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LDL-C goal achievement and lipid-lowering therapy in patients by atherosclerotic cardiovascular disease subtype: the SANTORINI study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2373] [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
Background
In the 2019 ESC/EAS guidelines, documented ASCVD is a criterion for patients being categorised as at very high cardiovascular (CV) risk, and stringent low-density lipoprotein cholesterol (LDL-C) reductions of ≥50% plus a goal of <1.4 mmol/L are recommended. Intensive lipid lowering therapy (LLT) is therefore key to reducing the risk of future CV events.
Purpose
To describe patient characteristics, approaches to lipid management and LDL-C goal attainment at baseline in the subgroup of secondary prevention patients with a history of ASCVD enrolled in the SANTORINI study.
Methods
SANTORINI is a multinational observational study (NCT-04271280) evaluating the real-world use of LLT in adult patients with high- and very-high CV risk enrolled from primary and secondary care sites across Europe between March 2020 and February 2021. The ASCVD status of patients was defined based on medical records as either coronary (myocardial infarction; unstable angina; angina pectoris; coronary artery bypass graft surgery; percutaneous transluminal coronary angioplasty; coronary artery disease [CAD]; CAD unequivocal on imaging), cerebral (stroke; transient ischaemic attack; cerebrovascular disease; cerebrovascular disease unequivocal on imaging; carotid artery disease), peripheral/other (peripheral arterial disease [PAD]; lower extremity artery disease; PAD unequivocal on imaging; retinal vascular disease; abdominal aortic aneurysm; renovascular disease) or polyvascular (≥1 ASCVD).
Results
Of the 9044 patients included in the analysis 6954 (76.9%) had a history of ASCVD. Baseline demographics and patient characteristics by type of ASCVD are shown in Table 1. The majority of patients were male (76.9%) and mean (SD) age was 66.1 (10.4) years. Mean (SD) LDL-C level was 2.29 (1.13) mmol/L and a total of 20.7% of patients achieved CV risk-based LDL-C goals. Fewer patients with cerebral ASCVD attained LDL-C goals (15.0%). Despite being at very-high CV risk, 21.4% of all patients had no documented LLT (up to 28.5% for the cerebral ASCVD group). The majority of patients (49.2%) received statin monotherapy, particularly moderate (21.8%) and high-intensity statins (24.9%). The peripheral/other ASCVD and cerebral ASCVD groups recorded the highest use of monotherapy across subgroups (≥57.8%), whereas any other LLT alone was consistently low, including ezetimibe (≤2.5%) and PCSK9i (≤2.0%). Overall, only 25.6% of patients received combination therapy (17.5% statin + ezetimibe; 4.7% PCSK9i + statin and/or ezetimibe; 3.4% other).
Conclusion
The SANTORINI baseline analysis shows that the majority of patients with ASCVD do not achieve their LDL-C goals. The underutilisation of combination therapy in this very high CV risk population highlights the need to move beyond high-intensity statin monotherapy and rather focus on combination therapies which achieve more intensive LDL-C reductions, thus improving LDL-C goal attainment.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Daiichi Sankyo Europe GmbH, Munich, Germany
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Cardiovascular risk factors in patients with and without a history of atherosclerotic cardiovascular disease in the SANTORINI study and estimation of risk. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2255] [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
Background
Strategies for the prevention of atherosclerotic cardiovascular disease (ASCVD) are related to individual risk factors, and according to guidelines the higher the risk, the more intense the treatment required. Identifying patients at highest risk who might benefit the most from interventions is central for tailored solutions and ASCVD prevention, and any underestimation of risk may increase the ASCVD burden in these patients.
Purpose
To describe demographics and cardiovascular (CV) risk factors of patients with and without prior ASCVD enrolled in the SANTORINI study, as well as their CV risk as assigned by the investigator at the time of enrolment.
Methods
SANTORINI is an observational study (NCT04271280) conducted in 14 European countries and including patients aged ≥18 years with high- and very-high CV risk, as assessed by the investigator, and requiring lipid-lowering therapy. Patients were recruited between March 2020 and February 2021. The ASCVD status (coronary; cerebral; peripheral/other; polyvascular) of patients was defined based on medical records and the basis for risk classification was documented. For those whose risk was classified by the investigator based on the 2019 ESC/EAS guidelines, the CV risk was re-assessed centrally based on the information present in the study database to assess concordance.
