The New England journal of medicine
-
The natriuretic peptides are counterregulatory hormones involved in volume homeostasis and cardiovascular remodeling. The prognostic significance of plasma natriuretic peptide levels in apparently asymptomatic persons has not been established. ⋯ In this community-based sample, plasma natriuretic peptide levels predicted the risk of death and cardiovascular events after adjustment for traditional risk factors. Excess risk was apparent at natriuretic peptide levels well below current thresholds used to diagnose heart failure.
-
Randomized Controlled Trial Clinical Trial
Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea.
B-type natriuretic peptide levels are higher in patients with congestive heart failure than in patients with dyspnea from other causes. ⋯ Used in conjunction with other clinical information, rapid measurement of B-type natriuretic peptide in the emergency department improved the evaluation and treatment of patients with acute dyspnea and thereby reduced the time to discharge and the total cost of treatment.
-
The cause of preeclampsia remains unclear. Limited data suggest that excess circulating soluble fms-like tyrosine kinase 1 (sFlt-1), which binds placental growth factor (PlGF) and vascular endothelial growth factor (VEGF), may have a pathogenic role. ⋯ Increased levels of sFlt-1 and reduced levels of PlGF predict the subsequent development of preeclampsia.
-
Review Historical Article
Islet transplantation as a treatment for diabetes - a work in progress.
-
Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes.
Insulin resistance appears to be the best predictor of the development of diabetes in the children of patients with type 2 diabetes, but the mechanism responsible is unknown. ⋯ These data support the hypothesis that insulin resistance in the skeletal muscle of insulin-resistant offspring of patients with type 2 diabetes is associated with dysregulation of intramyocellular fatty acid metabolism, possibly because of an inherited defect in mitochondrial oxidative phosphorylation.