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Sample records for 24-hour systolic bp

  1. Association of target organ damage with 24-hour systolic and diastolic blood pressure levels and hypertension subtypes in untreated Chinese.

    PubMed

    Wei, Fang-Fei; Li, Yan; Zhang, Lu; Xu, Ting-Yan; Ding, Feng-Hua; Staessen, Jan A; Wang, Ji-Guang

    2014-02-01

    The association of target organ damage with 24-hour systolic and diastolic blood pressure levels and ambulatory hypertension subtypes has not yet been examined in untreated Chinese patients. We measured left ventricular mass index by echocardiography (n=619), the urinary albumin:creatinine ratio (n=1047), and aortic pulse wave velocity by tonometry (n=1013) in 1047 untreated subjects (mean age, 50.6 years; 48.9% women). Normotension was a 24-hour systolic/diastolic blood pressure <130/<80 mm Hg. Hypertension subtypes were isolated diastolic hypertension and mixed systolic plus diastolic hypertension. We assessed associations of interest by multivariable-adjusted linear models. Using normotension as reference, mixed hypertension was associated with higher (P≤0.003) left ventricular mass index (+4.31 g/m(2)), urinary albumin:creatinine ratio (+1.63 mg/mmol), and pulse wave velocity (+0.76 m/s); and isolated diastolic hypertension was associated with similar left ventricular mass index and pulse wave velocity (P≥0.39), but higher urinary albumin:creatinine ratio (+1.24 mg/mmol; P=0.002). In younger participants (<55 years), the mutually independent effect sizes associated with 1 SD increases in 24-hour systolic/diastolic blood pressure were +3.31/-0.36 g/m(2) (P=0.009/0.79) for left ventricular mass index, +1.15/+1.14 mg/mmol (P=0.02/0.04) for the urinary albumin:creatinine ratio, and +0.54/-0.05 m/s (P<0.001/0.54) for pulse wave velocity. In older participants, these estimates were +3.58/+0.30 g/m(2) (P=0.045/0.88), +1.23/+1.05 mg/mmol (P=0.002/0.54), and +0.76/-0.49 m/s (P<0.001/<0.001), respectively. In conclusion, 24-hour systolic blood pressure and mixed hypertension are major determinants of target organ damage irrespective of age and target organ, whereas 24-hour diastolic blood pressure and isolated diastolic hypertension only relate to the urinary albumin:creatinine ratio below middle age.

  2. Effect of an L- and T-Type Calcium Channel Blocker on 24-Hour Systolic Blood Pressure and Heart Rate in Hypertensive Patients

    PubMed Central

    Tsutsumi, Takeshi; Ebado, Mio; Takeyama, Youichi

    2012-01-01

    Background and Objectives The aim of this study was to evaluate the effects of an L- and T-type calcium channel blocker (CCB) on 24-hour systolic blood pressure (24-hour SBP) and heart rate (24-hour HR) profiles in essential hypertensive patients. Subjects and Methods Thirty-seven consecutive patients were enrolled in this study. The 24-hour SBP and HR were recorded before and after treatment with efonidipine (L- and T-type CCB, 40 mg), after waking. Changes in 24-hour SBP and HR and the diurnal to nocturnal SBP ratio were measured. The best-fit curves of changes in SBP and HR were depicted using a periodic function. Results The mean 24-hour SBP and HR decreased significantly after treatment. The diurnal to nocturnal SBP ratio in dipper-type hypertension cases decreased from 16.7±6.1% to 8.3±9.8% (p<0.05), whereas in non-dipper hypertension cases, it increased from 2.3±2.9% to 7.7±5.1% (p<0.01). The antihypertensive effect was minimal at 5.0 hours after drug administration and it slowly recovered at a constant rate (2.1 mm Hg/h) over 12 hours in dipper cases. The median 24-hour changes in HR in the dipper and non-dipper cases were -2.3/min and -5.4/min, respectively. A continuous reduction in the change in HR was seen from 3.5 to 23 hours after drug administration. Conclusion The antihypertensive action of efonidipine was characterized by a slow recovery of the SBP decrease at a constant rate (2.1 mm Hg/h) and a non-administration time dependent reduction in 24-hour HR. PMID:22563335

  3. Predialysis systolic BP variability and outcomes in hemodialysis patients.

    PubMed

    Shafi, Tariq; Sozio, Stephen M; Bandeen-Roche, Karen J; Ephraim, Patti L; Luly, Jason R; St Peter, Wendy L; McDermott, Aidan; Scialla, Julia J; Crews, Deidra C; Tangri, Navdeep; Miskulin, Dana C; Michels, Wieneke M; Jaar, Bernard G; Herzog, Charles A; Zager, Philip G; Meyer, Klemens B; Wu, Albert W; Boulware, L Ebony

    2014-04-01

    BP variability (BPV) is an important predictor of outcomes in the general population, but its association with clinical outcomes in hemodialysis patients is not clear. We identified 11,291 patients starting dialysis in 2003-2008 and followed them through December 31, 2008 (median=22 months). Predialysis systolic BPV was assessed over monthly intervals. Outcomes included factors associated with BPV, mortality (all-cause and cardiovascular), and first cardiovascular event (cardiovascular death or hospitalization). Patients' mean age was 62 years, 55% of patients were men, and 58% of patients were white. Modifiable factors associated with higher BPV included obesity, higher calcium-phosphate product levels, and lower hemoglobin concentration; factors associated with lower BPV included greater fluid removal, achievement of prescribed dry weight during dialysis, higher hemoglobin concentration, and antihypertensive regimens without β-blockers or renin-angiotensin system blocking agents. In total, 3200 deaths occurred, including 1592 cardiovascular deaths. After adjustment for demographics, comorbidities, and clinical factors, higher predialysis BPV was associated with increased risk of all-cause mortality (hazard ratio [HR], 1.18; 95% confidence interval [95% CI] per 1 SD increase in BPV, 1.13 to 1.22), cardiovascular mortality (HR, 1.18; 95% CI, 1.12 to 1.24), and first cardiovascular event (HR, 1.11; 95% CI, 1.07 to 1.15). Results were similar when BPV was categorized in tertiles and patients were stratified by baseline systolic BP. In summary, predialysis systolic BPV is an important, potentially modifiable risk factor for death and cardiovascular outcomes in incident hemodialysis patients. Studies of BP management in dialysis patients should focus on both absolute BP and BPV.

  4. Effect of nasal continuous positive airway pressure during sleep on 24-hour blood pressure in obstructive sleep apnea.

    PubMed

    Wilcox, I; Grunstein, R R; Hedner, J A; Doyle, J; Collins, F L; Fletcher, P J; Kelly, D T; Sullivan, C E

    1993-09-01

    Ambulatory blood pressure (BP) was measured noninvasively (Oxford Medilog ABP) at 15-minute intervals for 24 hours before and after 8 weeks of treatment with nasal continuous positive airway pressure (nCPAP) in 19 men with obstructive sleep apnea (OSA). We included both normotensive and hypertensive patients, but hypertensives were studied after withdrawal of antihypertensive drugs. Ambulatory BP before and after treatment was compared using patients as their own controls. Treatment with nCPAP was successfully established in 14 of the 19 patients (74%). Blood pressure fell significantly in patients who were successfully treated: 24-hour mean BP (systolic/diastolic) decreased from 141 +/- 18/89 +/- 11 mm Hg to 134 +/- 19/85 +/- 13 mm Hg (p < 0.05). The reduction in 24-hour mean systolic BP occurred during both day and night, but a significant fall in mean diastolic BP was only observed during the day. The mean blood pressure fell in both normotensive and hypertensive patients. Patients who were inadequately treated with nCPAP had no reduction in mean 24-hour BP. Effective treatment of sleep apnea with nCPAP was associated with a significant fall in both systolic and diastolic BP independent of changes in body weight or alcohol consumption, suggesting that sleep apnea was an independent factor contributing to elevated nighttime and daytime BP in these patients.

  5. 24-Hour Relativistic Bit Commitment

    NASA Astrophysics Data System (ADS)

    Verbanis, Ephanielle; Martin, Anthony; Houlmann, Raphaël; Boso, Gianluca; Bussières, Félix; Zbinden, Hugo

    2016-09-01

    Bit commitment is a fundamental cryptographic primitive in which a party wishes to commit a secret bit to another party. Perfect security between mistrustful parties is unfortunately impossible to achieve through the asynchronous exchange of classical and quantum messages. Perfect security can nonetheless be achieved if each party splits into two agents exchanging classical information at times and locations satisfying strict relativistic constraints. A relativistic multiround protocol to achieve this was previously proposed and used to implement a 2-millisecond commitment time. Much longer durations were initially thought to be insecure, but recent theoretical progress showed that this is not so. In this Letter, we report on the implementation of a 24-hour bit commitment solely based on timed high-speed optical communication and fast data processing, with all agents located within the city of Geneva. This duration is more than 6 orders of magnitude longer than before, and we argue that it could be extended to one year and allow much more flexibility on the locations of the agents. Our implementation offers a practical and viable solution for use in applications such as digital signatures, secure voting and honesty-preserving auctions.

  6. Disproportional decrease in office blood pressure compared with 24-hour ambulatory blood pressure with antihypertensive treatment: dependency on pretreatment blood pressure levels.

    PubMed

    Schmieder, Roland E; Schmidt, Stephanie T; Riemer, Thomas; Dechend, Ralf; Hagedorn, Ina; Senges, Jochen; Messerli, Franz H; Zeymer, Uwe

    2014-11-01

    The long-term relationship between 24-hour ambulatory blood pressure (ABP) and office BP in patients on therapy is not well documented. From a registry we included all patients in whom antihypertensive therapy needed to be uptitrated. Drug treatment included the direct renin inhibitor aliskiren or an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or drugs not blocking the renin-angiotensin system, alone or on top of an existing drug regimen. In all patients, office BP and 24-hour ABP were obtained at baseline and after 1 year with validated devices. In the study population of 2722 patients, there was a good correlation between the change in office BP and 24-hour ABP (systolic: r=0.39; P<0.001; diastolic: r=0.34; P<0.001). However, the numeric decrease in office BP did not correspond to the decrease in ABP in a 1:1 fashion, for example, a decrease of 10, 20, and 30 mm Hg corresponded to a decrease of ≈7.2, 10.5, and 13.9 mm Hg in systolic ABP, respectively. The disproportionally greater decrease in systolic office BP compared with ABP was dependent on the level of the pretreatment BP, which was consistently higher for office BP than ABP. The white coat effect (difference between office BP and ABP) was on average 10/5 mm Hg lower 1 year after intensifying treatment and the magnitude of that was also dependent on pretreatment BP. There was a disproportionally greater decrease in systolic office BP than in ABP, which for both office BP and ABP seemed to depend on the pretreatment BP level.

  7. Physician-pharmacist co-management and 24-hour blood pressure control.

    PubMed

    Chen, Ziqian; Ernst, Michael E; Ardery, Gail; Xu, Yinghui; Carter, Barry L

    2013-05-01

    The objectives of this study were to compare indices of 24-hour blood pressure (BP) following a physician-pharmacist collaborative intervention and to describe the associated changes in antihypertensive medications. This was a secondary analysis of a prospective, cluster-randomized clinical trial conducted in 6 family medicine clinics randomized to co-managed (n=3 clinics, 176 patients) or control (n=3 clinics, 198 patients) groups. Mean ambulatory systolic BP (SBP) was significantly lower in the co-managed vs the control group: daytime BP 122.8 mm Hg vs 134.4 mm Hg (P<.001); nighttime SBP 114.8 mm Hg vs 123.7 mm Hg (P<.001); and 24-hour SBP 120.4 mm Hg vs 131.8 mm Hg (P<.001), respectively. Significantly more drug changes were made in the co-managed than in the control group (2.7 vs 1.1 changes per patient, P<.001), and there was greater diuretic use in co-managed patients (79.6% vs 62.6%, P<.001). Ambulatory BPs were significantly lower for the patients who had a diuretic added during the first month compared with those who never had a diuretic added (P<.01). Physician-pharmacist co-management significantly improved ambulatory BP compared with the control group. Antihypertensive drug therapy was intensified much more for patients in the co-managed group.

  8. 24-Hour Academic Libraries: Adjusting to Change

    ERIC Educational Resources Information Center

    Bowman, Adam C.

    2013-01-01

    The purpose of this study was to explore the adaptive measures that academic libraries perform when implementing and operating a 24-hour schedule. Five in-depth interviews were conducted with current managerial-level librarians at 24-hour academic libraries. The exploratory interviews revealed similar measures for security, budgeting, employee…

  9. Low correlation between visit-to-visit variability and 24-hour variability of blood pressure

    PubMed Central

    Muntner, Paul; Shimbo, Daichi; Diaz, Keith M.; Newman, Jonathan; Sloan, Richard P.; Schwartz, Joseph E.

    2013-01-01

    Visit-to-visit variability (VVV) of clinic systolic blood pressure (SBP) has been associated with cardiovascular disease risk. Given the need for obtaining blood pressure (BP) at multiple visits to calculate VVV, substituting BP variability from ambulatory blood pressure monitoring (ABPM) may be a practical alternative. We assessed the correlation between VVV of BP and BP variability from ABPM using data from 146 untreated, mostly normotensive participants (mean age 47.9 years) in a substudy of the ongoing Masked Hypertension Study. VVV of SBP and diastolic blood pressure (DBP) was estimated by the standard deviation (SDvvv) and average real variability (ARVvvv) from 6 study visits over a median of 216 days. ABPM data were used to calculate the day-night SD (SDdn) and the ARV of SBP and DBP over 24 hours (ARV24). For SBP, the mean SDvvv and SDdn were 6.3 (SD=2.5) and 8.8 (SD=1.8) mmHg, respectively, and mean ARVvvv and ARV24 were 7.2 (SD=3.2) and 8.4 (SD=2.1) mmHg, respectively. The Spearman correlation coefficient between SDvvv and SDdn of SBP was rs=0.25 and between ARVvvv and ARV24 was rs=0.17. Participants in the highest quartile of SDdn of SBP were 1.66 (95% CI: 0.93 – 2.75) times more likely to be in the highest quartile of SDvvv of SBP. The observed-to-expected ratio between the highest quartiles of ARVvvv and ARV24 of SBP was 0.89 (95% CI: 0.41 – 1.69). The correlations for SDvvv and SDdn and ARVvvv and ARV24 of DBP were minimal. These data suggest VVV and 24-hour variability are weakly correlated and not interchangeable. PMID:23784506

  10. The 24-Hour Mathematical Modeling Challenge

    ERIC Educational Resources Information Center

    Galluzzo, Benjamin J.; Wendt, Theodore J.

    2015-01-01

    Across the mathematics curriculum there is a renewed emphasis on applications of mathematics and on mathematical modeling. Providing students with modeling experiences beyond the ordinary classroom setting remains a challenge, however. In this article, we describe the 24-hour Mathematical Modeling Challenge, an extracurricular event that exposes…

  11. Depressive Symptoms and 24-Hour Ambulatory Blood Pressure in Africans: The SABPA Study

    PubMed Central

    Hamer, Mark; Frasure-Smith, Nancy; Lespérance, François; Harvey, Brian H.; Malan, Nico T.; Malan, Leoné

    2012-01-01

    Disturbances in circadian rhythm might play a central role in the neurobiology of depression. We examined the association between depressive symptoms and 24-hour ambulatory BP in a sample of 405 (197 black and 208 Caucasian) urbanized African teachers aged 25 to 60 yrs (mean 44.6 ± 9.6 yrs). Depressive symptoms were assessed using the self-administered 9-item Patient Health Questionnaire (PHQ-9). After adjusting for age, sex, and ethnicity, participants with severe depressive symptoms (PHQ-9 ≥ 15) had higher odds of hypertension defined from ambulatory BP and/or use of antihypertensive medication (odds ratio = 2.19, 95% CI, 1.00–4.90) in comparison to participants with no symptoms. Compared to Caucasians with no depressive symptoms, those with severe symptoms had blunted nocturnal systolic BP drop of 4.7 mmHg (95% CI, −0.5 to 10.0, P = 0.07). In summary, depressive symptoms were associated with the circadian BP profile in black and Caucasian Africans. PMID:22028954

  12. Reductions in Mean 24-Hour Ambulatory Blood Pressure After 6-Week Treatment With Canagliflozin in Patients With Type 2 Diabetes Mellitus and Hypertension.

    PubMed

    Townsend, Raymond R; Machin, Israel; Ren, Jimmy; Trujillo, Angelina; Kawaguchi, Masato; Vijapurkar, Ujjwala; Damaraju, Chandrasekharrao V; Pfeifer, Michael

    2016-01-01

    This randomized, double-blind, placebo-controlled study evaluated the early effects of canagliflozin on blood pressure (BP) in patients with type 2 diabetes mellitus (T2DM) and hypertension. Patients were randomized to canagliflozin 300 mg, canagliflozin 100 mg, or placebo for 6 weeks and underwent 24-hour ambulatory BP monitoring before randomization, on day 1 of treatment, and after 6 weeks. The primary endpoint was change in mean 24-hour systolic BP (SBP) from baseline to week 6. Overall, 169 patients were included (mean age, 58.6 years; glycated hemoglobin, 8.1%; seated BP 138.5/82.7 mm Hg). At week 6, canagliflozin 300 mg provided greater reductions in mean 24-hour SBP than placebo (least squares mean -6.2 vs -1.2 mm Hg, respectively; P=.006). Numerical reductions in SBP were observed with canagliflozin 100 mg. Canagliflozin was generally well tolerated, with side effects similar to those reported in previous studies. These results suggest that canagliflozin rapidly reduces BP in patients with T2DM and hypertension.

  13. Cardiovascular Outcomes in Patients with Normal and Abnormal 24-Hour Ambulatory Blood Pressure Monitoring

    PubMed Central

    Iqbal, P.; Stevenson, Louise

    2011-01-01

    Introduction. 24-hour ambulatory blood pressure monitoring (ABPM) plays an important role in assessing cardiovascular prognosis, through presence or absence of ABPM-related prognostic features. Objectives. To study relationship between 24-hour ABPM and cardiovascular outcomes in patients from Chesterfield Royal Hospital. Material and Methods. Over 12 months from the 1st of August 2002, 1187 individuals had 24-hour ABPM performed. Cardiovascular outcomes were studied in a subset (297) of the original cohort, made up by every 4th consecutive subject. The following ABPM-related prognostic features were studied—high day time systolic and diastolic BP (≥135, ≥85 mmHg), high night time systolic and diastolic BP (≥120 mmHg, ≥75 mmHg), absence of nocturnal dip (≤10% fall in night time SBP), high early morning SBP (≥140 mmHg), and morning surge (≥20/15 mmHg). The cardiovascular outcomes studied in the fourth table included fatal and nonfatal MI, new diagnosis of angina, acute coronary syndrome, sudden cardiac death, cardiac arrhythmias, acute LVF, cerbrovascular events, peripheral vascular disease, abdominal aortic aneurysm, and CKD stage 3 or above. Results. Over a followup period of 2015 ± 116 days (1720–2305 days) 82 cardiovascular events occurred in 61 subjects. Cardiac arrhythmias were the most common CV outcome (34 events) followed by cerebrovascular events (15). Statistically significant associations found were between cerebrovascular events and absent nocturnal dip ≤ 10% (P = .05) and high day time DBP (P = .029), peripheral vascular disease and morning surge ≥ 20/15 mmHg (P = .014), cardiac arrhythmias and high day time and night time DBP (P = .009 and .033, resp.). Conclusion. Significant associations were found between cerebrovascular events and absent nocturnal dip ≤ 10% and high day time DBP, peripheral vascular disease and morning surge ≥ 20/15 mmHg, cardiac arrhythmias and high day time and night time DBP. PMID

  14. The pressor effect of NO synthase inhibition correlates to pre-existing systolic BP in the rat.

    PubMed

    Elayan, Hamzeh H; Kennedy, Brian P; Ziegler, Michael G

    2002-01-10

    A number of studies have found that the vasopressor effect of nitric oxide (NO) synthase inhibition is small following treatment with hypotensive agents but is enhanced after hypertensive agents, and have implicated NO in the mechanism of action of these drugs. We investigated the hypothesis that the rate of vascular NO synthesis is directly related to blood pressure. The vasopressor effect of 10 mg/kg of L-nitro-L-arginine methyl ester (L-NAME) was studied in relation to changes in BP induced by a variety of treatments in both pentobarbital sodium anesthetized and pithed rats. BP reductions were induced by blood withdrawal, surgery and pithing. BP increases were made by injecting 10 and 15 microg/kg boluses of phenylephrine or by injecting 5% albumin solution. Pithing decreased baseline BP and attenuated the vasopressor effect of L-NAME while phenylephrine increased both BP levels and the hypertensive effect of L-NAME. Volume expansion with 5% albumin solution increased both BP and the vasopressor effect of L-NAME. Both surgery (abdominal incision) and withdrawal of 1 ml blood reduced BP and attenuated the pressor effect of L-NAME. When the results of all these studies were combined, systolic BP was found to correlate strongly with the vasopressor effect of L-NAME (R2 = 0.73, P < 0.0001). Diastolic BP correlated less well with L-NAME (R2 = 0.36, P < 0.0003). The results suggest that shear stress generated by blood flow during the systole releases NO, and lowers BP. The pressor effect of NO synthase inhibition is closely related to pre-existing systolic BP.

  15. Effect of Intensive Versus Standard Clinic-Based Hypertension Management on Ambulatory Blood Pressure: Results From the SPRINT (Systolic Blood Pressure Intervention Trial) Ambulatory Blood Pressure Study.

    PubMed

    Drawz, Paul E; Pajewski, Nicholas M; Bates, Jeffrey T; Bello, Natalie A; Cushman, William C; Dwyer, Jamie P; Fine, Lawrence J; Goff, David C; Haley, William E; Krousel-Wood, Marie; McWilliams, Andrew; Rifkin, Dena E; Slinin, Yelena; Taylor, Addison; Townsend, Raymond; Wall, Barry; Wright, Jackson T; Rahman, Mahboob

    2017-01-01

    The effect of clinic-based intensive hypertension treatment on ambulatory blood pressure (BP) is unknown. The goal of the SPRINT (Systolic Blood Pressure Intervention Trial) ambulatory BP ancillary study was to evaluate the effect of intensive versus standard clinic-based BP targets on ambulatory BP. Ambulatory BP was obtained within 3 weeks of the 27-month study visit in 897 SPRINT participants. Intensive treatment resulted in lower clinic systolic BP (mean difference between groups=16.0 mm Hg; 95% confidence interval, 14.1-17.8 mm Hg), nighttime systolic BP (mean difference=9.6 mm Hg; 95% confidence interval, 7.7-11.5 mm Hg), daytime systolic BP (mean difference=12.3 mm Hg; 95% confidence interval, 10.6-13.9 mm Hg), and 24-hour systolic BP (mean difference=11.2 mm Hg; 95% confidence interval, 9.7-12.8 mm Hg). The night/day systolic BP ratio was similar between the intensive (0.92±0.09) and standard-treatment groups (0.91±0.09). There was considerable lack of agreement within participants between clinic systolic BP and daytime ambulatory systolic BP with wide limits of agreement on Bland-Altman plots. In conclusion, targeting a systolic BP of <120 mm Hg, when compared with <140 mm Hg, resulted in lower nighttime, daytime, and 24-hour systolic BP, but did not change the night/day systolic BP ratio. Ambulatory BP monitoring may be required to assess the effect of targeted hypertension therapy on out of office BP. Further studies are needed to assess whether targeting hypertension therapy based on ambulatory BP improves clinical outcomes.

  16. Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level

    PubMed Central

    Grezzana, Guilherme Brasil; Moraes, David William; Stein, Airton Tetelbon; Pellanda, Lucia Campos

    2017-01-01

    Background Hypertension is an important risk factor for cardiovascular outcomes. Primary health care (PHC) physicians should be prepared to act appropriately in the prevention of cardiovascular risk factors. However, the rates of patients with control of blood pressure (BP) remain low. The impact of the reclassification of high BP by 24-hour ambulatory BP monitoring (ABPM) can lead to different medical decisions in PHC. Objective To evaluate the agreement between the BP measured by a conventional method by PHC physicians and by 24-hour ABPM, considering different BP normal thresholds for the 24-hour ABPM according to the V Brazilian ABPM Guidelines and the European Society of Hypertension Guidelines. Methods A cross-sectional study including 569 hypertensive patients. The BP was initially measured by the PHC physicians and, later, by 24-hour ABPM. The BP measurements were obtained independently between the two methods. The therapeutic targets for the conventional BP followed the guidelines by the Eighth Joint National Committee (JNC 8), the V ABPM Brazilian Guidelines, and the 2013 European Hypertension Guidelines. Results There was an accuracy of 54.8% (95% confidence interval [95%CI] 0.51 - 0.58%) for the BP measured with the conventional method when compared with the 24-hour ABPM, with a sensitivity of 85% (95%CI 80.8 - 88.6%), specificity of 31.9% (95%CI 28.7 - 34.7%), and kappa value of 0.155, when considering the European Hypertension Guidelines. When using more stringent thresholds to characterize the BP as "normal" by ABPM, the accuracy was 45% (95%CI 0.41 - 0.47%) for conventional measurement when compared with 24-hour ABPM, with a sensitivity of 86.7% (95%CI 0.81 - 0.91%), specificity of 29% (95%CI 0.26 - 0.30%), and kappa value of 0.103. Conclusion The BP measurements obtained by PHC physicians showed low accuracy when compared with those obtained by 24-hour ABPM, regardless of the threshold set by the different guidelines. PMID:28099585

  17. Correlation of 24-Hour Blood Pressure and Heart Rate Variability to Renal Function Parameters in Hypertensive Patients. The Effect of Smoking.

    PubMed

    Liakos, Charalampos I; Karpanou, Eva A; Markou, Maria I; Grassos, Charalampos A; Vyssoulis, Gregory P

    2015-12-01

    Intrarenal hemodynamics depend on blood pressure (BP), heart rate (HR), and smoking. Although BP levels have been associated with kidney function, the effect of HR levels, BP, and HR variability on renal function are less well clarified. This cross-sectional study sought to determine the association of 24-hour BP and HR variability with kidney function in hypertensive patients, stratified by smoking. The study comprised 9600 nondiabetic, never-treated hypertensive individuals without evident renal impairment examined from 1985 to 2014 (aged 53.3±13.4 years, 55.3% males). The 24-hour systolic BP (SBP) and HR variability were estimated via their coefficient of variation (CV =standard deviation×100/mean value) derived from ambulatory recording. The CV SBP-to-CV HR ratio (CV R) was used as a marker of the interplay between 24-hour SBP and HR variability. Renal function was estimated via 24-hour urine creatinine clearance (CrCl), estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), and 24-hour urine α1 -microglobulin. After adjustment for age, sex, and smoking, CV SBP was found to be weakly correlated to eGFR (r=-0.017, P=.1) and somewhat more strongly to CrCl, ACR, and α1 -microglobulin (r=-0.032, 0.072, and 0.065; P=.002, <.001 and <.001, respectively). CV HR was much better related to renal function, with stronger adjusted correlations to CrCl, eGFR, ACR, and α1 -microglobulin (r=0.185, 0.134, -0.306, -0.247; all P<.001, respectively). CV R also showed equally good adjusted correlations (r=-0.175, -0.125, 0.336, 0.262; all P<.001, respectively). Most adjusted correlations for CV HR and CV R were even better in smokers (r=0.213, 0.158, -0.332, -0.272 and -0.183, -0.118, 0.351, 0.275, respectively; all P<.001). CV HR and CV R emerge as better related to kidney function than CV SBP, especially in smokers. The correlation of CV HR and CV SBP to renal function is inverse to each other. ACR and α1 -microglobulin are better related to

  18. Pharmacist-physician co-management of hypertension reduces 24-hour ambulatory blood pressures

    PubMed Central

    Weber, Cynthia A.; Ernst, Michael E.; Sezate, Genesis S.; Zheng, Shimin; Carter, Barry L.

    2010-01-01

    Background Pharmacist-physician co-management of hypertension has been shown to improve office blood pressures (BP). We sought to describe the effect of such a model on 24-hour ambulatory BPs. Methods We performed a prospective, cluster-randomised controlled clinical trial in 179 patients with uncontrolled hypertension from five primary care clinics in Iowa City, Iowa. Patients were randomized by clinic to receive pharmacist-physician collaborative management of hypertension (intervention) or usual care (control) for a 9-month period. In the intervention group, pharmacists helped patients identify barriers to BP control, counselled on lifestyle and dietary modifications, and adjusted antihypertensive therapy in collaboration with the patient’s primary care provider. Patients were seen by pharmacists a minimum every 2 months. Ambulatory BP was obtained at baseline and study end. Results Baseline and end of study ambulatory BP profiles were evaluated for 175 patients. Ambulatory BPs were reduced to a greater extent in the intervention compared to control group (daytime ΔSBP [SD] 15.2[11.5] vs 5.5[13.5], p<0.001; nighttime ΔSBP [SD] 12.2[14.8] vs 3.4[13.3], p<0.001; 24-hour ΔSBP [SD] 14.1[11.3] vs 5.5[12.5], p<0.001). More patients in the intervention group had BP controlled at the end of the study (75% vs 50.7%, p<0.001) as defined by overall 24-hour ambulatory BP monitoring. Conclusions Pharmacist-physician collaborative management of hypertension achieved consistent and significantly greater reduction in 24-hour BP and a high rate of BP control. PMID:20937921

  19. Human prolactin - 24-hour pattern with increased release during sleep.

    NASA Technical Reports Server (NTRS)

    Sassin, J. F.; Weitzman, E. D.; Kapen, S.; Frantz, A. G.

    1972-01-01

    Human prolactin was measured in plasma by radioimmunoassay at 20-minute intervals for a 24-hour period in each of six normal adults, whose sleep-wake cycles were monitored polygraphically. A marked diurnal variation in plasma concentrations was demonstrated, with highest values during sleep. Periods of episodic release occurred throughout the 24 hours.

  20. Beetroot supplementation lowers daily systolic blood pressure in older, overweight subjects.

    PubMed

    Jajja, A; Sutyarjoko, A; Lara, J; Rennie, K; Brandt, K; Qadir, O; Siervo, M

    2014-10-01

    Although inorganic nitrate and beetroot juice supplementation are associated with decreased systolic blood pressure (BP), these results have primarily been obtained from short-term trials that focused on healthy young adults. Therefore, we hypothesized that oral supplementation of beetroot juice concentrate would decrease systolic BP in overweight older participants but that the decline in BP would not be sustained after a 1-week interruption of the beetroot juice supplementation. For 3 weeks, 24 participants were randomized to either the beetroot juice concentrate or blackcurrant juice group, with a 1-week postsupplementation phase (week 4). Changes in systolic and diastolic BP were assessed during the supplementation and postsupplementation phases. Blood pressure was measured using 3 different methods: (1) resting clinic BP, (2) 24-hour ambulatory BP monitoring, and (3) home monitoring of daily resting BP. The first 2 methods were applied at baseline and after weeks 3 and 4. Daily measurements were conducted throughout the study, with 21 subjects completing the study (beetroot/blackcurrant = 10/11; male/female = 12/9; age = 62.0 ± 1.4 years; body mass index = 30.1 ± 1.2 kg/m(2)). After 3 weeks, beetroot juice supplementation was not associated with significant changes in resting clinic BP or 24-hour ABPM. Conversely, beetroot juice concentrate reduced daily systolic BP after 3 weeks (-7.3 ± 5.9 mm Hg, P = .02); however, the effect was not maintained after the interruption of the supplementation (week 4, 2.8 ± 6.1 mm Hg, P = .09). In overweight older subjects, beetroot juice concentrate supplementation was associated with beneficial effects on daily systolic BP, although the effects were not significant when measured by 24-hour ABPM or resting clinic BP.

  1. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Sleeping Time and Certain Other Activities § 785.21 Less than 24-hour duty. An employee who is required to... difference that she is furnished facilities for sleeping. Her time is given to her employer. She is...

  2. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Sleeping Time and Certain Other Activities § 785.21 Less than 24-hour duty. An employee who is required to... difference that she is furnished facilities for sleeping. Her time is given to her employer. She is...

  3. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Sleeping Time and Certain Other Activities § 785.21 Less than 24-hour duty. An employee who is required to... difference that she is furnished facilities for sleeping. Her time is given to her employer. She is...

  4. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Sleeping Time and Certain Other Activities § 785.21 Less than 24-hour duty. An employee who is required to... difference that she is furnished facilities for sleeping. Her time is given to her employer. She is...

  5. 29 CFR 785.21 - Less than 24-hour duty.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Sleeping Time and Certain Other Activities § 785.21 Less than 24-hour duty. An employee who is required to... difference that she is furnished facilities for sleeping. Her time is given to her employer. She is...

  6. High serum lactate level may predict death within 24 hours

    PubMed Central

    Zoubi, Abd Almajid; Kuria, Shiran; Blum, Nava

    2015-01-01

    Background Unexpected death within 24 hours of admission is a real challenge for the clinician in the emergency room. How to diagnose these patients and the right approach to prevent sudden death with 24 hours is still an enigma. The aims of our study were to find the independent factors that may affect the clinical outcome in the first 24 hours of admission to the hospital. Methods We performed a retrospective study defining unexpected death within 24 hours of admission in our Department of Medicine in the last 6 years. We found 43 patients who died within 24 hours of admission, and compared their clinical and biochemical characteristics to 6055 consecutive patients who were admitted in that period of time and did not die within the first 24 hours of admission. The parameters that were used include gender, age, temperature, clinical and laboratory criteria for SIRS, arterial blood lactate, and arterial blood pH. Results Most of the patients who died within 24 hours had sepsis with SIRS. These patients were older (78.6±14.7 vs. 65.2±20.2 years [p<.0001]), had higher lactate levels (8.0±4.8 vs. 2.1±1.8mmol/L [p<.0001]), and lower pH (7.2±0.2 vs. 7.4±0.1 [p<.0001]). Logistic regression analysis found that lactate was the strongest independent parameter to predict death within 24 hours of admission (OR 1.366 [95% CI 1.235–1.512]), followed by old age (OR 1.048 [95% CI 1.048–1.075] and low arterial blood pH (OR 0.007 [CI <0.001–0.147]). When gender was analyzed, pH was not an independent variable in females (only in males). Conclusions The significant independent variable that predicted death within 24 hours of admission was arterial blood lactate level on admission. Older age was also an independent variable; low pH affected only males, but was a less dominant variable. We suggest use of arterial blood lactate level on admission as a bio-marker in patients with suspected sepsis admitted to the hospital for risk assessment and prediction of death within 24

  7. [Indices of static and dynamic components of pressure load (assessed by 24-hour blood pressure monitoring) and the state of renal function in patients with essential hypertension].

    PubMed

    Zelveian, P A; Buniatian, M S; Oshchepkova, E V; Lazareva, N V; Rogoza, A N

    2011-01-01

    Aim of this study was to evaluate possible relationship between parameters of blood pressure (BP) profile and glomerular filtration rate in patients (pts) with I-II stage essential hypertension (EH). Material and methods. We studied 120 pts (97 men), aged 23-65 (50,2+/-0,6) years with I (n=98) and II (n=22) stage EH. In BP profile (SL-90207) we calculated 24-hour, daytime, nighttime values of systolic, diastolic, pulse pressures (SBP, DBP, PP), time load (TL), variability and nocturnal fall (NF) of BP. The state of renal function was assessed by measurement of glomerular filtration rate (GFR) calculated by the Cockcroft formula. Results. After nonlinear statistical analysis by Gauss-Newton all patients were divided into three groups according to GFR tertiles. Significant differences were found between these groups by 24-hour, nighttime and daytime values of SBP and DBP. Values of SBP were the lowest in group II. In group II lowest values of PP were also observed, but statistically significant differences were found only in nocturnal PP values between groups II and III. There were no significant differences between groups by TL and NF of BP. In group Ill (high GFR) variability of daytime values of SBP and DBF were significantly higher. Univariate correlation analysis showed statistically significant negative relationship between GFR and nocturnal PP in patients with lowest level of GFR. Positive correlations between nocturnal values of PP and GFR in groups II and III were also observed. Conclusion. These results indicated the presence of strong relationship between high values of nocturnal PP and decreasing of glomerular filtration rate in patients with EH and thus confirmed significance of "constant" and "dynamic" components of pressure load as a marker of impairment of renal function.

  8. The 24 Hours before Hospitalization: Factors Related to Suicide Attempting.

    ERIC Educational Resources Information Center

    Chiles, John A.; And Others

    1986-01-01

    Psychiatric inpatients (N=59) were interviewd concerning psychological and environmental events that occurred in the 24 hours prior to their hospitalization. Suicide attempters were more likely to have used alcohol or marijuana and less likely to have contacted a health care professional than suicide ideators, even when past history of suicide…

  9. 24-hour rhythmicity of seizures in refractory focal epilepsy.

    PubMed

    Nzwalo, Hipólito; Menezes Cordeiro, Inês; Santos, Ana Catarina; Peralta, Rita; Paiva, Teresa; Bentes, Carla

    2016-02-01

    The occurrence of seizures in specific types of epilepsies can follow a 24-hour nonuniform or nonrandom pattern. We described the 24-hour pattern of clinical seizures in patients with focal refractory epilepsy who underwent video-electroencephalography monitoring. Only patients who were candidates for epilepsy surgery with an unequivocal seizure focus were included in the study. A total of 544 seizures from 123 consecutive patients were analyzed. Specific time of seizures were distributed along 3- or 4-hour time blocks or bins throughout the 24-hour period. The mean age of the subjects was 37.7 years, with standard deviation of 11.5 years, median of 37. The majority were females (70/56%). The majority of patients had a seizure focus located in the mesial temporal lobe (102/83%) and in the neocortical temporal lobe (13/11%). The remaining patients had a seizure focus located in the extratemporal lobe (8/6%). The most common etiology was mesial temporal sclerosis (86/69.9%). Nonuniform seizure distribution was observed in seizures arising from the temporal lobe (mesial temporal lobe and neocortical temporal lobe), with two peaks found in both 3- and 4-hour bins: 10:00-13:00/16:00-19:00 and 08:00-12:00/16:00-20:00 respectively (p=0.004). No specific 24-hour pattern was identified in seizures from extratemporal location. The 24-hour rhythmicity of seizure distribution is recognized in certain types of epilepsy, but studies on the topic are scarce. Their replication and validation is therefore needed. Our study confirms the bimodal pattern of temporal lobe epilepsy independently of the nature of the lesion. However, peak times differ between different studies, suggesting that the ambient, rhythmic exogenous factors or environmental/social zeitgebers, may modulate the 24-hour rhythmicity of seizures. Characterization of these 24-hour patterns of seizure occurrence can influence diagnosis and treatment in selected types of epilepsy, such as the case of temporal lobe

  10. Derivation of a measure of systolic blood pressure mutability: a novel information theory-based metric from ambulatory blood pressure tests.

    PubMed

    Contreras, Danitza J; Vogel, Eugenio E; Saravia, Gonzalo; Stockins, Benjamin

    2016-03-01

    We provide ambulatory blood pressure (BP) exams with tools based on information theory to quantify fluctuations thus increasing the capture of dynamic test components. Data from 515 ambulatory 24-hour BP exams were considered. Average age was 54 years, 54% were women, and 53% were under BP treatment. The average systolic pressure (SP) was 127 ± 8 mm Hg. A data compressor (wlzip) designed to recognize meaningful information is invoked to measure mutability which is a form of dynamical variability. For patients with the same average SP, different mutability values are obtained which reflects the differences in dynamical variability. In unadjusted linear regression models, mutability had low association with the mean systolic BP (R(2) = 0.056; P < .000001) but larger association with the SP deviation (R(2) = 0.761; P < .001). Wlzip allows detecting levels of variability in SP that could be hazardous. This new indicator can be easily added to the 24-hour BP monitors improving information toward diagnosis.

  11. Seasonal changes of 24-hour intraocular pressure rhythm in healthy Shanghai population

    PubMed Central

    Cheng, Jingyi; Xiao, Ming; Xu, Huan; Fang, Shaobin; Chen, Xu; Kong, Xiangmei; Sun, Xinghuai

    2016-01-01

    Abstract The aim of the present study was to investigate and compare the 24-hour intraocular pressure (IOP) rhythms in winter and summer in the healthy population of Shanghai, China. This is a cross-sectional study in which 24-hour IOP measurements were taken for all eligible healthy volunteers in winter and summer, respectively, and the temperature, hours of sunlight (sunlight time), and circulatory parameters, including heart rate, systolic blood pressure, and diastolic blood pressure, were also recorded. The 24-hour IOP curves and IOP parameters (mean, peak, trough, and fluctuation of IOP together with the diurnal-to-nocturnal IOP change) in winter and summer were obtained and compared. The magnitude of IOP changes from summer to winter was also calculated. A total of 29 participants (58 eyes), 14 (48.28%) male and 15 (51.72%) female, aged 43.66 ± 12.20 (19–61) years, were considered eligible for this study. Generally, IOP decreased progressively before noon, increased notably in the nocturnal period, and peaked at 12:00 am in winter and at 2:00 am in summer. The pattern of 24-hour IOP in winter and summer was significantly different (P = 0.002). The average IOPs from 4:00 pm to 8:00 am, except for 6:00 am, were significantly higher in winter (P < 0.05). However, no significant differences were shown after adjusting for temperature and/or sunlight time. From summer to winter, the extent of IOP increase was mostly around 0 to 3 mm Hg, and the IOPs increased more significantly in the nocturnal period than in the diurnal period (P = 0.05). The 24-hour IOP rhythms were different in winter and summer, with higher IOP level in winter. Temperature and sunlight time, which are independent of heart rate and blood pressure, affected the 24-hour IOP rhythms in healthy people in Shanghai, China. Further investigations are expected for the rhythm of some endogenous substance secretion and the inner mechanism of regulation of IOP. PMID:27495076

  12. The 24-hour pulse wave velocity, aortic augmentation index, and central blood pressure in normotensive volunteers.

    PubMed

    Kuznetsova, Tatyana Y; Korneva, Viktoria A; Bryantseva, Evgeniya N; Barkan, Vitaliy S; Orlov, Artemy V; Posokhov, Igor N; Rogoza, Anatoly N

    2014-01-01

    The purpose of this study was to examine the pulse wave velocity, aortic augmentation index corrected for heart rate 75 (AIx@75), and central systolic and diastolic blood pressure during 24-hour monitoring in normotensive volunteers. Overall, 467 subjects (206 men and 261 women) were recruited in this study. Participants were excluded from the study if they were less than 19 years of age, had blood test abnormalities, had a body mass index greater than 2 7.5 kg/m(2), had impaired glucose tolerance, or had hypotension or hypertension. Ambulatory blood pressure monitoring (ABPM) with the BPLab(®) device was performed in each subject. ABPM waveforms were analyzed using the special automatic Vasotens(®) algorithm, which allows the calculation of pulse wave velocity, AIx@75, central systolic and diastolic blood pressure for "24-hour", "awake", and "asleep" periods. Circadian rhythms and sex differences in these indexes were identified. Pending further validation in prospective outcome-based studies, our data may be used as preliminary diagnostic values for the BPLab ABPM additional index in adult subjects.

  13. Is 24-hour Intraocular Pressure Monitoring Necessary in Glaucoma?

    PubMed Central

    Mansouri, Kaweh; Weinreb, Robert N.; Medeiros, Felipe A.

    2013-01-01

    Although intraocular pressure (IOP) is the only treatable risk factor for glaucoma, its 24-hour behavior is poorly understood. Conflicting information is available in the literature with regard to the importance and predictive value of IOP peaks and fluctuations on the risk of glaucoma development and progression. This may be secondary to lack of prospective studies designed to address this issue. This article critically reviews the current evidence for the importance of 24-h IOP measurements in glaucoma and discusses shortcomings of current methods to assess 24-h IOP data, drawing attention to new developments in this field. PMID:23697618

  14. Activity-adjusted 24-hour ambulatory blood pressure and cardiac remodeling in children with sleep disordered breathing.

    PubMed

    Amin, Raouf; Somers, Virend K; McConnell, Keith; Willging, Paul; Myer, Charles; Sherman, Marc; McPhail, Gary; Morgenthal, Ashley; Fenchel, Matthew; Bean, Judy; Kimball, Thomas; Daniels, Stephen

    2008-01-01

    Questions remain as to whether pediatric sleep disordered breathing increases the risk for elevated blood pressure and blood pressure-dependent cardiac remodeling. We tested the hypothesis that activity-adjusted morning blood pressure surge, blood pressure load, and diurnal and nocturnal blood pressure are significantly higher in children with sleep disordered breathing than in healthy controls and that these blood pressure parameters relate to left ventricular remodeling. 24-hour ambulatory blood pressure parameters were compared between groups. The associations between blood pressure and left ventricular relative wall thickness and mass were measured. 140 children met the inclusion criteria. In children with apnea hypopnea index <5 per hour, a significant difference from controls was the morning blood surge. Significant increases in blood pressure surge, blood pressure load, and in 24-hour ambulatory blood pressure were evident in those whom the apnea hypopnea index exceeded 5 per hour. Sleep disordered breathing and body mass index had similar effect on blood pressure parameters except for nocturnal diastolic blood pressure, where sleep disordered breathing had a significantly greater effect than body mass index. Diurnal and nocturnal systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure predicted the changes in left ventricular relative wall thickness. Therefore, sleep disordered breathing in children who are otherwise healthy is independently associated with an increase in morning blood pressure surge, blood pressure load, and 24-hour ambulatory blood pressure. The association between left ventricular remodeling and 24-hour blood pressure highlights the role of sleep disordered breathing in increasing cardiovascular morbidity.

  15. Managing sleep and wakefulness in a 24-hour world.

    PubMed

    Coveney, Catherine M

    2014-01-01

    This article contributes to literature on the sociology of sleep by exploring the sleeping practices and subjective sleep experiences of two social groups: shift workers and students. It draws on data, collected in the UK from 25 semi-structured interviews, to discuss the complex ways in which working patterns and social activities impact upon experiences and expectations of sleep in our wired awake world. The data show that, typically, sleep is valued and considered to be important for health, general wellbeing, appearance and physical and cognitive functioning. However, sleep time is often cut back on in favour of work demands and social activities. While shift workers described their efforts to fit in an adequate amount of sleep per 24-hour period, for students, the adoption of a flexible sleep routine was thought to be favourable for maintaining a work-social life balance. Collectively, respondents reported using a wide range of strategies, techniques, technologies and practices to encourage, overcome or delay sleep(iness) and boost, promote or enhance wakefulness/alertness at socially desirable times. The analysis demonstrates how social context impacts not only on how we come to think about sleep and understand it, but also how we manage or self-regulate our sleeping patterns.

  16. Managing sleep and wakefulness in a 24-hour world

    PubMed Central

    Coveney, Catherine M

    2014-01-01

    This article contributes to literature on the sociology of sleep by exploring the sleeping practices and subjective sleep experiences of two social groups: shift workers and students. It draws on data, collected in the UK from 25 semi-structured interviews, to discuss the complex ways in which working patterns and social activities impact upon experiences and expectations of sleep in our wired awake world. The data show that, typically, sleep is valued and considered to be important for health, general wellbeing, appearance and physical and cognitive functioning. However, sleep time is often cut back on in favour of work demands and social activities. While shift workers described their efforts to fit in an adequate amount of sleep per 24-hour period, for students, the adoption of a flexible sleep routine was thought to be favourable for maintaining a work–social life balance. Collectively, respondents reported using a wide range of strategies, techniques, technologies and practices to encourage, overcome or delay sleep(iness) and boost, promote or enhance wakefulness/alertness at socially desirable times. The analysis demonstrates how social context impacts not only on how we come to think about sleep and understand it, but also how we manage or self-regulate our sleeping patterns. PMID:23957268

  17. Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation

    PubMed Central

    Hartley, Geoffrey L.; Zaharieva, Dessi; Basset, Fabien A.; Hynes, Zach

    2016-01-01

    Survivor of a ship ground in polar regions may have to wait more than five days before being rescued. Therefore, the purpose of this study was to explore cognitive performance during prolonged cold exposure. Core temperature (Tc) and cognitive test battery (CTB) performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature). Participants (recruited from those who have regular occupational exposure to cold) were instructed that they could freely engage in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test conditions were sufficient to significantly decrease Tc after exposure and to eliminate the typical 0.5–1.0°C circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance regardless of exposure time. Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the benefit of maintaining metabolic heat production, improve motivation, and act as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance. PMID:27478839

  18. Preparation and results of a 24-hour orbital flight.

    PubMed

    Titov, G S

    1963-01-01

    The space age presents man with unprecedented opportunities for discovery and for cooperative endeavors to benefit all mankind. My flight of August 6-7, 1961 was conducted for the purpose of determining whether man can stay and work effectively and whether all systems of the spaceship can operate successfully during a period of 24 hours in space. The flight of Vostok II represents an experimental step in a logical sequence which included the first earth orbiting flight of USSR citizen Yuri A. Gagarin. Preparation for the flight included the study of theoretical and applied subjects, testing in various kinds of apparatus which provide acceleration, heat and isolation experience, brief airborne weightless flights and parachute landings, in addition to extensive training in a real spacecraft having simulators for normal and emergency contingencies of space flight. The actual flight was therefore carried out with a sense of confidence and familiarity and with continuous close radio contact with ground centers from whom my fellow cosmonauts served as spokesmen. Sequential boosters totaling 600 000 kg thrust placed the 4731 kg spaceship into a perfect orbit varying in altitude from 178-246 km in a plane 64 degrees 58' inclined to the equator. The spaceship made 17 orbits around the earth landing 25 hours, 18 minutes after take-off. The cabin had full atmospheric pressure and a comfortable habitability which could be extended for 10 days. I was able to maneuver the spaceship and perform many other control functions, make observations and take pictures of the earth and its cloud cover, eat meals and sleep all with good efficiency. I experienced mild symptoms suggestive of seasickness which were aggravated by head turning, ameliorated by sleep and entirely relieved by resumption of g-loading during descent. Altogether analyses of the physical and structural performance of the spaceship and the continuously monitored physiological responses of the pilot indicate that all

  19. [A validation of the data obtained with the simultaneous recording of blood pressure and the 24-hour electrocardiogram].

    PubMed

    Germanò, G; Caparra, A; Valentino, S; Coia, F; Federico, L; Santucci, A

    1993-06-01

    Aim of this study was to evaluate the blood pressure (BP) measurement reliability of a light weight ambulatory BP and ECG recorder. Micro AM is a new 300 g portable apparatus that combines in one device both the ambulatory BP and solid state ECG recording. The dimensions of the Micro AM are 75 x 140 x 29 mm. The monitor measures BP using Korotkoff phase 1 for systolic and phase 5 for diastolic BP, and concurrently measures oscillometric BP, one method validating the other. In addition, the manual and programmed BP measurement modes can be supplemented by an "intelligent" mode in which the ECG triggers an ambulatory BP reading during an abnormal ST segment change. A standard mercury manometer was connected with the cuff of the Micro AM with a Y-shaped part, and 12 BP measurements were simultaneously taken at 5 min intervals by the automatic device in auscultatory mode and by a trained technician in 86 normotensive volunteers (aged from 18 to 44 years, 37 males and 49 females). The algebraic differences, the frequency distribution and the difference distribution of systolic and diastolic data between the 2 methods were calculated. The results show that the automatic method gives values for systolic BP that are lower than conventional ones (average differences -0.643 mmHg), whereas for diastolic BP, the values are higher (average differences +0.229 mmHg). Then, Student's paired t-test was used to evaluate statistically significant differences. The test relative to systolic BP was significant to the critical level of 0.1%, but the differences being 3 times smaller than the instrumental tolerance. On the contrary, diastolic BP differences were non significant. In conclusion, we found a good agreement between BP recorded automatically and by sphygmomanometer.

  20. Crossover comparison of atenolol, enalapril, hydrochlorothiazide and isradipine for isolated systolic systemic hypertension.

    PubMed

    Silagy, C A; McNeil, J J; McGrath, B P

    1992-11-15

    The benefit of antihypertensive therapy in reducing cardiovascular morbidity and mortality associated with isolated systolic hypertension has now been established by the Systolic Hypertension in the Elderly Program. However, there is little information about the relative effectiveness of different drug regimens in this condition. This study compared the efficacy and tolerability of 50 mg of atenolol, 10 mg of enalapril, 25 mg of hydrochlorothiazide and 2.5 mg of isradipine in the treatment of isolated systolic hypertension. After a 3-week placebo run-in phase, 24 subjects were randomized into a 4-period double-blind crossover study by use of an orthogonal latin square design. Treatment periods were of 6 weeks' duration with titration to a higher dose after 4 weeks in those not reaching goal blood pressure (BP). Each active treatment was followed by a 3-week placebo washout. Casual clinic and 24-hour ambulatory BP (Accutracker II) were measured at the end of each treatment phase. Routine biochemistry was also performed after the placebo run-in, at the end of each active treatment phase, and after the placebo run-out. Of the 24 subjects entered (mean age 72.3 years, 38% men) 20 completed the whole study. Mean +/- standard deviation of supine clinic and daytime ambulatory BP on entry were 181/79 +/- 21/9 mm Hg and 165/82 +/- 23/15 mm Hg, respectively. All drugs reduced mean casual and ambulatory BP significantly relative to placebo but only hydrochlorothiazide and enalapril produced a consistent hypotensive effect throughout the entire 24-hour period. Isradipine and enalapril exhibited a relatively greater effect on reducing systolic BP than either hydrochlorothiazide or atenolol.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Effects of verapamil SR and atenolol on 24-hour blood pressure and heart rate in hypertension patients with coronary artery disease: an international verapamil SR-trandolapril ambulatory monitoring substudy.

    PubMed

    Denardo, Scott J; Gong, Yan; Cooper-DeHoff, Rhonda M; Farsang, Csaba; Keltai, Matyas; Szirmai, László; Messerli, Franz H; Bavry, Anthony A; Handberg, Eileen M; Mancia, Giuseppe; Pepine, Carl J

    2015-01-01

    Elevated nighttime blood pressure (BP) and heart rate (HR), increased BP and HR variability, and altered diurnal variations of BP and HR (nighttime dipping and morning surge) in patients with systemic hypertension are each associated with increased adverse cardiovascular events. However, there are no reports on the effect of hypertension treatment on these important hemodynamic parameters in the growing population of hypertensive patients with atherosclerotic coronary artery disease (CAD). This was a pre-specified subgroup analysis of the INternational VErapamil SR-Trandolapril STudy (INVEST), which involved 22,576 clinically stable patients aged ≥ 50 years with hypertension and CAD randomized to either verapamil SR- or atenolol-based hypertension treatment strategies. The subgroup consisted of 117 patients undergoing 24-hour ambulatory monitoring at baseline and after 1 year of treatment. Hourly systolic and diastolic BP (SBP and DBP) decreased after 1 year for both verapamil SR- and atenolol-based treatment strategies compared with baseline (P<0.0001). Atenolol also decreased hourly HR (P<0.0001). Both treatment strategies decreased SBP variability (weighted standard deviation: P = 0.012 and 0.021, respectively). Compared with verapamil SR, atenolol also increased the prevalence of BP and HR nighttime dipping among prior non-dippers (BP: OR = 3.37; 95% CI: 1.26-8.97 P = 0.015; HR: OR = 4.06; 95% CI: 1.35-12.17; P = 0.012) and blunted HR morning surge (+2.8 vs. +4.5 beats/min/hr; P = 0.019). Both verapamil SR- and especially atenolol-based strategies resulted in favorable changes in ambulatory monitoring parameters that have been previously associated with increased adverse cardiovascular events.

  2. A comparison of overnight and 24 hour collection to measure urinary catecholamines.

    PubMed

    White, I R; Brunner, E J; Barron, J L

    1995-02-01

    The period of urine collection used to measure excretion of catecholamines varies in epidemiological practice. We set out to compare overnight with 24 hour collection. Twenty-four subjects each collected urine for 24 hours, with the overnight urine being separately collected. The correlation of overnight and 24 hour catecholamines was highest when both measures were standardised for creatinine excretion and when creatinine excretion was adjusted for urine flow rate. The observed correlations were 0.74 for dopamine, 0.81 for noradrenaline and 0.54 for adrenaline. The use of overnight collections may therefore require a sample size up to 1.5 times as large (for noradrenaline) or 3.4 times as large (for adrenaline) to achieve the same power as with 24 hour collections. However, the figures given exaggerate the advantage of 24 hour collections if these incorporate measurement errors that are not present in overnight collections.

  3. Enhanced carotid-cardiac baroreflex response and elimination of orthostatic hypotension 24 hours after acute exercise in paraplegics

    NASA Technical Reports Server (NTRS)

    Engelke, K. A.; Shea, J. D.; Doerr, D. F.; Convertino, V. A.

    1992-01-01

    To test the hypothesis that an acute bout of maximal exercise can ameliorate orthostatic hypotension consequent to prolonged wheelchair confinement, we evaluated heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure responses during 15 minutes of 70 degrees head-up tilt (HUT) in 10 paraplegic subjects 24 hours after arm crank exercise designed to elicit maximal effort, and during a control (no exercise) conditions. Additionally, the carotid baroreceptor stimulus-cardiac response relationship was determined by measurement of R-R interval during external application of graded pressures to the carotid sinuses. One week separated the treatment conditions. The maximum slope of the carotid-cardiac baroreflex response was increased (p = 0.049) by exercise (6.2 +/- 1.7 msec/mmHg) compared to control (3.3 +/- 0.6). During control HUT, HR increased from 61 +/- 1 to 90 +/- 7 bpm (p = 0.001) while SBP decreased from 118 +/- 5 to 106 +/- 9 mmHg (p = 0.025). During HUT 24 hours after exercise, HR increased from 60 +/- 2 to 90 +/- 4 bpm (p = 0.001), but the reduction in SBP was essentially eliminated (116 +/- 5 to 113 +/- 5 mmHg).

  4. Aldosterone-to-Renin Ratio Is Associated With Reduced 24-Hour Heart Rate Variability and QTc Prolongation in Hypertensive Patients.

    PubMed

    Grübler, Martin R; Kienreich, Katharina; Gaksch, Martin; Verheyen, Nicolas; Hartaigh, Bríain Ó; Fahrleitner-Pammer, Astrid; März, Winfried; Schmid, Johannes; Oberreither, Eva-Maria; Wetzel, Julia; Catena, Cristiana; Sechi, Leonardo A; Pieske, Burkert; Tomaschitz, Andreas; Pilz, Stefan

    2016-02-01

    Aldosterone is considered to exert direct effects on the myocardium and the sympathetic nervous system. Both QT time and heart rate (HR) variability (HRV) are considered to be markers of arrhythmic risk and autonomous dysregulation. In this study, we investigated the associations between aldosterone, QT time, and HRV in patients with arterial hypertension.We recruited 477 hypertensive patients (age: 60.2 ± 10.2 years; 52.3% females) with a mean systolic/diastolic 24-hour ambulatory blood pressure monitoring (ABPM) value of 128 ± 12.8/77.1 ± 9.2 mmHg and with a median of 2 (IQR: 1-3) antihypertensive agents. Patients were recruited from the outpatient clinic at the Department of Internal Medicine of the Medical University of Graz, Austria. Blood samples, 24-hour HRV derived from 24-hour blood pressure monitoring (ABPM) and ECG's were obtained. Plasma aldosterone and plasma renin concentrations were measured by means of a radioimmunoassay. Twenty-four-hour urine specimens were collected in parallel with ABPM.Mean QTc was 423.3 ± 42.0 milliseconds for males and 434.7 ± 38.3 milliseconds for females. Mean 24H-HR and 24H-HRV was 71.9 ± 9.8 and 10.0 ± 3.6 bpm, respectively. In linear regression analyses adjusted for age, sex, body mass index, ABPM, and current medication, aldosterone to active renin ratio (AARR) was significantly associated with the QTc interval, a marker for cardiac repolarization abnormalities (mean = 426 ± 42.4 milliseconds; β-coefficient = 0.121; P = 0.03) as well as with the 24-hour heart rate variability a surrogate for autonomic dysfunction (median = 9.67 [IQR = 7.38-12.22 bpm]; β-coefficient = -0.133; P = 0.01).In hypertensive patients, AARR is significantly related to QTc prolongation as well as HRV. Further studies investigating the effects of mineralocorticoid receptor blocker and aldosterone synthase inhibitors on QTc and HRV are warranted.

  5. Optimal dose of oral omeprazole for maximal 24 hour decrease of intragastric acidity.

    PubMed Central

    Sharma, B K; Walt, R P; Pounder, R E; Gomes, M D; Wood, E C; Logan, L H

    1984-01-01

    In a series of 59 experiments in nine duodenal ulcer patients, 24 hour intragastric acidity was measured before, during, and after treatment with daily oral omeprazole. Omeprazole 10, 20, and 30 mg/day for one week caused a 37, 90, and 97% decrease of 24 hour intragastric acidity, respectively. No further decrease of acidity was observed when the dose of omeprazole was doubled to 60 mg/day, or after a second week of treatment with 30 mg/day. One week after stopping treatment with omeprazole (14 doses) there was a significant 26% decrease of 24 hour intragastric acidity, with full recovery seven weeks later. Fasting plasma gastrin concentration was significantly raised during treatment with all doses of omeprazole. Omeprazole 30 mg/day is the optimal dose for a maximal decrease of 24 hour intragastric acidity in duodenal ulcer patients. PMID:6469081

  6. Comparison of anthropometric and training characteristics between recreational male marathoners and 24-hour ultramarathoners

    PubMed Central

    Rüst, Christoph Alexander; Knechtle, Beat; Knechtle, Patrizia; Rosemann, Thomas

    2012-01-01

    Background Of the anthropometry and training variables used to predict race performance in a 24-hour ultrarun, the personal best marathon time is the strongest predictor in recreational male 24-hour ultramarathoners. This finding raises the question of whether similarities exist between male recreational 24-hour ultramarathoners and male recreational marathoners. Methods The association between age, anthropometric variables (ie, body mass, body height, body mass index, percent body fat, skeletal muscle mass, limb circumference, and skinfold thickness at the pectoral, mid axillary, triceps, subscapular, abdominal, suprailiac, front thigh, and medial calf sites), previous experience and training characteristics (ie, volume, speed, and personal best time), and race time for 79 male recreational 24-hour ultramarathoners and 126 male recreational marathoners was investigated using bivariate and multivariate analysis. Results The 24-hour ultramarathoners were older (P < 0.05), had a lower circumference at both the upper arm (P < 0.05) and thigh (P < 0.01), and a lower skinfold thickness at the pectoral, axillary, and suprailiac sites (P < 0.05) compared with the marathoners. During training, the 24-hour ultramarathoners were running for more hours per week (P < 0.001) and completed more kilometers (P < 0.001), but were running slower (P < 0.01) compared with the marathoners. In the 24-hour ultramarathoners, neither anthropometric nor training variables were associated with kilometers completed in the race (P > 0.05). In the marathoners, percent body fat (P < 0.001) and running speed during training (P < 0.0001) were related to marathon race times. Conclusion In summary, differences in anthropometric and training predictor variables do exist between male recreational 24-hour ultramarathoners and male recreational marathoners for race performance. PMID:24198595

  7. Insights about serum sodium behavior after 24 hours of continuous renal replacement therapy

    PubMed Central

    Romano, Thiago Gomes; Martins, Cassia Pimenta Barufi; Mendes, Pedro Vitale; Besen, Bruno Adler Maccagnan Pinheiro; Zampieri, Fernando Godinho; Park, Marcelo

    2016-01-01

    Objective The aim of this study was to investigate the clinical and laboratorial factors associated with serum sodium variation during continuous renal replacement therapy and to assess whether the perfect admixture formula could predict 24-hour sodium variation. Methods Thirty-six continuous renal replacement therapy sessions of 33 patients, in which the affluent prescription was unchanged during the first 24 hours, were retrieved from a prospective collected database and then analyzed. A mixed linear model was performed to investigate the factors associated with large serum sodium variations (≥ 8mEq/L), and a Bland-Altman plot was generated to assess the agreement between the predicted and observed variations. Results In continuous renal replacement therapy 24-hour sessions, SAPS 3 (p = 0.022) and baseline hypernatremia (p = 0.023) were statistically significant predictors of serum sodium variations ≥ 8mEq/L in univariate analysis, but only hypernatremia demonstrated an independent association (β = 0.429, p < 0.001). The perfect admixture formula for sodium prediction at 24 hours demonstrated poor agreement with the observed values. Conclusions Hypernatremia at the time of continuous renal replacement therapy initiation is an important factor associated with clinically significant serum sodium variation. The use of 4% citrate or acid citrate dextrose - formula A 2.2% as anticoagulants was not associated with higher serum sodium variations. A mathematical prediction for the serum sodium concentration after 24 hours was not feasible. PMID:27410407

  8. [THE INFLUENCE OF CYTOFLAVIN AND CARDIOXIPIN ON THE PARAMETERS OF 24-HOUR ARTERIAL PRESSURE MONITORING IN PATIENTS WITH CHRONIC CEREBRAL CIRCULATION INSUFFICIENCY, ARTERIAL HYPERTENSION AND HYPERCHOLESTEROLEMIA].

    PubMed

    Vodop'ianova, O A; Moiseeva, I Ia; Rodina, O P; Kustikova, I N; Antropova, N V

    2015-01-01

    This comparative study of the influence of cytoflavin and cardioxipin on the parameters of 24-hour arterial pressure monitoring in 56 patients with chronic cerebral circulation insufficiency, arterial hypertension and hypercholesterolemia included 32 women and 24 men aged 42-72 years divided into 3 groups matchedfor the stage of diseases, age, sex, severity of AH, total cholesterol level, and antihypertensive therapy. Patients of group 1 were treated without cytoflavin and cardioxipin. Those in group 2 received daily i/v droplet infusion of 10 mg/kg cardioxipin (20-30 droplets/min). Patients of group 3 were given daily i/v droplet infusion of 10 ml cytoflavin in 200 ml 0.9% sodium chloride solution for 10 days. 24-hour arterial pressure monitoring was used to estimate the influence of the two drugs on systolic and diastolic pressure, its daily rhythm, AP variability and frequency of elevation. The study showed that both therapeutic modalities improved daily AP rhythm as manifested in a significant increase of the number of patients with the dipper rhythm and a decrease in the number of systolic/diastolic non-dipper patients. Moreover cytoflavin significantly decreased the number of systolic over-dippers compared with control group.

  9. Agreement between 24-hour salt ingestion and sodium excretion in a controlled environment.

    PubMed

    Lerchl, Kathrin; Rakova, Natalia; Dahlmann, Anke; Rauh, Manfred; Goller, Ulrike; Basner, Mathias; Dinges, David F; Beck, Luis; Agureev, Alexander; Larina, Irina; Baranov, Victor; Morukov, Boris; Eckardt, Kai-Uwe; Vassilieva, Galina; Wabel, Peter; Vienken, Jörg; Kirsch, Karl; Johannes, Bernd; Krannich, Alexander; Luft, Friedrich C; Titze, Jens

    2015-10-01

    Accurately collected 24-hour urine collections are presumed to be valid for estimating salt intake in individuals. We performed 2 independent ultralong-term salt balance studies lasting 105 (4 men) and 205 (6 men) days in 10 men simulating a flight to Mars. We controlled dietary intake of all constituents for months at salt intakes of 12, 9, and 6 g/d and collected all urine. The subjects' daily menus consisted of 27 279 individual servings, of which 83.0% were completely consumed, 16.5% completely rejected, and 0.5% incompletely consumed. Urinary recovery of dietary salt was 92% of recorded intake, indicating long-term steady-state sodium balance in both studies. Even at fixed salt intake, 24-hour urine collection for sodium excretion (UNaV) showed infradian rhythmicity. We defined a ±25 mmol deviation from the average difference between recorded sodium intake and UNaV as the prediction interval to accurately classify a 3-g difference in salt intake. Because of the biological variability in UNaV, only every other daily urine sample correctly classified a 3-g difference in salt intake (49%). By increasing the observations to 3 consecutive 24-hour collections and sodium intakes, classification accuracy improved to 75%. Collecting seven 24-hour urines and sodium intake samples improved classification accuracy to 92%. We conclude that single 24-hour urine collections at intakes ranging from 6 to 12 g salt per day were not suitable to detect a 3-g difference in individual salt intake. Repeated measurements of 24-hour UNaV improve precision. This knowledge could be relevant to patient care and the conduct of intervention trials.

  10. Asymptomatic rhythm and conduction abnormalities in children with acute rheumatic fever: 24-hour electrocardiography study.

    PubMed

    Karacan, Mehmet; Işıkay, Sedat; Olgun, Haşim; Ceviz, Naci

    2010-12-01

    Some rhythm and conduction abnormalities can occur in children with acute rheumatic fever. These abnormalities have been defined based on standard electrocardiography; however, the real prevalence of these abnormalities has not been investigated previously by the evaluation of long-term electrocardiographic recordings. In this study, we evaluated the asymptomatic rhythm and conduction abnormalities in children with acute rheumatic fever by evaluating the 24-hour electrocardiography. We evaluated the standard electrocardiography and the 24-hour electrocardiography of 64 children with acute rheumatic fever. On standard electrocardiography, the frequency of the first-degree atrioventricular block was found to be 21.9%. Electrocardiography at 24 hours detected three additional and separate patients with a long PR interval. Mobitz type I block and atypical Wenckebach periodicity were determined in one patient (1.56%) on 24-hour electrocardiography. While accelerated junctional rhythm was detected in three patients on standard electrocardiography, it was present in nine patients according to 24-hour electrocardiography. Premature contractions were present in 1.7% of standard electrocardiography, but in 29.7% of 24-hour electrocardiography. Absence of carditis was found to be related to the presence of accelerated junctional rhythm (p > 0.05), and the presence of carditis was found to be related to the presence of premature contractions (p = 0.000). In conclusion, our results suggest that in children with acute rheumatic fever, the prevalence of rhythm and conduction abnormalities may be much higher than determined on standard electrocardiography. Further studies are needed to clarify whether or not these abnormalities are specific to acute rheumatic fever.

  11. Ambulatory 24-hour cardiac oxygen consumption and blood pressure-heart rate variability: effects of nebivolol and valsartan alone and in combination.

    PubMed

    Izzo, Joseph L; Khan, Safi U; Saleem, Osman; Osmond, Peter J

    2015-07-01

    We compared an angiotensin receptor blocker (valsartan; VAL), a beta-blocker (nebivolol; NEB) and the combination of NEB/VAL with respect to 24-hour myocardial oxygen consumption (determined by 24-hour ambulatory heart rate-central systolic pressure product [ACRPP]) and its components. Subjects with hypertension (systolic blood pressure >140 or diastolic blood pressure >90; n = 26) were studied in a double-blinded, double-dummy, forced-titration, crossover design with 3 random-order experimental periods: VAL 320 mg, NEB 40 mg, and NEB/VAL 320/40 mg daily. After 4 weeks of each drug, ambulatory pulse wave analysis (MobilOGraph) was performed every 20 minutes for 24 hours. All three treatments resulted in nearly identical brachial and central systolic blood pressures. NEB alone or in combination with VAL resulted in lower ACRPP (by 11%-14%; P < .001 each) and heart rate (by 18%-20%; P < .001 each) compared with VAL, but stroke work (ACRPP per beat) was lower with VAL. Relative and adjusted variability (standard deviation and coefficient of variation) of heart rate were also lower with NEB and NEB/VAL than VAL. Results in African Americans, the majority subpopulation, were similar to those of the entire treatment group. We conclude that the rate-slowing effects of NEB cause ambulatory cardiac myocardial oxygen consumption to be lower with NEB monotherapy or NEB/VAL combination therapy than with VAL monotherapy. NEB/VAL is not superior to NEB alone in controlling heart rate, blood pressure, or ACRPP. Heart rate variability but not ACRPP variability is reduced by NEB or the combination NEB/VAL. There is no attenuation of beta-blocker-induced rate-slowing effects of in African Americans.

  12. Continual 24-hour observations of thermospheric winds made with the SOFDI instrument from Huancayo, Peru

    NASA Astrophysics Data System (ADS)

    Gerrard, Andrew; Meriwether, John W.

    The Second generation Optimized Fabry-Perot Doppler Imager (SOFDI), a state-of-the-art triple-etalon Fabry-Perot interferometer, has been sucessfully relocated to Huancayo, Peru and is making continual 24-hour observations. The 630-nm data, originating from layer-integrated OI emission with centroid heights of 250 km at night and 220 km during the day, are analyzed so as to obtain measurements of horizontal winds in the thermosphere. In this paper we report the most recent results from continuous 24-hour observations of these thermospheric parameters.

  13. Different systolic blood pressure targets for people with history of stroke or transient ischaemic attack: PAST-BP (Prevention After Stroke—Blood Pressure) randomised controlled trial

    PubMed Central

    McManus, Richard J; Roalfe, Andrea; Fletcher, Kate; Taylor, Clare J; Martin, Una; Virdee, Satnam; Greenfield, Sheila; Hobbs, F D Richard

    2016-01-01

    Objective To assess whether using intensive blood pressure targets leads to lower blood pressure in a community population of people with prevalent cerebrovascular disease. Design Open label randomised controlled trial. Setting 99 general practices in England, with participants recruited in 2009-11. Participants People with a history of stroke or transient ischaemic attack whose systolic blood pressure was 125 mm Hg or above. Interventions Intensive systolic blood pressure target (<130 mm Hg or 10 mm Hg reduction from baseline if this was <140 mm Hg) or standard target (<140 mm Hg). Apart from the different target, patients in both arms were actively managed in the same way with regular reviews by the primary care team. Main outcome measure Change in systolic blood pressure between baseline and 12 months. Results 529 patients (mean age 72) were enrolled, 266 to the intensive target arm and 263 to the standard target arm, of whom 379 were included in the primary analysis (182 (68%) intensive arm; 197 (75%) standard arm). 84 patients withdrew from the study during the follow-up period (52 intensive arm; 32 standard arm). Mean systolic blood pressure dropped by 16.1 mm Hg to 127.4 mm Hg in the intensive target arm and by 12.8 mm Hg to 129.4 mm Hg in the standard arm (difference between groups 2.9 (95% confidence interval 0.2 to 5.7) mm Hg; P=0.03). Conclusions Aiming for target below 130 mm Hg rather than 140 mm Hg for systolic blood pressure in people with cerebrovascular disease in primary care led to a small additional reduction in blood pressure. Active management of systolic blood pressure in this population using a <140 mm Hg target led to a clinically important reduction in blood pressure. Trial registration Current Controlled Trials ISRCTN29062286. PMID:26919870

  14. 29 CFR 785.22 - Duty of 24 hours or more.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Sleeping Time and Certain Other Activities § 785.22 Duty of 24 hours or more. (a) General. Where an... bona fide meal periods and a bona fide regularly scheduled sleeping period of not more than 8 hours from hours worked, provided adequate sleeping facilities are furnished by the employer and the...

  15. 29 CFR 785.22 - Duty of 24 hours or more.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Sleeping Time and Certain Other Activities § 785.22 Duty of 24 hours or more. (a) General. Where an... bona fide meal periods and a bona fide regularly scheduled sleeping period of not more than 8 hours from hours worked, provided adequate sleeping facilities are furnished by the employer and the...

  16. 24-Hour Access: Responding to Students' Need for Late Library Hours at the University of Denver

    ERIC Educational Resources Information Center

    Sewell, Bethany B.

    2013-01-01

    The University of Denver's Penrose Library saw a substantial increase in use as a result of several new and enhanced services over a six-year period. In turn, longer operating hours and increased staffing for a 24-hours-a-day, five-days-a-week (24 x 5) operating schedule was funded. This case study analyzes student need for longer library hours…

  17. Assessing dietary intake in childhood cancer survivors: Food frequency questionnaire versus 24-hour diet recalls

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cancer diagnosis and treatment may influence dietary intake. The validity of using self-reported methods to quantify dietary intake has not been evaluated in childhood cancer survivors. We validated total energy intake (EI) reported from Food Frequency Questionnaire (FFQ) and repeated 24-hour diet r...

  18. Mood-Dependent Cognitive Change in a Man with Bipolar Disorder Who Cycles Every 24 Hours

    ERIC Educational Resources Information Center

    Lam, Dominic; Mansell, Warren

    2008-01-01

    A case study of a bipolar patient whose mood changes every 24 hours is described to illustrate the changes in cognitive processing and content during different phases of bipolar disorder. The participant completed a battery of questionnaires and tasks on 4 separate occasions: twice when depressed and twice when manic. Depression tended to be…

  19. The Three-Continent, 24-Hour Help Desk: An Academic First?

    ERIC Educational Resources Information Center

    Sykes, Jean

    2002-01-01

    Describes Follow the Sun, a computer help-desk service that takes advantage of time differences around the world to permit four universities (University of Colorado Boulder, Australia's Macquarie and Newcastle universities, and the London School of Economics) to share services and provide 24-hour support to users. (EV)

  20. 29 CFR 785.22 - Duty of 24 hours or more.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Sleeping Time and Certain Other Activities § 785.22 Duty of 24 hours or more. (a) General. Where an... bona fide meal periods and a bona fide regularly scheduled sleeping period of not more than 8 hours from hours worked, provided adequate sleeping facilities are furnished by the employer and the...