Results
A total of 9044 patients were included in the analysis; of these, 76.9% had documented history of ASCVD (Table 1). Overall, the majority of patients were male (72.6%) and had a mean (SD) age of 65.3 (10.9) years. Mean (SD) LDL-C was 2.3 (1.13) mmol/L and 2.8 (1.37) mmol/L in the with and without ASCVD groups, respectively. Hypertension was common in both groups, whereas diabetes and familial hypercholesterolaemia were more prevalent in those without than those with ASCVD (44.6% vs 30.3% and 18.6% vs 7.2%, respectively). Patients with and without ASCVD had multiple CV risk factors (Table 1). Overall, ESC/EAS guidelines were cited as the most commonly used basis for risk classification (52.0%). Among all patients, the investigator assessed 26.0% and 84.2% of patients without and with ASCVD, respectively, as being very high-risk. However, central re-estimation for those using ESC/EAS guidelines suggested that 54.7% and 100% of those without and with ASCVD were at very high CV risk (Table 2).
Conclusion
Analysis of the SANTORINI baseline data shows that CV risk factors are common even in patients without documented ASCVD, and that the CV risk of patients both with and without ASCVD is underestimated in clinical practice, potentially contributing to clinical inertia in risk factor control.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Daiichi Sankyo Europe GmbH, Munich, Germany
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Overriding water table control on managed peatland greenhouse gas emissions. Nature 2021; 593:548-552. [PMID: 33882562 DOI: 10.1038/s41586-021-03523-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/08/2021] [Indexed: 02/02/2023]
Abstract
Global peatlands store more carbon than is naturally present in the atmosphere1,2. However, many peatlands are under pressure from drainage-based agriculture, plantation development and fire, with the equivalent of around 3 per cent of all anthropogenic greenhouse gases emitted from drained peatland3-5. Efforts to curb such emissions are intensifying through the conservation of undrained peatlands and re-wetting of drained systems6. Here we report eddy covariance data for carbon dioxide from 16 locations and static chamber measurements for methane from 41 locations in the UK and Ireland. We combine these with published data from sites across all major peatland biomes. We find that the mean annual effective water table depth (WTDe; that is, the average depth of the aerated peat layer) overrides all other ecosystem- and management-related controls on greenhouse gas fluxes. We estimate that every 10 centimetres of reduction in WTDe could reduce the net warming impact of CO2 and CH4 emissions (100-year global warming potentials) by the equivalent of at least 3 tonnes of CO2 per hectare per year, until WTDe is less than 30 centimetres. Raising water levels further would continue to have a net cooling effect until WTDe is within 10 centimetres of the surface. Our results suggest that greenhouse gas emissions from peatlands drained for agriculture could be greatly reduced without necessarily halting their productive use. Halving WTDe in all drained agricultural peatlands, for example, could reduce emissions by the equivalent of over 1 per cent of global anthropogenic emissions.
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A spatio-temporal and kinematic description of self-selected walking in adults with Achondroplasia. Gait Posture 2020; 80:391-396. [PMID: 32650227 DOI: 10.1016/j.gaitpost.2020.06.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/08/2020] [Accepted: 06/25/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Achondroplasia is characterised by a shorter appendicular limb to torso ratio, compared to age matched individuals of average stature (controls). Despite the well documented shorter leg length of individuals with compared to controls, there are few complete descriptions of gait kinematics reported for the population. AIM The aim of this study was to report the spatio-temporal and kinematic characteristics of self-selected walking (SSW) in a group with Achondroplasia (N = 10) and age matched group without Achondroplasia (controls, N = 17). METHOD Whole body 3D analysis of both groups was conducted using a 14 camera VICON system. Spatio-temporal and kinematic variables were determined through a Plug-in-Gait model. SSW was obtained from an average of three trials equating to a total of ∼120 m walking. RESULTS The group with Achondroplasia were 23 % slower (P < 0.001), had a 29 % shorter stride length (P < 0.001) and a 13 % higher stride frequency (P < 0.001) compared to controls. There were no differences in time normalised temporal measures of left toe off (P = 0.365), right heel contact (P = 0.442) or the duration of double support (P = 0.588) between groups. A number of discrete joint kinematic differences existed between groups, resulting in the group with Achondroplasia having more 'flexed' lower limbs than controls throughout the gait cycle. CONCLUSION Differences in absolute spatio-temporal variables between groups is likely due to the shorter leg length of the group with Achondroplasia, while their more flexed position of the lower limbs may facilitate toe-clearance during the swing phase.
