria , Puente de Arteria Coronaria , Dinamarca/epidemiología , Supervivencia sin Enfermedad , Femenino , Humanos , Incidencia , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Recurrencia , Sistema de Registros , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía Intervencional
12.
J Med Ethics ; 35(7): 424-8, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19567691

RESUMEN

Patient self-management of disease is increasingly supported by technologies that can monitor a wide range of behavioural and biomedical parameters. Incorporated into everyday devices such as cell phones and clothes, these technologies become integral to the psychosocial aspects of everyday life. Many technologies are likely to be marketed directly to families with ill members, and families may enlist the support of clinicians in shaping use. Current ethical frameworks are mainly conceptualised from the perspective of caregivers, researchers, developers and regulators in order to ensure the ethics of their own practices. This paper focuses on families as autonomous decision-makers outside the regulated context of healthcare. We discuss some morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones. An example - remote parental monitoring of adolescent blood glucose - is presented and discussed through the lens of two contrasting accounts of ethics; one reflecting the predominant focus on health outcomes within the health technology assessment (HTA) framework and the other that attends to the broader sociocultural contexts shaping technologies and their implications. Issues discussed include the focus of assessments, informed consent and child assent, and family co-creation of system characteristics and implications. The parents' decisions to remotely monitor their child has relational implications that are likely to influence conflict levels and thus also health outcomes. Current efforts to better integrate outcome assessments with social and ethical assessments are particularly relevant for informed decision-making about health monitoring technologies in families.


Asunto(s)
Cuidadores/psicología , Diabetes Mellitus Tipo 1/psicología , Conductas Relacionadas con la Salud , Monitoreo Ambulatorio/métodos , Aceptación de la Atención de Salud/psicología , Adolescente , Adulto , Factores de Edad , Glucemia/análisis , Automonitorización de la Glucosa Sanguínea , Niño , Diabetes Mellitus Tipo 1/sangre , Femenino , Humanos , Masculino , Monitoreo Ambulatorio/psicología , Principios Morales , Relaciones Padres-Hijo , Calidad de Vida/psicología , Autocuidado , Adulto Joven
13.
Int J Cardiovasc Imaging ; 35(9): 1709-1720, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31016502

RESUMEN

We aimed to identify factors influencing the sensitivity of perfusion imaging after an initial positive coronary computed tomography angiography (CCTA) using invasive coronary angiography (ICA) with conditional fractional flow reserve (FFR) as reference. Secondly we aimed to identify factors associated with revascularisation and to evaluate treatment outcome after ICA. We analysed 292 consecutive patients with suspected significant coronary artery disease (CAD) at CCTA, who underwent perfusion imaging with either cardiac magnetic resonance (CMR) or myocardial perfusion scintigraphy (MPS) followed by ICA with conditional FFR. Stratified analysis and uni- and multiple logistic regression analyses were performed to identify predictors of diagnostic agreement between perfusion scans and ICA and predictors of revascularisation. Myocardial ischemia evaluated with perfusion scans was present in 65/292 (22%) while 117/292 (40%) had obstructive CAD evaluated by ICA. Revascularisation rate was 90/292 (31%). The overall sensitivity for perfusion scans was 39% (30-48), specificity 89% (83-93), PPV 69% (57-80) and NPV 68% (62-74). Stratified analysis showed higher sensitivities in patients with multi-vessel disease at CCTA 49% (37-60) and typical chest pain 50% (37-60). Predictors of revascularisation were multi-vessel disease by CCTA (OR 3.51 [1.91-6.48]) and a positive perfusion scan (OR 4.69 [2.49-8.83]). The sensitivity for perfusion scans after CCTA was highest in patients with typical angina and multiple lesions at CCTA and predicted diagnostic agreement between perfusion scans and ICA. Abnormal perfusion and multi vessel disease at CCTA predicted revascularisation.


Asunto(s)
Angiografía por Tomografía Computarizada , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Vasos Coronarios/diagnóstico por imagen , Reserva del Flujo Fraccional Miocárdico , Imagen por Resonancia Magnética , Imagen de Perfusión Miocárdica/métodos , Cintigrafía/métodos , Anciano , Enfermedad de la Arteria Coronaria/fisiopatología , Enfermedad de la Arteria Coronaria/cirugía , Vasos Coronarios/fisiopatología , Vasos Coronarios/cirugía , Dinamarca , Femenino , Humanos , Masculino , Persona de Mediana Edad , Revascularización Miocárdica , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
14.
J Child Psychol Psychiatry ; 49(5): 553-62, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18341552