  1. 29 CFR 785.22 - Duty of 24 hours or more.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Sleeping Time and Certain Other Activities § 785.22 Duty of 24 hours or more. (a) General. Where an... bona fide meal periods and a bona fide regularly scheduled sleeping period of not more than 8 hours from hours worked, provided adequate sleeping facilities are furnished by the employer and the...

  2. 29 CFR 785.22 - Duty of 24 hours or more.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Sleeping Time and Certain Other Activities § 785.22 Duty of 24 hours or more. (a) General. Where an... bona fide meal periods and a bona fide regularly scheduled sleeping period of not more than 8 hours from hours worked, provided adequate sleeping facilities are furnished by the employer and the...

  3. 24 Hours of Sleep, Sedentary Behavior, and Physical Activity with Nine Wearable Devices

    PubMed Central

    Rosenberger, Mary E.; Buman, Matthew P.; Haskell, William L.; McConnell, Michael V.; Carstensen, Laura L.

    2015-01-01

    Getting enough sleep, exercising and limiting sedentary activities can greatly contribute to disease prevention and overall health and longevity. Measuring the full 24-hour activity cycle - sleep, sedentary behavior (SED), light intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) - may now be feasible using small wearable devices. PURPOSE This study compares nine devices for accuracy in 24-hour activity measurement. METHODS Adults (N=40, 47% male) wore nine devices for 24-hours: Actigraph GT3X+, activPAL, Fitbit One, GENEactiv, Jawbone Up, LUMOback, Nike Fuelband, Omron pedometer, and Z-Machine. Comparisons (to standards) were made for total sleep time (Z-machine), time spent in SED (activPAL), LPA (GT3x+), MVPA (GT3x+), and steps (Omron). Analysis included mean absolute percent error, equivalence testing, and Bland-Altman plots. RESULTS Error rates ranged from 8.1–16.9% for sleep; 9.5–65.8% for SED; 19.7–28.0% for LPA; 51.8–92% for MVPA; and 14.1–29.9% for steps. Equivalence testing indicated only two comparisons were significantly equivalent to standards: the LUMOback for sedentary behavior and the GT3X+ for sleep. Bland-Altman plots indicated GT3X+ had the closest measurement for sleep, LUMOback for sedentary behavior, GENEactiv for LPA, Fitbit for MVPA and GT3X+ for steps. CONCLUSIONS Currently, no device accurately captures activity data across the entire 24-hour day, but the future of activity measurement should aim for accurate 24-hour measurement as a goal. Researchers should continue to select measurement devices based on their primary outcomes of interest. PMID:26484953

  4. Experiences of 24-hour advice line services: a framework for good practice and meeting NICE guidelines.

    PubMed

    Yardley, Sarah J; Codling, Jan; Roberts, Dai; O Donnell, Valerie; Taylor, Sue

    2009-06-01

    This article presents a framework for the practical implementation of a 24-hour specialist palliative care advice line, illustrated by two case examples from the authors' experience. In the UK, National Institute for Health and Clinical Excellence guidance requires provision of 24-hour access to specialist palliative care advice for healthcare professionals and carers regardless of a patient's location. Effective implementation of a telephone advice line for specialist advice is one approach to addressing the current variability in palliative care service provision, both in the UK and elsewhere. The authors were unable to identify a model with documentation for ensuring adequate clinical governance of an advice line in the literature and so present their own. The accompanying case examples demonstrate the difference between 'evolution of services by demand' and taking a systemic approach to service design. Key recommendations for practice are outlined for an effective advice line service which incorporates training and education into the clinical governance structures of the host organization.

  5. Exercising in the Fasted State Reduced 24-Hour Energy Intake in Active Male Adults

    PubMed Central

    Deitrick, Ronald W.; Hillman, Angela R.

    2016-01-01

    The effect of fasting prior to morning exercise on 24-hour energy intake was examined using a randomized, counterbalanced design. Participants (12 active, white males, 20.8 ± 3.0 years old, VO2max: 59.1 ± 5.7 mL/kg/min) fasted (NoBK) or received breakfast (BK) and then ran for 60 minutes at 60%  VO2max. All food was weighed and measured for 24 hours. Measures of blood glucose and hunger were collected at 5 time points. Respiratory quotient (RQ) was measured during exercise. Generalized linear mixed models and paired sample t-tests examined differences between the conditions. Total 24-hour (BK: 19172 ± 4542 kJ versus NoBK: 15312 ± 4513 kJ; p < 0.001) and evening (BK: 12265 ± 4278 kJ versus NoBK: 10833 ± 4065; p = 0.039) energy intake and RQ (BK: 0.90 ± 0.03 versus NoBK: 0.86 ± 0.03; p < 0.001) were significantly higher in BK than NoBK. Blood glucose was significantly higher in BK than NoBK before exercise (5.2 ± 0.7 versus 4.5 ± 0.6 mmol/L; p = 0.025). Hunger was significantly lower for BK than NoBK before exercise, after exercise, and before lunch. Blood glucose and hunger were not associated with energy intake. Fasting before morning exercise decreased 24-hour energy intake and increased fat oxidation during exercise. Completing exercise in the morning in the fasted state may have implications for weight management. PMID:27738523

  6. Circadian polymorphisms in night owls, in bipolars, and in non-24-hour sleep cycles.

    PubMed

    Kripke, Daniel F; Klimecki, Walter T; Nievergelt, Caroline M; Rex, Katharine M; Murray, Sarah S; Shekhtman, Tatyana; Tranah, Gregory J; Loving, Richard T; Lee, Heon-Jeong; Rhee, Min Kyu; Shadan, Farhad F; Poceta, J Steven; Jamil, Shazia M; Kline, Lawrence E; Kelsoe, John R

    2014-10-01

    People called night owls habitually have late bedtimes and late times of arising, sometimes suffering a heritable circadian disturbance called delayed sleep phase syndrome (DSPS). Those with DSPS, those with more severe progressively-late non-24-hour sleep-wake cycles, and those with bipolar disorder may share genetic tendencies for slowed or delayed circadian cycles. We searched for polymorphisms associated with DSPS in a case-control study of DSPS research participants and a separate study of Sleep Center patients undergoing polysomnography. In 45 participants, we resequenced portions of 15 circadian genes to identify unknown polymorphisms that might be associated with DSPS, non-24-hour rhythms, or bipolar comorbidities. We then genotyped single nucleotide polymorphisms (SNPs) in both larger samples, using Illumina Golden Gate assays. Associations of SNPs with the DSPS phenotype and with the morningness-eveningness parametric phenotype were computed for both samples, then combined for meta-analyses. Delayed sleep and "eveningness" were inversely associated with loci in circadian genes NFIL3 (rs2482705) and RORC (rs3828057). A group of haplotypes overlapping BHLHE40 was associated with non-24-hour sleep-wake cycles, and less robustly, with delayed sleep and bipolar disorder (e.g., rs34883305, rs34870629, rs74439275, and rs3750275 were associated with n=37, p=4.58E-09, Bonferroni p=2.95E-06). Bright light and melatonin can palliate circadian disorders, and genetics may clarify the underlying circadian photoperiodic mechanisms. After further replication and identification of the causal polymorphisms, these findings may point to future treatments for DSPS, non-24-hour rhythms, and possibly bipolar disorder or depression.

  7. Iodine Excretion in 24-hour Urine Collection and Its Dietary Determinants in Healthy Japanese Adults

    PubMed Central

    Katagiri, Ryoko; Asakura, Keiko; Uechi, Ken; Masayasu, Shizuko; Sasaki, Satoshi

    2016-01-01

    Background Since seaweed is a common component of the Japanese diet, iodine intake in Japanese is expected to be high. However, urinary iodine excretion, measured using 24-hour urine samples, and its dietary determinants are not known. Methods Apparently healthy adults aged 20 to 69 years living in 20 areas throughout Japan were recruited in February and March, 2013. Urinary iodine excretion was evaluated using 24-hour urine collected from 713 subjects (362 men and 351 women), and the difference among age groups was assessed. The association between dietary intake of food groups and urinary iodine excretion was assessed among 358 subjects who completed a semi-weighed 4-day diet record (DR) and urine collection. The correlations between iodine intake and iodine excretion were also evaluated, and correlation coefficients were calculated for iodine intake in the DR of the overlapping day or the DR 1 day before and after urine collection. Results Median iodine excretion in 24-hour urine was 365 µg, and excretion was significantly higher in older subjects. Iodine intake estimated by the DRs was significantly correlated with urinary iodine excretion when DRs and urine collection were obtained on the same day (r = 0.37). After adjustment for confounding factors, iodine excretion was significantly associated with intakes of kelp and soup stock from kelp and fish. Conclusions Although multiple measurements for urinary iodine are required to confirm our results, this study showed the current iodine status of healthy Japanese adults. The results suggest that kelp and fish are the main contributors to Japanese iodine status measured by 24-hour urine. PMID:27374137

  8. 24-hour-restraint stress induces long-term depressive-like phenotypes in mice

    PubMed Central

    Zhou, Ying; Hu, Zhiqiang; Lou, Jingyu; Song, Wei; Li, Jing; Liang, Xiao; Chen, Chen; Wang, Shuai; Yang, Beimeng; Chen, Lei; Zhang, Xu; Song, Jinjing; Dong, Yujie; Chen, Shiqing; He, Lin; Xie, Qingguo; Chen, Xiaoping; Li, Weidong

    2016-01-01

    There is an increasing risk of mental disorders, such as acute stress disorder (ASD), post-traumatic stress disorder (PTSD) and depression among survivors who were trapped in rubble during earthquake. Such long-term impaction of a single acute restraint stress has not been extensively explored. In this study, we subjected mice to 24-hour-restraint to simulate the trapping episode, and investigated the acute (2 days after the restraint) and long-term (35 days after the restraint) impacts. Surprisingly, we found that the mice displayed depression-like behaviors, decreased glucose uptake in brain and reduced adult hippocampal neurogenesis 35 days after the restraint. Differential expression profiling based on microarrays suggested that genes and pathways related to depression and other mental disorders were differentially expressed in both PFC and hippocampus. Furthermore, the depression-like phenotypes induced by 24-hour-restraint could be reversed by fluoxetine, a type of antidepressant drug. These findings demonstrated that a single severe stressful event could produce long-term depressive-like phenotypes. Moreover, the 24-hour-restraint stress mice could also be used for further studies on mood disorders. PMID:27609090

  9. [24-hour energy metabolism in the human: circadian rhythm, relation to body weight and nutrition].

    PubMed

    Steiniger, J

    1985-04-15

    In 7 men with normal weight and 9 man with overweight and healthy metabolism the resting and fasting energy expenditure was indirectly calorimetrically pursued in the open system over 24 hours. The total energy expenditure over 24 hours revealed an ascertained dependence on body-weight and nutrition. The persons with overweight had a higher absolute energy expenditure, however, the activity of the energy metabolism of the body mass free from fat and the active body mass, respectively, decreased with increasing overweight. The resting and fasting energy expenditure showed in all measured parameters (oxygen consumption, respiratory quotient and nitrogen excretion in the urine) an ascertained daily periodicity (circadian rhythm), which was widely independent of body weight. Only the average daily level C0 (rhythm adjusted level) of the resting and fasting energy expenditure was positively correlated with the body weight and the food energy intake. A negative energy balance (reduction 1.2 MJ/d over 28 days) influenced only the total energy and substrate balance over 24 hours and the daily average level, respectively. The circadian conditions remained unchanged (Chossat's phenomenon). The variability in daily rhythm of the energy expenditure of nearly 25% of the daily average should be taken into consideration in the judgment of exogenically stimulated changes in the energy metabolism.

  10. ED 03-2 HOME BLOOD PRESSURE MONITORING IS BETTER THAN OFFICE BP AND AMBULATORY BP: UPDATE.

    PubMed

    Kario, Kazuomi

    2016-09-01

    cardiovascular events was revealed to be 144 mmHg, and approx. 125 mmHg was shown to be the minimum risk. There was no J-curve of morning systolic BP until around 100 mmHg. In a sub-analysis of the HONEST patient series with data separated for stroke and coronary events, the morning home BP values were a strong predictor of coronary events similarly to stroke events, but the predictive power of office systolic BP was weaker for coronary events than for stroke event (Kario, et al. J Am Coll Cardiol 2016;67:1519-1527). In addition, a J-curve was not observed in the relationship between morning home BP for coronary events or for stroke events.Nocturnal BP has traditionally been measured only by ABPM, and the clinical evidence of nocturnal hypertension is established based on the ABPM data. However, nocturnal BP can now be measured by HBPM as an alternative to ABPM. In our nationwide Japanese cohort, the Japan Morning Surge Home Blood Pressure (J-HOP) Study, we measured nocturnal BP by HBPM (Kario. J Clin Hypertens 2015;17:340-348). Morning home BP was the predictor of stroke event (Hoshide, Kario, et al. Hypertension 2016;68:54-61), while uncontrolled nocturnal hypertension was significantly associated with cardiovascular events. Since Asians show greater morning BP surges (Hoshide, Kario, Parati et al. Hypertension 2016;68:54-61), it is particularly important for Asians to achieve 'perfect 24-hr BP control,' i.e., the 24-hr BP level, nocturnal BP dipping, and BP variability including morning surge (Kario. Ann Glob Health 2016;82:254-273). We are developing the new ICT-based BP monitoring such as "IT-based home nocturnal BP monitoring" (Kario. Hypertens Res 2013;36:478-484) and "hypoxia-triggered home nocturnal BP monitoring (TNP)" (Kuwabara, Kario, et al. J Clin Hypertens 2016, in press) to clarify the clinical relevance of 24-hour BP control.A morning home BP-guided staged approach is the first step toward perfect 24-hr BP control, followed by the control of nocturnal

  11. Validation of triple pass 24-hour dietary recall in Ugandan children by simultaneous weighed food assessment

    PubMed Central

    Olupot-Olupot, Peter; Engoru, Charles; Ssenyondo, Tonny; Nteziyaremye, Julius; Amorut, Denis; Nakuya, Margaret; Arimi, Margaret; Frost, Gary; Maitland, Kathryn

    2016-01-01

    Background Undernutrition remains highly prevalent in African children, highlighting the need for accurately assessing dietary intake. In order to do so, the assessment method must be validated in the target population. A triple pass 24 hour dietary recall with volumetric portion size estimation has been described but not previously validated in African children. This study aimed to establish the relative validity of 24-hour dietary recalls of daily food consumption in healthy African children living in Mbale and Soroti, eastern Uganda compared to simultaneous weighed food records. Methods Quantitative assessment of daily food consumption by weighed food records followed by two independent assessments using triple pass 24-hour dietary recall on the following day. In conjunction with household measures and standard food sizes, volumes of liquid, dry rice, or play dough were used to aid portion size estimation. Inter-assessor agreement, and agreement with weighed food records was conducted primarily by Bland-Altman analysis and secondly by intraclass correlation coefficients and quartile cross-classification. Results 19 healthy children aged 6 months to 12 years were included in the study. Bland-Altman analysis showed 24-hour recall only marginally under-estimated energy (mean difference of 149kJ or 2.8%; limits of agreement -1618 to 1321kJ), protein (2.9g or 9.4%; -12.6 to 6.7g), and iron (0.43mg or 8.3%; -3.1 to 2.3mg). Quartile cross-classification was correct in 79% of cases for energy intake, and 89% for both protein and iron. The intraclass correlation coefficient between the separate dietary recalls for energy was 0.801 (95% CI, 0.429-0.933), indicating acceptable inter-observer agreement. Conclusions Dietary assessment using 24-hour dietary recall with volumetric portion size estimation resulted in similar and acceptable estimates of dietary intake compared with weighed food records and thus is considered a valid method for daily dietary intake assessment of

  12. Static stretching can impair explosive performance for at least 24 hours.

    PubMed

    Haddad, Monoem; Dridi, Amir; Chtara, Moktar; Chaouachi, Anis; Wong, Del P; Behm, David; Chamari, Karim

    2014-01-01

    The aim of this study was to compare the effects of static vs. dynamic stretching (DS) on explosive performances and repeated sprint ability (RSA) after a 24-hour delay. Sixteen young male soccer players performed 15 minutes of static stretching (SS), DS, or a no-stretch control condition (CC) 24 hours before performing explosive performances and RSA tests. This was a within-subject repeated measures study with SS, DS, and CC being counterbalanced. Stretching protocols included 2 sets of 7 minutes 30 seconds (2 repetitions of 30 seconds with a 15-second passive recovery) for 5 muscle groups (quadriceps, hamstring, calves, adductors, and hip flexors). Twenty-four hours later (without any kind of stretching in warm-up), the players were tested for the 30-m sprint test (with 10- and 20-m lap times), 5 jump test (5JT), and RSA test. Significant differences were observed between CC, SS, and DS with 5JT (F = 9.99, p < 0.00, effect size [ES] = 0.40), 10-m sprint time (F = 46.52, p < 0.00, ES = 0.76), 20-m sprint time (F = 18.44, p < 0.000, ES = 0.55), and 30-m sprint time (F = 34.25, p < 0.000, ES = 0.70). The significantly better performance (p < 0.05) was observed after DS as compared with that after CC and SS in 5JT, and sprint times for 10, 20, and 30 m. In contrast, significantly worse performance (p < 0.05) was observed after SS as compared with that after CC in 5JT, and sprint times for 10, 20, and 30 m. With RSA, no significant difference was observed between different stretching protocols in the total time (F = 1.55, p > 0.05), average time (F = 1.53, p > 0.05), and fastest time (F = 2.30, p > 0.05), except for the decline index (F = 3.54, p < 0.04, ES = 0.19). Therefore, the SS of the lower limbs and hip muscles had a negative effect on explosive performances up to 24 hours poststretching with no major effects on the RSA. Conversely, the DS of the same muscle groups are highly recommended 24 hours before performing sprint and long-jump performances. In

  13. Treating allergic conjunctivitis: A once-daily medication that provides 24-hour symptom relief

    PubMed Central

    Schaeffer, Jack; Donnenfeld, Eric

    2016-01-01

    Background: Allergic conjunctivitis (AC) is a common ocular inflammatory manifestation of allergen exposure in sensitized individuals. Signs and symptoms of AC can decrease quality of life, interfere with productivity, and lead to considerable economic burden. Consistent suppression of conjunctival inflammation is necessary for managing AC, but currently available medications require frequent administration and exhibit limited duration of action. Methods: In this review, we summarized AC pathogenesis, diagnosis, and current treatment options as well as their limitations. Findings from the literature were discussed in the context of the unmet need for a once-daily medication with sustained 24-hour effectiveness. Results: Topical pharmacologic treatments are the most common approach for managing extant AC; however, most available medications require multiple daily instillations. Dual-acting antihistamine-mast cell stabilizing agents are currently considered first-line therapeutics for AC because they provide acute relief of signs and symptoms and block persistent inflammation to promote regression of AC. Recent studies of a newly-developed, higher-concentration formulation of a dual-acting antihistamine-mast cell stabilizer have demonstrated that this formulation provides a 24-hour duration of action with once-daily dosing. Conclusions: Dual-acting AC medications exhibit a high degree of overall effectiveness and are well tolerated for chronic use. A newly available once-daily medication that manages signs and symptoms of AC for a full 24 hours may be considered a treatment of choice for patients experiencing seasonal or perennial AC. ClinicalTrials.gov NCT01743027 and NCT01479374 PMID:27466061

  14. Bioenergetical and Cardiac Adaptations of Pilots to a 24-Hour Team Kart Race.

    PubMed

    Durand, Sylvain; Ripamonti, Michael; Rahmani, Abderrahmane; Beaune, Bruno

    2015-11-01

    This study aimed to evaluate energy expenditure (EE) and heart rate (HR) response in kart pilots to successive driving bouts during a 24-hour team race. Eight adult male pilots (22.8 ± 4.1 years) participated to a team 24-hour speedway kart race in Le Mans (France). They alternatively piloted a 390 cm kart. Each relay was 45 minutes long and each pilot performed 4 relays. For each pilot, mean speeds were calculated from lap-to-lap duration recordings using a telemetric infrared timing device. Heart rate values were recorded continuously on 5-second intervals using a portable cardiometric device. Total energy expenditure (EET) and physical activity ratio (PAR) were determined by accelerometry. To pilot a kart during 45 minutes at a mean speed around 62 km·h induces a 300-kcal EET, corresponding to a 5.6-Mets PAR. This effort is responsive for a 73 b·min increase in HR, from 84.1 ± 7.6 to 157.4 ± 11.0 b·min (82% maximal heart rate intensity). However, during this relay period, HR values seemed independent to mean speed performance and bioenergetical values. Thus, in the context of the 24-hour team race, the variability in effort made during each relay and relay succession did not alter bioenergetical adaptation of pilots to kart driving. The high EE and HR values would be better explained by both emotional stress and environmental constraints such as speedway configuration and vibrations. The way how these factors specifically influence bioenergetical demand, and their relative importance, has to be specified to optimize training procedure and recommendations.

  15. Heterogeneity of Prognostic Studies of 24-Hour Blood Pressure Variability: Systematic Review and Meta-Analysis

    PubMed Central

    Taylor, Kathryn S.; Heneghan, Carl J.; Stevens, Richard J.; Adams, Emily C.; Nunan, David; Ward, Alison

    2015-01-01

    In addition to mean blood pressure, blood pressure variability is hypothesized to have important prognostic value in evaluating cardiovascular risk. We aimed to assess the prognostic value of blood pressure variability within 24 hours. Using MEDLINE, EMBASE and Cochrane Library to April 2013, we conducted a systematic review of prospective studies of adults, with at least one year follow-up and any day, night or 24-hour blood pressure variability measure as a predictor of one or more of the following outcomes: all-cause mortality, cardiovascular mortality, all cardiovascular events, stroke and coronary heart disease. We examined how blood pressure variability is defined and how its prognostic use is reported. We analysed relative risks adjusted for covariates including the appropriate mean blood pressure and considered the potential for meta-analysis. Our analysis of methods included 24 studies and analysis of predictions included 16 studies. There were 36 different measures of blood pressure variability and 13 definitions of night- and day-time periods. Median follow-up was 5.5 years (interquartile range 4.2–7.0). Comparing measures of dispersion, coefficient of variation was less well researched than standard deviation. Night dipping based on percentage change was the most researched measure and the only measure for which data could be meaningfully pooled. Night dipping or lower night-time blood pressure was associated with lower risk of cardiovascular events. The interpretation and use in clinical practice of 24-hour blood pressure variability, as an important prognostic indicator of cardiovascular events, is hampered by insufficient evidence and divergent methodologies. We recommend greater standardisation of methods. PMID:25984791

  16. Heterogeneity of prognostic studies of 24-hour blood pressure variability: systematic review and meta-analysis.

    PubMed

    Taylor, Kathryn S; Heneghan, Carl J; Stevens, Richard J; Adams, Emily C; Nunan, David; Ward, Alison

    2015-01-01

    In addition to mean blood pressure, blood pressure variability is hypothesized to have important prognostic value in evaluating cardiovascular risk. We aimed to assess the prognostic value of blood pressure variability within 24 hours. Using MEDLINE, EMBASE and Cochrane Library to April 2013, we conducted a systematic review of prospective studies of adults, with at least one year follow-up and any day, night or 24-hour blood pressure variability measure as a predictor of one or more of the following outcomes: all-cause mortality, cardiovascular mortality, all cardiovascular events, stroke and coronary heart disease. We examined how blood pressure variability is defined and how its prognostic use is reported. We analysed relative risks adjusted for covariates including the appropriate mean blood pressure and considered the potential for meta-analysis. Our analysis of methods included 24 studies and analysis of predictions included 16 studies. There were 36 different measures of blood pressure variability and 13 definitions of night- and day-time periods. Median follow-up was 5.5 years (interquartile range 4.2-7.0). Comparing measures of dispersion, coefficient of variation was less well researched than standard deviation. Night dipping based on percentage change was the most researched measure and the only measure for which data could be meaningfully pooled. Night dipping or lower night-time blood pressure was associated with lower risk of cardiovascular events. The interpretation and use in clinical practice of 24-hour blood pressure variability, as an important prognostic indicator of cardiovascular events, is hampered by insufficient evidence and divergent methodologies. We recommend greater standardisation of methods.

  17. Lack of effect of a 24-hour infusion of iloprost in intermittent claudication.

    PubMed

    Hay, C R; Waller, P C; Carter, C; Cameron, H A; Parnell, L; Ramsay, L E; Preston, F E; Greaves, M

    1987-04-15

    24 hour infusion of iloprost was compared with placebo infusion in 19 patients with stable intermittent claudication using a double blind, balanced crossover design. Despite significant inhibition of platelet aggregation to ADP and collagen (p less than 0.001) and the typical cardiovascular and gastrointestinal side effects, there was no significant effect on treadmill exercise times at any time up to 6 weeks after infusion. The 95% confidence limits indicated that an improvement of more than 25% was unlikely to occur. No significant changes in B thromboglobulin, platelet aggregate ratio, bleeding time, whole blood viscosity and euglobulin clot lysis time were demonstrated.

  18. [The changes in mental working capacity of operators during 24-hour shift work conditions].

    PubMed

    Kal'nysh, V V; Shvets', A V; Ieshchenko, O I

    2011-01-01

    Psychophysiological peculiarities of influence of a 24-hour shift work on the efficiency of operators have been discussed. It was shown that servicemen operators develop significant fatigue as a result of 24 hrs duty services. The informative psychophysiological characteristics which can be reliable indicators of fatigue level are highlighted. Individual psychophysiological indicators of fatigue level, according to different mechanisms of its development, have been proposed. The hypothesis about the existence of several compensatory mechanisms for maintenance of long duty operators' working capacity has been formulated.

  19. Assessing Dietary Intake in Childhood Cancer Survivors: Food Frequency Questionnaire Versus 24-Hour Diet Recalls.

    PubMed

    Zhang, Fang Fang; Roberts, Susan B; Must, Aviva; Wong, William W; Gilhooly, Cheryl H; Kelly, Michael J; Parsons, Susan K; Saltzman, Edward

    2015-10-01

    Cancer diagnosis and treatment may influence dietary intake. The validity of using self-reported methods to quantify dietary intake has not been evaluated in childhood cancer survivors. We validated total energy intake (EI) reported from Food Frequency Questionnaire (FFQ) and repeated 24-hour diet recalls (24HRs) against total energy expenditure (TEE) measured using the doubly labeled water method in 16 childhood cancer survivors. Dietary underreporting, assessed by (EI-TEE)/TEE × 100%, was 22% for FFQ and 1% for repeated 24HRs. FFQ significantly underestimates dietary intake and should not be used to assess the absolute intake of foods and nutrients in childhood cancer survivors.

  20. The Application of a Contact Lens Sensor in Detecting 24-Hour Intraocular Pressure-Related Patterns

    PubMed Central

    2016-01-01

    Glaucoma is one of the leading causes of blindness worldwide. Recent studies suggest that intraocular pressure (IOP) fluctuations, peaks, and rhythm are important factors in disease advancement. Yet, current glaucoma management remains hinged on single IOP measurements during clinic hours. To overcome this limitation, 24-hour IOP monitoring devices have been employed and include self-tonometry, permanent IOP, and temporary IOP monitoring. This review discusses each IOP measuring strategy and focuses on the recently FDA-approved contact lens sensor (CLS). The CLS records IOP-related ocular patterns for 24 hours continuously. Using the CLS, IOP-related parameters have been found to be associated with the rate of visual field progression in primary open-angle glaucoma, disease progression in primary angle-closure glaucoma, and various clinical variables in ocular hypertension. The CLS has been used to quantify blink rate and limbal strain and measure the circadian rhythm in a variety of disease states including normal-tension glaucoma and thyroid eye disease. The effects of various IOP-lowering interventions were also characterized using the CLS. CLS provides a unique, safe, and well-tolerated way to study IOP-related patterns in a wide range of disease states. IOP-related patterns may help identify patients most at risk for disease progression and assist with the development of tailored treatments. PMID:27525110

  1. Deviation of innate circadian period from 24 hours reduces longevity in mice

    PubMed Central

    Libert, Sergiy; Bonkowski, Michael S.; Pointer, Kelli; Pletcher, Scott D.; Guarente, Leonard

    2012-01-01

    Summary The variation of individual lifespans, even in highly inbred cohorts of animals and under strictly controlled environmental conditions, is substantial and not well understood. This variation in part could be due to epigenetic variation, which later affects the animal’s physiology and ultimately longevity. Identification of the physiological properties that impact health and lifespan is crucial for longevity research and the development of anti-aging therapies. Here we measured individual circadian and metabolic characteristics in a cohort of inbred F1 hybrid mice and correlated these parameters to their lifespans. We found that mice with innate circadian periods close to 24 hours (revealed during 30 days of housing in total darkness) enjoyed nearly 20% longer lifespans than their littermates, which had shorter or longer innate circadian periods. These findings show that maintenance of a 24 hour intrinsic circadian period is a positive predictor of longevity. Our data suggest that circadian period may be used to predict individual longevity and that processes that control innate circadian period affect aging. PMID:22702406

  2. Validity of 24-hour dietary recall interviews conducted among volunteers in an adult working community.

    PubMed

    Kahn, H A; Whelton, P K; Appel, L J; Kumanyika, S K; Meneses, J L; Hebert, P R; Woods, M

    1995-11-01

    There is considerable uncertainty regarding the validity of dietary data collected from free-living populations. Nevertheless, few attempts have been made to validate dietary assessment instruments. To address this issue, we compared average daily protein intake estimated from 24-hour dietary recall interviews to protein intake estimated from urinary nitrogen excretion in 24-hour samples. Among 244 community-dwelling adults who volunteered for a hypertension study, men (n = 139) overreported dietary protein intake by 12 to 19%. In contrast, women (n = 105) reported a dietary protein intake almost exactly in agreement with estimates based on urinary nitrogen levels. Thin men reported about one-third more protein intake than was reflected in their urinary nitrogen measurements. Our results suggest that the accuracy of dietary recall estimates may vary across subgroups of the population. Additional information from sufficiently large validation studies would be helpful in determining the role of dietary assessment instruments which are already in wide use in epidemiologic research. Until such information is obtained, doubts will remain regarding the validity of inferences drawn from nutritional epidemiologic studies.

  3. Comparison of 24-hour intragastric pH using four liquid formulations of lansoprazole and omeprazole.

    PubMed

    Sharma, V K

    1999-12-01

    The results of previous studies evaluating the effect of four liquid formulations of proton-pump inhibitors on 24-hour intragastric pH are described. Patients with a gastrostomy who were resident in a Veterans Affairs medical center or its affiliated nursing home were eligible for enrollment in one of four open-label studies in which each patient served as his own control. Patients underwent 24-hour intragastric pH studies before and after receiving seven consecutive days of one of the following liquid formulations of a proton-pump inhibitor administered once daily: omeprazole granules 20 mg in orange juice, lansoprazole granules 30 mg in orange juice, simplified omeprazole suspension 20 mg, and simplified lansoprazole suspension 30 mg. The suspensions were prepared with 10 mL of 8.4% sodium bicarbonate solution. Mean intragastric pH was measured, as was the time pH stayed above 3.0 and 4.0 during the 24-hour period. Six to 14 patients participated in each study. The mean posttreatment pH was 4.9+/-0.8, 4.7+/-0.6, 4.1+/-1.5, and 5.1+/-1.1 for omeprazole granules in orange juice, lansoprazole granules in orange juice, simplified omeprazole suspension, and simplified lansoprazole suspension, respectively. Both drugs in orange juice maintained pH above 4.0 longer than 14 hours and above 3.0 for close to 20 hours, which are the levels deemed optimal for healing erosive esophagitis and duodenal ulcers, respectively. Simplified lansoprazole suspension maintained pH above those thresholds for the optimal times, but simplified omeprazole suspension did not (20 and 15 hr above 3.0, 17 and 12 hr above 4.0 for lansoprazole and omeprazole, respectively). Further development of liquid formulations of proton-pump inhibitors may have important implications for the treatment of acid-related diseases in patients, including children, who are unable to swallow capsules.

  4. Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations: the INTERSALT study.

    PubMed

    Brown, Ian J; Dyer, Alan R; Chan, Queenie; Cogswell, Mary E; Ueshima, Hirotsugu; Stamler, Jeremiah; Elliott, Paul

    2013-06-01

    High intakes of dietary sodium are associated with elevated blood pressure levels and an increased risk of cardiovascular disease. National and international guidelines recommend reduced sodium intake in the general population, which necessitates population-wide surveillance. We assessed the utility of casual (spot) urine specimens in estimating 24-hour urinary sodium excretion as a marker of sodium intake in the International Cooperative Study on Salt, Other Factors, and Blood Pressure. There were 5,693 participants recruited in 1984-1987 at the ages of 20-59 years from 29 North American and European samples. Participants were randomly assigned to test or validation data sets. Equations derived from casual urinary sodium concentration and other variables in the test data were applied to the validation data set. Correlations between observed and estimated 24-hour sodium excretion were 0.50 for individual men and 0.51 for individual women; the values were 0.79 and 0.71, respectively, for population samples. Bias in mean values (observed minus estimated) was small; for men and women, the values were -1.6 mmol per 24 hours and 2.3 mmol per 24 hours, respectively, at the individual level and -1.8 mmol per 24 hours and 2.2 mmol per 24 hours, respectively, at the population level. Proportions of individuals with urinary 24-hour sodium excretion above the recommended levels were slightly overestimated by the models. Casual urine specimens may be a useful, low-burden, low-cost alternative to 24-hour urine collections for estimation of population sodium intakes; ongoing calibration with study-specific 24-hour urinary collections is recommended to increase validity.

  5. Setting Spacecraft Maximum Allowable Concentrations for 1 hour or 24 hour contingency exposures to airborne chemicals

    NASA Technical Reports Server (NTRS)

    Garcia, Hector D.; Limero, Thomas F.; James, John T.

    1992-01-01

    Since the early years of the manned space program, NASA has developed and used exposure limits called Spacecraft Maximum Allowable Concentrations (SMACs) to help protect astronauts from airborne toxicants. Most of these SMACS are based on an exposure duration of 7 days, since this is the duration of a 'typical' mission. A set of 'contingency SMACs' is also being developed for scenarios involving brief (1-hour or 24- hour) exposures to relatively high levels of airborne toxicants from event-related 'contingency' releases of contaminants. The emergency nature of contingency exposures dictates the use of different criteria for setting exposure limits. The NASA JSC Toxicology Group recently began a program to document the rationales used to set new SMACs and plans to review the older, 7-day SMACs. In cooperation with the National Research Council's Committee on Toxicology, a standard procedure has been developed for researching, setting, and documenting SMAC values.

  6. New method for assessing cardiac parasympathetic activity using 24 hour electrocardiograms.

    PubMed Central

    Ewing, D J; Neilson, J M; Travis, P

    1984-01-01

    Cardiac parasympathetic activity was assessed using 24 hour electrocardiographic recordings by measuring the incidence of larger changes in successive RR intervals, which in normal subjects occur frequently but irregularly. In 25 normal subjects the mean number of times per hour in which the change in successive RR interval was greater than 50 ms was 150-250 during waking and 350-450 during sleeping. By contrast, 30 diabetics with medically denervated hearts (12 with cardiovascular reflex evidence of parasympathetic damage and 18 with additional sympathetic damage) and six cardiac transplant patients with surgically denervated hearts had extremely low counts. Additionally, of 20 diabetics with normal cardiovascular reflexes, about half had abnormally low counts, suggesting that this method is better than currently available reflex tests in detecting early cardiac parasympathetic damage. This technique provides a valid and sensitive way of monitoring cardiac parasympathetic activity over prolonged periods. PMID:6383446

  7. After 24-hour scrub, another tower rollback for the Boeing Delta II rocket carrying Stardust

    NASA Technical Reports Server (NTRS)

    1999-01-01

    As tower rollback begins, the Boeing Delta II rocket carrying the Stardust spacecraft waits on Launch Pad 17-A, Cape Canaveral Air Station, for the second launch attempt at 4:04 p.m. EST. The original launch was scrubbed on Feb. 6 for 24 hours. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  8. Mice increased target biting behaviors 24 hours after co-administration of alcohol and fluoxetine.

    PubMed

    Mamiya, Ping Chao; Matray-Devoti, Judith; Fisher, Hans; Wagner, George C

    2017-02-10

    Increased alcohol consumption has been linked to social isolation. Individuals showed heightened aggression following social isolation. Animals treated with alcohol following social separation showed higher aggression and lower serotonin transmission. Although reduced serotonin transmission in the brain may be related to alcohol induced heightened aggression, it remains unclear whether there are specific brain regions where changes in serotonin transmission are critical for animal aggression following alcohol treatment. In the present study, we isolated mice for 4 - 6 weeks and injected them with alcohol, fluoxetine and alcohol with fluoxetine. We studied their aggression by using two types of behavioral paradigms: isolation-induced attack behavior towards a naïve mouse in a neutral cage, or shock-induced target biting aggression. We observed that alcohol administered at 500 mg/kg significantly increased animal attack behaviors towards naïve mice 30 minutes after injections. This dose of alcohol co-administered with a low dose of fluoxetine (2 mg/kg) further increased the attack behaviors, but with higher doses of fluoxetine decreased the attack behaviors. Alcohol administered at a dose of 1,000 mg/kg significantly decreased the shock-induced target biting rates 24 hours after injections. Interestingly, we observed a significant increase in target biting rates when alcohol was co-administered with fluoxetine at a dose of 16 mg/kg 24 hours after injections. We also observed the same heightened target biting rates when animals were injected with fluoxetine alone. This heightened biting attack engendered by the fluoxetine (alone or in combination with the alcohol) occurred at a time when brain serotonin activity was reduced by these drugs in the frontal lobe and hypothalamus. These observations indicate that heightened biting attack behavior may be associated with reduced serotonergic activity in brain regions regulating aggression.

  9. Effects of exenatide and liraglutide on 24-hour glucose fluctuations in type 2 diabetes.

    PubMed

    Nagakura, Jo; Yamakawa, Tadashi; Taguri, Masataka; Tsuchiya, Hirohisa; Shigematsu, Erina; Suzuki, Jun; Morita, Satoshi; Kadonosono, Kazuaki; Terauchi, Yasuo

    2016-01-01

    We evaluated the influence of short-term treatment with exenatide twice daily or liraglutide once daily on daily blood glucose fluctuations in 40 patients with type 2 diabetes inadequately controlled by sulfonylureas. The patients in a multicenter, open-label trial were randomly assigned to receive add-on exenatide (10 μg/day, n = 21) or add-on liraglutide (0.3-0.9 mg/day, n = 19), and underwent 24-hour continuous subcutaneous glucose monitoring. There was no significant between-group difference in glucose fluctuations during the day, as assessed by calculating mean amplitude of glycemic excursion (MAGE) and standard deviation (SD). However, the mean blood glucose levels at 3 hours after breakfast and dinner were significantly lower in the exenatide group than the liraglutide group (breakfast: 127.3 ± 24.1 vs. 153.4 ± 28.7 mg/dL; p = 0.006, dinner: 108.7 ± 17.3 vs. 141.9 ± 24.2 mg/dL; p < 0.001). In contrast, mean blood glucose levels and their SD were significantly lower between 0000 h and 0600 h in the liraglutide group than the exenatide group (average glucose: 126.9 ± 27.1 vs. 107.1 ± 24.0 mg/dL; p = 0.029, SD: 15.2 ± 10.5 vs. 8.7 ± 3.8; p = 0.020). Both groups had similar glucose fluctuations despite differences in 24-hour blood glucose profiles. Therefore, each of these agents may have advantages or disadvantages and should be selected according to the blood glucose profile of the patient.

  10. The effect of Operation 24 Hours on reducing collision in the City of Edmonton.

    PubMed

    Halim, Siana; Jiang, Heming

    2013-09-01

    In the City of Edmonton, in order to reduce the prevalence of collisions, the Operation 24 Hours program (OPS24) was developed by using existing police and transportation services resources. The program uses traditional manned police speed enforcement method, which are supplemented by traffic safety messages displayed on permanent and mobile dynamic messaging signs (DMS). In this paper, collision data analysis was performed by looking at the daily number of collisions from 2008 to 2011 that covers 28 Operation 24 Hours (OPS24) events. The objective of the collision data analysis is to analyze if there is a reduction in collision frequencies after OPS24 was held and examined how long the collision reduction effect last. Weather factors such as temperature, thickness of snow, and wind gust have been considered by many as a great influence on collision occurrences, especially in a city with long and cold winter such as Edmonton. Therefore, collision modeling was performed by considering these external weather factors. To analyze the linear and periodic trend of different collision types (injury, fatal, and property damage only (PDO)) and examine the influence of weather factors on collisions, negative binomial time series model that accounts for seasonality and weather factors was used to model daily collision data. The modeling also considered collision proportion to account for missing traffic volume data; the Gaussian time series model that accounts for seasonality and weather factors was used to model collision proportion. To estimate the collision trend and test for changes in collision levels before/after OPS24, interrupted time series model with segmented regression was used. While for estimating how long the effect of the OPS24 last, change point method was applied.

  11. Estimation of 24-hour urinary sodium excretion using spot urine samples.

    PubMed

    Rhee, Moo-Yong; Kim, Ji-Hyun; Shin, Sung-Joon; Gu, Namyi; Nah, Deuk-Young; Hong, Kyung-Soon; Cho, Eun-Joo; Sung, Ki-Chul

    2014-06-20

    The present study evaluated the reliability of equations using spot urine (SU) samples in the estimation of 24-hour urine sodium excretion (24-HUNa). Equations estimating 24-HUNa from SU samples were derived from first-morning SU of 101 participants (52.4 ± 11.1 years, range 24-70 years). Equations developed by us and other investigators were validated with SU samples from a separate group of participants (n = 224, 51.0 ± 10.9 years, range 24-70 years). Linear, quadratic, and cubic equations were derived from first-morning SU samples because these samples had a sodium/creatinine ratio having the highest correlation coefficient for 24-HUNa/creatinine ratio (r = 0.728, p < 0.001). In the validation group, the estimated 24-HUNa showed significant correlations with measured 24-HUNa values. The estimated 24-HUNa by the linear, quadratic, and cubic equations developed from our study were not significantly different from measured 24-HUNa, while estimated 24-HUNa by previously developed equations were significantly different from measured 24-HUNa values. The limits of agreement between measured and estimated 24-HUNa by six equations exceeded 100 mmol/24-hour in the Bland-Altman analysis. All equations showed a tendency of under- or over-estimation of 24-HUNa, depending on the level of measured 24-HUNa. Estimation of 24-HUNa from single SU by equations as tested in the present study was found to be inadequate for the estimation of an individual's 24-HUNa.

  12. Dietary restraint and disinhibition do not affect accuracy of 24-hour recall in a multiethnic population.

    PubMed

    Ard, Jamy D; Desmond, Renee Ann; Allison, David B; Conway, Joan Marie

    2006-03-01

    Some psychological predictors of eating behaviors have been shown to affect usefulness of methods for dietary assessment. Therefore, this study was conducted to determine the association of dietary restraint and disinhibition with dietary recall accuracy for total energy, fat, carbohydrate, and protein. In a cross-sectional study, data were obtained from 79 male and 71 female non-Hispanic whites and African-American volunteers. Participants selected and consumed all foods for a 1-day period under observation and actual intake was determined. The following day, each participant completed a telephone 24-hour recall using the US Department of Agriculture Multiple-Pass method to obtain recalled intake. The Eating Inventory, which measures dietary restraint and disinhibition, was administered prior to eating any food in the study. Repeated measures analyses of variance were used to determine if dietary restraint or disinhibition were independent predictors of recall accuracy. The mean (+/-standard deviation) age and body mass index of the participants was 43+/-12 years and 29+/-5.5 (calculated as kg/m2), respectively. On average, men overreported intake of energy by 265 kcal and women by 250 kcal; both groups also overreported intake of protein, carbohydrate, and fat. When controlling for body mass index, sex, and race, restraint was a significant independent predictor of energy intake (P=0.004) and negatively correlated with energy intake (r=-0.23, P<0.001). Unlike intake of carbohydrate or protein, fat intake was significantly and negatively associated with dietary restraint (P<0.001; r=-0.3). Dietary restraint did not affect accuracy of recall of intake of energy, fat, carbohydrate, or protein, but was significantly associated with intake of energy and fat. Disinhibition was not related to intake or accuracy. Dietetics professionals should consider dietary restraint a possible reason for a lower than expected estimate of energy intake when using 24-hour recalls.

  13. Attempt Quit Smoking 24+ Hours Maps and Data of Model-Based Small Area Estimates - Small Area Estimates

    Cancer.gov

    Attempt Quit Smoking 24+ Hours is defined as a person 18 years of age or older who must have reported smoking at least 100 cigarettes in his/her life, and now does not smoke at all but it has been less than 365 days since completely stopped smoking cigarettes, or now smoke everyday or some days but reported that have made attempt of quitting for more than 24 hours in the past 12 months.

  14. Acute and chronic effects of a hypocaloric diet on 24-hour blood pressure, heart rate and heart-rate variability in mildly-to-moderately obese patients with essential hypertension.

    PubMed

    Minami, J; Kawano, Y; Ishimitsu, T; Matsuoka, H; Takishita, S

    1999-11-01

    We examined the acute and chronic effects of a nutritionally balanced, moderately hypocaloric diet on 24-hour ambulatory blood pressure, heart rate and heart-rate variability in mildly-to-moderately obese patients with essential hypertension. We enrolled 16 obese patients with essential hypertension [age: 51-76 years, body mass index (BMI): 26-32 kg/m2]. For the initial week, a standard diet of 2,000 kcal/day was given, followed by a 3-week of a hypocaloric diet of 850 kcal/day. In the last period of the standard diet and in the first and the last periods of the hypocaloric diet, each subject's 24-hour ambulatory blood pressure, heart rate and R-R intervals of the electrocardiogram were recorded, and electrolytes and catecholamines in 24-hour urine samples were also measured. A power spectral analysis of the heart-rate variability was performed over a 24-hour period based on the autoregressive method. The subjects lost 3.7+/-0.3 kg (mean +/- s.e.m.) of body weight during the 3-week hypocaloric diet period. The 24-hour blood pressure did not differ between the last period of the standard diet and the first period of the hypocaloric diet; however, it showed a significant reduction after 3 weeks of the hypocaloric diet. The decrease in the 24-hour blood pressure during the study period was 10.5+/-1.5 mm Hg systole and 4.3+/-1.8 mm Hg diastole. In contrast, the 24-hour heart rate was significantly reduced in the first period of the hypocaloric diet, although the body weight and blood pressure did not change, and the rate was maintained even in the last period of the hypocaloric diet. The decrease in the 24-hour heart rate during the study period was 2.8+/-0.9 beats per minute. The hypocaloric diet did not change any autonomic indices obtained from a power spectral analysis of the heart-rate variability. In conclusion, different responses to a hypocaloric diet were observed between the blood pressure and the heart rate in obese hypertensive patients. The changes in

  15. Time-Based Measurement of Personal Mite Allergen Bioaerosol Exposure over 24 Hour Periods

    PubMed Central

    Tovey, Euan R.; Liu-Brennan, Damien; Garden, Frances L.; Oliver, Brian G.; Perzanowski, Matthew S.; Marks, Guy B.

    2016-01-01

    Allergic diseases such as asthma and rhinitis are common in many countries. Globally the most common allergen associated with symptoms is produced by house dust mites. Although the bed has often been cited as the main site of exposure to mite allergens, surprisingly this has not yet been directly established by measurement due to a lack of suitable methods. Here we report on the development of novel methods to determine the pattern of personal exposure to mite allergen bioaerosols over 24-hour periods and applied this in a small field study using 10 normal adults. Air was sampled using a miniature time-based air-sampler of in-house design located close to the breathing zone of the participants, co-located with a miniature time-lapse camera. Airborne particles, drawn into the sampler at 2L/min via a narrow slot, were impacted onto the peripheral surface of a disk mounted on the hour-hand of either a 12 or 24 hour clock motor. The impaction surface was either an electret cloth, or an adhesive film; both novel for these purposes. Following a review of the time-lapse images, disks were post-hoc cut into subsamples corresponding to eight predetermined categories of indoor or outdoor location, extracted and analysed for mite allergen Der p 1 by an amplified ELISA. Allergen was detected in 57.2% of the total of 353 subsamples collected during 20 days of sampling. Exposure patterns varied over time. Higher concentrations of airborne mite allergen were typically measured in samples collected from domestic locations in the day and evening. Indoor domestic Der p 1 exposures accounted for 59.5% of total exposure, whereas total in-bed-asleep exposure, which varied 80 fold between individuals, accounted overall for 9.85% of total exposure, suggesting beds are not often the main site of exposure. This study establishes the feasibility of novel methods for determining the time-geography of personal exposure to many bioaerosols and identifies new areas for future technical

  16. Non-24-Hour Sleep-Wake Disorder Revisited – A Case Study

    PubMed Central

    Garbazza, Corrado; Bromundt, Vivien; Eckert, Anne; Brunner, Daniel P.; Meier, Fides; Hackethal, Sandra; Cajochen, Christian

    2016-01-01

    The human sleep-wake cycle is governed by two major factors: a homeostatic hourglass process (process S), which rises linearly during the day, and a circadian process C, which determines the timing of sleep in a ~24-h rhythm in accordance to the external light–dark (LD) cycle. While both individual processes are fairly well characterized, the exact nature of their interaction remains unclear. The circadian rhythm is generated by the suprachiasmatic nucleus (“master clock”) of the anterior hypothalamus, through cell-autonomous feedback loops of DNA transcription and translation. While the phase length (tau) of the cycle is relatively stable and genetically determined, the phase of the clock is reset by external stimuli (“zeitgebers”), the most important being the LD cycle. Misalignments of the internal rhythm with the LD cycle can lead to various somatic complaints and to the development of circadian rhythm sleep disorders (CRSD). Non-24-hour sleep-wake disorders (N24HSWD) is a CRSD affecting up to 50% of totally blind patients and characterized by the inability to maintain a stable entrainment of the typically long circadian rhythm (tau > 24.5 h) to the LD cycle. The disease is rare in sighted individuals and the pathophysiology less well understood. Here, we present the case of a 40-year-old sighted male, who developed a misalignment of the internal clock with the external LD cycle following the treatment for Hodgkin’s lymphoma (ABVD regimen, four cycles and AVD regimen, four cycles). A thorough clinical assessment, including actigraphy, melatonin profiles and polysomnography led to the diagnosis of non-24-hour sleep-wake disorders (N24HSWD) with a free-running rhythm of tau = 25.27 h. A therapeutic intervention with bright light therapy (30 min, 10,000 lux) in the morning and melatonin administration (0.5–0.75 mg) in the evening failed to entrain the free-running rhythm, although a longer treatment duration and more intense therapy

  17. DB 01-3 TREATMENT TARGET OF SYSTOLIC BLOOD PRESSURE IN DIABETES MAY DIFFER ACCORDING TO ETHNICITY (PRO).

    PubMed

    Kario, Kazuomi

    2016-09-01

    Asians have specific characteristics of hypertension and related cardiovascular disease. Stroke is more common than coronary artery disease in Eastern Asian countries, while the coronary artery disease is more common than stroke in Western countries. The association slope between higher blood pressure (BP) and the risk of cardiovascular events is steeper in Asians than in Caucasians. This may partly explained by the recent result demonstrating that the morning BP surge in Asians is more extended (Hoshide, Kario, Parati et al. Hypertension 2016;68:54-61). Thus, 24-hr BP control including night-time and morning periods is especially important for Asian hypertensive patients (Kario. Essential manual of 24 hour blood pressure management. Wiley, UK, pp.1-158.2016).The existing direct evidence from Asian studies are limited than the accumulated evidence from Western countries. In the ACCORD BP trial which enrolled 4733 participants with type 2 diabetes and randomized them to a target systolic BP <120mmHg (intensive BP control) or <140mmHg (standard BP control). Despite the significant difference in the achieved systolic BP, there was no significant difference in the incidence of primary cardiovascular outcomes. Based on this evidence, the target systolic BP for diabetics has been revised from 130 mmHg to 140 mmHg in the majority of Western guidelines. However, in the ACCORD study, the intensive BP control was associated with significant reduction in both total stroke and nonfatal stroke. In addition, the ONTARGET study, which showed that in diabetic patients, the risk of stroke continued to decrease down to achieved SBP <115mmHg with no evidence of J curve.The new guidelines of the Japanese Society of Hypertension regarding the management of hypertension (JSH2014) were published in 2014 (Hypertens Res 2014;37:253-390). The JSH2014 guidelines use the systolic BP value 130 mmHg, a lower target clinic BP compared to the Western guidelines (140 mmHg), for hypertensive

  18. Gender differences in the relationship between resting heart rate variability and 24-hour blood pressure variability.

    PubMed

    Thayer, Julian F; Sollers, John J; Friedman, Bruce H; Koenig, Julian

    2016-01-01

    The study explored the relationship between time- and frequency-domain indices of cardiac autonomic control and 24 h blood pressure variability (BPV) in a sample of healthy men and women. Vagally mediated cardiac control was inversely related to 24 h BPV, and measures of cardiac autonomic control were better predictors of systolic BPV in men and better predictors of diastolic BPV in women. These findings may help researchers to understand the disparity in cardiovascular disease morbidity and mortality between men and women.

  19. Low mean impedance in 24-hour tracings and esophagitis in children: a strong connection.

    PubMed

    Salvatore, S; Salvatoni, A; Ummarino, D; Ghanma, A; Van der Pol, R; Rongen, A; Fuoti, M; Meneghin, F; Benninga, M Alexander; Vandenplas, Y

    2016-01-01

    Esophageal multiple intraluminal impedance baseline is an additional impedance parameter that was recently related to esophageal integrity. The aim of this study was to assess the relationship between mean esophageal impedance value and endoscopic findings in a large group of children. Children with symptoms of gastroesophageal reflux submitted to both endoscopy and impedance were included. Esophagitis was graded according to the Los Angeles classification. Mean impedance value was automatically calculated over 24-hour tracings. Data were adjusted for age through z-score transformation using percentiles normalized by the LMS (Lambda for the skew, Mu for the median, and Sigma for the generalized coefficient of variation) method. Nonparametric Mann-Whitney and Kruskal-Wallis tests, multiple, and stepwise regression were used. P-value <0.05 was considered as statistically significant. A total of 298 impedance tracings were analyzed. Endoscopic and histological esophagitis were detected in 30 and 29% patients, respectively. Median baseline z-score was significantly decreased both in proximal (P = 0.02) and distal (P = 0.01) esophagus in patients with endoscopic (but not histological) esophagitis. Patients with more severe esophagitis showed the lowest z-score. Bolus exposure index and the number of reflux episodes were the variables that were significantly associated with the baseline z-score. Impedance z-score is significantly decreased in infants and children with endoscopic esophagitis. Severity of esophagitis, bolus exposure index, and number of reflux episodes are factors influencing mean esophageal impedance.

  20. Deep venous thrombophlebitis: detection with 4-hour versus 24-hour platelet scintigraphy

    SciTech Connect

    Seabold, J.E.; Conrad, G.R.; Ponto, J.A.; Kimball, D.A.; Frey, E.E.; Ahmed, F.; Coughlan, J.D.; Jensen, K.C.

    1987-11-01

    Thirty-one nonheparinized patients with suspected deep venous thrombophlebitis (DVT) underwent contrast venography and indium-111 platelet scintigraphy (In-111 PS). Venography permitted identification of acute DVT in 12 of 31 cases (39%). One additional patient was considered to have acute DVT despite nonconclusive venography results. In-111 PS results were positive at 4 hours in nine of 13 cases (69%) and at 24 hours in 12 of 13 cases (92%). Two of four patients with false-negative 4-hour In-111 PS studies had received warfarin. Thus, the sensitivity of 4-hour In-111 PS in patients not receiving anticoagulants was 82%. Venography results were negative for acute DVT in 18 cases, and 4-hour In-111 PS studies were negative or equivocal in each. In-111 PS is an alternative to contrast venography for detecting acute DVT. If 4-hour In-111 PS results are positive, anticoagulation can be initiated. Delayed images are necessary if the 4-hour images are negative or equivocal.

  1. Neonatal family care for 24 hours per day: effects on maternal confidence and breast-feeding.

    PubMed

    Wataker, Heidi; Meberg, Alf; Nestaas, Eirik

    2012-01-01

    In family care (FC) program for neonatal intensive care units (NICUs), parents are encouraged to reside together with their infant for 24 hours a day to actively be involved in the care. The aim of this study was to assess the impact of FC on maternal confidence and breast-feeding. Maternal confidence and rate of breast-feeding were assessed in 31 mothers offered FC that included special family rooms in the NICU, and in 30 mothers from a comparable NICU providing traditional care without such facilities. One week prior to hospital discharge, mothers in the FC group felt better informed regarding nursing issues and had more confidence in interpretation of the infants regarding feeding issues and in caregiving without staff attendance (P < .05). They also reported a higher level of empowerment (P < .05). Three months after discharge, the mothers in the FC group had a higher self-reported skill level for interpretation of the infant's signals and knowledge about breast-feeding (P < .05). Despite similar rate of breast-feeding at discharge, more infants in the FC group were breastfed 3 months after discharge (P < .05). An FC program in the NICU promoted better maternal confidence during the hospital stay and 3 months after discharge compared with traditional care.

  2. The Canadian 24-Hour Movement Guidelines for Children and Youth: Implications for practitioners, professionals, and organizations.

    PubMed

    Latimer-Cheung, Amy E; Copeland, Jennifer L; Fowles, Jonathon; Zehr, Lori; Duggan, Mary; Tremblay, Mark S

    2016-06-01

    The new Canadian 24-Hour Movement Guidelines for Children and Youth emphasize the integration of all movement behaviours that occur over a whole day (i.e., light, moderate, and vigorous physical activity, sedentary behaviour, and sleep). These guidelines shift the paradigm away from considering each behaviour in isolation. This concept of the "whole day matters" not only calls for a change in thinking about movement but also for redevelopment of dissemination and implementation practice. Past guideline launch activities largely have aimed to create awareness through passive dissemination strategies (e.g., Website posts, distribution of print resources). For the integrated guidelines to have public health impact, we must move beyond dissemination and raising of awareness to implementation and behaviour change. Shifting this focus requires new, innovative approaches to intervention, including interdisciplinary collaboration, policy change, and refocused service provision. The purpose of this paper is to identify practitioners, professionals, and organizations with potential to disseminate and/or implement the guidelines, discuss possible implementation strategies for each of these groups, and describe the few resources being developed and those needed to support dissemination and implementation efforts. This discussion makes readily apparent the need for a well-funded, comprehensive, long-term dissemination, implementation, and evaluation plan to ensure uptake and activation of the guidelines.

  3. After 24-hour scrub, the Boeing Delta II rocket carrying Stardust waits for launch

    NASA Technical Reports Server (NTRS)

    1999-01-01

    In the late morning light at Launch Pad 17-A, Cape Cananveral Air Station, the fixed utility tower (right) casts a long shadow across the base of the Boeing Delta II rocket (left) waiting to launch the Stardust spacecraft. After a 24-hour scrub, the new targeted launch time is 4:04 p.m. EST. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  4. Obtaining liver tridimensional scaffold through the decellularization of rabbit whole liver in 24 hours

    NASA Astrophysics Data System (ADS)

    Federico, Schliamser; Ayelen, Rinaldi; Romina, Comin; Alba Nelly, Borchert; Adrian, Nari Gustavo; Alicia, Salvatierra Nancy; Mariana Paula, Cid

    2016-04-01

    In the present work, we development a new protocol for liver decellularization in which the hole decellularization was reached over 24 h. Introduction: the availability of transplantable livers is not sufficient to fulfill the current demand for grafts, with the search for therapeutic alternatives having generated different lines of research, one of which is the use of decellularized three-dimensional biological matrices and subsequent cell seeding to obtain a functional organ. Objective: to produce a decellularization protocol from rabbit liver to generate a three-dimensional matrixin which the time period involved didn't pass 24 h. Methods: The decellularization is obtained through the use of water and SDS (0,1-0,3 %), after freezing at -80 degrees, is the best alternative of different physical and/or chemical mechanisms to break down organ cells and leave only the extracellular matriz. After 24 h of retrograde perfusion, a decellularized translucent matrix was generated. To evaluate if the decellularization protocol was successful, with the extracellular matrix being preserved, we carried out histological (light microscopy) and biochemical (DNA quantification) studies. Results: the decellularization process was verified by macroscopic observation of the organ using microscopic observation corroborated the macroscopic results, with the hematoxylin-eosin and Masson staining showing no cells or nuclear material. In addition, the DNA quantification was less than 10% in the decellularized liver compared to control. Finally,the time taken to develop the decellularization protocol was less than 24 hours.

  5. Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours: randomised controlled trial

    PubMed Central

    Eriksson, Urs; Seifert, Burkhard; Schaffner, Andreas

    2001-01-01

    Objective To test the hypothesis that amphotericin B deoxycholate is less toxic when given by continuous infusion than by conventional rapid infusion. Design Randomised, controlled, non-blinded, single centre study. Setting University hospital providing tertiary clinical care. Patients 80 mostly neutropenic patients with refractory fever and suspected or proved invasive fungal infections. Intervention Patients were randomised to receive 0.97 mg/kg amphotericin B by continuous infusion over 24 hours or 0.95 mg/kg by rapid infusion over four hours. Main outcome measures Patients were evaluated for side effects related to infusion, nephrotoxicity, and mortality up to three months after treatment. Analysis was on an intention to treat basis. Results Patients in the continuous infusion group had fewer side effects and significantly reduced nephrotoxicity than those in the rapid infusion group. Overall mortality was higher during treatment and after three months' follow up in the rapid infusion than in the continuous infusion group. Conclusion Continuous infusions of amphotericin B reduce nephrotoxicity and side effects related to infusion without increasing mortality. PMID:11238151

  6. What and how much do we eat? 24-hour dietary recall method.

    PubMed

    Salvador Castell, Gemma; Serra-Majem, Lluis; Ribas-Barba, Lourdes

    2015-02-26

    Diet, along with lifestyle factors, is an important determinant of the health status of an individual and of a community. Dietary assessment at the population level provides us with key information on the frequency and distribution of possible inadequate diets and/or nutritional status. It is also useful as input into the elaboration of food and nutrition policies aiming to improve dietary habits and the health status of a community. This article reviews the characteristics, advantages and limitations of the 24-hour dietary recall method (24hDR), which is one of the most widely used tools in nutrition epidemiology to identify food, energy and nutrient intake in national nutrition surveys, cross-sectional studies, clinical trials and cohort studies as well as in the evaluation of individual dietary intake and Total Diet assessment. To reduce the key factors associated with bias, the importance of previously trained interviewers is highlighted, as well as the role of support materials and the contribution of novel technologies.

  7. After 24-hour scrub, the Boeing Delta II rocket carrying Stardust waits for launch

    NASA Technical Reports Server (NTRS)

    1999-01-01

    After a 24-hour postponement, the Boeing Delta II rocket carrying the Stardust spacecraft waits on Launch Pad 17-A, Cape Canaveral Air Station, for its scheduled launch at 4:04 p.m. EST. Umbilical lines (at top) still attached to the fixed utility tower (at right) feed electricity, air conditioning and coolants for the Stardust spacecraft inside the fairing (enclosing the upper stage) before launch. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  8. After 24-hour scrub, the Boeing Delta II rocket carrying Stardust launches on time

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Flames sear the pristine blue sky behind the Boeing Delta II rocket carrying the Stardust spacecraft after the 4:04:15 p.m. launch from Launch Pad 17-A, Cape Canaveral Air Station. A 24- hour scrub postponed the launch from the originally scheduled date of Feb. 6. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  9. A 24-hour study to investigate persistent chemical exposures associated with clandestine methamphetamine laboratories.

    PubMed

    VanDyke, Mike; Erb, Nicola; Arbuckle, Shawn; Martyny, John

    2009-02-01

    The clandestine manufacture of methamphetamine continues to be a concern across the United States. Although the exposures associated with the actual production process have been evaluated, the persistence of those exposures in a residential setting have not been investigated. This study was designed to document the contamination associated with two red phosphorous methamphetamine "cooks" conducted in a residence and the associated exposures up to 24 hours after the cook. The two cooks were conducted on the first day of the study, and exposures associated with different occupant activity levels were measured the following day. Airborne methamphetamine levels during the cook ranged from 520 microg/m(3) to 760 microg/m(3). On Day 2, airborne levels of methamphetamine ranged from 70 microg/m(3) to 210 microg/m(3) and increased with moderate to high activity levels within the residence. The majority of the methamphetamine measured during both days had a particle size of less than 1 mum, suggesting that the methamphetamine is formed as a condensation aerosol and is readily resuspended from contaminated surfaces. Significant methamphetamine contamination was found in the carpeting and likely was associated with the elevated levels of methamphetamine during activity. Levels of hydrogen chloride and iodine were also detected on Day 2 of the project although at very low levels. The study concluded that exposures may still present a significant inhalation exposure well after the actual cook.

  10. Preliminary report: the effect of a 6-month dietary glycemic index manipulation in addition to healthy eating advice and weight loss on arterial compliance and 24-hour ambulatory blood pressure in men: a pilot study.

    PubMed

    Philippou, Elena; Bovill-Taylor, Candace; Rajkumar, Chakravarthi; Vampa, Maria Luisa; Ntatsaki, Eleana; Brynes, Audrey E; Hickson, Mary; Frost, Gary S

    2009-12-01

    We aimed to determine whether altering dietary glycemic index (GI) in addition to healthy eating and weight loss advice affects arterial compliance and 24-hour blood pressure (BP), both coronary heart disease (CHD) risk factors. Middle-aged men with at least 1 CHD risk were randomized to a 6-month low-GI (LGI) or high-GI (HGI) diet. All were advised on healthy eating and weight loss. They were seen monthly to assess dietary compliance and anthropometrics. Carotid-femoral pulse wave velocity (PWV), fasting blood lipid profile, and glucose and insulin concentrations were measured at baseline and at months 3 and 6. Six-hour postprandial glucose and insulin responses and 24-hour ambulatory BP were also assessed at baseline and month 6. Thirty-eight subjects (HGI group, n = 16; LGI group, n = 22) completed the study. At month 6, groups differed in dietary GI, glycemic load, and carbohydrate intake (P < .001). Fasting insulin concentration and insulin resistance (calculated by homeostatic model assessment) were lower in the LGI than the HGI group (P < .01). The reduction in total cholesterol and 24-hour BP was bigger in the LGI than the HGI group (P < .05); and only the LGI group had significant reductions (P < .05) in PWV, low-density lipoprotein cholesterol, and triacylglycerol concentration. There were no differences in postprandial glucose or insulin responses between the groups. The results suggest that an LGI diet may be more beneficial in reducing CHD risk, including PWV and 24-hour BP, even in the setting of healthy eating and weight loss; and thus, further study is warranted.

  11. Experience with noninvasive ambulatory 24-hour blood pressure recording in a community hospital.

    PubMed

    van de Weijgert, E J; Braun, J J

    1992-04-01

    In 40 subjects (23 treated with antihypertensive medication), 24-h ambulatory blood pressure was measured with an oscillometric blood pressure monitor (Spacelabs model 90202). We studied applicability in the out-patient department with regard to patient tolerance, correlation with mercury manometer measurements, 24-h blood pressure variability and the use in detecting "white-coat" hypertension. The measurements were tolerated quite well except for complaints of sleep disturbance and local irritation from the cuff. The average percentage of missed measuring points was 9.2%. Correlation between blood pressure with the mercury manometer and the Spacelabs monitor (averages of three consecutive readings) was: systolic 0.87 and diastolic 0.73 (P less than 0.001). No evidence for systematic error between the two methods was found. Diurnal blood pressure variation was significant with an average night-time drop of 12 +/- 15 mmHg systolic and 12 +/- 11 mmHg diastolic. "Office" blood pressure measured with the Spacelabs monitor was in the hypertensive range for 28 patients (systolic greater than or equal to 160 and/or diastolic greater than or equal to 95 mmHg). Only 15 of these subjects still met the hypertension criteria on the basis of mean daytime ambulatory blood pressure values. When ambulatory blood pressures during arbitrary 3-h periods of the daytime were studied, the number of patients with established hypertension did not change. The patients with this "office" or "white-coat" hypertensive response could not be distinguished on the basis of variability in daytime blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. No Enhancement of 24-Hour Visuomotor Skill Retention by Post-Practice Caffeine Administration

    PubMed Central

    Hussain, Sara J.; Cole, Kelly J.

    2015-01-01

    Caffeine is widely consumed throughout the world and appears to indirectly facilitate learning and memory through effects on attention and motivation. Animal work indicates that post-training caffeine administration augments inhibitory avoidance memory, spatial memory, and object memory. In humans, post-training caffeine administration enhances the ability to discern between familiar images and new, similar images. However, the effect of post-training caffeine administration on motor memory has not been examined. Therefore, we tested two groups of low caffeine consumers (average weekly consumption ≤500 mg) in a double-blind, placebo-controlled study involving acquisition of a continuous isometric visuomotor tracking skill. On Day 1, subjects completed 5 blocks (150 repetitions) of training on the continuous isometric visuomotor skill and subsequently ingested either 200 mg of caffeine or placebo. On day 2, subjects completed an additional 5 blocks of training. Day 1 mean performance and performance variability were both similar between groups, suggesting that both groups acquired the motor skill similarly. For mean performance on Day 2, patterns of re-learning, mean performance learning magnitudes, mean performance learning rates, and mean performance retention magnitudes were all similar between groups. For performance variability on Day 2, there was a small trend towards increased variability in the caffeine group during re-learning, but performance variability learning magnitudes and performance variability retention magnitudes did not differ between groups. Because motor skill acquisition can also be conceptualized as a reduction in performance variability, these results suggest that there may be a small negative effect of post-practice caffeine administration on memory of a newly-learned visuomotor skill. Overall, we found no evidence to suggest that post-training caffeine administration enhances 24-hour retention of a newly-learned continuous visuomotor

  13. No Enhancement of 24-Hour Visuomotor Skill Retention by Post-Practice Caffeine Administration.

    PubMed

    Hussain, Sara J; Cole, Kelly J

    2015-01-01

    Caffeine is widely consumed throughout the world and appears to indirectly facilitate learning and memory through effects on attention and motivation. Animal work indicates that post-training caffeine administration augments inhibitory avoidance memory, spatial memory, and object memory. In humans, post-training caffeine administration enhances the ability to discern between familiar images and new, similar images. However, the effect of post-training caffeine administration on motor memory has not been examined. Therefore, we tested two groups of low caffeine consumers (average weekly consumption ≤500 mg) in a double-blind, placebo-controlled study involving acquisition of a continuous isometric visuomotor tracking skill. On Day 1, subjects completed 5 blocks (150 repetitions) of training on the continuous isometric visuomotor skill and subsequently ingested either 200 mg of caffeine or placebo. On day 2, subjects completed an additional 5 blocks of training. Day 1 mean performance and performance variability were both similar between groups, suggesting that both groups acquired the motor skill similarly. For mean performance on Day 2, patterns of re-learning, mean performance learning magnitudes, mean performance learning rates, and mean performance retention magnitudes were all similar between groups. For performance variability on Day 2, there was a small trend towards increased variability in the caffeine group during re-learning, but performance variability learning magnitudes and performance variability retention magnitudes did not differ between groups. Because motor skill acquisition can also be conceptualized as a reduction in performance variability, these results suggest that there may be a small negative effect of post-practice caffeine administration on memory of a newly-learned visuomotor skill. Overall, we found no evidence to suggest that post-training caffeine administration enhances 24-hour retention of a newly-learned continuous visuomotor

  14. The Impact of Using Different Methods to Assess Completeness of 24-Hour Urine Collection on Estimating Dietary Sodium.

    PubMed

    Wielgosz, Andreas; Robinson, Christopher; Mao, Yang; Jiang, Ying; Campbell, Norm R C; Muthuri, Stella; Morrison, Howard

    2016-06-01

    The standard for population-based surveillance of dietary sodium intake is 24-hour urine testing; however, this may be affected by incomplete urine collection. The impact of different indirect methods of assessing completeness of collection on estimated sodium ingestion has not been established. The authors enlisted 507 participants from an existing community study in 2009 to collect 24-hour urine samples. Several methods of assessing completeness of urine collection were tested. Mean sodium intake varied between 3648 mg/24 h and 7210 mg/24 h depending on the method used. Excluding urine samples collected for longer or shorter than 24 hours increased the estimated urine sodium excretion, even when corrections for the variation in timed collections were applied. Until an accurate method of indirectly assessing completeness of urine collection is identified, the gold standard of administering para-aminobenzoic acid is recommended. Efforts to ensure participants collect complete urine samples are also warranted.

  15. Non-24-hour sleep–wake syndrome improved by low-dose valproic acid: a case report

    PubMed Central

    Kurita, Masatake; Moriya, Takahiro; Nishino, Satoshi; Hirata, Eishin; Hirasawa, Noriyasu; Okubo, Yoshiro; Sato, Tadahiro

    2016-01-01

    A woman was diagnosed with non-24-hour sleep–wake syndrome and depressive symptoms. Her depressive symptoms did not respond to standard doses of several antidepressants or mood stabilizers. Furthermore, her sleep–wake cycle remained non-entrained despite treatment with a melatonin-related drug, vitamin B12, and phototherapy. Ultimately, her sleep–wake rhythm was restored to a 24-hour pattern with a low dose of valproic acid, and her depressive symptoms tended to improve as a result of synchronization without antidepressants. Low-dose valproic acid appears to be one of the effective means of entraining circadian rhythms in patients with non-24-hour sleep–wake syndrome, which in turn likely improves associated depressive symptoms. PMID:28008257

  16. Acute effects of nasal continuous positive airway pressure on 24-hour blood pressure and catecholamines in patients with obstructive sleep apnea.

    PubMed

    Minemura, H; Akashiba, T; Yamamoto, H; Akahoshi, T; Kosaka, N; Horie, T

    1998-12-01

    To assess the acute effects of nasal continuous positive airway pressure (CPAP) on the 24-hour blood pressure and the secretion of catecholamines in urine and plasma, we investigated the changes in the 24-hour blood pressure and urinary and plasma concentrations of epinephrine (E) and norepinephrine (NE) in 26 men with obstructive sleep apnea (OSA) with and without nasal CPAP. Nasal CPAP resulted in significant decreases in the daytime diastolic pressure (from 86 +/-16 mmHg to 83+/-12 mmHg), the nighttime diastolic pressure (from 81+/-12 mmHg to 77+/-9 mmHg) and the nighttime systolic pressures (from 125+/-15 mmHg to 120+/-10 mmHg). There was no significant difference between patients with and without CPAP in the daytime or nighttime urinary E level, but patients who received CPAP showed a significant decrease in daytime urinary NE level (from 156+/-112 microg/14h to 119+/-101 microg/14h) and nighttime urinary NE level (from 143+/-91 microg/10h to 112+/-65 microg/10h). The morning plasma level of NE also decreased (from 371+/-181 pg/ml to 273 +/-148 pg/ml) in patients who received nasal CPAP (p<0.02), but the plasma level of E remained unchanged. There were no correlations between PSG parameters and the reductions in blood pressure and the catecholamine levels induced by nasal CPAP. These findings suggest that OSA contributes, at least in part, to the development of systemic hypertension by increasing sympathetic nervous activity.

