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- SourceAvailable from: Javaid Iqbal[Show abstract] [Hide abstract]
ABSTRACT: Background Average life expectancy is rising, resulting in increasing numbers of elderly, frail individuals presenting with coronary artery disease and requiring percutaneous coronary intervention (PCI). PCI can be of value for this population, but little is known about the balance of benefit versus risk, particularly in the frail. Objective To determine the relationship between frailty and clinical outcomes in patients undergoing PCI. Methods Patients undergoing PCI, for either stable angina or acute coronary syndrome, were prospectively assessed for frailty using the Canadian Study of Health and Ageing Clinical Frailty Scale. Demographics, clinical and angiographic data were extracted from the hospital database. Mortality was obtained from the Office of National Statistics. Results Frailty was assessed in 745 patients undergoing PCI. The mean age of patients was 62±12 years and 70% were males. The median frailty score was 3 (IQR 2–4). A frailty score ≥5, indicating significant frailty, was present in 81 (11%) patients. Frail patients required longer hospitalisation after PCI. Frailty was also associated with increased 30-day (HR 4.8, 95% CI 1.4 to 16.3, p=0.013) and 1 year mortality (HR 5.9, 95% CI 2.5 to 13.8, p<0.001). Frailty was a predictor of length of hospital stay and mortality, independent of age, gender and comorbidities. Conclusions A simple assessment of frailty can help predict mortality and the length of hospital stay, and may therefore guide healthcare providers to plan PCI and appropriate resources for frail patients.09/2015; 2(1):e000294. DOI:10.1136/openhrt-2015-000294
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ABSTRACT: Microscopic turgor-operated gas valves on leaf surfaces-stomata-facilitate gas exchange between the plant and the atmosphere, and respond to multiple environmental and endogenous cues. Collectively, stomatal activities affect everything from the productivity of forests, grasslands and crops to biophysical feedbacks between land surface vegetation and climate. In 1976, plant physiologist Paul Jarvis reported an empirical model describing stomatal responses to key environmental and plant conditions that predicted the flux of water vapour from leaves into the surrounding atmosphere. Subsequent theoretical advances, building on this earlier approach, established the current paradigm for capturing the physiological behaviour of stomata that became incorporated into sophisticated models of land carbon cycling. However, these models struggle to accurately predict observed trends in the physiological responses of Northern Hemisphere forests to recent atmospheric CO2 increases, highlighting the need for improved representation of the role of stomata in regulating forest-climate interactions. Bridging this gap between observations and theory as atmospheric CO2 rises and climate change accelerates creates challenging opportunities for the next generation of physiologists to advance planetary ecology and climate science. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society.Philosophical Transactions of The Royal Society B Biological Sciences 04/2015; 370(1666). DOI:10.1098/rstb.2014.0311
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ABSTRACT: The Mongolian gerbil, Meriones unguiculatus, has been widely employed as a model for studies of the inner ear. In spite of its established use for auditory research, no robust protocols to induce ototoxic hair cell damage have been developed for this species. In this paper, we demonstrate the development of an aminoglycoside-induced model of hair cell loss, using kanamycin potentiated by the loop diuretic furosemide. Interestingly, we show that the gerbil is relatively insensitive to gentamicin compared to kanamycin, and that bumetanide is ineffective in potentiating the ototoxicity of the drug. We also examine the pathology of the spiral ganglion after chronic, long-term hair cell damage. Remarkably, there is little or no neuronal loss following the ototoxic insult, even at 8 months post-damage. This is similar to the situation often seen in the human, where functioning neurons can persist even decades after hair cell loss, contrasting with the rapid, secondary degeneration found in rats, mice and other small mammals. We propose that the combination of these factors makes the gerbil a good model for ototoxic damage by induced hair cell loss. Copyright © 2015. Published by Elsevier B.V.Hearing research 03/2015; 325. DOI:10.1016/j.heares.2015.03.002
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