Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Structural and heat-insulating foam concrete of non-autoclaved hardening based on microsilica

The article presents testing results of non-autoclave structural and heat-insulating foam concrete, made on the basis of astringents of different grades and with different fillers. It has been experimentally established that the best filler for foam concrete is microsilica due to its high specific surface area and low bulk density in comparison with the sand. The use of high-quality binders in foam concrete mixtures allows to increase not only the strength of foam concrete, but also the content of microsilica up to 70% with respect to mixtures at lower brands of Portland cement

Structural and heat-insulating foam concrete of non-autoclaved hardening based on microsilica

The article presents testing results of non-autoclave structural and heat-insulating foam concrete, made on the basis of astringents of different grades and with different fillers. It has been experimentally established that the best filler for foam concrete is microsilica due to its high specific surface area and low bulk density in comparison with the sand. The use of high-quality binders in foam concrete mixtures allows to increase not only the strength of foam concrete, but also the content of microsilica up to 70% with respect to mixtures at lower brands of Portland cement

Light fine-grained fibrous concrete for small architectural forms

The selection of the composition of a highly mobile concrete mixture for manufacturing small architectural forms has been performed, and the strength characteristics of light fine-grained fibrous concrete have been studied. It has been experimentally established that the optimal ratio of the Portland cement to microsilica is 1: 1. The introduction of basalt fiber in the amount of 0.5% of the mass of solids contributes to the increase in bending strength of fine-grained concrete to 70%

Doubly Protonated Species Collision Induced Dissociation for Identification of Isocyclosporins

Nonribosomal cyclopeptide cyclosporin A (CsA), produced by fungus Tolypocladium inflatum, is an extremely important immunosuppressive drug used in organ transplantations and for therapy of autoimmune diseases. Here we report for the first time production of CsA, along with related cyclosporins B and C, by Tolypocladium inflatum strains of marine origin (White Sea). Cyclosporins A–C contain an unusual amino acid, (4R)-4-((E)-2-butenyl)-4,N-dimethyl-l-threonine (MeBmt), and are prone to isomerization to non-active isocyclosporine by N→O acyl shift of valine connected to MeBmt in acidic conditions. CsA and isoCsA are not distinguishable in MS analysis of [M+H]+ ions due to the rapid [CsA+H]+→[isoCsA+H]+ conversion. We found that the N→O acyl shift is completely suppressed in cyclosporine [M+2H]2+ ions, and their MS/MS fragmentation can be used for rapid and unambiguous analysis of cyclosporins and isocylosporins. The fragmentation patterns of [CyA+2H]2+ and [isoCyA+2H]2+ ions were analyzed and explained. The developed approach could be useful for MS analysis of other peptides containing β-hydroxy-α-amino acids

Vaccinal Prevention of the Diseases Caused by Human Papillomavirus: Evidence-Based Medicine. Review of Clinical Guidelines

The article is devoted to the urgent problem of papillomavirus infection, the extremely high prevalence of which determines the key contribution to the structure of morbidity and mortality from oncological diseases. A chronic persistent course, resulting in benign and malignant tumors in the infection atrium, makes scientists seek new ways of treatment. A specific vaccinal prevention is recognized to be the only reliable protection method today. The article is an updated review of the clinical guidelines developed and approved by the professional association «Union of Pediatricians of Russia» in 2016 for a vaccinal prevention of the diseases caused by human papillomavirus, first published on pediatr-russia.ru. The widespread introduction of vaccines against human papillomavirus, which have confirmed the clinical efficacy and safety, can significantly reduce the global burden of diseases associated with papillomavirus infection

Cause of death and predictors of all-cause mortality in anticoagulated patients with nonvalvular atrial fibrillation: Data from ROCKET AF

Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intentionto- treat population. The median age was 73 years, and the mean CHADS2 score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P<0.0001) and age 6575 years (hazard ratio 1.69, 95% CI 1.51-1.90, P<0.0001) were associated with higher all-cause mortality. Multiple additional characteristics were independently associated with higher mortality, with decreasing creatinine clearance, chronic obstructive pulmonary disease, male sex, peripheral vascular disease, and diabetes being among the most strongly associated (model C-index 0.677). Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, 487 in 10 deaths were cardiovascular, whereas <1 in 10 deaths were caused by nonhemorrhagic stroke or systemic embolism. Optimal prevention and treatment of heart failure, renal impairment, chronic obstructive pulmonary disease, and diabetes may improve survival