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Despite 'orphan drug' legislation, bringing new medicines for rare diseases to market and securing funding for their provision is sometimes both costly and problematic, even in the case of medicines for very rare 'ultra orphan' oncological indications. In this paper difficulties surrounding the introduction of a new treatment for osteosarcoma exemplify the(More)
The parameters of wave intensity analysis are calculated from incremental changes in pressure and velocity. While it is clear that forward- and backward-traveling waves induce incremental changes in pressure, not all incremental changes in pressure are due to waves; changes in pressure may also be due to changes in the volume of a compliant structure. When(More)
OBJECTIVES Augmentation index (AIx) is widely used as a measure of wave reflection. We compared the relationship between AIx and age, height and sex with 'gold standard' measures of wave reflection derived from measurements of pressure and flow to establish how well AIx measures wave reflection. MATERIALS AND METHODS Measurements of carotid pressure and(More)
The augmentation index predicts cardiovascular mortality and is usually explained as a distally reflected wave adding to the forward wave generated by systole. We propose that the capacitative properties of the aorta (the arterial reservoir) also contribute significantly to the augmentation index and have calculated the contribution of the arterial(More)
Aortic pulse wave velocity (PWV) and augmentation index (AIx) are independent predictors of cardiovascular risk and mortality, but little is known about the effect of air temperature changes on these variables. Our study investigated the effect of exposure to whole-body mild-cold on measures of arterial stiffness (aortic and brachial PWV), and on central(More)
Pulse wave velocity is related to arterial stiffness. Pulse wave velocity changes with age and disease and is a useful indicator of cardiovascular disease. Different methods are used for evaluating pulse wave velocity in systemic vessels, but none is applicable to coronary arteries. In this study we first compare values of wave speed (c) calculated from(More)
This prospective study analyses the ability of several different intermediate hearing screening techniques to predict hearing aid acceptance in a pre-retirement population. In addition to the traditional methods of using sensitivity and specificity to analyse test performance, signal detection theory has been used to obtain a single detectability rate for(More)
Coronary artery hemodynamics are very different to that of the systemic arteries; unlike the systemic circulation, in the coronary circulation pressure is generated from both the proximal and distal end of the artery - due to the effect of contraction and relaxation of the myocardium on the microvasculature. As a result, the systemic artery hemodynamic(More)
OBJECTIVES To evaluate the first experience of real-time instantaneous wave-free ratio (iFR) measurement by clinicians. BACKGROUND The iFR is a new vasodilator-free index of coronary stenosis severity, calculated as a trans-lesion pressure ratio during a specific period of baseline diastole, when distal resistance is lowest and stable. Because all(More)
Pyrgulopsis gilae is a small springsnail that is narrowly distributed along the forks of the upper Gila River and currently being managed as a threatened and sensitive species by the State of New Mexico and United States Forest Service, respectively. A previous phylogeographic study of this species based on mitochondrial COI sequences delineated substantial(More)