A review of picotamide in the reduction of cardiovascular events in diabetic patients

Picotamide is an antiplatelet drug with a dual inhibitory action. Thus, picotamide inhibits both thromboxane A2 (TxA2) receptors and TxA2 synthase and, at variance with aspirin, does not interfere with endothelial prostacyclin (PGI2) production. Two large randomized trials have been performed to assess the clinical efficacy of picotamide in patients at risk of atherothrombosis. The ADEP study compared peripheral artery disease (PAD) patients randomized to picotamide or placebo. This study did not show a significant reduction of cardiovascular events by picotamide but a subgroup analysis showed its potential usefulness in patients with diabetes. To investigate this issue further, the DAVID study recently enrolled diabetic patients with PAD randomized to picotamide versus aspirin; the results showed a significant reduction of overall mortality in the picotamide group. Moreover long-term picotamide treatment in diabetes promotes the reduction of microalbuminuria and the inhibition of growth of carotid plaques. These data suggest that picotamide may represent an interesting drug to be further investigated in future trials in the atherothrombotic setting

Padrão dietético de adolescentes, adultos e idosos de Porto Alegre : comparação com dietas Mediterrânea e DASH

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Sedentarismo e padrão de atividade física em adolescentes, adultos e idosos de Porto Alegre

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A review of picotamide in the reduction of cardiovascular events in diabetic patients

OBJECTIVE Picotamide is an antiplatelet drug with a dual inhibitory action. METHOD Thus, picotamide inhibits both thromboxane A2 (TxA2) receptors and TxA2 synthase and, at variance with aspirin, does not interfere with endothelial prostacyclin (PGI2) production. Two large randomized trials have been performed to assess the clinical efficacy of picotamide in patients at risk of atherothrombosis. RESULT The ADEP study compared peripheral artery disease (PAD) patients randomized to picotamide or placebo. This study did not show a significant reduction of cardiovascular events by picotamide but a subgroup analysis showed its potential usefulness in patients with diabetes. To investigate this issue further, the DAVID study recently enrolled diabetic patients with PAD randomized to picotamide versus aspirin; the results showed a significant reduction of overall mortality in the picotamide group. CONCLUSION Moreover long-term picotamide treatment in diabetes promotes the reduction of microalbuminuria and the inhibition of growth of carotid plaques. These data suggest that picotamide may represent an interesting drug to be further investigated in future trials in the atherothrombotic setting

Carreiras e Transições de executivos bancários: caso de um banco localizado no Rio Grande do Sul

This article is the result of an exploratory research that aimed to understand the differences in the trajectories of bank executives. We interviewed nine of them employees of a private bank whose branches are located in interior of the state of Rio Grande do Sul. Individualized interviews were conducted with these professionals in their working environments. The interviews intended to deepen the knowledge about the conduct of their careers and were held in March and April of 2011. The analysis of the data was performed in a qualitative way and followed the guidelines proposed by Minayo (2001). Some differences in the trajectory of their careers were observed, which were presented in different ways because some are in the beginning of their careers, others in the middle of them and there are those who are nearing the end of their careers. The personal performance is measured throughout the journey that illustrates the construction of career, whether it is a noticeably faster construction or a slower one. It could be seen how difficult it is to promote a balance in relation to career transitions in order to obtain success. A successful career proved to be linked to mobility, to total availability to the organizational project and to readiness in the question of short term decision. It was observed to be difficult to promote a balance in relation to career transitions in order to be successful.  It is concluded that career success was related to mobility, the total availability to the organizational project and the readiness in terms of decision in the short term.Este artigo resulta de uma pesquisa exploratória que objetivou compreender as diferenças nas trajetórias de executivos bancários. Foram entrevistados nove deles, funcionários de um banco privado, cujas agências localizam-se no interior do Estado do Rio Grande do Sul. Foram realizadas entrevistas individuais, estruturadas com esses profissionais em seus ambientes de trabalho. As entrevistas visaram aprofundar o conhecimento sobre a condução de suas carreiras e foram realizadas em março e abril de 2011. A análise dos dados foi efetuada a partir da abordagem qualitativa e seguiu as orientações propostas por Minayo (2001). Observaram-se algumas diferenças na trajetória de suas carreiras, as quais se apresentaram de modo diferente, pois alguns estão no início da carreira; outros, no meio dela e há os que estão chegando ao fim de sua trajetória profissional. O desempenho pessoal é mensurado durante todo o percurso que ilustra a construção de carreira, seja ela uma construção visivelmente mais rápida, seja mais lenta. Observou-se ser difícil promover um ponto de equilíbrio em relação às transições na carreira de modo a obter sucesso. Conclui-se que o êxito na carreira mostrou-se atrelado à mobilidade, à disponibilidade total ao projeto organizacional e à prontidão no quesito decisão em curto prazo

Rare splenic complications and specific serology: decisive diagnostic tools in two cases of visceral leishmaniasis

Introduction: Visceral leishmaniasis (VL) is a major endemic vector-borne disease in Southern Europe. We present two cases of VL, both characterized by splenic complications. Methods and results: Case 1: A 47-year-old female presented with effort angina, hepatosplenomegaly and pancytopenia. The clinical course was complicated by splenic infarction. Although bone marrow biopsy failed to show amastigotes, diagnosis was performed by a fast agglutinating screening test (FAST) and confirmed by a direct agglutinating test (DAT). The patient was treated successfully with AmBisome. Case 2: A 22-year-old male who had undergone a splenectomy to treat splenic rupture related to a minor trauma four months earlier presented with fever, nocturnal sweats and weight loss. The lack of pancytopenia was due to the absence of the spleen. The first biopsy did not identify parasites, but because the FAST had been positive, another bone marrow biopsy was performed, which demonstrated leishmaniasis. This patient was treated with the same schedule of AmBisome infusion. Discussion: 1) The clinical presentation of VL can be atypical, 2) splenic complications can characterize this disease, and 3) specific serology may be an important tool to reach a diagnosis

Inhibition of platelet aggregation by aspirin progressively decreases in long-term treated patients

OBJECTIVES We sought to investigate, during a two-year follow-up period, the effects of aspirin on platelet aggregation. BACKGROUND The platelets of patients given aspirin may be less sensitive to antiplatelet treatment, although the extent of such phenomenon over long-term follow-up is unclear. METHODS Adenosine diphosphate (ADP) and collagen-induced platelet aggregation was periodically monitored before and after 2, 6, 12, and 24 months of treatment with aspirin (n = 150) or ticlopidine (n = 80) in patients matched for gender, age, and risk factors for atherothrombosis. RESULTS Compared with baseline values, two months of aspirin treatment significantly inhibited platelet aggregation; thereafter, this inhibitory effect progressively decreased. At 24-month follow-up, collagen-induced platelet aggregation was significantly higher than that observed at two months (p < 0.05); a more pronounced difference was observed when collagen-induced lag phase was considered (p < 0.01). Restoration of platelet aggregation was less evident when ADP was used as an agonist. Conversely, the inhibition induced by ticlopidine was constant throughout follow-up with both agonists. CONCLUSIONS The study demonstrates that a long-term treatment with aspirin is associated with a progressive reduction in platelet sensitivity to this drug. (C) 2004 by the American College of Cardiology Foundation