Int J Sports Med. 2009 Jun 30;
Lee CD, Jae SY, Iribarren C, Pettee KK, Choi YH
We investigated the association between cardiorespiratory fitness (CRF) and carotid atherosclerosis in 9 871 Korean men aged 40-81 years. We measured carotid intima-media thickness by using B-mode ultrasonography, and cardiorespiratory fitness was measured by a maximal treadmill exercise test using the Bruce protocol. Carotid atherosclerosis was defined as an intima-media wall thickness greater than 1.2 mm or stenosis >25% of carotid arteries, while CRF was classified as low fit (<20%), moderately fit (20-/=60%) categories based on age-specific VO (2peak) (ml/kg/min) percentiles. The presence of carotid atherosclerosis across CRF categories was 11.7% (low fit), 9.6%, and 7.7%, respectively. After adjustment for age, cigarette smoking, body mass index, physical activity, there was an inverse association between CRF and carotid atherosclerosis (p for trend <0.001). The odds ratio of presence of carotid atherosclerosis in the high-fit men versus the low-fit men was 0.67 (95% CI, 0.55, 0.80). After additional adjustment for high cholesterol, hypertension, and diabetes mellitus, the results remain unchanged and the odds ratios across CRF levels were (95% CI): 1.00 (low fit, referent), 0.85 (0.71, 1.01), 0.71 (0.59, 0.85) (p for trend <0.001), respectively. High levels of cardiorespiratory fitness were associated with a lower risk of having carotid atherosclerosis in middle-aged and elderly men.
Endokrynol Pol. 2009; 60(3): 180-188
Irzyniec T
Introduction: Abnormalities in calcium phosphate (Ca-P) metabolism and Ca-P related hormones are well documented in patients with essential hypertension (EH), but less in patients with non insulin dependent diabetes mellitus (NIDDM). The present study was designed to assess the responsiveness of parathormone (PTH) secretion to an oral phosphate (Pi) load (100 mmol) in patients with EH - NTS and hypertensive patients with NIDDM - CNT. Material and methods: In 29 patients in NTS group (45.6 +/- 1.3 y), 32 in CNT group (48.4 +/- 0.9 y) and in 23 healthy subjects-GK (42.7 +/- 2.7 y) - 25-OH-D(3), intact PTH, ionized (Ca(2+)) and phosphate (P) were estimated in blood serum before and PTH in 4, 8, 12, 18 and 24 hours, Ca(2+) and P in 2, 4, 6, 8, 10, 12, 18 and 24 hours after an oral administration of Pi. Urinary excretion of calcium and phosphate were also estimated on day before and at the day of an oral Pi load. Results: In NTS group lower basal 25-OH-D(3) serum levels (22.9 +/- 1.7 vs. 30.9 +/- 2 ng/ml; p = 0.02), while in CNT group higher PTH (22.7 +/- +/- 2.2 vs. 15.6 +/- 1.9 pg/ml; p < 0.05) levels were found. Both NTS and CNT patients showed an exaggerated response of PTH secretion to the Pi load (as expressed as the AUC) as compared with GK [757 +/- 51.7 vs. 790 +/- 53.8 vs. 600 +/- 39 (pg/ml)*24 h]. In addition patients in groups NTS and CNT showed a higher calciuria than GK (2.48 +/- 0.2 and 2.42 +/- 0,2 vs. 1.77 +/- 0.2 mmol/d.) and a delayed normalization of plasma P at the day of the Pi load. Conclusions: 1. Both NTS and CNT groups are characterized by an abnormal calcium and phosphate metabolism and exaggerated response of PTH secretion to an oral phosphate load as compared with GK controls. 2. Probably hypertension and not NIDDM seems to be the leading cause of calcium-phosphate abnormalities in hypertensive diabetic patients.
Clin Cardiol. 2009 Jun 30; 32(6): 308-314
Li X, Xu Y, Li J, Hu D
BACKGROUND: The China Cholesterol Education Program (CCEP) aimed to investigate the baseline characteristics of outpatients with coronary heart disease (CHD) according to gender, especially lipid levels, statin intervention, and rates of achieving their goal low-density lipoprotein cholesterol (LDL-C) level. METHODS: A total of 4778 CHD outpatients were enrolled from 52 centers in 6 Chinese cities from January 2006 to January 2007. RESULTS: Female outpatients were significantly older than male outpatients (66+/-10 vs 63+/-11 years, P <0.001). Male outpatients were more likely to smoke than female outpatients (P<0.001). Female outpatients had a higher prevalence of hypertension, diabetes mellitus, LDL-C level, and total cholesterol level (all P values <0.001). About 82% of the participants received statin therapy. The LDL-C levels were 3.06+/-1.08 mmol/L and 2.89+/-0.97 mmol/L in outpatients at high risk and very high risk respectively (P<0.001). Though there were higher rates of statin intervention, only 36.2% of the high risk outpatients got to the target LDL-C level (<2.6 mmol/L); 10.9% of the very high risk outpatients achieved the optimal LDL-C level (<1.82 mmol/L) suggested by National Cholesterol Education Program Adult Treatment Panel III. The rate of achieving target was only 42.2%, even when LDL-C <2.6 mmol/L was the target level for patients at very high risk. Only 19.4% of the outpatients at very high risk achieved the target (LDL-C <2.08 mmol/L) suggested by the updated Chinese guideline for CHD. CONCLUSION: Although the outpatients received a higher rate of statin therapy, the rates of achieving the target were lower. There is still a significant gap between the guidelines and clinical practice in statin intervention among these CHD outpatients, particularly for women. Copyright (c) 2009 Wiley Periodicals, Inc.
