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Lower PI (lower + pi)
Selected AbstractsA Prognostic Index Relating 24-Hour Ambulatory Blood Pressure to Cardiac Events in Ischemic Cardiomyopathy Following Defibrillator ImplantationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2008LANFRANCO ANTONINI M.D. Background:We assessed the role of left ventricular ejection fraction and of ambulatory blood pressure monitoring (ABPM) to predict cardiac death and heart failure in patients with defibrillator fulfilling MADIT II criteria. ABPM variables assessed included: mean 24 hours diastolic and systolic blood pressure, mean 24 hours heart rate, and pulse pressure. Methods:We studied 105 consecutive patients (age 67 ± 11), all with a defibrillator and ejection fraction , 30%). Results:At 1-year follow-up, there were 29 events (25%), three cardiac deaths, and 26 hospitalizations for heart failure. Age, creatinine, mean 24 hours diastolic blood pressure, and mean 24 hours systolic blood pressure (but not ejection fraction) were associated with events. A prognostic index (PI) was built by age and ABPM variables, according to the formula (120 , age) + (mean 24 hours diastolic blood pressure + mean 24 hours systolic blood pressure). Receiver operating characteristic curves showed the best cutoff for PI = 220 (sensitivity 81%, specificity 71%, positive predictive value 56%, negative predictive value 88%). Cox regression analysis confirmed the significant association between lower PI (< 220) and clinical events (HR 4.8, 95% CI 1.8,12.3, P = 0.0001 for PI). Overall, 12% of patients with high PI values (, 220 n = 71) had clinical events at 12-month follow-up, compared with 61% of patients with low PI (< 220 n = 34) (P < 0.0001). Conclusion:The PI built by mean 24 hours diastolic and systolic blood pressure and age could be a simple method to stratify risk of cardiac death and acute heart failure in MADIT II patients, in whom ejection fraction, uniformly depressed, is not predictive. [source] Testing the efficacy of plaque removal of a prototype brush head for a powered toothbrushJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2000G. I. McCracken Abstract Background/aims: The principal aim of the study was to compare the efficacy of a powered toothbrush (PTB) prototype (B) brush head in removing dental plaque to the relative efficacy of a marketed model (A). Method: A 12-week, 2-group, 2-treatment, double-blind trial of 2, two-brush heads (with the same power unit) recruited 62 volunteers (18,25 years) who were non-clinical university students. After a screening visit, 31 subjects were allocated to each of groups A and B at baseline with stratification according to gender and plaque index. After 48 h of plaque growth, subjects underwent a timed and supervised brushing episode with the allocated PTB (visit 1). Subjects then used the PTBs at home for 12 days before being recalled (visit 2) and asked again to abstain from all oral hygiene measures for 48 h. Supervised brushing was repeated (visit 3) before the subjects were dismissed for a further 10-week, unsupervised period of home use of the PTBs. The sequence of visits (2 and 3) was then repeated at visits 4 and 5. Results: The sole outcome variable was plaque which was scored at all visits using the modified Quigley & Hein Index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (S). At visits 1, 3 and 5, the PI was recorded both before and after supervised brushing. There were no significant differences in PI between the brushing groups at baseline, visit 1, visit 2 or visit 5 (2 sided t -test). At visit 3, the prototype achieved significantly lower PIs than the marketed PTB brush head for IP (and FM) surfaces, this difference was most apparent on posterior tooth surfaces. For within -group changes, PIs at visit 2 were significantly lower than those at baseline (paired t -test), an observation which may be attributable to the improved cleaning and ,novelty effect' of a PTB. The PIs at visit 5 were significantly higher than the baseline values (paired t test) and this may be accountable to an element of Hawthorne effect and/or, a fall off in compliance over the entire 12 weeks. Conclusion: We conclude that this in vivo model is appropriate for testing the efficacy of PTB prototypes but only over a 2-week period, as the inter-group differences were not maintained over the full 12 weeks of the trial. [source] Long slow night hemodialysis and quality of lifeHEMODIALYSIS INTERNATIONAL, Issue 1 2005P. Hakkarainen Background:,Long slow hemodialysis (LS-HD) improves many biochemical parameters compared with conventional HD. However, its influences on quality of life are less well known. Aims:,The objective of this study was to examine the quality of life of patients on LS-HD performed overnight compared to the patients on standard hemodialysis. This extends the previous study, conducted in 2001, which examined the LS-HD patients, quality of life. Patients and methods:,We sent questionnaires to 12 LS-HD (overnight, treatment time 8 h × 3/wk) patients and 15 day HD (4.5 h × 3/wk) patients, all being treated using the limited care method. Data was collected using two different structured questionnaires. One was constructed for a previous study (2001) and the other one was a standardized set of questionnaires (RAND-36). Research material was collected from patient documents, such as the essential biochemical parameters, blood pressure, weight gain, and weekly EPO doses were recorded. Ten of the LS-HD patients (83%) and 13/15 (87%) of day HD patients returned the questionnaires. Three day hemodialysis patients returned empty questionnaires, which were disqualified. Results:,Based on the medical facts, the results showed that the patients of LS-HD felt better than the patients in another group. Patients on the LS-HD had higher Kt/V (2.623 vs. 1.577) and Hb (118 vs. 111) and lower Pi (1.36 vs. 1.63) and EPO dose (epoietin-beta 2667 ky/week vs. 5833 ky/week; darbepoetin 16 ky/week vs. 37 ky/week). However, their predialysis BP as well as the weight gain between treatments and salt and fluid balances caused problems furthermore. The experiences of the therapy of the LS-HD patients were more positive than of the control group: they felt their medical condition was better than of the patients on day HD. However we didn't observe significant differences in the replies showing physical or psychosocial conditions between the two groups. Conclusions:,The study suggests that when patients can themselves make the choice between treatment modalities, it improves the quality of life of the patients. Control of anemia is improved in LS-HD overnight patients with lower doses of EPO. The LS-HD gives the patients more freedom of diet. However, more attention must be paid to salt and fluid restriction. The LS-HD makes it possible for many patients to work normally. [source] Age-dependent variations of cell response to oxidative stress: Proteomic approach to protein expression and phosphorylationELECTROPHORESIS, Issue 14 2005Yuri Miura Dr. Abstract We investigated the protein profiles of variously aged rat astrocytes in response to oxidative stress. After H2O2 -exposure of cells at 100,µM for 30,min, the relative intensity of ten protein spots changed on two-dimensional (2-D) gels compared with control gels after silver staining. Matrix-assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF-MS) analysis after in-gel digestion revealed that six of these spots corresponded to three kinds of proteins, each of which was composed of a protein and its modified form with a different isoelectric point (pI). These three proteins were identified as peroxiredoxins (PRDXs) II and III, and calpactin I light chain (p11). H2O2 -exposure increased the intensity of the spot with lower pI and simultaneously decreased that of the spot with higher pI for both PRDXs II and III. In addition, the expression of annexin VII, S -adenosyl- L -homocysteine hydrolase, elongation factor II fragment (EF-II), and adenosine deaminase was increased by H2O2 -exposure in astrocytes from variously aged rats. Using the Pro-Q® Diamond staining, heat shock protein 60,kDa (Hsp 60) and ,-tubulin were observed to be phosphorylated upon H2O2 -exposure. While phosphorylation of ,-tubulin was correlated positively with age, the changes in abundance of ten protein spots as described above were independent of age. These results suggest that aging does not suppress the responses aimed at limiting injury and promoting repair brought about by severe oxidative stress, and might affect cell dynamics including the formation of microtubules. [source] | ||||||||||