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Nutritional Risk In Critically Ill Patients: Preliminary Results On The Accuracy Of Different Screening Tools. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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2
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Low Calf Circumference Classified By Measured Or Body Mass Index-Adjusted Values: Prevalence In Hospitalized Patients. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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Body Mass Index Is Not Accurate To Diagnose Malnutrition In Hospitalized Patients: A Cross-Sectional Analysis. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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4
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Intermediate meals and the place of consumption - Which relationship? Int J Gastron Food Sci 2023. [DOI: 10.1016/j.ijgfs.2023.100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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5
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100 years of history-making urology – the Portuguese urology association. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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6
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Change in minimum indexed left atrial volume predicts incident heart failure: the multi-ethnic study of atherosclerosis. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background and Purpose
Longitudinal change in the left atrium prior to the onset of heart failure has not been as well studied as left atrial (LA) dysfunction in pre-existing heart failure. This study used cardiac magnetic resonance (CMR) imaging to investigate the relationship between longitudinal change in LA volume and function and incident heart failure (HF), in a multi-ethnic population free of known cardiovascular disease at baseline.
Methods and Results
In the Multi-Ethnic Study of Atherosclerosis (MESA), 2470 participants (60±9 years, 47% males), free at baseline of clinically recognized cardiovascular disease, had LA volume, emptying fractions and peak longitudinal strain assessed with Multimodality Tissue Tracking (MTT; version 6.0 Toshiba, Japan) on CMR imaging at baseline (2000-02) and at follow-up 9.4±0.6 years later. Seventy three (3%) participants subsequently developed incident HF 7.1±2.1 years after the follow-up CMR exam. In cox regression models, an annualized change in all LA parameters were significantly associated with an increased risk of incident HF. An annual increase of 1ml/m2 in minimum indexed LA volumes (∆LAVimin) was most strongly associated with the risk of incident HF (Hazard Ratio(HR)=1.85, 95% confidence interval(CI) [1.49-2.29], P<0.001) and improved model reclassification and discrimination in predicting incident HF (c-statistic=0.80, 95%CI [0.75-0.86]; NRI=0.13, P=0.04; IDI=0.04, P=0.01; x2=6.52, P=0.69) adjusting for known risk factors (age, gender, systolic blood pressure, anti-hypertensive medication use, smoking status, diabetes mellitus, total cholesterol, previous atrial fibrillation) and baseline LA parameters.
Conclusion
In this multi-ethnic population free of clinical cardiovascular disease at baseline, ∆LAVimin was most strongly associated with, and incrementally predictive of incident HF, after adjusting for known risk factors and baseline LA measures.
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Radiotherapy skin marking with lancets versus electric marking pen - Comfort, satisfaction, effectiveness and cosmesis results from the randomized, double-blind COMFORTATTOO trial. Radiography (Lond) 2023; 29:171-177. [PMID: 36410128 DOI: 10.1016/j.radi.2022.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/13/2022] [Accepted: 10/28/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Set-up skin markings are performed, in several centers, for radiotherapy (RT) treatments. This study aimed to compare two permanent methods: lancets and an electric marking pen, the Comfort Marker 2.0® (CM). METHODS This was a prospective, unicentric, randomized study. Patients aged 18 years or older referred to our department to receive RT were recruited. Patients were randomly assigned, in a 1:1 ratio, to receive set-up markings using lancets or CM. The markings arrangement followed our departmental protocols. The coprimary endpoints were patients' comfort and effectiveness. Secondary endpoints included radiation therapists (RTTs) satisfaction and cosmesis. RESULTS Between October 2021 and January 2022, 100 patients were enrolled (50 received lancets and 50 CM) and assessed for the comfort and satisfaction outcomes. CM was significantly less painful than the lancets, with 44% and 16% of the patients, respectively, considering the tattooing process painless (RR = 2.75; 95% IC: 1.36 - 5.58). On the RTT-reported satisfaction, CM had significantly easier processes than lancets (98.0% vs. 78.0%, respectively; RR = 1.26; 95% CI: 1.08 - 1.46). For effectiveness and cosmesis assessment, 98 patients were analyzed (48 received lancets and 50 CM). Patients receiving CM had a significantly higher proportion of markings graded as good and excellent compared to those receiving lancets (98.0% and 50.0%, respectively, had ≥75% of the tattoos assessed as good/excellent, RR = 1.96; 95% CI: 1.47 - 2.61). On the cosmetic evaluation, patients receiving CM had significantly better cosmetic markings, with a median score of 4.4 (vs. 3.5 for lancets, p <0.001). CONCLUSION The trial results demonstrated that tattooing with the CM is significantly less painful, more effective, easier to apply, and cosmetically superior to tattooing with lancets. IMPLICATIONS FOR PRACTICE Tattooing with CM allows for better results regarding pain, quality, ease and cosmesis.
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8
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Change in prostate cancer staging patterns in the post-COVID-19 era. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02363-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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9
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Consumption of legumes in children from 3 to 6 years – evaluation of an intervention program. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Eating habits are a key aspect of a healthy lifestyle. This study focuses on the importance of consuming legumes - rich and accessible source of protein, and a healthy and sustainable option, in environmental terms - contributing to increment health literacy levels at the population level.
Objectives
To design, implement and evaluate a program to promote the consumption of legumes - Beans4Life. Specifically, to assess its impact on the knowledge and frequency of consumption of the eight legumes (beans, grain, peas, beans, beans, lentils, chickpeas and lupins).
Methods
Pre-test post-test analytical study, with three evaluation moments: 1) before the intervention; 2) after the intervention with the children and 3) after the intervention with the guardians (end of the intervention). Participants: 90 children from 3 to 6 years old (54.4% male) and their guardians. Instruments: questionnaire to assess knowledge and food preferences, questionnaire on eating habits and a questionnaire to evaluate sessions. The intervention had two components, the first with the children (4 food education sessions) and the second with the families (activities that facilitate the inclusion of recipes with legumes in the family's daily life).
Results
Before the intervention, the results obtained show low levels of knowledge and frequency of consumption of legumes, influencing low health literacy. Peas and beans are the best known legumes (81.1% and 55.6%) and also preferred (77.8% and 73.3%). The results obtained in the second and third assessments show that there was a significant increase (p < 0.05) in the knowledge and frequency of consumption of most legumes.
Conclusions
The objectives initially proposed were achieved and it will be pertinent to continue the present study, with larger samples, in order to increase health literacy awareness and the consumption of this food group in childhood, and provide more robust results that help to clarify the relationships found.
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The influence of nutritional marketing on the preferences, attitudes and consumption of children from 6 to 10 years old. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Childhood obesity is a natural response to the modern food environment. A daily consumption of sugar that exceeds the WHO recommendation by 40.7% of Portuguese children influence this condition. It is recognized that children spend more time watching television and youtube, absorbing commercials about food, being susceptible to these messages and negative health literacy. Nutrition marketing is involved in these ads and most of them promote foods high in fat, sugar and salt through persuasive techniques.
Purpose
Assess implications of exposure to nutritional marketing through television and YouTube on preferences, attitudes and consumption of children from 6 to 10 years old and contribute to the increment of health literacy.
Materials and methods
Data collection through two online questionnaires about television and youtube habits and children's food preferences, developed by the research team. Statistical analysis was performed using IBM SPSS Statistics software.