  17. Resistance training decreases 24-hour blood pressure in women with metabolic syndrome

    PubMed Central

    2013-01-01

    Background The purpose of this study was to verify the effects of eight weeks of resistance training (RT) on 24 hour blood pressure (BP) in patients with and without metabolic syndrome (MetS). Methods Seventeen women volunteered to participate in this study, 9 with MetS (37.0 ± 8.7 yrs; body mass 77.3 ± 9.7 kg; body mass index 30.3 ± 4.2 kg · m-2) and 8 without MetS (35.1 ± 7.2 yrs; body mass 61.3 ± 8.1 kg; body mass index 24.2 ± 2.5 kg · m-2). Individuals were subjected to eight weeks (3 times/week) of whole body RT comprised of one exercise for each main muscle group with three sets of 8–12 repetitions of each subject’s maximal load . A rest interval of one minute was allowed between sets and exercises. Twenty-four hour BP was measured by ambulatory blood pressure monitoring. Results Mean and diastolic night-time BP decreased (−3.9 mmHg, p = 0.04; -5.5 mmHg, p = 0.03, respectively) after eight weeks of training in MetS patients. This decrease was observed at 11:00 pm, 02:00 am (only diastolic), 07:00 am, and 6:00 pm. There was no training effect on BP in women without MetS. Conclusions Considering the elevation of BP as a contributor to the pathogenesis of MetS, and also to the increase of cardiovascular risk, this study supports RT as a non-pharmacological therapy in the management of BP control for MetS. PMID:23711286

  18. To Compare the Microleakage Among Experimental Adhesives Containing Nanoclay Fillers after the Storages of 24 Hours and 6 Months

    PubMed Central

    Mousavinasab, Seyed Mostafa; Atai, Mohammad; Alavi, Bagher

    2011-01-01

    Objectives: To compare the microleakage among experimental adhesives containing nanoclay fillers after the storages of 24 hours and 6 months. Materials and Methods: Class V cavities were prepared on extracted human molars with the occlusal margins located in enamel and the cervical margins in cementum. Phosphoric acid was applied to the enamel and dentin margins.Subsequently, the cavities were treated using four groups of experimental adhesive systems and restored with a resin composite. Adper Single Bond® was used as control group. After 24- hour and 6- month storages, the samples were subjected to thermocycling shocks and then immersed in silver nitrate as well as developer solution and finally evaluated for leakage. The data were analyzed using SPSS software. Results: Based on Kruskal –Wallis test, significant differences were found between groups regarding microleakage. The Mann- Whitney test showed that Leakage was significantly lower in Adper Single Bond® compared to the other groups in dentinal margins after 24 hours and 6 months and in enamel margins after 6 months. The Wilcoxon Signed Ranks test showed that the enamel leakage in experimental adhesives was significantly lower than dentinal leakage after 24 hours as well as enamel leakage in Adper Single Bond and adhesive with 0.5% PMAA-g-nanoclay was significantly lower than dentinal margins after storage period of 6 months. Conclusion: All the experimental adhesives were effective in reducing enamel leakage after 24 hours, but were not effective in reducing dentinal leakage after 24 hours as well as in enamel and dentinal leakage after a 6-month storage. No improvement was observed in the microleakage in dentin in both short (24 hrs) and long times (6 months). The high microleakage in the adhesives is probably attributed to the high concentration of HEMA in the recipe of the bonding agent. PMID:21566692

  19. Executive Functions are not Affected by 24 Hours of Sleep Deprivation: A Color-Word Stroop Task Study

    PubMed Central

    Dixit, Abhinav; Mittal, Tushar

    2015-01-01

    Background: Sleep is an important factor affecting cognitive performance. Sleep deprivation results in fatigue, lack of concentration, confusion and sleepiness along with anxiety, depression and irritability. Sleep deprivation can have serious consequences in professions like armed forces and medicine where quick decisions and actions need to be taken. Color-Word Stroop task is one of the reliable tests to assess attention and it analyzes the processing of information in two dimensions i.e., reading of words and naming of colour. The evidence regarding the effect of sleep deprivation on Stroop interference is conflicting. The present study evaluated the effect of 24 hours of sleep deprivation on reaction time and interference in Stroop task. Materials and Methods: The present study was done on 30 healthy male medical student volunteers in the age group of 18-25 years after taking their consent and clearance from Institute Ethics Committee. Recordings of Stroop task were at three times: baseline (between 7-9 am), after 12 hours (7-9 pm) and after 24 hours (7-9 am, next day). The subjects were allowed to perform normal daily activities. Results: The study revealed a significant increase in reaction time after 24 hours of sleep deprivation in comparison to baseline and after 12 hours of sleep deprivation. There was no significant change in interference and facilitation after sleep deprivation in comparison to baseline. The number of errors also did not show any significant change after sleep deprivation. Conclusion: The study indicated that there was slowing of responses without change in executive functions after 24 hours of sleep deprivation. It is probable that 24 hours of sleep deprivation does not bring about change in areas of brain affecting executive functions in healthy individuals who have normal sleep cycle. The present study indicated that in professions like armed forces and medicine working 24 hours at a stretch can lead to decrease in motor responses

  20. Interchangeability between 24-hour collection and single spot urines for vanillylmandelic and homovanillic acid levels in the diagnosis of neuroblastoma.

    PubMed

    Cangemi, Giuliana; Barco, Sebastiano; Reggiardo, Giorgio; Viscardi, Elisabetta; Di Cataldo, Andrea; Garaventa, Alberto; Melioli, Giovanni; Conte, Massimo

    2013-12-01

    The determination of the two urinary catecholamine metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA) is of crucial importance for the diagnosis and follow-up of neuroblastoma (NB). The standard practice for their measurement requires the use of 24-hour collections that are time consuming and difficult to obtain. In this article, we directly demonstrate that 24-hour collections and single spot urines are interchangeable for the determination of HVA and VMA expressed as ratio on creatinine concentration. This study can be useful for a faster management of NB at onset.

  1. The Effects of Rilmenidine and Perindopril on Arousal Blood Pressure during 24 Hour Recordings in SHR

    PubMed Central

    Lim, Kyungjoon; Jackson, Kristy L.; Burke, Sandra L.; Head, Geoffrey A.

    2016-01-01

    The surge in arterial pressure during arousal in the waking period is thought to be largely due to activation of the sympathetic nervous system. In this study we compared in SHR the effects of chronic administration of the centrally acting sympatholytic agent rilmenidine with an angiotensin converting enzyme inhibitor perindopril on the rate of rise and power of the surge in mean arterial pressure (MAP) that occurs with arousal associated with the onset of night. Recordings were made using radiotelemetry in 17 adult SHR before and after treatment with rilmenidine (2mg/kg/day), perindopril (1mg/kg/day) or vehicle in the drinking water for 2 weeks. Rilmenidine reduced MAP by 7.2 ± 1.7mmHg while perindopril reduced MAP by 19 ± 3mmHg. Double logistic curve fit analysis showed that the rate and power of increase in systolic pressure during the transition from light to dark was reduced by 50% and 65%, respectively, but had no effect on diastolic pressure. Rilmenidine also reduced blood pressure variability in the autonomic frequency in the active period as assessed by spectral analysis which is consistent with reduction in sympathetic nervous system activity. Perindopril had no effect on the rate or power of the arousal surge in either systolic or diastolic pressure. These results suggest that the arousal induced surge in blood pressure can largely be reduced by an antihypertensive agent that inhibits the sympathetic nervous system and that angiotensin converting enzyme inhibition, while effective in reducing blood pressure, does not alter the rate or power of the surge associated with arousal. PMID:28002478

  2. 77 FR 65310 - Additional Air Quality Designations for the 2006 24-Hour Fine Particle National Ambient Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... AGENCY 40 CFR Part 81 Additional Air Quality Designations for the 2006 24-Hour Fine Particle National Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA). ACTION: Supplemental... particle (PM 2.5 ) national ambient air quality standards (NAAQS) air quality designations for the...

  3. Accuracy and Usefulness of Select Methods for Assessing Complete Collection of 24-Hour Urine: A Systematic Review.

    PubMed

    John, Katherine A; Cogswell, Mary E; Campbell, Norm R; Nowson, Caryl A; Legetic, Branka; Hennis, Anselm J M; Patel, Sheena M

    2016-05-01

    Twenty-four-hour urine collection is the recommended method for estimating sodium intake. To investigate the strengths and limitations of methods used to assess completion of 24-hour urine collection, the authors systematically reviewed the literature on the accuracy and usefulness of methods vs para-aminobenzoic acid (PABA) recovery (referent). The percentage of incomplete collections, based on PABA, was 6% to 47% (n=8 studies). The sensitivity and specificity for identifying incomplete collection using creatinine criteria (n=4 studies) was 6% to 63% and 57% to 99.7%, respectively. The most sensitive method for removing incomplete collections was a creatinine index <0.7. In pooled analysis (≥2 studies), mean urine creatinine excretion and volume were higher among participants with complete collection (P<.05); whereas, self-reported collection time did not differ by completion status. Compared with participants with incomplete collection, mean 24-hour sodium excretion was 19.6 mmol higher (n=1781 specimens, 5 studies) in patients with complete collection. Sodium excretion may be underestimated by inclusion of incomplete 24-hour urine collections. None of the current approaches reliably assess completion of 24-hour urine collection.

  4. Population Pharmacokinetic Model Characterizing 24-Hour Variation in the Pharmacokinetics of Oral and Intravenous Midazolam in Healthy Volunteers

    PubMed Central

    van Rongen, A; Kervezee, L; Brill, MJE; van Meir, H; den Hartigh, J; Guchelaar, H-J; Meijer, JH; Burggraaf, J; van Oosterhout, F

    2015-01-01

    Daily rhythms in physiology may affect the pharmacokinetics of a drug. The aim of this study was to evaluate 24-hour variation in the pharmacokinetics of the CYP3A substrate midazolam. Oral (2 mg) and intravenous (1 mg) midazolam was administered at six timepoints throughout the 24-hour period in 12 healthy volunteers. Oral bioavailability (population mean value [RSE%] of 0.28 (7.1%)) showed 24-hour variation that was best parameterized as a cosine function with an amplitude of 0.04 (17.3%) and a peak at 12:14 in the afternoon. The absorption rate constant was 1.41 (4.7%) times increased after drug administration at 14:00. Clearance (0.38 L/min (4.8%)) showed a minor 24-hour variation with an amplitude of 0.03 (14.8%) L/min and a peak at 18:50. Simulations show that dosing time minimally affects the concentration time profiles after intravenous administration, while concentrations are higher during the day compared to the night after oral dosing, reflecting considerable variation in intestinal processes. PMID:26380154

  5. Correlations of beta-aminoisobutyric acid in 8 hour and 24 hour urinary samples determined by dual column gas chromatography.

    PubMed

    Sjölin, K E; Nyholm, K K

    1980-05-01

    The correlations of beta-aminoisobutyric acid values in 8 hour and 24 hour urinary samples from 23 healthy persons were determined. beta-AIB in the 8 hour urinary samples was measured by gas chromatography and the 24 hour excretion was calculated from the results of three 8 hour determinations. Simultaneous determinations of urinary creatinine were performed by Jaffe's reaction. Based on the 8 hour values of urinary beta-AIB the results demonstrated a constant excretion of beta-aminoisobutyric acid within the 24 hour periods in both low and high excretors. The precision in distinguishing low and high 24 hour excretors of beta-AIB by using 8 hour values was 91%. If 8 hour values of beta-AIB were related to creatinine the same precision for this calculated ratio was 96.5%. However, for high excretors of beta-AIB, failures were 24.5% by using the 8 hour excretion of beta-AIB as indicator, but only 6.5% by using the ratio.

  6. Urinary saturation and risk factors for calcium oxalate stone disease based on spot and 24-hour urine specimens.

    PubMed

    Ogawa, Yoshihide; Yonou, Hiroyuki; Hokama, Sanehiro; Oda, Masami; Morozumi, Makoto; Sugaya, Kimio

    2003-09-01

    In 222 random spot urine specimens, the calcium concentration and calcium oxalate saturation [DG(CaOx)] were significantly higher among stone formers than among non-stone formers, while the citrate and creatinine-corrected citrate concentrations were lower. In 188 24-hour urine specimens, magnesium excretion was lower among stone formers than non-stone formers, while the creatinine-corrected calcium concentration and DG(CaOx) were higher. Among stone formers, there was no gender difference in the urinary concentrations of calcium, oxalate, citrate, magnesium, and DG(CaOx), but the creatinine-corrected calcium, citrate, and magnesium concentrations were higher in women, as well as 24-hour citrate excretion. The levels of calcium and oxalate have a major influence on DG(CaOx), while citrate and magnesium levels have a minor influence. DG(CaOx) was correlated with calcium and oxalate excretion, as well as with the creatinine-corrected calcium and oxalate concentrations. Approximately 5% of 24-hour urine specimens showed critical supersaturation, 80% showed metastable supersaturation, and 15% were unsaturated. Hypercalciuria or hyperoxaluria was fairly common (30% and 40%) in critically supersaturated urine, while it was less common (22.4% and 8.6%) in metastably supersaturated urine and was not detected in unsaturated urine. Hypocitraturia and/or hypomagnesiuria was more common (63.8-80%) at any saturation. The urinary calcium, oxalate, and citrate concentrations, as well as the creatinine-corrected calcium, oxalate, citrate, and magnesium concentrations and DG(CaOx), showed a significant correlation between 57 paired early morning spot urine and 24-hour urine specimens. The creatinine-corrected calcium and citrate concentrations of the early morning urine specimens were significantly correlated with the levels of calcium and citrate excretion in the paired 24-hour urine specimens. In conclusion, no parameter other than urinary saturation gives more than a vague

  7. Irregular 24-hour Activity Rhythms and the Metabolic Syndrome in Older Adults

    PubMed Central

    Sohail, Shahmir; Yu, Lei; Bennett, David A.; Buchman, Aron S.; Lim, Andrew S.P.

    2015-01-01

    Circadian rhythms – near 24-hour intrinsic biological rhythms – modulate many aspects of human physiology and hence disruption of circadian rhythms may have an important impact on human health. Experimental work supports a potential link between irregular circadian rhythms and several key risk factors for cardiovascular disease including hypertension, obesity, diabetes, and dyslipidemia, collectively termed the metabolic syndrome. While several epidemiological studies have demonstrated an association between shift-work and the components of the metabolic syndrome in working-age adults, there is a relative paucity of data concerning the impact of non-occupational circadian irregularity in older women and men. To address this question, we studied 7 days of actigraphic data from 1137 older woman and men participating in the Rush Memory and Aging Project, a community-based cohort study of the chronic conditions of aging. The regularity of activity rhythms was quantified using the nonparametric interdaily stability metric, and was related to the metabolic syndrome and its components obesity, hypertension, diabetes, and dyslipidemia. More regular activity rhythms were associated with a lower odds of having the metabolic syndrome (OR=0.69, 95%CI=0.60–0.80, p=5.8×10−7), being obese (OR=0.73, 95%CI=0.63–0.85, p=2.5×10−5), diabetic (OR=0.76, 95%CI=0.65–0.90, p=9.3×10−4), hypertensive (OR=0.78, 95%CI=0.66–0.91, p=2.0×10−3), or dyslipidemic (OR=0.82, 95%CI=0.72–0.92, p=1.2×10−3). These associations were independent of differences in objectively measured total daily physical activity or rest, and were not accounted for by prevalent coronary artery disease, stroke, or peripheral artery disease. Moreover, more regular activity rhythms were associated with lower odds of having cardiovascular disease (OR=0.83; 95%CI=0.73–0.95, p=5.7×10−3), an effect that was statistically mediated by the metabolic syndrome. We conclude that irregular activity

  8. Changes in platelet morphology and function during 24 hours of storage.

    PubMed

    Braune, S; Walter, M; Schulze, F; Lendlein, A; Jung, F

    2014-01-01

    aggregates could be visualized microscopically. After four hours, first debris and very small aggregates occurred. After 24 hours, platelet aggregates and also debris progressively increased. In accordance to this, the CASY system revealed an increase of platelet aggregates (up to 90 μm diameter) with increasing storage time. The percentage of CD62P positive platelets and PF4 increased significantly with storage time in resting PRP. When soluble ADP was added to stored PRP samples, the number of activatable platelets decreased significantly over storage time. The present study reveals the importance of a consequent standardization in the preparation of WB and PRP. Platelet morphology and function, particularly platelet reactivity to adherent or soluble agonists in their surrounding milieu, changed rapidly outside the vascular system. This knowledge is of crucial interest, particularly in the field of biomaterial development for cardiovascular applications, and may help to define common standards in the in vitro hemocompatibility testing of biomaterials.

  9. Neighborhood socioeconomic disadvantage is associated with higher ratio of 24-hour urinary sodium to potassium in young Japanese women.

    PubMed

    Murakami, Kentaro; Sasaki, Satoshi; Takahashi, Yoshiko; Uenishi, Kazuhiro

    2009-09-01

    Information on the relationship of neighborhood characteristics to objective indicators of dietary intake is extremely limited. The aim of this observational cross-sectional study was to examine the association between neighborhood socioeconomic status (SES) and 24-hour urinary excretion of sodium and potassium in a population with a high ratio of urinary sodium to potassium. Subjects were 1,032 female Japanese dietetics students aged 18 to 22 years, residing in 293 municipalities in Japan. Neighborhood SES index was defined by seven municipal-level variables, namely unemployment, household overcrowding, poverty, education, income, home ownership, and vulnerable groups, with an increasing index signifying increasing neighborhood socioeconomic disadvantage. Urinary excretion of sodium and potassium was estimated from a single 24-hour urine sample. Neighborhood SES index was not significantly associated with 24-hour urinary excretion of sodium (mean value for each quartile of neighborhood SES: 133.5, 135.2, 126.5, and 141.7 mmol/day, respectively; P for trend 0.10) or potassium (mean value for each quartile: 43.5, 42.2, 38.4, and 42.5 mmol/day, respectively; P for trend 0.44). However, neighborhood SES index was significantly positively associated with the ratio of 24-hour urinary sodium to potassium (mean value for each quartile: 3.14, 3.28, 3.37, and 3.41, respectively; P for trend 0.03). This significant association remained after adjustment for household SES variables (mean value for each quartile: 3.15, 3.35, 3.29, and 3.41, respectively; P for trend 0.04). Neighborhood socioeconomic disadvantage was associated with higher ratio of 24-hour urinary sodium to potassium in young Japanese women.

  10. Microleakage of Two Self-Adhesive Cements in the Enamel and Dentin After 24 Hours and Two Months

    PubMed Central

    Jaberi Ansari, Zahra; Kalantar Motamedi, Mojdeh

    2014-01-01

    Objective: Microleakage is a main cause of restorative treatment failure. In this study, we compared occlusal and cervical microleakage of two self-adhesive cements after 24 hours and two months. Materials and Methods: In this in-vitro experimental study, class II inlay cavities were prepared on 60 sound human third molars. Composite inlays were fabricated with Z100 composite resin. The teeth were randomly assigned to six groups. RelyX-Arc (control), RelyX-Unicem and Maxcem were used for the first three groups and specimens were stored in distilled water at 37°C for 24 hours. The same cements were used for the remaining three groups, but the specimens were stored for 2 months. The teeth were subjected to 500 thermal cycles (5°C and 55°C) and immersed in 0.5% basic fuchsin for 24 hours and then sectioned mesiodistally and dye penetration was evaluated in a class II cavity with occlusal and cervical margins using X20 magnification stereomicroscope. Data were analyzed using Kruskal Wallis and Mann-Whitney U tests. Results: After 24 hours, cements had significant differences only in cervical margin microleakage (P=0.0001) and microleakage of RelyX-Unicem and Maxcem was significantly more than that of RelyX-Arc (both P=0.0001). Cervical microleakage in RelyX-Unicem and Maxcem was greater than occlusal (P=0.0001 and P=0.001, respectively). Microleakage was not significantly different between the occlusal and cervical margins after 2 months. Conclusion: Cervical microleakage was greater than occlusal in RelyX-Unicem and Maxcem after 24h. The greatest microleakage was reported for the cervical margin of RelyX-Unicem after 24 hours. PMID:25584053

  11. Effects of para-aminobenzoic acid (PABA) form and administration mode on PABA recovery in 24-hour urine collections.

    PubMed

    Sharma, Rashmi S; Joy, Raechel C; Boushey, Carol J; Ferruzzi, Mario G; Leonov, Alexei P; McCrory, Megan A

    2014-03-01

    Para-aminobenzoic acid (PABA) has long been used as an objective measure to assess completeness of 24-hour urine collections. However, pharmaceutical-grade PABA for human ingestion is not available in the United States. An alternative, the potassium salt of PABA, aminobenzoate potassium, can be obtained for clinical use, although it has not yet been validated in this role. Both PABA and aminobenzoate potassium can be directly ingested in their tablet or capsule forms or added to food before consumption. Our aim was to investigate the effect of form (PABA vs aminobenzoate potassium) and administration mode (directly ingested as a tablet/capsule vs added to food) on urinary PABA recovery levels. Twenty healthy participants underwent 3 test days separated by two 24-hour wash-out periods. Three test conditions, one on each test day, were investigated in randomized order: PABA tablet, aminobenzoate potassium capsule, and PABA or aminobenzoate potassium in food. Ingestion of each dose was supervised and participants performed the 24-hour urine collections while free-living. The 24-hour urine collections were analyzed for PABA recovery (%R) levels using a colorimetric assay. Recoveries 85% to 110% were deemed complete and those >110% were reanalyzed by high pressure liquid chromatography and mass spectrometry. Only complete collections (>85%R) were included in analyses. The recovery for the PABA tablet, aminobenzoate potassium capsule, and PABA/aminobenzoate potassium in food were similar at 98.8%R±2.0%R, 95.1%R±2.3%R, and 93.2%R±2.1%R, respectively, and did not differ significantly. These results suggest that aminobenzoate potassium may be used as an alternative to PABA for assessing the completeness of 24-hour urine collections and to track compliance with consuming provided diets in community-dwelling studies.

  12. Estimation of daily salt intake through a 24-hour urine collection in Pohang, Korea.

    PubMed

    Kim, Yong Chul; Koo, Ho Seok; Kim, Suhnggwon; Chin, Ho Jun

    2014-09-01

    There is an established relationship between a high salt diet and public health problems, especially hypertension and cardiovascular disease. We estimated daily salt intake in a group of adults and assessed its association with related variables in Pohang, Korea. We conducted a cross-sectional survey in 2013 with 242 adults. Urine was collected for 24 hr to estimate daily salt intake, and questionnaires about salt preference were administered. The mean daily salt intake was 9.9±4.6 g. There was no difference in salt intake between high systolic blood pressure (SBP) participants and normal SBP participants (10.5±4.7 g/d vs. 9.6±4.3 g/d, P=0.339), but high diastolic blood pressure (DBP) participants reported more salt intake than normal DBP participants (10.4±4.9 g/d vs. 9.7±4.1 g/d, P=0.049). Salt intake and body mass index demonstrated a positive correlation (P=0.001). A preference for Korean soup or stew was associated with high salt intake (P=0.038). Dietary salt intake in Korean adults is still higher than the recommendation from the World Health Organization. More efforts should be made to reduce the salt consumption of Korean adults.

  13. Endothelial function in postmenopausal women with nighttime systolic hypertension

    PubMed Central

    Routledge, Faye S.; Hinderliter, Alan L.; McFetridge-Durdle, Judith; Blumenthal, James A.; Paine, Nicola J.; Sherwood, Andrew

    2014-01-01

    Objective Hypertension becomes more prevalent in women during their postmenopausal years. Nighttime systolic blood pressure (SBP) is especially predictive of adverse cardiac events and the relationship between rising nighttime SBP and cardiovascular risk increases more rapidly in women compared to men. The reasons for the prognostic significance of nighttime SBP are not completely known, but may involve vascular endothelial dysfunction. The purpose of this study was to examine the relationship of nighttime SBP and endothelial function, assessed by brachial artery flow-mediated dilation (FMD) and to determine whether postmenopausal women with nighttime hypertension (SBP≥120 mm Hg) evidenced greater endothelial dysfunction compared to women with normal nighttime SBP. Methods One-hundred postmenopausal women (mean age: 65.8 ± 7.5 years, body mass index: 28.3 ± 4.7 kg/m2, hypertension: 47%, coronary artery disease: 51%, mean clinic BP 137 ± 17/67 ± 11 mm Hg, 34 with nighttime hypertension) underwent 24-hour ambulatory BP monitoring, actigraphy, and brachial artery FMD assessments. Results Multivariate regression models showed that higher nighttime SBP and larger baseline artery diameter were inversely related to FMD. Nighttime SBP and baseline artery diameter accounted for 23% of the variance in FMD. After adjusting for baseline artery diameter, women with nighttime hypertension had lower FMD than women with normal nighttime SBP (2.95%±0.65 vs 5.52%±0.46, p = .002). Conclusions In postmenopausal women, nighttime hypertension was associated with reduced endothelial function. Research examining the therapeutic benefits of treating nighttime hypertension on endothelial function and future cardiovascular risk in postmenopausal women is warranted. PMID:25563797

  14. Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study.

    PubMed

    Sharman, James E; Marwick, Thomas H; Gilroy, Deborah; Otahal, Petr; Abhayaratna, Walter P; Stowasser, Michael

    2013-12-01

    Arm cuff blood pressure (BP) may overestimate cardiovascular risk. Central aortic BP predicts mortality and could be a better method for patient management. We sought to determine the usefulness of central BP to guide hypertension management. This was a prospective, open-label, blinded-end point study in 286 patients with hypertension randomized to treatment decisions guided by best-practice usual care (n=142; using office, home, and 24-hour ambulatory BP) or, in addition, by central BP intervention (n=144; using SphygmoCor). Therapy was reviewed every 3 months for 12 months, and recommendations were provided to each patient and his/her doctor on antihypertensive medication titration. Outcome measures were as follows: medication quantity (daily defined dose), quality of life, and left ventricular mass (3-dimensional echocardiography). There was 92% compliance with recommendations on medication titration, and quality of life improved in both groups (post hoc P<0.05). For usual care, there was no change in daily defined dose (all P>0.10), but with intervention there was a significant stepwise decrease in daily defined dose from baseline to 3 months (P=0.008) and each subsequent visit (all P<0.001). Intervention was associated with cessation of medication in 23 (16%) patients versus 3 (2%) in usual care (P<0.001). Despite this, there were no differences between groups in left ventricular mass index, 24-hour ambulatory BP, home systolic BP, or aortic stiffness (all P>0.05). We conclude that guidance of hypertension management with central BP results in a significantly different therapeutic pathway than conventional cuff BP, with less use of medication to achieve BP control and no adverse effects on left ventricular mass, aortic stiffness, or quality of life.

  15. Changes in foot volume, body composition, and hydration status in male and female 24-hour ultra-mountain bikers

    PubMed Central

    2014-01-01

    Background The effects of running and cycling on changes in hydration status and body composition during a 24-hour race have been described previously, but data for 24-hour ultra-mountain bikers are missing. The present study investigated changes in foot volume, body composition, and hydration status in male and female 24-hour ultra-mountain bikers. Methods We compared in 49 (37 men and 12 women) 24-hour ultra-mountain bikers (ultra-MTBers) changes (Δ) in body mass (BM). Fat mass (FM), percent body fat (%BF) and skeletal muscle mass (SM) were estimated using anthropometric methods. Changes in total body water (TBW), extracellular fluid (ECF) and intracellular fluid (ICF) were determined using bioelectrical impedance and changes in foot volume using plethysmography. Haematocrit, plasma [Na+], plasma urea, plasma osmolality, urine urea, urine specific gravity and urine osmolality were measured in a subgroup of 25 ultra-MTBers (16 men and 9 women). Results In male 24-hour ultra-MTBers, BM (P < 0.001), FM (P < 0.001), %BF (P < 0.001) and ECF (P < 0.05) decreased whereas SM and TBW did not change (P > 0.05). A significant correlation was found between post-race BM and post-race FM (r = 0.63, P < 0.001). In female ultra-MTBers, BM (P < 0.05), %BF (P < 0.05) and FM (P < 0.001) decreased, whereas SM, ECF and TBW remained stable (P > 0.05). Absolute ranking in the race was related to Δ%BM (P < 0.001) and Δ%FM in men (P < 0.001) and to Δ%BM (P < 0.05) in women. In male ultra-MTBers, increased post-race plasma urea (P < 0.001) was negatively related to absolute ranking in the race, Δ%BM, post-race FM and Δ%ECF (P < 0.05). Foot volume remained stable in both sexes (P > 0.05). Conclusions Male and female 24-hour ultra-MTBers experienced a significant loss in BM and FM, whereas SM remained stable. Body weight changes and increases in plasma urea do not reflect a change in body hydration status. No oedema

  16. Study on Operation Optimization of Pumping Station's 24 Hours Operation under Influences of Tides and Peak-Valley Electricity Prices

    NASA Astrophysics Data System (ADS)

    Yi, Gong; Jilin, Cheng; Lihua, Zhang; Rentian, Zhang

    2010-06-01

    According to different processes of tides and peak-valley electricity prices, this paper determines the optimal start up time in pumping station's 24 hours operation between the rating state and adjusting blade angle state respectively based on the optimization objective function and optimization model for single-unit pump's 24 hours operation taking JiangDu No.4 Pumping Station for example. In the meantime, this paper proposes the following regularities between optimal start up time of pumping station and the process of tides and peak-valley electricity prices each day within a month: (1) In the rating and adjusting blade angle state, the optimal start up time in pumping station's 24 hours operation which depends on the tide generation at the same day varies with the process of tides. There are mainly two kinds of optimal start up time which include the time at tide generation and 12 hours after it. (2) In the rating state, the optimal start up time on each day in a month exhibits a rule of symmetry from 29 to 28 of next month in the lunar calendar. The time of tide generation usually exists in the period of peak electricity price or the valley one. The higher electricity price corresponds to the higher minimum cost of water pumping at unit, which means that the minimum cost of water pumping at unit depends on the peak-valley electricity price at the time of tide generation on the same day. (3) In the adjusting blade angle state, the minimum cost of water pumping at unit in pumping station's 24 hour operation depends on the process of peak-valley electricity prices. And in the adjusting blade angle state, 4.85%˜5.37% of the minimum cost of water pumping at unit will be saved than that of in the rating state.

  17. Dipstick Spot urine pH does not accurately represent 24 hour urine PH measured by an electrode

    PubMed Central

    Omar, Mohamed; Sarkissian, Carl; Jianbo, Li; Calle, Juan; Monga, Manoj

    2016-01-01

    ABSTRACT Objectives To determine whether spot urine pH measured by dipstick is an accurate representation of 24 hours urine pH measured by an electrode. Materials and Methods We retrospectively reviewed urine pH results of patients who presented to the urology stone clinic. For each patient we recorded the most recent pH result measured by dipstick from a spot urine sample that preceded the result of a 24-hour urine pH measured by the use of a pH electrode. Patients were excluded if there was a change in medications or dietary recommendations or if the two samples were more than 4 months apart. A difference of more than 0.5 pH was considered an inaccurate result. Results A total 600 patients were retrospectively reviewed for the pH results. The mean difference in pH between spot urine value and the 24 hours collection values was 0.52±0.45 pH. Higher pH was associated with lower accuracy (p<0.001). The accuracy of spot urine samples to predict 24-hour pH values of <5.5 was 68.9%, 68.2% for 5.5 to 6.5 and 35% for >6.5. Samples taken more than 75 days apart had only 49% the accuracy of more recent samples (p<0.002). The overall accuracy is lower than 80% (p<0.001). Influence of diurnal variation was not significant (p=0.588). Conclusions Spot urine pH by dipstick is not an accurate method for evaluation of the patients with urolithiasis. Patients with alkaline urine are more prone to error with reliance on spot urine pH. PMID:27286119

  18. Antimicrobial Prophylaxis in Instrumented Spinal Fusion Surgery: A Comparative Analysis of 24-Hour and 72-Hour Dosages

    PubMed Central

    Abraham, Vineet Thomas; Ravichandran, Mirunalini; Achimuthu, Rajamani

    2016-01-01

    Study Design Prospective study. Purpose To compare the efficacy of 24-hour and 72-hour antibiotic prophylaxis in preventing surgical site infections (SSIs). Overview of Literature Antimicrobial prophylaxis in surgical practice has become a universally accepted protocol for minimizing postoperative complications related to infections. Although prophylaxis is an accepted practice, a debate exists with regard to the antibiotic type and its administration duration for various surgical procedures. Methods Our institute is a tertiary care hospital with more than 100 spinal surgeries per year for various spine disorders in the department of orthopedics. We conducted this prospective study in our department from June 2012 to January 2015. A total of 326 patients were enrolled in this study, with 156 patients in the 72-hour antibiotic prophylaxis group (group A) and 170 patients in the 24-hour group (group B). Cefazolin was the antibiotic used in both groups. Two surgeons were involved in conducting all the spinal procedures. Our study compared SSIs among patients undergoing instrumented spinal fusion. Results The overall rate of SSIs was 1.8% with no statistical difference between the two groups. Conclusions The 24-hour antimicrobial prophylaxis is as effective as the 72-hour dosage in instrumented spinal fusion surgery. PMID:27994776

  19. Vanilmandelic acid and homovanillic acid levels in patients with neural crest tumor: 24-hour urine collection versus random sample.

    PubMed

    Gregianin, L J; McGill, A C; Pinheiro, C M; Brunetto, A L

    1997-01-01

    Neuroblastoma is the most common solid tumor in childhood and is the most frequent neural crest tumor (NCT). More than 90% of the patients excrete high levels of vanilmandelic acid (VMA) and homovanillic acid (HVA) in the urine. Original biochemical methods for measuring these two metabolites of catecholamines employed a collection of urine for 24 hours to avoid errors related to circadian cycle variations. More recently, attempts have been made to replace the 24-hour collections by random samples (RSs). This has practical advantages particularly for young children. The objective of this study is to assess whether urinary VMA related to urinary creatinine levels can be determined reliably by the method of Pisano et al. from RSs in patients with NCT. The determination of the consumption of VMA in urine stored for prolonged periods of time was also studied. We found a good correlation between the values of metabolites of catecholamines in RSs compared with 24-hour urine collections. There was consumption of VMA in urine samples after storage. We conclude that determination of VMA in RSs of urine by Pisano's method may identify NCT production of catecholamines and that the consumption of these catecholamines is an important factor to consider in the interpretation of values obtained with stored urine specimens.

  20. Assessment of 24-hours Aldosterone Administration on Protein Abundances in Fluorescence-Sorted Mouse Distal Renal Tubules by Mass Spectrometry

    PubMed Central

    Jensen, Thomas B; Pisitkun, Trairak; Hoffert, Jason D; Jensen, Uffe B; Fenton, Robert A; Praetorius, Helle A; Knepper, Mark A; Praetorius, Jeppe

    2013-01-01

    Background/Aims Aldosterone exerts multiple long-term effects in the distal renal tubules. The aim of this study was to establish a method for identifying proteins in these tubules that change in abundance by only 24-hours aldosterone administration. Methods Mice endogenously expressing green fluorescent protein (eGFP) in the connecting tubule and cortical collecting ducts were treated with a subcutaneous injection of 2.0 mg/kg aldosterone or vehicle (n=5), and sacrificed 24 hours later. Suspensions of single cells were obtained enzymatically, and eGFP positive cells were isolated by fluorescence activated cell sorting (FACS). Samples of 100 μg proteins were digested with trypsin and labeled with 8-plex iTRAQ reagents and processed for liquid chromatography tandem mass spectrometry (LC-MS/MS). Results FACS yielded 1.4 million cells per mouse. The LC-MS/MS spectra were matched to peptides by the SEQUEST search algorithm, which identified 3002 peptides corresponding to 506 unique proteins of which 20 significantly changed abundance 24-hours after aldosterone injection. Conclusion We find the method suitable and useful for studying hormonal effects on protein abundance in distal tubular segments. PMID:23428628

  1. Chronic Kidney Disease Is Characterized by “Double Trouble” Higher Pulse Pressure plus Night-Time Systolic Blood Pressure and More Severe Cardiac Damage

    PubMed Central

    Fedecostante, Massimiliano; Spannella, Francesco; Cola, Giovanna; Espinosa, Emma; Dessì-Fulgheri, Paolo; Sarzani, Riccardo

    2014-01-01

    Background Hypertension plays a key role in chronic kidney disease (CKD), but CKD itself affects the blood pressure (BP) profile. The aim of this study was to assess the association of BP profile with CKD and the presence of cardiac organ damage. Methods We studied 1805 patients, referred to our Hypertension Centre, in whom ABPM, blood tests, and echocardiography were clinically indicated. The glomerular filtration rate was estimated (eGFR) using the MDRD equation and CKD was defined as eGFR<60 mL/min/1.73 m2. Cardiac organ damage was evaluated by echocardiography. Results Among patients with CKD there were higher systolic blood pressure (SBP) during the night-time, greater prevalence of non-dippers (OR: 1.8) and increased pulse pressure (PP) during 24-hour period, daytime and night-time (all p<0.001). Patients with CKD had a greater LVM/h2.7 index, and a higher prevalence of left ventricular hypertrophy and diastolic dysfunction (all p<0.001). Nocturnal SBP and PP correlated more strongly with cardiac organ damage (p<0.001). Patients with CKD had a greater Treatment Intensity Score (p<0.001) in the absence of a significantly greater BP control. Conclusions CKD patients have an altered night-time pressure profile and higher PP that translate into a more severe cardiac organ damage. In spite of a greater intensity of treatment in most patients with CKD, BP control was similar to patients without CKD. Our findings indicate the need of a better antihypertensive therapy in CKD, better selected drugs, dosages and posology to provide optimal coverage of 24 hours and night-time BP. PMID:24465931

  2. Caffeine does not entrain the circadian clock but improves daytime alertness in blind patients with non-24-hour rhythms

    PubMed Central

    St. Hilaire, Melissa A.; Lockley, Steven W.

    2015-01-01

    Objective/Background Totally blind individuals are highly likely to suffer from Non-24-Hour Sleep-Wake Disorder due to a failure of light to reset the circadian pacemaker in the suprachiasmatic nuclei. In this outpatient case series, we investigated whether daily caffeine administration could entrain the circadian pacemaker in non-entrained blind patients to alleviate symptoms of non-24-hour sleep–wake disorder. Patients/Methods Three totally blind males (63.0 ± 7.5 years old) were studied at home over ~4 months. Urinary 6-sulphatoxymelatonin (aMT6s) rhythms were measured for 48 h every 1–2 weeks. Participants completed daily sleep–wake logs, and rated their alertness and mood using nine-point scales every ~2–4 h while awake on urine sampling days. Caffeine capsules (150 mg per os) were self-administered daily at 10 a.m. for approximately one circadian beat cycle based on each participant's endogenous circadian period τ and compared to placebo (n = 2) or no treatment (n = 1) in a single-masked manner. Results Non-24-h aMT6s rhythms were confirmed in all three participants (τ range = 24.32–24.57 h). Daily administration of 150 mg caffeine did not entrain the circadian clock. Caffeine treatment significantly improved daytime alertness at adverse circadian phases (p < 0.0001) but did not decrease the occurrence of daytime naps compared with placebo. Conclusions Although caffeine was able to improve daytime alertness acutely and may therefore provide temporary symptomatic relief, the inability of caffeine to correct the underlying circadian disorder means that an entraining agent is required to treat Non-24-Hour Sleep–Wake Disorder in the blind appropriately. PMID:25891543

  3. Effects of Fibrinogen Concentrate on Thrombin Generation, Thromboelastometry Parameters, and Laboratory Coagulation Testing in a 24-Hour Porcine Trauma Model

    PubMed Central

    Zentai, Christian; Solomon, Cristina; van der Meijden, Paola E. J.; Spronk, Henri M. H.; Schnabel, Jonas; Rossaint, Rolf

    2015-01-01

    Introduction: In a 24-hour porcine model of liver injury, we showed that fibrinogen supplementation does not downregulate endogenous fibrinogen synthesis. Here we report data from the same study showing the impact of fibrinogen on coagulation variables. Materials and Methods: Coagulopathy was induced in 20 German land race pigs by hemodilution and blunt liver injury. Animals randomly received fibrinogen concentrate (100 mg/kg) or saline. Coagulation parameters were assessed and thromboelastometry (ROTEM) was performed. Results: Fibrinogen concentrate significantly reduced the prolongations of EXTEM clotting time, EXTEM clot formation time, and prothrombin time induced by hemodilution and liver injury. A decrease in clot strength was also ameliorated. Endogenous thrombin potential was significantly higher in the fibrinogen group than in the control group, 20 minutes (353 ± 24 vs 289 ± 22 nmol/L·min; P < .05) and 100 minutes (315 ± 40 vs 263 ± 38 nmol/L·min; P < .05) after the start of infusion. However, no significant between-group differences were seen in other thrombin generation parameters or in d-dimer or thrombin–antithrombin levels. Fibrinogen–platelet binding was reduced following liver injury, with no significant differences between groups. No significant between-group differences were observed in any parameter at ∼12 and ∼24 hours. Conclusion: This study suggests that, in trauma, fibrinogen supplementation may shorten some measurements of the speed of coagulation initiation and produce a short-lived increase in endogenous thrombin potential, potentially through increased clotting substrate availability. Approximately 12 and 24 hours after starting fibrinogen concentrate/saline infusion, all parameters measured in this study were comparable in the 2 study groups. PMID:25948634

  4. Reliability and predictive validity of energy intake measures from the 24-hour dietary recalls of homebound older adults.

    PubMed

    Sun, Yanhui; Roth, David L; Ritchie, Christine S; Burgio, Kathryn L; Locher, Julie L

    2010-05-01

    Twenty-four-hour dietary recalls are used frequently to study homebound older adults' eating behaviors. However, the reliability and predictive validity of this method have not been established in this population. The purpose of this study was to examine whether homebound older adults provide reliable and valid measures of total energy intake in 24-hour dietary recalls. Two hundred thirty homebound older adults were interviewed in their homes using a questionnaire to assess eating behaviors and factors that could affect those behaviors. Participants completed three 24-hour dietary recalls at baseline and again at 6-month follow-up. Two subsamples were identified for analyses. For participants who were not hospitalized during the 6-month interval and had their weight measured at both assessments (n=52), sufficient test-retest reliability of energy intake was observed (r=0.59), but energy intake deficiencies relative to estimated energy requirements did not predict actual weight loss (r=0.08). When this sample was supplemented with 91 participants who experienced any adverse event (weight loss of 2.5% or more, hospitalization, institutionalization, or mortality) in the 6-month period (n=143), adverse events were more likely to occur for those with insufficient energy intake (odds ratio 3.49, P=0.009), and in white participants compared to African-American participants (odds ratio 3.13, P=0.016). Adequate test-retest reliability of the 24-hour dietary recall was demonstrated, but additional research with larger samples and longer follow-up intervals is needed to better evaluate the predictive validity of energy intake measures for this population.

  5. Extent and Determinants of Thermogenic Responses to 24 Hours of Fasting, Energy Balance, and Five Different Overfeeding Diets in Humans

    PubMed Central

    Pannacciulli, Nicola; Bonfiglio, Susan; Pacak, Karel; Krakoff, Jonathan

    2013-01-01

    Context: Individual variation in the ability to convert excess calories to heat and the effects of dietary macronutrient composition are unclear. Objective: Stability and determinants of the energy expenditure (EE) response to overconsumption were assessed. Design, Setting, and Participants: Twenty subjects (75% male) with normal glucose regulation were evaluated during 24 hours each of energy balance, fasting, and 5 different diets with 200% energy requirements in a clinical research unit. Interventions: Five 1-day overfeeding diets were given in random order: high carbohydrate (75%) and low protein (3%); high carbohydrate and normal protein (20%); high fat (46%) and low protein; high fat (60%) and normal protein; and balanced (50% carbohydrates, 20% protein). Main Outcome Measures: The 24-hour EE, sleeping EE, and thermic effect of food (TEF) during each diet were measured with a metabolic chamber. Appetitive hormones were measured before and after the diets. Results: The EE response to overfeeding exhibited good intraindividual reproducibility. Similar increases above eucaloric feeding in 24-hour EE (mean 10.7 ± 5.7%, P < .001; range 2.9–18.8%) and sleeping EE (14.4 ± 11.3%, P < .001; range 1.0–45.1%) occurred when overfeeding diets containing 20% protein, despite differences in fat and carbohydrate content, but the EE response during overfeeding diets containing 3% protein was attenuated. The percent body fat negatively correlated with TEF during normal protein overfeeding (r = −0.53, P < .01). Fasting peptide YY negatively correlated with TEF (r = −0.56, P < .01) and the increase in sleeping EE (r = −0.54, P < .01) during overfeeding. Conclusions: There is an intrinsic EE response to overfeeding that negatively associates with adiposity, although it represents a small percentage of consumed calories. PMID:23666976

  6. The Automated Self-Administered 24-Hour Dietary Recall for Children, 2012 version, for youth aged 9 to 11 Years: A validation study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to validate the 2012 version of the Automated Self-Administered 24-Hour Dietary Recall for Children (ASA24-Kids-2012), a self-administered web-based 24-hour dietary recall (24hDR) instrument, among children aged 9 to 11 years, in two sites using a quasiexperimental design. In one s...

  7. Invasively Measured Aortic Systolic Blood Pressure and Office Systolic Blood Pressure in Cardiovascular Risk Assessment: A Prospective Cohort Study.

    PubMed

    Laugesen, Esben; Knudsen, Søren T; Hansen, Klavs W; Rossen, Niklas B; Jensen, Lisette Okkels; Hansen, Michael G; Munkholm, Henrik; Thomsen, Kristian K; Søndergaard, Hanne; Bøttcher, Morten; Raungaard, Bent; Madsen, Morten; Hulman, Adam; Witte, Daniel; Bøtker, Hans Erik; Poulsen, Per L

    2016-09-01

    Aortic systolic blood pressure (BP) represents the hemodynamic cardiac and cerebral burden more directly than office systolic BP. Whether invasively measured aortic systolic BP confers additional prognostic value beyond office BP remains debated. In this study, office systolic BP and invasively measured aortic systolic BP were recorded in 21 908 patients (mean age: 63 years; 58% men; 14% with diabetes mellitus) with stable angina pectoris undergoing elective coronary angiography during January 2001 to December 2012. Multivariate Cox models were used to assess the association with incident myocardial infarction, stroke, and death. Discrimination and reclassification were assessed using Harrell's C and the Continuous Net Reclassification Index. Data were analyzed with and without stratification by diabetes mellitus status. During a median follow-up period of 3.7 years (range: 0.1-10.8 years), 422 strokes, 511 myocardial infarctions, and 1530 deaths occurred. Both office and aortic systolic BP were associated with stroke in patients with diabetes mellitus (hazard ratio per 10 mm Hg, 1.18 [95% confidence interval, 1.07-1.30] and 1.14 [95% confidence interval, 1.05-1.24], respectively) and with myocardial infarction in patients without diabetes mellitus (hazard ratio, 1.07 [95% confidence interval, 1.02-1.12] and 1.05 [95% confidence interval, 1.01-1.10], respectively). In models including both BP measurements, aortic BP lost statistical significance and aortic BP did not confer improvement in either C-statistics or net reclassification analysis. In conclusion, invasively measured aortic systolic BP does not add prognostic information about cardiovascular outcomes and all-cause mortality compared with office BP in patients with stable angina pectoris, either with or without diabetes mellitus.

  8. Determination of and correlation between urine protein excretion and urine protein-to-creatinine ratio values during a 24-hour period in healthy horses and ponies.

    PubMed

    Uberti, Benjamin; Eberle, D Bernard; Pressler, Barrak M; Moore, George E; Sojka, Janice E

    2009-12-01

    OBJECTIVE-To determine whether urine protein-to-creatinine (UP:C) ratio assessment provides an estimate of urine protein excretion (UPE) over a 24-hour period in horses and ponies, establish a preliminary UP:C ratio reference range, and determine UP:C ratio variation over time in healthy equids. ANIMALS-11 female horses and 6 female ponies. PROCEDURES-Urine was collected from all equids at 4-hour intervals for 24 hours. Total 24-hour UPE (mg of protein/kg of body weight) and UP:C ratio were determined; these variables were also assessed in aliquots of urine collected at 4-hour intervals. On 2 additional days, urine samples were also obtained from 6 horses (1 sample/horse/d) to determine day-to-day variation in UP:C ratio. Correlation between 4-hour or 24-hour UPE and UP:C ratio values was assessed. Reference ranges for 24-hour UPE, 24-hour UP:C ratio, and 4-hour UP:C ratios were calculated as central 95th percentiles of observed values. RESULTS-Mean 24-hour UPE (4.28 +/- 2.99 mg/kg) and 24-hour UP:C ratio (0.0 to 0.37) had excellent correlation (R = 0.826; P < 0.001) in both horses and ponies; analysis of 4-hour data also revealed good correlation (R = 0.782; P < 0.001) with these variables. Calculated UPE and UP:C ratio reference ranges were similar to established ranges in other species. Day-to-day variability in UP:C ratio was minimal, and all results were within the reference range calculated by use of the 24-hour urine samples. CONCLUSIONS AND CLINICAL RELEVANCE-Assessment of the UP:C ratio appears to be a reliable method for estimating 24-hour UPE in horses and ponies.

  9. Urine 24-hour volume

    MedlinePlus

    ... in a day, such as: Creatinine Sodium Potassium Nitrogen Protein This test may also be done if ... disease Potassium urine test Sodium urine test Urea nitrogen urine test Urination - excessive amount Urine output - decreased ...

  10. 24-hour urine protein

    MedlinePlus

    ... your doctor may be able to order a test that is done on just one urine sample (protein-to-creatinine ratio). Normal Results The normal value is less than 100 milligrams per day or less than 10 milligrams per deciliter ... of these tests. Normal value ranges may vary slightly among different ...

  11. Ultra-Rapid dUT1 Measurements on Japan-Fennoscandian Baselines - Application to 24-hour Sessions

    NASA Technical Reports Server (NTRS)

    Matsuzaka, Shigeru; Kurihara, Shinobu; Sekido, Mamoru; Hobiger, Thomas; Haas, Rudiger; Ritakari, Jouko; Wagner, Jan

    2010-01-01

    GSI, NICT, OSO, and MRO have been engaged in Ultra-rapid dUT1 experiments since 2007 aiming at the technological possibility of real-time dUT1 results using the e-VLBI technique. We have already successfully determined dUT1 in less than four minutes after the end of an experimental Intensive session in 2008, and at present we routinely get the results within 30 minutes for regular Intensives. In 2009 we applied the technique to 24-hour sessions and continuously obtained dUT1 values by processing and analyzing Tsukuba Onsala data in near real-time. It showed a detailed behavior of UT1 variations, which could be very valuable for scientific study as well as for precise prediction of UT1-UTC.

  12. 24-hour energy expenditure and substrate oxidation rates are unaffected by body fat distribution in obese women.

    PubMed

    Buemann, B; Astrup, A; Quaade, F; Madsen, J

    1994-01-01

    Twenty-four-hour energy expenditure (EE) and nonprotein respiratory quotient (RQnp) were measured by indirect calorimetry in 19 upper-body-obese (UBO) and 15 lower-body-obese (LBO) women with similar body mass index (BMI) and body fat percent. The measurements were performed in a respiration chamber on a predetermined physical activity program and a controlled diet. No differences between the UBO and LBO groups were found in 24-hour, daytime, and sleeping EE after adjustment for differences in fat-free mass (FFM). Furthermore, no group effect was observed in RQnp, but a positive correlation was found between RQnp and age. Despite the fact that an increased free fatty acid (FFA) turnover has been found in UBO subjects, the present study does not support the contention that upper-body obesity is accompanied by an increased lipid oxidation.

  13. Prognostic Significance of Initial Serum Albumin and 24 Hour Daily Protein Excretion before Treatment in Multiple Myeloma.

    PubMed

    Chen, Jia-Hong; Hsu, Shun-Neng; Huang, Tzu-Chuan; Wu, Yi-Ying; Lin, Chin; Chang, Ping-Ying; Chen, Yeu-Chin; Ho, Ching-Liang

    2015-01-01

    Renal failure is a common morbidity in multiple myeloma (MM). Although proteinuria has been increasingly reported in malignancies, it is not routinely used to refine risk estimates of survival outcomes in patients with MM. Here we aimed to investigate initial serum albumin and 24-hour daily protein excretion (24-h DPE) before treatment as prognostic factors in patients with MM. We conducted a retrospective analysis of 102 patients with myeloma who were ineligible for haematopoietic stem cell transplantation between October 2000 and December 2012. Initial proteinuria was assessed before treatment by quantitative analysis of 24-hour urine samples. The demographic and laboratory characteristics, survival outcome, and significance of pre-treatment 24-h DPE and albumin in the new staging system of MM were analyzed. Pre-treatment proteinuria (>300 mg/day) was present in 66 patients (64.7%). The optimal cut-off value of 24-h DPE before treatment was 500 mg/day. Analysis of the time-dependent area under the curve showed that the serum albumin and 24-h DPE before treatment were better than 24-h creatinine clearance rate and β2-microglobulin. A subgroup analysis showed that an initial excess proteinuria (24-h DPE ≥ 500 mg) was associated with poor survival status (17.51 vs. 34.24 months, p = 0.002). Furthermore, initial serum albumin was an independent risk factor on multivariate analysis (<2.8 vs. ≥ 2.8, hazard ratio = 0.486, p = 0.029). Using the A-DPE staging system, there was a significant survival difference among patients with stage I, II, and III MM (p < 0.001). Initial serum albumin and 24-h DPE before treatment showed significant prognostic factors in patients with MM, and the new A-DPE staging system may be utilized instead of the International Staging System. Its efficacy should be evaluated by further large prospective studies.

  14. Biomechanical evaluation of three fixation modalities for preperitoneal inguinal hernia repair: a 24-hour postoperative study in pigs

    PubMed Central

    Guérin, Gaëtan; Bourges, Xavier; Turquier, Frédéric

    2014-01-01

    Purpose Tacks and sutures ensure a strong fixation of meshes, but they can be associated with pain and discomfort. Less invasive methods are now available. Three fixation modalities were compared: the ProGrip™ laparoscopic self-fixating mesh; the fibrin glue Tisseel™ with Bard™ Soft Mesh; and the SorbaFix™ absorbable fixation system with Bard™ Soft Mesh. Materials and methods Meshes (6 cm ×6 cm) were implanted in the preperitoneal space of swine. Samples were explanted 24 hours after surgery. Centered defects were created, and samples (either ten or eleven per fixation type) were loaded in a pressure chamber. For each sample, the pressure, the mesh displacement through the defect, and the measurements of the contact area were recorded. Results At all pressures tested, the ProGrip™ laparoscopic self-fixating mesh both exhibited a significantly lower displacement through the defect and retained a significantly higher percentage of its initial contact area than either the Bard™ Soft Mesh with Tisseel™ system or the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system. Dislocations occurred with the Bard™ Soft Mesh with Tisseel™ system and with the Bard™ Soft Mesh with SorbaFix™ absorbable fixation system at physiological pressure (,225 mmHg). No dislocation was recorded for the ProGrip™ laparoscopic self-fixating mesh. Conclusion At 24 hours after implantation, the mechanical fixation of the ProGrip™ laparoscopic self-fixating mesh was found to be significantly better than the fixation of the Tisseel™ system or the SorbaFix™ absorbable fixation system. PMID:25525396

  15. Ambulatory blood pressure monitoring: importance of sampling rate and duration--48 versus 24 hours--on the accurate assessment of cardiovascular risk.

    PubMed

    Hermida, Ramón C; Ayala, Diana E; Fontao, María J; Mojón, Artemio; Fernández, José R

    2013-03-01

    Independent prospective studies have found that ambulatory blood pressure (BP) monitoring (ABPM) is more closely correlated with target organ damage and cardiovascular disease (CVD) risk than clinic BP measurement. This is based on studies in which BP was sampled every 15-30 min for ≤24 h, without taking into account that reproducibility of any estimated parameter from a time series to be potentially used for CVD risk assessment might depend more on monitoring duration than on sampling rate. Herein, we evaluated the influence of duration (48 vs. 24 h) and sampling rate of BP measurements (form every 20-30 min up to every 2 h) on the prognostic value of ABPM-derived parameters. We prospectively studied 3344 subjects (1718 men/1626 women), 52.6 ± 14.5 yrs of age, during a median follow-up of 5.6 yrs. Those with hypertension at baseline were randomized to ingest all their prescribed hypertension medications upon awakening or ≥1 of them at bedtime. At baseline, BP was measured at 20-min intervals from 07:00 to 23:00 h and at 30-min intervals at night for 48 h, and physical activity was simultaneously monitored every min by wrist actigraphy to accurately derive the awake and asleep BP means. Identical assessment was scheduled annually and more frequently (quarterly) if treatment adjustment was required. ABPM profiles were modified to generate time series of identical 48-h duration but with data sampled at 1- or 2-h intervals, or shorter, i.e., first 24 h, time series with data sampled at the original rate (daytime 20-min intervals/nighttime 30-min intervals). Bland-Altman plots indicated that the range of individual differences in the estimated awake and asleep systolic (SBP) and diastolic BP (DBP) means between the original and modified ABPM profiles was up to 3-fold smaller for data sampled every 1 h for 48 h than for data sampled every 20-30 min for the first 24 h. Reduction of ABPM duration to just 24 h resulted in error of the

  16. The prevalence of exercise-associated hyponatremia in 24-hour ultra-mountain bikers, 24-hour ultra-runners and multi-stage ultra-mountain bikers in the Czech Republic

    PubMed Central

    2014-01-01

    Background To assess the prevalence of exercise-associated hyponatremia (EAH) in two 24-hour mountain bike (MTB) (R1,R2), one 24-hour running (R3) and one multi-stage MTB (R4) races held in the Czech Republic in a cluster of four cross-sectional studies. Methods In 27 ultra-mountain bikers (ultra-MTBers), 12 ultra-runners, and 14 multi-stage MTBers, fluid intake, changes (Δ) in body mass, hematocrit, plasma volume, plasma [Na+], plasma [K+], plasma osmolality, urine [Na+], urine [K+], urine specific gravity, urine osmolality, K+/Na+ ratio in urine, transtubular potassium gradient and glomerular filtration rate were measured and calculated. The use of non-steroidal anti-inflammatory drugs and symptoms of EAH were recorded using post-race questionnaires. Results Of the 53 finishers, three (5.7%) developed post-race EAH, thereof one (3.7%) ultra-MTBer, one (8.3%) ultra-runner and one (7.1%) multi-stage MTBer. Plasma [Na+] decreased significantly (p < 0.001) only in R4. Urine osmolality (R1, R3, R4 p < 0.001; R2 p < 0.05) and glomerular filtration rate (p < 0.001) increased, and body mass decreased in all races (p < 0.05). Δ body mass was inversely related to the number of kilometers achieved (p < 0.001) in R2 where better ultra-MTBers tended to lose more weight. Δ body mass (p < 0.001) and %Δ body mass (p = 0.05) were positively related to lower post-race plasma [Na+] in R3 that was associated with increased loss in body mass. Fluid intake was positively related to race performance in R1 and R2 (R1: p = 0.04; R2: p = 0.01) where ultra-MTBers in R1 and R2 who drank more finished ahead of those who drank less. Post-race plasma [Na+] was negatively associated with race performance in ultra-MTBers in R2 (p < 0.05), similarly ultra-runners in R3 (p < 0.05) where finishers with more kilometres had lower post-race plasma [Na+]. Conclusions The prevalence of EAH in the Czech Republic was no higher compared to existing reports on ultra-endurance athletes in other countries

  17. Mean 24-hours sympathetic nervous system activity decreases during head-down tilted bed rest but not during microgravity

    NASA Astrophysics Data System (ADS)

    Christensen, Nj; Heer, M.; Ivanova, K.; Norsk, P.

    Sympathetic nervous system activity is closely related to gravitational stress in ground based experiments. Thus a high activity is present in the standing-up position and a very low activity is observed during acute head-out water immersion. Adjustments in sympathetic activity are necessary to maintain a constant blood pressure during variations in venous return. Head-down tilted bed rest is applied as a model to simulate changes observed during microgravity. The aim of the present study was to test the hypothesis that mean 24-hours sympathetic activity was low and similar during space flight and in ground based observation obtained during long-term head-down tilted bed rest. Forearm venous plasma noradrenaline was measured by a radioenzymatic technique as an index of muscle sympathetic activity and thrombocyte noradrenaline and adrenaline were measured as indices of mean 24-hours sympathoadrenal activity. Previous results have indicated that thrombocyte noradrenaline level has a half-time of 2 days. Thus to reflect sympathetic activity during a specific experiment the study period must last for at least 6 days and a sample must be obtained within 12 hours after the experiment has ended. Ten normal healthy subjects were studied before and during a 14 days head-down tilted bed rest as well as during an ambulatory study period of a similar length. The whole experiment was repeated while the subjects were on a low calorie diet. Thrombocyte noradrenaline levels were studied in 4 cosmonauts before and within 12 hours after landing after more than 7 days in flight. Thrombocyte noradrenaline decreased markedly during the head-down tilted bed rest (p<0.001), whereas there were no significant changes in the ambulatory study. Plasma noradrenaline decreased in the adaptation period but not during the intervention. During microgravity thrombocyte noradrenaline increased in four cosmonauts and the percentage changes were significantly different in cosmonauts and in subjects

  18. Relationship between Ambulatory BP and Clinical Outcomes in Patients with Hypertensive CKD

    PubMed Central

    Rahman, Mahboob; Hu, Bo; Appel, Lawrence J.; Charleston, Jeanne; Contreras, Gabriel; Faulkner, Marquetta L.; Hiremath, Leena; Jamerson, Kenneth A.; Lea, Janice P.; Lipkowitz, Michael S.; Pogue, Velvie A.; Rostand, Stephen G.; Smogorzewski, Miroslaw J.; Wright, Jackson T.; Greene, Tom; Gassman, Jennifer; Wang, Xuelei; Phillips, Robert A.

    2012-01-01

    Summary Background and objectives Abnormal ambulatory BP (ABP) profiles are commonplace in CKD, yet the prognostic value of ABP for renal and cardiovascular outcomes is uncertain. This study assessed the relationship of baseline ABP profiles with CKD progression and subsequent cardiovascular outcomes to determine the prognostic value of ABP beyond that of clinic BP measurements. Design, setting, participants, & measurements Between 2002 and 2003, 617 African Americans with hypertensive CKD treated to a clinic BP goal of <130/80 mmHg were enrolled in this prospective, observational study. Participants were followed for a median of 5 years. Primary renal outcome was a composite of doubling of serum creatinine, ESRD, or death. The primary cardiovascular outcome was a composite of myocardial infarction, hospitalized congestive heart failure, stroke, revascularization procedures, cardiovascular death, and ESRD. Results Multivariable Cox proportional hazard analysis showed that higher 24-hour systolic BP (SBP), daytime, night-time, and clinic SBP were each associated with subsequent renal (hazard ratio, 1.17–1.28; P<0.001) and cardiovascular outcomes (hazard ratio, 1.22–1.32; P<0.001). After controlling for clinic SBP, ABP measures were predictive of renal outcomes in participants with clinic SBP <130 mmHg (P<0.05 for interaction). ABP predicted cardiovascular outcomes with no interaction based on clinic BP control. Conclusions ABP provides additional information beyond that of multiple clinic BP measures in predicting renal and cardiovascular outcomes in African Americans with hypertensive CKD. The primary utility of ABP in these CKD patients was to identify high-risk individuals among those patients with controlled clinic BP. PMID:22935847

  19. Antiproteinuric effect of cilnidipine in hypertensive Japanese treated with renin-angiotensin-system inhibitors - a multicenter, open, randomized trial using 24-hour urine collection.

    PubMed

    Miwa, Yoshikazu; Tsuchihashi, Takuya; Ohta, Yuko; Tominaga, Mitsuhiro; Kawano, Yuhei; Sasaguri, Toshiyuki; Ueno, Michio; Matsuoka, Hiroaki

    2010-01-01

    Sustained proteinuria is an important risk factor for not only renal but also cardiovascular morbidity and mortality. Although inhibitors of the renin-angiotensin system (RAS) have been shown to reduce proteinuria. Monotherapy with those drugs is often insufficient for optimal blood pressure (BP)-lowering and therefore, combined therapy is needed. Recent reports suggested that cilnidipine, a dual L-/N-type calcium channel blocker, has renoprotective effect by dilating both efferent and afferent arterioles. In this study, a multicenter, open, randomized trial was designed to compare the antiproteinuric effect between cilnidipine and amlodipine when coupled with RAS inhibitors in hypertensive patients with significant proteinuria. Proteinuria was evaluated by 24-h home urine collection for all patients. A total of 35 proteinuric (>0.1 g/day) patients with uncontrolled BP (>135/85 mmHg) were randomized to receive either cilnidipine (n = 18) or amlodipine (n = 17) after a 6-month treatment with RAS inhibitors and were followed for 48 weeks. At baseline, the cilnidipine group was older and had lower body mass index (BMI) compared to the amlodipine group. After 32 weeks of treatment, diastolic blood pressure (DBP) was slightly, but significantly reduced, in the cilnidipine group, although systolic blood pressure (SBP) and mean BP did not differ. The urinary protein did not differ at baseline (cilnidipine group 0.48 g/day, amlodipine group 0.52 g/day); however, it significantly decreased in the cilnidipine group (0.22 g/day) compared to the amlodipine group (0.50 g/day) after 48 weeks of treatment. Our findings suggest that cilnidipine is superior to amlodipine in preventing the progression of proteinuria in hypertensive patients even undergoing treatment with RAS inhibitors.

  20. Extracorporeal membrane oxygenation improves survival in a novel 24-hour pig model of severe acute respiratory distress syndrome

    PubMed Central

    Araos, Joaquín; Alegría, Leyla; García, Patricio; Damiani, Felipe; Tapia, Pablo; Soto, Dagoberto; Salomon, Tatiana; Rodriguez, Felipe; Amthauer, Macarena; Erranz, Benjamín; Castro, Gabriel; Carreño, Pamela; Medina, Tania; Retamal, Jaime; Cruces, Pablo; Bugedo, Guillermo; Bruhn, Alejandro

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) is increasingly being used to treat severe acute respiratory distress syndrome (ARDS). However, there is limited clinical evidence about how to optimize the technique. Experimental research can provide an alternative to fill the actual knowledge gap. The purpose of the present study was to develop and validate an animal model of acute lung injury (ALI) which resembled severe ARDS, and which could be successfully supported with ECMO. Eighteen pigs were randomly allocated into three groups: sham, ALI, and ALI + ECMO. ALI was induced by a double-hit consisting in repeated saline lavage followed by a 2-hour period of injurious ventilation. All animals were followed up to 24 hours while being ventilated with conventional ventilation (tidal volume 10 ml/kg). The lung injury model resulted in severe hypoxemia, increased airway pressures, pulmonary hypertension, and altered alveolar membrane barrier function, as indicated by an increased protein concentration in bronchoalveolar fluid, and increased wet/dry lung weight ratio. Histologic examination revealed severe diffuse alveolar damage, characteristic of ARDS. Veno-venous ECMO was started at the end of lung injury induction with a flow > 60 ml/kg/min resulting in rapid reversal of hypoxemia and pulmonary hypertension. Mortality was 0, 66.6 and 16.6% in the SHAM, ALI and ALI + ECMO groups, respectively (p < 0.05). This is a novel clinically relevant animal model that can be used to optimize the approach to ECMO and foster translational research in extracorporeal lung support. PMID:27398166

  1. Dietary quality varies according to data collection instrument: a comparison between a food frequency questionnaire and 24-hour recall.

    PubMed

    Rodrigues, Paulo Rogério Melo; de Souza, Rita Adriana Gomes; De Cnop, Mara Lima; Monteiro, Luana Silva; Coura, Camila Pinheiro; Brito, Alessandra Page; Pereira, Rosangela Alves

    2016-02-01

    The objective of this study was to assess the agreement between the Brazilian Healthy Eating Index - Revised (BHEI-R), estimated by a food frequency questionnaire (FFQ) and multiple 24-hour recalls (24h-R). The Wilcoxon paired test, partial correlations (PC), intraclass correlation coefficient (ICC), and Bland-Altman method were used. The total BHEI-R scores and its components ("total fruits", "whole fruits", "total vegetables", "integral cereals", "saturated fat", "sodium", and "energy intake derived from solid fat, added sugar, and alcoholic beverages") were statistically different, with the ICC and PC indicating poor concordance and correlation. The mean concordance estimated for the total BHEI-R and its components varied from 68% for "integral cereals" to 147% for "whole fruits". The suitable concordance limits were violated for most of the components of the BHEI-R. Poor concordance was observed between the BHEI-R estimated by the FFQ and by multiple 24h-R, which indicated a strong reliability of the BHEI-R on the instrument used to collect information on food consumption.

  2. Extracorporeal membrane oxygenation improves survival in a novel 24-hour pig model of severe acute respiratory distress syndrome.

    PubMed

    Araos, Joaquín; Alegría, Leyla; García, Patricio; Damiani, Felipe; Tapia, Pablo; Soto, Dagoberto; Salomon, Tatiana; Rodriguez, Felipe; Amthauer, Macarena; Erranz, Benjamín; Castro, Gabriel; Carreño, Pamela; Medina, Tania; Retamal, Jaime; Cruces, Pablo; Bugedo, Guillermo; Bruhn, Alejandro

    2016-01-01

    Extracorporeal membrane oxygenation (ECMO) is increasingly being used to treat severe acute respiratory distress syndrome (ARDS). However, there is limited clinical evidence about how to optimize the technique. Experimental research can provide an alternative to fill the actual knowledge gap. The purpose of the present study was to develop and validate an animal model of acute lung injury (ALI) which resembled severe ARDS, and which could be successfully supported with ECMO. Eighteen pigs were randomly allocated into three groups: sham, ALI, and ALI + ECMO. ALI was induced by a double-hit consisting in repeated saline lavage followed by a 2-hour period of injurious ventilation. All animals were followed up to 24 hours while being ventilated with conventional ventilation (tidal volume 10 ml/kg). The lung injury model resulted in severe hypoxemia, increased airway pressures, pulmonary hypertension, and altered alveolar membrane barrier function, as indicated by an increased protein concentration in bronchoalveolar fluid, and increased wet/dry lung weight ratio. Histologic examination revealed severe diffuse alveolar damage, characteristic of ARDS. Veno-venous ECMO was started at the end of lung injury induction with a flow > 60 ml/kg/min resulting in rapid reversal of hypoxemia and pulmonary hypertension. Mortality was 0, 66.6 and 16.6% in the SHAM, ALI and ALI + ECMO groups, respectively (p < 0.05). This is a novel clinically relevant animal model that can be used to optimize the approach to ECMO and foster translational research in extracorporeal lung support.

  3. Lessons from Studies to Evaluate an Online 24-Hour Recall for Use with Children and Adults in Canada.

    PubMed

    Kirkpatrick, Sharon I; Gilsing, Anne M; Hobin, Erin; Solbak, Nathan M; Wallace, Angela; Haines, Jess; Mayhew, Alexandra J; Orr, Sarah K; Raina, Parminder; Robson, Paula J; Sacco, Jocelyn E; Whelan, Heather K

    2017-01-31

    With technological innovation, comprehensive dietary intake data can be collected in a wide range of studies and settings. The Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool is a web-based system that guides respondents through 24-h recalls. The purpose of this paper is to describe lessons learned from five studies that assessed the feasibility and validity of ASA24 for capturing recall data among several population subgroups in Canada. These studies were conducted within a childcare setting (preschool children with reporting by parents), in public schools (children in grades 5-8; aged 10-13 years), and with community-based samples drawn from existing cohorts of adults and older adults. Themes emerged across studies regarding receptivity to completing ASA24, user experiences with the interface, and practical considerations for different populations. Overall, we found high acceptance of ASA24 among these diverse samples. However, the ASA24 interface was not intuitive for some participants, particularly young children and older adults. As well, technological challenges were encountered. These observations underscore the importance of piloting protocols using online tools, as well as consideration of the potential need for tailored resources to support study participants. Lessons gleaned can inform the effective use of technology-enabled dietary assessment tools in research.

  4. Global empirical model of TEC response to geomagnetic activity: Short-term (24 hours ahead) prediction model

    NASA Astrophysics Data System (ADS)

    Andonov, Borislav

    2013-04-01

    A global empirical model of the rTEC=(TECobs-TECmed)/TECmed depending on the geomagnetic activity (described by the Kp-index) and at a given moment is built by using global TEC data for full 13 years between 1999 and 2011.The data are downloaded from the CODE (Center for Orbit Determination in Europe) database in the Astronomical Institute, University of Bern. By using a 2D cross-correlation analysis it is found that the ionospheric response to the geomagnetic activity revealed both positive and negative phases of the response. The both phases of the ionospheric response have different duration and time delay with respect to the geomagnetic storm. It was found that these two parameters of the ionospheric response depend on the season, geographical/geomagnetic coordinates and local time. The rTEC response is represented by 2D (longitude-time) sine waves with different zonal wavenumbers and periods being harmonics of the diurnal period. The input data for the current and predicted geomagnetic activity are obtained from the MAK model developed in NIGGG-BAS, which uses the solar wind measurements from the ACE satellite. The background condition is defined by the recent CODE TEC maps. For each current hour the model provides predicted global TEC maps in geographic frame for the next 24 hours.

  5. Relative prognostic value of rest thallium-201 imaging, radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring after acute myocardial infarction

    SciTech Connect

    Hakki, A.H.; Nestico, P.F.; Heo, J.; Unwala, A.A.; Iskandrian, A.S.

    1987-07-01

    Rest thallium-201 scintigraphy, radionuclide ventriculography and 24 hour Holter monitoring are acceptable methods to assess myocardial necrosis, performance and electrical instability. This study examined the relative value of the three tests, when obtained a mean of 7 days after acute myocardial infarction, in predicting 1 year mortality in 93 patients. Planar thallium-201 images were obtained in three projections and were scored on a scale of 0 to 4 in 15 segments (normal score = 60). Patients were classified as having high risk test results as follows: thallium score less than or equal to 45 (33 patients), left ventricular ejection fraction less than or equal to 40% (51 patients) and complex ventricular arrhythmias on Holter monitoring (36 patients). During the follow-up of 6.4 +/- 3.4 months (mean +/- SD), 15 patients died of cardiac causes. All three tests were important predictors of survival by univariate Cox survival analysis; the thallium score, however, was the only important predictor by multivariate analysis. The predictive power of the thallium score was comparable with that of combined ejection fraction and Holter monitoring (chi-square = 21 versus chi-square = 22). Thus, rest thallium-201 imaging performed before hospital discharge provides important prognostic information in survivors of acute myocardial infarction which is comparable with that provided by left ventricular ejection fraction and Holter monitoring. Patients with a lower thallium score (large perfusion defects) are at high risk of cardiac death during the first year after infarction.

  6. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep.

    PubMed

    Tremblay, Mark S; Carson, Valerie; Chaput, Jean-Philippe; Connor Gorber, Sarah; Dinh, Thy; Duggan, Mary; Faulkner, Guy; Gray, Casey E; Gruber, Reut; Janson, Katherine; Janssen, Ian; Katzmarzyk, Peter T; Kho, Michelle E; Latimer-Cheung, Amy E; LeBlanc, Claire; Okely, Anthony D; Olds, Timothy; Pate, Russell R; Phillips, Andrea; Poitras, Veronica J; Rodenburg, Sophie; Sampson, Margaret; Saunders, Travis J; Stone, James A; Stratton, Gareth; Weiss, Shelly K; Zehr, Lori

    2016-06-01

    Leaders from the Canadian Society for Exercise Physiology convened representatives of national organizations, content experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children and youth aged 5-17 years respect the natural and intuitive integration of movement behaviours across the whole day (24-h period). The development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument and systematic reviews of evidence informing the guidelines were assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Four systematic reviews (physical activity, sedentary behaviour, sleep, integrated behaviours) examining the relationships between and among movement behaviours and several health indicators were completed and interpreted by expert consensus. Complementary compositional analyses were performed using Canadian Health Measures Survey data to examine the relationships between movement behaviours and health indicators. A stakeholder survey was employed (n = 590) and 28 focus groups/stakeholder interviews (n = 104) were completed to gather feedback on draft guidelines. Following an introductory preamble, the guidelines provide evidence-informed recommendations for a healthy day (24 h), comprising a combination of sleep, sedentary behaviours, light-, moderate-, and vigorous-intensity physical activity. Proactive dissemination, promotion, implementation, and evaluation plans have been prepared in an effort to optimize uptake and activation of the new guidelines. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed.

  7. The 24-hour shelf-life of cytapheresis platelet concentrates stored in polyvinyl chloride containers should be extended only with caution.

    PubMed

    Strauss, R G; Snyder, E L; Eckermann, I; Stewart, L

    1987-01-01

    A recent publication suggested that the 24-hour allowable shelf-life of apheresis platelet concentrates collected by open-system techniques be extended to 48 hours because platelets collected in this fashion usually remain sterile for that length of time. The current studies, however, show that the quality of platelet concentrates deteriorates rapidly after storage for more than 24 hours in the relatively small-volume, polyvinyl chloride containers of currently marketed, open-system software, as evidenced by the falling pH, the disintegration of platelets, and the inability of platelets to recover from hypotonic shock. Platelets were markedly defective within 48 hours. Thus, it seems unwise to extend the shelf-life of such platelet concentrates beyond 24 hours solely because they are likely to remain sterile. Collection techniques and software must also be modified to ensure satisfactory platelet quality before the period of storage should be extended.

  8. Effect of aging on 24-hour changes in dopamine and serotonin turnover and amino acid and somatostatin contents of rat corpus striatum.