RESUMEN

BACKGROUND: Epidemiological studies of mental health problems in the first years of life are few. This study aims to investigate infancy predictors of psychopathology in the second year of life. METHODS: A random general population sample of 210 children from the Copenhagen Child Birth Cohort CCC 2000 was investigated by data from National Danish registers and data collected prospectively from birth in a general child health surveillance programme. Mental health outcome at 1(1/2) years was assessed by clinical and standardised measures including the Child Behavior Check List 1(1/2)-5 (CBCL 1(1/2)-5), Infant Toddler Symptom Check List (ITSCL), Checklist for Autism in Toddlers (CHAT), Bayley Scales of Infant Development (BSID II), Mannheim Eltern Interview (MEI), Parent Child Early Relational Assessment (PC ERA) and Parent Infant Relationship Global Assessment Scale (PIR-GAS), and disordered children were diagnosed according to the International Classification of Diseases (ICD-10) and Diagnostic Classification Zero to Three (DC: 0-3). RESULTS: Deviant language development in the first 10 months of life predicted the child having any disorder at 1(1/2) years, OR 3.3 (1.4-8.0). Neuro-developmental disorders were predicted by deviant neuro-cognitive functioning, OR 6.8 (2.2-21.4), deviant language development, OR 5.9 (1.9-18.7) and impaired social interaction and communication, OR 3.8 (1.3-11.4). Unwanted pregnancy and parents' negative expectations of the child recorded in the first months of the child's life were significant predictors of relationship disturbances at 1(1/2) years. CONCLUSIONS: Predictors of neuro-developmental disorders and parent-child relationship disturbances can be identified in the first 10 months of life in children from the general population.


Asunto(s)
Encéfalo/fisiopatología , Trastornos de la Conducta Infantil/epidemiología , Trastornos de la Conducta Infantil/fisiopatología , Discapacidades del Desarrollo/epidemiología , Discapacidades del Desarrollo/fisiopatología , Trastornos de la Conducta Infantil/diagnóstico , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/epidemiología , Discapacidades del Desarrollo/diagnóstico , Femenino , Humanos , Lactante , Recién Nacido , Relaciones Madre-Hijo , Pruebas Neuropsicológicas , Relaciones Padres-Hijo , Vigilancia de la Población/métodos , Embarazo , Embarazo no Deseado , Sistema de Registros , Encuestas y Cuestionarios
15.
Eur Heart J Cardiovasc Imaging ; 19(4): 369-377, 2018 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-29447342

RESUMEN

Aims: Perfusion scans after coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) may reduce unnecessary invasive coronary angiographies (ICAs). However, the diagnostic accuracy of perfusion scans after primary CCTA is unknown. The aim of this study was to determine the diagnostic accuracy of cardiac magnetic resonance (CMR) and myocardial perfusion scintigraphy (MPS) against ICA with fractional flow reserve (FFR) in patients suspected of CAD by CCTA. Methods and results: Included were consecutive patients (1675) referred to CCTA with symptoms of CAD and low/intermediate risk profile. Patients with suspected CAD based on CCTA were randomized 1:1 to CMR or MPS followed by ICA with FFR. Obstructive CAD was defined as FFR ≤ 0.80 or > 90% diameter stenosis by visual assessment. After initial CCTA, 392 patients (23%) were randomized; 197 to CMR and 195 to MPS. Perfusion scans and ICA were completed in 292 patients (CMR 148, MPS 144). Based on the ICA, 117/292 (40%) patients were classified with CAD. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for CMR were 41%, 95% CI [28-54], 84% [75-91], 62% [45-78], and 68% [58-76], respectively. For the MPS group 36% [24-50], 94% [87-98], 81% [61-93], and 68% [59-76], respectively. Conclusion: Patients with low/intermediate CAD risk and a positive CCTA scan represent a challenge to perfusion techniques indicated by the low sensitivity of both CMR and MPS with FFR as a reference. The mechanisms underlying this discrepancy need further investigation.


Asunto(s)
Angiografía por Tomografía Computarizada/métodos , Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Imagen por Resonancia Cinemagnética/métodos , Imagen de Perfusión Miocárdica/métodos , Anciano , Enfermedad de la Arteria Coronaria/fisiopatología , Femenino , Reserva del Flujo Fraccional Miocárdico/fisiología , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad
16.
Phys Med Biol ; 62(24): 9240-9259, 2017 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-29058682

