Heart Rate-Induced Myocardial Ca Retention and Left Ventricular Volume Loss in Patients With Heart Failure With Preserved Ejection Fraction.

Background Increases in heart rate are thought to result in incomplete left ventricular (LV) relaxation and elevated filling pressures in patients with heart failure with preserved ejection fraction (HFpEF). Experimental studies in isolated human myocardium have suggested that incomplete relaxation is a result of cellular Ca overload caused by increased myocardial Na levels. We tested these heart rate paradigms in patients with HFpEF and referent controls without hypertension.

Oxygen Uptake and Lactate Kinetics in Patients with Chronic Obstructive Pulmonary Disease during Heavy Intensity Exercise: Role of Pedaling Cadence.

Oxygen uptake slow component ([Formula: see text]) is associated with lactate accumulation, likely a contribution of poorly oxidative muscle fibers. We aimed to test the hypothesis that higher muscle tension during slow pedaling rates would yield more prominent [Formula: see text] in healthy subjects, but not in COPD patients. Eight severe COPD patients and 8 age-matched healthy individuals performed 4 rest-heavy exercise transitions at 40 and 80 RPM.

Pharmacological heart rate lowering in patients with a preserved ejection fraction-review of a failing concept.

Epidemiological studies have demonstrated that high resting heart rates are associated with increased mortality. Clinical studies in patients with heart failure and reduced ejection fraction have shown that heart rate lowering with beta-blockers and ivabradine improves survival. It is therefore often assumed that heart rate lowering is beneficial in other patients as well.

Effect of Megestrol Acetate and Testosterone on Body Composition and Hormonal Responses in COPD Cachexia.

Underweight chronic obstructive pulmonary disease (COPD) patients with involuntary weight loss have a poor prognosis; no effective therapy is currently available. We conducted the first clinical trial seeking to determine whether combination therapy with an appetite stimulant and an anabolic steroid would have beneficial effects on body composition for patients with COPD cachexia. We conducted a 12-week pilot study in which 4 men and 5 women (age 64±10 y, forced expiratory volume in 1 second [FEV] 31±9 %pred.

Association of vascular endothelial factors with cardiovascular outcome and mortality in chronic kidney disease patients: a 4-year cohort study.

Background: Angiogenic cytokines fms-like tyrosine kinase-1(sFlt-1) and placental growth factor (PlGF) are associated with increased risk for cardiovascular disease (CVD) in the general population. In this study we examine the association between these vascular endothelial factors and atherosclerosis, cardiovascular outcome, and mortality in chronic kidney disease (CKD) patients.

Methods: Serum level of PlGF and sFlt-1 were measured in 301 patients with CKD, who were followed for up to 4 years.

Brugada phenocopy in concomitant ethanol and heroin overdose.

Brugada phenocopy describes conditions with Brugada-like ECG pattern but without true congenital Brugada syndrome. We report a case of 44-year-old man with no known medical history who presented with loss of consciousness. Toxicology screening was positive for opiates and high serum alcohol level.

Sinusoidal high-intensity exercise does not elicit ventilatory limitation in chronic obstructive pulmonary disease.

During exercise at critical power (CP) in chronic obstructive pulmonary disease (COPD) patients, ventilation approaches its maximum. As a result of the slow ventilatory dynamics in COPD, ventilatory limitation during supramaximal exercise might be escaped using rapid sinusoidal forcing. Nine COPD patients [age, 60.

Dietary sodium and clinical outcome in hemodialysis: where do we stand and what is next?

The association of dietary sodium and outcome is widely studied in the general population, but less is known in hemodialysis patients. The evidence supporting daily dietary sodium intake of 2 g on hemodialysis is not strong. Mc Causland et al.

The effects of anesthesia method on throat pain after elective rhinoplasty.

Objectives: Throat pain is a common postoperative complaint. In this study, we aimed to determine its incidence of throat pain after rhinoplasty by general anesthesia (GA) or conscious sedation (CS).

Methods: We evaluated throat pain in postanesthesia care unit, 4, 12 and 24 hours after surgery using a numerical rating scale (NRS) in a clinical trial.

Conceptualization of category-oriented likelihood ratio: a useful tool for clinical diagnostic reasoning.

Background: In the diagnostic reasoning process medical students and novice physicians need to be made aware of the diagnostic values of the clinical findings (including history, signs, and symptoms) to make an appropriate diagnostic decision. Diagnostic reasoning has been understood in light of two paradigms on clinical reasoning: problem solving and decision making. They advocate the reasoning strategies used by expert physicians and the statistical models of reasoning, respectively.

Six-minute walk distance predictors, including CT scan measures, in the COPDGene cohort.

Background: Exercise tolerance in COPD is only moderately well predicted by airflow obstruction assessed by FEV(1). We determined whether other phenotypic characteristics, including CT scan measures, are independent predictors of 6-min walk distance (6MWD) in the COPDGene cohort.

Methods: COPDGene recruits non-Hispanic Caucasian and African American current and ex-smokers.