Results
Forty-two students who were attending a private school, aged between 6 and 10 were evaluated. Access to youtube has led to less healthy choices for breakfast in 95% of students (p = 0.038). It was found that most children do not have TV in their room and have a more balanced breakfast (81%). Cereals, soft drinks and biscuits are foods groups that children see the most in the tv commercials (p = 0.001).
Conclusions
Exposure to nutritional marketing influences children's preferences, consumption and preferences. An active strategy should be encourage to increment health literacy levels at the family level influencing therefore children's healthier choices.
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Change in left atrial function and volume predicts heart failure with preserved and reduced ejection fraction: the multi-ethnic study of atherosclerosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
This study used cardiac magnetic resonance (CMR) imaging to investigate the relationship between longitudinal change in left atrial (LA) function and incident heart failure (HF), in a multi-ethnic population free of known cardiovascular disease at baseline.
Methods and results
In the Multi-Ethnic Study of Atherosclerosis (MESA), 2470 participants (60±9 years, 47% males), free at baseline of clinically recognized cardiovascular disease, had LA volume and function assessed with CMR imaging at baseline (2000–02) and 9.4±0.6 years later. Seventy three (3%) participants developed incident HF over 7.1±2.1 years; of these, 39 participants had preserved ejection fraction (HFpEF) and 34 participants had reduced ejection fraction (HFrEF). An annual decrease of 1-SD unit in peak LA strain (ΔLASmax) was most strongly associated with the risk of HFpEF (subdistribution HR=2.56, 95% confidence interval (CI) [1.34–4.90], P=0.004) and improved model reclassification and discrimination in predicting HFpEF (c-statistic=0.84, 95% CI [0.79–0.90]; NRI=0.34, P=0.01; IDI=0.02, P=0.02; x2=4.25, P=0.89) adjusting for event-specific risk factors and baseline LA parameters. An annual decrease of 1ml/m2 of pre-atrial LA volume index (ΔLAVipreA) was most strongly associated with the risk of HFrEF (subdistribution HR=1.88, 95% CI [1.44–2.45], P<0.001) and improved model reclassification and discrimination in predicting HFrEF (c-statistic=0.81, 95% CI (0.72–0.90); NRI=0.31, P=0.03; IDI=0.01, P=0.50; x2=15.4, P=0.08), adjusting for event-specific risk factors and baseline LA measures (Table 1).
Conclusion
In this multi-ethnic population free of clinical cardiovascular disease at baseline, ΔLASmax and ΔLAVipreA were associated with, and incrementally predictive of HFpEF and HFrEF respectively, after adjusting for event-specific risk factors and baseline LA measures.
Disclaimer
The views expressed in this abstract are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): National Heart, Lung and Blood InstituteNational Center for Advancing Translational Sciences
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Regional strain score as prognostic marker of cardiovascular events. from the Multi-Ethnic Study of Atherosclerosis (MESA). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) circumferential strain (Ecc) is an accurate indicator of regional myocardial function, particularly using the regional Ecc or layer-specific strain.
Purpose
To investigate the prognostic value of a regional strain score (RSS) for predicting the incident of heart failure (HF) and coronary heart disease (CHD) in a population without a history of cardiovascular disease at baseline.
Methods
In Multi-Ethnic Study of Atherosclerosis (MESA), 1,506 study participants (63.3±9.4 years, 54.6% men) underwent tagged magnetic resonance imaging for left ventricular circumferential strain (Ecc) analysis. Using −17% and −10% as Ecc cut-offs, each segment was rated from 0–2 points according to the Ecc value of each layer. The endo-Ecc, mid-Ecc, and epi-Ecc values from the 16-segment model were used to calculate three RSS: Endo-, Mid-, and Epi-RSS, respectively, which were defined as a percentage of good LV regional function. The Intramyocardial-RSS was the sum of these three RSS. Cox proportional models were used to evaluate the association between RSS and cardiovascular outcomes.
Results
After a median [IQR] follow-up of 15.9 [12.9–16.6] years, 122 hard CHD and 91 HF were observed. After adjustment, Mid-, Epi-, and Intramyocardial-RSS values <50% were independently associated with HF (HR 1.43; 95% CI [1.08–2.87], p=0.004; HR 1.80; 95% CI [1.12–3.07], p<0.001; and HR 2.01; 95% CI [1.19–3.20], p<0.001). After adjustment, Endo-, Mid-, Epi-, and Intramyocardial-RSS <50% were also independently associated with hard CHD (HR 1.31; 95% CI [1.03–1.51], p=0.04; HR 1.79; 95% CI [1.26–2.57], p<0.001; HR 2.03; 95% CI [1.45–3.40], p<0.001; and HR 2.28; 95% CI [1.51–3.53], p<0.001).
Conclusion
Layer-specific regional Ecc, assessed by RSS, provides a robust, independent predictive value for incident HF and hard CHD in asymptomatic participants without any cardiovascular disease at baseline.
Funding Acknowledgement
Type of funding sources: None.
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Determinants of left atrioventricular coupling index: the multi-ethnic study of atherosclerosis (MESA). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Recent studies have described a novel left atrioventricular coupling index (LACI), which had a better prognostic value than individual left atrial (LA) or left ventricular (LV) parameters measured separately to predict cardiovascular events.
Purpose
To identify the determinants of the LACI and its 10-year annual change (ΔLACI), measured by cardiovascular magnetic resonance (CMR), and to better understand the parameters governing this left atrioventricular coupling.
Methods
In the Multi-Ethnic Study of Atherosclerosis (MESA), 2,112 study participants, free of cardiovascular disease at baseline, had LACI assessed by CMR imaging at baseline (LACIBaseline, 2000–2002) and 10 years later (2010–2012). The LACI was defined as the ratio of LA to LV end-diastolic volumes. Linear regression analyses were performed to identify independent determinants of LACIBaseline or ΔLACI.
Results
In the 2,112 participants (58.8±9.1 years, 46.6% male), after adjustment for all covariates, age was independently associated with both LACIBaseline (R2=0.10, slope=0.16) and ΔLACI (R2=0.15, slope=0.008, both p<0.001). African Americans had the highest LACIBaseline value (18.0±7.7%). Although there was no difference in LACIBaseline between women and men (p=0.19), ΔLACI was higher in women than in men (1.0±1.1 vs. 0.8±1.0%/year, p<0.001). Diabetes and a higher BMI were independently associated with LACIBaseline (both p<0.001). LACIBaseline was independently associated with LV myocardial fibrosis markers (native T1: R2=0.11, slope = 0.09, p=0.038; and extra-cellular volume: R2=0.08, slope = 0.28, p=0.035) and NT-proBNP levels (R2=0.10, slope = −1.11, p<0.001) but was not associated with IL-6 or hsCRP.
Conclusions
Age, sex, ethnicity, diabetes, and BMI were independent determinants of LACI. LACI was independently associated with LV myocardial fibrosis markers and NT-proBNP levels.
Funding Acknowledgement
Type of funding sources: None.
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Prognostic value of a left atrioventricular coupling index (LACI) in pre- and post-menopausal women. from the multi-ethnic study of atherosclerosis (MESA). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Endogenous sex hormones associated with both the left atrial (LA) and left ventricular (LV) structures in peri-menopausal women, but the association of menopause status with left atrioventricular coupling is not well established.
