Determinants of left ventricular mass and hypertrophy in hemodialysis patients assessed by cardiac magnetic resonance imaging.

Background And Objectives: Left ventricular hypertrophy (LVH) is an independent risk factor for premature cardiovascular death in hemodialysis (HD) patients and one of the three forms of uremic cardiomyopathy. Cardiovascular magnetic resonance (CMR) is a volume-independent technique to assess cardiac structure. We used CMR to assess the determinants of left ventricular mass (LVM) and LVH in HD patients.

Cytomegalovirus resistance in solid organ transplant recipients treated with intravenous ganciclovir or oral valganciclovir.

Background: The rate of cytomegalovirus (CMV) mutations conferring ganciclovir resistance was assessed in a trial comparing intravenous ganciclovir and oral valganciclovir for treatment of CMV disease in solid organ transplant (SOT) recipients.

Methods: Viral genes (UL97 and UL54) conferring ganciclovir resistance were amplified and sequenced from blood samples collected at days 0 (before therapy), 21 (end of induction) and 49 (end of maintenance).

Results: The overall risk of developing a confirmed or probable ganciclovir resistance mutation during treatment was similar for patients treated with ganciclovir (2.

An improved high intensity recycling helium-3 beam source.

We describe an improved high intensity, recycling, supersonic atomic beam source. Changes address several issues previously limiting performance and reliability of the apparatus, including the use of newly available vacuum pumps and modifications to the recycling system. We achieve a source intensity of 2.

Comparison of predictive ability of lipoprotein components to that of traditional risk factors of coronary events in renal transplant recipients.

Objective: Risk factors for major adverse coronary events (MACE) in renal transplant recipients are often different from those of non-transplanted populations. We compared the predictive power of lipoprotein components (LC) to that of more traditional risk factors such as serum creatinine, diabetes and inflammation measured by C-reactive protein (CRP) in the assessment of lescol in renal transplantation (ALERT) trial population.

Methods: From the 2102 randomized patients in ALERT we selected 1734 patients with a complete set of risk and adjustment factors used in the study.

Metabolic syndrome and cardiovascular risk in renal transplant recipients: effects of statin treatment.

Background: Renal transplant recipients (RTR) have high risk for cardiovascular disease (CVD). They also have high prevalence of insulin resistance and metabolic syndrome (MS). Statin treatment reduces CVD risk in RTR.

Linewidths in bound state resonances for helium scattering from Si(111)-(1 × 1)H.

Helium-3 spin-echo measurements of resonant scattering from the Si(111)-(1 × 1)H surface, in the energy range 4-14 meV, are presented. The measurements have high energy resolution yet they reveal bound state resonance features with uniformly broad linewidths. We show that exact quantum mechanical calculations of the elastic scattering, using the existing potential for the helium/Si(111)-(1 × 1)H interaction, cannot reproduce the linewidths seen in the experiment.

The impact of pneumococcal conjugate vaccine on rates of myringotomy with ventilation tube insertion in Australia.

Background: In randomized controlled trials and postmarketing studies the heptavalent pneumococcal conjugate vaccine (7vPCV) has been shown to reduce myringotomy with ventilation tube insertion (MVTI) procedures in a 4-dose schedule. In Australia, a 3-dose schedule at 2, 4, and 6 months of age is routinely used in non-Indigenous children. Our aim was to determine if a reduction in MVTI comparable to that documented in the United States occurred in Australia despite the absence of the booster dose.

Inflammation in renal transplantation.

Background And Objectives: Renal transplant recipients experience premature cardiovascular disease and death. The association of inflammation, all-cause mortality, and cardiovascular events in renal transplant recipients has not been examined in a large prospective controlled trial.

Design, Setting, Participants, & Measurements: ALERT was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin on cardiovascular and renal outcomes in 2102 renal transplant recipients.

Ten years experience of in-center thrice weekly long overnight hemodialysis.