RESUMEN

A formalism has been proposed for small and non-standard photon fields in which [Formula: see text] correction factors are used to correct dosimeter response in small fields (indiviual or composite) relative to that in a larger machine-specific reference (MSR) field. For clinical plans consisting of several fields, a plan-class specific reference (PCSR) plan can also be defined, serving as an intermediate calibration field between the MSR and clinical plans within a certain plan-class. In this work, the formalism was applied in the calculation of [Formula: see text] for 21 clinical plans delivered by the [Formula: see text] radiosurgery system, each plan employing one or two of the smallest diameter collimators: 5 mm, 7.5 mm, and 10 mm. Three detectors were considered: the Exradin A16 and A26 micro chambers, and the W1 plastic scintillator. The clinical plans were grouped into 7 plan-classes according to commonly shared characteristics. The suitability of using a PCSR plan to represent the detector response of each plan within the plan-class was investigated. Total and intermediate correction factors were calculated using the [Formula: see text] Monte Carlo user code. The corrections for the micro chambers were large, primarily due to the presence of the low-density air cavity and the volume averaging effect. The correction for the scintillator was found to be close to unity for most plans, indicating that this detector may be used to measure small clinical plan correction factors in any plan except for those using the 5 mm collimator. The PCSR plan was shown to be applicable to plan-classes comprising isocentric plans only, with plan-classes divided according to collimator size. For non-isocentric plans, the variation of [Formula: see text] as a function of the point of measurement within a single plan, as well as the high inter-plan-class variability of the correction factor, precludes the use of a PCSR plan.


Asunto(s)
Radiocirugia/métodos , Planificación de la Radioterapia Asistida por Computador/métodos , Calibración , Humanos , Método de Montecarlo , Fotones/uso terapéutico , Radiometría
17.
Biochim Biophys Acta ; 502(1): 17-28, 1978 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-638140

RESUMEN

1. Conditions for the optimal coupled oxidation by rat liver mitochondria of long-chain free fatty acids were defined. The fatty acids studied were in the omega9 series: oleic (18 : 1), gondoic (20 : 1) and erucic (22 : 1) acids. Carnitine (about 0.1 mM) maximally stimulated State 3 respiration due to oleic and gondoic acids about three-fold (coenzyme A present), and coenzyme A (10--20 micrometer) stimulated about two-fold (carnitine present). When neither coenzyme A nor carnitine was added, respiration was very slow. 2. When respiration was limited by ADP, concentrations of added CoA only slightly in excess of that required for fatty acid oxidation very significantly decreased the ATP/ADP ratio maintained at a given rate of respiration imposed by externally added ATPase, and increased the level of membrane-associated acyl-CoA. This effect was most pronounced with oleic acid, and least with erucic acid. When excess ADP was present, higher concentrations of added coenzyme A (50--200 micrometer) inhibited to oxidation of oleic acid in a concentration-dependent manner, whereas the oxidation of substrates other than fatty acids was essentially unaffected. 3. It is concluded that, in addition to its requirement for fatty acid oxidation, coenzyme A exerts two independent effects on mitochondrial metabolism as here determined in vitro: (a) under conditions mimicking those in the intact cell with respect to phosphorylation-dependent respiration (ADP limiting), acyl-CoA formed from added coenzyme A and fatty acid inhibits the adenine nucleotide translocase, resulting in a lowering in the extramitochondrial ATP/ADP ratio obtained at any given rate of phosphorylation-limited respiration, and (b) under State 3 conditions (ADP in excess) coenzyme A ( less than 50--200 micrometer) specifically suppresses oxidation of long-chain fatty acids by limiting the rate of formation of intramitochondrial acyl-CoA.


Asunto(s)
Nucleótidos de Adenina/metabolismo , Carnitina/farmacología , Coenzima A/farmacología , Ácidos Grasos no Esterificados/metabolismo , Mitocondrias Hepáticas/metabolismo , Acilcoenzima A/biosíntesis , Adenosina Difosfato/metabolismo , Adenosina Trifosfato/metabolismo , Animales , Cinética , Masculino , Mitocondrias Hepáticas/efectos de los fármacos , Oxidación-Reducción/efectos de los fármacos , Ratas
18.
Biochim Biophys Acta ; 573(3): 417-29, 1979 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-465511

RESUMEN

1. The metabolism of palmitate and especially of erucate was studied in hepatocytes isolated from rats fed for 3 weeks a diet containing peanut oil (diet, 1), rapeseed oil (diet 2) and partially hydrogenated marine oil (diet 3). 2. The metabolism of palmitate was not significantly influenced by the diet. The rapeseed oil diet caused 1.4 fold and 1.3 fold increase and marine oil diet 3 fold and 2.2 fold increase in the oxidation and chain-shortening respectively of [14-14C]erucic acid in isolated hepatocytes. 3. Cyanide and antimycin A did not inhibit the chain-shortening of erucate in liver cells of rats fed rapeseed oil and peanut oil. The high capacity of the chain-shortening system in hepatocytes of marine oil-fed rats was partially inhibited. 4. Inhibition of the transfer of fatty acids into the mitochondria by lowering the intracellular carnitine concentration and/or by addition of (+)-decanoyl-carnitine resulted in a very pronounced apparent stimulation of the chain-shortening of erucic acid. It is suggested that the chain-shortening system may be virtually independent of the mitochondria, unless the availability of the extramitochondria NAD+ and/or NADP+ is rate-limiting under conditions of extremely low redox potential of the mitochondria. 5. Feeding marine oil or rapeseed oil to the rats induced a 30% increase in catalase activity, a 25--30% increase in urate oxidase activity and a 50% increase in the total CoA in the liver compared to rats fed peanut oil. 6. It is suggested that the increased metabolism of erucate in hepatocytes of marine oil and rapeseed oil-fed rats may be due to the increase in ther peroxisomal beta-oxidation.