    PubMed

    Esquifino, Ana I; Cano, Pilar; Chacon, Fernando; Reyes Toso, Carlos F; Cardinali, Daniel P

    2002-01-01

    This study examined the 24-hour changes in a number of transmitters in the corpus striatum of young and middle-aged male Wistar rats. The contents of excitatory amino acids (glutamate, aspartate) and inhibitory amino acids (gamma-aminobutyric acid, GABA; taurine, glycine) and of somatostatin were measured in 2-month- and 18- to 20-month-old rats killed at six different time points along the 24-hour cycle. The striatal serotonin and dopamine turnover was also measured. Both young and middle-aged rats showed significant 24-hour variations in striatal glutamate and aspartate contents; only in young rats these variations fitted a cosine function, with acrophase during the first part of rest span. Mesor values of striatal excitatory amino acid contents were lowest in middle-aged rats. Significant 24-hour variations in striatal contents of GABA, taurine, and glycine occurred in young rats, while only striatal GABA exhibited 24-hour changes in middle- aged rats (acrophases during the first part of rest span). For every inhibitory transmitter, the mesor values in middle-aged rats were significantly lower than in young rats. The 24-hour variation of the striatal somatostatin content showed acrophase during the first part of rest span, mesor values and amplitude being lowest in middle-aged rats. Aging rats exhibited significantly higher mesor values of striatal serotonin turnover (34% increase) and lower mesor values of dopamine turnover (69% decrease) than their younger counterparts. Some of the circadian modifications of motor function seen in aging rats could be related to the striatal transmitter changes reported herein.

  9. The relatively poor correlation between random and 24-hour urine protein excretion in patients with biopsy-proven glomerular diseases.

    PubMed

    Hogan, Marie C; Reich, Heather N; Nelson, Peter J; Adler, Sharon G; Cattran, Daniel C; Appel, Gerald B; Gipson, Debbie S; Kretzler, Matthias; Troost, Jonathan P; Lieske, John C

    2016-11-01

    Random urine protein creatinine ratios are used to estimate 24-hour urine protein excretion, which is considered a diagnostic gold standard. However, few studies are available of the sensitivity and specificity of this estimation in patients with glomerular proteinuria. To clarify this, we measured the urine protein and creatinine centrally in random and 24-hour urine collections at biopsy and longitudinally every 6 months in individuals participating in the Nephrotic Syndrome Study Network (NEPTUNE) cohort with glomerular disease. In the initial developmental cohort, 302 patients had same day random and 24-hour samples with a total of 827 paired measurements across all visits. The protein excretion (g/day) was higher in adult than pediatric patients. The correlation between the random urine protein creatinine ratio and 24-hour urine protein excretion was moderate in both groups (r of 0.60 and 0.67, respectively). However, the log10 transformation of values strengthened correlations in both groups (r of 0.85 and 0.82, respectively). Associations were moderately stronger among obese patients. Prediction equations were developed and validated in 232 unique cases from NEPTUNE (R(2) of 0.65). Thus, in patients with glomerular disease and proteinuria, the urine protein creatinine ratio correlates only moderately with 24-hour urine protein excretion. However an estimating equation was developed to derive 24-hour urine protein excretion from random urine protein creatinine ratio values with improved precision. The long-term prognostic value of log10-transformed random protein creatinine ratios values requires future study.

  10. Prevalence of Masked Hypertension: a Population-Based Survey in a Large City by Using 24-Hour Ambulatory Blood Pressure Monitoring

    PubMed Central

    Kim, Sun-Woong; Choi, Eun-Hee; Kim, Ji-Hyun; Nah, Deuk-Young; Shin, Sung-Joon; Gu, Namyi

    2016-01-01

    Background and Objectives We estimated the prevalence of hypertension and hypertension subtypes in a large semi-urban city in Korea, using 24-hour ambulatory blood pressure monitoring (ABPM) in a randomly selected sample population. Subjects and Methods A random sample (aged 20-65 years) from a city with an adult population of approximately 600000 was selected by using a list-assisted random digit dialing method. The 24-hour ABPM and conventional blood pressure measurement (CBPM) of these individuals were obtained. Results Among the 496 participants, valid 24-hour ABPM and CBPM were obtained from 462 (93%) individuals. The estimated prevalence of hypertension in Goyang was 17.54% by CBPM and 32.70% by 24-hour ABPM (p<0.01). In the age stratified analysis, both CBPM and 24-hour ABPM showed increased prevalence of hypertension with age. The estimated prevalence of masked hypertension was 16.22% and that of white-coat hypertension was 1.08%. Men had a higher prevalence of masked hypertension than women (20.79% vs. 11.86%, p=0.0295). The estimated prevalence of masked hypertension was 17.5%, 20.58%, 24.34%, and 13.29% in the age categories of 30s, 40s, 50s, and 60s, respectively. The estimated prevalence of masked uncontrolled hypertension was 26.79% in patients with hypertension who were taking antihypertensive medications. Conclusion The estimated prevalence of hypertension by 24-hour ABPM was higher than that by CBPM, revealing high prevalence of masked hypertension. The high prevalence of masked hypertension supports the adoption of ABPM in the national population survey and clinical practice to improve public health and reduce health care costs. PMID:27721860

  11. Jack Healy Remembers - Anecdotal Evidence for the Origin of the Approximate 24-hour Urine Sampling Protocol Used for Worker Bioassay Monitoring

    SciTech Connect

    Carbaugh, Eugene H.

    2008-10-01

    The origin of the approximate 24-hour urine sampling protocol used at Hanford for routine bioassay is attributed to an informal study done in the mid-1940s. While the actual data were never published and have been lost, anecdotal recollections by staff involved in the initial bioassay program design and administration suggest that the sampling protocol had a solid scientific basis. Numerous alternate methods for normalizing partial day samples to represent a total 24-hour collection have since been proposed and used, but no one method is obviously preferred.

  12. Investigations into the source of two fungicides measured in the air for 24 hours following application to a cereal crop.

    PubMed

    Ellis, M C Butler; Lane, A G; O'Sullivan, C M; Miller, P C H

    2009-01-01

    Airborne pesticides can be detected near to recently-treated arable fields for a period of days following the application. Identifying the source of such pesticides is important in developing predictive models for use in exposure and risk assessments. Previous work showed levels of pesticide in the air that were higher than expected for a low-vapour-pressure active ingredient, epoxiconazole, and comparable with an active ingredient of a significantly higher vapour pressure, fenpropidin. It was possible that the measured concentrations could be attributed to 'dust' particles emitted from the crop, either biological material contaminated with pesticide or solid dried deposits of active ingredient and other formulation components. A second experiment was therefore undertaken to measure airborne concentrations of the same active ingredients and to determine whether some or all of the measured airborne pesticide could be attributed to particles, using a Marple personal cascade impactor, which collects particles in the range 0.3 - 50 microm. Such samplers are not optimised to give good sampling efficiencies under the proposed field conditions, so some initial tests were undertaken in the Silsoe wind tunnel to assess its ability to sample particles in an air flow. In the subsequent field trial, a 192 m square plot in a commercially established winter cereal crop was sprayed with a tank mix of commercial formulations of epoxiconazole and fenpropidin. Measurements of airborne pesticides were made for 24 hours following the application with suction samplers attached to tenax tubes to evaluate vapour concentrations and with the cascade impactor to determine whether contaminated airborne particles were present. The concentrations of pesticide measured with the tenax tubes were significantly higher than the particulate component detected on the cascade impactor plates and it is therefore it was very unlikely that there was a significant contribution from pesticide

  13. Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

    PubMed Central

    Pieńkowska, Joanna; Gwoździewicz, Katarzyna; Skrobisz-Balandowska, Katarzyna; Marek, Iwona; Kostro, Justyna; Szurowska, Edyta; Studniarek, Michał

    2016-01-01

    Purpose Severe acute pancreatitis (AP) is still a significant clinical problem which is associated with a highly mortality. The aim of this study was the evaluation of prognostic value of CT regional perfusion measurement performed on the first day of onset of symptoms of AP, in assessing the risk of developing severe form of acute pancreatitis. Material and Methods 79 patients with clinical symptoms and biochemical criteria indicative of acute pancreatitis (acute upper abdominal pain, elevated levels of serum amylase and lipase) underwent perfusion CT within 24 hours after onset of symptoms. The follow-up examinations were performed after 4–6 days to detect progression of the disease. Perfusion parameters were compared in 41 people who developed severe form of AP (pancreatic and/or peripancreatic tissue necrosis) with parameters in 38 consecutive patients in whom course of AP was mild. Blood flow, blood volume, mean transit time and permeability surface area product were calculated in the three anatomic pancreatic subdivisions (head, body and tail). At the same time the patient's clinical status was assessed by APACHE II score and laboratory parameters such as CRP, serum lipase and amylase, AST, ALT, GGT, ALP and bilirubin were compared. Results Statistical differences in the perfusion parameters between the group of patients with mild and severe AP were shown. Blood flow, blood volume and mean transit time were significantly lower and permeability surface area product was significantly higher in patients who develop severe acute pancreatitis and presence of pancreatic and/or peripancreatic necrosis due to pancreatic ischemia. There were no statistically significant differences between the two groups in terms of evaluated on admission severity of pancreatitis assessed using APACHE II score and laboratory tests. Conclusions CT perfusion is a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who are at risk of

  14. Low-Glycemic-Index Foods Can Decrease Systolic and Diastolic Blood Pressure in the Short Term

    PubMed Central

    Hosseininasab, Mina; Norouzy, Abdolreza; Nematy, Mohsen; Bonakdaran, Shokoufeh

    2015-01-01

    Background. We aimed to compare the effects of low- and high-GI foods on 24-hour ambulatory blood pressure. Methods. This longitudinal study was performed on 30 women, aged 18 to 40 years, during 24 hours. In the first leg of study all recruited subjects were assigned to LGI period for 24 hours and, after a 2-week washout period, all subjects were assigned to HGI period. BP was measured every hour during the 24-hour monitoring. Results. After the intervention, there were significant decreases in SBP and DBP in the LGI period (102.26 ± 14.18 mmHg versus 112.86 ± 9.33 mmHg for SBP and 66.96 ± 10.39 mmHg versus 74.46 ± 7.61 mmHg for DBP) (P = 0.00 and P = 0.002, resp.). However, in the HGI period, there was no significant change in SBP or DBP (110.66 ± 9.85 versus 111.80 ± 9.57 for SBP and 71.16 ± 9.16 versus 74.26 ± 10.09 for DBP) (P = 0.6 and P = 0.06, resp.). Conclusion. The results suggest that LGI foods may be beneficial in reducing 24-hour BP. PMID:26509082

  15. Bath water contamination with Legionella and nontuberculous mycobacteria in 24-hour home baths, hot springs, and public bathhouses of Nagano Prefecture, Japan.

    PubMed

    Kobayashi, Michiko; Oana, Kozue; Kawakami, Yoshiyuki

    2014-01-01

    Bath water samples were collected from 116 hot springs, 197 public bathhouses, and 38 24-hour home baths in Nagano Prefecture, Japan, during the period of April 2009 to November 2011, for determining the presence and extent of contamination with Legionella and nontuberculous mycobacteria. Cultures positive for Legionella were observed in 123 of the 3,314 bath water samples examined. The distribution and abundance of Legionella and/or combined contamination with Legionella and nontuberculous mycobacteria were investigated to clarify the contamination levels. The abundance of Legionella was demonstrated to correlate considerably with the levels of combined contamination with Legionella and nontuberculous mycobacteria. Legionella spp. were obtained from 61% of the water samples from 24-hour home baths, but only from 3% of the samples from public bathhouses and hot springs. This is despite the fact that a few outbreaks of Legionnaires' disease in Nagano Prefecture as well as other regions of Japan have been traced to bath water contamination. The comparatively higher rate of contamination of the 24-hour home baths is a matter of concern. It is therefore advisable to routinely implement good maintenance of the water basins, particularly of the 24-hour home baths.

  16. 49 CFR 375.607 - What must I do if I am able to tender a shipment for final delivery more than 24 hours before a...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 5 2011-10-01 2011-10-01 false What must I do if I am able to tender a shipment for final delivery more than 24 hours before a specified date? 375.607 Section 375.607 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL...

  17. Effect of one week of CPAP treatment of obstructive sleep apnoea on 24-hour profiles of glucose, insulin and counter-regulatory hormones in type 2 diabetes.

    PubMed

    Mokhlesi, Babak; Grimaldi, Daniela; Beccuti, Guglielmo; Van Cauter, Eve

    2017-03-01

    Studies examining the impact of CPAP treatment on glycaemic control have yielded conflicting results, partly because of insufficient nightly CPAP use. We examined the 24-hour profiles of glucose, insulin and counter-regulatory hormones in 12 subjects with type 2 diabetes and OSA before and after 1 week of effective in-laboratory CPAP therapy over an entire 8-hour night thus ensuring optimal CPAP compliance. Blood samples were collected every 15 to 30 minutes for 24 hours under controlled conditions. The 24-hour mean glucose decreased from 153.2 ± 33.0 to 139.7 ± 24.2 mg/dL with CPAP (-13.5 ± 13.5 mg/dL; P = .005) without change in insulin levels. Morning fasting glucose levels decreased by 14.6 ± 3 mg/dL (P = .001) and the dawn phenomenon decreased by 7.8 ± 9.8 mg/dL (P = .019). CPAP treatment decreased norepinephrine levels while the 24-hour profiles of growth hormone and cortisol remained unchanged. In conclusion, 1 week of effective treatment of OSA over an entire 8-hour night results in a clinically significant improvement in glycaemic control via an amelioration of evening fasting glucose metabolism and a reduction in the dawn phenomenon, a late-night glucose increase that is not adequately treated by oral medications. Clinical Trials Information: ClinicalTrials.gov Identifier: NCT01136785.

  18. The effect of low level radiofrequency electromagnetic radiation on the excretion rates of stress hormones in operators during 24-hour shifts.

    PubMed

    Vangelova, K; Israel, M; Mihaylov, S

    2002-06-01

    The aim of the study was to investigate the effect of long term exposure to low level radiofrequency (RF) electromagnetic (EM) radiation on the excretion rates of stress hormones in satellite station operators during 24-hour shifts. Twelve male operators at a satellite station for TV communications and space research were studied during 24-hour shifts. Dosimetric evaluation of the exposure was carried out and showed low level exposure with specific absorption of 0.1127 J.kg-1. A control group of 12 unexposed male operators with similar job task and the same shift system were studied, too. The 11-oxycorticosteroids (11-OCS), adrenaline and noradrenaline were followed by spectrofluorimetric methods on 3-hour intervals during the 24-hour shifts. The data were analyzed by tests for interindividual analysis, Cosinor analysis and analysis of variance (ANOVA). Significant increase in the 24-hour excretion of 11-OCS and disorders in its circadian rhythm, manifested by increase in the mesor, decrease in the amplitude and shift in the acrophase were found in the exposed operators. The changes in the excretion rates of the catecholamines were significant and showed greater variability of both variables. The long term effect of the exposure to low-level RF EM radiation evoked pronounced stress reaction with changes in the circadian rhythm of 11-OCS and increased variability of catecholamines secretion. The possible health hazards associated with observed alteration in the stress system need to be clarified by identification of their significance and prognostic relevance.

  19. Validation of the automated self-administered 24-hour dietary recall for children (ASA24-Kids) among 9- to 11-year-old youth

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our purpose was to validate ASA24-Kids-2012, a self-administered web-based 24-hour dietary recall (24hDR) among 9- to 11-year-old children. Sixty-nine children in two sites participated in the study. In one site, trained staff observed and recorded types and portions of foods and drinks consumed by ...

  20. Characterization of pulmonary protein profiles in response to zinc oxide nanoparticles in mice: a 24-hour and 28-day follow-up study

    PubMed Central

    Pan, Chih-Hong; Chuang, Kai-Jen; Chen, Jen-Kun; Hsiao, Ta-Chih; Lai, Ching-Huang; Jones, Tim P; BéruBé, Kelly A; Hong, Gui-Bing; Ho, Kin-Fai; Chuang, Hsiao-Chi

    2015-01-01

    Although zinc oxide nanoparticles (ZnONPs) are recognized to cause systemic disorders, little is known about the mechanisms that underlie the time-dependent differences that occur after exposure. The objective of this study was to investigate the mechanistic differences at 24 hours and 28 days after the exposure of BALB/c mice to ZnONPs via intratracheal instillation. An isobaric tag for the relative and absolute quantitation coupled with liquid chromatography/tandem mass spectrometry was used to identify the differential protein expression, biological processes, molecular functions, and pathways. A total of 18 and 14 proteins displayed significant changes in the lung tissues at 24 hours and 28 days after exposure, respectively, with the most striking changes being observed for S100-A9 protein. Metabolic processes and catalytic activity were the main biological processes and molecular functions, respectively, in the responses at the 24-hour and 28-day follow-up times. The glycolysis/gluconeogenesis pathway was continuously downregulated from 24 hours to 28 days, whereas detoxification pathways were activated at the 28-day time-point after exposure. A comprehensive understanding of the potential time-dependent effects of exposure to ZnONPs was provided, which highlights the metabolic mechanisms that may be important in the responses to ZnONP. PMID:26251593

  1. Identifying nutrients that are under-reported by an automated 24-hour dietary recall method in overweight and obese women after weight loss

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Underreporting of energy intake by 15-50% is a common problem in dietary assessment. Evidence suggests overweight/obese respondents are more likely to under-report than normal weight. This study compared Automated Self-Administered 24-hour recall (ASA24)-reported dietary intake to true intake in ove...

  2. 24-HOUR DIFFUSIVE SAMPLING OF 1,3-BUTADIENE IN AIR ONTO CARBONPAK X SOLID ADSORBENT WITH THEMAL DESORPTION/GC/MS ANALYSIS - FEASIBILITY STUDIES

    EPA Science Inventory

    Diffusive sampling of 1,3-butadiene for 24 hours onto the graphitic adsorbent Carbopack X contained in a stainless steel tube badge (6.3 mm OD, 5 mm ID, and 90 mm in length) with analysis by thermal desorption/GC/MS has been evaluated in controlled tests. A test matrix of 42 tr...

  3. Characterization of pulmonary protein profiles in response to zinc oxide nanoparticles in mice: a 24-hour and 28-day follow-up study.

    PubMed

    Pan, Chih-Hong; Chuang, Kai-Jen; Chen, Jen-Kun; Hsiao, Ta-Chih; Lai, Ching-Huang; Jones, Tim P; BéruBé, Kelly A; Hong, Gui-Bing; Ho, Kin-Fai; Chuang, Hsiao-Chi

    2015-01-01

    Although zinc oxide nanoparticles (ZnONPs) are recognized to cause systemic disorders, little is known about the mechanisms that underlie the time-dependent differences that occur after exposure. The objective of this study was to investigate the mechanistic differences at 24 hours and 28 days after the exposure of BALB/c mice to ZnONPs via intratracheal instillation. An isobaric tag for the relative and absolute quantitation coupled with liquid chromatography/tandem mass spectrometry was used to identify the differential protein expression, biological processes, molecular functions, and pathways. A total of 18 and 14 proteins displayed significant changes in the lung tissues at 24 hours and 28 days after exposure, respectively, with the most striking changes being observed for S100-A9 protein. Metabolic processes and catalytic activity were the main biological processes and molecular functions, respectively, in the responses at the 24-hour and 28-day follow-up times. The glycolysis/gluconeogenesis pathway was continuously downregulated from 24 hours to 28 days, whereas detoxification pathways were activated at the 28-day time-point after exposure. A comprehensive understanding of the potential time-dependent effects of exposure to ZnONPs was provided, which highlights the metabolic mechanisms that may be important in the responses to ZnONP.

  4. Effect of captopril and melatonin on fibrotic rebuilding of the aorta in 24 hour light-induced hypertension.

    PubMed

    Repová-Bednárová, K; Aziriová, S; Hrenák, J; Krajčírovičová, K; Adamcová, M; Paulis, L; Simko, F

    2013-01-01

    Chronic continuous light exposure leads to melatonin deficiency along with complex neurohumoral activation resulting in hypertension development in rats. The aim of this study was to show, whether continuous light induces fibrotic rebuilding of the aorta and whether the treatment with melatonin or angiotensin converting enzyme inhibitor captopril can prevent these potential alterations. In a six-week experiment, 3-month-old Wistar rats were divided into 4 groups (ten per group): controls, rats exposed to continuous light, exposed to continuous light plus treated with captopril (100 mg/kg/24 h) and exposed to continuous light plus treated with melatonin (10 mg/kg/24 h). Systolic blood pressure (SBP) and collagen type I and III in the media of thoracic aorta were measured. Continuous light induced hypertension and fibrotic rebuilding of the aorta in terms of enhancement of collagen I and III concentration in the aortic media. Both captopril and melatonin prevented SBP rise and reduced collagen III concentration in the aorta. However, only melatonin reduced collagen I and the sum of collagen I and III in the aortic tissue. We conclude that in continuous light-induced hypertension, administration of melatonin, along with SBP reduction, decreases collagen I and III concentration in the aorta. It is suggested that antifibrotic effect of melatonin may reduce the stiffness of the aorta and small arteries and beneficially influence the nature of the pulse wave and peripheral vascular resistance.

  5. [Comparison of the data of 24-hour ECG monitoring and the condition of the coronary bed in patients with the variants of the course of unstable stenocardia].

    PubMed

    Karpov, Iu A; Pomerantsev, E V; Shibleva, V V; Merkulova, I N; Khakimov, A G; Podinovskaia, Ia A; Setin, V F

    1992-03-01

    A total of 232 patients with various clinical types of unstable angina pectoris were examined. All the patients underwent coronary angiographic studies, 24-hour ECG monitoring. In 40.5% of the patients, 24-hour monitoring revealed transient ST segment changes which were not accompanied by pain in 47% of the cases. ST segment changes were equally encountered in patients with one-, two-, and three-vessel disease in the presence or absence of pain. Ischemic ST segment changes generally occurred with an anginal episode in patients with crescendo unstable angina, whereas in those with more prolonged and intensified pain and angina at rest in particular, silent myocardial ischemic episodes were significantly more frequently recorded, which were more common in these patients with multivessel disease.

  6. Value of random urinary homovanillic acid and vanillylmandelic acid levels in the diagnosis and management of patients with neuroblastoma: comparison with 24-hour urine collections.

    PubMed

    Tuchman, M; Morris, C L; Ramnaraine, M L; Bowers, L D; Krivit, W

    1985-02-01

    Urinary homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels were determined in random samples and in 24-hour collections from 13 patients with neuroblastoma and 22 patients without neuroblastoma. Random sample levels were compared with levels in 24-hour collections and showed a positive correlation of 95% for HVA (N = 59) and 93% for VMA (N = 52). No false positives or false negatives occurred using random samples for diagnosis. Nonneuroblastoma (normal) HVA (N = 126) and VMA (N = 119) levels are reported for different age groups. Sequential random HVA and VMA determinations in patients with neuroblastoma during and after therapy are shown. Random urinary HVA and VMA levels are shown to be adequate for utilization in the diagnosis of neuroblastoma and sequential determinations of random HVA and VMA are shown to be helpful in the follow-up of those patients.

  7. In vitro study of 24-hour and 30-day shear bond strengths of three resin-glass ionomer cements used to bond orthodontic brackets.

    PubMed

    Lippitz, S J; Staley, R N; Jakobsen, J R

    1998-06-01

    Interest in using composite resin-glass ionomer hybrid cements as orthodontic bracket adhesives has grown because of their potential for fluoride release. The purpose of this pilot study was to compare shear bond strengths of three resin-glass ionomer cements (Advance, Fuji Duet, Fuji Ortho LC) used as bracket adhesives with a composite resin 24 hours and 30 days after bonding. The amount of adhesive remaining on the debonded enamel surface was scored for each adhesive. Mesh-backed stainless-steel brackets were bonded to 100 extracted human premolars, which were stored in artificial saliva at 37 degrees C until being tested to failure in a testing machine. The hybrid cements, with one exception, had bond strengths similar to those of the composite resin at 24 hours and 30 days. Fuji Ortho LC had significantly lower bond strengths (ANOVA p < or = 0.05) than the other adhesives at 24 hours and 30 days when it was bonded to unetched, water-moistened enamel. Adhesive-remnant scores were similar for all cements, except for cement Fuji Ortho LC when it was bonded to unetched enamel. The resin-glass ionomer cements we tested appear to have bond strengths suitable for routine use as orthodontic bracket-bonding adhesives.

  8. Deconvolution of insulin secretion, insulin hepatic extraction post-hepatic delivery rates and sensitivity during 24-hour standardized meals: time course of glucose homeostasis in leptin replacement treatment.

    PubMed

    Andreev, V P; Paz-Filho, G; Wong, M-L; Licinio, J

    2009-02-01

    Minimally invasive methodology, mathematical model, and software for analysis of glucose homeostasis by deconvolution of insulin secretion, hepatic extraction, post-hepatic delivery, and sensitivity from 24-hour standardized meals test have been developed and illustrated by the study of glucose homeostasis of a genetically based leptin-deficient patient before and after leptin replacement treatment. The only genetically leptin-deficient adult man identified in the world was treated for 24 months with recombinant methionyl human leptin. Blood was collected every 7 minutes for 24 hours, with standardized meals consumed during the 4 visits: at baseline, one-week, 18-months, and 24-months after initiation of the treatment. Concentrations of insulin, C-peptide, and plasma glucose were measured. Insulin secretion was obtained by deconvolution of C-peptide data. Hepatic insulin extraction was determined based on our modifications of the insulin kinetics model . Insulin sensitivity for each of the four meals was calculated by using the minimal glucose model approach. Hepatic extraction of insulin was the first element of glucose homeostasis to respond to leptin replacement treatment and increased 2-fold after one week of treatment. Insulin secretion and delivery rates decreased more than 2-fold and insulin sensitivity increased 10-fold after 24 months of treatment. Computer programs for analysis of 24-hour insulin secretion, extraction, delivery, and action are available upon request.

  9. Effects of transdermal scopolamine, alone or in combination with cimetidine, on total 24 hour gastric acid secretion in patients with duodenal ulcer.

    PubMed Central

    Richardson, C T; Feldman, M

    1986-01-01

    Transdermal scopolamine is an antimuscarinic preparation approved for use in the United States for prevention of motion sickness. A recent study using this drug (0.5 mg/patch) suggested that enough scopolamine was absorbed through the skin to reduce basal gastric acid secretion in patients with duodenal ulcer. We have compared the effect of transdermal scopolamine and oral cimetidine (400 mg twice daily) in seven men with chronic duodenal ulcer, both alone and in combination, on acid secretion throughout an entire 24 hour period in a placebo-controlled, randomised, double blinded cross over study. The effect of these drugs on basal, interprandial, and nocturnal gastric juice volume and hydrogen ion concentration also was measured. Transdermal scopolamine had no significant effect on mean 24 hour acid secretion (placebo, 409.4 mmol/day; scopolamine, 364.0 mmol/day) nor did it have a significant effect on gastric juice volume or hydrogen ion concentration. The combination of transdermal scopolamine plus cimetidine was not more effective than cimetidine alone in reducing total 24 hour acid secretion (mean, 231.8 versus 235.3 mmol/day) nor in reducing gastric juice volume or hydrogen ion concentration. PMID:3804025

  10. Factors Associated With High Sodium Intake Based on Estimated 24-Hour Urinary Sodium Excretion: The 2009-2011 Korea National Health and Nutrition Examination Survey.

    PubMed

    Hong, Jae Won; Noh, Jung Hyun; Kim, Dong-Jun

    2016-03-01

    Although reducing dietary salt consumption is the most cost-effective strategy for preventing progression of cardiovascular and renal disease, policy-based approaches to monitor sodium intake accurately and the understanding factors associated with excessive sodium intake for the improvement of public health are lacking. We investigated factors associated with high sodium intake based on the estimated 24-hour urinary sodium excretion, using data from the 2009 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Among 21,199 adults (≥19 years of age) who participated in the 2009 to 2011 KNHANES, 18,000 participants (weighted n = 33,969,783) who completed urinary sodium and creatinine evaluations were analyzed in this study. The 24-hour urinary sodium excretion was estimated using Tanaka equation. The mean estimated 24-hour urinary sodium excretion level was 4349 (4286-4413) mg per day. Only 18.5% (weighted n = 6,298,481/3,396,973, unweighted n = 2898/18,000) of the study participants consumed less the 2000 mg sodium per day. Female gender (P < 0.001), older age (P < 0.001), total energy intake ≥50 percentile (P < 0.005), and obesity (P < 0.001) were associated with high sodium intake, even after adjusting for potential confounders. Senior high school/college graduation in education and managers/professionals in occupation were associated with lower sodium intake (P < 0.001). According to hypertension management status, those who had hypertension without medication consumed more sodium than those who were normotensive. However, those who receiving treatment for hypertension consumed less sodium than those who were normotensive (P < 0.001). The number of family members, household income, and alcohol drinking did not affect 24-hour urinary sodium excretion. The logistic regression analysis for the highest estimated 24-hour urinary sodium excretion quartile (>6033 mg/day) using the abovementioned variables

  11. 24 Hours to Save the NHS - The Chief Executive's Account of Reform 2000 to 2006 Crisp Nigel 24 Hours to Save the NHS - The Chief Executive's Account of Reform 2000 to 2006 248pp Oxford University Press 9780199639953 0199639957 [Formula: see text].

    PubMed

    2012-02-22

    The title of this book comes from Tony Blair's political slogan on the eve of the 1997 election when he told voters they had '24 hours to save the NHS' by voting for a Labour government. The new millennium, however, still found the NHS in decline.

  12. Development and validity of a 3-day smartphone assisted 24-hour recall to assess beverage consumption in a Chinese population: a randomized cross-over study.

    PubMed

    Smith, Lindsey P; Hua, Jenna; Seto, Edmund; Du, Shufa; Zang, Jiajie; Zou, Shurong; Popkin, Barry M; Mendez, Michelle A

    2014-01-01

    This paper addresses the need for diet assessment methods that capture the rapidly changing beverage consumption patterns in China. The objective of this study was to develop a 3-day smartphone-assisted 24-hour recall to improve the quantification of beverage intake amongst young Chinese adults (n=110) and validate, in a small subset (n=34), the extent to which the written record and smartphone-assisted recalls adequately estimated total fluid intake, using 24-hour urine samples. The smartphone-assisted method showed improved validity compared with the written record-assisted method, when comparing reported total fluid intake to total urine volume. However, participants reported consuming fewer beverages on the smartphone-assisted method compared with the written record-assisted method, primarily due to decreased consumption of traditional zero-energy beverages (i.e. water, tea) in the smartphone-assisted method. It is unclear why participants reported fewer beverages in the smartphone-assisted method than the written record -assisted method. One possibility is that participants found the smartphone method too cumbersome, and responded by decreasing beverage intake. These results suggest that smartphone-assisted 24-hour recalls perform comparably but do not appear to substantially improve beverage quantification compared with the current written record-based approach. In addition, we piloted a beverage screener to identify consumers of episodically consumed SSBs. As expected, a substantially higher proportion of consumers reported consuming SSBs on the beverage screener compared with either recall type, suggesting that a beverage screener may be useful in characterizing consumption of episodically consumed beverages in China's dynamic food and beverage landscape.

  13. Differences in the Slope of the QT-RR Relation Based on 24-Hour Holter ECG Recordings between Cardioembolic and Atherosclerotic Stroke

    PubMed Central

    Fujiki, Akira; Sakabe, Masao

    2016-01-01

    Objective Detecting paroxysmal atrial fibrillation in patients with ischemic stroke presenting in sinus rhythm is difficult because such episodes are often short, and they are also frequently asymptomatic. It is possible that the ventricular repolarization dynamics may reflect atrial vulnerability and cardioembolic stroke. Hence, we compared the QT-RR relation between cardioembolic stroke and atherosclerotic stroke during sinus rhythm. Methods The subjects comprised 62 consecutive ischemic stroke patients including 31 with cardioembolic strokes (71.8±12.7 years, 17 men) and 31 with atherosclerotic strokes (74.8±10.8 years, 23 men). The QT and RR intervals were measured from ECG waves based on a 15-sec averaged ECG during 24-hour Holter recording using an automatic QT analyzing system. The QT interval dependence on the RR interval was analyzed using a linear regression line for each subject ([QT]=A[RR]+B; where A is the slope and B is the y-intercept). Results The mean slope of the QT-RR relation was significantly greater in cardioembolic stroke than in atherosclerotic stroke (0.187±0.044 vs. 0.142±0.045, p<0.001). The mean QT, RR, or QTc during 24-hour Holter recordings did not differ between them. An increased slope (≥0.14) of the QT-RR regression line could predict cardioembolic stroke with 97% sensitivity, 55% specificity and a positive predictive value of 64%. Conclusion The increased slope of the QT-RR linear regression line based on 24-hour Holter ECG in patients with ischemic stroke presenting in sinus rhythm may therefore be a simple and useful marker for cardioembolic stroke. PMID:27746427

  14. Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test

    PubMed Central

    Mene-Afejuku, Tuoyo O; Balogun, Michael O; Akintomide, Anthony O; Adebayo, Rasaaq A

    2017-01-01

    Background Hypertensive heart failure (HHF) is associated with a poor prognosis. There is paucity of data in Nigeria on prognosis among HHF patients elucidating the role of 24-hour Holter electrocardiogram (ECG) in concert with other risk factors. Objective The aim of this study was to determine the prognostic utility of 24-hour Holter ECG, the 6-minute walk test (6-MWT), echocardiography, clinical and laboratory parameters among HHF patients. Methods A total of 113 HHF patients were recruited and followed up for 6 months. Thirteen of these patients were lost to follow-up, and as a result only 100 HHF patients were analyzed. All the patients underwent baseline laboratory tests, echocardiography, 24-hour Holter ECG and the 6-MWT. HHF patients were analyzed as “mortality vs alive” and as “events vs no-events” based on the outcome at the end of 6 months. Events was defined as HHF patients who were rehospitalized for heart failure (HF), had prolonged hospital stay or died. No-events group was defined as HHF patients who did not meet the criteria for the events group. Results HHF patients in the mortality group (n = 7) had significantly higher serum urea (5.71 ± 2.07 mmol/L vs 3.93 ± 1.45 mmol/L, p = 0.003) than that in those alive. After logistic regression, high serum urea conferred increased mortality risk (p = 0.035). Significant premature ventricular complexes (PVCs) on 24-hour Holter ECG following logistic regression were also significantly higher (p = 0.015) in the mortality group than in the “alive” group (n = 93) at the end of the 6-month follow-up period. The 6-minute walk distance (6-MWD) was least among the HHF patients who died (167.26 m ± 85.24 m). However, following logistic regression, the 6-MWT was not significant (p = 0.777) for predicting adverse outcomes among HHF patients. Patients in the events group (n = 41) had significantly higher New York Heart Association (NYHA) class (p = 0.001), Holter-detected ventricular tachycardia (VT; p

  15. Correlation of random urine protein creatinine (P-C) ratio with 24-hour urine protein and P-C ratio, based on physical activity: a pilot study.

    PubMed

    Sadjadi, Seyed-Ali; Jaipaul, Navin

    2010-09-07

    Quantification of proteinuria is usually predicated upon 24-hour urine collection. Multiple factors influence urine collection and the rate of protein and creatinine excretion. Urine collection is often incomplete, and therefore creatinine and protein excretion rates are underestimated. A random urine protein-creatinine (P-C) ratio has been shown over the years to be a reliable alternative to the 24-hour collection for detection and follow up of proteinuria. However, urine protein excretion may be influenced by physical activity. We studied 48 patients with proteinuria and varying levels of physical activity to determine the correlation between the measures of urine protein excretion. The correlation coefficient (r) between 24-hour urine total protein and random urine P-C ratio was 0.75 (P < 0.01) in the overall study population, but varied according to the level of proteinuria and physical activity in a stratified analysis: r = 0.99 (P < 0.001) and r = 0.95 (P < 0.01) in bedridden patients; r = 0.44 (P = not significant [NS]) and r = 0.54 (P = NS) in semiactive patients; and r = 0.44 (P = NS) and r = 0.58 (P < 0.05) in active patients with nephrotic- (>3500 mg/day) and non-nephrotic (<3500 mg/day) range proteinuria, respectively. The correlation appeared to be stronger between random urine and 24-hour urine P-C ratio for the overall study population (r = 0.84; P < 0.001), and when stratified according to the level of proteinuria and physical activity: r = 0.99 (P < 0.001) and r = 0.92 (P < 0.01) in bedridden patients; r = 0.61 (P = NS) and r = 0.54 (P = NS) in semiactive patients; and r = 0.64 (P < 0.02) and r = 0.52 (P < 0.05) in active patients with nephrotic and non-nephrotic range proteinuria, respectively. We conclude that the random urine P-C ratio is a reliable and practical way of estimating and following proteinuria, but its precision and accuracy may be affected by the level of patient physical activity.

  16. Variability of Urinary Concentrations of Polycyclic Aromatic Hydrocarbon Metabolite in General Population and Comparison of Spot, First-Morning, and 24-Hour Void Sampling

    PubMed Central

    Li, Zheng; Romanoff, Lovisa C.; Lewin, Michael D; Porter, Erin N; Trinidad, Debra A; Needham, Larry L; Patterson, Donald G; Sjödin, Andreas

    2015-01-01

    Urinary hydroxy polycyclic aromatic hydrocarbons (OH-PAHs) are commonly used in biomonitoring to assess exposure to polycyclic aromatic hydrocarbons (PAHs). Similar to other biologically non-persistent chemicals, OH-PAHs have relatively short biological half-lives (4.4–35 hours). Little information is available on their variability in urinary concentrations over time in non- occupationally exposed subjects. This study was designed to (i) study the variability of 9 urinary OH-PAH metabolite concentrations over time and (ii) calculate sample size requirements for future epidemiological studies based on spot urine, first morning void and 24-hour void sampling. Individual urine samples (n = 427) were collected during one week from 8 non-occupationally exposed adults. We recorded the time and volume of each urine excretion, dietary details, and the driving activities of the participants. Within subjects, the coefficients of variation (CV) for the wet-weight concentration of OH-PAHs in all samples ranged from 45% to 297%; creatinine adjustment reduced the CV to 19–288% (p < 0.001; paired t-test). The simulated 24-hour void concentrations were the least variable measure, with CVs ranging 13–182% for the 9 OH-PAHs. Within-day variability contributed on average 84%, and between-day variability accounted for 16% of the total variance of 1-hydroxypyrene (1-PYR). Intraclass correlation coefficients (ICC) of 1-PYR levels were 0.55 for spot urine samples, 0.60 for first-morning voids, and 0.76 for 24-hour voids, indicating a high degree of correlation between urine measurements collected from the same subject over time. Sample size calculations were performed to estimate the number of subjects needed for detecting differences in geometric mean at a statistical power of 80% for spot urine, first-morning, and 24-hour void sampling. These data will aid in the design of future studies of PAHs and possibly other biologically non-persistent chemicals and the interpretation of

  17. Low adherence to exclusive breastfeeding in Eastern Uganda: A community-based cross-sectional study comparing dietary recall since birth with 24-hour recall

    PubMed Central

    Engebretsen, Ingunn Marie S; Wamani, Henry; Karamagi, Charles; Semiyaga, Nulu; Tumwine, James; Tylleskär, Thorkild

    2007-01-01

    Background Exclusive breastfeeding is recommended as the best feeding alternative for infants up to six months and has a protective effect against mortality and morbidity. It also seems to lower HIV-1 transmission compared to mixed feeding. We studied infant feeding practices comparing dietary recall since birth with 24-hour dietary recall. Methods A cross-sectional survey on infant feeding practices was performed in Mbale District, Eastern Uganda in 2003 and 727 mother-infant (0–11 months) pairs were analysed. Four feeding categories were made based on WHO's definitions: 1) exclusive breastfeeding, 2) predominant breastfeeding, 3) complementary feeding and 4) replacement feeding. We analyzed when the infant fell into another feeding category for the first time. This was based on the recall since birth. Life-table analysis was made for the different feeding categories and Cox regression analysis was done to control for potential associated factors with the different practices. Prelacteal feeding practices were also addressed. Results Breastfeeding was practiced by 99% of the mothers. Dietary recall since birth showed that 7% and 0% practiced exclusive breastfeeding by 3 and 6 months, respectively, while 30% and 3% practiced predominant breastfeeding and had not started complementary feeding at the same points in time. The difference between the 24-hour recall and the recall since birth for the introduction of complementary feeds was 46 percentage points at two months and 59 percentage points at four months. Prelacteal feeding was given to 57% of the children. High education and formal marriage were protective factors against prelacteal feeding (adjusted OR 0.5, 0.2 – 1.0 and 0.5, 0.3 – 0.8, respectively). Conclusion Even if breastfeeding is practiced at a very high rate, the use of prelacteal feeding and early introduction of other food items is the norm. The 24-hour recall gives a higher estimate of exclusive breastfeeding and predominant breastfeeding than

  18. What is a Systolic Algorithm?

    NASA Astrophysics Data System (ADS)

    Rao, Sailesh K.; Kollath, T.

    1986-07-01

    In this paper, we show that every systolic array executes a Regular Iterative Algorithm with a strongly separating hyperplane and conversely, that every such algorithm can be implemented on a systolic array. This characterization provides us with an unified framework for describing the contributions of other authors. It also exposes the relevance of many fundamental concepts that were introduced in the sixties by Hennie, Waite and Karp, Miller and Winograd, to the present day concern of systolic array

  19. Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form

    PubMed Central

    2012-01-01

    Residents in training, medical students and other staff in surgical sector, emergency room (ER) and intensive care unit (ICU) or Burn Unit face a multitude of questions regarding burn care. Treatment of burns is not always straightforward. Furthermore, National and International guidelines differ from one region to another. On one hand, it is important to understand pathophysiology, classification of burns, surgical treatment, and the latest updates in burn science. On the other hand, the clinical situation for treating these cases needs clear guidelines to cover every single aspect during the treatment procedure. Thus, 10 questions have been organised and discussed in a step-by-step form in order to achieve the excellence of education and the optimal treatment of burn injuries in the first 24 hours. These 10 questions will clearly discuss referral criteria to the burn unit, primary and secondary survey, estimation of the total burned surface area (%TBSA) and the degree of burns as well as resuscitation process, routine interventions, laboratory tests, indications of Bronchoscopy and special considerations for Inhalation trauma, immediate consultations and referrals, emergency surgery and admission orders. Understanding and answering the 10 questions will not only cover the management process of Burns during the first 24 hours but also seems to be an interactive clear guide for education purpose. PMID:22583548

  20. Sodium and potassium intake in South Africa: an evaluation of 24-hour urine collections in a white, black, and Indian population.

    PubMed

    Swanepoel, Bianca; Schutte, Aletta E; Cockeran, Marike; Steyn, Krisela; Wentzel-Viljoen, Edelweiss

    2016-11-01

    Limited number of studies on salt intake has been conducted in the South Africa. The present study established the sodium and potassium excretion (24-hour urine collection) of three different South African populations. In total, 692 successful 24-hour urine collections were analyzed for sodium, potassium, and iodine levels. The median sodium and potassium excretion was 122.9 and 33.5 mmol/d, respectively, and the median salt intake was 7.2 g/d. The majority (92.8%) of the population did not meet the recommended potassium intake/d, and 65.6% consumed more than 6 g of salt/d. Potassium excretion showed a linear relationship with salt intake (P-trend ≤ .001). The median sodium-to-potassium ratio was 3.5. These findings support the South African government's sodium reduction legislation, as well as global initiatives. More consideration should be given to promoting the intake of potassium-rich foods, as this may have a greater public health impact than focusing only on dietary sodium reduction.

  1. Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form.

    PubMed

    Alharbi, Ziyad; Piatkowski, Andrzej; Dembinski, Rolf; Reckort, Sven; Grieb, Gerrit; Kauczok, Jens; Pallua, Norbert

    2012-05-14

    Residents in training, medical students and other staff in surgical sector, emergency room (ER) and intensive care unit (ICU) or Burn Unit face a multitude of questions regarding burn care. Treatment of burns is not always straightforward. Furthermore, National and International guidelines differ from one region to another. On one hand, it is important to understand pathophysiology, classification of burns, surgical treatment, and the latest updates in burn science. On the other hand, the clinical situation for treating these cases needs clear guidelines to cover every single aspect during the treatment procedure. Thus, 10 questions have been organised and discussed in a step-by-step form in order to achieve the excellence of education and the optimal treatment of burn injuries in the first 24 hours. These 10 questions will clearly discuss referral criteria to the burn unit, primary and secondary survey, estimation of the total burned surface area (%TBSA) and the degree of burns as well as resuscitation process, routine interventions, laboratory tests, indications of Bronchoscopy and special considerations for Inhalation trauma, immediate consultations and referrals, emergency surgery and admission orders. Understanding and answering the 10 questions will not only cover the management process of Burns during the first 24 hours but also seems to be an interactive clear guide for education purpose.

  2. Comparison between two standardized cultural methods and 24 hour duplex SYBR green real-time PCR assay for Salmonella detectionin meat samples.

    PubMed

    Delibato, Elisabetta; Fiore, Alfonsina; Anniballi, Fabrizio; Auricchio, Bruna; Filetici, Emma; Orefice, Leucio; Losio, Marina Nadia; De Medici, Dario

    2011-07-01

    Food-borne diseases caused by Salmonella represent a worldwide public health problem. Salmonella must be absent in an established amount depending on the kind of the product and usually cultural methods have to be applied to evaluate the compliance of the products. ISO 6579:2002 in Europe and FSIS MLG 4.04.:2008 in the USA have usually been employed to detect Salmonella in meat, poultry and egg products. A Real Time PCR method using probes has recently been validated against the NMKL (Nordic Committee on Food Analysis) standard method. This method has been modified using the less expensive Sybr Green Real Time PCR approach and applied directly in the 18 hours preenrichment broth for the purpose of detecting Salmonella in meat products in less than 24 hours. The purpose of this study was to: - compare the effectiveness of ISO and FSIS cultural methods; - develop a new 24 hour duplex Sybr Green Real Time PCR-melting curve analysis; - evaluate the performance of Salmonella, Standard Method, Rapid Method, SYBR Green Real Time PCR. The equivalence between ISO and FSIS methods was demonstrated and the use of SYBR Green Real Time PCR as a screening tool for negative results seems appealing especially to evaluate compliance with the HACCP systems.

  3. A Case Report on Dyskinesia Following Rivastigmine Patch 13.3 mg/24 hours for Alzheimer's Disease: Perspective in the Movement Disorders Spectrum Following Use of Cholinesterase Inhibitors.

    PubMed

    Diaz, Maria Cristina B; Rosales, Raymond L

    2015-08-01

    Current reports on movement disorder adverse effects of acetylcholinesterase inhibitors only include extrapyramidal symptoms and myoclonus.Here is a case of an 81-year-old female Filipino with dementia who presented with first-onset generalized choreiform movements.The etiology of the clinical finding of dyskinesia was investigated through laboratories, neuroimaging, and electroencephalogram, all of which yielded negative results. Review of her medications included the rivastigmine (Exelon) patch, which had just been increased to 13.3 mg/24-hour-dose 3 months prior. With all other possible causes excluded, a trial discontinuation of rivastigmine, showed decreased frequency of the dyskinesia 48 hours after, with complete resolution after 6 days, and no recurrence since then.This case thus presents a probable association or causality between the choreiform movement and rivastigmine at 13.3 mg/24-hour-dose patch because of clear temporal proximity, lack of alternative explanations, and a reversal of the dyskinesia upon medicament discontinuation.

  4. Effect of current and lifetime posttraumatic stress disorder on 24-hour urinary catecholamines and cortisol: results from the Mind Your Heart Study

    PubMed Central

    Wingenfeld, Katja; Whooley, Mary A.; Neylan, Thomas C.; Otte, Christian; Cohen, Beth E.

    2014-01-01

    Summary Posttraumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular disease and several other chronic illnesses. Alterations in the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis in PTSD might contribute to these associations but findings regarding SNS and HPA activity in PTSD are heterogeneous. We measured 24-hour urinary catecholamines and cortisol in a large cohort of adult outpatients recruited from 2 Veterans Affairs medical centers. 24-hour urinary norepinephrine, epinephrine, dopamine and cortisol were measured by tandem mass spectrometry. Lifetime and current PTSD were assessed with the Clinician Administered PTSD Scale using DSM-IV-TR criteria. Out of 613 participants, 199 (32.5%) had current PTSD, 100 (16.3%) had lifetime but not current PTSD, and 314 (51.2%) never had PTSD. Patients with current PTSD had significantly higher norepinephrine secretion compared to those without PTSD. Patients in the lifetime PTSD group exhibited lower cortisol values compared to those without PTSD. Participants who never had PTSD showed the lowest norepinephrine and the highest cortisol values. All results remained stable when controlling for potentially confounding variables. This study provides evidence for increased norepinephrine secretion and decreased cortisol in PTSD. Future longitudinal studies are needed to determine whether these changes contribute to adverse health outcomes in patients with PTSD. PMID:25459895

  5. 24-hour urine copper test

    MedlinePlus

    ... associated with providing a urine sample. Alternative Names Quantitative urinary copper Images Copper urine test References McPherson ... for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis ...

  6. Resting Energy Expenditure and Systolic Blood Pressure Relationships in Women Across 4.5 Years

    PubMed Central

    Sriram, Neeraj; Hunter, Gary R.; Fisher, Gordon; Brock, David W.

    2014-01-01

    Recent studies have reported a strong association between blood pressure (BP) and resting energy expenditure (REE). However, it is not known if this relationship persists over time. Therefore, we examined the temporal relationship between REE and systolic BP. Additionally, we examined the impact of sympathetic tone and anthropometric variables on this relationship. All testing was performed on healthy, overweight African American and European American women aged 25 – 45 years over 4.5 years in the UAB General Clinical Research Center. Repeated measures mixed-models revealed REE as a significant determinant of systolic BP (β=0.0155, P<0.0001), independent of catecholamines, leg fat, visceral fat, fat free mass, fat mass, height, RSMI, and resting heart rate. Observations that REE is predictive of systolic BP across 4.5 years support previous findings that REE may potentially mediate resting BP, independent of anthropometric variables and a marker for sympathetic tone. PMID:24548382

  7. A systolic array parallelizing compiler

    SciTech Connect

    Tseng, P.S. )

    1990-01-01

    This book presents a completely new approach to the problem of systolic array parallelizing compiler. It describes the AL parallelizing compiler for the Warp systolic array, the first working systolic array parallelizing compiler which can generate efficient parallel code for complete LINPACK routines. This book begins by analyzing the architectural strength of the Warp systolic array. It proposes a model for mapping programs onto the machine and introduces the notion of data relations for optimizing the program mapping. Also presented are successful applications of the AL compiler in matrix computation and image processing. A complete listing of the source program and compiler-generated parallel code are given to clarify the overall picture of the compiler. The book concludes that systolic array parallelizing compiler can produce efficient parallel code, almost identical to what the user would have written by hand.

  8. Antiplatelet Effect Durability of a Novel, 24-Hour, Extended-Release Prescription Formulation of Acetylsalicylic Acid in Patients With Type 2 Diabetes Mellitus.

    PubMed

    Gurbel, Paul A; Bliden, Kevin P; Chaudhary, Rahul; Patrick, Jeff; Liu, Fang; Chen, Gailing; McLeod, Christopher; Tantry, Udaya S

    2016-12-15

    High platelet reactivity and high platelet turnover have been implicated in incomplete platelet inhibition during immediate-release acetylsalicylic acid therapy in patients with type 2 diabetes mellitus (DM). An extended-release acetylsalicylic acid (ER-ASA; Durlaza) formulation was developed to provide 24-hour antithrombotic effects with once-daily dosing. The objective of the study was to evaluate the antiplatelet effects of ER-ASA in patients with DM. In this open-label, single-center study, patients with DM (n = 40) and multiple cardiovascular risk factors received ER-ASA 162.5 mg/day for 14 ± 4 days. Multiple platelet function tests, serum and urinary thromboxane B2 metabolites, prostacyclin metabolite, and high-sensitive C-reactive protein levels were assessed at 1, 12, 16, and 24 hours post-dose. Patients with high platelet turnover and/or high platelet reactivity were treated with ER-ASA 325 mg/day for 14 ± 4 days, and laboratory analyses were repeated. All patients responded to ER-ASA 162.5 mg/day as measured by arachidonic acid-induced aggregation, and there was no loss of the platelet inhibitory effect of ER-ASA 162.5 mg/day over 24 hours post-dose (p = not significant). The antiplatelet effect was sustained over 24 hours for all platelet function measurements. Mean 1- to 24-hour serum thromboxane B2 levels were low with both doses and were lower with ER-ASA 325 mg/day compared with 162.5 mg/day therapy (p = 0.002). In conclusion, ER-ASA 162.5 mg daily dose provided sustained antiplatelet effects over 24 hours in patients with type 2 DM and multiple cardiovascular risk factors and had a favorable tolerability profile.

  9. Validity of a multipass, web-based, 24-hour self-administered recall for assessment of total energy intake in blacks and whites.

    PubMed

    Arab, Lenore; Tseng, Chi-Hong; Ang, Alfonso; Jardack, Patricia

    2011-12-01

    To date, Web-based 24-hour recalls have not been validated using objective biomarkers. From 2006 to 2009, the validity of 6 Web-based DietDay 24-hour recalls was tested among 115 black and 118 white healthy adults from Los Angeles, California, by using the doubly labeled water method, and the results were compared with the results of the Diet History Questionnaire, a food frequency questionnaire developed by the National Cancer Institute. The authors performed repeated measurements in a subset of 53 subjects approximately 6 months later to estimate the stability of the doubly labeled water measurement. The attenuation factors for the DietDay recall were 0.30 for blacks and 0.26 for whites. For the Diet History Questionnaire, the attenuation factors were 0.15 and 0.17 for blacks and whites, respectively. Adjusted correlations between true energy intake and the recalls were 0.50 and 0.47 for blacks and whites, respectively, for the DietDay recall. For the Diet History Questionnaire, they were 0.34 and 0.36 for blacks and whites, respectively. The rate of underreporting of more than 30% of calories was lower with the recalls than with the questionnaire (25% and 41% vs. 34% and 52% for blacks and whites, respectively). These findings suggest that Web-based DietDay dietary recalls offer an inexpensive and widely accessible dietary assessment alternative, the validity of which is equally strong among black and white adults. The validity of the Web-administered recall was superior to that of the paper food frequency questionnaire.

  10. Electronic Dietary Intake Assessment (e-DIA): Comparison of a Mobile Phone Digital Entry App for Dietary Data Collection With 24-Hour Dietary Recalls

    PubMed Central

    O'Connor, Sarah; Giannelli, Valentina; Yap, Megan LH; Tang, Lie Ming; Roy, Rajshri; Louie, Jimmy Chun Yu; Hebden, Lana; Kay, Judy; Allman-Farinelli, Margaret

    2015-01-01

    Background The electronic Dietary Intake Assessment (e-DIA), a digital entry food record mobile phone app, was developed to measure energy and nutrient intake prospectively. This can be used in monitoring population intakes or intervention studies in young adults. Objective The objective was to assess the relative validity of e-DIA as a dietary assessment tool for energy and nutrient intakes using the 24-hour dietary recall as a reference method. Methods University students aged 19 to 24 years recorded their food and drink intake on the e-DIA for five days consecutively and completed 24-hour dietary recalls on three random days during this 5-day study period. Mean differences in energy, macro-, and micronutrient intakes were evaluated between the methods using paired t tests or Wilcoxon signed-rank tests, and correlation coefficients were calculated on unadjusted, energy-adjusted, and deattenuated values. Bland-Altman plots and cross-classification into quartiles were used to assess agreement between the two methods. Results Eighty participants completed the study (38% male). No significant differences were found between the two methods for mean intakes of energy or nutrients. Deattenuated correlation coefficients ranged from 0.55 to 0.79 (mean 0.68). Bland-Altman plots showed wide limits of agreement between the methods but without obvious bias. Cross-classification into same or adjacent quartiles ranged from 75% to 93% (mean 85%). Conclusions The e-DIA shows potential as a dietary intake assessment tool at a group level with good ranking agreement for energy and all nutrients. PMID:26508282

  11. Correlation of Occupational Stress Index with 24-hour Urine Cortisol and Serum DHEA Sulfate among City Bus Drivers: A Cross-sectional Study

    PubMed Central

    Lin, Mia Chihya; Lu, Luo; Tai, John Jen

    2011-01-01

    Objectives The questionnaire of occupational stress index (OSI) has been popular in the workplace, and it has been tailored for bus drivers in Taiwan. Nevertheless, its outcomes for participants are based on self-evaluations, thus validation by their physiological stress biomarker is warranted and this is the main goal of this study. Methods A cross-sectional study of sixty-three city bus drivers and fifty-four supporting staffs for comparison was conducted. Questionnaire surveys, 24-hour urine cortisol testing, and blood draws for dehydroepiandrosterone-sulfate (DHEA-S) testing were performed. The measured concentrations of these biological measures were logarithmically transformed before the statistical analysis where various scores of stressor factors, moderators, and stress effects of each OSI domain were analyzed by applying multiple linear regression models. Results For drivers, the elevated 24-hour urine cortisol level was associated with a worker's relationship with their supervisor and any life change events in the most recent 3 months. The DHEA-S level was higher in drivers of younger age as well as drivers with more concerns relating to their salary and bonuses. Non-drivers showed no association between any stressor or satisfaction and urine cortisol and blood DHEA-S levels. Conclusion Measurements of biomarkers may offer additional stress evaluations with OSI questionnaires for bus drivers. Increased DHEA-S and cortisol levels may result from stressors like income security. Prevention efforts towards occupational stress and life events and health promotional efforts for aged driver were important anti-stress remedies. PMID:22953199

  12. Dynamically Reconfigurable Systolic Array Accelorators

    NASA Technical Reports Server (NTRS)

    Dasu, Aravind (Inventor); Barnes, Robert C. (Inventor)

    2014-01-01

    A polymorphic systolic array framework that works in conjunction with an embedded microprocessor on an FPGA, that allows for dynamic and complimentary scaling of acceleration levels of two algorithms active concurrently on the FPGA. Use is made of systolic arrays and hardware-software co-design to obtain an efficient multi-application acceleration system. The flexible and simple framework allows hosting of a broader range of algorithms and extendable to more complex applications in the area of aerospace embedded systems.

  13. A Pre-Screening Questionnaire to Predict Non-24-Hour Sleep-Wake Rhythm Disorder (N24HSWD) among the Blind

    PubMed Central

    Flynn-Evans, Erin E.; Lockley, Steven W.

    2016-01-01

    Study Objectives: There is currently no questionnaire-based pre-screening tool available to detect non-24-hour sleep-wake rhythm disorder (N24HSWD) among blind patients. Our goal was to develop such a tool, derived from gold standard, objective hormonal measures of circadian entrainment status, for the detection of N24HSWD among those with visual impairment. Methods: We evaluated the contribution of 40 variables in their ability to predict N24HSWD among 127 blind women, classified using urinary 6-sulfatoxymelatonin period, an objective marker of circadian entrainment status in this population. We subjected the 40 candidate predictors to 1,000 bootstrapped iterations of a logistic regression forward selection model to predict N24HSWD, with model inclusion set at the p < 0.05 level. We removed any predictors that were not selected at least 1% of the time in the 1,000 bootstrapped models and applied a second round of 1,000 bootstrapped logistic regression forward selection models to the remaining 23 candidate predictors. We included all questions that were selected at least 10% of the time in the final model. We subjected the selected predictors to a final logistic regression model to predict N24SWD over 1,000 bootstrapped models to calculate the concordance statistic and adjusted optimism of the final model. We used this information to generate a predictive model and determined the sensitivity and specificity of the model. Finally, we applied the model to a cohort of 1,262 blind women who completed the survey, but did not collect urine samples. Results: The final model consisted of eight questions. The concordance statistic, adjusted for bootstrapping, was 0.85. The positive predictive value was 88%, the negative predictive value was 79%. Applying this model to our larger dataset of women, we found that 61% of those without light perception, and 27% with some degree of light perception, would be referred for further screening for N24HSWD. Conclusions: Our model has

  14. Metabolic Engineering of Light and Dark Biochemical Pathways in Wild-Type and Mutant Strains of Synechocystis PCC 6803 for Maximal, 24-Hour Production of Hydrogen Gas

    SciTech Connect

    Ely, Roger L.; Chaplen, Frank W.R.

    2014-03-11

    This project used the cyanobacterial species Synechocystis PCC 6803 to pursue two lines of inquiry, with each line addressing one of the two main factors affecting hydrogen (H2) production in Synechocystis PCC 6803: NADPH availability and O2 sensitivity. H2 production in Synechocystis PCC 6803 requires a very high NADPH:NADP+ ratio, that is, the NADP pool must be highly reduced, which can be problematic because several metabolic pathways potentially can act to raise or lower NADPH levels. Also, though the [NiFe]-hydrogenase in PCC 6803 is constitutively expressed, it is reversibly inactivated at very low O2 concentrations. Largely because of this O2 sensitivity and the requirement for high NADPH levels, a major portion of overall H2 production occurs under anoxic conditions in the dark, supported by breakdown of glycogen or other organic substrates accumulated during photosynthesis. Also, other factors, such as N or S limitation, pH changes, presence of other substances, or deletion of particular respiratory components, can affect light or dark H2 production. Therefore, in the first line of inquiry, under a number of culture conditions with wild type (WT) Synechocystis PCC 6803 cells and a mutant with impaired type I NADPH-dehydrogenase (NDH-1) function, we used H2 production profiling and metabolic flux analysis, with and without specific inhibitors, to examine systematically the pathways involved in light and dark H2 production. Results from this work provided rational bases for metabolic engineering to maximize photobiological H2 production on a 24-hour basis. In the second line of inquiry, we used site-directed mutagenesis to create mutants with hydrogenase enzymes exhibiting greater O2 tolerance. The research addressed the following four tasks: 1. Evaluate the effects of various culture conditions (N, S, or P limitation; light/dark; pH; exogenous organic carbon) on H2 production profiles of WT cells and an NDH-1 mutant; 2. Conduct metabolic flux analyses for

  15. Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension.

    PubMed

    Mackenzie, Isla S; McEniery, Carmel M; Dhakam, Zahid; Brown, Morris J; Cockcroft, John R; Wilkinson, Ian B

    2009-08-01

    Isolated systolic hypertension is an important risk factor for cardiovascular disease and results primarily from elastic artery stiffening. Although various drug therapies are used to lower peripheral blood pressure (BP) in patients with isolated systolic hypertension, the effects of the 4 major classes of antihypertensive agents on central BP, pulse pressure (PP) amplification, and arterial stiffness in this condition are not clear. Fifty-nine patients over the age of 60 years with untreated isolated systolic hypertension (systolic BP > or =140 mm Hg and diastolic BP BP was measured using a mercury sphygmomanometer, and augmentation index and carotid-femoral (aortic) pulse wave velocity were measured at baseline, after 2 weeks of placebo therapy, and at the end of 10 weeks of active therapy. Peripheral systolic BP and peripheral PP were reduced similarly after treatment with all 4 classes of drug. However, central PP was only reduced significantly by perindopril, lercanidipine, and bendrofluazide, whereas atenolol had no effect. Lercanidipine reduced the augmentation index, whereas atenolol increased it. Aortic pulse wave velocity was not changed by any of the drugs. In summary, despite similar reductions in peripheral systolic and PPs with the 4 classes of drug, changes in central pressure and augmentation index varied. Because central PP and increased wave reflections are considered important risk factors in patients with isolated systolic hypertension, the choice of therapy may be influenced by these findings in the future.

  16. EXTRAPOLATION TECHNIQUES EVALUATING 24 HOURS OF AVERAGE ELECTROMAGNETIC FIELD EMITTED BY RADIO BASE STATION INSTALLATIONS: SPECTRUM ANALYZER MEASUREMENTS OF LTE AND UMTS SIGNALS.

    PubMed

    Mossetti, Stefano; de Bartolo, Daniela; Veronese, Ivan; Cantone, Marie Claire; Cosenza, Cristina; Nava, Elisa

    2016-12-01

    International and national organizations have formulated guidelines establishing limits for occupational and residential electromagnetic field (EMF) exposure at high-frequency fields. Italian legislation fixed 20 V/m as a limit for public protection from exposure to EMFs in the frequency range 0.1 MHz-3 GHz and 6 V/m as a reference level. Recently, the law was changed and the reference level must now be evaluated as the 24-hour average value, instead of the previous highest 6 minutes in a day. The law refers to a technical guide (CEI 211-7/E published in 2013) for the extrapolation techniques that public authorities have to use when assessing exposure for compliance with limits. In this work, we present measurements carried out with a vectorial spectrum analyzer to identify technical critical aspects in these extrapolation techniques, when applied to UMTS and LTE signals. We focused also on finding a good balance between statistically significant values and logistic managements in control activity, as the signal trend in situ is not known. Measurements were repeated several times over several months and for different mobile companies. The outcome presented in this article allowed us to evaluate the reliability of the extrapolation results obtained and to have a starting point for defining operating procedures.

  17. Control of bleeding by silk ligation and diathermy coagulation during tonsillectomy: A comparison of efficacy of the two techniques in the first 24 hours after surgery

    PubMed Central

    Anwar, Khurshid; Ahmad, Rafiq; Khan, Muneeb

    2015-01-01

    Objective: To assess and compare the relative efficacy of silk ligation and diathermy coagulation techniques in controlling bleeding during tonsillectomy in the first 24 hours. Methods: This prospective study was conducted at the Department of ENT, Khalifa Gul Nawaz Teaching Hospital, Bannu and this department related consultants’ private clinics from January 1, 2012 to December 31, 2014. The study included 180 cases. All patients included were having history of recurrent, acute tonsillitis, with more than 6–7 episodes in one year, five episodes per year for two years, or three episodes per year for three years. All the surgeries were performed by dissection method. Haemostasis during the procedure was secured by either ligation with silk 1 or using diathermy. The results were analyzed using SPSS 16.0 for windows. Results: A total of180 cases were included in the study. The ages of the patients ranged from 5 to 40 years with the mean age of 15.56 years and a std.deviation of +/- 8.24. The male to female ratio was 1.25:1. The number of hemorrhages occurring was greater in the ‘diathermy coagulation’ group as compared to the ‘silk ligation’ group. However, the observed difference was statistically insignificant (p >.05). Conclusion: Primary haemorrhage occurring during tonsillectomy is a serious threat and control of bleeding during the procedure should therefore be meticulous. Both suture ligation and coagulation diathermy for control of bleeders during the procedure by dissection method are equally effective. PMID:26430438

  18. Computer simulation of the effect of dDAVP with saline loading on fluid balance after 24-hour head-down tilt

    NASA Technical Reports Server (NTRS)

    Srinivasan, R. S.; Simanonok, K. E.; Charles, J. B.

    1994-01-01

    Fluid loading (FL) before Shuttle reentry is a countermeasure currently in use by NASA to improve the orthostatic tolerance of astronauts during reentry and postflight. The fluid load consists of water and salt tablets equivalent to 32 oz (946 ml) of isotonic saline. However, the effectiveness of this countermeasure has been observed to decrease with the duration of spaceflight. The countermeasure's effectiveness may be improved by enhancing fluid retention using analogs of vasopressin such as lypressin (LVP) and desmopressin (dDAVP). In a computer simulation study reported previously, we attempted to assess the improvement in fluid retention obtained by the use of LVP administered before FL. The present study is concerned with the use of dDAVP. In a recent 24-hour, 6 degree head-down tilt (HDT) study involving seven men, dDAVP was found to improve orthostatic tolerance as assessed by both lower body negative pressure (LBNP) and stand tests. The treatment restored Luft's cumulative stress index (cumulative product of magnitude and duration of LBNP) to nearly pre-bedrest level. The heart rate was lower and stroke volume was marginally higher at the same LBNP levels with administration of dDAVP compared to placebo. Lower heart rates were also observed with dDAVP during stand test, despite the lower level of cardiovascular stress. These improvements were seen with only a small but significant increase in plasma volume of approximately 3 percent. This paper presents a computer simulation analysis of some of the results of this HDT study.

  19. Canadian 24-Hour Movement Guidelines for Children and Youth: Exploring the perceptions of stakeholders regarding their acceptability, barriers to uptake, and dissemination.

    PubMed

    Faulkner, Guy; White, Lauren; Riazi, Negin; Latimer-Cheung, Amy E; Tremblay, Mark S

    2016-06-01

    Engaging stakeholders in the development of guidelines and plans for implementation is vital. The purpose of this study was to examine stakeholders' (parents, teachers, exercise professionals, paediatricians, and youth) perceptions of the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth ("Movement Guidelines"). Stakeholders (n = 104) engaged in semi-structured focus groups or interviews to discuss the perceived acceptability of the guidelines, potential barriers to implementation, and preferred methods and messengers of dissemination. A thematic analysis was conducted. Overall, there was consistent support across all stakeholder groups, with the exception of youth participants, for the Movement Guidelines. Stakeholders identified a range of barriers to the uptake of the guidelines including concerns with accurately defining key terms such as "recreational" screen time; everyday challenges such as financial and time constraints; and the possibility of the Movement Guidelines becoming just another source of stress and guilt for already busy and overwhelmed parents. Participants identified a range of recommended methods and messengers for future dissemination. School and medical settings were the most commonly recommended settings through which dissemination efforts should be delivered. Overall, participants representing a range of stakeholder groups were receptive to the new Movement Guidelines and endorsed their value. In complementing the Movement Guidelines, messaging and resources will need to be developed that address common concerns participants had regarding their dissemination and implementation.

  20. Donor-reactive CD8 Memory T Cells Infiltrate Cardiac Allografts Within 24 Hours Post-Transplant in Naïve Recipients

    PubMed Central

    Schenk, A.D.; Nozaki, T.; Rabant, M.; Valujskikh, A.; Fairchild, R.L.

    2008-01-01

    Normal immune responses stimulated by pathogenic and environmental antigens generate memory T cells that react with donor antigens and no currently used immunosuppressive drug completely inhibits memory T cell function. While donor-reactive memory T cells clearly compromise graft outcomes, mechanisms utilized by memory T cells to promote rejection are largely unknown. In the current study we investigated how early endogenous memory cells infiltrate and express effector function in cardiac allografts. Endogenous CD8 memory T cells in non-sensitized recipients distinguish syngeneic vs. allogeneic cardiac allografts within 24 hours of reperfusion. CD8-dependent production of IFN-γ and CXCL9/Mig was observed 24–72 hours post-transplant in allografts but not isografts. CXCL9 was produced by donor cells in response to IFN-γ made by recipient CD8 T cells reactive to donor class I MHC molecules. Activated CD8 T cells were detected in allografts at least three days before donor-specific effector T cells producing IFN-γ were detected in the recipient spleen. Early inflammation mediated by donor-reactive CD8 memory T cells greatly enhanced primed effector T cell infiltration into allografts. These results suggest that strategies for optimal inhibition of alloimmunity should include neutralization of infiltrating CD8 memory T cells within a very narrow window after transplantation. PMID:18557725

  1. Influence of irrigation protocols on the bond strength of fiber posts cemented with a self-adhesive luting agent 24 hours after endodontic treatment.

    PubMed

    Lima, Jessica Ferraz Carvalho; Lima, Adriano Fonseca; Humel, Maria Malerba Colombi; Paulillo, Luis Alexandre Maffei Sartini; Marchi, Giselle Maria; Ferraz, Caio Cezar Randi

    2015-01-01

    The aim of this in vitro study was to evaluate the influence of different irrigation protocols on the bond strength, at different root depths, of fiber posts cemented with a self-adhesive cement 24 hours after endodontic treatment. Fifty-six bovine incisor roots were endodontically prepared and separated into 7 groups (n = 8) according to irrigation protocols: group 1, sterile saline (control); group 2, chlorhexidine (CHX) gel 2% and saline; group 3, sodium hypochlorite (NaOCl) 5.25% and saline; group 4, CHX and saline (final irrigation with ethylenediaminetetraacetic acid [EDTA] 17%); group 5, NaOCl and saline (final irrigation with EDTA); group 6, CHX and saline (final irrigation with NaOCl and EDTA); and group 7, NaOCl (final irrigation with CHX and EDTA). No statistically significant difference was found among the groups. Within the limitations of this study, it can be concluded that the different irrigation protocols did not influence the bond strength of self-adhesive resin cement, which presented similar behaviors at the 3 root depths studied.

  2. Gastroesophageal and pharyngeal reflux detection using impedance and 24-hour pH monitoring in asymptomatic subjects: defining the normal environment.

    PubMed

    Oelschlager, Brant K; Quiroga, Elina; Isch, John A; Cuenca-Abente, Federico

    2006-01-01

    Airway symptoms are often caused by aspiration of refluxed materials into the larynx. In this study we sought to define the frequency, character, and proximal extent of refluxed contents - including nonacid reflux-in normal subjects using intraluminal impedance to improve our understanding of the relationship between reflux and aspiration. Ten subjects, who had no symptoms of gastroesophageal reflux disease or airway disease, underwent impedance/pH monitoring with a catheter that allowed simultaneous esophageal and pharyngeal monitoring. Impedance detected 496 gastroesophageal reflux episodes in the 10 subjects during 240 hours of study. The majority, 399 (81% of the total) were acid reflux episodes (pH < 4). Ninety-seven were nonacid (pH > 4). Most reflux episodes (348 of 496) reached the mid esophagus (9 cm above lower esophageal sphincter). There were 51 reflux episodes that reached the pharynx (PR). Only 13 (25%) of PR were acidic (pH < 4), while 38 were nonacid. Twenty-six PR episodes were liquid and 25 were mixed (liquid and gas). The median number of PR episodes measured with impedance was 5 (0-10). In asymptomatic subjects, most episodes of gastroesophageal reflux are acidic and reach the midesophagus. Reflux into the PR appears to be more common than previously believed, and most of these episodes are not acidic. Thus, traditional 24-hour pH monitoring may underestimate the presence of pharyngeal reflux. The combination of impedance with pH monitoring markedly enhances our ability to accurately detect potential microaspiration.

  3. Systoles in discrete dynamical systems

    NASA Astrophysics Data System (ADS)

    Fernandes, Sara; Grácio, Clara; Ramos, Carlos Correia

    2013-01-01

    The fruitful relationship between Geometry and Graph Theory has been explored by several authors benefiting also the Theory of discrete dynamical systems seen as Markov chains in graphs. In this work we will further explore the relation between these areas, giving a geometrical interpretation of notions from dynamical systems. In particular, we relate the topological entropy with the systole, here defined in the context of discrete dynamical systems. We show that for continuous interval maps the systole is trivial; however, for the class of interval maps with one discontinuity point the systole acquires relevance from the point of view of the dynamical behavior. Moreover, we define the geodesic length spectrum associated to a Markov interval map and we compute the referred spectrum in several examples.

  4. Dynamically Reconfigurable Systolic Array Accelerator

    NASA Technical Reports Server (NTRS)

    Dasu, Aravind; Barnes, Robert

    2012-01-01

    A polymorphic systolic array framework has been developed that works in conjunction with an embedded microprocessor on a field-programmable gate array (FPGA), which allows for dynamic and complimentary scaling of acceleration levels of two algorithms active concurrently on the FPGA. Use is made of systolic arrays and a hardware-software co-design to obtain an efficient multi-application acceleration system. The flexible and simple framework allows hosting of a broader range of algorithms, and is extendable to more complex applications in the area of aerospace embedded systems. FPGA chips can be responsive to realtime demands for changing applications needs, but only if the electronic fabric can respond fast enough. This systolic array framework allows for rapid partial and dynamic reconfiguration of the chip in response to the real-time needs of scalability, and adaptability of executables.

  5. 2001: A Space Odyssey Revisited: The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners. Revised

    NASA Technical Reports Server (NTRS)

    Borowski, Stanley; Dudzinski, Leonard A.

    2003-01-01

    The prospects for 24 hour commuter flights to the Moon, similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale, are examined using two near term, high leverage technologies: liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and lunar-derived oxygen (LUNOX) production. Iron-rich volcanic glass, or orange soil, discovered during the Apollo 17 mission to Taurus-Littrow, has produced a 4 percent oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way. LANTR utilizes the large divergent section of its nozzle as an afterburner into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging from the engine's choked sonic throat, essentially scramjet propulsion in reverse. By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that big engine performance can be obtained using smaller, more affordable, easier to test NTR engines. The use of high-density LOX in place of low density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or in-line Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an expendable mode initially, to maximize delivered surface payload on each mission. The increased payload is

  6. "2001: A Space Odyssey" Revisited: The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners. Revised

    NASA Technical Reports Server (NTRS)

    Borowski, Stanley K.; Dudzinski, Leonard A.

    2001-01-01

    The prospects for "24 hour" commuter flights to the Moon. similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale. are examined using two near term. "high leverage" technologies-liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and "lunar-derived" oxygen (LUNOX) production. Iron-rich volcanic glass. or "orange soil," discovered during the Apollo 17 mission to Taurus-Littrow. has produced a 4% oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way. LANTR utilizes the large divergent section of its nozzle as an "afterburner" into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging from the engine's choked sonic throat-essentially "scramjet propulsion in reverse." By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that "big engine" performance can be obtained using smaller. more affordable. easier to test NTR engines. The use of high-density LOX in place of low-density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or "in-line" Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an "expendable mode" initially, to maximize delivered surface payload on each mission. The increased

  7. "2001: A Space Odyssey" Revisited--The Feasibility of 24 Hour Commuter Flights to the Moon Using NTR Propulsion with LUNOX Afterburners

    NASA Technical Reports Server (NTRS)

    Borowski, Stanley K.; Dudzinski, Leonard A.

