Cholesterol emboli syndrome is a relatively rare, but potentially devastating, manifestation of atherosclerotic disease. Cholesterol emboli syndrome is characterized by waves of arterio-arterial embolization of cholesterol crystals and atheroma debris from atherosclerotic plaques in the aorta or its large branches to small or medium caliber arteries (100-200 μm in diameter) that frequently occur after invasive arterial procedures. End-organ damage is due to mechanical occlusion and inflammatory response in the destination arteries. Clinical manifestations may include renal failure, blue toe syndrome, global neurologic deficits and a variety of gastrointestinal, ocular and constitutional signs and symptoms. There is no specific therapy for cholesterol emboli syndrome. Supportive measures include modifications of risk factors, use of statins and antiplatelet agents, avoidance of anticoagulation and thrombolytic agents, and utilization of surgical and endovascular techniques to exclude sources of cholesterol emboli.
Theoretical and experimental work suggests that time to sex change in sequential hermaphrodites may be strongly linked to local population traits and the social environment of the individuals. We evaluated social control and temporal and spatial plasticity in the sex-change response of the protandric marine gastropod Crepidula coquimbensis, which inhabits the empty shells of other gastropods and reproduces via direct development. Over 2 yr, 2 populations with significant genetic distance were sampled, and the abundance, population sex ratio, and sex ratio within hosting shells was measured. Reproductive responses, minimum female size, and the size at which 50% of the males changed sex to female (L 50 ) were calculated for each location and sampling date. The sex ratio was male-biased in all cases. High temporal and spatial variability in the abundance, sex ratio, and body size at sex change was observed. However, negative and significant correlations were found between minimum female size and number of males in the aggregation and between population sex ratio and L 50 . Although earlier studies have suggested that sexchange strategy of gastropod species with direct development is less plastic and responsive to conspecifics, the present work indicates that the protandric marine gastropod C. coquimbensis may adjust its sexual strategy to local social conditions. KEY WORDS: Sequential hermaphroditism · Life-history strategy · Size advantage · Population genetics · Sex ratio
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Background: Over the past decade, ischemic heart disease (IHD) mortality trends have been less favorable among adults age 25-54 than age ≥55 years. Hypothesis: Disorders associated with IHD such as diabetes, chronic inflammatory and infectious diseases, and cocaine use are important contributors to premature IHD mortality. Methods: Multiple-cause-of-death analysis was performed using the New York City (NYC) Vital Statistics database. Frequencies of selected contributing causes on death records with IHD as the underlying cause for decedents age ≥25 were assessed (n = 418,151; 1990-2008). Concurrent Telephone risk-factor surveys (NYC Community Health Survey, Centers for Disease Control Behavioral Risk Factor Survey in New York State) were analyzed. Results: In sum, a prespecified contributing cause was identified on 13.6% of death certificates for IHD decedents age 25-54. Diabetes was reported more frequently for younger IHD decedents (15% of females and 10% of males age 25-54 vs 6% of both sexes age ≥ 55). In contrast, concurrent diabetes prevalence in New York State was 3.4% for those age 25-54 and 13.6% for those age >55 (P < 0.0001). Systemic lupus erythematosus, human immunodeficiency virus, and cocaine were also more likely to contribute to IHD death among younger than older people. Conclusions: Diabetes may be a potent risk factor for IHD death in young people, particularly young women, in whom it was reported on IHD death records at a rate 5× higher than local prevalence. The high frequency of reporting of studied contributing causes in younger IHD decedents may provide a focus for further IHD mortality-reduction efforts in younger adults.
IntroductionIn the United States, about 405,000 deaths in 2008 were attributed to ischemic heart disease (IHD), 1 a 70% decrease from the peak rate in 1968. This trend has not been consistent across groups. From 1999 to 2010, IHD mortality did not significantly change in young women, whereas young men experienced a small decrease and larger declines were observed among older women and men. 1 Over a similar period, the decline in IHD mortality was slower for Americans age < 55 years than older individuals. 2 Although the IHD mortality rate is much lower among younger than
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