Purpose
To assess the prognostic value of a left atrioventricular coupling index (LACI) in pre- and post-menopausal women without a history of cardiovascular disease (CVD) at baseline in the Multi-Ethnic Study of Atherosclerosis (MESA).
Methods
In women participating in the MESA study, the LACI was measured as the ratio of the left atrial (LA) end-diastolic volume to the left ventricular (LV) end-diastolic volume using cardiovascular magnetic resonance (CMR). Cox proportional hazard models were used to assess the association between the LACI and the outcomes of atrial fibrillation (AF), heart failure (HF), and hard CVD defined by myocardial infarction, resuscitated cardiac arrest, stroke, or coronary heart disease death.
Results
Among the 2,087 women participants (61±10 years), 485 cardiovascular events were observed during the mean follow-up period of 13.2±3.3 years. A higher LACI was independently associated with AF (HR 1.70; 95% CI [1.51–1.90]), HF (HR 1.62; [1.33–1.97]), and hard CVD (HR 1.30; [1.13–1.51], all p<0.001). Adjusted models with the LACI showed significant improvement in model discrimination and reclassification when compared to currently used standard models used to predict the incidence of AF (C-statistic=0.82 vs. 0.79; NRI=0.325; IDI=0.036), HF (C-statistic=0.84 vs. 0.81; NRI=0.571; IDI=0.023), hard CVD (C-statistic=0.78 vs. 0.76; NRI=0.229; IDI=0.012).
Conclusion
In a multi-ethnic population of pre- and post-menopausal women, the LACI is an independent predictor of HF, AF, and hard CVD. In both pre- and post-menopausal women, the LACI has an incremental prognostic value for predicting cardiovascular events over traditional risk factors and sex hormone levels.
ClinicalTrials: gov Identifier: NCT00005487
Funding Acknowledgement
Type of funding sources: None.
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Home-delivered meals for people with dementia: Which model delays nursing home placement? - Protocol for a feasibility pilot. Contemp Clin Trials 2022; 121:106897. [PMID: 36055581 PMCID: PMC9817376 DOI: 10.1016/j.cct.2022.106897] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/29/2022] [Accepted: 08/22/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Home-delivered meals promote food security, socialization, and independence among homebound older adults. However, it is unclear which of the two predominant modes of meal delivery, daily-delivered vs. drop-shipped, frozen meals, promotes community living for homebound older adults with dementia. Our objective is to present the protocol for a pilot multisite, two-arm, pragmatic feasibility trial comparing the effect of two modes of meal delivery on nursing home placement among people with dementia. We include justifications for individual randomization with different consent processes and waivers for specific elements of the trial. METHODS 236 individuals with dementia on waiting lists at three Meals on Wheels programs' in Florida and Texas will be randomized to receive either: 1) meals delivered multiple times per week by a Meals on Wheels volunteer or paid driver who may socialize with and provide an informal wellness check or 2) frozen meals that are mailed to participants' homes every two weeks. We will evaluate and refine processes for recruitment and randomization; assess adherence to the intervention; identify common themes in participant experience; and test processes for linking participant data with Medicare records and nursing home assessment data. We will conduct exploratory analyses examining time to nursing home placement, the primary outcome for the larger trial. CONCLUSION This pilot will inform the follow-on large-scale, definitive pragmatic trial. In addition, the justifications for individual randomization with differing consent procedures for elements of a pragmatic trial provide a model for future trialists looking to develop ethical and feasible pragmatic studies enrolling people with dementia.
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Factors Associated with Mortality in Older Cancer Patients with Sars from Covid-19: Explainable-AI Analysis. J Geriatr Oncol 2022. [PMCID: PMC9595426 DOI: 10.1016/s1879-4068(22)00428-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Methane emissions and rumen metabolite concentrations in cattle fed two different silages. Sci Rep 2022; 12:5441. [PMID: 35361825 PMCID: PMC8971404 DOI: 10.1038/s41598-022-09108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, 18 animals were fed two forage-based diets: red clover (RC) and grass silage (GS), in a crossover-design experiment in which methane (CH4) emissions were recorded in respiration chambers. Rumen samples obtained through naso-gastric sampling tubes were analysed by NMR. Methane yield (g/kg DM) was significantly lower from animals fed RC (17.8 ± 3.17) compared to GS (21.2 ± 4.61) p = 0.008. In total 42 metabolites were identified, 6 showing significant differences between diets (acetate, propionate, butyrate, valerate, 3-phenylopropionate, and 2-hydroxyvalerate). Partial least squares discriminant analysis (PLS-DA) was used to assess which metabolites were more important to distinguish between diets and partial least squares (PLS) regressions were used to assess which metabolites were more strongly associated with the variation in CH4 emissions. Acetate, butyrate and propionate along with dimethylamine were important for the distinction between diets according to the PLS-DA results. PLS regression revealed that diet and dry matter intake are key factors to explain CH4 variation when included in the model. Additionally, PLS was conducted within diet, revealing that the association between metabolites and CH4 emissions can be conditioned by diet. These results provide new insights into the methylotrophic methanogenic pathway, confirming that metabolite profiles change according to diet composition, with consequences for CH4 emissions.
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Prognostic value of left atrioventricular coupling index (LACI) in pre- and post-menopausal women : from the multi-ethnic study of atherosclerosis (MESA). Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Although endogenous sex hormones influence both left atrial (LA) and left ventricular (LV) structure in peri-menopausal women, no study has ever evaluated the interaction between sex hormones levels and the left atrioventricular coupling.
PURPOSE
This study aimed to assess the prognostic value of a left atrioventricular coupling index (LACI) in pre- and post-menopausal women without history of CVD at baseline.
METHODS
In all women participating in the Multi-Ethnic Study of Atherosclerosis (MESA) with baseline cardiovascular magnetic resonance (CMR) study, LACI was measured as the ratio of the LA end-diastolic volume divided by the LV end-diastolic volume. Cox proportional hazard models were used to assess the association between LACI and the outcomes of atrial fibrillation (AF), heart failure (HF), coronary heart disease (CHD) death, and hard CVD defined by myocardial infarction, resuscitated cardiac arrest, stroke, or CHD death. In multivariable analyses, the associations between LACI and the time-to-event were evaluated, adjusting for demographics, traditional cardiovascular risk factors, menopausal status and sex hormone levels.
RESULTS
Among the 2,087 women (61.2 ± 10.1 years), 485 cardiovascular events were observed during mean follow-up period of 13.2 ± 3.3 years. Greater LACI was independently associated with AF (HR 1.70; 95% CI [1.51-1.90]), HF (HR 1.62; 95% CI [1.33-1.97]), CHD death (HR 1.36; 95% CI [1.10-1.68]), and hard CVD (1.30; 95% CI [1.13-1.51], all p < 0.001). Adjusted models with LACI showed significant improvement in model discrimination and reclassification compared to currently used standard models to predict the incidences of AF (C-statistic: 0.82 vs. 0.79; NRI = 0.325; IDI = 0.036), HF (C-statistic: 0.84 vs. 0.81; NRI = 0.571; IDI = 0.023), CHD death (C-statistic: 0.87 vs. 0.85; NRI = 0.506; IDI = 0.012), and hard CVD (C-statistic: 0.78 vs. 0.76; NRI = 0.229; IDI = 0.012). The prognostic value of LACI was homogeneous in both pre- and post-menopausal women with a better discrimination and reclassification compared to individual LA or LV parameters.