Testosterone and resistance training effects on muscle nitric oxide synthase isoforms in COPD men.

Background: Skeletal muscle dysfunction contributes to exercise limitation in COPD. The role of the nitric oxide synthase (NOS) system in muscle dysfunction is ill defined. Reduced levels of endothelial NOS (eNOS) and elevated levels of inducible NOS (iNOS) in the skeletal muscle of COPD patients have been recently reported.

Childhood physical abnormalities following paternal exposure to sulfur mustard gas in Iran: a case-control study.

Background: Mustard gas, a known chemical weapon, was used during the Iran-Iraq war of 1980-1988. We aimed to determine if exposure to mustard gas among men was significantly associated with abnormalities and disorders among progenies.

Methods: Using a case-control design, we identified all progenies of Sardasht men (exposed group, n = 498), who were born at least nine months after the exposure, compared to age-matched controls in Rabat, a nearby city (non-exposed group, n = 689).

Metabolic syndrome predicts poor health-related quality of life in women but not in men: Tehran Lipid and Glucose Study.

Objective: To compare health-related quality of life (HRQOL) in those with and without metabolic syndrome in a general Iranian population.

Methods: This was a cross-sectional study of HRQOL conducted in a sample of individuals with and without metabolic syndrome using the data obtained from the Tehran Lipid and Glucose Study (TLGS) and information specifically collected for the present investigation. Metabolic syndrome was defined according to the adult treatment panel III (ATPIII) and HRQOL was assessed using the Short Form Health Survey (SF-36).

Association of serum alkaline phosphatase and bone mineral density in maintenance hemodialysis patients.

Recent studies indicate that serum alkaline phosphatase (AlkPhos), a surrogate of high turnover bone disease, is associated with coronary artery calcification and death risk in maintenance hemodialysis (MHD) patients. The association between AlkPhos and bone mineral density (BMD) is not well studied. We studied the association between AlkPhos and dual-energy X-ray absorptiometry-assessed BMD in a group of MHD patients in Southern California.

Breath-by-breath quantification of progressive airflow limitation during exercise in COPD: a new method.

During heavy exercise in chronic obstructive pulmonary disease (COPD), dynamic airways compression leads to a progressive fall in intrabreath flow. This is manifested by concavity in the spontaneous expiratory flow-volume (SEFV) curve. We developed a method to quantify the SEFV curve configuration breath-by-breath during incremental exercise utilizing a computerized analysis.

Association of soluble endotoxin receptor CD14 and mortality among patients undergoing hemodialysis.

Background: CD14 is a key molecule in innate immunity that mediates cell activation and signaling in response to endotoxin and other bacterial wall-derived components. CD14 protein exists in soluble (sCD14) and membrane-bound forms. The correlates of sCD14 in persons undergoing long-term hemodialysis (HD) therapy are not known.

Association of serum alkaline phosphatase with coronary artery calcification in maintenance hemodialysis patients.

Background And Objectives: Recent in vitro studies have shown a link between alkaline phosphatase and vascular calcification in patients with chronic kidney disease (CKD). High serum levels of alkaline phosphatase are associated with increased death risk in epidemiologic studies of maintenance hemodialysis (MHD) patients. We hypothesized that coronary artery calcification is independently associated with increased serum alkaline phosphatase levels in MHD patients.

Association of serum total iron-binding capacity and its changes over time with nutritional and clinical outcomes in hemodialysis patients.

Serum transferrin, estimated by total iron-binding capacity (TIBC), may be a marker of protein-energy wasting (PEW) in maintenance hemodialysis (MHD) patients. We hypothesized that low TIBC or its fall over time is associated with poor clinical outcomes. In 807 MHD patients in a prospective 5-year cohort, associations of TIBC and its changes over time with outcomes were examined after adjustment for case-mix and markers of iron stores and malnutrition-inflammation including serum interleukin-6, iron and ferritin.

Association of Malnutrition-Inflammation Score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study.

Background: The Malnutrition-Inflammation Score (MIS), an inexpensive and easy-to-assess score of 0 to 30 to examine protein-energy wasting (PEW) and inflammation, includes 7 components of the Subjective Global Assessment, body mass index, and serum albumin and transferrin concentrations. We hypothesized that MIS risk stratification of hemodialysis (HD) patients in predicting outcomes is better than its components or laboratory markers of inflammation.

Study Design: 5-Year cohort study.

Association of serum prealbumin and its changes over time with clinical outcomes and survival in patients receiving hemodialysis.

Background: In patients receiving maintenance hemodialysis (MHD), a low serum prealbumin is an indicator of protein-energy wasting.

Objective: We hypothesized that baseline serum prealbumin correlates independently with health-related quality of life (QoL) and death and that its change over time is a robust mortality predictor.

Design: Associations and survival predictability of serum prealbumin at baseline and its changes over 6 mo were examined in a 5-y (2001-2006) cohort of 798 patients receiving MHD.