Gender differences in variables related to B-natriuretic peptide, left ventricular ejection fraction and mass, and peak oxygen consumption, in patients with heart failure.

AIM AND METHODS: We assessed gender differences in variables related to B-natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), peak oxygen consumption (peak-VO2), and LV mass (LVM), among patients recently hospitalized for suspected heart failure (HF). RESULTS: Of 930 consecutive patients, 409 accepted follow-up after discharge, 221 of these had definite HF (90 women, mean age 74.5 [9.8]years). In 141 HF patients (61 women) with BNP data, women had lower BNP than men (43.9 [38.1] versus 76.3 [88.9]pmol/L, P=0.0193). LVEF (all HF patients) was higher in women (49.8 [13.4] versus 42.4 [13.9]%, P=0.0004). Peak-VO2 (147 HF patients, 48 women) was lower in women (13.9 [4.3] versus 16.3 [4.2]mL/kg/min, P=0.0093). LVM index (200 HF patients, 78 women) was lower in women (130.4 [46.5] versus 171.7 [57.6]g/m(2), P<0.0001). Among HF patients, variables independently related to BNP were body mass index (BMI) and peak-VO2 exclusively among men, mitral regurgitation, respiratory disease and angiotensin receptor blocker treatment only among women. Variables independently related to LVEF were resting heart rate, acetylic salicylic acid use and BNP exclusively among men. No variable was exclusive for women. Variables independently related to peak-VO2 were right ventricular size, BNP, resting and peak heart rate solely among men, BMI and stable angina pectoris exclusively among women. Variables independently related to LVM were left atrial diameter only among men, BMI exclusively among women. CONCLUSION: Among elderly HF patients, there were some important gender differences in BNP, LVEF, peak-VO2 and LVM, and in variables independently related to these factors.

Gender aspects on heart failure incidence and mortality in a middle-aged, urban, community-based population sample: the Malmö preventive project.

UNLABELLED: There is little epidemiological data on heart failure (HF) in the younger age groups dominating clinical HF trials. We assessed gender-specific long-term HF incidence and mortality in an urban community-based sample of middle-aged subjects. Between 1974 and 1992, 33,342 HF-free subjects (10,900 [32.7%] women, mean age 45.7 +/- 7.4 years) were included in the Malmö Preventive Project, on average 21.7 +/- 4.3 years before study end. Patients hospitalised for or dying of HF were categorised as HF patients, and 120 (1.1%) women versus 644 (2.9%) men experienced HF: 6.0 vs. 12.3 cases per 10,000 person years; hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.50-0.74, P < 0.0001. Among all subjects, women compared with men had lower all-cause (49.3 vs. 84.0 cases per 10,000 person years; HR 0.68, 95% CI 0.64-0.73, P < 0.0001) and HF-related (2.6 vs. 7.4 cases per 10,000 person years; HR 0.50, 95% CI 0.37-0.67, P < 0.0001) mortality risk. Female and male HF patients had similar age-adjusted mortality risk: 1,314 vs. 1,602 cases per 10,000 patient years; HR 0.78, 95% CI 0.58-1.07, P = 0.12. Among HF patients, 55.3% of deaths in women and 40.6% in men were non-cardiovascular, and only 7.9% deaths were due to HF. IN CONCLUSION: In a middle-aged, urban, community-based sample, women had lower risk of HF, all-cause death and HF-related death over two decades of follow-up. Female and male HF patients had similar mortality risk after the diagnosis of HF. In these comparatively young HF patients, few deaths were due to HF and more than 4 out of 10 deaths were non-cardiovascular.

Gender aspects on survival among patients admitted to hospital with suspected or diagnosed heart failure.

OBJECTIVES AND DESIGN: There are conflicting data on gender differences in survival among heart failure (HF) patients. We prospectively assessed gender differences in survival among 930 consecutive patients (464 [49.9%] women, mean age 76.1+/-10.1 years), admitted to hospital with suspected or diagnosed HF. RESULTS: Overall, women had lower unadjusted mortality hazard ratio (HR) than men: HR 0.827; 95% confidence interval (CI) 0.690-0.992; p=0.040. Adjusted HR was 0.786; 95% CI 0.601-1.028; p=0.079. Unadjusted mortality was significantly higher among patients with a discharge HF diagnosis, compared to those without: HR 1.330; 95% CI 1.107-1.597; p=0.002; adjusted p=0.289. Women and men with a discharge HF diagnosis had similar survival: unadjusted HR 1.052; 95% CI 0.829-1.336; p=0.674; adjusted HR 0.875; 95% CI 0.625-1.225; p=0.437. Women had lower mortality risk among patients without a discharge HF diagnosis: HR 0.630, 95% CI 0.476-0.833, p=0.001; adjusted HR 0.611, p=0.036. CONCLUSION: Prognosis was poor among patients hospitalised with suspected or diagnosed HF. Among all patients, women had better survival, whereas both sexes had similar survival when the HF diagnosis was certified.