CONCLUSIONS
In a multi-ethnic population of pre- and post-menopausal women, LACI is an independent predictor of HF, AF, CHD death and hard CVD. In both pre- and post-menopausal women, LACI has an incremental prognostic value to predict cardiovascular events over traditional risk factors and sex hormone levels.
ClinicalTrials.gov Identifier: NCT00005487 Abstract Figure. Kaplan-Meier curves by LACI terciles Abstract Figure. Kaplan-Meier curves by LACI and Menop.
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Determinants of left atrioventricular coupling index as a prognostic marker of cardiovascular events from the multi-ethnic atherosclerosis study (MESA). Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Recent studies have emphasized the incremental prognostic value of a novel left atrioventricular coupling index (LACI) and its 10-year annual change (ΔLACI) to predict cardiovascular events. However, no study has investigated the potential determinants of this index.
PURPOSE
To identify the determinants of LACI and ΔLACI, measured by cardiovascular magnetic resonance (CMR), and to better understand the parameters governing this left atrioventricular coupling in the Multi-Ethnic Study of Atherosclerosis (MESA).
METHODS
In the MESA, 2,112 study participants, free of cardiovascular disease at baseline, had LACI assessed by CMR imaging at baseline (LACIBaseline, Exam 1, 2000–2002) and 10 years later (Exam 5, 2010–2012). The LACI was defined as the ratio of left atrium to left ventricular (LV) end-diastolic volumes. Multivariable linear regression analyses were performed, adjusting for traditional risk factors and LV structure, to identify independent determinants of LACIBaseline or ΔLACI.
RESULTS
In the 2,112 participants (mean age 58.8 ± 9.1 years and 46.6% male), after adjustment for all covariates, age was independently associated with both LACIBaseline (R2 = 0.10) and ΔLACI (R2 = 0.15, both p < 0.001). Although there was no difference in LACIBaseline between women and men (p = 0.19), ΔLACI was higher in women than in men (1.0 ± 1.1 vs. 0.8 ± 1.0 %/year, p < 0.001). African Americans had the highest LACIBaseline value (18.0 ± 7.7%) while Chinese Americans had the lowest (13.8 ± 6.4%, p < 0.001). Diabetes and a higher body mass index were independently associated with LACIBaseline (coefficients B: 1.75 and 0.24, respectively, both p < 0.001). LACIBaseline was independently associated with LV myocardial fibrosis markers (native T1: R2 = 0.11, p = 0.038; and extra-cellular volume [ECV]: R2 = 0.08, p = 0.035) and NT-proBNP levels (R2 = 0.10, p < 0.001) but was not associated with inflammation biomarkers.
CONCLUSIONS
In a multi-ethnic population, age, sex, ethnicity, diabetes, and a higher body mass index were independent determinants of LACI. LACI was independently associated with LV myocardial fibrosis markers and NT-proBNP levels but not associated with inflammation biomarkers.
ClinicalTrials.gov Identifier: NCT00005487 Abstract Figure. Relationship between LACI and Age Abstract Figure. Relationship between LACI and Gender
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Change in left atrioventricular coupling index to predict incident atrial fibrillation: the multi-ethnic study of atherosclerosis (MESA). Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Left atrial (LA) and left ventricular (LV) structural and functional parameters have independent prognostic values as predictors of atrial fibrillation (AF).
PURPOSE
To investigate the prognostic value of a left atrioventricular coupling index (LACI) and average annualized change in LACI measured by cardiac MRI to predict incident AF in a population-based sample from the Multi-Ethnic Study of Atherosclerosis (MESA).
METHODS
In a secondary analysis of the prospective Multi-Ethnic Study of Atherosclerosis (MESA) study, 1,911 study participants, free of clinically recognized AF and cardiovascular disease at baseline, had LACI assessed with cardiac MRI at baseline (Exam 1, 2000-2002), and ten years later (Exam 5, 2010-2012). LACI was defined as the ratio of LA to LV end-diastolic volumes. Univariable and multivariable Cox proportional hazard models were used to evaluate the associations of LACI and average annualized change in LACI (ΔLACI) with incident AF.
RESULTS
Among the 1,911 participants (mean age 59 ± 9 years and 907 men), 87 incident AF events occurred over 3.9 ± 0.9 years following the second imaging (Exam 5). After adjustment for traditional risk factors, greater LACI and ΔLACI were independently associated with AF (HR 1.69, 95% CI[1.46-1.96] and HR 1.71, 95% CI[1.50-1.94], respectively; both p<.001). Adjusted models for LACI and ΔLACI showed improvement in model discrimination compared to currently used AF risk score (CHARGE-AF score) model (AUC: 0.78 vs. 0.74, and AUC: 0.80 vs. 0.74, both p<.001); and to the final model including individual LA or LV parameters for predicting AF incidence (AUC: 0.78 vs. 0.76, and AUC: 0.80 vs. 0.78, both p<.001).
CONCLUSIONS
Atrioventricular coupling (LACI) and coupling change (ΔLACI) were strong predictors for AF in a multi-ethnic population. Both had incremental prognostic value for predicting AF over traditional risk factors, and superior discrimination compared to the CHARGE-AF score and to individual LA or LV parameters.
ClinicalTrials.gov Identifier: NCT00005487 Abstract Figure. Kaplan-Meier curves by change in LACI Abstract Figure. Kaplan-Meier curves by ΔLACI and LACI
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Layer-specific regional circumferential strain as prognostic marker of cardiovascular events. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Left ventricular (LV) circumferential strain (Ecc) is an accurate indicator of regional myocardial function. Recent studies have emphasized the potential superiority of regional Ecc, particularly using the layer-specific strain. To date, no studies have assessed the prognostic value of layer-specific regional Ecc in the general population.
PURPOSE
This study aimed to investigate the prognostic value of the layer-specific regional Ecc for predicting the incident of heart failure (HF) and coronary heart disease (CHD) in a population without a history of cardiovascular disease at baseline.
METHODS
Data from participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent tagged magnetic resonance imaging for strain determination were analyzed. Using −17% and −10% as Ecc cut-offs, each segment was rated from 0–2 points according to the Ecc value of each layer. The endo-Ecc, mid-Ecc, and epi-Ecc values from the 16-segment model were used to calculate three indexes: Endo-MyoHealth, Mid-MyoHealth, and Epi-MyoHealth, respectively, which were defined as a percentage of good LV regional function. The Intramyocardial-MyoHealth index was the sum of these three MyoHealth indexes. Cox proportional hazard models were used to evaluate the association between each MyoHealth index and incident HF and hard CHD.
RESULTS
Among the 1,506 participants (63.3 ± 9.4 years, 54.6% men), 122 cases of hard CHD and 91 cases of HF were observed (median [IQR] follow-up 15.9 [12.9-16.6] years). After adjustment, Mid-, Epi-, and Intramyocardial-MyoHealth index values <50% were independently associated with HF (adjusted HR 1.43; 95% CI [1.08-2.87], p = 0.004; HR 1.80; 95% CI [1.12-3.07], p < 0.001; and HR 2.01; 95% CI [1.19-3.20], p < 0.001). After adjustment, Endo-, Mid-, Epi-, and Intramyocardial-MyoHealth <50% were also independently associated with hard CHD (adjusted HR 1.31; 95% CI [1.03-1.51], p = 0.04; HR 1.79; 95% CI [1.26-2.57], p < 0.001; HR 2.03; 95% CI [1.45-3.40], p < 0.001; and HR 2.28; 95% CI [1.51-3.53], p < 0.001).