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LEAVE NO-ONE BEHIND: STAKEHOLDER ENGAGEMENT WITH AN INTEGRATED ONCOGERIATRIC PATIENT PATHWAY – A SNAPSHOT SERVICE EVALUATION OF FRAILTY SCORING AND GERIATRIC INPUT FOR PATIENTS WITH BREAST CANCER >70 YEARS OLD IN CARDIFF AND VALE UNIVERSITY HEALTH BOARD (CAVUHB). J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31252-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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TOO OLD TO OPERATE? A CASE SERIES OF VULNERABLE OR FRAIL OLDER PEOPLE (>70 YEARS) WITH BREAST CANCER IN CARDIFF AND VALE UNIVERSITY HEALTH BOARD (CAVUHB) AND THE IMPACT OF ONCOGERIATRIC ASSESSMENT ON TREATMENT DECISIONS. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31253-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Wetland soils are globally important carbon stores, and natural wetlands provide a sink for atmospheric carbon dioxide (CO2) through ongoing carbon accumulation. Recognition of coastal wetlands as a significant contributor to carbon storage (blue carbon) has generated interest into the climate change mitigation benefits of restoring or recreating saltmarsh habitat. However, the length of time a re-created marsh will take to become functionally equivalent to a natural (reference) system, or indeed, whether reference conditions are attainable, is largely unknown. Here, we describe a combined field chronosequence and modelling study of saltmarsh carbon accumulation and provide empirically based predictions of changes in the carbon sequestration rate over time following saltmarsh restoration. Carbon accumulation was initially rapid (average 1.04 t C ha-1 yr-1 during the first 20 years), slowing to a steady rate of around 0.65 t C ha-1 yr-1 thereafter. The resulting increase in C stock gave an estimated total C accumulation of 74 t C ha-1 in the century following restoration. This is approximately the same as our observations of natural marsh C content (69 t C ha-1), suggesting that it takes approximately 100 years for restored saltmarsh to obtain the same carbon stock as natural sites.
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A quantitative description of self-selected walking in adults with Achondroplasia using the gait profile score. Gait Posture 2019; 68:150-154. [PMID: 30476692 DOI: 10.1016/j.gaitpost.2018.11.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/18/2018] [Accepted: 11/15/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Achondroplasia is characterised by a shorter appendicular limb-to-torso ratio, compared to age matched individuals of average stature (controls). Previous work shows gait kinematics of individuals with Achondroplasia differing to controls, but no global quantification of gait has been made in adults with Achondroplasia. AIM The aim of this study was to quantify gait differences between a group of adult males with Achondroplasia and controls during self-selected walking (SSW) using the Gait Profile Score (GPS). DESIGN Whole body motion analysis of 10 adults with Achondroplasia (22 ± 3 yrs) who had not undergone leg lengthening and 17 adult controls (22 ± 2 yrs) was undertaken using a 14 camera VICON system (100 Hz). For each group, fifteen root mean squared Gait Variable Scores (GVS, units °) were computed from lower limb kinematic data and then summed to calculate GPS (°). RESULTS The group with Achondroplasia had higher GVSs than controls in 10 of the 15 measures (P < 0.05) with the largest differences found in ankle plantar/dorsiflexion (P < 0.001), knee flexion/extension (P < 0.001), and hip internal/external rotation (P < 0.001). The GPS value of the group with Achondroplasia was 64% higher than controls (11.4° (2.0) v 4.1° (1.8), P < 0.001). CONCLUSION Gait is quantitatively different in adults with Achondroplasia compared to controls. The differences in GPS between groups are due to differences in joint kinematics, which are possibly manifested by maintaining toe-clearance during swing. Gait models derived from the anatomy of individuals with Achondroplasia may improve these data.
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A comparison of once and twice daily administration of trilostane to dogs with hyperadrenocorticism. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2018. [DOI: 10.1055/s-0038-1623672] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Summary
Objective: This retrospective study describes the use of trilostane given once versus twice daily in dogs with hyperadrenocorticism (SID vs. BIDgroup) in separate clinical trials.
Material and methods: The groups were compared over a six month period using laboratory findings, dose required to suppress post-ACTH cortisol, and clinical scores from owner and clinician questionnaires.
Results: Ninety-three dogs enrolled the trials but for analysis of the final visit results only 56 dogs filled the inclusion criteria: 30 dogs in the SID-group and 26 dogs in the BID-group. Both treatment groups showed an improvement in clinical scores with time and no significant difference between them. In the BID-group post-ACTH cortisol concentrations went below 250 nmol/l sooner and in a higher proportion of dogs than in the SID-group.Twice-daily administration of trilostane also achieved a faster and more effective control for comparable daily doses. A higher individual tolerability (based on clinical scores) was found in the SID-group but there were no supporting laboratory findings. No dogs developed serious side-effects.