Relating land cover characteristics and common loon mercury levels using geographic information systems.

This effort models the relationship between mercury (Hg) levels in the common loon (Gavia immer) and land cover types as defined by the National Land Cover Database (NLCD). We constructed the model within the framework of a GIS to analyze the spatial relationships between land cover types and blood Hg levels in male common loons. Thiessan polygons were used to generate the territory for each loon. We created 150, 300, and 600-m buffers around the Thiessan polygons and modeled the relationships that existed in each distance class. Within the 150-m buffer, three cover types, crop land, shrub land, and wetland were significantly related to blood Hg levels (r2 = 0.552, p < 0.001), which may indicate that the proximity of these cover types influences Hg availability in loon territories. Cropland exhibited a negative relationship with blood Hg levels and may play a role in reducing the amount of available Hg within the study area while wetlands and shrub lands exhibit a positive relationship. The study area consisted of five major lakes and eleven smaller ponds in northwest Maine, and data included a total of 61 male common loon blood Hg samples.

Development of the health and economic consequences of smoking interactive model.

OBJECTIVE: To describe the health and economic consequences of smoking model, a user friendly, web based tool, designed to estimate the health and economic outcomes associated with smoking and the benefits of smoking cessation. RESULTS: An overview of the development of the model equations and user interface is given, and data from the UK are presented as an example of the model outputs. These results show that a typical smoking cessation strategy costs approximately 1200 pounds sterling per life year saved and 22,000 pounds sterling per death averted. CONCLUSIONS: The model successfully captures the complexity required to model smoking behaviour and associated mortality, morbidity, and health care costs. Furthermore, the interface provides the results in a simple and flexible way so as to be useful to a variety of audiences and to simulate a variety of smoking cessation methods.

Identification and characterization of human fructose or glucose taste variants with hypogeusia for one monosaccharide but not for the other.

Human psychophysical functions for sweetness are similar for sucrose and fructose, but different for glucose, and suggest different mechanisms for fructose and glucose. Drosophila behavioral and electrophysiological data are similar to the human data and indicate separate receptor cell mechanisms for the monosaccharides. Moreover, fructose 'nontasters' (NTs) and glucose NTs have been identified in two Drosophila species. Identification of human NTs would confirm separate mechanisms and could lead to identification of proteins in human sweet taste by molecular genetic techniques. To identify human NTs, we first obtained responses for sucrose, fructose and glucose from 20 subjects. They tasted seven concentrations of each sugar (2-128 mM), paired with water, and indicated the sweeter of each pair. Functions for recognition indices (RIs) (proportion of subjects recognizing the sugar as sweeter) were similar for sucrose and fructose and different for glucose; this result agrees with the previous studies and supports different mechanisms for the monosaccharides. At 128 mM, RIs for all three sugars were 1.0; this result is consistent with the monogeusia reported by Breslin et al. for concentrations higher than those tested here. Eleven rising-phase concentrations (10-35 mM fructose, 10-90 mM glucose) then were tested on 32 subjects. A statistically significant interaction indicated different regression slopes and supported different monosaccharide mechanisms. From these data, positive identification values (PIDs) (lowest concentration at which the sugar always was judged sweeter than the water) were determined for each subject. The fructose log(PID) and glucose log(PID) data were not well correlated; thus separate mechanisms were supported further. Next, NT traits were defined by log(PID)s > or = 2 SD above the mean for one sugar, while the PID for the other remained within 1 SD of the population mean log(PID). Ninety-two subjects were screened to identify 12 glucose NTs and four fructose NTs. Two glucose NTs and three average subjects were tested in six additional sessions. The NTs showed an experience-induced change: there was a statistically significant reduction of glucose PIDs, but not of fructose PIDs. No change occurred in PIDs of the average subjects for either sugar.

Microdialysis-immunoaffinity capillary electrophoresis studies on neuropeptide-induced lymphocyte secretion.

A micro-sampling procedure has been developed for studying lymphocyte secretion of biologically important peptides in low cell density cultures. The technique is based on microdialysis recovery of the analytes of interest coupled with immunoaffinity capillary electrophoresis separation of the microdialysis samples and laser-induced fluorescence detection. Although the technique is able to recover secreted materials only at the 5-10 cell level, the detection system has a limit of detection (LOD) in the attomole (10(-18) M) range. This degree of sensitivity indicates that the system has the potential to measure secreted products at the single cell level. An added advantage of this system over other sampling techniques is that the microdialysis probe allows continuous sampling over time.