CONCLUSIONS
Layer-specific regional Ecc, assessed via MyoHealth indexes, provides a robust, independent predictive value for incident HF and hard CHD in asymptomatic participants without any history of previous clinical cardiovascular disease.
Unique identifier Clinical.gov : NCT00005487. Abstract Figure. Abstract Figure. Kaplan Meier curves
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Barriers to identifying residents with dementia for embedded pragmatic trials: A call to action. J Am Geriatr Soc 2022; 70:638-641. [PMID: 34727369 PMCID: PMC8821246 DOI: 10.1111/jgs.17539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/11/2021] [Accepted: 10/17/2021] [Indexed: 02/03/2023]
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Myocardial Strain-Based on Regional Wall Motion Abnormalities Index : A Prognostic Marker of Incident Heart Failure. Cardiovascular MRI study from the Multi-Ethnic Study of Atherosclerosis (MESA). ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2022. [DOI: 10.1016/j.acvdsp.2021.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Change in left atrioventricular coupling index to predict hard cardiovascular disease: The Multi-Ethnic Study of Atherosclerosis (MESA). ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2022. [DOI: 10.1016/j.acvdsp.2021.09.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Analytical and Clinical Performance Evaluation of ARK Fentanyl II Assay on Beckman Coulter AU System. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
Drugs of abuse, specifically opioids, have been in recent years an important focus in both medicine and media due to the ‘opioid epidemic’ and large numbers of overdose deaths. Synthetic opioids such as fentanyl have contributed to this epidemic. The CDC reports that of roughly 50,000 opioid overdose deaths in 2019, nearly 73% were due to synthetic opioids. The objective of this study is to assess the analytical and clinical performance of the Fentanyl II Assay by ARK Diagnostics, Inc.
Methods/Case Report
Fentanyl was qualitatively determined by the ARK Fentanyl II Assay, a homogenous enzyme immunoassay based on competition between drug in the specimen and drug labeled with recombinant glucose-6- phosphate dehydrogenase (rG6PDH) for antibody binding sites. The presence of drug in urine increases enzyme activity, which converts nicotinamide adenine dinucleotide (NAD) to NADH in the presence of glucose-6-phosphate, resulting in an absorbance change measured by spectrophotometry. The evaluation was performed following CLSI guidelines. The analytical performance was evaluated for accuracy and precision.
Results (if a Case Study enter NA)
To evaluate the accuracy, twelve positive and eight negative specimens were tested by the ARK immunoassay performed on two Beckman Coulter instruments (AU480 and AU680) and by LC- MS/MS. The results from both instruments showed 100% agreement with the results from LC-MS/MS. On instrument AU480, the within-run CVs were 18.0% at the level of 22.510 ng/mL and 0.8% at the level of 552.628 ng/mL. The between-run CVs were 8.8% at the level of 68.928 ng/mL and 3.7% at the level of 158.947 ng/mL. On instrument AU680, the within-run CVs were 273.4% at the level of 1.052 ng/mL and 0.8% at the level of 523.788 ng/mL. The between-run CVs were 7.8% at the level of 53.779 ng/mL and 3.1% at the level of 145.263 ng/mL. In May 2021, 2,075 fentanyl assays were run at UAB. Of those, 476 returned a positive result with a positive rate of 22.9%, and 1,599 were negative with a negative rate of 77.1%. One positive result was confirmed by LC-MS/MS as negative for fentanyl but positive for norfentanyl, a metabolite of fentanyl. The clinical specificity was 99.9% and sensitivity was 100%.
Conclusion
In Conclusion, the ARK fentanyl Assay II on Beckman Coulter AU system has good accuracy, sensitivity and specificity. The precision at medium and high levels are good. However, the precision at low level needs to be improved.
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725MO Phase I study of the combination of the dual RAF/MEK inhibitor VS-6766 and the FAK inhibitor defactinib: Results of efficacy in low grade serous ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Immunotherapy and Systemic Therapy in Metastatic/Recurrent Endometrial and Cervical Cancers. Clin Oncol (R Coll Radiol) 2021; 33:608-615. [PMID: 34312021 DOI: 10.1016/j.clon.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Despite advances in the treatment of gynaecological malignancies, both recurrent endometrial and cervical cancers when not amenable to localised therapy (surgery or radiotherapy), remain incurable with limited prognosis and effective treatment options. Chemotherapy remains the standard of care for women with metastatic endometrial or cervical cancers. The addition of bevacizumab to first-line chemotherapy for metastatic cervical cancer patients represents a significant step forward in improving survival. More recently, immunotherapeutic strategies targeting the PD-1/-L1 pathway have shown clinical activity in both endometrial and cervical cancers. The increased understanding of the molecular biology of these cancers is shaping target-specific treatments. Here we summarise current treatment options and results from clinical trials of immunotherapy and other targeted therapies that have already changed, or have the potential to change, clinical practice in metastatic/recurrent endometrial and cervical cancer.
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Change in left atrioventricular coupling index to predict incident atrial fibrillation: the multi-ethnic study of atherosclerosis (MESA). Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Left atrial (LA) and left ventricular (LV) structural and functional parameters have independent prognostic values as predictors of atrial fibrillation (AF).
PURPOSE
Due to the intrinsic physiological relationship between LA and LV, we sought to investigate the prognostic value of a left atrioventricular coupling index (LACI) as well as change in LACI to predict incident AF in a multi-ethnic population.
METHODS
In the Multi-Ethnic Study of Atherosclerosis (MESA), 1,911 study participants, free of clinically recognized AF and cardiovascular disease at baseline, had LACI assessed with CMR imaging at baseline (Exam 1, 2000–2002), and ten years later (Exam 5, 2010–2012). LACI was defined as the ratio of LA to LV end-diastolic volumes. Univariable and multivariable Cox proportional hazard models were used to evaluate the associations of LACI and average annualized change in LACI (ΔLACI) with incident AF.
RESULTS
Among the 1,911 participants (mean age 59 ± 9 years and 47.5% male participants), 87 incident AF events occurred over 3.9 ±0.9 years following the second imaging (Exam 5). After adjustment for traditional risk factors, greater LACI and ΔLACI were independently associated with AF (HR 1.69, 95% CI [1.46-1.96] and HR 1.71, 95% CI [1.50-1.94], respectively; both p < 0.0001). Adjusted models for LACI and ΔLACI showed significant improvement in model discrimination compared to currently used AF risk score model for predicting AF incidence (C-statistic: 0.78 vs. 0.74, and C-statistic: 0.80 vs. 0.74, respectively). The LACI and ΔLACI also showed superior discrimination performance for AF compared to the multivariable model including CHARGE-AF score, and individual LA or LV parameters.
CONCLUSIONS
Atrioventricular coupling (LACI) and coupling change (ΔLACI) are strong predictors for AF incidence in a multi-ethnic population. Both have incremental prognostic value for predicting AF over traditional risk factors, and superior discrimination power compared to the CHARGE-AF score and to individual LA or LV parameters.