    1998-01-01

    The prospects for "24 hour" commuter flights to the Moon, similar to that portrayed in 2001: A Space Odyssey but on a more Spartan scale, are examined using two near term, "high leverage" technologies--liquid oxygen (LOX)-augmented nuclear thermal rocket (NTR) propulsion and "lunar-derived" oxygen (LUNOX) production. Ironrich volcanic glass, or "orange soil," discovered during the Apollo 17 mission to Taurus-Littrow, has produced a 4% oxygen yield in recent NASA experiments using hydrogen reduction. LUNOX development and utilization would eliminate the need to transport oxygen supplies from Earth and is expected to dramatically reduce the size, cost and complexity of space transportation systems. The LOX-augmented NTR concept (LANTR) exploits the high performance capability of the conventional liquid hydrogen (LH2)-cooled NTR and the mission leverage provided by LUNOX in a unique way, LANTR utilizes the large divergent section of its nozzle as an "afterburner" into which oxygen is injected and supersonically combusted with nuclear preheated hydrogen emerging front the engine's choked sonic throat--essentially "scramjet propulsion in reverse." By varying the oxygen-to-hydrogen mixture ratio, the LANTR engine can operate over a wide range of thrust and specific impulse (Isp) values while the reactor core power level remains relatively constant. The thrust augmentation feature of LANTR means that "big engine" performance can be obtained using smaller, more affordable, easier to test NTR engines. The use of high-density LOX in place of low-density LH2 also reduces hydrogen mass and tank volume resulting in smaller space vehicles. An implementation strategy and evolutionary lunar mission architecture is outlined which requires only Shuttle C or "in-line" Shuttle-derived launch vehicles, and utilizes conventional NTR-powered lunar transfer vehicles (LTVs), operating in an "expendable mode" initially, to maximize delivered surface payload on each mission. The increased

  8. Epidemiology of Urban Traffic Accident Victims Hospitalized More Than 24 Hours in a Level III Trauma Center, Kashan County, Iran, During 2012-2013

    PubMed Central

    Mahdian, Mehrdad; Sehat, Mojtaba; Fazel, Mohammad Reza; Moraveji, Alireza; Mohammadzadeh, Mahdi

    2015-01-01

    Background: Urban traffic accidents are an extensively significant problem in small and busy towns in Iran. This study tried to explore the epidemiological pattern of urban traffic accidents in Kashan and Aran-Bidgol cities, Iran. Objectives: This study aimed to assess various epidemiological factors affecting victims of trauma admitted to a main trauma center in Iran. Patients and Methods: During a retrospective study, data including age, sex, injury type and pattern, outcome, hospital stay and treatment expenditures regarding urban Road Traffic Accidents (RTAs) for one year (March 2012-March 2013) were obtained from the registry of trauma research center, emergency medical services and deputy of health of Kashan University of Medical Sciences. One-way ANOVA and chi-square tests were used to analyze data using SPSS version 16.0. P value < 0.05 was considered significant. Results: A total of 1723 victims (82.6% male, sex ratio of almost 5:1) were considered in this study. Mortality rate in trauma cases hospitalized more than 24 hours during our study was 0.8%. Young motorcyclist men with the rate of more than 103 per 10000 were the most vulnerable group. The most common injury was head injury (73.6%) followed by lower limb injury (33.2%). A significant association was found between mechanism of injury and head, lower limb, multiple injuries and high risk age group. Conclusions: Urban RTAs are one of the most important problems in Kashan and Aran-Bidgol cities, which impose a great economic burden on health system. Motorcyclists are the most vulnerable victims and multiple trauma and head injury are seen among them extensively. PMID:26101765

  9. Spatial characteristics of extreme rainfall over China with hourly through 24-hour accumulation periods based on national-level hourly rain gauge data

    NASA Astrophysics Data System (ADS)

    Zheng, Yongguang; Xue, Ming; Li, Bo; Chen, Jiong; Tao, Zuyu

    2016-11-01

    Hourly rainfall measurements of 1919 national-level meteorological stations from 1981 through 2012 are used to document, for the first time, the climatology of extreme rainfall in hourly through 24-h accumulation periods in China. Rainfall amounts for 3-, 6-, 12- and 24-h periods at each station are constructed through running accumulation from hourly rainfall data that have been screened by proper quality control procedures. For each station and for each accumulation period, the historical maximum is found, and the corresponding 50-year return values are estimated using generalized extreme value theory. Based on the percentiles of the two types of extreme rainfall values among all the stations, standard thresholds separating Grade I, Grade II and Grade III extreme rainfall are established, which roughly correspond to the 70th and 90th percentiles for each of the accumulation periods. The spatial characteristics of the two types of extreme rainfall are then examined for different accumulation periods. The spatial distributions of extreme rainfall in hourly through 6-h periods are more similar than those of 12- and 24-h periods. Grade III rainfall is mostly found over South China, the western Sichuan Basin, along the southern and eastern coastlines, and in the large river basins and plains. There are similar numbers of stations with Grade III extreme hourly rainfall north and south of 30°N, but the percentage increases to about 70% south of 30°N as the accumulation period increases to 24 hours, reflecting richer moisture and more prolonged rain events in southern China. Potential applications of the extreme rainfall climatology and classification standards are suggested at the end.

  10. Establishing normal plasma and 24-hour urinary biochemistry ranges in C3H, BALB/c and C57BL/6J mice following acclimatization in metabolic cages.

    PubMed

    Stechman, Michael J; Ahmad, Bushra N; Loh, Nellie Y; Reed, Anita A C; Stewart, Michelle; Wells, Sara; Hough, Tertius; Bentley, Liz; Cox, Roger D; Brown, Steve D M; Thakker, Rajesh V

    2010-07-01

    Physiological studies of mice are facilitated by normal plasma and 24-hour urinary reference ranges, but variability of these parameters may increase due to stress that is induced by housing in metabolic cages. We assessed daily weight, food and water intake, urine volume and final day measurements of the following: plasma sodium, potassium, chloride, urea, creatinine, calcium, phosphate, alkaline phosphatase, albumin, cholesterol and glucose; and urinary sodium, potassium, calcium, phosphate, glucose and protein in 24- to 30-week-old C3H/HeH, BALB/cAnNCrl and C57BL/6J mice. Between 15 and 20 mice of each sex from all three strains were individually housed in metabolic cages with ad libitum feeding for up to seven days. Acclimatization was evaluated using general linear modelling for repeated measures and comparison of biochemical data was by unpaired t-test and analysis of variance (SPSS version 12.0.1). Following an initial 5-10% fall in body weight, daily dietary intake, urinary output and weight in all three strains reached stable values after 3-4 days of confinement. Significant differences in plasma glucose, cholesterol, urea, chloride, calcium and albumin, and urinary glucose, sodium, phosphate, calcium and protein were observed between strains and genders. Thus, these results provide normal reference values for plasma and urinary biochemistry in three strains housed in metabolic cages and demonstrate that 3-4 days are required to reach equilibrium in metabolic cage studies. These variations due to strain and gender have significant implications for selecting the appropriate strain upon which to breed genetically-altered models of metabolic and renal disease.

  11. External Beam Radiotherapy Plus 24-Hour Continuous Infusion of Gemcitabine in Unresectable Pancreatic Carcinoma: Long-Term Results of a Phase II Study

    SciTech Connect

    Mattiucci, Gian C.; Morganti, Alessio G.; Valentini, Vincenzo; Ippolito, Edy; Alfieri, Sergio; Antinori, Armando; Crucitti, Antonio; D'Agostino, Giuseppe R.; Di Lullo, Liberato; Luzi, Stefano; Mantini, Giovanna; Smaniotto, Daniela; Doglietto, Gian B.; Cellini, Numa

    2010-03-01

    Purpose: To evaluate the efficacy of gemcitabine-based chemoradiation (CT-RT) in treating patients (pts) affected by locally advanced pancreatic cancers (LAPC). Methods and Materials: Weekly gemcitabine (100 mg/m{sup 2}) was given as a 24-hour infusion during the course of three-dimensional radiotherapy (50.4 Gy to the tumor, 39.6 Gy to the nodes). After CT-RT, pts received five cycles of sequential chemotherapy with gemcitabine (1000 mg/m{sup 2}; 1, 8, q21). Response rate was assessed according to World Health Organization criteria 6 weeks after the end of CT-RT. Local control (LC), time to progression (TTP), metastases-free survival (MFS), and overall survival (OS) were analyzed by the Kaplan Meier method. Results: Forty pts (male/female 22/18; median age 62 years, range, 36-76) were treated from 2000 to 2005. The majority had T4 tumour (n = 34, 85%), six pts (15%) had T3 tumour. Sixteen pts (40%) were node positive at diagnosis. Grade 3-4 acute toxicity was observed in 21 pts (52.5%). Thirty pts (75%) completed the treatment schedule. A clinical response was achieved in 12 pts (30%). With a median follow-up of 76 months (range, 32-98), 2-year LC was 39.6% (median, 12 months), 2-year TTP was 18.4% (median, 10 months), and 2-year MFS was 29.7% (median, 10 months). Two-year OS (25%; median, 15.5 months) compared with our previous study on 5-fluorouracil-based CT-RT (2.8%) was significantly improved (p <0.001). Conclusions: Gemcitabine CT-RT seems correlated with improved outcomes. Healthier patients who are likely to complete the treatment schedule may benefit most from this therapy.

  12. The association of night-time systolic blood pressure with ultrasound markers of subclinical cardiac and vascular disease

    PubMed Central

    Ho, Emily; Dolan, Eamon; Curtin, Ronan J.; Kearney, Patricia M.

    2017-01-01

    Introduction The aim of this study was to examine the association of night-time systolic blood pressure (BP) with subclinical cardiac dysfunction measured by global longitudinal strain (GLS) and subclinical vascular damage measured by carotid intima–media thickness (CIMT) and carotid plaques. Methods GLS was measured by speckle-tracking analysis of echocardiogram images. CIMT was measured at the distal 1 cm of the common carotid artery. The presence of carotid plaques was recorded. Philips QLAB cardiac and vascular ultrasound quantification software was used for analysis. The association of night-time systolic BP with GLS, CIMT and carotid plaques was assessed using linear and logistic regression. Results Fifty (response rate 63%) individuals took part in this study. In univariable models, night-time systolic BP was significantly associated with GLS [β coefficient 0.85 for every 10 mmHg increase, 95% confidence interval (CI): 0.3–1.4] and carotid plaques (odds ratio 1.9 for every 10 mmHg increase, 95% CI: 1.1–3.2). Univariable analysis of daytime systolic BP did not show any statistically significant associations. In age-adjusted and sex-adjusted models, the association for night-time systolic BP and GLS remained significant (β coefficient 0.68 for every 10 mmHg increase, 95% CI: 0.1–1.3). The association for carotid plaques was no longer statistically significant. In multivariable models, findings were diminished. Discussion Our results suggest a trend towards an association between night-time systolic BP and subclinical cardiac and vascular disease. When assessing ambulatory blood pressure monitoring results, the absolute night-time systolic BP seems to be a better prognostic parameter than daytime systolic BP, but ultimately a large randomised controlled trial involving chronotherapy is necessary to fully address this. PMID:27845956

  13. Radial Pulse Character Relationship to Systolic Blood Pressure and Trauma Outcomes

    DTIC Science & Technology

    2005-12-01

    RADIAL PULSE CHARACTER RELATIONSHIPS TO SYSTOLIC BLOOD PRESSURE AND TRAUMA OUTCOMES John McManus, MD, MCR, Andrey L. Yershov, MD, PhD, David Ludwig...pable pulse characteristics in the radial artery would es- timate systolic blood pressure (SBP) and predict outcome in trauma patients. Methods. Data...setting is problematic. The ability to obtain a blood pressure (BP) measurement in an aus- tere environment is often limited by time constraints

  14. Toe photoplethysmographic monitor, a promising noninvasive technique for tracking systolic blood pressure trends beat-to-beat.

    PubMed

    Fu, Zhi Qing; Fan, Jin; Wang, Yu Tang

    2014-08-01

    The call for early detection of hypotension creates a heavy demand for new methods that can monitor trends in blood pressure (BP) levels continuously and noninvasively. Photoplethysmography (PPG) is widely used in hemodynamic analysis. We assessed the feasibility of toe PPG in tracing BP trends using BP readings obtained by standard intermittent noninvasive BP measurements from the arm of a patient with severe hypoxic-ischemic brain injury. We demonstrated that an attenuated or inversed dicrotic wave of toe PPG is predictive of BP trends, and this method could be applicable for the continuous noninvasive monitoring of systolic BP at a beat-by-beat basis.

  15. Performance of the Automated Self-Administered 24-hour Recall relative to a measure of true intakes and to an interviewer-administered 24-h recall123

    PubMed Central

    Kirkpatrick, Sharon I; Subar, Amy F; Douglass, Deirdre; Zimmerman, Thea P; Thompson, Frances E; Kahle, Lisa L; George, Stephanie M; Dodd, Kevin W; Potischman, Nancy

    2014-01-01

    Background: The Automated Self-Administered 24-hour Recall (ASA24), a freely available Web-based tool, was developed to enhance the feasibility of collecting high-quality dietary intake data from large samples. Objective: The purpose of this study was to assess the criterion validity of ASA24 through a feeding study in which the true intake for 3 meals was known. Design: True intake and plate waste from 3 meals were ascertained for 81 adults by inconspicuously weighing foods and beverages offered at a buffet before and after each participant served him- or herself. Participants were randomly assigned to complete an ASA24 or an interviewer-administered Automated Multiple-Pass Method (AMPM) recall the following day. With the use of linear and Poisson regression analysis, we examined the associations between recall mode and 1) the proportions of items consumed for which a match was reported and that were excluded, 2) the number of intrusions (items reported but not consumed), and 3) differences between energy, nutrient, food group, and portion size estimates based on true and reported intakes. Results: Respondents completing ASA24 reported 80% of items truly consumed compared with 83% in AMPM (P = 0.07). For both ASA24 and AMPM, additions to or ingredients in multicomponent foods and drinks were more frequently omitted than were main foods or drinks. The number of intrusions was higher in ASA24 (P < 0.01). Little evidence of differences by recall mode was found in the gap between true and reported energy, nutrient, and food group intakes or portion sizes. Conclusions: Although the interviewer-administered AMPM performed somewhat better relative to true intakes for matches, exclusions, and intrusions, ASA24 performed well. Given the substantial cost savings that ASA24 offers, it has the potential to make important contributions to research aimed at describing the diets of populations, assessing the effect of interventions on diet, and elucidating diet and health

  16. Sex and age-related differences in performance in a 24-hour ultra-cycling draft-legal event – a cross-sectional data analysis

    PubMed Central

    2014-01-01

    Background The purpose of this study was to examine the sex and age-related differences in performance in a draft-legal ultra-cycling event. Methods Age-related changes in performance across years were investigated in the 24-hour draft-legal cycling event held in Schötz, Switzerland, between 2000 and 2011 using multi-level regression analyses including age, repeated participation and environmental temperatures as co-variables. Results For all finishers, the age of peak cycling performance decreased significantly (β = −0.273, p = 0.036) from 38 ± 10 to 35 ± 6 years in females but remained unchanged (β = −0.035, p = 0.906) at 41.0 ± 10.3 years in males. For the annual fastest females and males, the age of peak cycling performance remained unchanged at 37.3 ± 8.5 and 38.3 ± 5.4 years, respectively. For all female and male finishers, males improved significantly (β = 7.010, p = 0.006) the cycling distance from 497.8 ± 219.6 km to 546.7 ± 205.0 km whereas females (β = −0.085, p = 0.987) showed an unchanged performance of 593.7 ± 132.3 km. The mean cycling distance achieved by the male winners of 960.5 ± 51.9 km was significantly (p < 0.001) greater than the distance covered by the female winners with 769.7 ± 65.7 km but was not different between the sexes (p > 0.05). The sex difference in performance for the annual winners of 19.7 ± 7.8% remained unchanged across years (p > 0.05). The achieved cycling distance decreased in a curvilinear manner with advancing age. There was a significant age effect (F = 28.4, p < 0.0001) for cycling performance where the fastest cyclists were in age group 35–39 years. Conclusion In this 24-h cycling draft-legal event, performance in females remained unchanged while their age of peak cycling performance decreased and performance in males improved while their age of peak cycling performance remained unchanged. The annual fastest females and males were 37.3 ± 8.5 and 38.3 ± 5.4 years old, respectively. The sex

  17. Urinary catecholamines in essential hypertension: results of 24-hour urine catecholamine analyses from patients in the Medical Research Council trial for mild hypertension and from matched controls.

    PubMed

    Brown, M J; Causon, R C; Barnes, V F; Brennan, P; Barnes, G; Greenberg, G

    1985-10-01

    Four consecutive 24-h urine samples were collected from 134 male and 134 female placebo-treated patients in the Medical Research Council Trial for Mild Hypertension. Similar samples were collected from age and sex-matched normotensive controls. On the fourth day noradrenaline excretion was 22.05 +/- 1.01 nmol/mmol creatinine in the hypertensives compared with 22.22 +/- 1.16 nmol/mmol creatinine in the controls. Adrenaline excretion on the same day was 6.13 +/- 0.33 nmol/mmol creatinine in the hypertensive subjects compared with 6.32 +/- 0.38 nmol/mmol creatinine in the controls. There was no significant difference for either catecholamine between the two groups. However, in the control group there was a highly significant correlation between excretion of adrenaline and systolic blood pressure (r = 0.218, p = 0.0004) and between noradrenaline excretion and systolic blood pressure (r = 0.200, p = 0.001). Catecholamine excretion and blood pressure were not significantly correlated in the hypertensive patients. There were no significant correlations in either group between catecholamine excretion and heart rate, caffeine intake, nicotine consumption or the Bortner self-assessment score of personality type. This study has found no evidence of elevated sympathoadrenal activity in mild hypertensives. The correlations in the control group may reflect the role of sympathoadrenal activity in acute fluctuations in blood pressure or may suggest that the level of blood pressure within the 'normal' range depends in part on the level of sympathoadrenal activity.

  18. Efficacy/safety of a fixed-dose amlodipine/olmesartan medoxomil-based treatment regimen in hypertensive blacks and non-blacks with uncontrolled BP on prior antihypertensive monotherapy.

    PubMed

    Nesbitt, Shawna; Shojaee, Ali; Maa, Jen-Fue

    2013-04-01

    In this secondary analysis of a dose-titration study of patients with hypertension uncontrolled on prior monotherapy, blacks (n=234) and non-blacks (n=765) were switched to amlodipine (AML)/olmesartan medoxomil (OM) 5/20 mg, with uptitration every 4 weeks to AML/OM 5/40 mg and then AML/OM 10/40 mg to achieve a seated cuff blood pressure (SeBP) of <120/70 mm Hg. Hydrochlorothiazide 12.5 and 25 mg could be added if SeBP was ≥125/75 mm Hg. The cumulative proportions of patients achieving systolic SeBP <140 mm Hg (<130 mm Hg if diabetic) at 12 weeks were 71.6% for blacks and 77.2% for non-blacks. Mean SeBP change from baseline in blacks (mean baseline BP: 153.0/93.7 mm Hg) ranged from -11.7/-6.1 mm Hg for AML/OM 5/20 mg to -23.6/-12.9 mm Hg for AML/OM 10/40 mg +hydrochlorothiazide 25 mg (all P<.0001). Antihypertensive efficacy was maintained throughout the 24-hour dosing interval. An AML/OM-based regimen was effective in blacks with hypertension uncontrolled on prior monotherapy.

  19. Systolic VLSI for Kalman filters

    NASA Technical Reports Server (NTRS)

    Yeh, H.-G.; Chang, J. J.

    1986-01-01

    A novel two-dimensional parallel computing method for real-time Kalman filtering is presented. The mathematical formulation of a Kalman filter algorithm is rearranged to be the type of Faddeev algorithm for generalizing signal processing. The data flow mapping from the Faddeev algorithm to a two-dimensional concurrent computing structure is developed. The architecture of the resulting processor cells is regular, simple, expandable, and therefore naturally suitable for VLSI chip implementation. The computing methodology and the two-dimensional systolic arrays are useful for Kalman filter applications as well as other matrix/vector based algebraic computations.

  20. Heritability of HR and BP Response To Exercise Training in the HERITAGE Family Study.

    ERIC Educational Resources Information Center

    Rice, Treva; Gagnon, Jacques; Leon, Arthur S.; Skinner, James S.; Wilmore, Jack H.; Bouchard, Claude; Rao, D. C.

    2002-01-01

    Assessed the heritability of response to exercise training in resting blood pressure (BP) and heart rate (HR) among sedentary Caucasians comprising 98 families who completed an exercise training program. Results indicated that the trainability of systolic BP and HR in families with elevated BP was partially determined by genetic factors. Diastolic…

  1. Estimated 24-hour urine sodium excretion is correlated with blood pressure in Korean population: 2009-2011 Korean National Health and Nutritional Examination Survey.

    PubMed

    Oh, Jieun; Lee, Jeonghwan; Koo, Ho Seok; Kim, Suhnggwon; Chin, Ho Jun

    2014-09-01

    No large-scale studies have investigated the association between salt intake and hypertension in Korean population. To investigate the relationship of blood pressure to salt consumption, we analyzed data from 19,476 participants in the 2009-2011 Korean National Health and Nutritional Examination Survey (KNHANES). Urinary sodium excretion over 24-hr (24HUNa) was estimated from spot urine tests using Tanaka's equation. The study subjects were stratified into hypertensive and normotensive groups. Hypertensive participants (n=6,552, 33.6%) had higher estimated 24HUNa, 150.4±38.8 mEq/day, than normotensive participants, 140.5±34.6 mEq/day (P<0.001). The association between 24HUNa and blood pressure outcomes was not affected by adjustment for other risk factors for hypertension (odds ratio 0.001; 95% confidence interval 0.001-0.003; P<0.001). Increases in 24HUNa of 100 mEq/day were associated with a 6.1±0.3/2.9±0.2 mmHg increase in systolic/diastolic blood pressure in all participants. This effect was stronger in hypertensive participants (increase of 8.1±0.5/3.4±0.3 mmHg per 100 mEq/day) and smaller in normotensive participants (2.9±0.3/1.3±0.2 mmHg). These results support recommendations for low salt intake in Korean population to prevent and control adverse blood pressure levels.

  2. Remifentanil patient-controlled analgesia for labor – monitoring of newborn heart rate, blood pressure and oxygen saturation during the first 24 hours after delivery

    PubMed Central

    Konefał, Halina; Jaskot, Brygida; Pastuszka, Joanna

    2012-01-01

    Introduction There is no available information about the effects of remifentanil labor analgesia on newborns’ vital signs in the first hours after delivery. The aim of the study was to assess changes in the heart rate, blood pressure and oxygen saturation during the first 24 h of neonatal life after using remifentanil patient-controlled analgesia (PCA) for labor analgesia. Material and methods Forty-four full-term neonates, 23 from intravenous PCA remifentanil labor anesthesia 0.2 µg/kg, repeated not more frequently than every 2 min, and 21 born to mothers without any pharmacological forms of analgesia, were studied. Heart rate, oxygen saturation, and systolic (SBP) and diastolic blood pressure (DBP) were monitored using a Nellcor Oxi Max monitor N5500 (Tyco Healthcare), and recorded at 1 h, 6 h, 12 h and 24 h. Results No significant differences in heart rate (p = 0.54; p = 0.26; p = 0.60; p = 0.83), oxygen saturation (p = 0.21; p = 0.27; p = 0.61; p = 0.9) and DBP (p = 0.98; p = 0.31; p = 0.83; p = 0.58) between the groups at 1 h, 6 h, 12 h and 24 h. Newborns from the remifentanil group had lower SBP at 1 h of life (59 mm Hg vs. 68.5 mm Hg) but the difference was just on the borderline of statistical significance (p > 0.06). There were no significant differences in SBP between the groups at 6 h (p = 0.65), 12 h (p = 0.11), and 24 h (p = 0.89) of life. Conclusions Remifentanil PCA analgesia during labor does not significantly modify the oxygen saturation, heart rate and blood pressure in infants during the first day of their life. Therefore, further studies are needed to explain the observed trend for arterial hypotension in the first hour of life in infants born to mothers treated with remifentanil. PMID:24049531

  3. Effects of Sacubitril/Valsartan Versus Olmesartan on Central Hemodynamics in the Elderly With Systolic Hypertension: The PARAMETER Study.

    PubMed

    Williams, Bryan; Cockcroft, John R; Kario, Kazuomi; Zappe, Dion H; Brunel, Patrick C; Wang, Qian; Guo, Weinong

    2017-03-01

    Effective treatment of systolic hypertension in elderly patients remains a major therapeutic challenge. A multicenter, double-blind, randomized controlled trial with sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, was conducted to determine its effects versus olmesartan (angiotensin receptor blocker) on central aortic pressures, in elderly patients (aged ≥60 years) with systolic hypertension and pulse pressure >60 mm Hg, indicative of arterial stiffness. Patients (n=454; mean age, 67.7 years; mean seated systolic blood pressure, 158.6 mm Hg; mean seated pulse pressure, 69.7 mm Hg) were randomized to receive once-daily sacubitril/valsartan 200 mg or olmesartan 20 mg, force titrated to double the initial doses after 4 weeks, before primary assessment at 12 weeks. The study extended double-blind treatment for 12 to 52 weeks, during which amlodipine (2.5-5 mg) and subsequently hydrochlorothiazide (6.25-25 mg) were added-on for patients not achieving blood pressure target (<140/90). At week 12, sacubitril/valsartan reduced central aortic systolic pressure (primary assessment) greater than olmesartan by -3.7 mm Hg (P=0.010), further corroborated by secondary assessments at week 12 (central aortic pulse pressure, -2.4 mm Hg, P<0.012; mean 24-hour ambulatory brachial systolic blood pressure and central aortic systolic pressure, -4.1 mm Hg and -3.6 mm Hg, respectively, both P<0.001). Differences in 24-hour ambulatory pressures were pronounced during sleep. After 52 weeks, blood pressure parameters were similar between treatments (P<0.002); however, more patients required add-on antihypertensive therapy with olmesartan (47%) versus sacubitril/valsartan (32%; P<0.002). Both treatments were equally well tolerated. The PARAMETER study (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Measuring Arterial Stiffness in the Elderly), for the first time, demonstrated

  4. Cross sectional longitudinal study of spot morning urine protein:creatinine ratio, 24 hour urine protein excretion rate, glomerular filtration rate, and end stage renal failure in chronic renal disease in patients without diabetes.

    PubMed Central

    Ruggenenti, P.; Gaspari, F.; Perna, A.; Remuzzi, G.

    1998-01-01

    OBJECTIVE: To evaluate whether the protein:creatinine ratio in spot morning urine samples is a reliable indicator of 24 hour urinary protein excretion and predicts the rate of decline of glomerular filtration rate and progression to end stage renal failure in non-diabetic patients with chronic nephropathy. DESIGN: Cross sectional correlation between the ratio and urinary protein excretion rate. Univariate and multivariate analysis of baseline predictors, including the ratio and 24 hour urinary protein, of decline in glomerular filtration rate and end stage renal failure in the long term. SETTING: Research centre in Italy. SUBJECTS: 177 non-diabetic outpatients with chronic renal disease screened for participation in the ramipril efficacy in nephropathy study. MAIN OUTCOME MEASURES: Rate of decline in filtration rate evaluated by repeated measurements of unlabelled iohexol plasma clearance and rate of progression to renal failure. RESULTS: Protein:creatinine ratio was significantly correlated with absolute and log transformed 24 hour urinary protein values (P = 0.0001 and P < 0.0001, respectively.) Ratios also had high predictive value for rate of decline of the glomerular filtration rate (univariate P = 0.0003, multivariate P = 0.004) and end stage renal failure (P = 0.002 and P = 0.04). Baseline protein:creatinine ratios and rate of decline of the glomerular filtration rate were also significantly correlated (P < 0.0005). In the lowest third of the protein:creatinine ratio (< 1.7) there was 3% renal failure compared with 21.2% in the highest third (> 2.7) (P < 0.05). CONCLUSIONS: Protein:creatinine ratio in spot morning urine samples is a precise indicator of proteinuria and a reliable predictor of progression of disease in non-diabetic patients with chronic nephropathies and represents a simple and inexpensive procedure in establishing severity of renal disease and prognosis. PMID:9501711

  5. Index Blood Tests and National Early Warning Scores within 24 Hours of Emergency Admission Can Predict the Risk of In-Hospital Mortality: A Model Development and Validation Study

    PubMed Central

    Mohammed, Mohammed A.; Rudge, Gavin; Watson, Duncan; Wood, Gordon; Smith, Gary B.; Prytherch, David R.; Girling, Alan; Stevens, Andrew

    2013-01-01

    Background We explored the use of routine blood tests and national early warning scores (NEWS) reported within ±24 hours of admission to predict in-hospital mortality in emergency admissions, using empirical decision Tree models because they are intuitive and may ultimately be used to support clinical decision making. Methodology A retrospective analysis of adult emergency admissions to a large acute hospital during April 2009 to March 2010 in the West Midlands, England, with a full set of index blood tests results (albumin, creatinine, haemoglobin, potassium, sodium, urea, white cell count and an index NEWS undertaken within ±24 hours of admission). We developed a Tree model by randomly splitting the admissions into a training (50%) and validation dataset (50%) and assessed its accuracy using the concordance (c-) statistic. Emergency admissions (about 30%) did not have a full set of index blood tests and/or NEWS and so were not included in our analysis. Results There were 23248 emergency admissions with a full set of blood tests and NEWS with an in-hospital mortality of 5.69%. The Tree model identified age, NEWS, albumin, sodium, white cell count and urea as significant (p<0.001) predictors of death, which described 17 homogeneous subgroups of admissions with mortality ranging from 0.2% to 60%. The c-statistic for the training model was 0.864 (95%CI 0.852 to 0.87) and when applied to the testing data set this was 0.853 (95%CI 0.840 to 0.866). Conclusions An easy to interpret validated risk adjustment Tree model using blood test and NEWS taken within ±24 hours of admission provides good discrimination and offers a novel approach to risk adjustment which may potentially support clinical decision making. Given the nature of the clinical data, the results are likely to be generalisable but further research is required to investigate this promising approach. PMID:23734195

  6. Improved Oxygenation 24 Hours After Transition to Airway Pressure Release Ventilation or High-Frequency Oscillatory Ventilation Accurately Discriminates Survival in Immunocompromised Pediatric Patients With Acute Respiratory Distress Syndrome*

    PubMed Central

    Yehya, Nadir; Topjian, Alexis A.; Thomas, Neal J.; Friess, Stuart H.

    2014-01-01

    Objectives Children with an immunocompromised condition and requiring invasive mechanical ventilation have high risk of death. Such patients are commonly transitioned to rescue modes of non-conventional ventilation, including airway pressure release ventilation and high-frequency oscillatory ventilation, for acute respiratory distress syndrome refractory to conventional ventilation. Our aim was to describe our experience with airway pressure release ventilation and high-frequency oscillatory ventilation in children with an immunocompromised condition and acute respiratory distress syndrome refractory to conventional ventilation and to identify factors associated with survival. Design Retrospective cohort study. Setting Tertiary care, university-affiliated PICU. Patients Sixty pediatric patients with an immunocompromised condition and acute respiratory distress syndrome refractory to conventional ventilation transitioned to either airway pressure release ventilation or high-frequency oscillatory ventilation. Interventions None. Measurements and Main Results Demographic data, ventilator settings, arterial blood gases, oxygenation index, and Pao2/Fio2 were recorded before transition to either mode of nonconventional ventilation and at predetermined intervals after transition for up to 5 days. Mortality in the entire cohort was 63% and did not differ between patients transitioned to airway pressure release ventilation and high-frequency oscillatory ventilation. For both airway pressure release ventilation and high-frequency oscillatory ventilation, improvements in oxygenation index and Pao2/Fio2 at 24 hours expressed as a fraction of pretransition values (oxygenation index24/oxygenation indexpre and Pao2/Fio224/Pao2/FIO2pre) reliably discriminated nonsurvivors from survivors, with receiver operating characteristic areas under the curves between 0.89 and 0.95 (p for all curves < 0.001). Sensitivity-specificity analysis suggested that less than 15% reduction in

  7. Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells 24-Hours Post-Exposure to 532 nm, 3.0 ns Pulsed Laser Light and 1064 nm, 170 ps Pulsed Laser Light 12-Hours Post-Exposure: Results Compendium

    DTIC Science & Technology

    2004-06-01

    Laser Light and 1064 nm, 170 ps Pulsed Laser Light 12-hours Post-Exposure: Results Compendium John W. Obringer Martin D. Johnson Laser and Optics...Explanted Human Retinal Pigment Epithelial Cells 12-hours Post-Exposure to 532 nm, 3.0 ns Pulsed Laser Light and 1064 nm, 170 ps Pulsed Laser Lightl2-hours...Explanted Human Retinal Pigment Epithelial USAFA F05611-02-P-0471 Cells 24-Hours Post-Exposure to 532 nm, 3.0 ns Pulsed Laser-Light and 1064nm, 170 ps Pulsed

  8. Clinical usefulness of the second peak of radial systolic blood pressure for estimation of aortic systolic blood pressure.

    PubMed

    Kohara, K; Tabara, Y; Tomita, H; Nagai, T; Igase, M; Miki, T

    2009-08-01

    Central aortic blood pressure (BP), obtained from radial arterial waveform using the transfer function method (TFM), has been shown to have prognostic value independently of brachial BP. In this study, the relationship between peripheral systolic BP (SBP) and aortic SBP was evaluated. We further investigated whether TFM-derived aortic SBP can be estimated by information obtained from the radial waveform. The radial waveform was analysed to obtain the first peak of radial SBP (SBP1), second peak of radial SBP (SBP2), radial augmentation index (AI) (radial (SBP2-DBP)/(SBP1-DBP) x 100 and aortic SBP and AI using TFM in 233 subjects in the supine position. Measurements were repeated after changing position to the prone position. The constructed equation was validated in 149 community residents with different backgrounds. Radial SBP2 was closer to TFM-derived aortic SBP compared with brachial SBP. TFM-derived aortic SBP was approximated by the equation: aortic SBP=18.9-radial SBP2-0.03 x HR-0.214 x radial AI (r2=0.992). The equation was also applicable to predicting aortic SBP in the prone position as well as in different populations (mean difference between predicted aortic SBP and TFM-derived aortic SBP: -0.01+/-1.34 and 1.05+/-1.47 mm Hg, respectively). Radial arterial waveform analysis can be used for estimation of TFM-derived aortic SBP.

  9. Association of uremic pruritus in hemodialysis patients with the number of days of high mean 24-hour particulate matter with a diameter of <2.5 μm

    PubMed Central

    Liu, Ming-Hui; Chan, Ming-Jen; Hsu, Ching-Wei; Weng, Cheng-Hao; Yen, Tzung-Hai; Huang, Wen-Hung

    2017-01-01

    Uremic pruritus (UP) is a common and incapacitating symptom in patients undergoing hemodialysis (HD). The pathogenesis of UP is multifactorial and complex. Particulate matter (PM), a major air pollutant, is a mixture of particles with various chemical compositions. PM is associated with several allergic diseases, including dermatitis. To assess the role of PM (PM with a diameter of <10 μm [PM10] and PM with a diameter of <2.5 μm [PM2.5]) and other clinical variables in UP in patients on HD, we recruited 866 patients on maintenance HD (MHD). We analyzed the number of days of mean 24-hour PM10 ≥125 μg/m3/12 months (NDPM10) or the number of days of mean 24-hour PM2.5 ≥35 μg/m3/12 months (NDPM2.5) exceeding the standard level in the past 12 months respectively to determine the association with UP. In a multivariate logistic regression, HD duration, serum ferritin levels, low-density lipoprotein (LDL) levels, and NDPM2.5 ≥116 days/12 months were positively associated with UP. This cross-sectional study showed that the number of days on which the environmental PM2.5 exceeds the standard level might be associated with UP in patients on MHD. PMID:28260912

  10. 24-hour urinary aldosterone excretion test

    MedlinePlus

    ... sodium is in your diet Whether your kidneys work properly The condition being diagnosed Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor ...

  11. Brachial vs. central systolic pressure and pulse wave transmission indicators: a critical analysis.

    PubMed

    Izzo, Joseph L

    2014-12-01

    This critique is intended to provide background for the reader to evaluate the relative clinical utilities of brachial cuff systolic blood pressure (SBP) and its derivatives, including pulse pressure, central systolic pressure, central augmentation index (AI), and pulse pressure amplification (PPA). The critical question is whether the newer indicators add sufficient information to justify replacing or augmenting brachial cuff blood pressure (BP) data in research and patient care. Historical context, pathophysiology of variations in pulse wave transmission and reflection, issues related to measurement and model errors, statistical limitations, and clinical correlations are presented, along with new comparative data. Based on this overview, there is no compelling scientific or practical reason to replace cuff SBP with any of the newer indicators in the vast majority of clinical situations. Supplemental value for central SBP may exist in defining patients with exaggerated PPA ("spurious systolic hypertension"), managing cardiac and aortic diseases, and in studies of cardiovascular drugs, but there are no current standards for these possibilities.

  12. Cross-Sectional Study of 24-Hour Urinary Electrolyte Excretion and Associated Health Outcomes in a Convenience Sample of Australian Primary Schoolchildren: The Salt and Other Nutrients in Children (SONIC) Study Protocol

    PubMed Central

    Baxter, Janet R; Campbell, Karen J; Riddell, Lynn J; Rigo, Manuela; Liem, Djin Gie; Keast, Russell S; He, Feng J; Nowson, Caryl A

    2015-01-01

    Background Dietary sodium and potassium are involved in the pathogenesis of cardiovascular disease. Data exploring the cardiovascular outcomes associated with these electrolytes within Australian children is sparse. Furthermore, an objective measure of sodium and potassium intake within this group is lacking. Objective The primary aim of the Salt and Other Nutrient Intakes in Children (“SONIC”) study was to measure sodium and potassium intakes in a sample of primary schoolchildren located in Victoria, Australia, using 24-hour urine collections. Secondary aims were to identify the dietary sources of sodium and potassium, examine the association between these electrolytes and cardiovascular risk factors, and assess children’s taste preferences and saltiness perception of manufactured foods. Methods A cross-sectional study was conducted in a convenience sample of schoolchildren attending primary schools in Victoria, Australia. Participants completed one 24-hour urine collection, which was analyzed for sodium, potassium, and creatinine. Completeness of collections was assessed using collection time, total volume, and urinary creatinine. One 24-hour dietary recall was completed to assess dietary intake. Other data collected included blood pressure, body weight, height, waist and hip circumference. Children were also presented with high and low sodium variants of food products and asked to discriminate salt level and choose their preferred variant. Parents provided demographic information and information on use of discretionary salt. Descriptive statistics will be used to describe sodium and potassium intakes. Linear and logistic regression models with clustered robust standard errors will be used to assess the association between electrolyte intake and health outcomes (blood pressure and body mass index/BMI z-score and waist circumference) and to assess differences in taste preference and discrimination between high and low sodium foods, and correlations between

  13. Reduced effect of percutaneous renal denervation on blood pressure in patients with isolated systolic hypertension.

    PubMed

    Ewen, Sebastian; Ukena, Christian; Linz, Dominik; Kindermann, Ingrid; Cremers, Bodo; Laufs, Ulrich; Wagenpfeil, Stefan; Schmieder, Roland E; Böhm, Michael; Mahfoud, Felix

    2015-01-01

    Renal denervation can reduce blood pressure in certain patients with resistant hypertension. The effect in patients with isolated systolic hypertension (ISH, ≥140/<90 mm Hg) is unknown. This study investigated the effects of renal denervation in 126 patients divided into 63 patients with ISH and 63 patients with combined hypertension (CH, ≥140/≥90 mm Hg) defined as baseline office systolic blood pressure (SBP) ≥140 mm Hg despite treatment with ≥3 antihypertensive agents. Renal denervation significantly reduced office SBP and diastolic blood pressure (DBP) at 3, 6, and 12 months by 17/18/17 and 5/4/4 mm Hg in ISH and by 28/27/30 and 13/16/18 mm Hg in CH, respectively. The reduction in SBP and DBP in ISH was lower compared with patients with CH at all observed time points (P<0.05 for SBP/DBP intergroup comparison). The nonresponder rate (change in office SBP <10 mm Hg) after 6 months was 37% in ISH and 21% in CH (P<0.001). Mean 24-hour ambulatory SBP and DBP after 3, 6, and 12 months were significantly reduced by 10/13/15 and 6/6/9 mm Hg in CH, respectively. In patients with ISH the reduction in systolic ambulatory blood pressure was 4/8/7 mm Hg (P=0.032/P<0.001/P=0.009) and 3/4/2 mm Hg (P=0.08/P<0.001/P=0.130) in diastolic ambulatory blood pressure after 3, 6, and 12 months, respectively. The ambulatory blood pressure reduction was significantly lower after 3 and 12 months in SBP and after 12 months in ambulatory DBP, respectively. In conclusion, renal denervation reduces office and ambulatory blood pressure in patients with ISH. However, this reduction is less pronounced compared with patients with CH.

  14. Isolated Systolic Hypertension in Young and Middle-Aged Adults.

    PubMed

    Yano, Yuichiro; Lloyd-Jones, Donald M

    2016-11-01

    Young and middle-aged adults (ages ≤50 years) are increasingly prone to stroke, kidney disease, and worsening cardiovascular disease (CVD) mortality. An alarming increase in the prevalence of high blood pressure (BP) may underlie the adverse trend. However, there is often uncertainty in BP management for young and middle-aged adults. Isolated systolic hypertension (ISH) is one such example. Whether ISH in young and middle-aged adults represents "pseudo" or "spurious" hypertension is still being debated. ISH in young and middle-aged adults is a heterogeneous entity; some individuals appear to have increased stroke volume, whereas others have stiffened aortae, or both. One size does not seem to fit all in the clinical management of ISH in young and middle-aged adults. Rather than treating ISH as a monolithic condition, detailed phenotyping of ISH based on (patho)physiology and in the context of individual global cardiovascular risks would seem to be most useful to assess an individual expected net benefit from therapy. This review provides an overview of the current understanding of ISH in young and middle-aged adults, including the prevalence, pathophysiology, and treatment.

  15. [The influence of citoflavin on molecular mechanisms of hypertensive encephalopathy development in patients with systolic arterial hypertension].

    PubMed

    Kartashova, E A; Romantsov, M G; Sarvilina, I V

    2014-01-01

    The molecular pharmacological effects of cytoflavin in patients with hypertensive encephalopathy (HE) and isolated systolic arterial hypertension (ISAH) have been investigated using the following methods: assessment of complaints, 24-hour arterial pressure monitoring, ultrasound diagnostics including echocardiography, measurement of lipid profiles and coagulograms, and molecular phenotyping by MALDI-TOF/TOF-MS. A combination of cytoflavin administration with standard therapy of HE and ISAH led to the most expressed return development of clinical symptoms, restoration of the hemodynamic, structural, and geometrical parameters of cardiovascular system, and normalization of the indices of lipid profiles and coagulograms in comparison to patients with HE and ISAH, which accepted only standard therapy. Molecular mechanisms of cytoflavin action have been revealed, which include control of the activity of cellular signaling pathways by means of intermolecular interactions. The optimized therapy of HE and ISAH is recommended for clinical application, which assumes a combined use of standard therapy and cytoflavin and provides a geroprotective action upon the cardiovascular system.

  16. Azilsartan medoxomil plus chlorthalidone reduces blood pressure more effectively than olmesartan plus hydrochlorothiazide in stage 2 systolic hypertension.

    PubMed

    Cushman, William C; Bakris, George L; White, William B; Weber, Michael A; Sica, Domenic; Roberts, Andrew; Lloyd, Eric; Kupfer, Stuart

    2012-08-01

    Azilsartan medoxomil, an effective, long-acting angiotensin II receptor blocker, is a new treatment for hypertension that is also being developed in fixed-dose combinations with chlorthalidone, a potent, long-acting thiazide-like diuretic. We compared once-daily fixed-dose combinations of azilsartan medoxomil/chlorthalidone force titrated to a high dose of either 40/25 mg or 80/25 mg with a fixed-dose combination of the angiotensin II receptor blocker olmesartan medoxomil plus the thiazide diuretic hydrochlorothiazide force titrated to 40/25 mg. The design was a randomized, 3-arm, double-blind, 12-week study of 1071 participants with baseline clinic systolic blood pressure 160 to 190 mm Hg and diastolic blood pressure ≤119 mm Hg. Patients had a mean age of 57 years; 59% were men, 73% were white, and 22% were black. At baseline, mean clinic blood pressure was 165/96 mm Hg and 24-hour mean blood pressure was 150/88 mm Hg. Changes in clinic (primary end point) and ambulatory systolic blood pressures at week 12 were significantly greater in both azilsartan medoxomil/chlorthalidone arms than in the olmesartan/hydrochlorothiazide arm (P<0.001). Changes in clinic systolic blood pressure (mean±SE) were -42.5±0.8, -44.0±0.8, and -37.1±0.8 mm Hg, respectively. Changes in 24-hour ambulatory systolic blood pressure were -33.9±0.8, -36.3±0.8, and -27.5±0.8 mm Hg, respectively. Adverse events leading to permanent drug discontinuation occurred in 7.9%, 14.5%, and 7.1% of the groups given azilsartan medoxomil/chlorthalidone 40/25 mg, azilsartan medoxomil/chlorthalidone 80/25 mg, and olmesartan/hydrochlorothiazide 40/25 mg, respectively. This large, forced-titration study has demonstrated superior antihypertensive efficacy of azilsartan medoxomil/chlorthalidone fixed-dose combinations compared with the maximum approved dose of olmesartan/hydrochlorothiazide.

  17. Elevated BP after AKI.

    PubMed

    Hsu, Chi-yuan; Hsu, Raymond K; Yang, Jingrong; Ordonez, Juan D; Zheng, Sijie; Go, Alan S

    2016-03-01

    The connection between AKI and BP elevation is unclear. We conducted a retrospective cohort study to evaluate whether AKI in the hospital is independently associated with BP elevation during the first 2 years after discharge among previously normotensive adults. We studied adult members of Kaiser Permanente Northern California, a large integrated health care delivery system, who were hospitalized between 2008 and 2011, had available preadmission serum creatinine and BP measures, and were not known to be hypertensive or have BP>140/90 mmHg. Among 43,611 eligible patients, 2451 experienced AKI defined using observed changes in serum creatinine concentration measured during hospitalization. Survivors of AKI were more likely than those without AKI to have elevated BP--defined as documented BP>140/90 mmHg measured during an ambulatory, nonemergency department visit--during follow-up (46.1% versus 41.2% at 730 days; P<0.001). This difference was evident within the first 180 days (30.6% versus 23.1%; P<0.001). In multivariable models, AKI was independently associated with a 22% (95% confidence interval, 12% to 33%) increase in the odds of developing elevated BP during follow-up, with higher adjusted odds with more severe AKI. Results were similar in sensitivity analyses when elevated BP was defined as having at least two BP readings of >140/90 mmHg or those with evidence of CKD were excluded. We conclude that AKI is an independent risk factor for subsequent development of elevated BP. Preventing AKI during a hospitalization may have clinical and public health benefits beyond the immediate hospitalization.

  18. Elevated BP after AKI

    PubMed Central

    Hsu, Raymond K.; Yang, Jingrong; Ordonez, Juan D.; Zheng, Sijie; Go, Alan S.

    2016-01-01

    The connection between AKI and BP elevation is unclear. We conducted a retrospective cohort study to evaluate whether AKI in the hospital is independently associated with BP elevation during the first 2 years after discharge among previously normotensive adults. We studied adult members of Kaiser Permanente Northern California, a large integrated health care delivery system, who were hospitalized between 2008 and 2011, had available preadmission serum creatinine and BP measures, and were not known to be hypertensive or have BP>140/90 mmHg. Among 43,611 eligible patients, 2451 experienced AKI defined using observed changes in serum creatinine concentration measured during hospitalization. Survivors of AKI were more likely than those without AKI to have elevated BP—defined as documented BP>140/90 mmHg measured during an ambulatory, nonemergency department visit—during follow-up (46.1% versus 41.2% at 730 days; P<0.001). This difference was evident within the first 180 days (30.6% versus 23.1%; P<0.001). In multivariable models, AKI was independently associated with a 22% (95% confidence interval, 12% to 33%) increase in the odds of developing elevated BP during follow-up, with higher adjusted odds with more severe AKI. Results were similar in sensitivity analyses when elevated BP was defined as having at least two BP readings of >140/90 mmHg or those with evidence of CKD were excluded. We conclude that AKI is an independent risk factor for subsequent development of elevated BP. Preventing AKI during a hospitalization may have clinical and public health benefits beyond the immediate hospitalization. PMID:26134154

  19. Medication adherence and visit-to-visit variability of systolic blood pressure in African Americans with chronic kidney disease in the AASK trial.

    PubMed

    Hong, K; Muntner, P; Kronish, I; Shilane, D; Chang, T I

    2016-01-01

    Lower adherence to antihypertensive medications may increase visit-to-visit variability of blood pressure (VVV of BP), a risk factor for cardiovascular events and death. We used data from the African American Study of Kidney Disease and Hypertension (AASK) trial to examine whether lower medication adherence is associated with higher systolic VVV of BP in African Americans with hypertensive chronic kidney disease (CKD). Determinants of VVV of BP were also explored. AASK participants (n=988) were categorized by self-report or pill count as having perfect (100%), moderately high (75-99%), moderately low (50-74%) or low (<50%) proportion of study visits with high medication adherence over a 1-year follow-up period. We used multinomial logistic regression to examine determinants of medication adherence, and multivariable-adjusted linear regression to examine the association between medication adherence and systolic VVV of BP, defined as the coefficient of variation or the average real variability (ARV). Participants with lower self-reported adherence were generally younger and had a higher prevalence of comorbid conditions. Compared with perfect adherence, moderately high, moderately low and low adherence was associated with 0.65% (±0.31%), 0.99% (±0.31%) and 1.29% (±0.32%) higher systolic VVV of BP (defined as the coefficient of variation) in fully adjusted models. Results were qualitatively similar when using ARV or when using pill counts as the measure of adherence. Lower medication adherence is associated with higher systolic VVV of BP in African Americans with hypertensive CKD; efforts to improve medication adherence in this population may reduce systolic VVV of BP.

  20. Does Systolic Blood Pressure Response to Lifestyle Intervention Indicate Metabolic Risk and Health-Related Quality-of-Life Improvement Over 1 Year?

    PubMed

    Stuckey, Melanie I; Gill, Dawn P; Petrella, Robert J

    2015-05-01

    The purpose of this study was to determine whether responders (minimum 4-mm Hg reduction of systolic blood pressure [BP]) at 24 weeks) to a 52-week lifestyle intervention had greater changes in metabolic risk factors and health-related quality of life than nonresponders. Participants (N=126; age, 57.4 [9.1] years) had waist circumference (WC), resting BP, glycated hemoglobin, lipids, and fitness assessed at baseline and at 12, 24, and 52 months. The 36-item short-form survey was administered to assess HRQOL. At baseline, responders had higher mental health scores (P=.04) and systolic and diastolic BPs (P<.001) than nonresponders. Across 52 weeks, responders also had greater improvements in diastolic BP (P<.001), WC (P=.01), and maximal oxygen uptake (P=.04) compared with nonresponders. Participants with clinically important changes in systolic BP at 24 weeks had greater metabolic improvements across 52 weeks, compared with those without clinically important systolic BP changes.

  1. Comparison of thrombolysis in myocardial infarction, Global Registry of Acute Coronary Events, and Acute Physiology and Chronic Health Evaluation II risk scores in patients with acute myocardial infarction who require mechanical ventilation for more than 24 hours.

    PubMed

    Eran, Oren; Novack, Victor; Gilutz, Harel; Zahger, Doron

    2011-02-01

    The ability to provide an accurate prognosis in an intensive care unit is of major importance. Numerous risk scores have been developed to predict hospital mortality based on demographic, physiologic, and clinical data. These scores were universally developed in general medical or surgical intensive care units. Patients admitted to a cardiac care unit differ in many aspects from those admitted to general medical intensive care units. Few patients require mechanical ventilation and prolonged intensive care. Performance of risk scores developed for patients with acute myocardial infarction (AMI) in this subgroup is unknown. We prospectively studied 51 consecutive patients who were admitted to a cardiac care unit from September 2006 to March 2008 for AMI and received mechanical ventilation for >24 hours. Acute Physiology and Chronic Health Evaluation II (APACHE II), Thrombolysis In Myocardial Infarction, and Global Registry of Acute Coronary Events risk scores were calculated for each patient. Mortality rates were extrapolated based on these 3 risk scores. Twenty-two of 51 patients (43%) died in hospital. Age, mean arterial pressure, urea, albumin, hemoglobin, need for vasopressors, and estimated glomerular filtration rate were predictive of mortality. APACHE II and Global Registry of Acute Coronary Events scores were higher in nonsurvivors but Thrombolysis In Myocardial Infarction risk score was not predictive of mortality. APACHE II score had the highest value for area under receiver operator characteristics curve for mortality prediction. In conclusion, patients with AMI requiring mechanical ventilation have a high mortality rate. This risk is predicted by co-morbidities better than by direct cardiac parameters. Consequently, conventional AMI risk scores do not perform well in this very sick population and the APACHE II score better predicts their short-term outcome.

  2. Baseline Characteristics of African Americans in the Systolic Blood Pressure Intervention Trial (SPRINT)

    PubMed Central

    Still, Carolyn H.; Craven, Timothy E.; Freedman, Barry I.; Van Buren, Peter; Sink, Kaycee M.; Killeen, Anthony A.; Bates, Jeffrey T.; Bee, Alberta; Contreras, Gabriel; Oparil, Suzanne; Pedley, Carolyn; Wall, Barry; White, Suzanne; Woods, Delia; Rodriguez, Carlos; Wright, Jackson T.

    2015-01-01

    The Systolic Blood Pressure Intervention Trial (SPRINT) will compare treatment to a systolic blood pressure goal of <120 mmHg to treatment to the currently recommended goal of <140 mmHg for effects on incident cardiovascular, renal, and neurologic outcomes including cognitive decline. Objectives The objectives of this analysis are to compare baseline characteristics of African American (AA) and non-AA SPRINT participants and explore factors associated with uncontrolled blood pressure (BP) by race. Methods SPRINT enrolled 9,361 hypertensive participants over age 50. This cross-sectional analysis examines sociodemographics, baseline characteristics, and study measures among AAs compared to non-AAs. Results AAs made up 31% of participants. AAs (compared to non-AAs) were younger and less frequently male, had less education, and were more likely uninsured or covered by Medicaid. In addition, AAs scored lower on the cognitive screening test when compared to non-AAs. Multivariable logistic regression analysis found BP control rates to <140/90 mmHg were higher for AAs who were male, had higher number of chronic diseases, were on diuretic treatment, and had better medication adherence. Conclusion SPRINT is well poised to examine the effects of SBP targets on clinical outcomes as well as predictors influencing BP control in AAs. PMID:26320890

  3. Central Systolic Hypertension in Patients with Well-Controlled Hypertension

    PubMed Central

    Potočárová, Mária; Murín, Ján; Kozlíková, Katarína; Luha, Ján; Čaprnda, Martin

    2017-01-01

    Background. Central systolic blood pressure (CSBP) has prognostic significance and simplified devices for its estimation have been introduced recently. The aim of this study was to assess the achievement of the target CSBP in treated hypertensive patients. Subjects and Methods. One hundred patients with well-controlled hypertension were analysed. For CSBP estimation, we used the Arteriograph (TensioMed Ltd.), which uses one cuff for all measurements, the “single-point measurement” approach. Results. We found that 62% of patients had CSBP ≥ 130 mmHg, the suggested cut-off value for hypertension. When sex-specific classification was employed (CSBP ≥ 137 mmHg for female and CSBP ≥ 133 mmHg for male), only 13% of patients (mainly women) remained in the hypertensive range. We also found that 55% of patients had a CSBP higher than brachial pressure. Multiple analyses showed that CSBP was significantly associated with sex, height, and return time. Conclusions. A high proportion of treated hypertensive patients had CSBP levels that exceeded their brachial BP. CSBP positively correlated with lower height and shorter return time of the reflected pressure wave and was significantly higher in females compared to males. These findings suggest that, for CSBP classification, it is important to take height and sex-specific differences into account. PMID:28127560

  4. BP, cardiovascular disease, and death in the Folic Acid for Vascular Outcome Reduction in Transplantation trial.

    PubMed

    Carpenter, Myra A; John, Alin; Weir, Matthew R; Smith, Stephen R; Hunsicker, Lawrence; Kasiske, Bertram L; Kusek, John W; Bostom, Andrew; Ivanova, Anastasia; Levey, Andrew S; Solomon, Scott; Pesavento, Todd; Weiner, Daniel E

    2014-07-01

    The optimal BP level in kidney transplant recipients remains uncertain. This post hoc analysis of the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) trial cohort assessed associations of BP with a pooled cardiovascular disease (CVD) outcome and with all-cause mortality. In 3474 prevalent kidney transplant patients, mean age was 52±9 years, 63% were men, 76% were white, 20% had a history of CVD, 40% had a history of diabetes mellitus, and the median time since transplant was 4.1 years (25th to 75th percentiles, 1.7-7.4); mean systolic BP was 136±20 mmHg and mean diastolic BP was 79±12 mmHg. There were 497 CVD events and 406 deaths. After adjustment for demographic and transplant characteristics and CVD risk factors, each 20-mmHg increase in baseline systolic BP associated with a 32% increase in subsequent CVD risk (hazard ratio [HR], 1.32; 95% confidence interval [95% CI], 1.19 to 1.46) and a 13% increase in mortality risk (HR, 1.13; 95% CI, 1.01 to 1.27). Similarly, after adjustment, at diastolic BP levels<70 mmHg, each 10-mmHg decrease in diastolic BP level associated with a 31% increase in CVD risk (HR, 1.31; 95% CI, 1.06 to 1.62) and a 31% increase in mortality risk (HR, 1.31; 95% CI, 1.03 to 1.66). However, at diastolic BP levels>70 mmHg, there was no significant relationship between diastolic BP and outcomes. Higher systolic BP strongly and independently associated with increased risk of CVD and all-cause mortality, without evidence of a J shape, whereas only lower levels of diastolic BP associated with increased risk of CVD and death in this trial.

  5. How many clinic BP readings are needed to predict cardiovascular events as accurately as ambulatory BP monitoring?

    PubMed

    Eguchi, K; Hoshide, S; Shimada, K; Kario, K

    2014-12-01

    We tested the hypothesis that multiple clinic blood pressure (BP) readings over an extended baseline period would be as predictive as ambulatory BP (ABP) for cardiovascular disease (CVD). Clinic and ABP monitoring were performed in 457 hypertensive patients at baseline. Clinic BP was measured monthly and the means of the first 3, 5 and 10 clinic BP readings were taken as the multiple clinic BP readings. The subjects were followed up, and stroke, HARD CVD, and ALL CVD events were determined as outcomes. In multivariate Cox regression analyses, ambulatory systolic BP (SBP) best predicted three outcomes independently of baseline and multiple clinic SBP readings. The mean of 10 clinic SBP readings predicted stroke (hazards ratio (HR)=1.39, 95% confidence interval (CI)=1.02-1.90, P=0.04) and ALL CVD (HR=1.41, 95% CI=1.13-1.74, P=0.002) independently of baseline clinic SBP. Clinic SBPs by three and five readings were not associated with any CVD events, except that clinic SBP by three readings was associated with ALL CVD (P=0.015). Besides ABP values, the mean of the first 10 clinic SBP values was a significant predictor of stroke and ALL CVD events. It is important to take more than several clinic BP readings early after the baseline period for the risk stratification of future CVD events.

  6. Temporal Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells at 0.5, 1.0, 3.0, 6.0, 12 and 24 Hours Post-Exposure to 1064 nm, 3.6 ns Pulsed Laser Light

    DTIC Science & Technology

    2005-05-01

    USAFA TR 2005-05 Temporal Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells at 0.5, 1.0, 3.0, 6.0, 12 and 24 Hours...AIR FORCE ACADEMY COLORADO 80840 20050630 417 USAFA TR 2005-05 This article, "Temporal Differential Gene Expression in Explanted Human Retinal ...Differential Gene Expression in Explanted Human Retinal Pigment USAFA F05611-02-P-0471 Epithelial Cells at 0.5, 1.0, 3.0, 6.0, 12 and 24-Hours Post-Exposure

  7. The Preoperative Patient With a Systolic Murmur

    PubMed Central

    Cowie, Brian

    2015-01-01

    Context: Patients with undifferentiated systolic murmurs present commonly during the perioperative period. Traditional bedside assessment and auscultation has not changed significantly in almost 200 years and relies on interpreting indirect acoustic events as a means of evaluating underlying cardiac pathology. This is notoriously inaccurate, even in expert cardiology hands, since many different valvular and cardiac diseases present with a similar auditory signal. Evidence Acquisition: The data on systolic murmurs, physical examination, perioperative valvular disease in the setting of non-cardiac surgery is reviewed. Results: Significant valvular heart disease increases perioperative risk in major non-cardiac surgery and increases long term patient morbidity and mortality. We propose a more modern approach to physical examination that incorporates the use of focused echocardiography to allow direct visualization of cardiac structure and function. This improves the diagnostic accuracy of clinical assessment, allows rational planning of surgery and anaesthesia technique, risk stratification, postoperative monitoring and appropriate referral to physicians and cardiologists. Conclusions: With a thorough preoperative assessment incorporating focused echocardiography, anaesthetists are in the unique position to enhance their role as perioperative physicians and influence short and long term outcomes of their patients. PMID:26705529

  8. 78 FR 60270 - BP America Inc., BP Corporation North America Inc., BP America Production Company, and BP Energy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission BP America Inc., BP Corporation North America Inc., BP America Production Company, and BP Energy Company; Notice of Designation of Commission Staff as Non-Decisional With respect to an order issued by the Commission...

  9. Isolated Systolic Hypertension in Young and Middle-Aged Adults and 31-Year Risk for Cardiovascular Mortality

    PubMed Central

    Yano, Yuichiro; Stamler, Jeremiah; Garside, Daniel B.; Daviglus, Martha L.; Franklin, Stanley S.; Carnethon, Mercedes R.; Liu, Kiang; Greenland, Philip; Lloyd-Jones, Donald M.

    2016-01-01

    BACKGROUND Isolated systolic hypertension (ISH), defined as systolic blood pressure (SBP) ≥140 mm Hg and diastolic blood pressure (DBP) <90 mm Hg, in younger and middle-aged adults is increasing in prevalence. OBJECTIVE The aim of this study was to assess the risk for cardiovascular disease (CVD) with ISH in younger and middle-aged adults. METHODS CVD risks were explored in 15,868 men and 11,213 women 18 to 49 years of age (mean age 34 years) at baseline, 85% non-Hispanic white, free of coronary heart disease (CHD) and antihypertensive therapy, from the Chicago Heart Association Detection Project in Industry study. Participant classifications were as follows: 1) optimal-normal blood pressure (BP) (SBP <130 mm Hg and DBP <85 mm Hg); 2) high-normal BP (130 to 139/85 to 89 mm Hg); 3) ISH; 4) isolated diastolic hypertension (SBP <140 mm Hg and DBP ≥90 mm Hg); and 5) systolic diastolic hypertension (SBP ≥140 mm Hg and DBP ≥90 mm Hg). RESULTS During a 31-year average follow-up period (842,600 person-years), there were 1,728 deaths from CVD, 1,168 from CHD, and 223 from stroke. Cox proportional hazards models were adjusted for age, race, education, body mass index, current smoking, total cholesterol, and diabetes. In men, with optimal-normal BP as the reference stratum, hazard ratios for CVD and CHD mortality risk for those with ISH were 1.23 (95% confidence interval [CI]: 1.03 to 1.46) and 1.28 (95% CI: 1.04 to 1.58), respectively. ISH risks were similar to those with high-normal BP and less than those associated with isolated diastolic hypertension and systolic diastolic hypertension. In women with ISH, hazard ratios for CVD and CHD mortality risk were 1.55 (95% CI: 1.18 to 2.05) and 2.12 (95% CI: 1.49 to 3.01), respectively. ISH risks were higher than in those with high-normal BP or isolated diastolic hypertension and less than those associated with systolic diastolic hypertension. CONCLUSIONS Over long-term follow-up, younger and middle-aged adults with ISH

  10. A Logical Characterization of Systolic Languages

    NASA Astrophysics Data System (ADS)

    Monti, Angelo; Peron, Adriano

    In this paper we study, in the framework of mathematical logic, ℒ(SBTA) i.e. the class of languages accepted by Systolic Binary Tree Automata. We set a correspondence (in the style of Büchi Theorem for regular languages) between ℒ(SBTA) and MSO[Sig], i.e. a decidable Monadic Second Order logic over a suitable infinite signature Sig. We also introduce a natural subclass of ℒ(SBTA) which still properly contains the class of regular languages and which is proved to be characterized by Monadic Second Order logic over a finite signature Sig' ⊂ Sig. Finally, in the style of McNaughton Theorem for star free regular languages, we introduce an expression language which precisely denotes the class of languages defined by the first order fragment of MSO[Sig'].

  11. Singular value decomposition with systolic arrays

    NASA Technical Reports Server (NTRS)

    Ipsen, I. C. F.

    1984-01-01

    Systolic arrays for determining the singular value decomposition of a mxn, m n, matrix A of bandwidth w are presented. After A has been reduced to bidiagonal form B by means of Givens plane rotations, the singular values of B are computed by the Golub-Reinsch iteration. The products of plane rotations form the matrices of left and right singular vectors. Assuming each processor can compute or supply a plane rotation, O(wn) processors accomplish the reduction to bidiagonal form in O(np) steps, where p is the number of superdiagonals. A constant number of processors then determines each singular value in about 6n steps. The singular vectors are computed by rerouting the rotations through the arrays used for the reduction to bidiagonal form, or else along the way by employing another rectangular array of O(wm) processors.

  12. Blood pressure (BP) assessment-from BP level to BP variability.

    PubMed

    Feber, Janusz; Litwin, Mieczyslaw

    2016-07-01

    The assessment of blood pressure (BP) can be challenging in children, especially in very young individuals, due to their variable body size and lack of cooperation. In the absence of data relating BP with cardiovascular outcomes in children, there is a need to convert absolute BP values (in mmHg) into age-, gender- and height appropriate BP percentiles or Z-scores in order to compare a patient's BP with the BP of healthy children of the same age, but also of children of different ages. Traditionally, the interpretation of BP has been based mainly on the assessment of the BP level obtained by office, home or 24-h BP monitoring. Recent studies suggest that it is not only BP level (i.e. average BP) but also BP variability that is clinically important for the development of target organ damage, including the progression of chronic kidney disease. In this review we describe current methods to evaluate of BP level, outline available methods for BP variability assessment and discuss the clinical consequences of BP variability, including its potential role in the management of hypertension.

  13. Differences in central systolic blood pressure and aortic stiffness between aerobically trained and sedentary individuals.

    PubMed

    Laurent, Pierre; Marenco, Patrice; Castagna, Olivier; Smulyan, Harold; Blacher, Jacques; Safar, Michel E

    2011-01-01

    The purpose of this study was to evaluate central (carotid) artery blood pressure (BP) in endurance athletes. Carotid-femoral (= aortic) pulse wave velocity (PWV) together with radial and carotid tonometry and pulse wave analysis were performed at rest in 30 endurance athletes and 30 sedentary controls, all males matched for age, height, brachial systolic BP (SBP), and diastolic BP. Whereas brachial BP was similar in the two groups, carotid SBP and pulse pressure (PP) were higher in endurance athletes than in controls irrespective of age (123.1 ± 2.17 vs. 110.2 ± 1.29 mm Hg, and 50.9 ± 1.95 vs. 34.1 ± 1.01 mm Hg; P < .0001 for both). PP amplification evaluated from the brachial/carotid PP ratio was lower in athletes than in controls (1.05 ± 0.04 vs. 1.40 ± 0.02; P < .0001). When compared with controls, athletes had lower PWV (7.81 ± 0.17 vs. 9.8 ± 0.23 m/second; P < .0001), higher reflected wave transit time/left ventricular ejection time ratio (P = .02), and lower heart rate (52.03 ± 1.54 vs. 68.9 ± 1.72 beats/minute; P < .0001). When matched for brachial BP, central SBP and PP were higher in endurance athletes than in sedentary controls. The possible negative pathophysiological impact of increased central BP on the overall favorable effects of training deserves further study.

  14. Recursive least squares estimation and Kalman filtering by systolic arrays

    NASA Technical Reports Server (NTRS)

    Chen, M. J.; Yao, K.

    1988-01-01

    One of the most promising new directions for high-throughput-rate problems is that based on systolic arrays. In this paper, using the matrix-decomposition approach, a systolic Kalman filter is formulated as a modified square-root information filter consisting of a whitening filter followed by a simple least-squares operation based on the systolic QR algorithm. By proper skewing of the input data, a fully pipelined time and measurement update systolic Kalman filter can be achieved with O(n squared) processing cells, resulting in a system throughput rate of O (n).

  15. L-NAME raises systolic blood pressure in the pithed rat by a direct adrenal epinephrine releasing action.

    PubMed

    Elayan, Hamzeh H; Kennedy, Brian P; Ziegler, Michael G

    2002-04-21

    It is generally thought that inhibition of nitric oxide synthase leads to blood pressure elevation largely through reduction in vascular levels of the vasodilator nitric oxide. However, there are several reports suggesting that NO synthase inhibitors cause adrenal epinephrine (E) release by both central and peripheral mechanisms. We investigated the role of adrenal E in the pressor effects of the nitric oxide synthase inhibitor L-NAME in the pithed rat to help distinguish central from peripherally mediated actions. L-NAME (10 mg/kg) raised both systolic and diastolic BP by about 30 mm Hg (P < .01) in the absence of exogenous electrical stimulation of sympathetic nerves. During stimulation at 10 V and frequencies of 1 or 2 Hz, systolic BP was about 70 mm Hg higher in L-NAME treated rats than in drug free stimulated rats. This enhancement of systolic BP by L-NAME was less pronounced at 5 or 10 Hz stimulation frequencies. Following these types of electrical stimulations of pithed rats, both plasma norepinephrine (NE) and E levels were dramatically elevated above resting plasma levels. L-NAME pretreatment of these electrically stimulated rats increased plasma E levels by an additional 60% and decreased NE by 18%. Acute adrenalectomy dramatically reduced plasma E levels and abolished the ability of L-NAME to enhance the pressor effect of sympathetic stimulation. In contrast, acute adrenalectomy of unstimulated pithed rats did not significantly reduce the pressor response to L-NAME. We conclude that adrenal E release may mediate much of the systolic pressor response of L-NAME in the stimulated pithed rat, but the magnitude of this effect varies with stimulation frequency. Since pithing disrupts central pathways, this induction of adrenal E release by L-NAME is a peripheral effect.

  16. Nesfatin-1 and Vitamin D levels may be associated with systolic and diastolic blood pressure values and hearth rate in polycystic ovary syndrome.

    PubMed

    Sahin, Figen Kir; Sahin, Serap Baydur; Ural, Ulku Mete; Cure, Medine Cumhur; Senturk, Senol; Tekin, Yesim Bayoglu; Balik, Gulsah; Cure, Erkan; Yuce, Suleyman; Kirbas, Aynur

    2015-07-09

    Obesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR).This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS) were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram.The levels of N1 (p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (p = 0.036), homeostasis model assessment as an index of insulin resistance (HOMA-IR) (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) BP and HR (p < 0.001) in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004). N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone.Elevated N1 and decreased VD levels may be related to the presence of high-normal BP or hypertension in PCOS subjects.  N1 level may be associated with an increased BP due to its relation to inflammation and IR.

  17. Nesfatin-1 and Vitamin D levels may be associated with systolic and diastolic blood pressure values and hearth rate in polycystic ovary syndrome

    PubMed Central

    Sahin, Figen Kir; Sahin, Serap Baydur; Ural, Ulku Mete; Cure, Medine Cumhur; Senturk, Senol; Tekin, Yesim Bayoglu; Balik, Gulsah; Cure, Erkan; Yuce, Suleyman; Kirbas, Aynur

    2015-01-01

    Obesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR). This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS) were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram. The levels of N1 (p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (p = 0.036), homeostasis model assessment as an index of insulin resistance (HOMA-IR) (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) BP and HR (p < 0.001) in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004). N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone. Elevated N1 and decreased VD levels may be related to the presence of high-normal BP or hypertension in PCOS subjects. N1 level may be associated with an increased BP due to its relation to inflammation and IR. PMID:26295295

  18. BP control and left ventricular hypertrophy regression in children with CKD.

    PubMed

    Kupferman, Juan C; Aronson Friedman, Lisa; Cox, Christopher; Flynn, Joseph; Furth, Susan; Warady, Bradley; Mitsnefes, Mark

    2014-01-01

    In adult patients with CKD, hypertension is linked to the development of left ventricular hypertrophy, but whether this association exists in children with CKD has not been determined conclusively. To assess the relationship between BP and left ventricular hypertrophy, we prospectively analyzed data from the Chronic Kidney Disease in Children cohort. In total, 478 subjects were enrolled, and 435, 321, and 142 subjects remained enrolled at years 1, 3, and 5, respectively. Echocardiograms were obtained 1 year after study entry and then every 2 years; BP was measured annually. A linear mixed model was used to assess the effect of BP on left ventricular mass index, which was measured at three different visits, and a mixed logistic model was used to assess left ventricular hypertrophy. These models were part of a joint longitudinal and survival model to adjust for informative dropout. Predictors of left ventricular mass index included systolic BP, anemia, and use of antihypertensive medications other than angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Predictors of left ventricular hypertrophy included systolic BP, female sex, anemia, and use of other antihypertensive medications. Over 4 years, the adjusted prevalence of left ventricular hypertrophy decreased from 15.3% to 12.6% in a systolic BP model and from 15.1% to 12.6% in a diastolic BP model. These results indicate that a decline in BP may predict a decline in left ventricular hypertrophy in children with CKD and suggest additional factors that warrant additional investigation as predictors of left ventricular hypertrophy in these patients.

  19. Galectin-3 Reflects Mitral Annular Plane Systolic Excursion Being Assessed by Cardiovascular Magnetic Resonance Imaging

    PubMed Central

    Kim, Seung-Hyun; Natale, Michele; Hoffmann, Julia; Reckord, Nadine; Hoffmann, Ursula; Budjan, Johannes; Henzler, Thomas; Papavassiliu, Theano; Borggrefe, Martin; Bertsch, Thomas; Akin, Ibrahim

    2016-01-01

    Background. This study investigates whether serum levels of galectin-3 may reflect impaired mitral annular plane systolic excursion (MAPSE) in patients undergoing cardiac magnetic resonance imaging (cMRI). Methods. Patients undergoing cMRI during routine clinical care were included prospectively within an all-comers design. Blood samples for biomarker measurements were collected within 24 hours following cMRI. Statistical analyses were performed in all patients and in three subgroups according to MAPSE (MAPSE I: ≥11 mm, MAPSE II: ≥8 mm–<11 mm, and MAPSE III: <8 mm). Patients with right ventricular dysfunction (<50%) were excluded. Results. 84 patients were included in the study. Median LVEF was 59% (IQR 51–64%). Galectin-3 correlated significantly with NT-proBNP (r = 0.42, p = 0.0001). Galectin-3 increased significantly according to the different stages of impaired MAPSE (p = 0.006) and was able to discriminate both patients with impaired MAPSE <11 mm (area under the curve (AUC) = 0.645, p = 0.024) and <8 mm (AUC = 0.733, p = 0.003). Combining galectin-3 with NT-proBNP improved discrimination of MAPSE <8 mm (AUC 0.803, p = 0.0001). In multivariable logistic regression models galectin-3 was still associated with impaired MAPSE (MAPSE < 11 mm: odds ratio (OR) = 3.53, p = 0.018; MAPSE < 8 mm: OR = 3.18, p = 0.06). Conclusions. Galectin-3 reflects MAPSE being assessed by cardiac MRI. PMID:28044067

  20. Efficient algorithm and systolic architecture for modular division

    NASA Astrophysics Data System (ADS)

    Chen, Chuanpeng; Qin, Zhongping

    2011-06-01

    A new efficient modular division algorithm suitable for systolic implementation and its systolic architecture is proposed in this article. With a new exit condition of while loop and a new updating method of a control variable, the new algorithm reduces the average of iteration numbers by more than 14.3% compared to the algorithm proposed by Chen, Bai and Chen. Based on the new algorithm, we design a fast systolic architecture with an optimised core computing cell. Compared to the architecture proposed by Chen, Bai and Chen, our systolic architecture has reduced the critical path delay by about 18% and the total computational time for one modular division by almost 30%, with the cost of about 1% more cells. Moreover, by the addition of a flag signal and three logic gates, the proposed systolic architecture can also perform Montgomery modular multiplication and a fast unified modular divider/multiplier is realised.

