Association between real-world home blood pressure measurement patterns and blood pressure variability among older individuals with hypertension: A community-based blood pressure variability study

Home blood pressure (BP) monitoring is a useful tool for hypertension management. BP variability (BPV) has been associated with an increased risk of cardiovascular events. However, little is known about the correlation between BPV and different measurement patterns of long-term home BP monitoring. This longitudinal cohort study aimed to assess the associations between dynamic BP measurement patterns and BPV. A total of 1128 participants (mean age, 77.4 ± 9.3 years; male, 51%) with 23 269 behavior measuring units were included. We used sliding window sampling to classify the home BP data with a regular 6-month interval into units in a sliding manner until the data are not continuous. Three measurement patterns (stable frequent [SF], stable infrequent [SI], and unstable [US]) were assessed based on the home BP data obtained within the first 3 months of the study, and the data in the subsequent 3 months were used to assess the BPV of that unit. We used linear mixed-effects model to assess the association between BP measurement patterns and BPV with adjustment for possible confounding factors including average BP. Average real variability and coefficient variability were used as measures of the BPV. No significant differences were observed in average BP between the SF, SI, and US patterns. However, BPV in the SF group was significantly lower than that in the US and SI groups (all p-values < .05). The BPV in SI and US groups was not significantly different. A stable and frequent BP measuring pattern was independently associated with a lower BPV.

Suppression of polyglutamine protein toxicity by co-expression of a heat-shock protein 40 and a heat-shock protein 110

A network of heat-shock proteins mediates cellular protein homeostasis, and has a fundamental role in preventing aggregation-associated neurodegenerative diseases. In a Drosophila model of polyglutamine (polyQ) disease, the HSP40 family protein, DNAJ-1, is a superior suppressor of toxicity caused by the aggregation of polyQ containing proteins. Here, we demonstrate that one specific HSP110 protein, 70 kDa heat-shock cognate protein cb (HSC70cb), interacts physically and genetically with DNAJ-1 in vivo, and that HSC70cb is necessary for DNAJ-1 to suppress polyglutamine-induced cell death in Drosophila. Expression of HSC70cb together with DNAJ-1 significantly enhanced the suppressive effects of DNAJ-1 on polyQ-induced neurodegeneration, whereas expression of HSC70cb alone did not suppress neurodegeneration in Drosophila models of either general polyQ disease or Huntington's disease. Furthermore, expression of a human HSP40, DNAJB1, together with a human HSP110, APG-1, protected cells from polyQ-induced neural degeneration in flies, whereas expression of either component alone had little effect. Our data provide a functional link between HSP40 and HSP110 in suppressing the cytotoxicity of aggregation-prone proteins, and suggest that HSP40 and HSP110 function together in protein homeostasis control.

Elderly patients with resected stage II, IIIA non-small cell lung cancer, increased referral rate to medical oncologists, 1992-2002

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Background: Resectable non-small-cell lung cancer (NSCLC) has been once considered as a surgical disease and therefore managed by surgeons alone, as the primary therapeutic option was surgical resection. However, it is now widely accepted that the optimal care for NSCLC requires a multidisciplinary care approach between surgeons, radiation oncologists and medical oncologists. Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we identified 3266 patients over 66 years with Stage II, IIIA NSCLC who underwent resection between 1992 and 2002. We examined the trend of medical oncology referral, indentified the predictors associated with medical oncology referral and subsequent use of adjuvant chemotherapy. Results: From 1992 to 2002, 1562 patients (47.8%) with resected stage II, IIIA NSCLC were referred to the medical oncologists; there was a steady rising trend in the proportion of the patients referral to medical oncology over the ten year period. The medical oncology referral rate increased from 26.9% in 1992 to 60.5% in 2002 (P<0.001). This change has paralleled to a rising trend in use of adjuvant chemotherapy in same population during same period. Among those seen by oncologists, 518 (33.2%) of patients received adjuvant chemotherapy. Female, white race, younger age, advanced tumor stage, adenocarcinoma, later year of diagnosis and being married were strong predictors to be seen by a medical oncologist. Patients older than 70 years of age, African American race and living in certain SEER geographic region were less likely to be referred to medical oncologists. Patients who had a medical oncology consultation were more likely to receive adjuvant chemotherapy (adjusted odds ratio [OR], 5.14; 95% CI, 4.11 to 6.43). Conclusions: The medical oncology referral rate doubled during last decade. Access to medical oncology consultation is linked to the use of adjuvant chemotherapy in the patients with resected Stage II, IIIA NSCLC. The steady increase in referral to medical oncologists paralleled an increase in the use of adjuvant chemotherapy. This changing pattern of medical oncology referral may mirror the changing attitude and perception towards to the benefits of adjuvant chemotherapy in the community.

No significant financial relationships to disclose.

Complement activation by neurofibrillary tangles in Alzheimer's disease

Brain inflammation is widely documented to occur in Alzheimer's disease (AD), but its sources are still incompletely understood. Here, we present in vitro and in situ evidence that, like amyloid beta peptide (Abeta), tau, the major protein constituent of the neurofibrillary tangle, is a potent, antibody-independent activator of the classical complement pathway. Complement activation, in turn, is known to drive numerous inflammatory responses, including scavenger cell activation and cytokine production. Because Abeta deposits and extracellular tangles are present from early preclinical to terminal stages of AD, their ability to activate complement provides a ready mechanism for initiating and sustaining chronic, low-level inflammatory responses that may cumulate over the disease course.

CT appearance of ectopic pancreas: a case report

The appearance of ectopic pancreas on computed tomography (CT) is described in a 47-year-old man with bowel obstruction. The enhancement pattern of ectopic pancreas after intravenous iodine contrast administration is the same as that of leiomyoma or carcinoid. This CT finding has not been reported previously to our knowledge.

A cysteine-rich isoform of neuregulin controls the level of expression of neuronal nicotinic receptor channels during synaptogenesis

We report here that neuregulin (NRG) isoforms with a conserved cysteine-rich domain (CRD) in their N terminus regulate expression of nicotinic acetylcholine receptors (nAChRs) at developing interneuronal synapses and report the isolation of transmembrane NRG isoforms with this CRD within the N-terminal portion. CRD-NRG mRNA and immunoreactive protein are detected early in developing presynaptic (visceral motor) neurons. The levels of expression of CRD-NRG peak prior to the formation of synapses with their postsynaptic partners, the ganglionic sympathetic neurons. Recombinant CRD-NRG mimics the effects of presynaptic input on target neurons. Functional deletion of CRD-NRG from presynaptic neurons abolishes the upregulation of nAChR expression induced by input-derived soluble material. Thus, CRD-NRG appears to be both a necessary and a sufficient signal for the control of neuronal nAChR expression during synaptogenesis.

Absence of biomagnetic effects in Nitella

The ability of N. flexilis and N. translucens to survive exposure to magnetic fields up to 1.6 T for extended periods of time was tested. Internodal cells subjected to such fields for as long as 72 h showed no evidence of damage. The active response of internodal cells was studied using an especially constructed sample chamber which allowed the use of intracellular microelectrodes. Action potentials in longitudinal and transverse fields as large as 2.0 T appeared identical to those in zero field. The results are in sharp contrast to observations reported by Arajs et al. (1975, Proceedings of the International Conference on Magnetism and Magnetic Materials).