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Prognostic value of pre-hospitalization stress perfusion CMR to predict death in patients hospitalized for COVID-19. Eur Heart J Cardiovasc Imaging 2021. [PMCID: PMC8344446 DOI: 10.1093/ehjci/jeab090.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: None. BACKGROUND Inducible ischemia is a strong marker of vascular vulnerability that may be a key pathogenetic determinant of COVID-19 severity. PURPOSE This study investigated the prognostic value of prior inducible ischemia on stress perfusion CMR to predict death in patients hospitalized for COVID-19. METHODS In an observational study, we retrospectively analyzed consecutive patients referred for stress perfusion CMR within last two years prior to hospitalization for COVID-19. The primary outcome was all-cause death, including in-hospital and post-hospitalisation deaths, based on the electronic national death registry. RESULTS Among the patients referred for stress perfusion CMR, 481 were hospitalized for COVID-19 (mean age =68.4 ± 9.6 years, 61.3% males) and completed the follow-up (median 73[36-101] days). There were 93 (19.3%) all-cause deaths, of which 13.7% were in-hospital and 5.6% post-hospitalisation deaths. Using Kaplan-Meier analysis, age, male gender, hypertension, diabetes, known CAD, the presence of prior inducible ischemia, the number of ischemic segments, the presence of LGE, and LVEF were significantly associated with all-cause death. In multivariable stepwise Cox regression analysis, age (HR: 1.04; 95%CI:1.01-1.07, p = 0.023), hypertension (HR: 2.77; 95%CI:1.71-4.51, p < 0.001), diabetes (HR: 1.72; 95%CI:1.08-2.74, p = 0.022), known CAD (HR: 1.78; 95%CI:1.07-2.94, p = 0.025) and the presence of prior inducible ischaemia (HR: 2.05; 95%CI:1.27-3.33, p = 0.004) were independent predictors of all-cause death. CONCLUSIONS In COVID-19 patients, prior inducible myocardial ischemia by stress CMR over the last two years preceding the COVID-19 pandemic was independently associated with all-cause in-hospital and post-hospitalisation deaths, suggesting involvement of vasculature and endothelial dysfunction in the severity of COVID-19.
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Left atrioventricular coupling index to predict incident heart failure: the multi-ethnic study of atherosclerosis (MESA). Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Although left atrial (LA) and left ventricular (LV) structural and functional parameters have independent prognostic value as predictors of HF, the close physiological relationship between LA and LV suggest that the assessment of LA/LV coupling could better reflect left atrioventricular dysfunction and be a better predictor of heart failure (HF).
PURPOSE
We investigated the prognostic value of a left atrioventricular coupling index (LACI), measured by cardiovascular magnetic resonance (CMR), as well as change in LACI to predict incident HF in the Multi-Ethnic Study of Atherosclerosis (MESA).
METHODS
In the MESA, 2,250 study participants, free of clinically recognized HF and cardiovascular disease at baseline, had LACI assessed by CMR imaging at baseline (Exam 1, 2000–2002), and ten years later (Exam 5, 2010–2012). LACI was defined as the ratio of LA to LV end-diastolic volumes. Univariable and multivariable Cox proportional hazard models were used to evaluate the associations of LACI and average annualized change in LACI (ΔLACI) with incident HF after adjustment on traditional HF risk factors. The incremental risk prediction was calculated using C-statistic, categorical net reclassification index (NRI) and integrative discrimination index (IDI).
RESULTS
Among the 2,250 participants (mean age 59.3 ± 9.3 years and 47.6% male participants), 50 incident HF events occurred over 6.8 ± 1.3 years after the second CMR exam. After adjustment, greater LACI and ΔLACI were independently associated with HF (adjusted HR 1.44, 95% CI [1.25-1.66] and adjusted HR 1.55, 95% CI [1.30-1.85], respectively; both p < 0.0001). Adjusted models for LACI showed significant improvement in model discrimination and reclassification compared to currently used HF risk score model for predicting HF incidence (C-statistic: 0.81 vs. 0.77; NRI = 0.411; IDI = 0.043). After adjustment, ΔLACI showed also significant improvement in model discrimination compared to the multivariable model with traditional HF risk factors for predicting incident HF (C-statistic: 0.82 vs. 0.77; NRI = 0.491; IDI = 0.058).
CONCLUSIONS
In a multi-ethnic population, atrioventricular coupling (LACI) and coupling change (ΔLACI) are independently associated with incident HF. Both have incremental prognostic value for predicting HF over traditional HF risk factors.
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Coronary Atherosclerotic Plaque Characteristics By Ultra-high-resolution Cardiac Ct Compared To Conventional Image Reconstructions In Patients With Severe Coronary Artery Disease. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Using Healthcare Data in Embedded Pragmatic Clinical Trials among People Living with Dementia and Their Caregivers: State of the Art. J Am Geriatr Soc 2021; 68 Suppl 2:S49-S54. [PMID: 32589274 DOI: 10.1111/jgs.16617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/25/2020] [Accepted: 04/29/2020] [Indexed: 12/16/2022]
Abstract
Embedded pragmatic clinical trials (ePCTs) are embedded in healthcare systems as well as their data environments. For people living with dementia (PLWD), settings of care can be different from the general population and involve additional people whose information is also important. The ePCT designs have the opportunity to leverage data that becomes available through the normal delivery of care. They may be particularly valuable in Alzheimer's disease and Alzheimer's disease-related dementia (AD/ADRD), given the complexity of case identification and the diversity of care settings. Grounded in the objectives of the Data and Technical Core of the newly established National Institute on Aging Imbedded Pragmatic Alzheimer's Disease and AD-Related Dementias Clinical Trials Collaboratory (IMPACT Collaboratory), this article summarizes the state of the art in using existing data sources (eg, Medicare claims, electronic health records) in AD/ADRD ePCTs and approaches to integrating them in real-world settings. J Am Geriatr Soc 68:S49-S54, 2020.