  1. Systolic array IC for genetic computation

    NASA Astrophysics Data System (ADS)

    Anderson, D.

    Measuring similarities between large sequences of genetic information is a formidable task requiring enormous amounts of computer time. Geneticists claim that nearly two months of CRAY-2 time are required to run a single comparison of the known database against the new bases that will be found this year, and more than a CRAY-2 year for next year's genetic discoveries, and so on. The DNA IC, designed at HP-ICBD in cooperation with the California Institute of Technology and the Jet Propulsion Laboratory, is being implemented in order to move the task of genetic comparison onto workstations and personal computers, while vastly improving performance. The chip is a systolic (pumped) array comprised of 16 processors, control logic, and global RAM, totaling 400,000 FETS. At 12 MHz, each chip performs 2.7 billion 16 bit operations per second. Using 35 of these chips in series on one PC board (performing nearly 100 billion operations per second), a sequence of 560 bases can be compared against the eventual total genome of 3 billion bases, in minutes--on a personal computer. While the designed purpose of the DNA chip is for genetic research, other disciplines requiring similarity measurements between strings of 7 bit encoded data could make use of this chip as well. Cryptography and speech recognition are two examples. A mix of full custom design and standard cells, in CMOS34, were used to achieve these goals. Innovative test methods were developed to enhance controllability and observability in the array. This paper describes these techniques as well as the chip's functionality. This chip was designed in the 1989-90 timeframe.

  2. Systolic array IC for genetic computation

    NASA Technical Reports Server (NTRS)

    Anderson, D.

    1991-01-01

    Measuring similarities between large sequences of genetic information is a formidable task requiring enormous amounts of computer time. Geneticists claim that nearly two months of CRAY-2 time are required to run a single comparison of the known database against the new bases that will be found this year, and more than a CRAY-2 year for next year's genetic discoveries, and so on. The DNA IC, designed at HP-ICBD in cooperation with the California Institute of Technology and the Jet Propulsion Laboratory, is being implemented in order to move the task of genetic comparison onto workstations and personal computers, while vastly improving performance. The chip is a systolic (pumped) array comprised of 16 processors, control logic, and global RAM, totaling 400,000 FETS. At 12 MHz, each chip performs 2.7 billion 16 bit operations per second. Using 35 of these chips in series on one PC board (performing nearly 100 billion operations per second), a sequence of 560 bases can be compared against the eventual total genome of 3 billion bases, in minutes--on a personal computer. While the designed purpose of the DNA chip is for genetic research, other disciplines requiring similarity measurements between strings of 7 bit encoded data could make use of this chip as well. Cryptography and speech recognition are two examples. A mix of full custom design and standard cells, in CMOS34, were used to achieve these goals. Innovative test methods were developed to enhance controllability and observability in the array. This paper describes these techniques as well as the chip's functionality. This chip was designed in the 1989-90 timeframe.

  3. Lower Protein-to-Carbohydrate Ratio in Maternal Diet is Associated with Higher Childhood Systolic Blood Pressure up to Age Four Years

    PubMed Central

    Blumfield, Michelle L.; Nowson, Caryl; Hure, Alexis J.; Smith, Roger; Simpson, Stephen J.; Raubenheimer, David; MacDonald-Wicks, Lesley; Collins, Clare E.

    2015-01-01

    The prenatal environment can influence development of offspring blood pressure (BP), which tracks into adulthood. This prospective longitudinal study investigated whether maternal pregnancy dietary intake is associated with the development of child BP up to age four years. Data are from 129 mother-child dyads enrolled in the Women and Their Children’s Health study. Maternal diet was assessed using a validated 74-item food frequency questionnaire at 18 to 24 weeks and 36 to 40 weeks, with a reference period of the previous three months. Child systolic and diastolic BP were measured at 3, 6, 9, 12, 24, 36 and 48 months, using an automated BP monitor. Using mixed-model regression analyses adjusted for childhood growth indices, pregnancy intakes of percentage of energy (E%) polyunsaturated fat (β coefficient 0.73; 95% CI 0.003, 1.45; p = 0.045), E% omega-6 fatty acids (β coefficient 0.89; 95% CI 0.09, 1.69; p = 0.03) and protein-to-carbohydrate (P:C) ratio (β coefficient −14.14; 95% CI −27.68, −0.60; p = 0.04) were associated with child systolic BP trajectory up to 4 years. Child systolic BP was greatest at low proportions of dietary protein (<16% of energy) and high carbohydrate (>40% of energy) intakes. There may be an ideal maternal macronutrient ratio associated with optimal infant BP. Maternal diet, which is potentially modifiable, may play an important role in influencing offspring risk of future hypertension. PMID:25919307

  4. Blood Pressure, Left Ventricular Geometry, and Systolic Function in Children Exposed to Inorganic Arsenic

    PubMed Central

    Osorio-Yáñez, Citlalli; Ayllon-Vergara, Julio C.; Arreola-Mendoza, Laura; Aguilar-Madrid, Guadalupe; Hernández-Castellanos, Erika; Sánchez-Peña, Luz C.

    2015-01-01

    Background: Inorganic arsenic (iAs) is a ubiquitous element present in the groundwater worldwide. Cardiovascular effects related to iAs exposure have been studied extensively in adult populations. Few epidemiological studies have been focused on iAs exposure–related cardiovascular disease in children. Objective: In this study we investigated the association between iAs exposure, blood pressure (BP), and functional and anatomical echocardiographic parameters in children. Methods: A cross-sectional study of 161 children between 3 and 8 years was conducted in Central Mexico. The total concentration of arsenic (As) species in urine (U-tAs) was determined by hydride generation–cryotrapping–atomic absorption spectrometry and lifetime iAs exposure was estimated by multiplying As concentrations measured in drinking water by the duration of water consumption in years (LAsE). BP was measured by standard protocols, and M-mode echocardiographic parameters were determined by ultrasonography. Results: U-tAs concentration and LAsE were significantly associated with diastolic (DBP) and systolic blood pressure (SBP) in multivariable linear regression models: DBP and SBP were 0.013 (95% CI: 0.002, 0.024) and 0.021 (95% CI: 0.004, 0.037) mmHg higher in association with each 1-ng/mL increase in U-tAs (p < 0.025), respectively. Left ventricular mass (LVM) was significantly associated with LAsE [5.5 g higher (95% CI: 0.65, 10.26) in children with LAsE > 620 compared with < 382 μg/L-year; p = 0.03] in an adjusted multivariable model. The systolic function parameters left ventricular ejection fraction (EF) and shortening fraction were 3.67% (95% CI: –7.14, –0.20) and 3.41% (95% CI: –6.44, –0.37) lower, respectively, in children with U-tAs > 70 ng/mL compared with < 35 ng/mL. Conclusion: Early-life exposure to iAs was significantly associated with higher BP and LVM and with lower EF in our study population of Mexican children. Citation: Osorio-Yáñez C, Ayllon-Vergara JC

  5. Long-term impact of systolic blood pressure and glycemia on the development of microalbuminuria in essential hypertension.

    PubMed

    Pascual, Jose Maria; Rodilla, Enrique; Gonzalez, Carmen; Pérez-Hoyos, Santiago; Redon, Josep

    2005-06-01

    The objective was to assess the temporal impact of factors related to the development of microalbuminuria during the follow-up of young adult normoalbuminurics with high-normal blood pressure or at stage 1 of essential hypertension. Prospective follow-up was conducted on 245 normoalbuminuric hypertensive subjects (mean age 40.9 years; 134 men; blood pressure 139.7/88.6 mm Hg; body mass index 28.5 kg/m2) never treated previously with antihypertensive drugs, with yearly urinary albumin excretion measurements, until the development of microalbuminuria. After enrollment, patients were placed on usual care including nonpharmacological treatment or with an antihypertensive drug regime to achieve a blood pressure of <135/85 mm Hg. Thirty subjects (12.2%) developed microalbuminuria after a mean follow-up of 29.9 months (range 12 to 144 months), 2.5 per 100 patients per year. Baseline urinary albumin excretion (hazard ratio, 1.07; P=0.006) and systolic blood pressure during the follow-up (hazard ratio, 1.03; P=0.008) were independent factors related to the follow-up urinary albumin excretion in a Cox proportional hazard model. A significant increase in the risk of developing microalbuminuria for urinary albumin excretion at baseline >15 mg per 24-hour systolic blood pressure >139 mm Hg and a positive trend in fasting glucose were observed in the univariate analyses. However, in the multivariate analysis, only the baseline urinary albumin excretion and the trend of fasting glucose were independently related to the risk of developing microalbuminuria. In mild hypertensives, the development of microalbuminuria was linked to insufficient blood pressure control and to a progressive increment of glucose values.

  6. Relationship between 24-h urine sodium/potassium ratio and central aortic systolic blood pressure in hypertensive patients.

    PubMed

    Rhee, Moo-Yong; Shin, Sung-Joon; Gu, Namyi; Nah, Deuk-Young; Kim, Byong-Kyu; Hong, Kyung-Soon; Cho, Eun-Joo; Sung, Ki-Chul; Lee, Sim-Yeol; Kim, Kwang-Il

    2016-11-24

    Studies evaluating the relationship between measured 24-h urine sodium (24HUNa), potassium (24HUK) and aortic blood pressure (BP) are rare, and no such study has been performed with an Asian population. We evaluated the relationship between 24HUNa, 24HUK, casual BP, 24-h ambulatory BP and aortic BP by analyzing data from 524 participants with valid 24-h urine collection, 24-h ambulatory BP and central BP measurements (mean age 48.1±9.8 years, 193 men). Hypertension was defined as a 24-h ambulatory BP ⩾130/80 mm Hg or current treatment for hypertension (n=219). The participants with hypertension and high 24HUNa (mean 210.5±52.0 mmol  per day, range 151.0-432.0) showed higher 24-h systolic (P=0.037) and diastolic BP (P=0.037) and aortic systolic BP (AoSBP, P=0.038) than the participants with hypertension and low 24HUNa (mean 115.7±25.0 mmol per day, range 45.6-150.0), adjusted for confounders. The participants with hypertension and a high ratio of 24HUNa and 24HUK (24HUNa/24HUK, mean 4.03±1.00, range 2.93-7.96) had higher AoSBP than the participants with hypertension and a low 24HUNa/24HUK ratio (mean 2.13±0.54, range 0.53-2.91), adjusted for confounders (P=0.026). The participants with hypertension demonstrated a significant linear relationship between AoSBP and 24HUNa/24HUK ratio that was independent of 24HUNa, according to the multiple regression analysis (P=0.047). In hypertensive patients, 24HUNa/24HUK was positively and more strongly related to AoSBP compared with 24HUNa alone. The result indicates that high sodium and low potassium intake may increase the subsequent risk of cardiovascular disease by elevating AoSBP.Hypertension Research advance online publication, 24 November 2016; doi:10.1038/hr.2016.161.

  7. The effect of music therapy on postoperative pain, heart rate, systolic blood pressures and analgesic use following nasal surgery.

    PubMed

    Tse, Mimi M Y; Chan, M F; Benzie, Iris F F

    2005-01-01

    The prevalence of unrelieved postoperative pain is high and may lead to adverse effects including prolonged hospitalization and delayed recovery. Distraction may be an effective pain-relieving strategy, and can be implemented by several means including affective imaging, games, and possibly music. The aim of this study was to explore the effect of music therapy on postoperative pain. Fifty-seven patients (24 females, 33 males; mean +/- SD age 39.9 +/- 14.35 years [range 15 to 69 years] were matched for age and sex and then nonselectively assigned to either an experimental (n = 27) or a control (n = 30) group. Music was played intermittently to members of the experimental group during the first 24 hour postoperative period. Pain intensity was measured using the Pain Verbal Rating Scales (VRS). Significant decreases in pain intensity over time were found in the experimental group compared to the control group (p < 0.0001). In addition, the experimental group had a lower systolic blood pressure and heart rate, and took fewer oral analgesics for pain. These findings suggest that music therapy is an effective nonpharmacologic approach for postoperative pain management.

  8. Continuous measurement of systolic blood pressure using the PTT and other parameters.

    PubMed

    Park, E; Cho, B; Park, S; Lee, J; Lee, J; Kim, I; Kim, Sun

    2005-01-01

    In this paper, we proposed the regression model which could estimate unspecified people's systolic blood pressure (SBP) conveniently and continuously and checked its accuracy through clinical experiments. The method for estimating each individual SBP by using only pulse transit time (PTT) has been studied, but it is difficult to estimate unspecified people's SBP with the method using only PTT. Thus we researched several physical characteristic parameters which might affect blood pressure (BP) with the standard that we can measure them easily and conveniently, chose valid physical characteristic parameters through a clinical testing and correlation analysis, and made the regression model using PTT and valid physical characteristic parameters for estimating unspecified people's SBP. Comparing the result of the proposed method with American National Standards Institute of the Association of the Advancement of Medical Instrument (ANSI/AAMI), we know that the proposed regression model gives an acceptable result.

  9. Effects of overweight and the PLA2G7 V279F polymorphism on the association of age with systolic blood pressure

    PubMed Central

    Kim, Minjoo; Kim, Minkyung; Yoo, Hye Jin; Jang, Hye Young; Lee, Sang-Hyun

    2017-01-01

    This prospective study aimed to determine the effects of the persistence of overweight for three years and the PLA2G7 V279F polymorphism, as well as the interaction between these factors, on the association of age with blood pressure (BP). Healthy middle-aged subjects with normotensive BP were divided into the normal-weight and overweight groups. The PLA2G7 V279F genotype, BP, lipoprotein-associated phospholipase A2 (Lp-PLA2) activity, and oxidized low-density lipoprotein (ox-LDL) were determined. Lp-PLA2 activity was lower in the F allele subjects (n = 111) than in those with the VV genotype (n = 389). The overweight individuals with the F allele had lower Lp-PLA2 activity and ox-LDL at both baseline and after three years and lower systolic and diastolic BP and LDL cholesterol after three years compared with those with the VV phenotype. After three years, the overweight subjects with the VV phenotype exhibited greater increases in Lp-PLA2 activity, systolic BP, and ox-LDL than those with the F allele and normal-weight subjects with the VV phenotype. A multivariate analysis revealed that the PLA2G7 V279F genotype, baseline BMI, changes in Lp-PLA2 activity and ox-LDL remained independently and positively associated with changes in systolic BP. The simultaneous presence of the PLA2G7 279VV genotype and persistence of overweight synergistically increases the risk for hypertension, whereas lower Lp-PLA2 activity in PLA2G7 279F allele carriers might offer certain protection against hypertension, even in individuals who have been overweight for over three years. PMID:28334001

  10. Attenuation of systolic blood pressure and pulse transit time hysteresis during exercise and recovery in cardiovascular patients.

    PubMed

    Liu, Qing; Yan, Bryan P; Yu, Cheuk-Man; Zhang, Yuan-Ting; Poon, Carmen C Y

    2014-02-01

    Pulse transit time (PTT) is a cardiovascular parameter of emerging interest due to its potential to estimate blood pressure (BP) continuously and without a cuff. Both linear and nonlinear equations have been used in the estimation of BP based on PTT. This study, however, demonstrates that there is a hysteresis phenomenon between BP and PTT during and after dynamic exercise. A total of 46 subjects including 16 healthy subjects, 13 subjects with one or more cardiovascular risk factors, and 17 patients with cardiovascular disease underwent graded exercise stress test. PTT was measured from electrocardiogram and photoplethysmogram of the left index finger of the subject, i.e., a pathway that includes predominately aorta, brachial, and radial arteries. The results of this study showed that, for the same systolic BP (SBP), PTT measured during exercise was significantly larger than PTT measured during recovery for all subject groups. This hysteresis was further quantified as both normalized area bounded by the SBP-PTT relationship (AreaN) and SBP difference at PTT during peak exercise plus 20 ms (ΔSBP20). Significant attenuation of both AreaN (p <; 0.05) and ΔSBP20 (p <; 0.01) is observed in cardiovascular patients compared with healthy subjects, independent of resting BP. Since the SBP-PTT relationship are determined by the mechanical properties of arterial wall, which is predominately mediated by the sympathetic nervous system through altered vascular smooth muscle (VSM) tone during exercise, results of this study are consistent with the previous findings of autonomic nervous dysfunction in cardiovascular patients. We further conclude that VSM tone has a nonnegligible influence on the BP-PTT relationship and thus should be considered in the PTT-based BP estimation.

  11. Genetics and genomics of dilated cardiomyopathy and systolic heart failure.

    PubMed

    Tayal, Upasana; Prasad, Sanjay; Cook, Stuart A

    2017-02-22

    Heart failure is a major health burden, affecting 40 million people globally. One of the main causes of systolic heart failure is dilated cardiomyopathy (DCM), the leading global indication for heart transplantation. Our understanding of the genetic basis of both DCM and systolic heart failure has improved in recent years with the application of next-generation sequencing and genome-wide association studies (GWAS). This has enabled rapid sequencing at scale, leading to the discovery of many novel rare variants in DCM and of common variants in both systolic heart failure and DCM. Identifying rare and common genetic variants contributing to systolic heart failure has been challenging given its diverse and multiple etiologies. DCM, however, although rarer, is a reasonably specific and well-defined condition, leading to the identification of many rare genetic variants. Truncating variants in titin represent the single largest genetic cause of DCM. Here, we review the progress and challenges in the detection of rare and common variants in DCM and systolic heart failure, and the particular challenges in accurate and informed variant interpretation, and in understanding the effects of these variants. We also discuss how our increasing genetic knowledge is changing clinical management. Harnessing genetic data and translating it to improve risk stratification and the development of novel therapeutics represents a major challenge and unmet critical need for patients with heart failure and their families.

  12. Use of systolic pressure variation to predict the cardiovascular response to mini-fluid challenge in anaesthetised dogs.

    PubMed

    Rabozzi, R; Franci, P

    2014-11-01

    Systolic pressure variation (SPV), the maximum variation in systolic pressure values following a single positive pressure breath delivered by controlled mechanical ventilation (CMV), is highly correlated with volaemia in dogs. The aim of this study was to determine an SPV value that would indicate when fluid administration would be beneficial in clinical practice. Twenty-six client-owned dogs were anaesthetised, following which CMV with a peak inspiratory pressure (PIP) of 8 cmH2O was applied. After SPV measurement and recording of heart rate (HR) and blood pressure (BP), 3 mL/kg fluid were administered, then HR and BP were recorded again. Dogs exhibiting a 10% decrease in HR and/or an increase in BP were defined as responders, and their SPV pre-bolus was analysed retrospectively. SPV values > 4 mmHg or >4.5% predicted haemodynamic improvement in dogs with normal cardiovascular function, with a sensitivity of 90% and a specificity of 87%. The area under the curve receiver operating characteristic value for SPV was 0.931 mmHg (95% confidence interval, CI, 0.76-0.99 mmHg) and 0.944% (95% CI 0.78-0.99%). It is proposed that SPV values > 4.5% in dogs with a normal cardiovascular function, anaesthetised with isoflurane in oxygen and air, and on CMV (PIP 8 cmH2O), can be used to predict a cardiovascular response (>10% increase in mean arterial BP and/or >10% decrease in heart rate).

  13. Application of Mitral Annular Systolic Displacements and Velocities for the Evaluation of Left Ventricular Systolic Function and Reserve

    PubMed Central

    Sharif, Dawod; Sharif-Rasslan, Amal; Shahla, Camilia; Rosenschein, Uri

    2011-01-01

    Background Mitral annular systolic displacement from M-mode echocardiography and velocity from tissue Doppler imaging reflect subendocardial longitudinal systolic LV performance and may precede radial abnormalities. The aim of this study is to evaluate the utility of mitral annular systolic displacement (D) and velocity (V) during dobutamine stress echocardiography (DSE) in detecting left ventricular (LV) functional reserve and wall motion abnormality (WMA). Methods and Results Fifty-nine subjects, 15 with resting WMA, underwent DSE and measurement of mitral systolic (D) and (V) before and immediately after DSE. Annular septal (D) was lower in those with WMA than in those without, at rest 10.5 ± 4 cm versus 13.2 ± 2 cm, p = 0.015, and after DSE, 11.7 ± 3.8 cm versus 14 ± 2.25 cm, p = 0.036, but without significant change after stress. Annular systolic (V) at rest with WMA was 9.7 ± 1.8 cm/sec and similar to those without, 11.25 ± 2.7 cm/sec. In both groups the velocity increased after DSE, 14.5 ± 4.5 cm/sec, p = 0.025 with WMA and 17.8 ± 3.2 cm/sec, p = 1.99 x 10-10 in those without WMA. Velocities after DSE were lower in those with WMA, p = 2.25 x 10-6. Conclusions To evaluate LV systolic performance mitral annular systolic longitudinal displacement is valuable at rest, but for assessment of LV functional reserve after stress velocities are better.

  14. Heart Rate and Systolic Blood Pressure Variability on Recently Diagnosed Diabetics

    PubMed Central

    Michel-Chávez, Anaclara; Estañol, Bruno; Gien-López, José Antonio; Robles-Cabrera, Adriana; Huitrado-Duarte, María Elena; Moreno-Morales, René; Becerra-Luna, Brayans

    2015-01-01

    Background Diabetes affects approximately 250 million people in the world. Cardiovascular autonomic neuropathy is a common complication of diabetes that leads to severe postural hypotension, exercise intolerance, and increased incidence of silent myocardial infarction. Objective To determine the variability of heart rate (HR) and systolic blood pressure (SBP) in recently diagnosed diabetic patients. Methods The study included 30 patients with a diagnosis of type 2 diabetes of less than 2 years and 30 healthy controls. We used a Finapres® device to measure during five minutes beat-to-beat HR and blood pressure in three experimental conditions: supine position, standing position, and rhythmic breathing at 0.1 Hz. The results were analyzed in the time and frequency domains. Results In the HR analysis, statistically significant differences were found in the time domain, specifically on short-term values such as standard deviation of NN intervals (SDNN), root mean square of successive differences (RMSSD), and number of pairs of successive NNs that differ by more than 50 ms (pNN50). In the BP analysis, there were no significant differences, but there was a sympathetic dominance in all three conditions. The baroreflex sensitivity (BRS) decreased in patients with early diabetes compared with healthy subjects during the standing maneuver. Conclusions There is a decrease in HR variability in patients with early type 2 diabetes. No changes were observed in the BP analysis in the supine position, but there were changes in BRS with the standing maneuver, probably due to sympathetic hyperactivity. PMID:26176187

  15. FFT Computation with Systolic Arrays, A New Architecture

    NASA Technical Reports Server (NTRS)

    Boriakoff, Valentin

    1994-01-01

    The use of the Cooley-Tukey algorithm for computing the l-d FFT lends itself to a particular matrix factorization which suggests direct implementation by linearly-connected systolic arrays. Here we present a new systolic architecture that embodies this algorithm. This implementation requires a smaller number of processors and a smaller number of memory cells than other recent implementations, as well as having all the advantages of systolic arrays. For the implementation of the decimation-in-frequency case, word-serial data input allows continuous real-time operation without the need of a serial-to-parallel conversion device. No control or data stream switching is necessary. Computer simulation of this architecture was done in the context of a 1024 point DFT with a fixed point processor, and CMOS processor implementation has started.

  16. Low Power Systolic Array Based Digital Filter for DSP Applications

    PubMed Central

    Karthick, S.; Valarmathy, S.; Prabhu, E.

    2015-01-01

    Main concepts in DSP include filtering, averaging, modulating, and correlating the signals in digital form to estimate characteristic parameter of a signal into a desirable form. This paper presents a brief concept of low power datapath impact for Digital Signal Processing (DSP) based biomedical application. Systolic array based digital filter used in signal processing of electrocardiogram analysis is presented with datapath architectural innovations in low power consumption perspective. Implementation was done with ASIC design methodology using TSMC 65 nm technological library node. The proposed systolic array filter has reduced leakage power up to 8.5% than the existing filter architectures. PMID:25922854

  17. Systolic time interval data acquisition system. Specialized cardiovascular studies

    NASA Technical Reports Server (NTRS)

    Baker, J. T.

    1976-01-01

    The development of a data acquisition system for noninvasive measurement of systolic time intervals is described. R-R interval from the ECG determines instantaneous heart rate prior to the beat to be measured. Total electromechanical systole (Q-S2) is measured from the onset of the ECG Q-wave to the onset of the second heart sound (S2). Ejection time (ET or LVET) is measured from the onset of carotid upstroke to the incisure. Pre-ejection period (PEP) is computed by subtracting ET from Q-S2. PEP/ET ratio is computed directly.

  18. Low Power Systolic Array Based Digital Filter for DSP Applications.

    PubMed

    Karthick, S; Valarmathy, S; Prabhu, E

    2015-01-01

    Main concepts in DSP include filtering, averaging, modulating, and correlating the signals in digital form to estimate characteristic parameter of a signal into a desirable form. This paper presents a brief concept of low power datapath impact for Digital Signal Processing (DSP) based biomedical application. Systolic array based digital filter used in signal processing of electrocardiogram analysis is presented with datapath architectural innovations in low power consumption perspective. Implementation was done with ASIC design methodology using TSMC 65 nm technological library node. The proposed systolic array filter has reduced leakage power up to 8.5% than the existing filter architectures.

  19. Mapping technique for VLSI/WSI implementation of multidimensional systolic arrays

    NASA Astrophysics Data System (ADS)

    Abdelrazik, Mohamed B.

    1990-09-01

    This paper describes a niapping technique for transforming a linear systolic array into multidimensional systolic arrays in order to achieve high-speed with less overhead. This technique is systematic therefore it would be useful for logic synthesis. The application of this technique in DSP and numerical computations reduces the design time which results in low design cost. This technique produces various structures (semi-systolic quasi-systolic and pure systolic arrays) which could be considered as application specific array processors.

  20. Sun Blasts 6 CMEs in 24 Hour Period

    NASA Video Gallery

    This movie from the chronograph on board the SOlar and Heliospheric Observatory (SOHO), shows the sun's atmosphere – the corona – from September 17 to September 20. The sun let loose with at ...

  1. Rethinking the Youth Weight Debate: The 24 Hour Day

    ERIC Educational Resources Information Center

    Dodd, Graham; Biggs, Sarah; Agley, Daniel; Dollman, James; Lushington, Kurt

    2008-01-01

    Approaches to weight management have traditionally focussed on caloric intake versus caloric expenditure. Despite a range of interventions based on these approaches, the proportion of overweight children and adolescents continues to rise. There are increasing indications that other factors, such as sleep duration, may be at play. This commentary…

  2. Newborn Infants' Memory for Speech Sounds Retained over 24 Hours.

    ERIC Educational Resources Information Center

    Swain, Irina U.; And Others

    1993-01-01

    Neonates who were exposed to the same or different words on two consecutive days habituated to the sound on day one and recovered head turning on day two. Infants who heard the same word again on day two responded less well than infants exposed to the word for the first time on day two. (BC)

  3. Knighthelm 24-hour HMD: from development to production

    NASA Astrophysics Data System (ADS)

    White, John; Cameron, Alexander A.

    2001-08-01

    The BAE SYSTEMS Knighthelm HMD is a unique two-part helmet design, using a form fitted inner helmet with an outer display module. It has been refined and enhanced, as part of an extensive development program, for the German Army Tiger helicopter, and is optimized for the attack helicopter application. The design optically mixes the output of an Image Intensifier Tube with Cathode Ray Tube imagery. This provides a flexible display of symbology overlaid on NVG imagery or symbology overlaid on FLIR video viewed as a collimated image in the see through combiner eyepiece in front of the users eyes.

  4. Perceptually relevant remapping of human somatotopy in 24 hours

    PubMed Central

    Kolasinski, James; Makin, Tamar R; Logan, John P; Jbabdi, Saad; Clare, Stuart; Stagg, Charlotte J; Johansen-Berg, Heidi

    2016-01-01

    Experience-dependent reorganisation of functional maps in the cerebral cortex is well described in the primary sensory cortices. However, there is relatively little evidence for such cortical reorganisation over the short-term. Using human somatosensory cortex as a model, we investigated the effects of a 24 hr gluing manipulation in which the right index and right middle fingers (digits 2 and 3) were adjoined with surgical glue. Somatotopic representations, assessed with two 7 tesla fMRI protocols, revealed rapid off-target reorganisation in the non-manipulated fingers following gluing, with the representation of the ring finger (digit 4) shifted towards the little finger (digit 5) and away from the middle finger (digit 3). These shifts were also evident in two behavioural tasks conducted in an independent cohort, showing reduced sensitivity for discriminating the temporal order of stimuli to the ring and little fingers, and increased substitution errors across this pair on a speeded reaction time task. DOI: http://dx.doi.org/10.7554/eLife.17280.001 PMID:28035900

  5. A 24-hour remote surveillance system for terrestrial wildlife studies

    USGS Publications Warehouse

    Sykes, P.W.; Ryman, W.E.; Kepler, C.B.; Hardy, J.W.

    1995-01-01

    The configuration, components, specifications and costs of a state-of-the-art closed-circuit television system with wide application for wildlife research and management are described. The principal system components consist of color CCTV camera with zoom lens, pan/tilt system, infrared illuminator, heavy duty tripod, coaxial cable, coaxitron system, half-duplex equalizing video/control amplifier, timelapse video cassette recorder, color video monitor, VHS video cassettes, portable generator, fuel tank and power cable. This system was developed and used in a study of Mississippi sandhiIl Crane (Grus canadensis pratensis) behaviors during incubation, hatching and fledging. The main advantages of the system are minimal downtime where a complete record of every event, its time of occurrence and duration, are permanently recorded and can be replayed as many times as necessary thereafter to retrieve the data. The system is particularly applicable for studies of behavior and predation, for counting individuals, or recording difficult to observe activities. The system can be run continuously for several weeks by two people, reducing personnel costs. This paper is intended to provide biologists who have litte knowledge of electronics with a system that might be useful to their specific needs. The disadvantages of this system are the initial costs (about $9800 basic, 1990-1991 U.S. dollars) and the time required to playback video cassette tapes for data retrieval, but the playback can be sped up when litte or no activity of interest is taking place. In our study, the positive aspects of the system far outweighed the negative.

  6. Platelet activation of mechanical versus bioprosthetic heart valves during systole.

    PubMed

    Hedayat, Mohammadali; Asgharzadeh, Hafez; Borazjani, Iman

    2017-03-11

    Thrombus formation is a major concern for recipients of mechanical heart valves (MHVs), which requires them to take anticoagulant drugs for the rest of their lives. Bioprosthetic heart valves (BHVs) do not require life-long anticoagulant therapy but deteriorate after 10-15years. The thrombus formation is initiated by the platelet activation which is thought to be mainly generated in MHVs by the flow through the hinge and the leakage flow during the diastole. However, our results show that the activation in the bulk flow during the systole phase might play an essential role as well. This is based on our results obtained by comparing the thrombogenic performance of a MHV and a BHV (as control) in terms of shear induced platelet activation under exactly the same conditions. Three different mathematical activation models including linear level of activation, damage accumulation, and Soares model are tested to quantify the platelet activation during systole using the previous simulations of the flow through MHV and BHV in a straight aorta under the same physiologic flow conditions. Results indicate that the platelet activation in the MHV at the beginning of the systole phase is slightly less than the BHV. However, at the end of the systole phase the platelet activation by the bulk flow for the MHV is several folds (1.41, 5.12, and 2.81 for linear level of activation, damage accumulation, and Soares model, respectively) higher than the BHV for all tested platelet activation models.

  7. Effects of short-term exercise-training on aortic systolic pressure augmentation in overweight and obese individuals.

    PubMed

    Millen, Aletta M E; Norton, Gavin R; Avidon, Ingrid; Woodiwiss, Angela J

    2013-07-01

    To determine whether exercise training-induced decreases in blood pressure (BP) can be explained by decreases in aortic systolic pressure augmentation in overweight or obese individuals. Thirty-five sedentary or recreationally active men and women (30-57 years) who were either overweight (40 %) or obese (60 %) completed 6 weeks of exercise training (≥3 days/week; stationary bike and/or treadmill) either preceded (n = 19) or followed (n = 16) by a 6-week control period of no exercise. Aortic augmentation pressure (AP), aortic and peripheral augmentation indices (AIx), and central aortic BP (SphygmoCor) were determined before and after exercise training and a control period. Peak oxygen consumption increased (p = 0.0001) from 27.0 ± 5.1 to 28.8 ± 5.8 mL/(kg min) after 6 weeks of exercise. Exercise training decreased brachial systolic (SBP) and diastolic BP from 142 ± 8/94 ± 8 to 134 ± 11/86 ± 11 mmHg (p < 0.005/p < 0.005); whereas no changes were observed after the control period (141 ± 11/91 ± 9 mmHg, p = 0.81/p = 0.34). Neither AP (baseline: 9.2 ± 4.2 mmHg; after 6 weeks training: 8.7 ± 6.1 mmHg), aortic AIx (baseline: 24.6 ± 11.0 %; after 6 weeks training: 22.7 ± 11.1 %), nor peripheral AIx (baseline: 81.4 ± 16.7 mmHg; after 6 weeks training: 76.4 ± 16.5 mmHg) were modified by exercise training. Although aortic SBP decreased after exercise (132 ± 8 to 124 ± 12 mmHg, p < 0.002), these changes were accounted for by decreases in mean arterial pressure. In overweight or obese individuals, although short-term aerobic exercise training, which improved cardiorespiratory fitness, may produce marked decreases in aortic and brachial BP; these effects are not attributed to alterations in aortic systolic pressure augmentation.

  8. Automatic noninvasive measurement of systolic blood pressure using photoplethysmography

    PubMed Central

    Nitzan, Meir; Patron, Amikam; Glik, Zehava; Weiss, Abraham T

    2009-01-01

    Background Automatic measurement of arterial blood pressure is important, but the available commercial automatic blood pressure meters, mostly based on oscillometry, are of low accuracy. Methods In this study, we present a cuff-based technique for automatic measurement of systolic blood pressure, based on photoplethysmographic signals measured simultaneously in fingers of both hands. After inflating the pressure cuff to a level above systolic blood pressure in a relatively slow rate, it is slowly deflated. The cuff pressure for which the photoplethysmographic signal reappeared during the deflation of the pressure-cuff was taken as the systolic blood pressure. The algorithm for the detection of the photoplethysmographic signal involves: (1) determination of the time-segments in which the photoplethysmographic signal distal to the cuff is expected to appear, utilizing the photoplethysmographic signal in the free hand, and (2) discrimination between random fluctuations and photoplethysmographic pattern. The detected pulses in the time-segments were identified as photoplethysmographic pulses if they met two criteria, based on the pulse waveform and on the correlation between the signal in each segment and the signal in the two neighboring segments. Results Comparison of the photoplethysmographic-based automatic technique to sphygmomanometry, the reference standard, shows that the standard deviation of their differences was 3.7 mmHg. For subjects with systolic blood pressure above 130 mmHg the standard deviation was even lower, 2.9 mmHg. These values are much lower than the 8 mmHg value imposed by AAMI standard for automatic blood pressure meters. Conclusion The photoplethysmographic-based technique for automatic measurement of systolic blood pressure, and the algorithm which was presented in this study, seems to be accurate. PMID:19857254

  9. The impact of fertilization on the chicken egg yolk plasma and granule proteome 24 hours post-lay at room temperature: capitalizing on high-pH/low-pH reverse phase chromatography in conjunction with tandem mass tag (TMT) technology.

    PubMed

    Padliya, Neerav D; Qian, Meiqian; Mimi Roy, Sushmita; Chu, Patrick; Zheng, Haiyan; Tess, Alex; Dariani, Maghsoud; Hariri, Robert J

    2015-07-01

    Chicken egg yolk is a rich source of nutrients providing high quality proteins, vitamins, minerals, carotenoids and antioxidants. Chicken egg yolk, recovered from whole egg within 24 hours post-lay has been utilized as a starting material in the preparation of a dietary supplement that has been demonstrated to lead to gains in muscle mass in a human clinical study. Further, an oil derived from chicken egg yolk has been utilized as a topical agent to treat third degree burn injury. The molecular changes that take place in fertilized, chicken egg yolk during the first 24 hours post-lay are not well understood. By studying how the protein composition of egg yolk varies with fertility status, one can utilize this knowledge to develop egg yolk-based products that have been optimized for specific applications. In this study, a direct quantitative comparison was made between the proteome of fertilized chicken egg yolk and the proteome of unfertilized chicken egg yolk, both maintained at 20 °C and analyzed within 24 hours post-lay. Egg yolk proteins from each fertility state were digested with trypsin, labeled with distinct chemical labels (tandem mass tag reagents) and then combined in a 1 : 1 ratio. A TMT-labeled tryptic digest derived from chicken egg yolk proteins (fertilized and unfertilized) was separated using high-pH/low-pH reverse-phase chromatography and analyzed using mass spectrometry. 225 protein identifications were made from this TMT-labeled tryptic digest based on a minimum of 2 unique peptides observed per protein. 9 proteins increased in abundance in fertilized egg yolk relative to unfertilized egg yolk and 9 proteins decreased in abundance in fertilized egg yolk relative to unfertilized egg yolk. Some proteins that increased in abundance in fertilized egg yolk play an important role in angiogenesis (pleiotrophin, histidine rich glycoprotein) and defense against pathogens (mannose-binding lectin, β-defensin 11, serum amyloid P-component, ovostatin

  10. Home and Online Management and Evaluation of Blood Pressure (HOME BP) digital intervention for self-management of uncontrolled, essential hypertension: a protocol for the randomised controlled HOME BP trial

    PubMed Central

    Morton, Katherine; Stuart, Beth; Raftery, James; Bradbury, Katherine; Yao, Guiqing Lily; Zhu, Shihua; Little, Paul; Yardley, Lucy

    2016-01-01

    Introduction Self-management of hypertension, including self-monitoring and antihypertensive medication titration, lowers blood pressure (BP) at 1 year compared to usual care. The aim of the current trial is to assess the effectiveness of the Home and Online Management and Evaluation of Blood Pressure (HOME BP) intervention for the self-management of hypertension in primary care. Methods and analysis The HOME BP trial will be a randomised controlled trial comparing BP self-management—consisting of the HOME BP online digital intervention with self-monitoring, lifestyle advice and antihypertensive drug titration—with usual care for people with uncontrolled essential hypertension. Eligible patients will be recruited from primary care and randomised to usual care or to self-management using HOME BP. The primary outcome will be the difference in mean systolic BP (mm Hg) at 12-month follow-up between the intervention and control groups adjusting for baseline BP and covariates. Secondary outcomes (also adjusted for baseline and covariates where appropriate) will be differences in mean BP at 6 months and diastolic BP at 12 months; patient enablement; quality of life, and economic analyses including all key resources associated with the intervention and related services, adopting a broad societal perspective to include NHS, social care and patient costs, considered within trial and modelled with a lifetime horizon. Medication beliefs, adherence and changes; self-efficacy; perceived side effects and lifestyle changes will be measured for process analyses. Qualitative analyses will explore patient and healthcare professional experiences of HOME BP to gain insights into the factors affecting acceptability, feasibility and adherence. Ethics and dissemination This study has received NHS ethical approval (REC reference 15/SC/0082). The findings from HOME BP will be disseminated widely through peer-reviewed publications, scientific conferences and workshops. If

  11. The value of the mean peak systolic velocity of the superior thyroidal artery in the differential diagnosis of thyrotoxicosis

    PubMed Central

    Kim, Tae Kyoon; Lee, Eun Ju

    2015-01-01

    Purpose: The aim of this study was to validate the superior thyroidal artery mean peak systolic velocity (STA-mPSV) as an alternative to other diagnostic parameters in the differentiation of the causes of thyrotoxicosis in Korean patients. Methods: This study was conducted with newly diagnosed and untreated thyrotoxic patients. Forty patients were diagnosed with Graves disease (GD) and 20 patients with destructive thyroiditis (DT). Another 60 healthy subjects without thyroid disease participated as the control group. Blood samples were taken to evaluate the thyroid function and thyroid autoantibodies (TRAb). Twenty-four hour radioactive iodine uptake (RAIU) scanning was performed to confirm GD or DT. The STA-mPSV was measured using color Doppler ultrasonography. Results: The STA-mPSV was significantly higher in the untreated GD group than in the DT group (GD, 78.96±29.04 cm/sec; DT, 29.97±14.67 cm/sec; control, 17.55±4.99 cm/sec; P<0.001). The area under the curve (AUC) of the STA-mPSV for the differential diagnosis of untreated GD and DT was 0.9506 (optimal cutoff value, 41.3 cm/sec; sensitivity, 95%, 38/40; specificity, 85%, 17/20) in the receiver operating characteristic analysis. The AUC values of the STA-mPSV, RAIU, and TRAb were 0.9506, 1, and 0.9988, respectively (P=0.159). Conclusion: In clinical practice, the STA-mPSV has a diagnostic value similar to that of the TRAb and 24-hour RAIU in the differential diagnosis of newly diagnosed Korean thyrotoxic patients. PMID:25971899

  12. Impact of Antihypertensive Agents on Central Systolic Blood Pressure and Augmentation Index: A Meta-Analysis

    PubMed Central

    McGaughey, Tracey J.; Fletcher, Emily A.

    2016-01-01

    BACKGROUND New evidence suggests that central systolic blood pressure (cSBP) and augmentation index (AI) are superior predictors of adverse cardiovascular outcomes compared to peripheral systolic BP (pSBP). We performed a meta-analysis assessing the impact of antihypertensives on cSBP and AI. METHODS PubMed, Cochrane Library, and CINAHL were searched until September 2014 to identify eligible articles. A DerSimonian and Laird random-effects model was used to calculate the weighted mean difference (WMD) and its 95% confidence interval (CI). Fifty-two and 58 studies incorporating 4,381 and 3,716 unique subjects were included for cSBP and AI analysis, respectively. RESULTS Overall, antihypertensives reduced pSBP more than cSBP (WMD 2.52mm Hg, 95% CI 1.35 to 3.69; I 2 = 21.9%). β-Blockers (BBs) posed a significantly greater reduction in pSBP as compared to cSBP (WMD 5.19mm Hg, 95% CI 3.21 to 7.18). α-Blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, renin-angiotensin aldosterone system inhibitors and nicorandil reduced cSBP and pSBP in a similar manner. The overall reduction in AI from baseline was 3.09% (95% CI 2.28 to 3.90; I 2 = 84.5%). A significant reduction in AI was seen with angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, renin-angiotensin aldosterone system inhibitors, BBs, α-blockers (ABs), nicorandil, and moxonidine reduced AI nonsignificantly. CONCLUSIONS BBs are not as beneficial as the other antihypertensives in reducing cSBP and AI. PMID:26289583

  13. Comprehensive Approach to Lower Blood Pressure (CALM-BP): a randomized controlled trial of a multifactorial lifestyle intervention.

    PubMed

    Ziv, A; Vogel, O; Keret, D; Pintov, S; Bodenstein, E; Wolkomir, K; Doenyas, K; Mirovski, Y; Efrati, S

    2013-10-01

    Complementary medicine advocates the use of a multifactorial approach to address the varied aspects of hypertension. The aim of this study was to compare the blood pressure (BP) effect and medication use of a novel Comprehensive Approach to Lowering Measured Blood Pressure (CALM-BP), based on complementary medicine principles, with the standard recommended Dietary Approach to Stop Hypertension (DASH). A total of 113 patients treated with antihypertensive drugs were randomly assigned to either CALM-BP treatment (consisting of rice diet, walks, yoga, relaxation and stress management) or to a DASH+exercise control group (consisting of DASH and walks). Ambulatory 24-h and home BP were monitored over a 16-week programme, followed by 6 months of maintenance period. Medications were reduced if systolic BP dropped below 110 mm Hg accompanied by symptoms. In addition to BP reduction, medications were reduced because of symptomatic hypotension in 70.7% of the CALM-BP group compared with 32.7% in the DASH group, P<0.0001. After 6 months, medication status was not altered in the majority of individuals. Significant reductions in body mass index, cholesterol and improved quality-of-life scores were observed only in the CALM-BP group. Lifestyle and diet modifications based on complementary medicine principles are highly effective with respect to BP control, medication use and cardiovascular risk factors.

  14. Effect of angiotensin receptor blockade on central aortic systolic blood pressure in hypertensive Asians measured using radial tonometry: an open prospective cohort study

    PubMed Central

    Teong, Hui Hwang; Chin, Adeline Mei Lin; Sule, Ashish Anil; Tay, Jam Chin

    2016-01-01

    INTRODUCTION Central aortic systolic pressure (CASP) has been shown to be a stronger predictor of cardiovascular events than brachial blood pressure (BP). Different classes of drugs have differential effects on CASP and brachial BP. This open prospective cohort study aimed to observe changes in CASP (measured using radial tonometry) among hypertensive Asians after 12 weeks of treatment with valsartan, an angiotensin receptor blocker (ARB). METHODS Patients with treatment-naïve hypertension or uncontrolled hypertension who were on non-ARB therapy were eligible for inclusion. Patients with uncontrolled BP (i.e. ≥ 140/90 mmHg) received valsartan for 12 weeks. The patients’ brachial systolic and diastolic BP (SBP and DBP), and CASP changes were monitored using the BPro® watch. RESULTS The mean age of the 44 enrolled patients was 35 years. At baseline, the mean BP and CASP were 150.2/91.4 ± 10.6/9.4 mmHg and 136.3 ± 12.2 mmHg, respectively. Valsartan reduced SBP, DBP and CASP by 14.9 ± 10.7 mmHg, 10.9 ± 8.4 mmHg and 15.3 ± 10.9 mmHg, respectively (all p < 0.001). Every 1.0-mmHg reduction in brachial SBP resulted in a 0.8-mmHg reduction in CASP (p < 0.001). A CASP cut-off of 122.5 mmHg discriminated between controlled and uncontrolled BP (sensitivity 74%, specificity 88%). CONCLUSION Using radial tonometry, we demonstrated good correlation between CASP and brachial SBP reductions after 12 weeks of treatment with valsartan in our study cohort. Correlation analysis between CASP and SBP reductions may be useful for demonstrating whether a drug is able to lower CASP beyond lowering SBP. PMID:26875683

  15. A comparison of systolic blood pressure measurement obtained using a pulse oximeter, and direct systolic pressure measurement in anesthetized sows.

    PubMed Central

    Caulkett, N A; Duke, T; Bailey, J V

    1994-01-01

    Systolic blood pressure measurement obtained with a pulse oximeter has been compared to values obtained by other indirect methods in man. Direct pressure measurement is subject to less error than indirect techniques. This study was designed to compare systolic pressure values obtained using a pulse oximeter, with values obtained by direct arterial pressure measurement. The pulse oximeter waveform was used as an indication of perfusion. A blood pressure cuff was applied proximal to the pulse oximeter probe. The cuff was inflated until the oximeter waveform disappeared, this value was recorded as the systolic pressure at the disappearance of the waveform (SPD). The cuff was inflated to a pressure > 200 mmHg, then gradually deflated until the waveform reappeared, this value was recorded as the systolic pressure at reappearance of the waveform (SPR). The average of the two values, SPD and SPR, was calculated and recorded as SPA. The study was performed in sows (n = 21) undergoing cesarean section under epidural anesthesia and IV sedation. A total of 280 measurements were made of SPD, SPR and SPA. Regression analysis of SPA and direct measurement revealed a correlation coefficient (r) of 0.81. Calculation of mean difference (bias) and standard deviation of the bias (precision) for direct pressure--SPA revealed a value of 1.3 +/- 12.1. When compared with direct measurement, the correlation of this technique was similar to that recorded for other indirect techniques used in small animals. This indicates that this technique would be useful for following systolic pressure trends.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8004540

  16. Nifedipine GITS/Candesartan Combination Therapy Lowers Blood Pressure Across Different Baseline Systolic and Diastolic Blood Pressure Categories: DISTINCT Study Subanalyses

    PubMed Central

    Cha, Gloria; Villa, Giuseppe; Mancia, Giuseppe

    2016-01-01

    Abstract DISTINCT was an 8‐week, double‐blind, randomized study to investigate the antihypertensive efficacy and safety of various nifedipine gastrointestinal treatment system (GITS)/candesartan cilexetil (N/C) dose combinations, vs respective monotherapies or placebo, in patients with diastolic blood pressure (DBP) ≥95 to <110 mm Hg. The current prespecified analysis compared BP reduction in participants with mild vs moderate baseline hypertension (ie, systolic [S]BP <160 mm Hg vs ≥160 mm Hg and DBP <100 mm Hg vs ≥100 mm Hg). A total of 1362 patients were analyzed by descriptive statistics. In all patient subgroups investigated, the NC combinations (ie, N: 20, 30, or 60 mg; C: 4, 8, 16, or 32 mg daily) provided greater SBP and DBP lowering and higher rates of BP control (defined as BP <140/90 mm Hg) than respective monotherapies or placebo, with greatest absolute BP reductions observed in the moderately elevated SBP or DBP subgroups. A trend to dose‐response relationship was observed in each subgroup. In each SBP and DBP subgroup, treatment‐related vasodilatory events (flushing, headache, or edema) were less frequent for patients receiving NC combination therapy than N monotherapy. These analyses support the use of calcium antagonist and angiotensin receptor blocker combination therapy in patients with both mild and moderate hypertension, for whom effective BP normalization and good drug tolerance would greatly reduce the risk of cardiovascular events. PMID:26829251

  17. Intracranial Aneurysm Risk Locus 5q23.2 Is Associated with Elevated Systolic Blood Pressure

    PubMed Central

    Gaál, Emília Ilona; Rehnström, Karola; Kettunen, Johannes; Sarin, Antti-Pekka; Niemelä, Mika; Jula, Antti; Raitakari, Olli T.; Lehtimäki, Terho; Eriksson, Johan G.; Widen, Elisabeth; Günel, Murat; Kurki, Mitja; von und zu Fraunberg, Mikael; Jääskeläinen, Juha E.; Hernesniemi, Juha; Järvelin, Marjo-Riitta; Pouta, Anneli; Newton-Cheh, Christopher; Salomaa, Veikko; Palotie, Aarno; Perola, Markus

    2012-01-01

    Although genome-wide association studies (GWAS) have identified hundreds of complex trait loci, the pathomechanisms of most remain elusive. Studying the genetics of risk factors predisposing to disease is an attractive approach to identify targets for functional studies. Intracranial aneurysms (IA) are rupture-prone pouches at cerebral artery branching sites. IA is a complex disease for which GWAS have identified five loci with strong association and a further 14 loci with suggestive association. To decipher potential underlying disease mechanisms, we tested whether there are IA loci that convey their effect through elevating blood pressure (BP), a strong risk factor of IA. We performed a meta-analysis of four population-based Finnish cohorts (nFIN = 11 266) not selected for IA, to assess the association of previously identified IA candidate loci (n = 19) with BP. We defined systolic BP (SBP), diastolic BP, mean arterial pressure, and pulse pressure as quantitative outcome variables. The most significant result was further tested for association in the ICBP-GWAS cohort of 200 000 individuals. We found that the suggestive IA locus at 5q23.2 in PRDM6 was significantly associated with SBP in individuals of European descent (pFIN = 3.01E-05, pICBP-GWAS = 0.0007, pALL = 8.13E-07). The risk allele of IA was associated with higher SBP. PRDM6 encodes a protein predominantly expressed in vascular smooth muscle cells. Our study connects a complex disease (IA) locus with a common risk factor for the disease (SBP). We hypothesize that common variants in PRDM6 can contribute to altered vascular wall structure, hence increasing SBP and predisposing to IA. True positive associations often fail to reach genome-wide significance in GWAS. Our findings show that analysis of traditional risk factors as intermediate phenotypes is an effective tool for deciphering hidden heritability. Further, we demonstrate that common disease loci identified in a population isolate

  18. Low-dose ionizing irradiation triggers a 53BP1 response to DNA double strand breaks in mouse spermatogonial stem cells.

    PubMed

    Le, Wei; Qi, Lixin; Li, Jiaxuan; Wu, DengIong; Xu, Jun; Zhang, Jinfu

    2016-01-01

    The present study aims to examine the effect of low-dose ionizing irradiation on DNA double strand breaks (DSB) in mouse spermatogonial stem cells (SSCs) and reveal the underlying pathways for the DNA repair for DSB in SSCs. Eighteen one-month-old mice were divided into 6 groups and sacrificed separately at 45 minutes, 2 hours, 24 hours, 48 hours, and 72 hours after 0.1Gy X-ray irradiation (mice without receiving ionizing irradiation served as control). After perfusion fixation, testes were removed, sectioned, and followed by staining of γH2AX, 53BP1, Caspase 3, and promyelocytic leukemia zinc-finger (PLZF) for analysis among the different groups. The staining was observed by immunofluorescence visualized by confocal laser scanning. After low-dose irradiation, only 53BP1, but not Caspase3 or γH2AX was upregulated in PLZF positive SSCs within 45 minutes. The expression level of 53BP1 gradually decreased 24 hours after irradiation. Moreover, low-dose irradiation had no effect on the cell number and apoptotic status of SSCs. However other spermatogenic cells highly expressed γH2AX shortly after irradiation which was dramatically reduced following the events of DNA repair. It appears that low-dose ionizing irradiation may cause the DNA DSB of mouse spermatogenic cells. 53BP1, but not γH2AX, is involved in the DNA repair for DSB in SSCs. Our data indicates that 53BP1 plays an important role in the pathophysiological repair of DNA DSB in SSCs. This may open a new avenue to understanding the mechanisms of DNA repair of SSCs and male infertility.

  19. Systolic Signal Processor/High Frequency Direction Finding

    DTIC Science & Technology

    1990-10-01

    MUSIC ) algorithm and the finite impulse response (FIR) filter onto the testbed hardware was supported by joint sponsorship of the block and major bid...computational throughput. The systolic implementations of a four-channel finite impulse response (FIR) filter and multiple signal classification ( MUSIC ... MUSIC ) algorithm was mated to a bank of finite impulse response (FIR) filters and a four-channel data acquisition subsystem. A complete description

  20. Systolic time intervals in children with heart disease.

    PubMed

    Hedvall, G

    1983-03-01

    Of the systolic time intervals, the preejection period is known to correlate well with invasively measured isometric contraction time, and increase of the quotient preejection period/left ventricular ejection time (PEP/LVET) is considered to be of a good indicator of left ventricular failure. The different systolic time intervals have been recorded from the carotid pulse curve from 40 normal children, 20 aged five and 20 aged ten years. Their PEP/LVET was 0.31 +/- 0.04. Seventy-eight children with different heart diseases were then investigated. In patients with congenital total heart block or extrasystoles, there was a negative correlation between PEP/LVET and the R-R interval, in accordance with the Frank-Starling law. In patients with ventricular septal defects PEP/LVET differentiates between small and large shunts; the increased PEP/LVET of the latter normalizes after operation. The increased PEP/RVET of children with transposition of the great arteries is an expression of the inadequacy of the right ventricle as a systemic chamber. In aortic stenosis "normalization" of a previously decreased PEP/LVET may indicate early left ventricular failure. In primary myocardial disease registration of the systolic time intervals enables us to follow the left ventricular function more closely than is possible with invasive techniques.

  1. Coronary MR Angiography at 3T During Diastole and Systole

    PubMed Central

    Gharib, Ahmed M.; Herzka, Daniel A.; Ustun, Ali O.; Desai, Milind Y.; Locklin, Julia; Pettigrew, Roderic I.; Stuber, Matthias

    2016-01-01

    Purpose To investigate the impact of end-systolic imaging on quality of right coronary magnetic resonance angiography (MRA) in comparison to diastolic and to study the effect of RR interval variability on image quality. Materials and Methods The right coronary artery (RCA) of 10 normal volunteers was imaged at 3T using parallel imaging (sensitivity encoding [SENSE]). Navigator-gated three-dimensional (3D) gradient echo was used three times: 1) end-systolic short acquisition (SS): 35-msec window; 2) diastolic short (DS): middiastolic acquisition using 35-msec window; and 3) diastolic long (DL): 75-msec diastolic acquisition window. Vectorcardiogram (VCG) data was used to analyze RR variability. Vessel sharpness, length, and diameter were compared to each other and correlated with RR variability. Blinded qualitative image scores of the images were compared. Results Quantitative and qualitative parameters were not significantly different and showed no significant correlation with RR variability. Conclusion Imaging the RCA at 3T during the end-systolic rest period using SENSE is possible without significant detrimental effect on image quality. Breaking away from the standard of imaging only during diastole can potentially improve image quality in tachycardic patients or used for simultaneous imaging during both periods in a single scan. PMID:17896391

  2. Differences in ward-to-cath lab systolic blood pressure predicts long-term adverse outcomes after drug-eluting stent implantation.

    PubMed

    Her, Ae-Young; Ann, Soe Hee; Lee, Jun Ho; Kim, Jong Min; Kim, Yong Hoon; Garg, Scot; Singh, Gillian Balbir; Shin, Eun-Seok

    2015-11-01

    We sought to investigate the effect of ward-to-cath lab blood pressure (BP) differences on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES). There are limited data available on the association between PCI with DES and BP differences on long-term clinical outcomes. This study enrolled 994 patients who underwent PCI with DES from March 2003 to August 2007. Resting BP was measured in a ward environment before transfer to the cardiac catheterization lab (cath lab), and again when the patient was laid down on the cath lab table. Patients were divided into two groups according to the difference in ward-to-cath lab systolic BP. Large difference group (n = 383) was defined as the absolute systolic difference of >20 mmHg and small difference group (n = 424) as the absolute systolic difference of ≤20 mmHg. The primary endpoints were all-cause mortality, cardiac death, nonfatal myocardial infarction and stroke. A total of 807 patients (mean age 60 ± 10 years, 522 males) received follow-up for 5.1 ± 2.4 years. The rate of all-cause mortality was significantly higher in the large difference group compared to the small difference group (6.6 vs. 2.8 %; adjusted hazard ratio (HR) 2.43; 95 % confidence interval (CI) 1.22-4.83; p = 0.012). There were higher cardiac deaths seen in the large difference group compared to the small difference group (3.9 vs. 1.4 %; adjusted HR 2.84; 95 % CI 1.1-7.31; p = 0.031). Stroke (2.4 vs. 1.2 %, p = 0.125) and TVR (3.7 vs. 1.7 %, p = 0.051) had higher trends in the large difference group compared to the small difference group. The composite of primary endpoints (all-cause mortality, cardiac death, nonfatal MI and stroke) occurred more frequently in the large difference group compared to the small difference group (10.0 vs. 6.4 %; adjusted HR 1.71; 95 % CI 1.04-2.81; p = 0.033). A difference in ward-to-cath lab systolic BP of >20 mmHg may contribute to increased adverse

  3. The effects of a special Agnus castus extract (BP1095E1) on prolactin secretion in healthy male subjects.

    PubMed

    Merz, P G; Gorkow, C; Schrödter, A; Rietbrock, S; Sieder, C; Loew, D; Dericks-Tan, J S; Taubert, H D

    1996-01-01

    The effects of three doses of a special Agnus castus extract (BP1095E1)--extracts from 120 mg, 240 mg and 480 mg of drug per day--were examined within the framework of a placebo-controlled clinical study of tolerance and prolactin secretion in 20 healthy male subjects during a period of 14 days. There was good tolerance during the study as regards the following: adverse effects, the effects on blood pressure and heart rate, blood count, Quick's test, clinical chemistry as well as testosterone, FSH and LH values. During each study phase the 24-hour prolactin secretion profile was measured from the penultimate to the final day, and the amount of prolactin release was monitored an hour after TRH stimulation on the last day. A significant increase in the 24-hour profile was registered with the lowest dose in comparison to placebo, the opposite being the case with the higher doses, i.e. a slight reduction. In contrast to the administration of placebo, the 1-hour AUC after TRH stimulation resulted in a significant increase with the lowest dose and a significant reduction with the highest dose. The results suggest effects of the special Agnus castus extract which are dependent on the dose administered and the initial level of prolactin concentration.

  4. Seasonal variation in self-measured home blood pressure among patients on antihypertensive medications: HOMED-BP study.

    PubMed

    Hanazawa, Tomohiro; Asayama, Kei; Watabe, Daisuke; Hosaka, Miki; Satoh, Michihiro; Yasui, Daisaku; Obara, Taku; Inoue, Ryusuke; Metoki, Hirohito; Kikuya, Masahiro; Imai, Yutaka; Ohkubo, Takayoshi

    2017-03-01

    Seasonal variation of blood pressure (BP) has been reported in small populations or by BP levels captured at only a few points in a year, for example, summer and winter. We aimed to investigate the multiyear seasonal variation in self-measured home BP among hypertensive patients receiving antihypertensive medications. We selected 1649 eligible patients receiving antihypertensive drug treatment, and weekly averaged home BPs were analyzed throughout the follow-up period. Systolic and diastolic home BPs were fitted with the cosine function: 'Variation+Other Effects+Intercept', in which the 'Variation' was expressed by a cosine curve with three parameters representing: (1) maximum-minimum difference of home BP in one cycle of the cosine curve; (2) time required for one cycle of the cosine curve for home BP variation; and (3) time at which home BP reached the maximum point. Maximum-minimum differences in home BP were 6.7/2.9 mm Hg, and the highest home BPs were observed in mid-to-late January. In the multivariable-adjusted model, a large maximum-minimum difference in home BP was associated with lower body mass index and older age, and larger differences were observed in men compared with women. Summer-winter difference in home BP was essentially similar every year, though it was marginally reduced by 0.14/0.04 mm Hg per year, under long-term antihypertensive treatment. Records of daily home BP measurements enable us to capture long-term factors such as seasonal variation. Home BP should therefore be carefully monitored, particularly in patients with increased BP in winter, to mitigate cardiovascular risk.

  5. A Unified Approach to the Analysis and Synthesis of Systolic Arrays.

    DTIC Science & Technology

    1985-04-01

    ANALYSIS AND SYNTHESIS OF SYSTOLIC ARRAYS... Analysis and Synthesis of Systolic Arrays N/A N/A N/A N/A 12. PERSONAL AUTHOR($) Hornick, Scot Wayne 13&. TYP OF REPORT K-J 1131L TIME COVERIO 14. OATS OF...frame- work to unify the analysis and synthesis of systolic networks. We describe a class of transformations on systolic networks that alter

  6. Twenty-Four-Hour Blood Pressure Monitoring to Predict and Assess Impact of Renal Denervation: The DENERHTN Study (Renal Denervation for Hypertension).

    PubMed

    Gosse, Philippe; Cremer, Antoine; Pereira, Helena; Bobrie, Guillaume; Chatellier, Gilles; Chamontin, Bernard; Courand, Pierre-Yves; Delsart, Pascal; Denolle, Thierry; Dourmap, Caroline; Ferrari, Emile; Girerd, Xavier; Michel Halimi, Jean; Herpin, Daniel; Lantelme, Pierre; Monge, Matthieu; Mounier-Vehier, Claire; Mourad, Jean-Jacques; Ormezzano, Olivier; Ribstein, Jean; Rossignol, Patrick; Sapoval, Marc; Vaïsse, Bernard; Zannad, Faiez; Azizi, Michel

    2017-03-01

    The DENERHTN trial (Renal Denervation for Hypertension) confirmed the blood pressure (BP) lowering efficacy of renal denervation added to a standardized stepped-care antihypertensive treatment for resistant hypertension at 6 months. We report here the effect of denervation on 24-hour BP and its variability and look for parameters that predicted the BP response. Patients with resistant hypertension were randomly assigned to denervation plus stepped-care treatment or treatment alone (control). Average and standard deviation of 24-hour, daytime, and nighttime BP and the smoothness index were calculated on recordings performed at randomization and 6 months. Responders were defined as a 6-month 24-hour systolic BP reduction ≥20 mm Hg. Analyses were performed on the per-protocol population. The significantly greater BP reduction in the denervation group was associated with a higher smoothness index (P=0.02). Variability of 24-hour, daytime, and nighttime BP did not change significantly from baseline to 6 months in both groups. The number of responders was greater in the denervation (20/44, 44.5%) than in the control group (11/53, 20.8%; P=0.01). In the discriminant analysis, baseline average nighttime systolic BP and standard deviation were significant predictors of the systolic BP response in the denervation group only, allowing adequate responder classification of 70% of the patients. Our results show that denervation lowers ambulatory BP homogeneously over 24 hours in patients with resistant hypertension and suggest that nighttime systolic BP and variability are predictors of the BP response to denervation.

  7. Impact of Stress Reduction Interventions on Hostility and Ambulatory Systolic Blood Pressure in African American Adolescents

    ERIC Educational Resources Information Center

    Wright, Lynda Brown; Gregoski, Mathew J.; Tingen, Martha S.; Barnes, Vernon A.; Treiber, Frank A.

    2011-01-01

    This study examined the impact of breathing awareness meditation (BAM), life skills (LS) training, and health education (HE) interventions on self-reported hostility and 24-hour ambulatory blood pressure (ABP) in 121 African American (AA) ninth graders at increased risk for development of essential hypertension. They were randomly assigned to BAM,…

  8. Validation of the A&D BP UA-651 device for home blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Benetti, Elisabetta; Fania, Claudio; Palatini, Paolo

    2014-02-01

    The objective of this study was to determine the accuracy of the A&D BP UA-651 device for home blood pressure (BP) measurement according to the International Protocol of the European Society of Hypertension. Device evaluation was carried out in 33 patients. The mean age of the patients was 48.3±15.5 years, the mean systolic BP was 138.3±24.9 mmHg (range 90-180), the mean diastolic BP was 88.3±13.8 mmHg (range 60-108), and the mean arm circumference was 28.6±3.4 cm (range 23-36). The protocol requirements were followed precisely. The device passed all requirements, fulfilling the standards of the protocol. On average, the device underestimated the systolic BP by 0.4±4.4 mmHg and diastolic BP by 1.3±3.5 mmHg. The device-observer discrepancies were unrelated to patients' clinical characteristics. These data show that the A&D BP UA-651 device fulfilled the requirements for validation by the International Protocol and can be recommended for clinical use in the adult population.

  9. Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015

    PubMed Central

    Auger, R. Robert; Burgess, Helen J.; Emens, Jonathan S.; Deriy, Ludmila V.; Thomas, Sherene M.; Sharkey, Katherine M.

    2015-01-01

    A systematic literature review and meta-analyses (where appropriate) were performed and the GRADE approach was used to update the previous American Academy of Sleep Medicine Practice Parameters on the treatment of intrinsic circadian rhythm sleep-wake disorders. Available data allowed for positive endorsement (at a second-tier degree of confidence) of strategically timed melatonin (for the treatment of DSWPD, blind adults with N24SWD, and children/ adolescents with ISWRD and comorbid neurological disorders), and light therapy with or without accompanying behavioral interventions (adults with ASWPD, children/adolescents with DSWPD, and elderly with dementia). Recommendations against the use of melatonin and discrete sleep-promoting medications are provided for demented elderly patients, at a second- and first-tier degree of confidence, respectively. No recommendations were provided for remaining treatments/ populations, due to either insufficient or absent data. Areas where further research is needed are discussed. Citation: Auger RR, Burgess HJ, Emens JS, Deriy LV, Thomas SM, Sharkey KM. Clinical practice guideline for the treatment of intrinsic circadian rhythm sleep-wake disorders: advanced sleep-wake phase disorder (ASWPD), delayed sleep-wake phase disorder (DSWPD), non-24-hour sleep-wake rhythm disorder (N24SWD), and irregular sleep-wake rhythm disorder (ISWRD). An update for 2015. J Clin Sleep Med 2015;11(10):1199–1236. PMID:26414986

  10. [Prognostic Value of Central Aortic Pressure in Pregnant Women With Hypertension].

    PubMed

    Chulkov, V S; Sinitsin, S P; Vereina, N K

    2015-01-01

    Prognostic value of central aortic pressure and peripheral blood pressure in relation to the development of pre-eclampsia was assessed in pregnant women with different forms of hypertension. It was shown that development of pre-eclampsia was associated with higher mean 24-hour systolic blood pressure (BP), time index of systolic BP, variability of diastolic BP, and pulse BP measured on weeks 16-22 of gestation. Pregnant women with hypertension, especially those with pre-eclampsia were characterized by absence of proper nocturnal BP lowering or BP elevation during night hours (non-dippers and night-peakers). Critical values for prediction of preeclampsia were daily average central (aortic) systolic BP higher than 115 mm Hg and a mean daily brachial systolic BP above 131 mm Hg.

  11. "Sawfish" systolic narrowing of the left anterior descending coronary artery: an angiographic sign of hypertrophic cardiomyopathy.

    PubMed

    Brugada, P; Bär, F W; de Zwaan, C; Roy, D; Green, M; Wellens, H J

    1982-10-01

    The morphologic characteristics at coronary arteriography of systolic narrowing of the left anterior descending coronary artery (LAD) were evaluated in 14 patients. Six patients had systolic narrowing of the LAD not associated with other cardiac abnormalities (group A) and eight patients had systolic narrowing of the LAD associated with hypertrophic cardiomyopathy (group B). Patients in group A showed a smooth and progressive constriction of the vessel up to the point of maximal stenosis, giving it a "rat-tail" appearance. There was no systolic narrowing of septal branches or of other epicardial vessels in this group. In patients of group B, systolic narrowing of the LAD had a "saw-fish" appearance. Seven patients had systolic narrowing of the septal branches, and five had systolic narrowing of other epicardial vessels. These data indicate that systolic narrowing of the LAD in patients with hypertrophic cardiomyopathy differs angiographically from systolic narrowing due to an intramural course of a part of the vessel (as in group A patients). We postulate that in patients with hypertropic cardiomyopathy, fiber hypertrophy and disarray in the vicinity of the coronary vessels is responsible for the morphology and the widespread distribution of systolic narrowing.

  12. Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study.

    PubMed

    Nagai, M; Dote, K; Kato, M; Sasaki, S; Oda, N; Kagawa, E; Nakano, Y; Yamane, A; Kubo, Y; Higashihara, T; Miyauchi, S; Harada, W; Masuda, H

    2016-10-20

    In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors. Based on 12 visits (1 × /month for 1 year), we calculated visit-to-visit BP variability expressed as the standard deviation (s.d.), coefficient of variation (CV), maximum BP, minimum BP and delta (maximum-minimum) BP. We measured mean intima-media thickness (IMT) as well as stiffness parameter β were measured at baseline and at the mean 4.2-year follow-up. In a multiple regression analysis, the maximum, minimum, s.d. and average of systolic BP (SBP) were significantly associated with a change in β-values between the baseline and follow-up after adjustment for age, smoking, lower high-density lipoprotein level, baseline β-value and follow-up period. There were no significant associations between the visit-to-visit BP variability measures and the change in mean IMT. Significant associations of maximum, minimum, s.d. and average SBP were found with increased β-values in the subjects without calcium channel blocker (CCB) use and in the subjects using renin-angiotensin system inhibitors (RASIs). Thus, exaggerated visit-to-visit SBP variability and a high average SBP level were significant predictors of progression in carotid arterial stiffness in high-risk elderly without CCBs use and in those using a RASI.Journal of Human Hypertension advance online publication, 20 October 2016; doi:10.1038/jhh.2016.77.

  13. Fluctuation in systolic blood pressure is a major systemic risk factor for development of primary open-angle glaucoma

    PubMed Central

    Lee, Na Young; Jung, Younhea; Han, Kyungdo; Park, Chan Kee

    2017-01-01

    We evaluated the risk of development of primary open-angle glaucoma (POAG) in terms of variability in BP using a nationwide, population-based, 11-year longitudinal study using the Korean National Health Insurance Research Database. We included patients who underwent health care examinations more than twice between January 2002 and December 2006. We divided all subjects by the quartiles of variability in systolic blood pressure (SBP), diastolic blood pressure (DBP), and the difference between SBP and DBP. Of the total of 80,021 included subjects, 910 were diagnosed with POAG between January 2007 and December 2013. Both the Kaplan-Meier survival curves and log-rank test data indicated that patients with higher-level BP variability developed POAG significantly more frequently than did patients with lower-level variability (P < 0.001). On multivariate Cox’s regression modeling including gender, age, sex, household income, smoking status, level of alcohol intake, extent of exercise, diabetes mellitus status, dyslipidemia status, SBP, and DBP; the hazard ratios among the highest and lowest quartiles of SD SBP and CV SBP were 1.256 and 1.238, respectively. Our findings suggest that subjects in the highest quartile of SBP variability were significantly more likely to develop POAG in our population-based sample of Korean adults. PMID:28262703

  14. Real-time neuronal networks reconstruction using hierarchical systolic arrays.

    PubMed

    Yu, Bo; Mak, Terrence; Sun, Yihe; Poon, Chi-Sang

    2011-01-01

    The correlation network of neurons emerges as an important mathematical framework for a spectrum of applications including neural modeling, brain disease prediction and brain-machine interface. However, construction of correlation network is computationally expensive, especially when the number of neurons is large and this prohibits realtime applications. This paper proposes a hardware architecture using hierarchical systolic arrays to reconstruct the correlation network. Through mapping an efficient algorithm for cross-correlation onto a massively parallel structure, the hardware can accomplish the network construction with extremely small delay. The proposed structure is evaluated using Field Programmable Gate Array (FPGA). Results show that our method is three orders of magnitudes faster than the software approach using desktop computer. This new method enables real-time network construction and leads to future novel devices of realtime neuronal network monitoring and rehabilitation.

  15. Systolic Blood Pressure Accuracy Enhancement in the Electronic Palpation Method Using Pulse Waveform

    DTIC Science & Technology

    2007-11-02

    1 of 4 SYSTOLIC BLOOD PRESSURE ACCURACY ENHANCEMENT IN THE ELECTRONIC PALPATION METHOD USING PULSE WAVEFORM H. S. S. Sorvoja1, R. A. Myllylä1...systolic blood pressure measurements based on pulse waveform. A set of measurement was carried out with elderly cardiac surgery patients. The experiments... blood pressure . Systolic pressure errors were defined and correlations with other specific values, like pressure rise time, pulse wave velocity

  16. [Left ventricular systolic function: how to understand it and analyze it].

    PubMed

    Fernández-Pérez, G C; Franco López, A; García Fernández, M Á; Corral de la Calle, M Á; Encinas de la Iglesia, J; Velasco Casares, M

    2014-01-01

    In cardiac magnetic resonance imaging studies, left ventricular systolic function is usually calculated automatically. To understand and interpret parameters of left ventricular systolic function correctly, it is fundamental to understand how each parameter is obtained and why values obtained with different techniques, for example, ultrasonography and magnetic resonance imaging, can differ. This article provides details about the usual analysis of systolic function from the quantitative and qualitative points of view; it also explains other methods that do not require specific software. Moreover, we provide a file that we designed for use with Microsoft Excel(®) to enable simple, intuitive analysis of systolic function. Readers can use this file freely.

  17. A pilot study on the effects of magnesium supplementation with high and low habitual dietary magnesium intake on resting and recovery from aerobic and resistance exercise and systolic blood pressure.

    PubMed

    Kass, Lindsy S; Skinner, Philip; Poeira, Filipe

    2013-01-01

    The effects of magnesium supplementation on blood pressure (BP) have been studied for over 25 years and results have been inconsistent. Blood pressure reductions in randomized studies have varied from 12 mmHg reductions to no reduction. The objective of this pilot intervention was to investigate the effect of magnesium supplementation on systolic blood pressure whilst resting and during recovery from aerobic and resistance exercise and on performance. A further objective was to see whether the effect of a high vs low habitual dietary magnesium intake affected these results. Sixteen male volunteers were randomly assigned to either a 300 mg·d(-1) magnesium oxide supplementation (MO) or a control group (CG) for 14 days. Resting blood pressure (BP) and heart rate (HR) were measured before subjects performed a maximal 30 minute cycle, immediately followed by three x 5 second isometric bench press, both at baseline and after the intervention. Blood pressure and heart rate were recorded immediately post exercise and after five minutes recovery. A 3 day food diary was recorded for all subjects to measure dietary magnesium intake. At the end of the intervention, the supplemented group, had a reduction in mean resting systolic BP by 8.9 mmHg (115.125 ± 9.46 mmHg, p = 0.01) and post exercise by 13 mmHg (122.625 ± 9. 88 mmHg, p = 0.01). Recovery BP was 11.9 mmHg lower in the intervention group compared to control (p = 0.006) and HR decreased by 7 beats per minute in the experimental group (69.0 ± 11.6 bpm, p = 0. 02). Performance indicators did not change within and between the groups. Habitual dietary magnesium intake affected both resting and post exercise systolic BP and the subsequent effect of the magnesium supplementation. These results have an implication in a health setting and for health and exercise but not performance. Key pointsMagnesium supplementation will have an effect on resting and recovery systolic blood pressure with aerobic exercise

  18. Circadian Variations in Blood Pressure, Heart Rate, and HR-BP Cross-Correlation Coefficient during Progression of Diabetes Mellitus in Rat.