Conclusion: This study reveals only small practical differences between once and twice daily trilostane administrations in treating hyperadrenocorticism. And the overall benefits of twice daily dosing have to be considered against the effect on the owners and their compliance with treatment.
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Effect of ICS on glycaemic control in patients with COPD and comorbid type 2 diabetes: historical case-matched cohort study. Pneumologie 2017. [DOI: 10.1055/s-0037-1598312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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FRI0431 Fatigue Is A Determinant of Reduced Work Productivity in Ankylosing Spondylitis: Results from A Prospective Cohort Study: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Predicting nitrogen and acidity effects on long-term dynamics of dissolved organic matter. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2014; 184:271-282. [PMID: 24077255 DOI: 10.1016/j.envpol.2013.08.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 08/08/2013] [Accepted: 08/11/2013] [Indexed: 06/02/2023]
Abstract
Increases in dissolved organic carbon (DOC) fluxes may relate to changes in sulphur and nitrogen pollution. We integrated existing models of vegetation growth and soil organic matter turnover, acid-base dynamics, and organic matter mobility, to form the 'MADOC' model. After calibrating parameters governing interactions between pH and DOC dissolution using control treatments on two field experiments, MADOC reproduced responses of pH and DOC to additions of acidifying and alkalising solutions. Long-term trends in a range of acid waters were also reproduced. The model suggests that the sustained nature of observed DOC increases can best be explained by a continuously replenishing potentially-dissolved carbon pool, rather than dissolution of a large accumulated store. The simulations informed the development of hypotheses that: DOC increase is related to plant productivity increase as well as to pH change; DOC increases due to nitrogen pollution will become evident, and be sustained, after soil pH has stabilised.
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P276 The Impact of the Optimum Patient Care Service on Outcomes for Adult Asthmatic Patients: Abstract P276 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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A comparison of once and twice daily administration of trilostane to dogs with hyperadrenocorticism. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2012; 40:415-424. [PMID: 23242222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 05/31/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This retrospective study describes the use of trilostane given once versus twice daily in dogs with hyperadrenocorticism (SID vs. BID-group) in separate clinical trials. MATERIAL AND METHODS The groups were compared over a six month period using laboratory findings, dose required to suppress post-ACTH cortisol, and clinical scores from owner and clinician questionnaires. RESULTS Ninety-three dogs enrolled the trials but for analysis of the final visit results only 56 dogs filled the inclusion criteria: 30 dogs in the SID-group and 26 dogs in the BID-group. Both treatment groups showed an improvement in clinical scores with time and no significant difference between them. In the BID-group post-ACTH cortisol concentrations went below 250 nmol/l sooner and in a higher proportion of dogs than in the SID-group. Twice-daily administration of trilostane also achieved a faster and more effective control for comparable daily doses. A higher individual tolerability (based on clinical scores) was found in the SID-group but there were no supporting laboratory findings. No dogs developed serious side-effects. CONCLUSION This study reveals only small practical differences between once and twice daily trilostane administrations in treating hyperadrenocorticism. And the overall benefits of twice daily dosing have to be considered against the effect on the owners and their compliance with treatment.
