THE DESIGN AND ANALYSIS OF EXPERIMENTS. By Oscar Kempthorne. New York, John Wiley and Sons, Inc., 1952. 631 pp. $8.50. This book by a teacher of statistics (as well as a consultant for \"experimenters\") is a comprehensive study of the philosophical background for the statistical design of experiment. It is necessary to have some facility with algebraic notation and manipulation to be able to use the volume intelligently. The problems are presented from the theoretical point of view, without such practical examples as would be helpful for those not acquainted with mathematics. The mathematical justification for the techniques is given. As a somewhat advanced treatment of the design and analysis of experiments, this volume will be interesting and helpful for many who approach statistics theoretically as well as practically. With emphasis on the \"why,\" and with description given broadly, the author relates the subject matter to the general theory of statistics and to the general problem of experimental inference. MARGARET J. ROBERTSON

The Design and Analysis of Experiments

Global strategy for asthma management and prevention

ecent research has shown that inflammation plays a key role in coronary artery disease (CAD) and other manifestations of atherosclerosis. Immune cells dominate early atherosclerotic lesions, their effector molecules accelerate progression of the lesions, and activation of inflammation can elicit acute coronary syndromes. This review highlights the role of inflammation in the pathogenesis of atherosclerotic CAD. It will recount the evidence that atherosclerosis, the main cause of CAD, is an inflammatory disease in which immune mechanisms interact with metabolic risk factors to initiate, propagate, and activate lesions in the arterial tree. A decade ago, the treatment of hypercholesterolemia and hypertension was expected to eliminate CAD by the end of the 20th century. Lately, however, that optimistic prediction has needed revision. Cardiovascular diseases are expected to be the main cause of death globally within the next 15 years owing to a rapidly increasing prevalence in developing countries and eastern Europe and the rising incidence of obesity and diabetes in the Western world. 1 Cardiovascular diseases cause 38 percent of all deaths in North America and are the most common cause of death in European men under 65 years of age and the second most common cause in women. These facts force us to revisit cardiovascular disease and consider new strategies for prediction, prevention, and treatment.

/pdf/inflammation-atherosclerosis-and-coronary-artery-disease-23ryhxhuc2.pdf

Inflammation, Atherosclerosis, and Coronary Artery Disease

ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation : The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC).

/pdf/2015-esc-guidelines-for-the-management-of-acute-coronary-6did6h5nxk.pdf

2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)

ACCF
: American College of Cardiology Foundation
ACS
: acute coronary syndrome
AHA
: American Heart Association
CAD
: coronary artery disease
CABG
: coronary artery bypass grafting
CKMB
: creatine kinase MB isoform
cTn
: cardiac troponin
CT
: computed tomography
CV
: coefficient of variation
ECG
: electrocardiogram
ESC
: European Society of Cardiology
FDG
: fluorodeoxyglucose
h
: hour(s)
HF
: heart failure
LBBB
: left bundle branch block
LV
: left ventricle
LVH
: left ventricular hypertrophy
MI
: myocardial infarction
mIBG
: meta-iodo-benzylguanidine
min
: minute(s)
MONICA
: Multinational MONItoring of trends and determinants in CArdiovascular disease)
MPS
: myocardial perfusion scintigraphy
MRI
: magnetic resonance imaging
mV
: millivolt(s)
ng/L
: nanogram(s) per litre
Non-Q MI
: non-Q wave myocardial infarction
NSTEMI
: non-ST-elevation myocardial infarction
PCI
: percutaneous coronary intervention
PET
: positron emission tomography
pg/mL
: pictogram(s) per millilitre
Q wave MI
: Q wave myocardial infarction
RBBB
: right bundle branch block
sec
: second(s)
SPECT
: single photon emission computed tomography
STEMI
: ST elevation myocardial infarction
ST–T
: ST-segment –T wave
URL
: upper reference limit
WHF
: World Heart Federation
WHO
: World Health Organization

Myocardial infarction (MI) can be recognised by clinical features, including electrocardiographic (ECG) findings, elevated values of biochemical markers (biomarkers) of myocardial necrosis, and by imaging, or may be defined by pathology. It is a major cause of death and disability worldwide. MI may be the first manifestation of coronary artery disease (CAD) or it may occur, repeatedly, in patients with established disease. Information on MI rates can provide useful information regarding the burden of CAD within and across populations, especially if standardized data are collected in a manner that …