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Change in left atrioventricular coupling index to predict incident atrial fibrillation: The Multi-Ethnic Study of Atherosclerosis (MESA). ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Left atrioventricular coupling index to predict incident heart failure: The Multi-Ethnic Study of Atherosclerosis (MESA). ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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POS0878 ULTRASOUND ASSESSMENT OF DERMAL THICKNESS AND SKIN STIFFNESS IN UNDIFFERENTIATED CONNECTIVE TISSUE DISEASE AT RISK FOR SYSTEMIC SCLEROSIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:High-frequency ultrasound (HFUS) and shear-wave elastography (SWE) allow an objective assessment of skin involvement in systemic sclerosis (SSc) patients.1 Till now it has been applied to patients with established diagnosis.2,3 However, there is no data concerning its application in Undifferentiated Connective Tissue Disease at risk for SSc (UCTD-risk-SSc), i.e., patients with Raynaud’s phenomenon and either SSc marker autoantibodies or typical capillaroscopic findings or both, not satisfying classification criteria for SSc.4Objectives:To compare ultrasound-dermal thickness (DT) and skin stiffness, using high-frequency ultrasound and shear-wave elastography, in UCTD-risk-SSc and healthy controls.Methods:Forty UCTD-risk-SSc patients and 40 age- and gender-matched healthy controls were included. Ultrasound-DT was measured using an 18MHz probe, and skin stiffness (i.e. shear-wave velocity values, SWV) using the VTIQ software with a 9MHz probe, at the 17 Rodnan skin sites. The mRSS score was, by definition, zero in all sites, both in cases and controls. Continuous data were expressed as the mean (SD), and Mann-Whitney U test was performed to compare differences between the groups, as variables were not normally distributed. Associations between variables were analysed using the Spearman’s correlation.Results:SWV values were significantly higher in patients with UCTD-risk-SSc compared with controls at the right and left hands, and in the right and left fingers (table 1). Higher values of ultrasound dermal-thickness were found in the fingers and hands bilaterally, although differences were only significantly at the hands, compared with healthy controls (table 1). There were no significant differences in the other Rodnan skin sites. There was no significant correlation between ultrasound-dermal thickness and stiffness at the same skin site.Conclusion:This study provides the first evidence suggesting that ultrasound-DT and stiffness can discriminate patients with UCTD-risk-SSc from healthy controls. Prospective studies including a larger number of patients with different subsets of UCTD-risk-SSc are needed to investigate diagnostic and prognostic value of the ultrasound parameters in this group.References:[1]Santiago T, et al. Arthritis Care Res (Hoboken). 2019;71:563-574.[2]Hesselstrand R, et al. Rheumatology (Oxford). 2008;47:84-7.[3]Flower V et al. jrheum.200234.[4]Valentini, G., et al. Arthritis Care Res, 66: 1520-1527.Table 1.Clinical and ultrasound parameters in UCTD-risk-SSc and healthy control groups.UCTD-risk-SSc (n=40)Healthy controls (n=40)p valueAge, mean (SD)51.4 (14.9)49.8 (13.9)NsFemale, n (%)36 (90.0)36 (90.0)Raynaud phenomenon, %100.0%-ANAs100.0-Anti-centromere, %60.0Anti-Scl70+, %11.5Scleroderma/non-scleroderma pattern in capillaroscopy, %5.0/95.0--Ultrasound parametersDermal thickness (mm) Dorsal hand right0.77 (0.32)0.62 (0.12)0.02 Dorsal hand left0.79 (0.39)0.62 (9.13)0.02 Proximal phalanx right0.64 (0.14)0.61 (0.11)Ns Proximal phalanx left0.66 (0.16)0.60 (0.09)NsSWV values (m/s) Dorsal hand right1.94 (0.40)1.61 (0.24)0.0001 Dorsal hand left1.82 (0.36)1.65 (0.25)0.025 Proximal phalanx right2.09 (0.60)1.68 (0.24)0.001 Proximal phalanx left2.13 (0.82)1.66 (0.27)0.004Legend: ANA: Antinuclear antibodies; Ns: Non-significant; UCTD: Undifferentiated Connective Tissue Disease; SD: Standard DeviationDisclosure of Interests:None declared
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Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study. J Thromb Haemost 2021; 19:408-416. [PMID: 33119949 DOI: 10.1111/jth.15146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 01/16/2023]
Abstract
AIMS Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation. METHODS AND RESULTS We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (<90 mm Hg). We compared the risks of recurrent VTE, major bleeding, and mortality using time-to-event multivariable competing risk modeling. There were 3.5% of massive PE among 38 996 patients with PE. During the anticoagulation period, massive PE was associated with a greater risk of major bleeding (subhazard ratio [sHR] 1.72, 95% confidence interval [CI] 1.28-2.32), but not of recurrent VTE (sHR 1.15, 95% CI 0.75-1.74) than non-massive PE. An increased risk of mortality was only observed in the first month after PE. After discontinuation of anticoagulation, among 11 579 patients, massive PE and non-massive PE had similar risks of mortality, bleeding, and recurrent VTE (sHR 0.85, 95% CI 0.51-1.40), but with different case fatality of recurrent PE (11.1% versus 2.4%, P = .03) and possibly different risk of recurrent fatal PE (sHR 3.65, 95% CI 0.82-16.24). CONCLUSION In this large prospective registry, the baseline hemodynamic status of the incident PE did not influence the risk of recurrent VTE, during and after the anticoagulation periods, but was possibly associated with recurrent PE of greater severity.
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Incident heart failure prediction: left atrioventricular functional coupling index (LAFCI) from the multi-ethnic study of atherosclerosis (MESA). ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Podocyturia mRNAs and Risk of Adverse Cardiovascular Outcomes from the Multi-Ethnic Study of Atherosclerosis (MESA): Preliminary Findings. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Prognostic marker for incident atrial fibrillation from the Multi-Ethnic Study of Atherosclerosis (MESA). ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2021. [DOI: 10.1016/j.acvdsp.2020.10.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Glim criteria in critically ill patients: Preliminary results of its accuracy and predictive validity. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sepsis in hospitalized patients with suspected infection in an HIV/AIDS center in Rio de Janeiro, Brazil. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Avaliação do ponto de congelamento do leite cru por espectroscopia de infravermelho com transformada de Fourier como método de triagem. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi investigar a interferência do teor de gordura do leite no ponto de congelamento (PC) obtido pelo infravermelho com transformada de Fourier (FTIR). Uma fração de leite cru foi desnatada, obtendo-se creme e leite desnatado. O leite integral e o desnatado foram adicionados com água (0%, 2%, 5%, 10%, 15% e 20%). O leite desnatado remanescente foi adicionado com creme (5%, 10%, 15%, 20%) e água (0%, 2%, 5%, 10%, 15% e 20%). As amostras foram analisadas para PC (crioscópio eletrônico e FTIR) e composição (FTIR). O PC medido por FTIR foi altamente correlacionado com o método do crioscópio eletrônico (acima de 98,5%) e, como esperado, a adição de água foi significativa (P≤0,001) ao aumentar o PC do leite em ambos os métodos. No entanto, o alto teor de gordura no leite cru resultou na redução do PC ao se utilizar o FTIR, enquanto o baixo teor de gordura resultou em aumento do PC (P≤0,001). Uma vez que a adição de água causou o efeito inverso do alto teor de gordura no PC medido por FTIR, é importante considerar o teor de gordura do leite para evitar interpretações erradas do PC quando se utiliza o método FTIR.
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Biogenesis of circular RNAs and their role in cellular and molecular phenotypes of neurological disorders. Semin Cell Dev Biol 2020; 114:1-10. [PMID: 32893132 DOI: 10.1016/j.semcdb.2020.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/28/2020] [Accepted: 08/05/2020] [Indexed: 01/04/2023]
Abstract
Circular RNA (circRNA) is an unusual class of RNA-like structures composed by exonic and/or intronic sequences that are regulated by the backsplicing mechanism and by the spliceosome-mediated machinery. These circular transcripts tend to accumulate during aging in several human tissues, especially in the mammalian brain, and their expression is correlated with the occurrence of several human pathologies, including a broad spectrum of neurological disorders. Previous findings have also shown that circRNAs are significantly present in the neuronal tissue and are up-regulated during neurogenesis, with a significant number been derived from neural genes, suggesting these circular molecules are involved in the cellular and molecular phenotype of our brain. However, the complete biogenesis, the many types of circRNA molecules, and their involvement with neuronal phenotype and with the occurrence of pathologies are still a challenging avenue for researchers. In this updated review, we discuss the current findings of the biogenesis and the diversity of cirRNAs and their molecular involvement in neurological tissue phenotype. We also discuss how some circRNAs can act as sponge molecules, regulating the activity of microRNA expression over gene translation. Finally, we also show the correlation of altered circRNA expression in neurological disorders.
