Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

WALANT–Epinephrine injection may lead to short term, reversible episodes of critical oxygen saturation in the fingertips

Introduction!#!Although the WALANT technique's long-term safeness has been demonstrated in many studies, there are only few data investigating its short-term effects on tissue perfusion and oxygen levels. It was hypothesized that, temporarily, critical levels of tissue perfusion may occur.!##!Methods!#!Seventeen patients, who were scheduled for different procedures in WALANT technique, were injected with 5-7 ml of 1% Articain containing 1:200,000 epinephrine at the finger base. Capillary-venous oxygen saturation, hemoglobin volume in the capillaries, and relative blood flow in the fingertips were recorded once per second by white light spectrometry and laser Doppler flowmetry before, during and after injection for an average of 32 min.!##!Results!#!Clinically, no persistent tissue malperfusion was observed, and there were no postoperative complications. Capillary-venous oxygen saturation was reduced by ≥ 30% in seven patients. Critical levels of oxygen saturation were detected in four patients during 13 intervals, each lasting for 132.5 s on average. Oxygen saturation returned to noncritical values in all patients by the end of the observation period. Blood flow in the fingertips was reduced by more than 30% in nine patients, but no critical levels were observed, as with the hemoglobin. Three patients demonstrated a reactive increase in blood flow of more than 30% after injection.!##!Conclusions!#!Injection of tumescent local anesthesia containing epinephrine into finger base may temporarily cause a substantial reduction in blood flow and lead to critical levels of oxygen saturation in the fingertips. However, this was fully reversible within minutes and does not cause long-term complications

Plasma-source ion implantation compared with glow-discharge plasma nitriding of stainless steel

Plasma-source ion implantation (PSII) is a promising technology to overcome the line-of-sight limitations of beam-line ion implantation. Among the possible fields of commercial use, nitriding of stainless steels by plasma-source ion implantation seems to be one of the favourites. However, the technology of glow-discharge plasma nitriding (GDPN) is already being used commercially. Therefore, it remains to be determined whether PSII is more suitable to the demands of an industrial technology than GDPN. In particular, the incorporation rate of nitrogen during treatment has to be investigated, as the incorporation rate of nitrogen determines the depth of the nitrided layer for a given treatment time. For nitriding of stainless steel, PSII and GDPN were performed for the same treatment time of 2 h, using the same treatment voltage (700 V) and duty ratio (50%) during the nitriding process. The temperature during treatment was fixed at 380 °C and controlled by an isolated thermocouple. The only difference in the experimental conditions was the pressure, during treatment, of 0.1 Pa in the case of PSII and 500 Pa in the case of GDPN. Pure nitrogen as well as a nitrogen-hydrogen mixture was used as the feed gas. The resulting concentration profiles were determined by glow-discharge optical spectroscopy depth profiling to determine the nitrogen incorporation rate of both nitriding techniques. The surface properties were investigated by wear and hardness measurements. Both technologies yield the formation of a hard nitrided layer with an increased hardness. The highest nitrogen concentration and widest hardened layer was found in the case of PSII, using a nitrogen-hydrogen plasma

Betrieb eines Texturdiffraktometers hoher Aufloesung (Spektrometer NSWR am Impulsreaktor IBR-2 im VIK Dubna) Schlussbericht

In 1996 the neutron time-of-flight diffractometer NSWR was used as a compound instrument for the quantitative texture analysis of geological samples especially in national and international cooperation. First time the NSWR was integrated in the proposal system of FLNF in the JINR Dubna. There were investigated the texture of quartzites, marbles, carbonates, granulites, xenolithes, pyrophyllites, Olioklas, amphibiolites and of materials. At the stress measuring instrument Epsilon the test investigations were finished and routine investigations of materials were started. Apparative and methodical developments: - closing of the construction of the new detector arrangement SKAT for increase the accuracy and the efficiency of the texture measurements -improvement of the stress measurement instrument Epsilon - development of control- and interpretation software for - the operating of the detector arrangement SKAT - the additional secand detector of Epsilon - the compatibility of the interpretation software in the FLNF of the JINR Dubna and the texture instrument TEX-2 at the GKSS Geesthacht. (orig.)SIGLEAvailable from TIB Hannover: DtF QN1(58,21) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman

Auswirkungen der Softwaregestaltung Vorstudie zur Technikfolgenabschaetzung

Available from TIB Hannover: F94B530+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman

Comparison of Different Approaches To Quantify Staphylococcus aureus Cells by Real-Time Quantitative PCR and Application of This Technique for Examination of Cheese

Two different real-time quantitative PCR (RTQ-PCR) approaches were applied for PCR-based quantification of Staphylococcus aureus cells by targeting the thermonuclease (nuc) gene. Purified DNA extracts from pure cultures of S. aureus were quantified in a LightCycler system using SYBR Green I. Quantification proved to be less sensitive (60 nuc gene copies/μl) than using a fluorigenic TaqMan probe (6 nuc gene copies/μl). Comparison of the LightCycler system and the well-established ABI Prism 7700 SDS with TaqMan probes revealed no statistically significant differences with respect to sensitivity and reproducibility. Application of the RTQ-PCR assay to quantify S. aureus cells in artificially contaminated cheeses of different types achieved sensitivities from 1.5 × 10(2) to 6.4 × 10(2) copies of the nuc gene/2 g, depending on the cheese matrix. The coefficients of correlation between log CFU and nuc gene copy numbers ranged from 0.979 to 0.998, thus enabling calculation of the number of CFU of S. aureus in cheese by performing RTQ-PCR