Sun exposure influences the prognostic power of components of mineral metabolism in patients with coronary artery disease.

BACKGROUND AND AIM: Calcidiol (vitamin D metabolite) plasma levels vary with sun exposure (SE). However, it is not known if SE influences its prognostic ability. We have studied the effect of SE on plasma levels of the components of mineral metabolism (calcidiol, fibroblast growth factor-23 [FGF-23], parathormone [PTH], and phosphate [P]) and on their prognostic value in patients with coronary artery disease (CAD). METHODS AND RESULTS: We studied prospectively 704 patients with stable CAD. Clinical variables and baseline calcidiol, FGF-23, PTH, and P plasma levels were assessed. We divided the population in two subgroups, according to the period of plasma extraction: High SE (HSE) (April-September) and low SE (LSE) (October-March). The outcome was the development of acute ischemic events (acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death. Mean follow-up was 2.15 ± 0.99 years. Calcidiol and P levels were higher in HSE group. In the whole population, calcidiol (HR = 0.84 for each 5 ng/ml increase, 95% CI = 0.71-0.99; p = 0.038) and FGF-23 (HR = 1.14 for each 100 RU/ml increase, 95% CI = 1.05-1.23; p = 0.009) were predictors of the outcome, along with age, hypertension, body-mass index, peripheral artery disease, and P levels. In the LSE subgroup, calcidiol (HR = 0.75; 95% CI = 0.57-0.99; p = 0.034) and FGF-23 (HR = 1.34; 95% CI = 1.13-1.58; p = 0.003) remained as predictors of the outcome. In the HSE group calcidiol and FGF-23 had not independent prognostic value. CONCLUSIONS: In patients with stable CAD, low calcidiol and high FGF-23 plasma levels predict an adverse prognosis only when the sample is obtained during the months with LSE. SE should be taken into account in the clinical practice.

Parathormone Levels Are Independently Associated with the Presence of Left Ventricular Hypertrophy in Patients with Coronary Artery Disease.

BACKGROUND: Abnormalities of mineral metabolism and inflammation may affect the cardiovascular system. We have assessed the relationship of left ventricular hypertrophy (LVH) with inflammation and mineral metabolism. METHODS: LVH was measured in 146 outpatients with stable coronary artery disease (SCAD) using echocardiography. Calcidiol (a vitamin D metabolite), parathyroid hormone (PTH), fibroblast growth factor-23, high-sensitivity C-reactive protein, MCP-1 (monocyte chemoattractant protein-1), galectin-3, NGAL (neutrophil gelatinase-associated lipocalin), and sTWEAK (soluble TNF-related weak inducer of apoptosis) plasma levels were studied. RESULTS: LVH, defined as septal thickness ≥11 mm, was present in 19.9% of cases. These patients were older [75.0 (61.0-81.0) vs 64.0 (51.0-76.0) years; p=0.002], had higher prevalence of left ventricular ejection fraction (LVEF)>40%, and had higher PTH [84.7 (59.6-104.7) vs 63.2 (49.2-85.2) pg/ml; p=0.007], galectin-3 [9.6 (8.0-11.1) vs 8.3 (6.9-9.9) ng/ml; p=0.037], and NGAL (208.5±87.6 vs 173.9±73.4 ng/ml; p=0.031) plasma levels than those without LVH. Glomerular filtration rate was lower in patients with LVH than in those without it (65.1±20.0 vs 74.7±19.9 mL/min/1.73 m2; p=0.021). There were no significant differences in hypertension (79.3 vs 68.4%; p=0.363) or sex between both groups. Variables showing differences based on univariate analysis and hypertension were entered into a logistic regression analysis. Only age [odds ratio (OR) =1.052 (1.011-1.096); p=0.013], PTH plasma levels [OR=1.017 (1.003-1.031); p=0.021], and LVEF>40% [OR=7.595 (1.463-39.429); p=0.016] were independent predictors of LVH. CONCLUSIONS: In patients with SCAD, elevated PTH levels are independently associated with the presence of LVH. Further studies are needed to elucidate the role of PTH in the development of myocardial hypertrophy.

Ongoing measles outbreak in Elche, Spain, 29 January to 9 March 2012.

On 29 January 2012, the first case of measles in Elche, Spain, since 2001 was notified through the epidemiological surveillance system of the Valencian Community. As of 9 March, 109 cases have been notified. The outbreak started in a neighbourhood where the vaccination coverage of the population is inadequate. This report highlights the need to vaccinate the susceptible population and also points to the importance of developing coordinated measures between public health centres and hospital preventive services.