Background And Objectives: Published studies suggest that longer hemodialysis (HD) sessions are associated with improved morbidity and mortality, but few centers offer long sessions. The Western Infirmary renal unit has offered long overnight hemodialysis (LOH) (6 to 7 h) thrice weekly since 1998. The aim of this study was to describe patients who chose LOH and compare outcomes with patients on conventional hours (4 to 5 h) HD.

Acute rejection and chronic nephropathy: a systematic review of the literature.

Background: The risk of graft failure is the pivotal measure of effectiveness when evaluating immunosuppressive regimens for renal transplantation. However, to date most randomized trials of immunosuppressive therapy have had acute rejection as the primary endpoint for treatment comparisons. The objective here was to review the evidence relating acute rejection to renal graft function and graft survival.

Long-term outcomes of CMV disease treatment with valganciclovir versus IV ganciclovir in solid organ transplant recipients.

Though an important cause of morbidity and mortality in solid organ transplantation (SOT), the long-term outcomes of cytomegalovirus (CMV) disease treatment have not been well studied. In a randomized trial, 321 SOT recipients with CMV disease were followed 1 year after treatment with either twice daily intravenous ganciclovir or oral valganciclovir (for 21 days) followed by once daily valganciclovir until day 49 in all patients. Clinical and viral eradication of CMV disease was similar between groups.

Studying the microscopic nature of diffusion with helium-3 spin-echo.

Helium-3 spin-echo (3HeSE) is a powerful, new experimental technique for studying dynamical phenomena at surfaces with ultra-high energy resolution. Resolution is achieved by using the 3He nuclear spin as an internal timer, to enable measurement of the energy changes of individual atoms as they scatter. The technique yields a measurement of surface correlation in reciprocal space and real time, and probes the nanometre length scales and picosecond to nanosecond timescales that are characteristic of many important atomistic processes.

Effect of fluvastatin on cardiac outcomes in kidney transplant patients with systemic lupus erythematosus: a randomized placebo-controlled study.

Objective: Patients with systemic lupus erythematosus (SLE), with or without end-stage renal failure, are at increased risk of premature cardiovascular disease. Although statin therapy has been found to reduce cardiovascular risk in the general population, its effectiveness in kidney transplant recipients with SLE has not been examined. This study was undertaken to investigate the effect of fluvastatin on cardiac end points in a randomized controlled trial of renal transplant patients with SLE.

Rosuvastatin and cardiovascular events in patients undergoing hemodialysis.

Background: Statins reduce the incidence of cardiovascular events in patients at high cardiovascular risk. However, a benefit of statins in such patients who are undergoing hemodialysis has not been proved.

Methods: We conducted an international, multicenter, randomized, double-blind, prospective trial involving 2776 patients, 50 to 80 years of age, who were undergoing maintenance hemodialysis.

Cardiovascular disease in patients with renal disease: the role of statins.

Objectives: Atherosclerosis is common in patients with chronic kidney disease (CKD), and cardiovascular disease (CVD) represents a major cause of death. The National Kidney Foundation guidelines favour the use of statin therapy for treatment of dyslipidaemia in patients with CKD. Much evidence supports statin therapy for reducing CVD and improving outcomes in the general population, but there is less evidence in patients with CKD.

Cerebrovascular events in renal transplant recipients.

Background: The incidence of stroke and risk factors for different subtypes of cerebrovascular (CBV) events in renal transplant recipients have not been examined in any large prospective controlled trial.

Methods: The Assessment of Lescol in Renal Transplantation was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin (40-80 mg) daily on cardiovascular, and renal outcomes in renal transplant recipients. Patients initially randomized to fluvastatin or placebo in the 5 to 6 year trial was offered open-label fluvastatin in a 2-year extension to the original study.

Simulation and analysis of solenoidal ion sources.

We present a detailed analysis and simulation of solenoidal, magnetically confined electron bombardment ion sources, aimed at molecular beam detection. The aim is to achieve high efficiency for singly ionized species while minimizing multiple ionization. Electron space charge plays a major role and we apply combined ray tracing and finite element simulations to determine the properties of a realistic geometry.