    PubMed

    Anigbogu, Chikodi N; Williams, Daniel T; Brown, David R; Silcox, Dennis L; Speakman, Richard O; Brown, Laura C; Karounos, Dennis G; Randall, David C

    2011-01-01

    Circadian changes in cardiovascular function during the progression of diabetes mellitus in the diabetes prone rat (BBDP) (n = 8) were studied. Age-matched diabetes-resistant rats (BBDR) served as controls. BP was recorded via telemetry in contiguous 4 hr time periods over 24 hours starting with 12 midnight to 4 am as period zero (P0). Prior to onset of diabetes BP was high at P0, peaked at P2, and then fell again at P3; BP and heart rate (HR) then increased gradually at P4 and leveled off at P5, thereby exhibiting a bipodal rhythm. These patterns changed during long-term diabetes. The cross-correlation coefficient of BP and HR was not significantly different across groups at onset, but it fell significantly at 9 months of duration of diabetes (BBDP: 0.39 ± 0.06; BBDR: 0.65 ± 0.03; P < .05). These results show that changes in circadian cardiovascular rhythms in diabetes mellitus became significant at the late stage of the disease.

  19. Right ventricular systolic function is not the sole determinant of tricuspid annular motion.

    PubMed

    López-Candales, Angel; Rajagopalan, Navin; Saxena, Neil; Gulyasy, Beth; Edelman, Kathy; Bazaz, Raveen

    2006-10-01

    Maximal tricuspid annular plane systolic excursion (TAPSE) correlates well with right ventricular (RV) function; however, little is known regarding the impact of left ventricular (LV) systolic function on TAPSE. Consequently, TAPSE was examined in 206 patients (105 men; mean age 56 +/- 17 years), and the data were analyzed with respect to RV (RV fractional area change 45 +/- 19%) and LV (56 +/- 17%) systolic function. The mean TAPSE for the population studied was 1.97 +/- 0.72 cm. Although a strong linear correlation was noted between RV fractional area change and TAPSE (r = 0.73, p <0.0001), relative differences with regard to TAPSE were also found. First, the greatest TAPSE was noted only when RV and LV systolic function were normal (2.46 +/- 0.50 cm). Second, patients with reduced RV systolic function had the smallest TAPSE (1.28 +/- 0.48 cm, p <0.0001). Third, patients with normal RV function but reduced LV systolic function had TAPSE (1.91 +/- 0.54 cm, p <0.0001) that was intermediate between that of patients with normal RV and LV systolic function and those with abnormal RV systolic function. Fourth, patients with reduced biventricular function had the smallest TAPSE (1.16 +/- 0.41 cm, p <0.0001). In conclusion, TAPSE is not only determined by RV systolic function but also appears to depend on LV systolic function. TAPSE <2.0 cm is associated with some degree of either RV or LV dysfunction, whereas a value >2.0 cm suggests normal biventricular systolic function.

  20. LGALS3BP — EDRN Public Portal

    Cancer.gov

    LGALS3BP is a secreted protein that binds to a human macrophage-associated lectin known as Mac-2 and also binds galectin 1. Elevated levels of LGALS3BP have been found in the serum of patients with cancer and in those infected by the human immunodeficiency virus (HIV).

  1. Automatic Identification of Systolic Time Intervals in Seismocardiogram

    NASA Astrophysics Data System (ADS)

    Shafiq, Ghufran; Tatinati, Sivanagaraja; Ang, Wei Tech; Veluvolu, Kalyana C.

    2016-11-01

    Continuous and non-invasive monitoring of hemodynamic parameters through unobtrusive wearable sensors can potentially aid in early detection of cardiac abnormalities, and provides a viable solution for long-term follow-up of patients with chronic cardiovascular diseases without disrupting the daily life activities. Electrocardiogram (ECG) and siesmocardiogram (SCG) signals can be readily acquired from light-weight electrodes and accelerometers respectively, which can be employed to derive systolic time intervals (STI). For this purpose, automated and accurate annotation of the relevant peaks in these signals is required, which is challenging due to the inter-subject morphological variability and noise prone nature of SCG signal. In this paper, an approach is proposed to automatically annotate the desired peaks in SCG signal that are related to STI by utilizing the information of peak detected in the sliding template to narrow-down the search for the desired peak in actual SCG signal. Experimental validation of this approach performed in conventional/controlled supine and realistic/challenging seated conditions, containing over 5600 heart beat cycles shows good performance and robustness of the proposed approach in noisy conditions. Automated measurement of STI in wearable configuration can provide a quantified cardiac health index for long-term monitoring of patients, elderly people at risk and health-enthusiasts.

  2. Detection of systolic ejection click using time growing neural network.

    PubMed

    Gharehbaghi, Arash; Dutoit, Thierry; Ask, Per; Sörnmo, Leif

    2014-04-01

    In this paper, we present a novel neural network for classification of short-duration heart sounds: the time growing neural network (TGNN). The input to the network is the spectral power in adjacent frequency bands as computed in time windows of growing length. Children with heart systolic ejection click (SEC) and normal children are the two groups subjected to analysis. The performance of the TGNN is compared to that of a time delay neural network (TDNN) and a multi-layer perceptron (MLP), using training and test datasets of similar sizes with a total of 614 normal and abnormal cardiac cycles. From the test dataset, the classification rate/sensitivity is found to be 97.0%/98.1% for the TGNN, 85.1%/76.4% for the TDNN, and 92.7%/85.7% for the MLP. The results show that the TGNN performs better than do TDNN and MLP when frequency band power is used as classifier input. The performance of TGNN is also found to exhibit better immunity to noise.

  3. Modeling systolic pressure variation due to positive pressure ventilation.

    PubMed

    Messerges, Joanne

    2006-01-01

    Although many clinical techniques have been proposed to assess blood volume none have been established as an undisputed standard practice, Volume studies suggest systolic pressure variation (SPV) as a promising volume indicator but underlying influences on SPV are not well understood. Successful modeling of SPV will reveal the major SPV influencers, guide algorithm development to accommodate these influencers, and potentially lead to a more clinically relevant interpretation of SPV values, thus improving upon current clinical methods for assessing blood volume. This study takes a first step towards identifying SPV influencers by investigating three variations of an existing pressure-flow cardiovascular model. Each successive version introduces an additional modification in attempt to model SPV under normovolemic and hypovolemic conditions, where the last model accounts for positive pressure ventilation, venous compression, and a rightward septum shift. Under normovolemic conditions, each model yields SPV values of 5.8, 6.4, and 6.7 mmHg, respectively. Under hypovolemic conditions the results do not agree with clinical findings, suggesting these three mechanisms alone do not dictate the clinical SPV response to a decrease in volume. Model results are used to suggest improvements for future work.

  4. Automatic Identification of Systolic Time Intervals in Seismocardiogram

    PubMed Central

    Shafiq, Ghufran; Tatinati, Sivanagaraja; Ang, Wei Tech; Veluvolu, Kalyana C.

    2016-01-01

    Continuous and non-invasive monitoring of hemodynamic parameters through unobtrusive wearable sensors can potentially aid in early detection of cardiac abnormalities, and provides a viable solution for long-term follow-up of patients with chronic cardiovascular diseases without disrupting the daily life activities. Electrocardiogram (ECG) and siesmocardiogram (SCG) signals can be readily acquired from light-weight electrodes and accelerometers respectively, which can be employed to derive systolic time intervals (STI). For this purpose, automated and accurate annotation of the relevant peaks in these signals is required, which is challenging due to the inter-subject morphological variability and noise prone nature of SCG signal. In this paper, an approach is proposed to automatically annotate the desired peaks in SCG signal that are related to STI by utilizing the information of peak detected in the sliding template to narrow-down the search for the desired peak in actual SCG signal. Experimental validation of this approach performed in conventional/controlled supine and realistic/challenging seated conditions, containing over 5600 heart beat cycles shows good performance and robustness of the proposed approach in noisy conditions. Automated measurement of STI in wearable configuration can provide a quantified cardiac health index for long-term monitoring of patients, elderly people at risk and health-enthusiasts. PMID:27874050

  5. Systolic closure of aortic valve in patients with prosthetic mitral valves.

    PubMed Central

    Eldar, M; Motro, M; Rath, S; Schy, N; Neufeld, H N

    1982-01-01

    Systolic closure of the aortic valve was found in 10 of 36 patients who underwent mitral valve replacement. Eight patients had early systolic closure, and two had mid-systolic closure. The left ventricular outflow tract dimension on M-mode and two dimensional echocardiograms, left ventricular posterior wall and septal thickness, left ventricular dimensions in systole and diastole, aortic valve opening, and mitral to aortic valve distance were not significantly different between patients with and without systolic closure of the aortic valve. Two of the 10 patients with systolic aortic valve closure were catheterised and in neither was there a gradient between the left ventricle and the aorta. The two patients with mid-systolic closure, however, were the patients who had the narrowest left ventricular outflow tract which could cause significant distortion of blood flow. Systolic closure of the aortic valve in patients with mitral valve replacement is probably not caused by left ventricular outflow tract obstruction, though abnormalities in laminar flow from the left ventricular outflow tract may be involved. Images PMID:7082513

  6. Vasopressin V2 receptor antagonist tolvaptan is effective in heart failure patients with reduced left ventricular systolic function and low blood pressure.

    PubMed

    Suzuki, Satoshi; Yoshihisa, Akiomi; Yamaki, Takayoshi; Sugimoto, Koichi; Kunii, Hiroyuki; Nakazato, Kazuhiko; Abe, Yukihiko; Saito, Tomiyoshi; Ohwada, Takayuki; Suzuki, Hitoshi; Saitoh, Shu-ichi; Kubota, Isao; Takeishi, Yasuchika

    2015-01-01

    Diuresis is a major therapy for the reduction of congestive symptoms in acute decompensated heart failure (ADHF) patients. Carperitide has natriuretic and vasodilatory effects, and tolvaptan produces water excretion without electrolyte excretion. We previously reported the usefulness of tolvaptan compared to carperitide in ADHF patients with fluid volume retention. The purpose of this study was to examine whether the efficacy of tolvaptan was altered in ADHF patients with reduced left ventricular systolic function and in those with hypotension. A total of 109 hospitalized ADHF patients were randomly assigned to either a tolvaptan or a carperitide treatment group. Baseline clinical characteristics were not different between the two groups. We divided these patients based on the left ventricular ejection fraction (EF) by echocardiography, and blood pressure (BP) at the time of admission. Daily urine volume between the tolvaptan and carperitide groups in patients with preserved EF (≥ 50%) was not different, however, in those with reduced EF (< 50%), the urine volume was significantly higher in the tolvaptan group than in the carperitide group (day 2, 3, 4, P < 0.05 for all). Daily urine volume did not differ between these two groups in the high blood pressure group (BP ≥ 140 mmHg), but was significantly higher in the tolvaptan group than in the carperitide group (day 1, P = 0.021; day 3, P = 0.017) in the low blood pressure group (BP < 140 mmHg). The present study reveals that tolvaptan is more effective than carperitide, especially in ADHF patients with reduced left ventricular systolic function and without hypertension.

  7. Validation of the A&D BP UB-543 wrist device for home blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Fania, Claudio; Benetti, Elisabetta; Palatini, Paolo

    2015-08-01

    The aim of this study was to determine the accuracy of the A&D BP UB-543 wrist device for home blood pressure (BP) measurement according to the International Protocol of the European Society of Hypertension. The A&D BP UB-543 monitor is provided with a correct position guidance (CPG) indicator that ensures the correct placement of the wrist at the heart level. Device evaluation was carried out in 33 patients with the CPG indicator on. The mean age of the patients was 53.1±16.4 years, the mean systolic BP was 141.8±25.1 mmHg (range 84 : 196), the mean diastolic BP was 88.2±14.5 mmHg (range 34 : 132), the mean arm circumference was 29.0±3.6 cm (range 21 : 38), and the mean wrist circumference was 17.5±1.4 cm (range 15 : 20). The protocol requirements were followed precisely. The device passed all requirements, fulfilling the standards of the protocol. On average, the device overestimated the systolic BP by 1.1±2.9 mmHg and underestimated diastolic BP by 0.1±3.0 mmHg. These data show that the A&D BP UB-543 wrist device used correctly with the CPG indicator on met the requirements for validation by the International Protocol and can be recommended for clinical use in the adult population.

  8. Use of Inotropic Agents in Treatment of Systolic Heart Failure.

    PubMed

    Tariq, Sohaib; Aronow, Wilbert S

    2015-12-04

    The most common use of inotropes is among hospitalized patients with acute decompensated heart failure, with reduced left ventricular ejection fraction and with signs of end-organ dysfunction in the setting of a low cardiac output. Inotropes can be used in patients with severe systolic heart failure awaiting heart transplant to maintain hemodynamic stability or as a bridge to decision. In cases where patients are unable to be weaned off inotropes, these agents can be used until a definite or escalated supportive therapy is planned, which can include coronary revascularization or mechanical circulatory support (intra-aortic balloon pump, extracorporeal membrane oxygenation, impella, left ventricular assist device, etc.). Use of inotropic drugs is associated with risks and adverse events. This review will discuss the use of the inotropes digoxin, dopamine, dobutamine, norepinephrine, milrinone, levosimendan, and omecamtiv mecarbil. Long-term inotropic therapy should be offered in selected patients. A detailed conversation with the patient and family shall be held, including a discussion on the risks and benefits of use of inotropes. Chronic heart failure patients awaiting heart transplants are candidates for intravenous inotropic support until the donor heart becomes available. This helps to maintain hemodynamic stability and keep the fluid status and pulmonary pressures optimized prior to the surgery. On the other hand, in patients with severe heart failure who are not candidates for advanced heart failure therapies, such as transplant and mechanical circulatory support, inotropic agents can be used for palliative therapy. Inotropes can help reduce frequency of hospitalizations and improve symptoms in these patients.

  9. JS ISH-ISN-3 OPTIMAL TARGETS FOR BP CONTROL IN CKD.

    PubMed

    Wheeler, David

    2016-09-01

    Hypertension is the most prevalent complication of chronic kidney disease (CKD). Lowering high blood pressure slows progressive loss of kidney function and may also reduce the associated risk of cardiovascular complications, a common cause of premature death in CKD patients.Current International Guidelines produced by Kidney Disease: Improving Global Outcomes (KDIGO) acknowledges that no single BP target is optimal for all CKD patients, and encourages individualization of treatment depending on age, the severity of albuminuria and comorbidities. When published in 2012, the available evidence indicated that in CKD patients without albuminuria, the target BP should be ≤140 mmHg systolic and ≤90 mmHg diastolic. However, in most patients with an albumin excretion rate of ≥30 mg/24 h (i.e., those with both micro- and macroalbuminuria), a lower target of ≤130 mmHg systolic and ≤80 mmHg diastolic was suggested. In achieving BP control, the value of lifestyle changes and the need for multiple pharmacological agents was acknowledged. Use of agents that block the renin-angiotensin-aldosterone system was recommended or suggested in all patients with an albumin excretion rate of ≥30 mg/24 h. Recommendations are almost identical in CKD patients with and without diabetes.Recent data from SPRINT (which included CKD patients) and other clinical trials has led nephrologists to ask whether targets lower than those recommend by KDIGO are appropriate and the guidelines are currently undergoing an update. Controversies remain around discontinuation of ACE/ARB in patients with stage 4-5 CKD and dual renin-angiotensin-aldosterone system blockade.

  10. Interoperability of wearable cuffless BP measuring devices.

    PubMed

    Liu, Jing; Zhang, Yuan-Ting

    2014-01-01

    While a traditional cuff-based Blood Pressure (BP) measuring device can only take a snap shot of BP, real-time and continuous measurement of BP without an occluding cuff is preferred which usually use the pulse transit time (PTT) in combination with other physiological parameters to estimate or track BP over a certain period of time after an initial calibration. This article discusses some perspectives of interoperability of wearable medical devices, based on IEEE P1708 draft standard that focuses on the objective performance evaluation of wearable cuffless BP measuring devices. The ISO/IEEE 11073 family of standards, supporting the plug-and play feature, is intended to enable medical devices to interconnect and interoperate with other medical devices and with computerized healthcare information systems in a manner suitable for the clinical environment. In this paper, the possible adoption of ISO/IEEE 11073 for the interoperability of wearable cuffless BP devices is proposed. In the consideration of the difference of the continuous and cuffless BP measuring methods from the conventional ones, the existing device specialization standards of ISO/IEEE 11073 cannot be directly followed when designing the cuffless BP device. Specifically, this paper discusses how the domain information model (DIM), in which vital sign information is abstracted as objects, is used to structure the information about the device and that generated from the device. Though attention should also be paid to adopt the communication standards for other parts for the communication system, applying communication standards that enable plug-and-play feature allows achieving the interoperability of different cuffless BP measuring devices with possible different configurations.

  11. Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry

    PubMed Central

    Bakris, George; Bhatt, Deepak L.; Esler, Murray; Ewen, Sebastian; Fahy, Martin; Kandzari, David; Kario, Kazuomi; Mancia, Giuseppe; Weber, Michael; Böhm, Michael

    2017-01-01

    Aims Catheter-based renal artery denervation (RDN) has been shown to lower blood pressure (BP) in certain patients with uncontrolled hypertension. Isolated systolic hypertension (ISH) (systolic BP [SBP] ≥140 mmHg and diastolic BP <90 mmHg), characterized by increased vascular stiffness, is the predominant hypertensive phenotype in elderly patients. This study compared baseline characteristics and SBP change at 6 months between patients with ISH and combined systolic–diastolic hypertension (CH). Methods and results This study pooled data from 1103 patients from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. A total of 429 patients had ISH, and 674 had CH. Patients with ISH were significantly older than those with CH (66 vs. 55 years), had more type 2 diabetes mellitus (52.9 vs. 34.6%), and a lower estimated glomerular filtration rate (71.8 vs. 78.6 mL/min/1.73 m2); all P < 0.001. At 6 months, the SBP drop for CH patients was −18.7 ± 23.7 mmHg compared with a reduction of −10.9 ± 21.7 mmHg for ISH patients −7.8 mmHg, 95% confidence interval, CI, −10.5, −5.1, P < 0.001). The change in 24-h SBP at 6 months was −8.8 ± 16.2 mmHg in patients with CH vs. −5.8 ± 15.4 mmHg in ISH (−3.0 mmHg, 95% CI −5.4, −0.6, P = 0.015). Presence of ISH at baseline but not age was associated with less pronounced BP changes following the procedure. The strongest predictor of office SBP reduction at 6 months was CH, followed by aldosterone antagonist use and non-use of vasodilators. Conclusion The reduction in BP among patients with ISH following RDN was less pronounced than the reduction in patients with CH. Clinical.Trials.gov identifiers NCT01534299 and NCT01418261. PMID:28158510

  12. Validation of the A&D BP UA-651 device with a wide-range cuff for home blood pressure measurement according to the European Society of Hypertension International Protocol revision 2010.

    PubMed

    Benetti, Elisabetta; Fania, Claudio; Palatini, Paolo

    2015-06-01

    The aim of this study was to determine the accuracy of the A&D BP UA-651 device coupled to a wide-range cuff for home blood pressure (BP) measurement according to the International Protocol of the European Society of Hypertension. The device was evaluated in 33 patients. The mean age of the patients was 56.5±15.1 years. The mean systolic BP was 144.3±23.8 mmHg (range 88 : 196), the mean diastolic BP was 87.5±15.8 mmHg (range 38 : 132), and the mean arm circumference was 29.0±3.4 cm (range 22 : 36). The protocol requirements were followed precisely. The device passed all requirements, fulfilling the standards of the protocol. On average, the device overestimated the systolic BP by 0.7±3.4 mmHg and underestimated the diastolic BP by 0.8±3.6 mmHg. The measurement error was unrelated to the patient's arm circumference. These data show that the A&D BP UA-651 device coupled to a wide-range cuff fulfilled the requirements for validation by the International Protocol over a wide range of arm circumferences and can be recommended for clinical use in the adult population.

  13. Cardiac Organ Damage and Arterial Stiffness in Autonomic Failure: Comparison With Essential Hypertension.

    PubMed

    Milazzo, Valeria; Maule, Simona; Di Stefano, Cristina; Tosello, Francesco; Totaro, Silvia; Veglio, Franco; Milan, Alberto

    2015-12-01

    Autonomic failure (AF) is characterized by orthostatic hypotension, supine hypertension, and increased blood pressure (BP) variability. AF patients develop cardiac organ damage, similarly to essential hypertension (EH), and have higher arterial stiffness than healthy controls. Determinants of cardiovascular organ damage in AF are not well known: both BP variability and mean BP values may be involved. The aim of the study was to evaluate cardiac organ damage, arterial stiffness, and central hemodynamics in AF, compared with EH subjects with similar 24-hour BP and a group of healthy controls, and to evaluate determinants of target organ damage in patients with AF. Twenty-seven patients with primary AF were studied (mean age, 65.7±11.2 years) using transthoracic echocardiography, carotid-femoral pulse wave velocity, central hemodynamics, and 24-hour ambulatory BP monitoring. They were compared with 27 EH subjects matched for age, sex, and 24-hour mean BP and with 27 healthy controls. AF and EH had similar left ventricular mass (101.6±33.3 versus 97.7±28.1 g/m(2), P=0.59) and carotid-femoral pulse wave velocity (9.3±1.8 versus 9.2±3.0 m/s, P=0.93); both parameters were significantly lower in healthy controls (P<0.01). Compared with EH, AF patients had higher augmentation index (31.0±7.6% versus 26.1±9.2%, P=0.04) and central BP values. Nighttime systolic BP and 24-hour systolic BP predicted organ damage, independent of BP variability. AF patients develop hypertensive heart disease and increased arterial stiffness, similar to EH with comparable mean BP values. Twenty-four-hour and nighttime systolic BP were determinants of cardiovascular damage, independent of BP variability.

  14. The utility of transoesophageal echocardiography for estimating right ventricular systolic pressure.

    PubMed

    Cowie, B; Kluger, R; Rex, S; Missant, C

    2015-03-01

    With the reduction in use of the pulmonary artery catheter, alternative methods of pulmonary pressure estimation are required. The use of echocardiographically-derived right ventricular systolic pressure has recently been questioned, but this technique has not been validated in anaesthetised surgical patients with transoesophageal echocardiography. One hundred measurements of right ventricular systolic pressure with transoesophageal echocardiography were compared with the pulmonary artery systolic pressure obtained simultaneously from a pulmonary artery catheter in patients undergoing cardiac surgery. Simultaneous right ventricular systolic pressure and pulmonary artery systolic pressure measurements were possible in all patients, and these measurements were strongly correlated (r = 0.98, p < 0.001), with minimal bias and narrow limits of agreement (approximately -5 to +5 mmHg), across a broad range of pulmonary pressures. Measurement of right ventricular systolic pressure using tranoesophageal echocardiography is readily achievable and closely correlates with pulmonary artery systolic pressure, with minimal bias, in cardiac surgical patients undergoing general anaesthesia and positive pressure mechanical ventilation of the lungs.

  15. The millimetre spectrum of BP Cru

    NASA Astrophysics Data System (ADS)

    Pestalozzi, Michele; Hobbs, George; Torkelsson, Ulf

    2010-04-01

    In this experiment we attempt to detect the millimetre emission from the high-mass X-ray binary BP Cru. This object is composed of a hypergiant (Wray 977) and a slow spinning X-ray pulsar (GX301-2). The recent ATCA observations of centimeter emission (Pestalozzi et al. 2009, this was the first detection of radio emission towards BP Cru) suggested that radio emission consists of two components, a transient non-thermal one and a persistent thermal one, probably arising from the large stellar wind of Wray 977. As stellar winds often show a positive spectral index, we ask to observe BP Cru at 13 and 7 mm, where we expect fluxes of around 1 mJy. Any detection will allow us to probe the inner parts of the wind and characterise the structure of the stellar wind of BP Cru. For this detection experiment we require 11 hours of observations with ATCA.

  16. BP: synthesis and properties of boron phosphide

    NASA Astrophysics Data System (ADS)

    Woo, Katherine; Lee, Kathleen; Kovnir, Kirill

    2016-07-01

    Cubic boron phosphide, BP, is notorious for its difficult synthesis, thus preventing it from being a widely used material in spite of having numerous favorable technological properties. In the current work, three different methods of synthesis are developed and compared: from the high temperature reaction of elements, Sn flux assisted synthesis, and a solid state metathesis reaction. Structural and optical properties of the products synthesized from the three methods were thoroughly characterized. Solid state metathesis is shown to be the cleanest and most efficient method in terms of reaction temperature and time. Synthesis by Sn flux resulted in a novel Sn-doped BP compound. Undoped BP samples exhibit an optical bandgap of ∼2.2 eV while Sn-doped BP exhibits a significantly smaller bandgap of 1.74 eV. All synthesized samples show high stability in concentrated hydrochloric acid, saturated sodium hydroxide solutions, and fresh aqua regia.

  17. Left ventricular hypertrophy by electrocardiogram as a predictor of success in home blood pressure control: HOMED-BP study.

    PubMed

    Tanabe, Ayumi; Asayama, Kei; Hanazawa, Tomohiro; Watabe, Daisuke; Nomura, Kyoko; Okamura, Tomonori; Ohkubo, Takayoshi; Imai, Yutaka

    2017-01-12

    Few studies have focused on the effect of organ damage on achievement of long-term home blood pressure (BP) control. Based on the nationwide home BP-based trial data, we aimed to investigate the factors associated with home BP control, in particular, left ventricular hypertrophy (LVH) using the electrocardiogram in patients who started antihypertensive drug treatment. According to the trial protocol, we defined BP as controlled when systolic home BP reached specified targets (125-134 mm Hg in usual control (UC), n=1261; <125 mm Hg in tight control (TC), n=1288). At baseline, before drug treatment started, the mean Sokolow-Lyon voltage was 2.57±0.87 mV, and the mean Cornell product was 1573±705 mm·ms. The numbers of patients who achieved the target BP level in the UC and TC groups were 892 (70.7%) and 576 (44.7%), respectively. In both the UC and TC groups, systolic home BP at baseline was significantly lower in patients who achieved target levels than in those who did not achieve target levels (P<0.0001). Sokolow-Lyon voltage was significantly lower in patients who achieved target levels than in those who did not (P⩽0.0055). The Cornell product levels in each group were similar (P⩾0.12), although significantly different between patients who did or did not achieve the target level when the UC and TC groups were combined for analysis (P=0.031). Sokolow-Lyon voltage was significantly associated with achievement of home BP control in the multivariable-adjusted model (odds ratio, 1.13; 95% confidence intervals, 1.02-1.26; P=0.015), but Cornell product was not (P=0.13). These results indicate the difficulty of sufficient antihypertensive treatment when untreated patients had target organ damage, that is, LVH diagnosed by Sokolow-Lyon voltage.Hypertension Research advance online publication, 12 January 2017; doi:10.1038/hr.2016.176.

  18. On the design of fault-tolerant two-dimensional systolic arrays for yield enhancement

    SciTech Connect

    Kim, J.H.; Reddy, S.M.

    1989-04-01

    The continuing growth of interest in systolic arrays poses the problem of ensuring an acceptable yield. In this paper, the authors propose a unified approach to the design of fault-tolerant systolic arrays incorporating design for testability, a testing scheme, a reconfiguration algorithm, time complexity analysis of the proposed reconfiguration algorithm, and yield analysis. A main feature of the proposed designs is that multiple PE's in a 2-D array can be tested simultaneously, thus reducing the testing time significantly. Another feature is that with introduction of delay registers, the proposed reconfiguration algorithm reconfigures a faulty 2-D systolic array into a fault-free array without reducing throughput. The overall aim of this paper is to provide a design for a 2-D systolic array that produces high yield in VLSI/WSI implementations.

  19. Pulmonary Hypertension Secondary to Left Ventricular Systolic Dysfunction: Contemporary Diagnosis and Management

    PubMed Central

    Shah, Ravi V.; Semigran, Marc J.

    2011-01-01

    Pulmonary hypertension secondary to left ventricular systolic dysfunction is often a poor prognostic marker in chronic heart failure. In this article, we review evidence supporting modern strategies addressing pulmonary hypertension in patients with left ventricular systolic dysfunction, including right-sided heart catheterization with vasoreactivity testing and subsequent parenteral, oral, and inhaled therapy. We delineate a diagnostic approach to secondary pulmonary hypertension and outline evidence-based therapeutic strategies for management in acute and chronic heart failure. PMID:19032918

  20. Reference values of tricuspid annular peak systolic velocity in healthy pediatric patients, calculation of z score, and comparison to tricuspid annular plane systolic excursion.

    PubMed

    Koestenberger, Martin; Nagel, Bert; Ravekes, William; Avian, Alexander; Heinzl, Bernd; Cvirn, Gerhard; Fritsch, Peter; Fandl, Andrea; Rehak, Thomas; Gamillscheg, Andreas

    2012-01-01

    The tricuspid annular peak systolic velocity (TAPSV) is an echocardiographic measurement assessing right ventricular systolic function in children and adults. We determined the growth-related changes of the TAPSV to establish the references values for the entire pediatric age group. A prospective study was conducted of a group of 860 healthy pediatric patients (age 1 day to 18 years; body surface area [BSA] 0.14 to 2.30 m(2)). We determined the effects of age, gender, and BSA on the TAPSV values. Stepwise linear multiple regression analysis was used to estimate the TAPSV from the age, BSA, and gender. A correlation of normal TAPSV with normal tricuspid annular plane systolic excursion values was performed. The TAPSV ranged from a mean of 7.2 cm/s (z score ± 2: 4.8 to 9.5 cm/s) in the newborn to 14.3 cm/s (z score ± 2: 10.6 to 18.6 cm/s) in the 18-year-old adolescent. The TAPSV values showed a positive correlation with age and BSA, with a nonlinear course. No significant difference was found in the TAPSV values according to gender. A significant correlation was found between the TAPSV and tricuspid annular plane systolic excursion values in our pediatric population. In conclusion, the z scores of the TAPSV values were calculated, and percentile charts were established to serve as reference data for patients with congenital heart disease.

  1. Realizations and performances of least-squares estimation and Kalman filtering by systolic arrays

    SciTech Connect

    Chen, M.J.

    1987-01-01

    Fast least-squares (LS) estimation and Kalman-filtering algorithms utilizing systolic-array implementation are studied. Based on a generalized systolic QR algorithm, a modified LS method is proposed and shown to have superior computational and inter-cell connection complexities, and is more practical for systolic-array implementation. After whitening processing, the Kalman filter can be formulated as a SRIF data-processing problem followed by a simple LS operation. This approach simplifies the computational structure, and is more reliable when the system has singular or near singular coefficient matrix. To improve the throughput rate of the systolic Kalman filter, a topology for stripe QR processing is also proposed. By skewing the order of input matrices, a fully pipelined systolic Kalman-filtering operation can be achieved. With the number of processing units of the O(n/sup 2/), the system throughput rate becomes of the O(n). The numerical properties of the systolic LS estimation and the Kalman filtering algorithms under finite word-length effect are studied via analysis and computer simulations, and are compared with that of conventional approaches. Fault tolerance of the LS estimation algorithm is also discussed. It is shown that by using a simple bypass register, reasonable estimation performance is still possible for a transient defective processing unit.

  2. Reproducibility of the systolic time intervals: effect of the temporal range of measurements.

    PubMed

    Kupari, M

    1983-06-01

    The aim of this study was to evaluate the reproducibility of conventionally measured systolic time intervals. To that end, three to eight serial measurements were performed on four different groups of healthy subjects (total number, 49) within dissimilar time periods: 1) within 3 h; 2) within 24 h; 3) within 1 to 2 weeks; and 4) within 14 to 18 months. Judged as the mean coefficients of variation, the variability of the systolic time intervals tended to be smallest in the 3 h measurements and largest in the 24 h measurements. The pooled variances of the serial measurements made within 24 h were in general significantly larger than the respective variances in the measurements made within 3 h. This was due to statistically significant diurnal decreases in left ventricular ejection time and total electromechanic systole in the 24 h study. Otherwise the reproducibility of the method was high. For instance, the mean coefficients of variation for ejection time and total electromechanic systole corrected for heart rate were only 1% and 1.2%, respectively, in serial measurements made at identical diurnal time points within 14 to 18 months. The pooled variances of the measurements made within the shortest and longest temporal ranges were not statistically different. It is concluded that measurement of the systolic time intervals is very applicable to intervention and follow-up studies provided the normal circadian rhythmicity of the phases of systole is adequately taken into account in the design of the study.

  3. Color-coded Doppler imaging of systolic flow patterns in hypertrophic cardiomyopathy.

    PubMed

    Tencate, F J; Mayala, A P; Vletter, W B; Roelandt, J

    1985-01-01

    We studied 11 patients with hypertrophic cardiomyopathy by color Doppler echocardiography (Group I: 6 patients with outflow obstruction, and Group II: 5 patients without outflow obstruction) to assess systolic structure and function as observed by cross-sectional echocardiography in relation to the flow dynamics. The structure and function included systolic anterior motion of mitral valve (SAM), midsystolic aortic valve closure (AoC), systolic cavity obliteration and the presence and timing of mitral incompetence. Their occurrence and timing was related to presence of aortic systolic flow and presence of turbulence. While all patients in Group I had SAM and turbulence, none of the patients in Group II had SAM nor turbulence. Early mitral incompetence appearing before SAM and turbulence, occurred in all patients of Group I and in none of Group II. Midsystolic aortic valve closure was only present in Group I and blood flow was unilaterally directed so that only 60% of aortic cross-sectional area showed blood flow. We conclude that mitral incompetence in hypertrophic cardiomyopathy in early systole is common when outflow gradient is present and is independent of mitral incompetence of mid- and late systole. During SAM, turbulence in the subaortic area and mid and late mitral incompetence occurred simultaneously. The midsystolic aortic valve closure was related to the unilaterally directed blood flow through the aortic cross-sectional area.

  4. Mitral Annular Systolic Velocities Predict Left Ventricular Wall Motion Abnormality During Dobutamine Stress Echocardiography

    PubMed Central

    Sharif, Dawod; Sharif-Rasslan, Amal; Shahla, Camilia

    2011-01-01

    Background Longitudinal systolic left ventricular contraction is complementary to the radial performance and can be assessed using tissue Doppler imaging (TDI). This study was performed to evaluate the contribution of mitral annular systolic velocities using TDI after dobutamine stress echocardiography (DSE). Methods and Results Fifty subjects with suspected coronary artery disease and chest pain were examined, using DSE as usual, as well as TDI imaging of the mitral annulus at the septal, lateral, inferior, anterior, posterior regions and the proximal anteroseptal region from the apical views, before and immediately after DSE. In 24 subjects the study was normal, while wall motion abnormality was seen in 26, 9 of them only after DSE. Mitral annular systolic velocity at the 6 locations increased significantly after DSE both in normal subjects and in those with wall motion abnormality (WMA). After DSE mitral annular septal systolic velocity in normals, 19.2 ± 3.8 cm/sec, was higher than in those with WMA, 14.6 ± 2.5 cm/sec, P < 0.0003. Post-DSE mitral systolic velocity was senstive and accurate in predicting WMA. Conclusions Systolic mitral TDI velocities increase after DSE, however to a lesser extent in those with wall motion abnormality, and can differentiate them from normal subjects.

  5. Masked Hypertension and Left Atrial Dysfunction: A Hidden Association.

    PubMed

    Tadic, Marijana; Cuspidi, Cesare; Radojkovic, Jana; Rihor, Branislav; Kocijanic, Vesna; Celic, Vera

    2017-03-01

    Masked hypertension (MH) is a clinical condition that indicates normal values of clinic blood pressure (BP) but elevated 24-hour BP. The purpose of this study was to investigate the relationship between MH and left atrial (LA) phasic function evaluated by both the volumetric and speckle tracking method. This cross-sectional study included 49 normotensive individuals, 50 patients with MH, and 70 untreated sustained hypertensive patients adjusted by age and sex. MH was diagnosed if clinic BP was normal and 24-hour BP was increased. LA reservoir function was lower in patients with MH and those with sustained hypertension compared with the normotensive group. LA conduit function gradually decreased, while LA booster pump function progressively increased, from normotension to sustained hypertension. Similar results were obtained by two-dimensional echocardiographic strain analysis. Independently of main clinic and echocardiographic characteristics, 24-hour systolic BP was associated with LA passive ejection fraction, LA total longitudinal strain, LA positive longitudinal strain, and LA stiffness index. In conclusion, MH is associated with impairment of LA phasic function and stiffness, and 24-hour systolic BP increment was closely related with LA remodeling.

  6. Differential control of systolic and diastolic blood pressure in blacks with essential hypertension.

    PubMed Central

    Ayodele, Olugbenga E.; Alebiosu, C. Olutayo; Salako, Babatunde L.

    2004-01-01

    OBJECTIVE: The risk of cardiovascular and renal diseases has been shown to be higher for systolic blood pressure than diastolic blood pressure. The aim of this study was to assess the differential control of systolic and diastolic blood pressure in Nigerians with primary hypertension. DESIGN AND SETTING: This was a prospective observational study carried out at the Medical Outpatient Department of the State Hospital, Abeokuta, Nigeria. Ethical approval for the study was obtained from the ethical committee of the hospital. METHODOLOGY: The study population consisted of 185 consecutive patients (65 males, 120 females), aged 35-85 years with primary hypertension who had been on drugs one- to 25 years prior to the onset of the study. Clinic blood pressure control was assessed during a year period. Six consecutive clinic blood pressure readings were recorded for each patient and the average calculated (systolic blood pressure and diastolic blood pressure separately). Patients were classified into subgroups based on the pattern of blood pressure control. RESULTS: Clinic systolic blood pressure and diastolic blood pressure was controlled in 58 patients (31.4%). Systolic blood pressure control was less frequent than diastolic blood pressure control (35.7% versus 51.4%, p<0.05). Patients with uncontrolled systolic blood pressure were significantly older than patients with only uncontrolled diastolic blood pressure (66.7+/-7.4 versus 52.9+/-8.7 years, p<0.001). CONCLUSION: Systolic blood pressure is less frequently controlled than diastolic blood pressure in Nigerians treated for primary hypertension. This may increase the patient's risk of developing stroke, and cardiovascular and renal complications. PMID:15040512

  7. Systolic Strain Abnormalities to Predict Hospital Readmission in Patients With Heart Failure and Normal Ejection Fraction

    PubMed Central

    Borer, Steven M.; Kokkirala, Aravind; O'Sullivan, David M.; Silverman, David I.

    2011-01-01

    Background Despite intensive investigation, the pathogenesis of heart failure with normal ejection fraction (HFNEF) remains unclear. We hypothesized that subtle abnormalities of systolic function might play a role, and that abnormal systolic strain and strain rate would provide a marker for adverse outcomes. Methods Patients of new CHF and left ventricular ejection fraction > 50% were included. Exclusion criteria were recent myocardial infarction, severe valvular heart disease, severe left ventricular hypertrophy (septum >1.8 cm), or a technically insufficient echocardiogram. Average peak systolic strain and strain rate were measured using an off-line grey scale imaging technique. Systolic strain and strain rate for readmitted patients were compared with those who remained readmission-free. Results One hundred consecutive patients with a 1st admission for HFNEF from January 1, 2004 through December 31, 2007, inclusive, were analyzed. Fifty two patients were readmitted with a primary diagnosis of heart failure. Systolic strain and strain rates were reduced in both study groups compared to controls. However, systolic strain did not differ significantly between the two groups (-11.7% for those readmitted compared with -12.9% for those free from readmission, P = 0.198) and systolic strain rates also were similar (-1.05 s-1 versus -1.09 s-1, P = 0.545). E/e’ was significantly higher in readmitted patients compared with those who remained free from readmission (14.5 versus 11.0, P = 0.013). E/e’ (OR 1.189, 95% CI 1.026-1.378; P = 0.021) was found to be an independent predictor for HFNEF readmission. Conclusions Among patients with new onset HFNEF, SS and SR rates are reduced compared with patients free of HFNEF, but do not predict hospital readmission. Elevated E/e’ is a predictor of readmission in these patients.

  8. The design and rationale of a multi-center clinical trial comparing two strategies for control of systolic blood pressure: The Systolic Blood Pressure Intervention Trial (SPRINT)

    PubMed Central

    2014-01-01

    Background High blood pressure is an important public health concern because it is highly prevalent and a risk factor for adverse health outcomes, including coronary heart disease, stroke, decompensated heart failure, chronic kidney disease, and decline in cognitive function. Observational studies show a progressive increase in risk associated with blood pressure above 115/75 mm Hg. Prior research has shown that reducing elevated systolic blood pressure lowers the risk of subsequent clinical complications from cardiovascular disease. However, the optimal systolic blood pressure to reduce blood pressure-related adverse outcomes is unclear, and the benefit of treating to a level of systolic blood pressure well below 140 mm Hg has not been proven in a large, definitive clinical trial. Purpose To describe the design considerations of the Systolic Blood Pressure Intervention Trial (SPRINT) and the baseline characteristics of trial participants. Methods SPRINT is a multi-center, randomized, controlled trial that compares two strategies for treating systolic blood pressure: one targets the standard target of <140 mm Hg, and the other targets a more intensive target of <120 mm Hg. Enrollment focused on volunteers of age ≥50 years (no upper limit) with an average baseline systolic blood pressure ≥130 mm Hg and evidence of cardiovascular disease, chronic kidney disease, 10-year Framingham cardiovascular disease risk score ≥15%, or age ≥75 years. SPRINT recruitment also targeted three pre-specified subgroups: participants with chronic kidney disease (estimated glomerular filtration rate <60 ml/min/1.73m2), participants with a history of cardiovascular disease, and participants 75 years of age or older. The primary outcome is first occurrence of a myocardial infarction, acute coronary syndrome, stroke, heart failure, or cardiovascular disease death. Secondary outcomes include all-cause mortality, decline in kidney function or development of end-stage renal disease

  9. Cardiac MyBP-C regulates the rate and force of contraction in mammalian myocardium Cardiac Myosin Binding Protein C

    PubMed Central

    Moss, Richard L.; Fitzsimons, Daniel P.; Ralphe, J. Carter

    2014-01-01

    Cardiac myosin binding protein-C (cMyBP-C) is a thick filament-associated protein that appears to contribute to the regulation of cardiac contraction through interactions with either myosin or actin or both. Several studies over the past several years have suggested that the interactions of cMyBP-C with its binding partners vary with its phosphorylation state, binding predominantly to myosin when dephosphorylated and to actin when it is phosphorylated by PKA or other kinases. Here, we summarize evidence suggesting that phosphorylation of cMyBP-C is a key regulator of the kinetics and amplitude of cardiac contraction during β-adrenergic stimulation and increased stimulus frequency. We propose a model for these effects via a phosphorylation-dependent regulation of the kinetics and extent of cooperative recruitment of cross-bridges to the thin filament – phosphorylation of cMyBP-C accelerates cross-bridge binding to actin, thereby accelerating recruitment and increasing the amplitude of the cardiac twitch. In contrast, enhanced lusitropy as a result of phosphorylation appears to be due to a direct effect of phosphorylation to accelerate cross-bridge detachment rate. Depression or elimination of one or both of these processes in a disease such as end-stage heart failure appears to contribute to the systolic and diastolic dysfunction that characterizes the disease. PMID:25552695

  10. Licensing: BP, Lurgi unveil new butanediol process

    SciTech Connect

    Rotman, D.

    1995-07-26

    BP Chemicals and Lurgi (Frankfurt) say they have jointly developed a direct butane-to-1,4-butanediol process and are ready to license the technology. The companies-which began cooperating on the technology in early 1994-say the process, which is being marketed under the name Geminox, promises to be about 40% cheaper to operate than existing butandiol technologies.

  11. Diastolic, systolic and sarcoplasmic reticulum [Ca2+] during inotropic interventions in isolated rat myocytes.

    PubMed Central

    Frampton, J E; Orchard, C H; Boyett, M R

    1991-01-01

    1. The fluorescent indicator Fura-2 has been used to monitor intracellular [Ca2+] (Ca2+i) in myocytes isolated from the ventricles of rat hearts. 2. The relationships between diastolic Ca2+i, systolic Ca2+i and the Ca2+ content of the sarcoplasmic reticulum (SR; assayed using caffeine) have been studied during changes of stimulation rate and bathing [Ca2+] (Ca2+o). 3. When stimulation rate was increased, there were increases in diastolic Ca2+i, systolic Ca2+i and the Ca2+ content of the SR. 4. The SR inhibitor ryanodine (1 mumol l-1) decreased the size of the Ca2+i transient, and abolished the increase of Ca2+i produced by caffeine (10 mmol l-1). In the presence of ryanodine, increasing stimulation rate increased diastolic Ca2+i but not systolic Ca2+i. 5. Increasing Ca2+o led to increases of diastolic Ca2+i, systolic Ca2+i and SR Ca2+ content similar to those observed during changes in stimulation rate. 6. Ryanodine altered the relationship between systolic and diastolic Ca2+i during changes of Ca2+o. 7. These results are consistent with a change of diastolic Ca2+i leading to an increase in the Ca2+ content of the SR, and hence an increase in the size of the Ca2+i transient during changes in stimulation rate and Ca2+o. Images Fig. 1 Fig. 4 Fig. 10 PMID:1890639

  12. Variability of maximum systolic amplitude of ΔZ/Δt curve in pregnancy. Perennial observations

    NASA Astrophysics Data System (ADS)

    Ilyin, I.; Karpov, A.; Korotkova, M.

    2010-04-01

    Maximum systolic amplitude is quite an important component of the impedance cardiogram ΔZ/Δt curve. Its values make it possible to calculate many hemodynamic indices. Therefore it is necessary to keep informed about monthly, annual and perennial maximum systolic amplitude trend. We can produce the measuring data of the maximum systolic amplitude for a fifteen-year period (from 1994 to 2009). The impedance cardiograms were obtained with the help of an electric impedance analyzer "RA-5" (1 mA, 70 kHz) with disk ECG electrodes. The data analyzed were taken from the pregnant women with non-complicated pregnancy (n=5709). We have analyzed the average monthly and annual changes of the maximum systolic amplitude ΔZ/Δt curve. It allowed us to reveal the six-year periodicity of the maximum systolic amplitude changes. There were discovered statistically significant peak values difference of the amplitude (p>0.001). The data obtained should be taken into consideration when using impedance cardiography in clinical practice. The article is supplied with tables and diagrams.

  13. Rapid changes in rate-corrected and uncorrected systolic time intervals during cold pressor test.

    PubMed

    Mäntysaari, M; Antila, K; Peltonen, T

    1985-02-01

    The changes in heart rate and systolic time intervals were studied in a group of 10 young healthy male volunteers during immersion of their hand in ice water for 1 min. The heart rate and systolic time intervals were measured from electro-, phono-, and impedance cardiograms in the standard way. When the cold immersion was done in the supine position the left ventricular ejection time (LVET) and the electromechanic systole (Q-S2Tc) shortened, and when corrected for the heart rate the Q-S2Tc lengthened in the beginning of the immersion. In the head-up position the Q-S2T shortened in the beginning of the immersion while the rate-corrected systolic time intervals remained unchanged. Most of the changes in the systolic time intervals disappeared before the last quarter of the cold immersion. It was observed that during the cold immersion the linear regression coefficients between the heart rate and the Q-S2T in the supine position as well as between the heart rate and the LVET, Q-S2T and the PEP in the head-up position were greater than the regression coefficients used in the rate correction.

  14. Sudden Cardiac Arrest in Patients with Preserved Left Ventricular Systolic Function: A Clinical Dilemma

    PubMed Central

    Sawhney, Navinder; Narayan, Sanjiv M.

    2009-01-01

    Stratifying the risk for sudden cardiac arrest (SCA) in individuals with preserved systolic function remains a pressing public health problem. Current guidelines for the implantation of cardiac defibrillators largely ignore patients with preserved systolic function, even though they account for the majority of cases. However, risk stratification for such individuals is increasingly feasible. Notably, most individuals who experience SCA have structural heart disease, even if undiagnosed. Thus, clinical risk scores have been developed to identify high risk. Moreover, there are now promising data that T-Wave Alternans (TWA), alone and in combination with other indices, effectively predicts SCA in this population. This article presents our current understanding of SCA due to ventricular arrhythmias in patients with preserved LV systolic function, and attempts to build a framework to predict risk in this population. PMID:19251226

  15. Partitioning: An essential step in mapping algorithms into systolic array processors

    SciTech Connect

    Navarro, J.J.; Llaberia, J.M.; Valero, M.

    1987-07-01

    Many scientific and technical applications require high computing speed; those involving matrix computations are typical. For applications involving matrix computations, algorithmically specialized, high-performance, low-cost architectures have been conceived and implemented. Systolic array processors (SAPs) are a good example of these machines. An SAP is a regular array of simple processing elements (PEs) that have a nearest-neighbor interconnection pattern. The simplicity, modularity, and expandability of SAPs make them suitable for VLSI/WSI implementation. Algorithms that are efficiently executed on SAPs are called systolic algorithms (SAs). An SA uses an array of systolic cells whose parallel operations must be specified. When an SA is executed on an SAP, the specified computations of each cell are carried out by a PE of the SAP.

  16. Questionable accuracy of home blood pressure measurements in the obese population – Validation of the Microlife WatchBP O3® and Omron RS6® devices according to the European Society of Hypertension-International Protocol

    PubMed Central

    Azaki, Alaa; Diab, Reem; Harb, Aya; Asmar, Roland; Chahine, Mirna N

    2017-01-01

    Objective Two oscillometric devices, the Microlife WatchBP O3® and the Omron RS6®, designed for self-blood pressure measurement were evaluated according to the European Society of Hypertension (ESH)-International Protocol (IP) Revision 2010 in the obese population. Methods The Microlife WatchBP O3 measures blood pressure (BP) at the brachial level and the Omron RS6 measures BP at the wrist level. The ESH-IP revision 2010 includes a total of 33 subjects. The difference between observers’ and device BP values was calculated for each measure. A total of 99 pairs of BP differences were classified into three categories (≤5, ≤10, and ≤15 mmHg). The protocol procedures were followed precisely in each of the two studies. Results Microlife WatchBP O3 and Omron RS6 failed to fulfill the criteria of the ESH-IP. The mean differences between the device and the mercury readings were: 0.3±7.8 mmHg and −1.9±6.4 mmHg for systolic BP and diastolic BP, respectively, for Microlife WatchBP O3, and 2.7±9.9 mmHg for SBP and 3.5±11.1 mmHg for diastolic BP for Omron RS6. Conclusion Microlife WatchBP O3 and Omron RS6 readings differing from the mercury standard by more than 5, 10, and 15 mmHg failed to fulfill the ESH-IP revision 2010 requirements in obese subjects. Therefore, the two devices cannot be recommended for use in obese subjects. PMID:28280348

  17. Cardiac systolic regional function and synchrony in endurance trained and untrained females

    PubMed Central

    Hedman, Kristofer; Tamás, Éva; Bjarnegård, Niclas; Brudin, Lars; Nylander, Eva

    2015-01-01

    Background Most studies on cardiac function in athletes describe overall heart function in predominately male participants. We aimed to compare segmental, regional and overall myocardial function and synchrony in female endurance athletes (ATH) and in age-matched sedentary females (CON). Methods In 46 ATH and 48 CON, echocardiography was used to measure peak longitudinal systolic strain and myocardial velocities in 12 left ventricular (LV) and 2 right ventricular (RV) segments. Regional and overall systolic function were calculated together with four indices of dyssynchrony. Results There were no differences in regional or overall LV systolic function between groups, or in any of the four dyssynchrony indices. Peak systolic velocity (s′) was higher in the RV of ATH than in CON (9.7±1.5 vs 8.7±1.5 cm/s, p=0.004), but not after indexing by cardiac length (p=0.331). Strain was similar in ATH and CON in 8 of 12 LV myocardial segments. In septum and anteroseptum, basal and mid-ventricular s′ was 6–7% and 17–19% higher in ATH than in CON (p<0.05), respectively, while s′ was 12% higher in CON in the basal LV lateral wall (p=0.013). After indexing by cardiac length, s′ was only higher in ATH in the mid-ventricular septum (p=0.041). Conclusions We found differences between trained and untrained females in segmental systolic myocardial function, but not in global measures of systolic function, including cardiac synchrony. These findings give new insights into cardiac adaptation to endurance training and could also be of use for sports cardiologists evaluating female athletes. PMID:27900120

  18. Cardiac dilatation and pump dysfunction without intrinsic myocardial systolic failure following chronic beta-adrenoreceptor activation.

    PubMed

    Osadchii, Oleg E; Norton, Gavin R; McKechnie, Richard; Deftereos, Dawn; Woodiwiss, Angela J

    2007-04-01

    There is no direct evidence to indicate that pump dysfunction in a dilated chamber reflects the impact of chamber dilatation rather than the degree of intrinsic systolic failure resulting from myocardial damage. In the present study, we explored the relative roles of intrinsic myocardial systolic dysfunction and chamber dilatation as mediators of left ventricular (LV) pump dysfunction. Administration of isoproterenol, a beta-adrenoreceptor agonist, for 3 mo to rats (0.1 mg.kg(-1).day(-1)) resulted in LV pump dysfunction as evidenced by a reduced LV endocardial fractional shortening (echocardiography) and a decrease in the slope of the LV systolic pressure-volume relation (isolated heart preparations). Although chronic beta-adrenoreceptor activation induced cardiomyocyte damage (deoxynucleotidyl transferase-mediated dUTP nick-end labeling) as well as beta(1)- and beta(2)-adrenoreceptor inotropic downregulation (attenuated contractile responses to dobutamine and salbutamol), these changes failed to translate into alterations in intrinsic myocardial contractility. Indeed, LV midwall fractional shortening (echocardiography) and the slope of the LV systolic stress-strain relation (isolated heart preparations) were unchanged. A normal intrinsic myocardial systolic function, despite the presence of cardiomyocyte damage and beta-adrenoreceptor inotropic downregulation, was ascribed to marked increases in myocardial norepinephrine release, to upregulation of alpha-adrenoreceptor-mediated contractile effects as determined by phenylephrine responsiveness, and to compensatory LV hypertrophy. LV pump failure was attributed to LV dilatation, as evidenced by increased LV internal dimensions (echocardiography), and a right shift and increased volume intercept of the LV diastolic pressure-volume relation. In conclusion, chronic sympathetic stimulation, despite reducing beta-adrenoreceptor-mediated inotropic responses and promoting myocyte apoptosis, may nevertheless induce pump

  19. Prognostic value of echocardiographic indicators of left ventricular systolic function in asymptomatic dialysis patients.

    PubMed

    Zoccali, Carmine; Benedetto, Francesco A; Mallamaci, Francesca; Tripepi, Giovanni; Giacone, Giuseppe; Cataliotti, Alessandro; Seminara, Giuseppe; Stancanelli, Benedetta; Malatino, Lorenzo S

    2004-04-01

    Patients with end-stage renal disease (ESRD) are at high risk for heart failure, but the prevalence and the prognostic value of asymptomatic systolic dysfunction in these patients are unknown. In this prospective cohort study, the authors have therefore assessed by echocardiography the prevalence and the prognostic value of systolic function as estimated by ejection fraction (EF), fractional shortening at endocardial level (endoFS), and at midwall (mwFS), in a cohort of 254 asymptomatic dialysis patients. Systolic dysfunction had a prevalence rate of 26% by endoFS and of 48% by mwFS. During the follow-up period, 125 patients had one or more fatal and nonfatal CV events. On multivariate COX regression analysis, the three LV systolic function indicators were independently associated with incident fatal and nonfatal CV events, and there were no differences in the predictive power of these indicators (P > 0.30). The prediction power of LV function indicators was largely independent of traditional and novel risk factors in ESRD such as C-reactive protein and asymmetric dimethyl arginine (ADMA). ADMA was significantly related with LV function indicators as well as with mortality and incident CV events, but these links were much reduced (P = NS) in models including LV function indicators. Of note, the risk of CV events was minimal in patients with normal LV mass and function, intermediate in patients with either LVH or systolic dysfunction, and maximal in patients displaying both alterations. The study of myocardial contractility by echocardiography provides prognostic information independently of LV mass and other risk factors in ESRD. Risk stratification by simple systolic function parameters may prove useful in secondary prevention strategies in these patients.

  20. Systematic review and meta-analysis of preterm birth and later systolic blood pressure.

    PubMed

    de Jong, Femke; Monuteaux, Michael C; van Elburg, Ruurd M; Gillman, Matthew W; Belfort, Mandy B

    2012-02-01

    Lower birth weight because of fetal growth restriction is associated with higher blood pressure later in life, but the extent to which preterm birth (<37 completed weeks' gestation) or very low birth weight (<1500 g) predicts higher blood pressure is less clear. We performed a systematic review of 27 observational studies that compared the resting or ambulatory systolic blood pressure or diagnosis of hypertension among children, adolescents, and adults born preterm or very low birth weight with those born at term. We performed a meta-analysis with the subset of 10 studies that reported the resting systolic blood pressure difference in millimeters of mercury with 95% CIs or SEs. We assessed methodologic quality with a modified Newcastle-Ottawa Scale. The 10 studies were composed of 1342 preterm or very low birth weight and 1738 term participants from 8 countries. The mean gestational age at birth of the preterm participants was 30.2 weeks (range: 28.8-34.1 weeks), birth weight was 1280 g (range: 1098-1958 g), and age at systolic blood pressure measurement was 17.8 years (range: 6.3-22.4 years). Former preterm or very low birth weight infants had higher systolic blood pressure than term infants (pooled estimate: 2.5 mm Hg [95% CI: 1.7-3.3 mm Hg]). For the 5 highest quality studies, the systolic blood pressure difference was slightly greater, at 3.8 mm Hg (95% CI: 2.6-5.0 mm Hg). We conclude that infants who are born preterm or very low birth weight have modestly higher systolic blood pressure later in life and may be at increased risk for developing hypertension and its sequelae.

  1. Circuit for detecting initial systole and dicrotic notch. [for monitoring arterial pressure

    NASA Technical Reports Server (NTRS)

    Gebben, V. D.; Webb, J. A., Jr. (Inventor)

    1974-01-01

    Circuitry is disclosed for processing an arterial pressure waveform to produce during any one cycle a pulse corresponding to the initial systole and a pulse corresponding to the dicrotic notch. In a first channel, an electrical analog of the arterial pressure waveform is filtered and then compared to the original waveform to produce an initial systole signal. In a second channel, the analog is differentiated, filtered, and fed through a gate controlled by pulses from the first channel to produce an electrical pulse corresponding to the dicrotic notch.

  2. Constant-load versus heart rate-targeted exercise - Responses of systolic intervals

    NASA Technical Reports Server (NTRS)

    Lance, V. Q.; Spodick, D. H.

    1975-01-01

    Various systolic intervals were measured prior to and during heart rate-targeted bicycle ergometer exercise. There were striking similarities within each matched exercise set for Q-Im, isovolumetric contraction time, preejection period (PEP), and PEP/left ventricular ejection time (LVET). LVET was significantly shorter for rate-targeted exercise. It is concluded that either constant-load or rate-targeted bicycle ergometry may be used with the choice of method determined by the purpose of the protocol, and that systolic intervals (except LVET) should not be much altered owing to the method chosen.

  3. A new class of drugs for systolic heart failure: The PARADIGM-HF study.

    PubMed

    Sabe, Marwa A; Jacob, Miriam S; Taylor, David O

    2015-10-01

    The PARADIGM-HF trial (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) found a combination drug containing sacubitril (a neprilysin inhibitor) and valsartan (an angiotensin II receptor blocker) superior to enalapril (an angiotensin-converting enzyme inhibitor) in patients with systolic heart failure. Recently approved by the US Food and Drug Administration, sacubitril-valsartan is the first new drug in over a decade to decrease death rates in patients with systolic heart failure.

  4. Asiago spectroscopic classification of ASASSN-16bp

    NASA Astrophysics Data System (ADS)

    Tomasella, L.; Pastorello, A.; Benetti, S.; Cappellaro, E.; Elias-Rosa, N.; Ochner, P.; Tartaglia, L.; Terreran, G.; Turatto, M.

    2016-02-01

    The Asiago Transient Classification Program (Tomasella et al. 2014, AN, 335, 841) reports the spectroscopic classification of ASASSN-16bp ( = AT 2016adq), discovered by All Sky Automated Survey for SuperNovae ASAS-SN (see Shappee et al. 2014, ApJ, 788, 48 and http://www.astronomy.ohio-state.edu/~assassin/index.shtml ), in CGCG 336-041 (Atel #8666) The observation was performed with the Asiago 1.82 m Copernico Telescope (+AFOSC; range 340-820 nm; resolution 1.4 nm). Name | Discovery UT | Obs. Date UT |z | Type | Phase |Notes ASASSN-16bp | 20160209.61 | 20160211.11 |0.034194 | Ia | ~10d | (1) (1) Also known as SN2016adq in CGCG 336-041 (z=0.034194, d=145 Mpc, via NED).

  5. Pulse transit time as a surrogate measure of changes in systolic arterial pressure in children during sleep.

    PubMed

    Vlahandonis, Anna; Biggs, Sarah N; Nixon, Gillian M; Davey, Margot J; Walter, Lisa M; Horne, Rosemary S C

    2014-08-01

    Pulse transit time has been proposed as a surrogate measure of systolic arterial pressure, as it is dependent upon arterial stiffness. Past research has shown that pulse transit time has a significant inverse relationship to systolic arterial pressure in adults; however, studies in children are limited. This study aimed to explore the relationship between systolic arterial pressure and pulse transit time in children during sleep. Twenty-five children (13.1 ± 1.6 years, 48% male) underwent overnight polysomnography (PSG) with a simultaneous recording of continuous systolic arterial pressure and photoplethysmography. Pulse transit time was calculated as the time delay between the R-wave peak of the electrocardiogram (ECG) to the 50% point of the upstroke of the corresponding photoplethysmography waveform; 500 beats of simultaneous systolic arterial pressure and pulse transit time were analysed in each sleep stage for each child. Pulse transit time was normalized to each subject's mean wake pulse transit time. The ability of pulse transit time to predict systolic arterial pressure change was determined by linear mixed-effects modelling. Significant negative correlations between pulse transit time and systolic arterial pressure were found for individual children for each sleep stage [mean correlations for cohort: non-rapid eye movement (NREM) sleep 1 and 2 r = -0.57, slow wave sleep (SWS) r = -0.76, REM r = -0.65, P < 0.01 for all]. Linear mixed-model analysis demonstrated that changes in pulse transit time were a significant predictor of changes in systolic arterial pressure for each sleep stage (P < 0.001). The model of pulse transit time-predicted systolic arterial pressure closely tracked actual systolic arterial pressure changes over time. This study demonstrated that pulse transit time was accurate in tracking systolic arterial pressure changes over time. Thus, the use of pulse transit time as a surrogate measure of changes in systolic arterial pressure in

  6. Prediction of pharmacologically induced baroreflex sensitivity from local time and frequency domain indices of R-R interval and systolic blood pressure signals obtained during deep breathing.

    PubMed

    Arica, Sami; Firat Ince, N; Bozkurt, Abdi; Tewfik, Ahmed H; Birand, Ahmet

    2011-07-01

    Pharmacological measurement of baroreflex sensitivity (BRS) is widely accepted and used in clinical practice. Following the introduction of pharmacologically induced BRS (p-BRS), alternative assessment methods eliminating the use of drugs were in the center of interest of the cardiovascular research community. In this study we investigated whether p-BRS using phenylephrine injection can be predicted from non-pharmacological time and frequency domain indices computed from electrocardiogram (ECG) and blood pressure (BP) data acquired during deep breathing. In this scheme, ECG and BP data were recorded from 16 subjects in a two-phase experiment. In the first phase the subjects performed irregular deep breaths and in the second phase the subjects received phenylephrine injection. From the first phase of the experiment, a large pool of predictors describing the local characteristic of beat-to-beat interval tachogram (RR) and systolic blood pressure (SBP) were extracted in time and frequency domains. A subset of these indices was selected using twelve subjects with an exhaustive search fused with a leave one subject out cross validation procedure. The selected indices were used to predict the p-BRS on the remaining four test subjects. A multivariate regression was used in all prediction steps. The algorithm achieved best prediction accuracy with only two features extracted from the deep breathing data, one from the frequency and the other from the time domain. The normalized L2-norm error was computed as 22.9% and the correlation coefficient was 0.97 (p=0.03). These results suggest that the p-BRS can be estimated from non-pharmacological indices computed from ECG and invasive BP data related to deep breathing.

  7. Systolically gated 3D phase contrast MRA of mesenteric arteries in suspected mesenteric ischemia

    SciTech Connect

    Wasser, M.N.; Schultze Kool, L.J.; Roos, A. de

    1996-03-01

    Our goal was to assess the value of MRA for detecting stenoses in the celiac (CA) and superior mesenteric (SMA) arteries in patients suspected of having chronic mesenteric ischemia, using an optimized systolically gated 3D phase contrast technique. In an initial study in 24 patients who underwent conventional angiography of the abdominal vessels for different clinical indications, a 3D phase contrast MRA technique (3D-PCA) was evaluated and optimized to image the CAs and SMAs. Subsequently, a prospective study was performed to assess the value of systolically gated 3D-PCA in evaluation of the mesenteric arteries in 10 patients with signs and symptoms of chronic mesenteric ischemia. Intraarterial digital subtraction angiography and surgical findings were used as the reference standard. In the initial study, systolic gating appeared to be essential in imaging the SMA on 3D-PCA. In 10 patients suspected of mesenteric ischemia, systolically gated 3D-PCA identified significant proximal disease in the two mesenteric vessels in 4 patients. These patients underwent successful reconstruction of their stenotic vessels. Cardiac-gated MRA may become a useful tool in selection of patients suspected of having mesenteric ischemia who may benefit from surgery. 16 refs., 6 figs., 4 tabs.

  8. Joint Symbolic Dynamics Analysis of Heart Rate and Systolic Blood Pressure Interactions in Dilated Cardiomyopathy

    DTIC Science & Technology

    2007-11-02

    Abstract- The dilated cardiomyopathy (DCM) induces important changes in the autonomic control. Measures of heart rate (HR) variability and systolic...rather simple physiological interpretations and seems to be particularly suitable for risk stratification in patients with dilated cardiomyopathy ...Keywords - Symbolic dynamics, heart rate variability, blood pressure variability I. INTRODUCTION Patients suffering from dilated cardiomyopathy

  9. Assessment of right ventricular systolic function by echocardiography after surgical repair of congenital heart defects.

    PubMed

    Khraiche, Diala; Ben Moussa, Nidhal

    2016-02-01

    Postoperative impairment of right ventricular (RV) systolic function can appear after surgical repair of complex congenital heart defects, such as tetralogy of Fallot; it is caused by chronic volume and/or pressure overload due to pulmonary regurgitation and/or stenosis. RV dysfunction is strongly associated with prognosis in these patients. Cardiac magnetic resonance imaging is the gold standard for quantification of RV volumes and ejection fraction in patients with congenital heart diseases; however, it is costly and is not widely available. Echocardiography is the imaging modality that is most available and most frequently used to assess RV systolic function. However, RV ejection fraction cannot be measured accurately by standard two-dimensional echocardiography because of its pyramidal shape. Surrogate parameters of RV systolic function are mostly used in routine practice. New techniques of two-dimensional strain and three-dimensional quantification of RV volumes and ejection fraction have been developed in recent years. The aim of this article is to show the pertinence of each variable of RV systolic function measured by echocardiography in patients with repaired congenital heart disease and residual chronic RV overload.

  10. Estimation of central systolic blood pressure using an oscillometric blood pressure monitor.

    PubMed

    Cheng, Hao-Min; Wang, Kang-Ling; Chen, Ying-Hwa; Lin, Shing-Jong; Chen, Lung-Ching; Sung, Shih-Hsien; Ding, Philip Yu-An; Yu, Wen-Chung; Chen, Jaw-Wen; Chen, Chen-Huan

    2010-06-01

    Current noninvasive techniques for assessing central aortic pressure require the recording of an arterial pressure wave using a high-fidelity applanation tonometer. We therefore developed and validated a novel method to estimate the central aortic systolic pressure using an oscillometric blood pressure monitor alone. Invasive high-fidelity right brachial and central aortic pressure waves, and left-brachial pulse volume plethysmography from an oscillometric blood pressure monitor, were obtained at baseline and 3 min after administration of sublingual nitroglycerin in 100 patients during cardiac catheterization. In the initial 50 patients (Generation Group), Central systolic blood pressure was predicted by a multi-variate prediction model generated from the comprehensive analysis of the invasive brachial pressure wave, including brachial late-systolic shoulder pressure value and parameters related to wave reflection and arterial compliance. Another prediction model was similarly constructed from the noninvasively calibrated pulse volume plethysmography. Both models were validated in the subsequent 50 patients (Validation Group) with results: r=0.98 (P<0.001) and mean difference=0.5+/-4.5 (95% confidence interval -8.3 to 9.3) mm Hg for the invasive model, and r=0.93 (P<0.001) and mean difference=-0.1+/-7.6 (95% confidence interval -15.0 to 14.8) mm Hg for the noninvasive model. Thus, our results indicate that central aortic systolic blood pressure could be estimated by analysis of the noninvasive brachial pressure wave alone from an oscillometric blood pressure monitor.

  11. Linkage analysis of systolic blood pressure: a score statistic and computer implementation

    PubMed Central

    Wang, Kai; Peng, Yingwei

    2003-01-01

    A genome-wide linkage analysis was conducted on systolic blood pressure using a score statistic. The randomly selected Replicate 34 of the simulated data was used. The score statistic was applied to the sibships derived from the general pedigrees. An add-on R program to GENEHUNTER was developed for this analysis and is freely available. PMID:14975145

  12. Relationship between systolic time intervals and heart rate during four circulatory stress tests.

    PubMed

    Mäntysaari, M; Antila, K; Peltonen, T

    1984-01-01

    The linear regression equations between heart rate and systolic time intervals were calculated before and during a handgrip test, an orthostatic test, the Valsalva test and a cold pressor test. The subjects were 30 healthy men, average age 20 years. During the 1st min of orthostasis the regression line of the left ventricular ejection time (LVET) was significantly (P less than 0.05) steeper than at rest and that of the pre-ejection period (PEP) was significantly (P less than 0.01) less steep than at rest, and the regression between HR and the PEP/LVET ratio deviated significantly (P less than 0.001) from zero. During the Valsalva maneuver, the regression line of the LVET became significantly (P less than 0.001) steeper than at rest and the regression coefficient of the PEP changed from negative to positive, the difference being significant (P less than 0.001); the regression between HR and the PEP/LVET also deviated significantly (P less than 0.001) from zero. During the cold pressor test the regression line of the electromechanic systole (Q-S2 time) was significantly (P less than 0.01) less steep than at rest. It was concluded that the use of regression equations calculated for the systolic time intervals and heart rate at rest can lead to errors when applied to rate correction of systolic time intervals during an orthostatic, Valsalva, or a cold pressor test.

  13. Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study.

    PubMed

    Ding, Ming; Huang, Tao; Bergholdt, Helle Km; Nordestgaard, Børge G; Ellervik, Christina; Qi, Lu

    2017-03-16

    Objective To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal.Design Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable.Setting CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium.Participants Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis.Main outcome measures The instrumental variable estimation was conducted using the ratio of coefficients approach. Using meta-analysis, an additional eight published randomized clinical trials on the association of dairy consumption with systolic blood pressure were summarized.Results Compared with the CC genotype (CC is associated with complete lactase deficiency), the CT/TT genotype (TT is associated with lactose persistence, and CT is associated with certain lactase deficiency) of LCT-13910 (lactase persistence gene) rs4988235 was associated with higher dairy consumption (0.23 (about 55 g/day), 95% confidence interval 0.17 to 0.29) serving/day; P<0.001) and was not associated with systolic blood pressure (0.31, 95% confidence interval -0.05 to 0.68 mm Hg; P=0.09) or risk of hypertension (odds ratio 1.01, 95% confidence interval 0.97 to 1.05; P=0.27). Using LCT-13910 rs4988235 as the instrumental variable, genetically determined dairy consumption was not associated with systolic blood pressure (β=1.35, 95% confidence interval -0.28 to 2.97 mm Hg for each serving/day) or risk of hypertension (odds ratio 1.04, 0.88 to 1.24). Moreover, meta-analysis of the published clinical trials showed that higher dairy intake has no significant effect on change in systolic blood pressure for interventions over one month to 12 months (intervention compared with control groups: β=-0.21, 95% confidence interval -0

  14. [Atrial filling fraction predicts left ventricular systolic function after myocardial infarction: pre-discharge echocardiographic evaluation].

    PubMed

    Galderisi, M; Fakher, A; Petrocelli, A; Alfieri, A; Garofalo, M; de Divitiis, O

    1995-10-01

    Aim of the study was to examine the relation between Doppler-derived indices of left ventricular diastolic and systolic function early after myocardial infarction. Fifty-three patients (31 males, 22 females) recovering from acute myocardial infarction underwent predischarge Doppler echocardiographic examination. Patients with age > 70 years, previous myocardial infarction, more than mild mitral and aortic regurgitation, mitral and aortic stenosis were excluded. Twenty-two healthy subjects (13 males; 9 females) free of coronary risk factors were selected as the control group. Both end-diastolic and end-systolic volumes and ejection fraction were measured by two-dimensional echocardiography. Pulsed Doppler was used to evaluate mitral inflow and left ventricular outflow velocity patterns. The following indices were measured: peak velocity of early (E) and late (A) flows, ratio of E/A peak velocities, ratio of early to late time velocity integrals, atrial filling fraction (time velocity integral A / time velocity integral of flow during total diastole) and deceleration time of E wave for mitral inflow; peak and time-velocity integral for left ventricular outflow. Stroke volume and cardiac output were obtained by pulsed Doppler using the left ventricular outflow method. The two groups were comparable for age, with blood pressure (p < 0.05) and heart rate (p < 0.01) reduced in myocardial infarction patients. Both end-diastolic and end-systolic volumes were significantly higher (both p < 0.0001) and ejection fraction (p < 0.0001) lower after myocardial infarction. Also stroke volume and cardiac output (both p < 0.0001) were reduced in myocardial infarction patients. No significant difference in Doppler indices of diastolic function was observed between the two groups, except for shortened deceleration time (p < 0.0001) in myocardial infarction patients. Multilinear regression analyses were performed separately into the two groups to identify determinants of left

  15. Ambulatory BP monitoring and clinic BP in predicting small-for-gestational-age infants during pregnancy.

    PubMed

    Eguchi, K; Ohmaru, T; Ohkuchi, A; Hirashima, C; Takahashi, K; Suzuki, H; Kario, K; Matsubara, S; Suzuki, Mitsuaki

    2016-01-01

    The significance of ambulatory blood pressure (ABP) monitoring during pregnancy has not been established. We performed a prospective study to elucidate whether ABP measures are associated with small-for-gestational-age birth weight (SGA). We studied 146 pregnant women who were seen for maternal medical checkups or suspected hypertension. ABP monitoring was performed for further assessment of hypertension. The outcome measure was SGA. The subjects were classified by their medical history and ABP as having preeclampsia or gestational hypertension (n=68 cases), chronic hypertension (n=48) or white-coat hypertension (n=30). There were 50 (34.2%) cases of SGA by the fetal growth reference standard. In multivariable logistic regression analyses adjusting for age, body mass index, the presence of prior pregnancy, current smoking habit and the use of antihypertensive medications, 24-h SBP (per 10 mm Hg (odds ratio (OR): 1.74; 95% confidence interval (CI): 1.28-2.38; P<0.001)) was more closely associated with SGA than clinic BP (OR: 1.40; 95% CI: 0.92-2.13; P=0.11). The results were essentially the same if 24-h BP was replaced by awake or sleep SBP. Ambulatory diastolic BP showed the same tendency. However, abnormal circadian rhythm was not associated with the outcome. In conclusion, ambulatory BP monitoring measures performed during pregnancy were more closely associated with SGA than clinic BP.

  16. Characteristic systolic waveform of left ventricular longitudinal strain rate in patients with hypertrophic cardiomyopathy.