Comportamiento del tejido osteomedular de ratones después de la implantación de mineral trióxido agregado o cemento a base de pasta zinquenólica / Marrow bone reaction of rats after implantation of mineral trioxide aggregate or a zinc-oxide eugenol sealer

El objetivo de este estudio fue evualar las respuestas del tejido osteomedular de ratones a través de la colocación de tubos provistos de mineral trióxido agregado o cemento a base de pasta zinquenólica con adición de agentes radiopacificadores (yodoformo o subnitrato de bismuto) con y sin hidróxido de cálcio. Transcurridos 30, 60 Y 90 días de la implantación, el análisis microscópico y estadístico de los especímenes con los testes Kruskall Wallis y Mann Whitney revelaron que la inflamacion fue más exacerbada en los grupos que presentaban oxido de zinc y eugenol, pero disminuyó con el correr del tiempo, llegando a igualarse a los 60 días, con la inflamación referente al trióxido mineral agregado (MTA) (ps 0,05). Solamente los grupos de MTA y control presentaron neoformación ósea en contacto (ps 0,05). Basandonos en estas observaciones, se puede afirmar que el reparo intraóseo en presencia de MTA es mas rapido que el observado con el o óxido de zinc y eugenol

The marrow bone reaction to mineral trioxide aggregate or a potential zinc-oxide eugenol sealer, added up of radiopaque substances and calcium hydroxide, were studied with using an intraosseous implant technique. The tubes containing the distinct materials were introduced surgically into rat and femur tibias. Control tubes were left empty. After 30, 60 and 90 days, the specimens were histologically processed and microscopically evaluated. The statistical analysis revealed that the MT A cement samples displayed no inflammatory response and direct bone apposition after 30 days, while the response of zincoxide based sealer was characterized by granulation tissue regression and mineralized barrier up to 60 days IpsO.05). Based on these results, repair seems to occur in advance when mineral trioxide aggregate is used

Differences in physical characteristics in collegiate baseball players. A descriptive position by position analysis.

Physical characteristics including height, weight, body composition, and somatotype of NCAA Division II baseball players were evaluated to determine if differences in physical profiles exist by position at this level of competition. Differences in height, weight, lean body weight and somatoplots were found among various players. Pitchers were found to be taller that infielders and outfielders and displayed more endomorphy and less mesomorphy than the outfielders. Among the infielders, first basemen were taller than second basemen and third basemen while shortstops were found to be taller than second basemen. With respect to weight, first basemen and catchers were found to be heavier than second basemen. The second basemen had less lean body mass than all other infield groups. The data reveal more than a general description is warranted when describing the physical characteristics of baseball players at this level of play.

Anxiety and intense running exercise in the presence and absence of interpersonal competition.

The purposes of this study were to evaluate the effects of intense running exercise in the presence and absence of interpersonal competition on both (a) pre-exercise anxiety levels and (b) alterations in anxiety as a consequence of the exercise. Seven females and 10 males performed a 5-mile run over the same outdoor course on two separate days. In one condition the subjects ran in a road-race in which intense exercise was combined with interpersonal competition. In the second condition, exercise of the same intensity (84% VO2max) and duration was completed, but interpersonal competition was absent. Cognitive (State-Trait Anxiety Inventory; STAI) and somatic (Body Awareness Scale; BAS) aspects of anxiety were measured 15 min before and after exercise as well as on a separate day under non-stressful, baseline conditions. A main effect for the Trials factor was found using repeated measures ANOVA [Condition (presence/absence of interpersonal competition) X Gender X Trials (baseline/pre-exercise/post-exercise)], and post-hoc analysis revealed that post-exercise state anxiety and body awareness levels were both reduced compared to pre-exercise baseline values. Condition and Gender main effects were not significant nor were any of the interaction effects. Pre-exercise STAI and BAS levels were found to be significantly (p less than .01) elevated above baseline values. However, while post-exercise STAI scores were significantly (p less than .01) below the baseline STAI level, the post-exercise BAS values did not fall below the corresponding baseline level.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of large decompressive craniectomy on the outcome of surgical treatment in spontaneous intracerebral haematomas.

The outcome of a series of 73 patients with spontaneous intraparenchymatous haematomas treated by surgical evacuation of the clot and decompressive craniectomy has been described. Comparing postoperative mortality of this series with another series of patients (54 cases) treated only with surgical removal of the clot without decompressive craniectomy a statistically significant improvement in the mortality rate after craniectomy could be observed in acute cases demanding surgical intervention for preservation of life in the first 24 hours. If signs of brain-stem suffering appear surgical mortality increases proportionally to the duration of this symptomatology. In these cases surgery, if it is to be useful, has to be performed as soon as possible. The morbidity of the surviving patients is not greater in this series with decompressive craniectomy than in series without decompression.