The effect of multiple micronutrient supplementation on left ventricular ejection fraction in patients with chronic stable heart failure: a randomized, placebo-controlled trial:A randomized, placebo-controlled trial

Objectives: This study sought to investigate the effect of a multiple micronutrient supplement on left ventricular ejection fraction (LVEF) in patients with heart failure. Background: Observational studies suggest that patients with heart failure have reduced intake and lower concentrations of a number of micronutrients. However, there have been very few intervention studies investigating the effect of micronutrient supplementation in patients with heart failure. Methods: This was a randomized, double-blind, placebo-controlled, parallel-group study involving 74 patients with chronic stable heart failure that compared multiple micronutrient supplementation taken once daily versus placebo for 12 months. The primary endpoint was LVEF assessed by cardiovascular magnetic resonance imaging or 3-dimensional echocardiography. Secondary endpoints were Minnesota Living With Heart Failure Questionnaire score, 6-min walk test distance, blood concentrations of N-terminal prohormone of brain natriuretic peptide, C-reactive protein, tumor necrosis factor alpha, interleukin-6, interleukin-10, and urinary levels of 8-iso-prostaglandin F2 alpha. Results: Blood concentrations of a number of micronutrients increased significantly in the micronutrient supplement group, indicating excellent compliance with the intervention. There was no significant difference in mean LVEF at 12 months between treatment groups after adjusting for baseline (mean difference: 1.6%, 95% confidence interval: -2.6 to 5.8, p = 0.441). There was also no significant difference in any of the secondary endpoints at 12 months between treatment groups. Conclusions: This study provides no evidence to support the routine treatment of patients with chronic stable heart failure with a multiple micronutrient supplement. (Micronutrient Supplementation in Patients With Heart Failure [MINT-HF]; NCT01005303).

Predictive Factors for Local Control in Primary and Metastatic Lung Tumours after Four to Five Fraction Stereotactic Ablative Body Radiotherapy: A Single Institution's Comprehensive Experience

<p>AIMS: We report the outcomes of a large lung stereotactic ablative body radiotherapy (SABR) programme for primary non-small cell lung cancer (NSCLC) and pulmonary metastases. The primary study aim was to identify factors predictive for local control.</p><p>MATERIALS AND METHODS: In total, 311 pulmonary tumours in 254 patients were treated between 2008 and 2011 with SABR using 48-60 Gy in four to five fractions. Local, regional and distant failure data were collected prospectively, whereas other end points were collected retrospectively. Potential clinical and dosimetric predictors of local control were evaluated using univariate and multivariate analyses.</p><p>RESULTS: Of the 311 tumours, 240 were NSCLC and 71 were other histologies. The 2 year local control rate was 96% in stage I NSCLC, 76% in colorectal cancer (CRC) metastases and 91% in non-lung/non-CRC metastases. Predictors of better local control on multivariate analysis were non-CRC tumours and a larger proportion of the planning target volume (PTV) receiving ≥100% of the prescribed dose (higher PTV V100). Among the 45 CRC metastases, a higher PTV V100 and previous chemotherapy predicted for better local control.</p><p>CONCLUSIONS: Lung SABR of 48-60 Gy/four to five fractions resulted in high local control rates for all tumours except CRC metastases. Covering more of the PTV with the prescription dose (a higher PTV V100) also resulted in superior local control.</p>

Bioavailability of 2,4-dichlorophenol associated with soil water-soluble humic material

<p>Interaction of organic xenobiotics with soil water-soluble humic material (WSHM) may influence their environmental fate and bioavailability. We utilized bacterial assays (lux-based toxicity and mineralization by Burkholderia sp. RASC) to assess temporal changes in the bioavailability of [¹⁴C]-2,4-dichlorophenol (2,4-DCP) in soil water extracts (29.5 μg mL^-1 2,4-DCP; 840.2 μg mL^-1 organic carbon). HPLC determined and bioavailable concentrations were compared. Gel permeation chromatography (GPC) was used to confirm the association of a fraction (>50%) of [¹⁴C]-2,4-DCP with WSHM. Subtle differences in parameters describing 2,4-DCP mineralization curves were recorded for different soil-2,4-DCP contact times. Problems regarding the interpretation of mineralization data when assessing the bioavailability of toxic compounds are discussed. The lux-bioassay revealed a time-dependent reduction in 2,4-DCP bioavailability: after 7 d, less than 20% was bioavailable. However, GPC showed no quantitative difference in the amount of WSHM-associated 2,4-DCP over this time. These data suggest qualitative changes in the nature of the 2,4-DCP-WSHM association and that associated 2,4-DCP may exert a toxic effect. Although GPC distinguished between free- and WSHM-associated 2,4-DCP, it did not resolve the temporal shift in bioavailability revealed by the lux biosensor. These results stress that assessment of risk posed by chemicals must be considered using appropriate biological assays.</p>

Biotransformation of 2,4,6-trinitrotoluene (TNT) by ectomycorrhizal basidiomycetes

<p>The ability of four ectomycorrhizal basidiomycetes to biotransform 2,4,6-trinitrotoluene (TNT) in axenic culture was tested. All species were capable of TNT biotransformation to a greater or lesser extent. When biotransformation was expressed on a biomass basis 4 out of the 5 isolates tested were equally efficient at transforming TNT. The factors regulating TNT biotransformation were investigated in detail for one fungus, Suillus variegatus. When the fungus was grown under nitrogen limiting conditions the rate of biotransformation decreased relative to nitrogen sufficient conditions, but no decrease was observed under short term carbon starvation. Extracellular enzymes of S. variegatus could transform TNT, but transformation was greater in intact cells. The mycelial cell wall fraction did not degrade TNT. The TNT concentration that caused 50% reduction in biomass (EC₅₀) for S. variegatus was within the range observed for other basidiomycete fungi being between 2-10 μg mL^-1. The potential use of ectomycorrhizal basidiomycetes as in-situ bioremediation agents for TNT contaminated soils is discussed.</p>