Asunto(s)
Ácidos Erucicos/metabolismo , Ácidos Grasos Insaturados/metabolismo , Hígado/metabolismo , Aceites/farmacología , Animales , Arachis , Brassica , Carnitina/metabolismo , Catalasa/metabolismo , Coenzima A/metabolismo , Dieta , Hígado/efectos de los fármacos , Masculino , Microcuerpos/enzimología , Oxidación-Reducción/efectos de los fármacos , Palmitatos/metabolismo , Ratas , Urato Oxidasa/metabolismo
19.
Biochim Biophys Acta ; 881(1): 87-92, 1986 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-3947675

RESUMEN

Feeding male rats a high cal% partially hydrogenated fish oil diet induced morphological and biochemical changes in hepatocytes at the mitochondrial and peroxisomal level. At the mitochondrial level, formation of megamitochondria was related to the development of an essential fatty acid deficiency, as measured by a high 20:3/20:4 fatty acid ratio. These mitochondrial changes were fully prevented by adding linoleic acid to the partially hydrogenated fish oil diet. The megamitochondria revealed a normal specific content of respiratory chain pigments, normal specific respiratory rates and a normal energy coupling. At the peroxisomal level, feeding of the partially hydrogenated fish oil diet caused a considerable proliferation, which was unrelated to essential fatty acid deficiency. The total number of peroxisomes increased 1.9-fold, and 2.6-fold in the presence of added linoleic acid. Essential fatty acid deficiency seemed to result in an inhibition of peroxisomal biogenesis. It was concluded that the induction of megamitochondria by partially hydrogenated fish oil was fully attributable to essential fatty acid deficiency, whereas peroxisomal proliferation must be attributed to other factors in the diet.


Asunto(s)
Ácidos Grasos Esenciales/deficiencia , Aceites de Pescado/farmacología , Hígado/efectos de los fármacos , Microcuerpos/efectos de los fármacos , Mitocondrias Hepáticas/efectos de los fármacos , Animales , Ácido Linoleico , Ácidos Linoleicos/farmacología , Hígado/metabolismo , Hígado/ultraestructura , Masculino , Microcuerpos/ultraestructura , Mitocondrias Hepáticas/ultraestructura , Oxidación-Reducción/efectos de los fármacos , Consumo de Oxígeno/efectos de los fármacos , Ratas , Ratas Endogámicas
20.
Biochim Biophys Acta ; 753(3): 460-6, 1983 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-6615876

RESUMEN

In male rats fed a 30 cal% high-erucic acid (22:1 (13) (cis] rapeseed oil diet for 4 weeks a transient, small increase in peroxisomal beta-oxidation was observed in liver homogenates and isolated peroxisomes after approximately 1 week. Morphometric analysis revealed a progressive decrease in the average size of the liver peroxisomes (by approx. 20%), as well as their volume fraction (by more than 40%). A negative dose-response was observed when peroxisomal beta-oxidation was determined in animals fed rapeseed oil diets with a variable content of erucic acid. When erucic acid was given as subcutaneous injections the peroxisomal beta-oxidation decreased, in both liver homogenates and isolated peroxisomes. In contrast to recent proposals, our findings indicate that the amount of erucic acid cannot account for the small increase in peroxisomal beta-oxidation observed in the liver of rats adapted to a diet containing 30 cal% rapeseed oil with a high content of this fatty acid. In fact, by the selected criteria erucic acid seems to have a negative modulating effect on both the peroxisomal beta-oxidation enzyme system and biogenesis.


Asunto(s)
3-Hidroxiacil-CoA Deshidrogenasas , Enoil-CoA Hidratasa , Ácidos Erucicos/farmacología , Ácidos Grasos Insaturados/farmacología , Hígado/enzimología , Microcuerpos/enzimología , Oxidación-Reducción/efectos de los fármacos , Aceites de Plantas , Adaptación Biológica , Animales , Fenómenos Químicos , Química , Ácidos Grasos Monoinsaturados , Hígado/efectos de los fármacos , Hígado/ultraestructura , Masculino , Microcuerpos/efectos de los fármacos , Complejos Multienzimáticos/antagonistas & inhibidores , Aceites , Oxidorreductasas/antagonistas & inhibidores , Aceite de Brassica napus , Ratas , Ratas Endogámicas
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