Predictors of ACEI/ARB therapy in patients with hypertrophic cardiomyopathy : results of a national registry

© The European Society of Cardiology 2018. All rights reserved. For Permissions, please e-mail: [email protected]: Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) are not considered disease-modifying drugs in hypertrophic cardiomyopathy (HCM) and their use is usually dependent on other clinical indications. Few data exist about the use of ACEI/ARB in HC in the real world, particularly in patients with intraventricular obstruction. Objective: In this study, we sought to determine the frequency of ACEI / ARB therapy in patients with HCM and the predictors for their use.info:eu-repo/semantics/publishedVersio

Catalytic Conversion of Glycerol to Bio-Based Aromatics

Green application of biodiesel-derived glycerol will boost biodiesel production in terms of sustainability and economics. The glycerol to liquid fuels is a promising route that provides an additional energy source, which contributes significantly to energy transition besides biodiesel. This pathway could generate alkyl-aromatic hydrocarbons with a yield of ∼60%, oxygenates, and gases. MFI Zeolites (H-ZSM-5) catalysts are mainly used to propagate the aromatization pathway. This chapter presents the pathways, challenges, catalytic design, influences of catalyst acidity, metal addition, reaction condition, and catalysts deactivation on glycerol conversion to hydrocarbon fuels and aromatics. Studies revealed that time on stream, temperature, and weight hourly space velocity (range of 0.1–1 h−1) influences the benzene, toluene, and xylene BTX and benzene, toluene, ethylbenzene, and xylene BTEX yield. Acidity of the H-ZSM-5 could be tailored by metals, additives, and binders. Bronsted acidity promotes coke formation which results in reversible deactivation of the H-ZSM-5 catalyst. It is hoped that this study will promote intensified research on the use of glycerol for purposes of fuel generating and valuable products

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Levosimendan Efficacy and Safety: 20 years of SIMDAX in Clinical Use

Levosimendan was first approved for clinic use in 2000, when authorisation was granted by Swedish regulatory authorities for the haemodynamic stabilisation of patients with acutely decompensated chronic heart failure. In the ensuing 20 years, this distinctive inodilator, which enhances cardiac contractility through calcium sensitisation and promotes vasodilatation through the opening of adenosine triphosphate-dependent potassium channels on vascular smooth muscle cells, has been approved in more than 60 jurisdictions, including most of the countries of the European Union and Latin America. Areas of clinical application have expanded considerably and now include cardiogenic shock, takotsubo cardiomyopathy, advanced heart failure, right ventricular failure and pulmonary hypertension, cardiac surgery, critical care and emergency medicine. Levosimendan is currently in active clinical evaluation in the US. Levosimendan in IV formulation is being used as a research tool in the exploration of a wide range of cardiac and non-cardiac disease states. A levosimendan oral form is at present under evaluation in the management of amyotrophic lateral sclerosis. To mark the 20 years since the advent of levosimendan in clinical use, 51 experts from 23 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Hungary, Italy, the Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, UK and Ukraine) contributed to this essay, which evaluates one of the relatively few drugs to have been successfully introduced into the acute heart failure arena in recent times and charts a possible development trajectory for the next 20 years

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Conocimiento, uso y valor cultural de seis presas del jaguar (Panthera onca) y su relación con éste, en San Nicolás de los Montes, San Luis Potosí, Mexico Knowledge, use and cultural value of six prey of jaguar (Panthera onca) and their relationship with this species in San Nicolás de los Montes, San Luis Potosí, Mexico

Durante 2007 se obtuvo información del conocimiento y la percepción que los pobladores del ejido tienen sobre el jaguar, sus presas y los factores que afectan la distribución y su conservación. Mediante el índice de importancia cultural (IIC) se determinó el conocimiento que los ejidatarios tienen de las presas, y el uso y valor que les otorgan. Las presas que reconocieron importantes fueron venado cola blanca (Odocoileus virginianus), temazate (Mazama temama), pecarí (Tayassu pecari), tejón (Nasua narica), armadillo (Dasypus novemcinctus) y tepezcuintle (Cuniculus paca); 72% de los encuestados también identificaron especies domésticas como presas del jaguar. Según su percepción, las más abundantes son pecarí, tejón y armadillo. El valor de uso más importante es el alimenticio, puesto que 82% de los encuestados ha consumido alguna especie silvestre. El valor más alto del IIC fue para el venado (27.17). En el ejido se considera perjudicial el jaguar por alimentarse del ganado. Los pobladores y los jaguares utilizan las mismas especies para obtener beneficio. El presente estudio constituye una base para el desarrollo de trabajos tendientes a manejar y conservar los recursos naturales que existen en el ejido considerando las necesidades de la población humana, de su fauna silvestre y la relación entre éstas.During 2007, we obtained information about the knowledge, perception of rural people regarding jaguar, its preys and the factors that affect its distribution and conservation. Additionally, we determined with the Index of Cultural Importance the knowledge, use and value that rural people assign to preys of the jaguar. They recognized as important prey species of the jaguar to white-tailed deer (Odocoileus virginianus), brocket (Mazama temama), pecari (Tayassu peccari), coati (Nasua narica), armadillo (Dasypus novemcinctus) and paca (Cuniculus paca). Most of the villagers (72%) identified also domestic species as preys of the jaguar. According to villager´s perception, the more abundant species were pecari, coati and armadillo. Wildlife use for food was the most important since 82% of the interviewed people have consumed some species. The highest value of Cultural Importance was for white tailed deer (27.17). Jaguars in the ejido are considered harmful animals since they prey on livestock. Rural people and jaguars benefit from same wildlife species. The present study is the framework to develop future projects focused on managing and conserving natural resources that exist in the ejido San Nicolás de los Montes, San Luis Potosí