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Asthma control with extrafine-particle hydrofluoroalkane-beclometasone vs. large-particle chlorofluorocarbon-beclometasone: a real-world observational study. Clin Exp Allergy 2011; 41:1521-32. [PMID: 21752116 DOI: 10.1111/j.1365-2222.2011.03820.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The extrafine-particle formulation of hydrofluoroalkane-beclometasone (EF HFA-BDP; Qvar®) demonstrates improved total and small airway deposition compared with large-particle chlorofluorocarbon (CFC)-BDP. In some short-term studies, EF HFA-BDP provides greater effects on lung function than CFC-BDP, and hence is recommended to be prescribed at a lower dose, but whether there are differences in asthma outcomes during long-term treatment is unknown. OBJECTIVE To compare the effectiveness of EF HFA-BDP vs. CFC-BDP over 1 year. METHODS This retrospective matched cohort study examined outcomes in a large primary care database for patients aged 5-60 years with asthma receiving their first inhaled corticosteroid (ICS) prescription (initiation population) or first ICS dose increase (step-up population) by a pressurized metered-dose inhaler (pMDI) as EF HFA-BDP or CFC-BDP. Patients were matched on baseline demographic and asthma severity measures in EF HFA-BDP:CFC-BDP ratios of 1:3 and 1:2 for initiation and step-up populations, respectively. Step-up patients were matched also on ICS dose during a baseline year. Co-primary endpoints were asthma control (composite measure comprising no recorded hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection) and exacerbation rate during the outcome year. RESULTS For the initiation population (EF HFA-BDP n=2882; CFC-BDP n=8646), adjusted odds of achieving asthma control with EF HFA-BDP vs. CFC-BDP was 1.15 (95% CI 1.02-1.28). For the step-up population (n=258 and 516), adjusted odds of asthma control with EF HFA-BDP was 1.72 (95% CI 1.14-2.56). EF HFA-BDP was prescribed at a median dose half that of CFC-BDP. CONCLUSION AND CLINICAL RELEVANCE During 1 year after initiating or stepping up ICS therapy by pMDI, patients who received EF HFA-BDP were more likely to achieve asthma control than those receiving CFC-BDP. These findings suggest that ICS formulation, particle size, and deposition characteristics play important roles in real-life effectiveness of asthma therapy. This study shows that an EF-particle formulation of beclometasone can be used at half the dose of the large-particle formulation with at least as good clinical outcomes.
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Comparative Effectiveness Of Extrafine Hydrofluoroalkane Beclomethasone And Fluticasone In Asthma Management: A Real-world Observational Study From The United States. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Methodology problems in using eGFR to investigate the prevalence of renal anaemia. Diabet Med 2008; 25:1126-7; author reply 1127. [PMID: 19183320 DOI: 10.1111/j.1464-5491.2008.02528.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Advice lines. Sweet success. THE HEALTH SERVICE JOURNAL 2001; 111:29. [PMID: 11458563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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The 2.0 A structure of human ferrochelatase, the terminal enzyme of heme biosynthesis. NATURE STRUCTURAL BIOLOGY 2001; 8:156-60. [PMID: 11175906 DOI: 10.1038/84152] [Citation(s) in RCA: 184] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Human ferrochelatase (E.C. 4.99.1.1) is a homodimeric (86 kDa) mitochondrial membrane-associated enzyme that catalyzes the insertion of ferrous iron into protoporphyrin to form heme. We have determined the 2.0 A structure from the single wavelength iron anomalous scattering signal. The enzyme contains two NO-sensitive and uniquely coordinated [2Fe-2S] clusters. Its membrane association is mediated in part by a 12-residue hydrophobic lip that also forms the entrance to the active site pocket. The positioning of highly conserved residues in the active site in conjunction with previous biochemical studies support a catalytic model that may have significance in explaining the enzymatic defects that lead to the human inherited disease erythropoietic protoporphyria.
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Abstract
The purpose of this study was to evaluate and compare four different methods of normalising the amplitude of electromyograms (EMGs), from the biceps brachii. Five males performed isotonic contractions of the elbow flexors with an external force of 50 N, 100 N, 150 N and 200 N. These were followed by a single isometric maximal voluntary contraction (MVC) and ten isokinetic MVCs at 0.35 rad s(-1) intervals between 0.35 rad s(-1) and 3.50 rad s(-1). The processed EMGs recorded from the isotonic contractions were normalised by expressing them as a percentage of: (i) the mean (Dynamic Mean Method) and (ii) the peak EMG from the same contraction (Dynamic Peak Method), (iii) the EMG from the isometric MVC (Isometric MVC Method), and (iv) the EMG from an isokinetic MVC at the same elbow angle and angular velocity (Isokinetic MVC Method). The root mean square difference (RMSD) between the outputs of the Isokinetic MVC and Dynamic Mean methods was significantly greater (P<0.05) than between the Isokinetic MVC method and the Dynamic Peak and the Isometric MVC methods. The small (10%) difference between the Isokinetic MVC and the Isometric MVC Methods was a consequence, firstly, of the lack of difference in EMG recorded from the isometric and isokinetic MVCs and, secondly, the consistency in EMG over the range of motion and at different angular velocities of isokinetic MVC. We conclude that only the Isometric and Isokinetic MVC methods should be used to normalise the amplitude of EMGs from the biceps brachii.
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Indo-Asians with diabetes: a special case. THE PRACTITIONER 1996; 240:120-4. [PMID: 8736201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Death and the Elderly Diabetic Person. Age Ageing 1993. [DOI: 10.1093/ageing/22.suppl_3.p10-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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