    PubMed

    Okada, Kazunori; Kaga, Sanae; Mikami, Taisei; Masauzi, Nobuo; Abe, Ayumu; Nakabachi, Masahiro; Yokoyama, Shinobu; Nishino, Hisao; Ichikawa, Ayako; Nishida, Mutsumi; Murai, Daisuke; Hayashi, Taichi; Shimizu, Chikara; Iwano, Hiroyuki; Yamada, Satoshi; Tsutsui, Hiroyuki

    2016-10-18

    We analyzed the waveform of systolic strain and strain-rate curves to find a characteristic left ventricular (LV) myocardial contraction pattern in patients with hypertrophic cardiomyopathy (HCM), and evaluated the utility of these parameters for the differentiation of HCM and LV hypertrophy secondary to hypertension (HT). From global strain and strain-rate curves in the longitudinal and circumferential directions, the time from mitral valve closure to the peak strains (T-LS and T-CS, respectively) and the peak systolic strain rates (T-LSSR and T-CSSR, respectively) were measured in 34 patients with HCM, 30 patients with HT, and 25 control subjects. The systolic strain-rate waveform was classified into 3 patterns ("V", "W", and "√" pattern). In the HCM group, T-LS was prolonged, but T-LSSR was shortened; consequently, T-LSSR/T-LS ratio was distinctly lower than in the HT and control groups. The "√" pattern of longitudinal strain-rate waveform was more frequently seen in the HCM group (74 %) than in the control (4 %) and HT (20 %) groups. Similar but less distinct results were obtained in the circumferential direction. To differentiate HCM from HT, the sensitivity and specificity of the T-LSSR/T-LS ratio <0.34 and the "√"-shaped longitudinal strain-rate waveform were 85 and 63 %, and 74 and 80 %, respectively. In conclusion, in patients with HCM, a reduced T-LSSR/T-LS ratio and a characteristic "√"-shaped waveform of LV systolic strain rate was seen, especially in the longitudinal direction. The timing and waveform analyses of systolic strain rate may be useful to distinguish between HCM and HT.

  17. Role of echocardiography in diagnosis and risk stratification in heart failure with left ventricular systolic dysfunction

    PubMed Central

    Ciampi, Quirino; Villari, Bruno

    2007-01-01

    Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Echocardiography represents the "gold standard" in the assessment of LV systolic dysfunction and in the recognition of systolic heart failure, since dilatation of the LV results in alteration of intracardiac geometry and hemodynamics leading to increased morbidity and mortality. The functional mitral regurgitation is a consequence of adverse LV remodelling that occurs with a structurally normal valve and it is a marker of adverse prognosis. Diastolic dysfunction plays a major role in signs and symptoms of HF and in the risk stratification, and provides prognostic information independently in HF patients and impaired systolic function. Ultrasound lung comets are a simple echographic sign of extravascular lung water, more frequently associated with left ventricular diastolic and/or systolic dysfunction, which can integrate the clinical and pathophysiological information provided by conventional echocardiography and provide a useful information for prognostic stratification of HF patients. Contractile reserve is defined as the difference between values of an index of left ventricular contractility during peak stress and its baseline values and the presence of myocardial viability predicts a favorable outcome. A non-invasive echocardiographic method for the evaluation of force-frequency relationship has been proposed to assess the changes in contractility during stress echo. In conclusion, in HF patients, the evaluation of systolic, diastolic function and myocardial contractile reserve plays a fundamental role in the risk stratification. The highest risk is present in HF patients with a heart that is weak, big, noisy, stiff and wet. PMID:17910744

  18. Role of echocardiography in diagnosis and risk stratification in heart failure with left ventricular systolic dysfunction.

    PubMed

    Ciampi, Quirino; Villari, Bruno

    2007-10-02

    Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Echocardiography represents the "gold standard" in the assessment of LV systolic dysfunction and in the recognition of systolic heart failure, since dilatation of the LV results in alteration of intracardiac geometry and hemodynamics leading to increased morbidity and mortality. The functional mitral regurgitation is a consequence of adverse LV remodelling that occurs with a structurally normal valve and it is a marker of adverse prognosis. Diastolic dysfunction plays a major role in signs and symptoms of HF and in the risk stratification, and provides prognostic information independently in HF patients and impaired systolic function. Ultrasound lung comets are a simple echographic sign of extravascular lung water, more frequently associated with left ventricular diastolic and/or systolic dysfunction, which can integrate the clinical and pathophysiological information provided by conventional echocardiography and provide a useful information for prognostic stratification of HF patients. Contractile reserve is defined as the difference between values of an index of left ventricular contractility during peak stress and its baseline values and the presence of myocardial viability predicts a favorable outcome. A non-invasive echocardiographic method for the evaluation of force-frequency relationship has been proposed to assess the changes in contractility during stress echo. In conclusion, in HF patients, the evaluation of systolic, diastolic function and myocardial contractile reserve plays a fundamental role in the risk stratification. The highest risk is present in HF patients with a heart that is weak, big, noisy, stiff and wet.

  19. Chronic pulmonary hypertension shortens the duration of mitral annular systolic and diastolic tissue Doppler signals.

    PubMed

    López-Candales, Angel; Edelman, Kathy; Gulyasy, Beth; Candales, Maria Dolores

    2012-03-01

    Some data suggests that both left ventricular (LV) systolic and diastolic function are impaired in patients with chronic pulmonary hypertension (cPH); however, a clear understanding of these specific abnormalities remains poorly characterized. LV systolic and diastolic function as well as LV myocardial performance index (MPI) were obtained and compared to total duration of mitral annular (MA) TDI systolic (MASTDId) and diastolic (MADTDId) measurements, corrected for heart rate, in 20 controls (Group I: mean 53 ± 18 years) and 30 patients (Group II: mean 55 ± 14 years) with cPH. Group II patients had relatively faster heart rates (75 ± 14 bpm vs. 63 ± 12 bpm; P < 0.003), higher LV ejection fraction (78 ± 10% vs. 68 ± 6%; P < 0.0004), similar MA systolic excursion (1.4 ± 0.2), unchanged MA TDI Ea/Aa ratios (0.86 ± 0.46 vs. 1.05 ± 0.41; P = 0.15), significantly higher LV MPI (0.98 ± 0.56 vs. 0.60 ± 0.11; P < 0.004), with a significantly shorter heart rate corrected MASTDId (251 ± 66 ms vs. 305 ± 30 ms; P < 0.001) and MADTDId (378 ± 87 ms vs. 497 ± 114 ms; P < 0.0001) than Group I. It appears that cPH shortens the total duration of both MA systolic and diastolic TDI intervals. Whether this is a result of altered LV geometry and/or confounded by the presence of relatively faster heart rates in cPH patients will require further study.

  20. How Many Measurements Are Needed to Estimate Blood Pressure Variability Without Loss of Prognostic Information?

    PubMed Central

    2014-01-01

    BACKGROUND Average real variability (ARV) is a recently proposed index for short-term blood pressure (BP) variability. We aimed to determine the minimum number of BP readings required to compute ARV without loss of prognostic information. METHODS ARV was calculated from a discovery dataset that included 24-hour ambulatory BP measurements for 1,254 residents (mean age = 56.6 years; 43.5% women) of Copenhagen, Denmark. Concordance between ARV from full (≥80 BP readings) and randomly reduced 24-hour BP recordings was examined, as was prognostic accuracy. A test dataset that included 5,353 subjects (mean age = 54.0 years; 45.6% women) with at least 48 BP measurements from 11 randomly recruited population cohorts was used to validate the results. RESULTS In the discovery dataset, a minimum of 48 BP readings allowed an accurate assessment of the association between cardiovascular risk and ARV. In the test dataset, over 10.2 years (median), 806 participants died (335 cardiovascular deaths, 206 cardiac deaths) and 696 experienced a major fatal or nonfatal cardiovascular event. Standardized multivariable-adjusted hazard ratios (HRs) were computed for associations between outcome and BP variability. Higher diastolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.19), and cardiac (HR = 1.19) mortality and fatal combined with nonfatal cerebrovascular events (HR = 1.16). Higher systolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.17), and cardiac (HR = 1.24) mortality. CONCLUSIONS Forty-eight BP readings over 24 hours were observed to be adequate to compute ARV without meaningful loss of prognostic information. PMID:23955605

  1. Deficiency in Either 4E-BP1 or 4E-BP2 Augments Innate Antiviral Immune Responses

    PubMed Central

    Nehdi, Atef; Sean, Polen; Linares, Izzar; Colina, Rodney; Jaramillo, Maritza; Alain, Tommy

    2014-01-01

    Genetic deletion of both 4E-BP1 and 4E-BP2 was found to protect cells against viral infections. Here we demonstrate that the individual loss of either 4E-BP1 or 4E-BP2 in mouse embryonic fibroblasts (MEFs) is sufficient to confer viral resistance. shRNA-mediated silencing of 4E-BP1 or 4E-BP2 renders MEFs resistant to viruses, and compared to wild type cells, MEFs knockout for either 4E-BP1 or 4E-BP2 exhibit enhanced translation of Irf-7 and consequently increased innate immune response to viruses. Accordingly, the replication of vesicular stomatitis virus, encephalomyocarditis virus, influenza virus and Sindbis virus is markedly suppressed in these cells. Importantly, expression of either 4E-BP1 or 4E-BP2 in double knockout or respective single knockout cells diminishes their resistance to viral infection. Our data show that loss of 4E-BP1 or 4E-BP2 potentiates innate antiviral immunity. These results provide further evidence for translational control of innate immunity and support targeting translational effectors as an antiviral strategy. PMID:25531441

  2. Aortic annulus dimension assessment by computed tomography for transcatheter aortic valve implantation: differences between systole and diastole.

    PubMed

    Bertaso, Angela G; Wong, Dennis T L; Liew, Gary Y H; Cunnington, Michael S; Richardson, James D; Thomson, Viji S; Lorraine, Brett; Kourlis, George; Leech, Diana; Worthley, Matthew I; Worthley, Stephen G

    2012-12-01

    Accurate assessment of aortic annular dimensions is essential for successful transcatheter aortic valve implantation (TAVI). Annular dimensions are conventionally measured in mid-systole by multidetector computed tomography (MDCT), echocardiography and angiography. Significant differences in systolic and diastolic aortic annular dimensions have been demonstrated in cohorts without aortic stenosis (AS), but it is unknown whether similar dynamic variation in annular dimensions exists in patients with severe calcific AS in whom aortic compliance is likely to be substantially reduced. We investigated the variation in aortic annular dimensions between systole and diastole in patients with severe calcific AS. Patients with severe calcific AS referred for TAVI were evaluated by 128-slice MDCT. Aortic annular diameter was measured during diastole and systole in the modified coronal, modified sagittal, and basal ring planes (maximal, minimal and mean diameters). Differences between systole and diastole were analysed by paired t test. Fifty-nine patients were included in the analysis. Three of the five aortic dimensions measured increased significantly during systole. The largest change was a 0.75 mm (3.4%) mean increase in the minimal diameter of the basal ring during systole (p = 0.004). This corresponds closely to the modified sagittal view, which also increased by mean 0.42 mm (1.9%) during systole (p = 0.008). There was no significant change in the maximal diameter of the basal ring or the modified coronal view during systole (p > 0.05). There is a small magnitude but statistically significant difference in aortic annulus dimensions of patients with severe AS referred for TAVI when measured in diastole and systole. This small difference is unlikely to alter clinical decisions regarding prosthesis size or suitability for TAVI.

  3. Instability of a Möbius Strip Minimal Surface and a Link with Systolic Geometry

    NASA Astrophysics Data System (ADS)

    Pesci, Adriana I.; Goldstein, Raymond E.; Alexander, Gareth P.; Moffatt, H. Keith

    2015-03-01

    We describe the first analytically tractable example of an instability of a nonorientable minimal surface under parametric variation of its boundary. A one-parameter family of incomplete Meeks Möbius surfaces is defined and shown to exhibit an instability threshold as the bounding curve is opened up from a double-covering of the circle. Numerical and analytical methods are used to determine the instability threshold by solution of the Jacobi equation on the double covering of the surface. The unstable eigenmode shows excellent qualitative agreement with that found experimentally for a closely related surface. A connection is proposed between systolic geometry and the instability by showing that the shortest noncontractable closed geodesic on the surface (the systolic curve) passes near the maximum of the unstable eigenmode.

  4. Instability of a Möbius strip minimal surface and a link with systolic geometry.

    PubMed

    Pesci, Adriana I; Goldstein, Raymond E; Alexander, Gareth P; Moffatt, H Keith

    2015-03-27

    We describe the first analytically tractable example of an instability of a nonorientable minimal surface under parametric variation of its boundary. A one-parameter family of incomplete Meeks Möbius surfaces is defined and shown to exhibit an instability threshold as the bounding curve is opened up from a double-covering of the circle. Numerical and analytical methods are used to determine the instability threshold by solution of the Jacobi equation on the double covering of the surface. The unstable eigenmode shows excellent qualitative agreement with that found experimentally for a closely related surface. A connection is proposed between systolic geometry and the instability by showing that the shortest noncontractable closed geodesic on the surface (the systolic curve) passes near the maximum of the unstable eigenmode.

  5. Effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants

    SciTech Connect

    Younkin, D.P.; Reivich, M.; Jaggi, J.L.; Obrist, W.D.; Delivoria-Papadopoulos, M.

    1987-06-01

    The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 (/sup 133/Xe) clearance technique, which uses an intravenous bolus of /sup 133/Xe, an external chest detector to estimate arterial /sup 133/Xe concentration, eight external cranial detectors to measure cephalic /sup 133/Xe clearance curves, and a two-compartmental analysis of the cephalic /sup 133/Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBF varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications.

  6. Two-dimensional speckle-tracking-derived segmental peak systolic longitudinal strain identifies regional myocardial involvement in patients with myocarditis and normal global left ventricular systolic function.

    PubMed

    Uppu, Santosh C; Shah, Amee; Weigand, Justin; Nielsen, James C; Ko, H Helen; Parness, Ira A; Srivastava, Shubhika

    2015-06-01

    The presence of myocardial late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) imaging in concert with electrocardiography and elevated biomarkers helps support the diagnosis of acute myocarditis. Two-dimensional echocardiography is limited to global and qualitative regional function assessment and may not contribute to the diagnosis, especially in the presence of normal LV systolic function. Two-dimensional speckle-tracking (2D-STE)-derived segmental peak systolic (pkS) longitudinal strain (LS) may identify segmental myocardial involvement in myocarditis. We sought to identify an association between segmental pkS, LGE, and troponin levels in patients with myocarditis. Retrospective analysis of myocardial segmental function by 2D-STE segmental strain was compared to the presence of LGE and admission peak troponin levels in patients with acute myocarditis and preserved global LV systolic function. American Heart Association 17-segment model was used for comparison between imaging modalities. Global function was assessed by m-mode-derived shortening fraction (SF). Descriptive statistics and regression analysis were utilized. Forty-four CMRs performed to evaluate for myocarditis were identified. Of the 44, 10 patients, median age 17.5 years (14-18.5 years) and median SF 35 % (28-44 %), had paired CMR and 2D-STE data for analysis, and 161/170 segments could be analyzed by both methods for comparison. PkS LS was decreased in 51 % of segments that were positive for LGE with average pkS of -14.7 %. Segmental pkS LS abnormalities were present in all but one patient who had abnormal pkS circumferential strain. Global pkS LS was decreased in patients with myocarditis. There is a moderate correlation between decreased pkS LS and the presence of LGE by CMR, 2D-STE for myocardial involvement in acute myocarditis can serve as an useful noninvasive adjunct to the existing tests used for the diagnosis of acute myocarditis and might have a role in prognostication.

  7. Left ventricular outflow tract mean systolic acceleration as a surrogate for the slope of the left ventricular end-systolic pressure-volume relationship

    NASA Technical Reports Server (NTRS)

    Bauer, Fabrice; Jones, Michael; Shiota, Takahiro; Firstenberg, Michael S.; Qin, Jian Xin; Tsujino, Hiroyuki; Kim, Yong Jin; Sitges, Marta; Cardon, Lisa A.; Zetts, Arthur D.; Thomas, James D.

    2002-01-01

    OBJECTIVE: The goal of this study was to analyze left ventricular outflow tract systolic acceleration (LVOT(Acc)) during alterations in left ventricular (LV) contractility and LV filling. BACKGROUND: Most indexes described to quantify LV systolic function, such as LV ejection fraction and cardiac output, are dependent on loading conditions. METHODS: In 18 sheep (4 normal, 6 with aortic regurgitation, and 8 with old myocardial infarction), blood flow velocities through the LVOT were recorded using conventional pulsed Doppler. The LVOT(Acc) was calculated as the aortic peak velocity divided by the time to peak flow; LVOT(Acc) was compared with LV maximal elastance (E(m)) acquired by conductance catheter under different loading conditions, including volume and pressure overload during an acute coronary occlusion (n = 10). In addition, a clinically validated lumped-parameter numerical model of the cardiovascular system was used to support our findings. RESULTS: Left ventricular E(m) and LVOT(Acc) decreased during ischemia (1.67 +/- 0.67 mm Hg.ml(-1) before vs. 0.93 +/- 0.41 mm Hg.ml(-1) during acute coronary occlusion [p < 0.05] and 7.9 +/- 3.1 m.s(-2) before vs. 4.4 +/- 1.0 m.s(-2) during coronary occlusion [p < 0.05], respectively). Left ventricular outflow tract systolic acceleration showed a strong linear correlation with LV E(m) (y = 3.84x + 1.87, r = 0.85, p < 0.001). Similar findings were obtained with the numerical modeling, which demonstrated a strong correlation between predicted and actual LV E(m) (predicted = 0.98 [actual] -0.01, r = 0.86). By analysis of variance, there was no statistically significant difference in LVOT(Acc) under different loading conditions. CONCLUSIONS: For a variety of hemodynamic conditions, LVOT(Acc) was linearly related to the LV contractility index LV E(m) and was independent of loading conditions. These findings were consistent with numerical modeling. Thus, this Doppler index may serve as a good noninvasive index of LV

  8. Ratio of Systolic Blood Pressure to Right Atrial Pressure, a Novel Marker to Predict Morbidity and Mortality in Acute Systolic Heart Failure.

    PubMed

    Omar, Hesham R; Charnigo, Richard; Guglin, Maya

    2017-04-01

    Congestion is the main contributor to heart failure (HF) morbidity and mortality. We assessed the combined role of congestion and decreased forward flow in predicting morbidity and mortality in acute systolic HF. The Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial data set was used to determine if the ratio of simultaneously measured systolic blood pressure (SBP)/right atrial pressure (RAP) on admission predicted HF rehospitalization and 6-month mortality. One hundred ninety-five patients (mean age 56.5 years, 75% men) who received pulmonary artery catheterization were studied. The RAP, SBP, and SBP/RAP had an area under the curve (AUC) of 0.593 (p = 0.0205), 0.585 (p = 0.0359), and 0.621 (p = 0.0026), respectively, in predicting HF rehospitalization. The SBP/RAP was a superior marker of HF rehospitalization compared with RAP alone (difference in AUC 0.0289, p = 0.0385). The optimal criterion of SBP/RAP <11 provided the highest combined sensitivity (77.1%) and specificity (50.9%) in predicting HF rehospitalization. The SBP/RAP had an AUC 0.622, p = 0.0108, and a cut-off value of SBP/RAP <8 had a sensitivity of 61.9% and specificity 64.1% in predicting mortality. Multivariate analysis showed that an SBP/RAP <11 independently predicted rehospitalization for HF (estimated odds ratio 3.318, 95% confidence interval 1.692 to 6.506, p = 0.0005) and an SBP/RAP <8 independently predicted mortality (estimated hazard ratio 2.025, 95% confidence interval 1.069 to 3.833, p = 0.030). In conclusion, SBP/RAP ratio is a marker that identifies a spectrum of complications after hospitalization of patients with decompensated systolic HF, starting with increased incidence of HF rehospitalization at SBP/RAP <11 to increased mortality with SBP/RAP <8.

  9. Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis.

    PubMed

    Guazzi, M; Bandera, F; Pelissero, G; Castelvecchio, S; Menicanti, L; Ghio, S; Temporelli, P L; Arena, R

    2013-11-01

    Echo-derived pulmonary arterial systolic pressure (PASP) and right ventricular (RV) tricuspid annular plane systolic excursion (TAPSE; from the end of diastole to end-systole) are of basic relevance in the clinical follow-up of heart failure (HF) patients, carrying two- to threefold increase in cardiac risk when increased and reduced, respectively. We hypothesized that the relationship between TAPSE (longitudinal RV fiber shortening) and PASP (force generated by the RV) provides an index of in vivo RV length-force relationship, with their ratio better disclosing prognosis. Two hundred ninety-three HF patients with reduced (HFrEF, n = 247) or with preserved left ventricular (LV) ejection fraction (HFpEF, n = 46) underwent echo-Doppler studies and N-terminal pro-brain-type natriuretic peptide assessment and were tracked for adverse events. The median follow-up duration was 20.8 mo. TAPSE vs. PASP relationship showed a downward regression line shift in nonsurvivors who were more frequently presenting with higher PASP and lower TAPSE. HFrEF and HFpEF patients exhibited a similar distribution along the regression line. Given the TAPSE, PASP, and TAPSE-to-PASP ratio (TAPSE/PASP) collinearity, separate Cox regression and Kaplan-Meier analyses were performed: one with TAPSE and PASP as individual measures, and the other combining them in ratio form. Hazard ratios for variables retained in the multivariate regression were as follows: TAPSE/PASP

  10. Depression of systolic and diastolic myocardial reserve during atrial pacing tachycardia in patients with dilated cardiomyopathy.

    PubMed Central

    Feldman, M D; Alderman, J D; Aroesty, J M; Royal, H D; Ferguson, J J; Owen, R M; Grossman, W; McKay, R G

    1988-01-01

    Previous reports have shown that increases in heart rate may result in enhanced left ventricular (LV) systolic and diastolic performance. To assess whether this phenomenon occurs in the presence of depressed LV function, the effects of pacing on LV pressure and volume were compared in seven patients with dilated cardiomyopathy (LV ejection fraction 0.19 +/- 0.11) and six patients with no or minimal coronary artery disease (LV ejection fraction 0.69 +/- 0.11). Patients with normal LV function demonstrated significant increases in LV peak-positive dP/dt, LV end-systolic pressure-volume ratio, LV peak filling rate, and a progressive leftward and downward shift of their pressure-volume diagrams, compatible with increased contractility and distensibility in response to pacing tachycardia. There was no change in LV peak-negative dP/dt or tau. Patients with dilated cardiomyopathy, in contrast, demonstrated no increase in either LV peak-positive dP/dt or the end-systolic pressure-volume ratio, and absence of a progressive leftward shift of their pressure-volume diagrams. Moreover, cardiomyopathy patients demonstrated no increase in LV peak-negative dP/dt or LV peak filling rate and a blunted downward shift of the diastolic limb of their pressure-volume diagrams. Tau, as determined from a derivative method, became abbreviated although never reaching control values. We conclude that patients with dilated cardiomyopathy may demonstrate little or no significant enhancement in systolic and diastolic function during atrial pacing tachycardia, suggesting a depression of both inotropic and lusitropic reserve. PMID:3183060

  11. On realizations of least-squares estimation and Kalman filtering by systolic arrays

    NASA Technical Reports Server (NTRS)

    Chen, M. J.; Yao, K.

    1986-01-01

    Least-squares (LS) estimation is a basic operation in many signal processing problems. Given y = Ax + v, where A is a m x n coefficient matrix, y is a m x 1 observation vector, and v is a m x 1 zero mean white noise vector, a simple least-squares solution is finding the estimated vector x which minimizes the norm of /Ax-y/. It is well known that for an ill-conditioned matrix A, solving least-squares problems by orthogonal triangular (QR) decomposition and back substitution has robust numerical properties under finite word length effect since 2-norm is preserved. Many fast algorithms have been proposed and applied to systolic arrays. Gentleman-Kung (1981) first presented the trianglular systolic array for a basic Givens reduction. McWhirter (1983) used this array structure to find the least-squares estimation errors. Then by geometric approach, several different systolic array realizations of the recursive least-squares estimation algorithms of Lee et al (1981) were derived by Kalson-Yao (1985). Basic QR decomposition algorithms are considered in this paper and it is found that under a one-row time updating situation, the Householder transformation degenerates to a simple Givens reduction. Next, an improved least-squares estimation algorithm is derived by considering a modified version of fast Givens reduction. From this approach, the basic relationship between Givens reduction and Modified-Gram-Schmidt transformation can easily be understood. This improved algorithm also has simpler computational and inter-cell connection complexities while compared with other known least-squares algorithms and is more realistic for systolic array implementation.

  12. Bit-systolic arithmetic arrays using dynamic differential gallium arsenide circuits

    NASA Technical Reports Server (NTRS)

    Beagles, Grant; Winters, Kel; Eldin, A. G.

    1992-01-01

    A new family of gallium arsenide circuits for fine grained bit-systolic arithmetic arrays is introduced. This scheme combines features of two recent techniques of dynamic gallium arsenide FET logic and differential dynamic single-clock CMOS logic. The resulting circuits are fast and compact, with tightly constrained series FET propagation paths, low fanout, no dc power dissipation, and depletion FET implementation without level shifting diodes.

  13. Systolic-diastolic functional coupling in healthy children and in those with dilated cardiomyopathy.

    PubMed

    Friedberg, Mark K; Margossian, Renee; Lu, Minmin; Mercer-Rosa, Laura; Henderson, Heather T; Nutting, Arni; Friedman, Kevin; Molina, Kimberly M; Altmann, Karen; Canter, Charles; Sleeper, Lynn A; Colan, Steven D

    2016-06-01

    Systolic and diastolic function affect dilated cardiomyopathy (DCM) outcomes. However, systolic-diastolic coupling, as a distinct characteristic, may itself affect function but is poorly characterized. We hypothesized that echocardiographic left ventricular (LV) longitudinal systolic tissue velocities (S') correlate with diastolic longitudinal velocities (E') and that their relationship is associated with ventricular function and that this relationship is impaired in pediatric DCM. We analyzed data from the Pediatric Heart Network Ventricular Volume Variability study, using linear regression and generalized additive modeling to assess relationships between S' and E' at the lateral and septal mitral annulus. We explored relationships between the systolic:diastolic (S:D) coupling ratio (S':E' relative to age) and ventricular function. Up to 4 echocardiograms from 130 DCM patients (mean age: 9.3 ± 6.1 yr) and 1 echocardiogram from each of 591 healthy controls were analyzed. S' and E' were linearly related in controls (r = 0.64, P < 0.001) and DCM (r = 0.83, P < 0.001). In DCM, the magnitude of association between S' and E' was reduced with progressive ventricular remodeling. The S:D ratio was more strongly associated with LV function in controls vs. DCM. The septal S:D ratio was higher (presumed worse) in DCM vs. controls (0.69 ± 0.13 vs. 0.62 ± 0.12, P = 0.001). A higher septal S:D ratio was associated with worse LV dimensions (parameter estimate: 0.0061, P = 0.004), mass (parameter estimate: 0.0074, P = 0.002), ejection fraction (parameter estimate: -0.0303, P = 0.024), and inflow propagation (parameter estimate: -0.3538, P < .001). S:D coupling becomes weaker in DCM with LV remodeling and dysfunction. The S:D coupling ratio may be useful to assess coupling, warranting study in relation to patient outcomes.

  14. Wave reflection augments central systolic and pulse pressures during facial cooling.

    PubMed

    Edwards, David G; Roy, Matthew S; Prasad, Raju Y

    2008-06-01

    Cardiovascular events are more common in the winter months, possibly because of hemodynamic alterations in response to cold exposure. The purpose of this study was to determine the effect of acute facial cooling on central aortic pressure, arterial stiffness, and wave reflection. Twelve healthy subjects (age 23 +/- 3 yr; 6 men, 6 women) underwent supine measurements of carotid-femoral pulse wave velocity (PWV), brachial artery blood pressure, and central aortic pressure (via the synthesis of a central aortic pressure waveform by radial artery applanation tonometry and generalized transfer function) during a control trial (supine rest) and a facial cooling trial (0 degrees C gel pack). Aortic augmentation index (AI), an index of wave reflection, was calculated from the aortic pressure waveform. Measurements were made at baseline, 2 min, and 7 min during each trial. Facial cooling increased (P < 0.05) peripheral and central diastolic and systolic pressures. Central systolic pressure increased more than peripheral systolic pressure (22 +/- 3 vs. 15 +/- 2 mmHg; P < 0.05), resulting in decreased pulse pressure amplification ratio. Facial cooling resulted in a robust increase in AI and a modest increase in PWV (AI: -1.4 +/- 3.8 vs. 21.2 +/- 3.0 and 19.9 +/- 3.6%; PWV: 5.6 +/- 0.2 vs. 6.5 +/- 0.3 and 6.2 +/- 0.2 m/s; P < 0.05). Change in mean arterial pressure but not PWV predicted the change in AI, suggesting that facial cooling may increase AI independent of aortic PWV. Facial cooling and the resulting peripheral vasoconstriction are associated with an increase in wave reflection and augmentation of central systolic pressure, potentially explaining ischemia and cardiovascular events in the cold.

  15. Functional and hemodynamic cardiac determinants of exercise capacity in patients with systolic heart failure.

    PubMed

    Hummel, Yoran M; Bugatti, Silvia; Damman, Kevin; Willemsen, Suzan; Hartog, Jasper W L; Metra, Marco; Sipkens, Johannes S; van Veldhuisen, Dirk J; Voors, Adriaan A

    2012-11-01

    Decreased exercise capacity is the main symptom in patients with heart failure (HF). We assessed the association among noninvasively determined maximal cardiac output at exercise, systolic and diastolic cardiac functions at rest, and peak oxygen uptake (pVo(2)) exercise capacity in patients with congestive HF. We studied 102 patients 62 ± 11 years of age with New York Heart Association class II to IV stable HF and left ventricular (LV) ejection fraction <45%. All patients underwent echocardiography and a treadmill cardiopulmonary exercise test for evaluation of pVo(2) corrected for fat-free mass. During the cardiopulmonary exercise test, cardiac output was estimated noninvasively and continuously using Nexfin HD. Fat-free mass-corrected pVo(2) was associated in an univariate linear regression analysis with peak exercise cardiac index (CI) (beta 0.511, p <0.001), LV end-diastolic pressure estimates (peak early diastolic filling velocity/early diastolic tissue velocity [E/e'], beta -0.363, p = 0.001), and right ventricular function (tricuspid annular plane systolic excursion, beta 0.393, p <0.001). In multivariate analysis peak exercise CI (beta 0.380, p = 0.001), but not cardiac output or LV ejection fraction at rest, was an independent predictor of pVo(2). Other independent predictors of pVo(2) were E/e' (beta -0.276, p = 0.009) and tricuspid annular plane systolic excursion (beta 0.392, p <0.001), also when adjusted for age and gender. In conclusion, peak CI is an independent predictor of fat-free mass-corrected pVo(2) in patients with systolic HF. Of all echocardiographic parameters at rest, right ventricular function and E/e' were independently and significantly associated with pVo(2), whereas LV ejection fraction at rest was not.

  16. A Systolic VLSI Design of a Pipeline Reed-solomon Decoder

    NASA Technical Reports Server (NTRS)

    Shao, H. M.; Truong, T. K.; Deutsch, L. J.; Yuen, J. H.; Reed, I. S.

    1984-01-01

    A pipeline structure of a transform decoder similar to a systolic array was developed to decode Reed-Solomon (RS) codes. An important ingredient of this design is a modified Euclidean algorithm for computing the error locator polynomial. The computation of inverse field elements is completely avoided in this modification of Euclid's algorithm. The new decoder is regular and simple, and naturally suitable for VLSI implementation.

  17. Effect of coronary artery bypass graft surgery on left ventricular systolic function

    PubMed Central

    Koene, Ryan J.; Kealhofer, Jessica V.; Adabag, Selcuk; Vakil, Kairav

    2017-01-01

    Background Changes in left ventricular (LV) systolic function in response to coronary artery bypass grafting (CABG) have not been fully assessed. Methods Between January 2001 and December 2014, 2,838 consecutive patients underwent isolated CABG at the Minneapolis Veterans Affairs Health Care System. Of these, 375 had echocardiographic assessment of LV function before (within 6 months) and after (3 to 24 months) CABG and were included in this analysis. Results While the mean LV ejection fraction (LVEF) did not change following CABG [(49±13)% vs. (49±12)%, P=0.51], LVEF decreased in the subgroup with normal (≥50%) pre-operative LVEF [from (59±5)% to (56±9)%, P<0.001] and improved in those with decreased (<50%) pre-operative LVEF [from (36±9)% to (41±12)%, P<0.001]. There was a significant reduction in LV internal diameter during end-diastole (LVIDd) (5.4±0.8 vs. 5.3±0.9, P=0.002) and an increase in left atrial diameter (LAD) (4.4±0.7 vs. 4.6±0.7, P<0.001). There were no perioperative changes in LV internal diameter during end-systole, LV mass, posterior wall thickness, or septal wall thickness. LVEF improved by >5% in 24% of the study population, did not change (+/− 5%) in 55%, and worsened by >5% in 21%. Patients with improved EF were less often diabetic and had lower pre-operative LVEF, and greater LV dimensions at baseline. Conclusions After CABG, there was a decrease in LVIDd and an increase in LAD. Also, a decrease in LV systolic function with CABG was observed in patients with normal pre-operative LVEF and an improvement in LV systolic function was observed in patients with decreased pre-operative LVEF. PMID:28275473

  18. Effect of food intake on left and right ventricular systolic tissue Doppler measurements.

    PubMed

    Dieden, Anna; Gårdinger, Ylva; Hlebowicz, Joanna; Björgell, Ola; Dencker, Magnus

    2016-09-01

    Systolic tissue Doppler measurements (s') have been used to measure the velocity in myocardial motion and are a valuable tool for evaluating the systolic function of the left and right ventricles. Digestion of food is known to significantly alter hemodynamics and may therefore affect s'. The effect of food intake on s' parameters has not yet been studied. We assessed whether s' is affected by food intake. Nineteen healthy subjects aged 26·2 ± 4·2 years were investigated. s' was measured with pulsed tissue Doppler imaging in the right and left ventricles before the subjects ate a standardized meal and also 30 and 110 min after the meal. Three measurements were taken in each projection, and a mean value was calculated for each. s' increased significantly (P<0·05) from fasting to 30 min after food intake in every measured site except in the left inferolateral wall (P = 0·15, NS). Several, but not all, variables returned to base value 110 min after food intake. This study shows that food intake affects the tissue Doppler variables used to evaluate systolic heart function. Further studies are needed in older healthy subjects and older subjects with various cardiovascular diseases.

  19. End-systolic pressure-volume relationship and intracellular control of contraction.

    PubMed

    Landesberg, A

    1996-01-01

    The left ventricular (LV) pressure-volume relationship and the effect of ejection on pressure generation are predicted theoretically based on the intracellular control mechanisms. The control of contraction is described based on coupling calcium kinetics and cross-bridge cycling. The analysis of published skinned and intact cardiac muscle data suggests two feedback control loops: 1) a positive cooperative mechanism that determines the force-length relationship, the length dependence calcium sensitivity of the contractile filaments, and the related Frank Starling law; and 2) a negative mechanical feedback that determines the force-velocity relationship and the generated power. The interplay between these two feedback mechanisms explains the wide spectrum of phenomena associated with the end-systolic pressure-volume relationship (ESPVR); it provides an explanation for the "shortening deactivation" and for the recent observations of the positive effect of ejection on the ESPVR, i.e., the increase of the end-systolic pressure of the ejecting beat over the pressure of the isovolumic beat at the same end-systolic volume. Furthermore, the analysis suggests that the LV contractility depends on the balance between the two intracellular mechanisms and that the effect of loading conditions is determined through these intracellular mechanisms.

  20. Automatic detection of end-diastole and end-systole from echocardiography images using manifold learning.

    PubMed

    Gifani, Parisa; Behnam, Hamid; Shalbaf, Ahmad; Sani, Zahra Alizadeh

    2010-09-01

    The automatic detection of end-diastole and end-systole frames of echocardiography images is the first step for calculation of the ejection fraction, stroke volume and some other features related to heart motion abnormalities. In this paper, the manifold learning algorithm is applied on 2D echocardiography images to find out the relationship between the frames of one cycle of heart motion. By this approach the nonlinear embedded information in sequential images is represented in a two-dimensional manifold by the LLE algorithm and each image is depicted by a point on reconstructed manifold. There are three dense regions on the manifold which correspond to the three phases of cardiac cycle ('isovolumetric contraction', 'isovolumetric relaxation', 'reduced filling'), wherein there is no prominent change in ventricular volume. By the fact that the end-systolic and end-diastolic frames are in isovolumic phases of the cardiac cycle, the dense regions can be used to find these frames. By calculating the distance between consecutive points in the manifold, the isovolumic frames are mapped on the three minimums of the distance diagrams which were used to select the corresponding images. The minimum correlation between these images leads to detection of end-systole and end-diastole frames. The results on six healthy volunteers have been validated by an experienced echo cardiologist and depict the usefulness of the presented method.

  1. Systolic Peak Detection in Acceleration Photoplethysmograms Measured from Emergency Responders in Tropical Conditions

    PubMed Central

    Elgendi, Mohamed; Norton, Ian; Brearley, Matt; Abbott, Derek; Schuurmans, Dale

    2013-01-01

    Photoplethysmogram (PPG) monitoring is not only essential for critically ill patients in hospitals or at home, but also for those undergoing exercise testing. However, processing PPG signals measured after exercise is challenging, especially if the environment is hot and humid. In this paper, we propose a novel algorithm that can detect systolic peaks under challenging conditions, as in the case of emergency responders in tropical conditions. Accurate systolic-peak detection is an important first step for the analysis of heart rate variability. Algorithms based on local maxima-minima, first-derivative, and slope sum are evaluated, and a new algorithm is introduced to improve the detection rate. With 40 healthy subjects, the new algorithm demonstrates the highest overall detection accuracy (99.84% sensitivity, 99.89% positive predictivity). Existing algorithms, such as Billauer's, Li's and Zong's, have comparable although lower accuracy. However, the proposed algorithm presents an advantage for real-time applications by avoiding human intervention in threshold determination. For best performance, we show that a combination of two event-related moving averages with an offset threshold has an advantage in detecting systolic peaks, even in heat-stressed PPG signals. PMID:24167546

  2. Speckle-Tracking analysis of left ventricular systolic function in the intensive care unit.

    PubMed

    Cinotti, Raphaël; Delater, Adrien; Fortuit, Camille; Roquilly, Antoine; Mahé, Pierre-Joachim; Demeure-dit-Latte, Dominique; Asehnoune, Karim

    2015-01-01

    Speckle-tracking analysis is a new available tool in order to assess left ventricular function in cardiology. Its novelty relies on the technological ability to track natural acoustic markers (known as speckle) within the myocardium during the cardiac cycle. This technology allows the evaluation of myocardium strain during systole and diastole. To date, global longitudinal strain (GLS) has been extensively studied in cardiology. It is now well established that GLS is more sensitive than left ventricular ejection fraction with 2D echocardiography in detecting systolic function impairment. It is also superior to left ventricular ejection fraction in the prediction of major cardio-vascular events. In the intensive care unit (ICU) setting, data are scarce. In experimental model and human studies in septic shock, speckle-tracking analysis suggests that GSL is impaired along with preserved left ventricular ejection fraction. Recent data also suggest that GLS impairment could predict in-ICU mortality in septic shock. In severe subarachnoid haemorrhage patients, speckle-tracking analysis could be more sensitive in detecting stress cardiomyopathy. However, there are many gaps to fill in the critically ill patient. For instance, the influence of mechanical ventilation on GLS is not fully elucidated, and there are, to date, too few data to exactly assess potential GLS alterations on the patient's outcome. Nonetheless, this new tool provides objective and sensitive data with acceptable intra and inter-observer variability and may be of primary interest in the evaluation of left-ventricular systolic function in the ICU.

  3. Evaluation of left ventricular systolic function in young adults with mitral valve prolapse

    PubMed Central

    Malev, Eduard; Zemtsovsky, Eduard; Pshepiy, Asiyet; Timofeev, Eugeny; Reeva, Svetlana; Prokudina, Maria

    2012-01-01

    OBJECTIVE: To evaluate left ventricular function in young adults with mitral valve prolapse (MVP) without significant mitral regurgitation using two-dimensional strain imaging. METHODS AND RESULTS: A total of 58 asymptomatic young subjects (mean [± SD] age 19.7±1.6 years; 72% male) with MVP were compared with 60 sex- and age-matched healthy subjects. MVP was diagnosed by billowing one or both mitral leaflets >2 mm above the mitral annulus in the long-axis parasternal view. Longitudinal, radial and circumferential strain and strain rate were determined using speckle tracking with a grey-scale frame rate of 50 fps to 85 fps. There were no significant differences in the global systolic left ventricular function of the subjects with MVP compared with the control group. In the MVP group, most of the global myocardial systolic deformation indexes were not reduced. Only the global circumferential strain showed a decrease in the prolapse subjects. Regional, longitudinal, circumferential and radial strain and strain rate were decreased only in septal segments. A decrease in the rotation of the same septal segments at the basal level was also observed. CONCLUSION: Regional septal myocardial deformation indexes decrease in subjects with MVP. These changes may be the first sign indicating the deterioration of left ventricular systolic function as well as the existence of primary cardiomyopathy in asymptomatic young subjects with MVP. PMID:23592928

  4. BP Spill Sampling and Monitoring Data

    EPA Pesticide Factsheets

    This dataset analyzes waste from the the British Petroleum Deepwater Horizon Rig Explosion Emergency Response, providing opportunity to query data sets by metadata criteria and find resulting raw datasets in CSV format.The data query tool allows users to download EPA's air, water and sediment sampling and monitoring data that has been collected in response to the BP oil spill. All sampling and monitoring data that has been collected to date is available for download as raw structured data.The query tools enables CSV file creation to be refined based on the following search criteria: date range (between April 28, 2010 and 9/29/2010); location by zip, city, or county; media (solid waste, weathered oil, air, surface water, liquid waste, tar, sediment, water); substance categories (based on media selection) and substances (based on substance category selection).

  5. Single-beat estimation of the ventricular pumping mechanics in terms of the systolic elastance and resistance.

    PubMed

    Chang, K C; Kuo, T S

    1997-11-07

    An elastance-resistance model has long been used to assess the systolic mechanical behavior of the ventricular pump under an in situ, open-chest experiment. However, there is difficulty in the clinical application of such a model because of the required isovolumetric signal that is obtained by occluding the ascending aorta in diastole. In this study, we determine the characteristics of an elastance-resistance model in the absence of isovolumeric measurement to quantify the physical properties of the left ventricle. A high-fidelity multisensor catheter was used to record the left ventricular pressure and ascending aortic flow in nine anesthetized, closed-chest dogs. The isovolumetric pressure was estimated from the instantaneous pressure of an ejecting contraction by a curve-fitting technique. Thus, the parameters in the characterization of systolic pumping mechanics could be inferred by the use of fitting this elastance-resistance model. The results showed that the maximal systolic elastance was 7.3 +/- 2.8 mmHg and theoretical maximum flow was 494 +/- 194 ml s-1. These data were compatible with other reports in the literature. Moreover, in every dog studied the maximal systolic elastance was smaller than the end-systolic elastance which was determined by using the end-systolic pressure-volume relation. We suggested that an elastance-resistance model with the estimated isovolumetric pressure has the potential to measure the intrinsic systolic mechanics of the left ventricle in a closed-chest cardiovascular system.

  6. The relationship between mitral annular systolic velocity and ejection fraction in patients with preserved global systolic function of the left ventricle

    PubMed Central

    2013-01-01

    Background The aim of the study was to investigate the relationship between the ejection fraction (EF) and the mitral annular systolic velocity (Sm) in patients with preserved left ventricular systolic function (EF>55%). The study task was to evaluate whether the assessment of Sm(avg) can be used as an alternative to the Simpson’s method in assessment of the EF. The expected benefit was that Sm could be used to predict EF, when EF is difficult to assess due to poor image quality (IQ). Method Sm was obtained by spectral pulse wave Tissue Doppler Imaging (pwTDI) from the lateral and septal sites of the mitral annulus (MA) and an averaged value was calculated - Sm(avg). EF was assessed using Simpson’s rule. Participants were divided into controls (n=70), hypertensive (HTN, n=56), HTN with diastolic dysfunction (HTN/DD, n=65), HTN with diabetes mellitus (HTN/DM, n=52) and HTN with DD and DM (HTN/DD/DM, n=65). Results Sm(avg) showed strong correlation with EF (r=0.978; p<0.0001). There were no significant differences between the correlation coefficients between the subgroups and the controls. The mathematical model that the study recommended to assess the EF is: EF=45.0 + 2 × Sm(avg). Conclusion The assessment of Sm(avg) could be used as an alternative to EF. This approach may be useful especially when the IQ is poor. The method maintains high accuracy and reproducibility in prediction of the EF. PMID:24160570

  7. Association of early systolic blood pressure response to exercise with future cardiovascular events in patients with uncomplicated mild-to-moderate hypertension.

    PubMed

    Cho, Min Soo; Jang, Sun-Joo; Lee, Chang Hoon; Park, Chong-Hun

    2012-09-01

    The relationship between blood pressure (BP) response during exercise and future cardiovascular events remains unclear. We assessed the association between an increase in early systolic BP (SBP) during exercise tests and future cardiovascular events in patients with sustained hypertension (sHT). Between 2002 and 2005, we enrolled 300 patients newly diagnosed with mild-to-moderate sHT without complications from the Asan Ambulatory Blood Pressure Monitoring registry. All the patients successfully performed treadmill tests, achieving target heart rate according to the Naughton/Balke protocol. The patients were divided into quartiles according to their SBP at 8 min (7.4 metabolic equivalent tasks). The primary outcome was the composite of all-cause death, new-onset ischemic heart disease and stroke. The 5-year survival rates did not differ significantly among quartiles 1-4 (100% vs. 96.6% vs. 94.4% vs. 98.3%, P=0.211). Relative to quartile 1, the 5-year event-free survival rates were significantly lower in patients in quartiles 3 (86.9% vs. 98.3%, P=0.023) and 4 (88.2% vs. 98.3%, P=0.023). After multivariable adjustment for covariates, the risk for the composite end point was higher for patients in quartiles 3 (Hazard ratio (HR) 4.69, 95% confidence interval (CI) 1.28-17.13, P=0.020) and 4 (HR 3.65, 95% CI 0.92-14.50, P=0.065) than in quartiles 1 and 2. Cardiovascular risk was significantly higher in patients with stage 4 SBP (>180 mm Hg) even after adjustment (HR 4.00, 95% CI 1.19-13.44, P=0.025). Increased submaximal SBP response to exercise may be a predictor of future cardiovascular events in patients with mild-to-moderate sHT.

  8. Relationship of myocardial mechanics and regional volume change in patients with left ventricular systolic dysfunction.

    PubMed

    Wu, Ji; Mukerji, Rita; Xie, Gong-Yuan

    2011-07-01

    The contraction and rotation of left ventricular (LV) segments in a synchronous fashion is vital for cardiac pump function. However, no data exist regarding the relationship of LV segmental mechanics and regional volume change in patients with LV systolic dysfunction. Thirty-two patients with EF < 50% and fifty-two normal subjects were enrolled. The radius strain and rotation were assessed in six segments at three short axis views using speckle tracking imaging. The mean and standard deviation (SD) of the strain peak time index (SPTI%) and the rotation peak time index (RPTI%) for each view were calculated as representing myocardial segmental synchrony. The mean and the SD of the 4-D mini-volume time index (VMTI, %) from 16 regions were calculated as representing regional volume change using real-time three-dimensional echocardiography (RT-3DE). The SD for each time index was averaged as the systolic dyssynchrony index (SDI) in both groups. The differences of the SPTI and the RPTI to the VMTI (T(sv) and T(rv)) were calculated as dyssynchrony between myocardial segmental mechanics and regional volume change. The time interval of the RPTI between apical and basal rotation (T(abrot)) was also calculated. The relationship of T(sv), T(rv) and T(abrot) to LV ejection fraction (EF) was then analyzed. In patients with LV systolic dysfunction, both peak strain and peak rotation occurred later than the regional minimum volume (55.3 ± 11.1% vs. 45.9 + 5.5%; 50.4 ± 8.7% vs. 45.9 ± 5.5% (both P < 0.05) as compared with normal subjects (41.1 ± 6.6% vs. 40.3 ± 3.8%; 44.1 ± 7.5% vs. 40.3 ± 3.8%). The SDI in each time index is also significantly wider than in normal subjects (P < 0.001). In addition, there was a negative correlation between T(sv), T(rv) and T(abrot) with EF, respectively (P < 0.05). In patients with abnormal LV systolic function the rotation occurs significantly later than regional volume change as compared with normal subjects. There

  9. Exaggerated blood pressure response to exercise is not associated with masked hypertension in patients with high normal blood pressure levels.

    PubMed

    Grossman, Alon; Cohen, Noa; Shemesh, Joseph; Koren-Morag, Nira; Leibowitz, Avshalom; Grossman, Ehud

    2014-04-01

    The association between exaggerated blood pressure (BP) response to exercise (ExBPR) and "masked hypertension" is unclear. Medical records of patients with high-normal BP who were evaluated in the Chaim Sheba Screening Institute Ramat Gan, Israel, during the years 2002-2007 and referred for 24-hour ambulatory BP monitoring (ABPM) and exercise test were reviewed. Data on exercise tests performed in the preceding 5 years were retrieved. Reproducible ExBPR was defined when it was recorded at least twice. BP levels on 24-hour ABPM were compared between patients with a normal BP response and those with an ExBPR (systolic BP ≥200 mm Hg). Sixty-nine normotensive patients with high normal BP levels were identified. ExBPR was recorded in 43 patients and was reproducible in 28. BP levels on 24-hour ABPM were similar in patients with and without ExBPR. In patients with high-normal BP levels, ExBPR is not associated with masked hypertension.

  10. Twenty-four-hour ambulatory blood pressure in children with sleep-disordered breathing.

    PubMed

    Amin, Raouf S; Carroll, John L; Jeffries, Jenny L; Grone, Charles; Bean, Judy A; Chini, Barbara; Bokulic, Ronald; Daniels, Stephen R

    2004-04-15

    Obstructive sleep apnea causes intermittent elevation of systemic blood pressure (BP) during sleep. To determine whether obstructive apnea in children has a tonic effect on diurnal BP, 24-hour ambulatory blood pressure was obtained from 60 children with mean age of 10.8 +/- 3.5 years. Thirty-nine children had obstructive apnea and 21 had primary snoring. Children with obstructive apnea had significantly greater mean BP variability during wakefulness and sleep, a higher night-to-day systolic BP, and a smaller nocturnal dipping of mean BP. Variability of mean arterial pressure during wakefulness was predicted by the desaturation, body mass, and arousal indices, whereas variability during sleep was predicted by apnea-hypopnea and body mass indices. Nocturnal BP dipping was predicted by the desaturation index. There were no significant differences in systolic, diastolic, or mean arterial BP during sleep between the groups. Diastolic BP during wakefulness was significantly different between the groups and correlated negatively with apnea-hypopnea index. We conclude that obstructive apnea in children is associated with 24-hour BP dysregulation and that, independent of obesity, the frequency of obstructive apnea, oxygen desaturation, and arousal contributes to abnormal BP control.

  11. Waste Sampling Data for BP Spill/Deepwater Horizon

    EPA Pesticide Factsheets

    The Deepwater Horizon oil spill (also referred to as the BP oil spill) began on 20 April 2010 in the Gulf of Mexico on the BP-operated Macondo Prospect. Following the explosion and sinking of the Deepwater Horizon oil rig, a sea-floor oil gusher flowed for 87 days, until it was capped on 15 July 2010.In response to the BP oil spill, EPA sampled air, water, sediment, and waste generated by the cleanup operations.

  12. Air Sampling Data for BP Spill/Deepwater Horizon

    EPA Pesticide Factsheets

    The Deepwater Horizon oil spill (also referred to as the BP oil spill) began on 20 April 2010 in the Gulf of Mexico on the BP-operated Macondo Prospect. Following the explosion and sinking of the Deepwater Horizon oil rig, a sea-floor oil gusher flowed for 87 days, until it was capped on 15 July 2010.In response to the BP oil spill, EPA sampled air, water, sediment, and waste generated by the cleanup operations.

  13. Air Monitoring Data for BP Spill/Deepwater Horizon

    EPA Pesticide Factsheets

    The Deepwater Horizon oil spill (also referred to as the BP oil spill) began on 20 April 2010 in the Gulf of Mexico on the BP-operated Macondo Prospect. Following the explosion and sinking of the Deepwater Horizon oil rig, a sea-floor oil gusher flowed for 87 days, until it was capped on 15 July 2010.In response to the BP oil spill, EPA sampled air, water, sediment, and waste generated by the cleanup operations.

  14. Surface Water Sampling Data for BP Spill/Deepwater Horizon

    EPA Pesticide Factsheets

    The Deepwater Horizon oil spill (also referred to as the BP oil spill) began on 20 April 2010 in the Gulf of Mexico on the BP-operated Macondo Prospect. Following the explosion and sinking of the Deepwater Horizon oil rig, a sea-floor oil gusher flowed for 87 days, until it was capped on 15 July 2010.In response to the BP oil spill, EPA sampled air, water, sediment, and waste generated by the cleanup operations.

  15. Sediment Sampling Data for BP Spill/Deepwater Horizon

    EPA Pesticide Factsheets

    The Deepwater Horizon oil spill (also referred to as the BP oil spill) began on 20 April 2010 in the Gulf of Mexico on the BP-operated Macondo Prospect. Following the explosion and sinking of the Deepwater Horizon oil rig, a sea-floor oil gusher flowed for 87 days, until it was capped on 15 July 2010.In response to the BP oil spill, EPA sampled air, water, sediment, and waste generated by the cleanup operations.

  16. Water Sampling Data for BP Spill/Deepwater Horizon

    EPA Pesticide Factsheets

    The Deepwater Horizon oil spill (also referred to as the BP oil spill) began on 20 April 2010 in the Gulf of Mexico on the BP-operated Macondo Prospect. Following the explosion and sinking of the Deepwater Horizon oil rig, a sea-floor oil gusher flowed for 87 days, until it was capped on 15 July 2010.In response to the BP oil spill, EPA sampled air, water, sediment, and waste generated by the cleanup operations.

  17. Exercise thermoregulation in men after 1 and 24-hours of 6 degrees head-down tilt

    NASA Technical Reports Server (NTRS)

    Ertl, A. C.; Dearborn, A. S.; Weidhofer, A. R.; Bernauer, E. M.; Greenleaf, J. E.

    2000-01-01

    BACKGROUND: Exercise thermoregulation is dependent on heat loss by increased skin blood flow (convective and conductive heat loss) and through enhanced sweating (evaporative heat loss). Reduction of plasma volume (PV), increased plasma osmolality, physical deconditioning, and duration of exposure to simulated and actual microgravity reduces the ability to thermoregulate during exercise. HYPOTHESIS: We hypothesized that 24 h of head down tilt (HDT24) would alter thermoregulatory responses to a submaximal exercise test and result in a higher exercise rectal temperature (Tre) when compared with exercise Tre after 1 h of head down tilt (HDT1). METHODS: Seven men (31+/-SD 6 yr, peak oxygen uptake (VpO2peak) of 44+/-6 ml x kg(-1) x min(-1)) were studied during 70 min of supine cycling at 58+/-SE 1.5% VO2peak at 22.0 degrees C Tdb and 47% rh. RESULTS: Relative to pre-tilt sitting chair rest data, HDT1 resulted in a 6.1+/-0.9% increase and HDT24 in a 4.3+/-2.3% decrease in PV (delta = 10.4% between experiments, p<0.05) while plasma osmolality remained unchanged (NS). Pre-exercise Tre was elevated after HDT24 (36.71 degrees C +/-0.06 HDT1 vs. 36.93 degrees C+/-0.11 HDT24, p<0.05). The 70 min of exercise did not alter this relationship (p<0.05) with respective end exercise increases in Tre to 38.01 degrees C and 38.26 degrees C (degrees = 1.30 degrees C (HDT1) and 1.33 degrees C (HDT24)). While there were no pre-exercise differences in mean skin temperature (Tsk), a significant (p<0.05) time x treatment interaction occurred during exercise: after min 30 in HDT24 the Tsk leveled off at 31.1 degrees C, while it continued to increase reaching 31.5 degrees C at min 70 in HDT1. A similar response (NS) occurred in skin blood velocity. Neither local sweating rates nor changes in body weight during exercise of -1.63+/-0.24 kg (HDT1) or - 1.33+/-0.09 kg (HDT24) were different (NS) between experiments. CONCLUSION: While HDT24 resulted in elevated pre-exercise Tre, reduced PV, attenuation of Tsk and skin blood velocity during exercise, the absolute increase in exercise Tre was not altered. But if sweat rate and cutaneous vascular responses were similar at different core temperatures (unchanged thermoregulation), the Tre offset could have been caused by the HDT-induced hypovolemia.

  18. Successful in vitro antigen-dependent activation of 24-hour-old peripheral blood lymphocytes.

    PubMed

    Owen, J A; Muirhead, K; Jensen, C; Jonak, Z L

    1996-03-28

    We describe a simple, rapid and reproducible in vitro culture system in which human peripheral blood lymphocytes (PBLs), donated 24 h prior to initiation of culture can be stimulated to produce antigen-specific antibodies. Peripheral blood lymphocytes purified by Ficoll-Hypaque centrifugation were passed over a G10 Sephadex column and then activated in vitro in the presence of 0.003% staphylococcus Cowan A, 2.8 x 10(-6) M indomethacin and appropriate concentrations of tetanus toxoid antigen. After the first 24 h in culture, a five-fold concentrated supernatant from an allogeneic mixed lymphocyte culture was added. The cell surface phenotypes of the PBLs were analyzed by flow cytometry at the initiation and termination of culture, in order to provide a comprehensive characterization of the cellular composition of a successful in vitro stimulation system. Our results clearly show that the majority of peripheral blood B cells can be induced to an activated stage (blast transformation) and interleukin 2 (IL-2) receptor expression, following very simple manipulations of the lymphoid population. Tetanus toxoid-specific antibody production can be readily generated in this cell population. In contrast, T cells were not activated to express IL-2 receptors and reach blast transformation, and did not show appreciable proliferation. Our system provides a population of B cells producing antibodies of desired specificity which could be utilized for the generation of human hybridomas or could serve as a donor population for antibody engineering via the combinatorial library approach. Careful light scattering and cell surface phenotypic analyses of the cells entering, proliferating and differentiating in these cultures enabled several novel observations to be made.

  19. Influence of mild cold on the components of 24 hour thermogenesis in rats.

    PubMed Central

    Brown, D; Livesey, G; Dauncey, M J

    1991-01-01

    1. The influence of two weeks' acclimation to either 28 degrees C (thermal neutrality) or 21 degrees C (mild cold) on 24 h heat production and motor activity has been investigated in male Wistar rats. Food intake was controlled and provided as a single meal of approximately 170 kJ per day. Mathematical modelling was used to relate metabolic rate to measured movement and time of day. 2. For animals at thermal neutrality it was clear that metabolic rate increased during periods of substantial measured movement and returned to baseline during periods of minimal activity. Total heat production could therefore be divided into two components: underlying and movement-induced thermogenesis. 3. At 21 degrees C, a more complex model was needed. During periods of substantial activity, the relation between metabolic rate and movement was similar to that at 28 degrees C and total heat production could be divided into the same two components of underlying and movement-induced thermogenesis. However, during periods of prolonged inactivity, a different model was required, which included a component of extra metabolic activity, termed supplementary thermogenesis. By fitting this model to data at 28 and 21 degrees C, it was possible to partition 24 h heat production into the three possible sources of underlying, movement-induced and supplementary thermogenesis. 4. Total 24 h heat production was approximately 25% higher for rats at 21 compared with 28 degrees C (P less than 0.01) and underlying thermogenesis was approximately 20% higher for those in the mild cold (P less than 0.01). Measured movement was significantly reduced in the mild cold (P less than 0.05) although it was energetically less efficient since there was no difference in movement-induced thermogenesis, which accounted for 18 and 15% of total heat production at 28 and 21 degrees C respectively. Supplementary thermogenesis was observed only in the mild cold and it accounted for approximately 6% of 24 h heat production, while the peak value accounted for 20% of total heat production. Circadian variations in thermogenesis were also different at 28 compared with 21 degrees C. Possible mechanisms accounting for the components of underlying thermogenesis and supplementary thermogenesis are discussed. PMID:1816371

  20. Food-anticipatory rhythms under 24-hour schedules of limited access to single macronutrients.

    PubMed

    Mistlberger, R E; Houpt, T A; Moore-Ede, M C

    1990-01-01

    Food-restricted rats anticipate a fixed daily mealtime by entrainment of a circadian timekeeping mechanism separate from that which generates daily light-entrainable activity rhythms. The entrainment pathways and rhythm-generating substrates for food-anticipatory rhythms are unknown. In this study, we attempted to define minimal food-related stimuli necessary or sufficient for food anticipation by employing schedules of restricted macronutrient availability, with or without free access to a complementary diet. Rats did not anticipate a daily meal of protein, carbohydrate, or fat, as measured by tilt-cage, running-wheel, or food-bin activity, when they had free access to other nutrients. However, rats did anticipate single-macronutrient meals when they were limited to only two, larger, complementary meals each day (protein-fat, protein-carbohydrate) providing a reduced total number of calories. Previous work has shown that caloric restriction per se is not a prerequisite for food anticipation. In combination with that study, the present results indicate that the size of a nutrient meal, in absolute terms or relative to total daily nutrient intake, is of pre-eminent importance in determining its value as a synchronizer of anticipatory rhythms. The results further suggest that physiological responses unique to the ingestion and absorption of any particular macronutrient are not necessary components of the entrainment pathway.

  1. [Individual peculiarities of adaptation to long-term space flights: 24-hour heart rhythm monitoring

    NASA Technical Reports Server (NTRS)

    Baevskii, R. M.; Bogomolov, V. V.; Gol'dberger, A. L.; Nikulina, G. A.; Charl'z, D. B.; Goldberger, A. L. (Principal Investigator); Charles, J. B. (Principal Investigator)

    2000-01-01

    Presented are results of studying 24-hr variability of the cardiac rhythm which characterizes individual difference in reactions of two crew members to the same set of stresses during a 115-day MIR mission. Spacelab (USA) cardiorecorders were used. Data of monitoring revealed significantly different baseline health statuses of the cosmonauts. These functional differences were also observed in the mission. In one of the cosmonauts, the cardiac regulation changed over to a more economic functioning with the autonomous balance shifted towards enhanced sympathetic activity. After 2-3 months on mission he had almost recovered pre-launch level of regulation. In the other, the regulatory system was appreciably strained at the beginning of the mission as compared with preflight baseline. Later on, on flight months 2-3, this strain kept growing till a drastic depletion of the functional reserve. On return to Earth, this was manifested by a strong stress reaction with a sharp decline in power of high-frequency and grow in power of very low frequency components of the heart rhythm. The data suggest that adaptation to space flight and reactions in the readaptation period are dependent on initial health status of crew members, and functional reserve.

  2. Formative research of a quick list for an automated self-administered 24-Hour dietary recall

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Twenty-four-hour dietary recalls are used to collect high-quality dietary data. Because they require highly trained interviewers, recalls are expensive and impractical for large-scale nutrition research, leading to the use of food frequency questionnaires. We are developing a computer-based, self-ad...

  3. Estimating 24-hour urine sodium level with spot urine sodium and creatinine.

    PubMed

    Koo, Ho Seok; Kim, Yong Chul; Ahn, Shin Young; Oh, Se Won; Kim, Suhnggwon; Chin, Ho Jun; Park, Jung Hwan

    2014-09-01

    The 24-hr urine sodium excretion level was estimated based on the spot urine sodium, and the efficacy of the formula was validated to determine the status of low salt intake <100 mEq Na/day. The 24-hr urine samples were collected from 400 patients. The 24-hr urine creatinine level was estimated with the use of three formulas: a newly derived Korean equation (E24UCR_K), and Tanaka (E24UCR_T) and Cockcroft-Gault (E24UCR_CG) equations. The correlation coefficients between the estimated and measured 24-hr urine creatinine for these three equations were 0.863, 0.846, and 0.896, respectively (All P<0.001). After estimating the 24-hr urine sodium levels, the correlation coefficients between the estimated and measured 24-hr urine sodium levels were 0.466, 0.490, and 0.516, respectively (All P<0.001). The sensitivity of three formulas to estimate the measured 24-hr urine sodium≥100 mEq/day using the estimated amount≥100 mEq/day was 84.3%, 87.6%, and 84.8%, respectively. In conclusion, the three equations used to estimate the 24-hr urine sodium content were useful to determine the status of low salt intake.

  4. Specific Antivenom Ability in Neutralizing Hepatic and Renal Changes 24 Hours after Latrodectus dahli Envenomation

    PubMed Central

    Valikhanfard-Zanjani, Elham; Zare-Mirakabadi, Abbas; Oryan, Shahrbanoo; Goodarzi, Hamid Reza; Rajabi, Mahdise

    2016-01-01

    Background: Latrodectism, a syndrome caused by Latrodectus genus, is one of the clinical problems that occur predominantly in north east of Iran. Nowadays antivenom therapy has become the most useful treatment for animal bites; however there is still a controversy about route and time of antivenom administration in spider bite. The aim of the present study was to determine the efficacy of specific antivenom in neutralizing hepatic and renal symptoms 24 h after Latrodectus dahli envenomation. Methods: We selected a group of male New Zealand white rabbits, weighing 2±0.3 kg. The L. dahli venom (0.5 mg/kg) was injected subcutaneously. Specific antivenom (2.5 ml, I.V) was injected 24 h following venom injection. Blood sampling was performed before and 24 h after venom injection, as well within 24, 48 and 72 h after antivenom administration. Serum levels of (aspartate amino transferase (AST) alanine amino transferase (ALT), alkaline phosphatase (ALP), urea, bilirubin, creatinine and albumin were determined in all the sam. Results: Latrodectus dahli venom caused significant increase (P< 0.05) in all foresaid serum parameters. Antivenom reversed the AST, ALP, creatinine, urea and bilirubin to normal levels, but failed about ALT level, also non-significant decrease was observed in albumin levels. Conclusion: Antivenom administration 24 h after venom injection can greatly reverse symptoms caused by venom. Future studies in human beings should be conducted to assess the protection against the specific-Latrodectus anti-venom. PMID:27308281

  5. 24 Hours in a Day: A Listening Update to the Time Studies

    ERIC Educational Resources Information Center

    Janusik, Laura A.; Wolvin, Andrew D.

    2009-01-01

    Time is an important communication variable that has been impacted by new technology and changed the way people communicate. This study of communication time use by college students provides an update to earlier studies by factoring in computer and telephone use--media that have forced a multitasking approach to communication. Undergraduate…

  6. Albumin infusion in humans does not model exercise induced hypervolaemia after 24 hours

    NASA Technical Reports Server (NTRS)

    Haskell, A.; Gillen, C. M.; Mack, G. W.; Nadel, E. R.

    1998-01-01

    We rapidly infused 234 +/- 3 mL of 5% human serum albumin in eight men while measuring haematocrit, haemoglobin concentration, plasma volume (PV), albumin concentration, total protein concentration, osmolality, sodium concentration, renin activity, aldosterone concentration, and atrial natriuretic peptide concentration to test the hypotheses that plasma volume expansion and plasma albumin content expansion will not persist for 24 h. Plasma volume and albumin content were expanded for the first 6 h after infusion (44.3 +/- 1.9-47.2 +/- 2.0 mL kg-1 and 1.9 +/- 0.1-2.1 +/- 0.1 g kg-1 at pre-infusion and 1 h, respectively, P < 0.05), but by 24 h plasma volume and albumin content decreased significantly from 1 h post-infusion and were not different from pre-infusion (44.8 +/- 1.9 mL kg-1 and 1.9 +/- 0.1 g kg-1, respectively). Plasma aldosterone concentration showed a significant effect of time over the 24 h after infusion (P < 0.05), and showed a trend to decrease at 2 h after infusion (167.6 +/- 32.5(-1) 06.2 +/- 13.4 pg mL-1, P = 0.07). These data demonstrate that a 6.8% expansion of plasma volume and 10.5% expansion of plasma albumin content by infusion does not remain in the vascular space for 24 h and suggest a redistribution occurs between the intravascular space and interstitial fluid space.

  7. Case Study: Psychiatric Misdiagnosis of Non-24-Hours Sleep-Wake Schedule Disorder Resolved by Melatonin

    ERIC Educational Resources Information Center

    Dagan, Yaron; Ayalon, Liat

    2005-01-01

    This case study describes a 14-year-old male suffering from significant academic and personal difficulties, who has been diagnosed with depression, schizotypal personality disorder, and learning disabilities. Because of excessive sleepiness, assessment for a potential sleep disorder was performed. An overnight polysomnographic study revealed no…

  8. 24-hour pattern of work-related injury risk of French firemen: nocturnal peak time.

    PubMed

    Riedel, Marc; Berrez, Stéphane; Pelisse, Didier; Brousse, Eric; Forget, Coralie; Marlot, Michel; Smolensky, Michael H; Touitou, Yvan; Reinberg, Alain

    2011-10-01

    The first aim of the study was to assess clock-time patterning of work-related injuries (WRIs) of firemen (FM) of Saône et Loire-71 (France) during the 4-yr span of 1 January 2004 to 31 December 2007. FM of this service are legally required to log every WRI and seek its evaluation by the medical service, whether the WRI was the result of worksite duties or exercise/sport activities at the station. WRI was defined specifically as a (nonexercise, nonsport, and nonemotional/stress) work-associated trauma, verified both by log book and medical records. For the corresponding years, the 24-h pattern of emergency calls (Calls) plus road traffic (Traffic) on the main roads of the service area was also assessed. Relative risk (R) of WRI was calculated as the quantity of WRIs/h divided by the quantity of Call responses/h × 1000, which takes into account the number of at-risk FM/unit time, since each dispatched emergency vehicle is staffed with 4 FM. Comparably trained regular (RFM) and volunteer (VFM) FM experienced a total of 187 WRIs. The 24-h WRI curve patterns of RFM and VFM were correlated (r = 0.4, p < .05), with no histogram difference (p > .05). Analysis of variance (ANOVA) validated comparable clock-time patterns in WRIs of RFM and VFM each year and each season (all p < .0001). Thus, time series of the RFM and VFM were pooled, revealing a statistical significant 24-h variation in WRIs (ANOVA, p > .0006; Cosinor analysis, p < .0001), with peak at 16:00 h and trough at 04:00 h. The 24-h pattern in Traffic, which mirrors that of human activity, with peak ∼18:00 h and trough ∼03:00 h, was also verified (ANOVA, p < .0001; Cosinor, p < .0001). Calls (n = 112,059) resulting in FM responses also exhibited statistically significant 24-h variation, with peak at ∼20:00 h and trough at ∼06:00 h. The 24-h pattern of R showed a nocturnal peak at 02:00 h (R = 2.87 ± 0.46; mean ± SEM) and diurnal trough 14:00 h (R = 1.30 ± 0.05) (t test, p < .02); clock-time-related changes in R were further validated by ANOVA (p = .0001) and Cosinor (p < .0001), with acrophase (peak time, Ø) of 02:43 h ± 68 min (SD). The second aim of the study was to evaluate the relationship between the 24-h patterns of WRIs and lag-time (LT) response (used as a measure of work performance) of FM of the same service to urgent medical calls for out-of-hospital cardiac arrests. Highest R of WRI at 02:00 h corresponded closely to longest LT (raw data at ∼02:00 h and Cosinor derived Ø of 02.54 h ± 71 min [SD]), thereby supporting the hypothesis of a common mechanism underlying the two 24-h profiles. A third aim was to determine the relevance of a new concept in work safety, "chronoprevention," for future FM training programs.

  9. Cardiorespiratory Assessment of 24-Hour Crash-Diet Effects on Altitude, +Gz, ad Fatigue Tolerances,

    DTIC Science & Technology

    1981-02-01

    Physiological measurements were recorded for 10 min at GL, after which the chamber pressure was reduced over a 10 min period to an altitude equivalent of...3,810 m. At altitude, four separate math tests were alternated with 10-min periods of resting physiological measurements as indicated in Table II...on this type of function. DISCUSSION In the nonfasting control condition, statistically significant physiological displacements (Tables IV-X) were

  10. Sex difference in the near-24-hour intrinsic period of the human circadian timing system

    PubMed Central

    Duffy, Jeanne F.; Cain, Sean W.; Chang, Anne-Marie; Phillips, Andrew J. K.; Münch, Mirjam Y.; Gronfier, Claude; Wyatt, James K.; Dijk, Derk-Jan; Czeisler, Charles A.

    2011-01-01

    The circadian rhythms of melatonin and body temperature are set to an earlier hour in women than in men, even when the women and men maintain nearly identical and consistent bedtimes and wake times. Moreover, women tend to wake up earlier than men and exhibit a greater preference for morning activities than men. Although the neurobiological mechanism underlying this sex difference in circadian alignment is unknown, multiple studies in nonhuman animals have demonstrated a sex difference in circadian period that could account for such a difference in circadian alignment between women and men. Whether a sex difference in intrinsic circadian period in humans underlies the difference in circadian alignment between men and women is unknown. We analyzed precise estimates of intrinsic circadian period collected from 157 individuals (52 women, 105 men; aged 18–74 y) studied in a month-long inpatient protocol designed to minimize confounding influences on circadian period estimation. Overall, the average intrinsic period of the melatonin and temperature rhythms in this population was very close to 24 h [24.15 ± 0.2 h (24 h 9 min ± 12 min)]. We further found that the intrinsic circadian period was significantly shorter in women [24.09 ± 0.2 h (24 h 5 min ± 12 min)] than in men [24.19 ± 0.2 h (24 h 11 min ± 12 min); P < 0.01] and that a significantly greater proportion of women have intrinsic circadian periods shorter than 24.0 h (35% vs. 14%; P < 0.01). The shorter average intrinsic circadian period observed in women may have implications for understanding sex differences in habitual sleep duration and insomnia prevalence. PMID:21536890

  11. Effect of 16 and 24 hours daily radiation (light) on lettuce growth

    NASA Technical Reports Server (NTRS)

    Koontz, H. V.; Prince, R. P.; Knott, W. M. (Principal Investigator)

    1986-01-01

    A 50% increase in total radiation by extending the photoperiod from 16 to 24 hr doubled the weight of all cultivars of loose-leaf lettuce (Lactuca sativa L.) 'Grand Rapids Forcing', 'Waldmanns Green', 'Salad Bowl', and 'RubyConn', but not a Butterhead cultivar, 'Salina'. When total daily radiation (moles of photons) was the same, plants under continuous radiation weighed 30% to 50% more than plants under a 16 hr photoperiod. By using continuous radiation on loose-leaf lettuce, fewer lamp fixtures were required and yield was increased.

  12. Mothers' Maximum Drinks Ever Consumed in 24 Hours Predicts Mental Health Problems in Adolescent Offspring

    ERIC Educational Resources Information Center

    Malone, Stephen M.; McGue, Matt; Iacono, William G.

    2010-01-01

    Background: The maximum number of alcoholic drinks consumed in a single 24-hr period is an alcoholism-related phenotype with both face and empirical validity. It has been associated with severity of withdrawal symptoms and sensitivity to alcohol, genes implicated in alcohol metabolism, and amplitude of a measure of brain activity associated with…

  13. 24 Hours in the Children's Section: An Observational Study at the Public Library

    ERIC Educational Resources Information Center

    Becker, Katherine

    2012-01-01

    The purpose of this study was to explore patronage and usage of the children's section of a public library. Patrons of the children's section of a public library in a small Northern Arizona city were observed for a total of 24 h over 12 sessions. Analytic induction was used to formulate categories based on field notes made during these…

  14. Enhanced depth OCT imaging of the lamina cribrosa for 24 hours

    PubMed Central

    Naranjo-Bonilla, Pedro; Giménez-Gómez, Rafael; Ríos-Jiménez, David; Varas-Fabra, María Luísa; Muñoz-Villanueva, María del Carmen; García-Catalán, Rocío; Font-Ugalde, Pilar; Poblador-Fernández, María Soledad; Lancho-Alonso, José Luís; Gallardo-Galera, José María

    2017-01-01

    The lamina cribrosa thickness (LCT) could be affected by dynamic changes in its structure. Using Spectral-domain-optical coherence tomography (SD-OCT), we have studied the behaviour of the laminar region in 14 young subjects over 24h. Significant changes in LCT were observed, depending on the time at which the measurement was taken, with the maximum thickness being observed at 7.30 p.m., and the minimum at 7.30 a.m. This finding could suggests a circadian pattern in the LCT thickness in healthy subjects, which could have implications for the classification, diagnosis and prognosis of both normal and glaucomatous subjects. PMID:28251093

  15. Moderate alcohol consumption and 24-hour urinary levels of melatonin in postmenopausal women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Low overnight urinary melatonin metabolite concentrations have been associated with increased risk for breast cancer among postmenopausal women. The Postmenopausal Women's Alcohol Study was a controlled feeding study to test the effects of low to moderate alcohol intake on potential risk factors for...

  16. Design of solar thermal dryers for 24-hour food drying processes (abstract)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Solar drying is a ubiquitous method that has been adopted for many years as a food preservation method. Most of the published articles in the literature provide insight on the performance of solar dryers in service but little information on the dryer construction material selection process or mater...

  17. 24-Hour Glucose Profiles on Diets Varying in Protein Content and Glycemic Index

    PubMed Central

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