An assessment of herpesvirus co-infections in patients with CMV disease: correlation with clinical and virologic outcomes.

The effect of herpesvirus co-infections (HHV-6, HHV-7) on cytomegalovirus (CMV) disease and its response to therapy is unknown. We prospectively analyzed herpesvirus co-infections in transplant recipients with CMV disease. All patients received 3 weeks of antiviral therapy.

Impact of dryland salinity on population dynamics of vector mosquitoes (Diptera: Culicidae) of Ross River virus in inland areas of southwestern Western Australia.

Clearing of native vegetation for agriculture since European settlement has left 1.047 million ha of southwestern Australia affected by a severe form of environmental degradation called dryland salinity, characterized by secondary soil salinization and waterlogging. This area may expand by a further 1.

The utility of mosquito-borne disease as an environmental monitoring tool in tropical ecosystems.

The intrinsic link between ecosystem health and human health has been firmly established in the literature and has given rise to the development of new multidisciplinary fields of research such as medical geology. An important practical implication of the ecosystem health approach is the utility of human disease outbreaks as indicators of underlying ecosystem disruption. The use of such a bioindicator is particularly relevant in developing countries where monitoring of traditional environmental and ecological indicators is not routinely undertaken.

Influence of hosts on the ecology of arboviral transmission: potential mechanisms influencing dengue, Murray Valley encephalitis, and Ross River virus in Australia.

Ecological interactions are fundamental to the transmission of infectious disease. Arboviruses are particularly elegant examples, where rich arrays of mechanisms influence transmission between vectors and hosts. Research on host contributions to the ecology of arboviral diseases has been undertaken within multiple subdisciplines, but significant gaps in knowledge remain and multidisciplinary approaches are needed.

Vascular function assessed with cardiovascular magnetic resonance predicts survival in patients with advanced chronic kidney disease.

Background: Increased arterial stiffness is associated with mortality in patients with chronic kidney disease. Cardiovascular magnetic resonance (CMR) permits assessment of the central arteries to measure aortic function.

Methods: We studied the relationship between central haemodynamics and outcome using CMR in 144 chronic kidney disease patients with estimated glomerular filtration rate <15 ml/min (110 on dialysis).

The prediction of self-care behaviors in end-stage renal disease patients using Leventhal's Self-Regulatory Model.

Objective: To assess the utility of Leventhal's Self-Regulatory Model (SRM) to predict self-care behavior with regard to dietary, medication, and fluid regimes in end-stage renal disease (ESRD) patients.

Methods: In a prospective study, ESRD patients treated via hospital-based haemodialysis (N=73) were screened for cognitive deficits and completed questionnaires that enquired about illness perceptions, coping strategies, knowledge of kidney disease, and psychological distress at Time 1. Physiological proxy measures of self-care behaviors regarding diet (serum potassium levels), fluid intake (mean and standard deviation of interdialytic weight gain), and medication (serum phosphate levels) regimes were collected 3 weeks later at Time 2.

Renal transplantation is not associated with regression of left ventricular hypertrophy: a magnetic resonance study.

Background And Objectives: Patients with end-stage renal failure (ESRD) have an increased risk of premature cardiovascular (CV) disease. Left ventricular hypertrophy is an independent risk factor for CV events and death in ESRD. Renal transplantation has been associated with reduction in CV risk and echocardiographic regression of left ventricular hypertrophy.

Is there an association between dryland salinity and Ross River virus disease in southwestern Australia?

Land use change has the potential to cause severe ecosystem degradation and drive changes in disease transmission and emergence. Broadscale clearing of native vegetation for agriculture in southwestern Australia has resulted in severe ecosystem degradation, which has been compounded by the subsequent development of large areas of dryland salinity. The mosquito-borne disease, Ross River virus (RRV), has been noted as a potential adverse human health outcome in these salinity affected regions.