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Coronary Stent Assessment Using Ultra-high-resolution CT. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Association Between Cartilage Calcification Score And Risk Factors Of Coronary Heart Disease: The Mesarthritis Pilot Study. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Body composition and eating habits of workers with normal day and shift work. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa040.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction Recently, shift work and it consequences have been studied due to the strong relationship between shift work, sleep disorders and unhealthy eating habits, which could influence body composition and related health problems.
Objectives To analyse the influence of shift work on body composition and eating habits of workers.
Methodology Data collection was carried out through an interview with employees from a company in which data were collected such as sex, age, average number of hours of sleep and work schedule. An anthropometric evaluation was performed and weight, body fat mass percentage and waist circumference were measured. The height was self-reported. Individuals were also asked to answer to a semi-quantitative food frequency questionnaire. Data analysis was performed with descriptive and statistical analysis using U-Mann-Whitney test, in the IBM SPSS Statistics 25 program.
Results The final sample consisted of 20 shift workers and 20 normal day workers. The mean BMI of normal day workers was 23.54 ± 3.19 kg/m2, and the average of the shift workers was 27.97 ± 5.48 kg/m2 (p = 0,001). Regarding the percentage of fat mass, the mean of the normal day sample was 28.53 ± 6.30% and the shift work sample showed an average of 29.85 ± 8.54% (p = 0,841). The shift sample reported a higher average daily intake of processed foods, high energy density food products with high fat and sugar content.
Conclusion The higher BMI and fat percentage observed in shift workers comparing to normal day works are a topic of concern and could contribute to the assumption that the dynamics required by shift work can lead to changes in circadian rhythm, leading to metabolic alterations that could influence body composition and dietary choices.
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THU0355 PARAMETRIC CARDIAC MAGNETIC RESONANCE IMAGING IDENTIFIES ARRHYTHMOGENIC SUBSTRATES IN SYSTEMIC SCLEROSIS PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Cardiac involvement in systemic sclerosis (SSc) accounts for 26-36% of deaths. This most frequently manifests as ventricular rhythm disturbances (VRDs), eventually culminating in sudden cardiac death. However, no specific guidelines exist for implantation of cardioverter defibrillators (ICD) in SSc patients. Parametric cardiovascular magnetic resonance (CMR) indices of myocardial oedema and fibrosis like native T1/T2 mapping have been shown to be associated with prognosis in SSc patients with acute cardiac events and normal echocardiograms. However, their relationship with arrhythmogenicity per se has not been previously investigated in SSc.Objectives:To investigate the relationship between parametric CMR indices and arrhythmogenicity in SSc patients.Methods:84 consecutive SSc patients (80% diffuse-cutaneous SSc) from eight European centers presenting with cardiac symptoms were examined using a 1.5 T CMR system. 24h Holter recordings were obtained within a month of the CMR scan. The presence of VRDs was defined as any type of premature ventricular contraction (PVC) in couples, triplets, bigeminism, trigeminism, quadrigeminism and non-sustained ventricular tachycardia, as well as having >30 PVCs per hour. Logistic regression analysis was used to evaluate the relationship between VRD occurrence and native T1/T2 mapping as well as myocardial extracellular volume fraction (ECV).Results:Mean age in the cohort was 55 (13) years and 78 (93%) patients were female. Of these, 67 (80%) experienced at least one type of VRDs. Each 10 ms increase of native T1-mapping was associated with a higher occurrence of VRDs [odds ratio (95% confidence interval): 1.21 (1.08-1.36), p=0.001]. Similarly, a 1% increase in ECV conferred an increased probability of experiencing VRDs [1.25 (1.01-1.53), p=0.037]. Lastly, a 1ms unit increase in T2-mapping also led to increased probability of having experienced VRDs [1.09 (1.01-1.19), p=0.035].Conclusion:Parametric CMR indices are associated with arrhythmogenicity in SSc patients with cardiac symptoms and should be investigated further in larger studies for their clinical utility in selecting high-risk SSc patients for ICD implantation.Disclosure of Interests:Sophie I. Mavrogeni: None declared, Luna Gargani: None declared, Alessia Pepe: None declared, Lorenzo Monti: None declared, George Markousis-Mavrogenis: None declared, Maria De Santis: None declared, Antonella Meloni: None declared, Loukia Koutsogeorgopoulou: None declared, Georgia Karabela: None declared, Efthymios Stavropoulos: None declared, Gkikas Katsifis Grant/research support from: UCB Pharma, Janssen, Abbvie, Novartis, MSD, Aenorasis, Genesis Pharma, Pfizer, Roche, Consultant of: UCB Pharma, Janssen, Abbvie, Novartis, MSD, Aenorasis, Genesis Pharma, Pfizer, Roche, Speakers bureau: UCB Pharma, Janssen, Abbvie, Novartis, MSD, Aenorasis, Genesis Pharma, Pfizer, Roche, Konstantinos Bratis: None declared, Silvia Bellando Randone: None declared, Serena Guiducci: None declared, Cosimo Bruni: None declared, Alberto Moggi-Pignone: None declared, Theodoros Dimitroulas: None declared, Paraskevi Voulgari: None declared, Genovefa Kolovou: None declared, Vasiliki-Kalliopi Bournia Grant/research support from: Travel Grant from Boehringer Ingelheim, Monica Mukherjee: None declared, Joao Lima: None declared, George D. Kitas: None declared, Petros Sfikakis Grant/research support from: Grant/research support from Abvie, Novartis, MSD, Actelion, Amgen, Pfizer, Janssen Pharmaceutical, UCB, Marco Matucci-Cerinic Grant/research support from: Actelion, MSD, Bristol-Myers Squibb, Speakers bureau: Acetelion, Lilly, Boehringer Ingelheim
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Relationship of salt added during preparation and salt intake of cooks. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa040.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction The excessive consumption of sodium is one of the main problems in public health and responsible for the loss of years of a healthy life. The salt added to the meals represents a large part of the salt ingested, and the collaborators/cooks responsible for its addition need careful analysis, and intervention adjusted to the analysed reality, its salt consumption and its perception of saltiness may influence the amount of salt added.
Objectives This study had as main objective to perceive the relationship between the perception of salt of the employees of the Food and Nutrition Unit and the amount of salt added in the meals that were confectioned.
Methodology An observational, analytical, cross-sectional study was conducted, in which 6 selected cooks from the IPSS’s of Águeda participated. In order to estimate the amount of salt added to the meals, 20 samples of meals prepared by the cooks were taken, and a quantitative assessment of average salt per meal was made using Flame Photometry. The cooks were also subjected to two taste sensitivity tests. The data treatment was performed using the statistical software SPSS, and a statistical significance level of 5% was considered.
Results A better perception of the salty taste was observed in the cooks of Institution B. Although there were no differences with statistical significance in the quantity of salt of the meals between the two institutions, the mean and maximum addition of salt in the cooked meals was higher in institution B, regardless of the cook evaluated.
Conclusion The perception of the salty taste of the cooks does not seem to determine the amount of salt added to the meals.
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P-01-6 Effects of Cocoa Powder Supplementation in the Metabolism and the Testicles of Wistar Rats Submitted to Early Weaning. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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P-01-3 Study of Testicular Morphology and Food Preference in Wistar Rats Submitted to Chronic Stress. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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