Clin Cardiol. 2009 Jun 30; 32(6): 327-331
Tamariz L, Hassan B, Palacio A, Arcement L, Horswell R, Hebert K
BACKGROUND: Metabolic syndrome (MetS) is a risk factor for diabetes, cardiovascular disease, and heart failure, but little is known about the impact of MetS in patients who already have heart failure (HF). HYPOTHESIS: MetS increases mortality in HF. METHODS: We performed an analysis in 865 indigent HF patients enrolled in a HF disease management program at the Chabert Medical Center in Louisiana. All subjects were classified as having MetS if they met three or more of the National Cholesterol Education Program criteria. Mortality was defined using the Social Security Death Index. We calculated the relative hazard (RH) of death for those patients with and without MetS. RESULTS: The prevalence of MetS was 40% (95% confidence interval [CI]: 37-43). These subjects had similar ages (54.3+/-13.4 vs 55.7+/-12.8 years), more likely to be female (43% vs 33%), had similar baseline ejection fraction (31.4+/-9.7 vs 30.0+/-11.0), and New York Heart Association (NYHA) classification (2.20+/-0.9 vs 2.15+/-0.9). After 2.6+/-2.2 years of follow-up 24% of the MetS group died compared to 16% in the non-MetS group (p < 0.01). The RH of death for the MetS group was 1.5 (95% CI: 1.1-2.1) when compared to the non-MetS group after adjustment demographics, use of angiotensin-converting enzyme (ACE) inhibitor and beta-blocker, hematocrit, creatinine, educational level, and baseline ejection fraction. CONCLUSIONS: The prevalence of MetS is high in indigent HF patients, and it increases the risk of death. Physicians treating patients with HF need to address the current MetS epidemic in HF. Copyright (c) 2009 Wiley Periodicals, Inc.
J Comput Chem. 2009 Jun 30;
Vilar S, Karpiak J, Costanzi S
In this study, we evaluated the applicability of ligand-based and structure-based models to quantitative affinity predictions and virtual screenings for ligands of the beta(2)-adrenergic receptor, a G protein-coupled receptor (GPCR). We also devised and evaluated a number of consensus models obtained through partial least square regressions, to combine the strengths of the individual components. In all cases, the bioactive conformation of each ligand was derived from molecular docking at the crystal structure of the receptor. We identified the most effective models applicable to the different scenarios, in the presence or in the absence of a training set. For ranking the affinity of closely related analogs when a training set is available, a ligand-based consensus model (LI-CM) seems to be the best choice, while the structure-based MM-GBSA score seems the best alternative in the absence of a training set. For virtual screening purposes, the structure-based MM-GBSA score was found to be the method of choice. Consensus models consistently had performances superior or close to those of the best individual components, and were endowed with a significantly increased robustness. Given multiple models with no a priori knowledge of their predictive capabilities, constructing a consensus model ensures results very close to those that the best model alone would have yielded. (c) 2009 Wiley Periodicals, Inc. J Comput Chem 2009.
Graefes Arch Clin Exp Ophthalmol. 2009 Jun 30;
Nakao K, Mizushima Y, Abematsu N, Goh N, Sakamoto T
BACKGROUND: Optic disc swelling is a common finding associated with Vogt-Koyanagi-Harada disease (VKH); however, visual field loss from optic disc involvement is uncommon. This reports report presents recent findings regarding unusual patients with visual field defects from optic disc involvement, thus suggesting the presence of anterior ischemic optic neuropathy (AION) in the acute phase of VKH. METHODS: Observational case series. A consecutive series of 52 patients with VKH (6 complete VKH, 46 incomplete VKH) was reviewed. Fifteen patients in this series had optic disc swelling, and six of them developed irreversible visual field defects in the acute phase of VKH. The clinical features of these six patients were analyzed. RESULTS: The patients with associated visual field loss were four males and two females between 54 to 79 years of age. They had bilateral panuveitis associated with meningismus. All of the patients had bilateral optic disc swelling and fluorescein angiography showed both a filling delay and late leakage of the optic disc. Visual field examinations revealed various degrees of visual field defects in 11 eyes. They were treated with high-dose corticosteroid therapy, and several weeks later, both the uveal inflammation and optic disc swelling disappeared. The visual fields showed some improvement as the retinal detachments and disc swelling resolved, but the visual field defects remained in ten eyes. The small and localized visual field defects were asymptomatic. Subsequently, optic disc pallor developed in nine eyes and retinal nerve fiber layer thickness, measured by optical coherence tomography, was decreased in six eyes. The fundus gradually showed various degrees of hypopigmentation, but did not show any chorioretinal atrophy causing visual field loss. Four patients had risk factors for AION, including diabetes mellitus or a relatively small optic nerve head. CONCLUSIONS: In this consecutive series of patients with VKH, 15 out of 52 patients were found to have disc swelling, and six patients, who were mostly elderly, had associated visual field loss, which is probably due to AION associated with VKH.
