In a large cohort of patients with advanced HF of multiple etiologies, obesity is not associated with increased mortality and may confer a more favorable prognosis. Further studies need to delineate whether weight loss promotion in medically optimized patients with HF is a worthwhile therapeutic goal.
Obstructive sleep apnea (OSA) is characterized by repeated occurrences of hypoxic, hypercapnic, and transient blood pressure elevation episodes that may damage or alter neural structures. Underdeveloped structures or pre-existing damage in brain areas may also contribute to the genesis of the syndrome. Brain morphology in 21 patients with OSA and in 21 control subjects was assessed using high-resolution T1-weighted magnetic resonance imaging. Three-dimensional brain images were obtained with voxels of approximately 1 mm3. Images were spatially normalized and segmented into gray matter, white matter, and cerebrospinal fluid. For each segment, regional volumetric differences were determined relative to age, handedness, and group (patients with OSA versus control subjects), using voxel-based morphometry, with OSA effects weighted by disease severity. A significant age effect on total gray matter was found in control subjects but not in patients with OSA. Diminished regional and often unilateral gray matter loss was apparent in multiple sites of the brain in patients with OSA, including the frontal and parietal cortex, temporal lobe, anterior cingulate, hippocampus, and cerebellum. Unilateral loss in well-perfused structures suggests onset of neural deficits early in the OSA syndrome. The gray matter loss occurs within sites involved in motor regulation of the upper airway as well as in areas contributing to cognitive function.
Significance
Following the sinking of the
Deepwater Horizon
in the Gulf of Mexico an unprecedented quantity of oil irrupted into the ocean at a depth of 1.5 km. The novelty of this event makes the oil’s subsequent fate in the deep ocean difficult to predict. This work identifies a fallout plume of hydrocarbons from the Macondo Well contaminating the ocean floor over an area of 3,200 km
2
. Our analysis suggests the oil initially was suspended in deep waters and then settled to the underlying sea floor. The spatial distribution of contamination implicates accelerated settling as an important fate for suspended oil, supports a patchwork mosaic model of oil deposition, and frames ongoing attempts to determine the event’s impact on deep-ocean ecology.
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