/pdf/third-universal-definition-of-myocardial-infarction-1nbq846anm.pdf

Third universal definition of myocardial infarction

Patients with unstable coronary artery disease have a serious but variable prognosis. An early and specific prediction of risk is essential for stratification of treatment. Serum was obtained at a median of 9.5 hours from symptom onset in 7800 patients with unstable coronary artery disease included in the GUSTO-IV trial for analyses of creatinine, troponin-T, C-reactive protein (CRP) and N-terminal pro brain natriuretic peptide (NT-proBNP). Quartiles of troponin-T were related to an increased mortality and to an increased incidence of myocardial infarction. Increasing quartiles of C-reactive protein were also related to an increased mortality but there was no relation to the incidence of myocardial infarction. On multivariate analysis, troponin-T was the strongest marker for prediction of myocardial infarction, but reduced creatinine clearance and ST-depression at admission were also significant predictors. Prediction of subsequent mortality was possible with several risk indicators. Elevation of NT-proBNP was the strongest predictor of short and long-term mortality with a continuous increase in one-year mortality in relation to the levels. Also reduced creatinine clearance, elevation of CRP, troponin-T, ST-depression and clinical factors indicating a history of cardiovascular disease provided independent prognostic information on long-term mortality. A multimarker strategy with creatinine clearance, troponin, CRP and NT-proBNP together with ischemic ECG changes and clinical background characteristics provides the best prognostic information for choice of treatment in patients with unstable coronary artery disease.

Prognosis in unstable coronary artery disease. Multimarker strategy is the best basis for the therapeutic choice

Available data indicate that the use of B-type natriuretic peptide (BNP) or N-terminal-proBNP (NT-proBNP) improve the diagnostics of suspected heart failure as compared to the currently used clinic ...

BNP eller NT-proBNP bör analyseras vid misstänkt hjärtsvikt : Riktlinjer för analys och tolkning

Background Exacerbations of chronic obstructive pulmonary disease (COPD) are heterogeneous in their aetiology and inflammatory response. We investigated the presence of biological phenotypes of COPD exacerbations and biomarker associations with pathogens and inflammation. Method Patients with COPD were observed for 1 year at stable and exacerbation visits. Spirometry, health quality assessments, blood and sputum (for differential cell counts) were collected at each visit. A large panel of biomarkers were measured in sputum and serum. Viruses and selected bacteria were assessed in sputum by polymerase chain reaction and routine diagnostic bacterial culture. Biomarkers that differentiated exacerbations associated with bacteria, viruses or eosinophilic airway inflammation were investigated. Biological phenotypes were explored using cluster analysis. Result 145 patients (101 men, 44 women) entered the study. 182 exacerbations were captured from 86 patients. 55%, 26% and 28% met our definitions for bacteria, virus or sputum eosinophil associated exacerbations. Respectively each of the associated exacerbations were best identified by sputum IL-1β (area under receiver operator curve 0.89 (95% CI 0.83 to 0.95), serum CXCL10 (IP-10) 0.83 (0.70 to 0.96), and percentage peripheral blood eosinophils 0.85 (0.78 to 0.93). The odds ratio (95% CI) of an eosinophil or bacteria associated exacerbation was 2.7 (1.3 to 5.7) and 4.9 (2.4 to 9.9) if a sputum eosinophilia or bacterial pathogen was detected on ≥1 occasion at stable state. Four biological clusters were identified which validated the subgroups of exacerbations associated with bacteria, virus or sputum eosinophilia. Conclusion COPD exacerbation heterogeneity can be defined. Sputum IL-1β, serum CXCL10 (IP-10) and percentage peripheral blood eosinophils could be used to identify bacteria, virus or eosinophil associated exacerbations of COPD. Whether these biomarkers can be applied to direct therapy warrants further investigation.

https://thorax.bmj.com/content/thoraxjnl/65/Suppl_4/A3.2.full.pdf

T6 Acute exacerbations of chronic obstructive pulmonary disease: identification of phenotype-specific biomarkers and biological clusters

Radioimmunoassay ofserummyoglobin in neuromuscular diseases

Sepsis is a major burden to society and our health care systems. Early detection and treatment are keys to the improvement of the outcome of patients with sepsis with lower morbidity and mortality. We show in this review the potential usefulness, and superiority to current biomarkers, of plasma measurements of HNL Dimer in the monitoring of antibiotics in patients with sepsis. Future studies should be initiated to confirm this important aspect of sepsis management.

Per Venge

Papers

Prognosis in unstable coronary artery disease. Multimarker strategy is the best basis for the therapeutic choice

BNP eller NT-proBNP bör analyseras vid misstänkt hjärtsvikt : Riktlinjer för analys och tolkning

T6 Acute exacerbations of chronic obstructive pulmonary disease: identification of phenotype-specific biomarkers and biological clusters

Radioimmunoassay ofserummyoglobin in neuromuscular diseases

HNL Dimer- A Specific Biomarker of Neutrophil Activity - In Sepsis and Antibiotics Monitoring. A Mini-Review