Increase in mortality rate following coprescription of cisapride and contraindicated drugs

BACKGROUND: No epidemiologic study, as of this writing, has been published on the use of cisapride with contraindicated drugs and its relation to mortality rates in a population-based setting. OBJECTIVE: To estimate the prevalence of concomitant use of cisapride with contraindicated drugs and evaluate the association between this and the risk of mortality. METHODS: Claims data were obtained from the Health Insurance Review Agency of Korea. The study population consisted of patients younger than 85 years who visited clinics or hospitals in the city of Busan as new users of cisapride between November 1, 2000, and April 30, 2002. The coprescription of cisapride was defined as prescribing cisapride with one or more contraindicated drugs with the same prescription. Nationwide mortality data were also used. The prevalence of coprescribing cisapride was estimated and the association between this and the risk of mortality was assessed by rate ratios (RRs). The RRs were estimated using Cox's regression model with time-dependent covariate, adjusted for age, sex, and comorbidities. RESULTS: A total of 36,865 patients out of 56,012 claims were newly prescribed cisapride; of these, 1175 patients (3.2%) were concomitantly prescribed at least one contraindicated drug, which suggested adjusted mortality RRs of 14.08 (95% CI 7.41 to 26.76) for recent users and 1.33 (95% CI 0.92 to 1.93) for past users of cisapride. CONCLUSIONS: Despite the discontinuation of the drug's commercial marketing, cisapride was still in use in clinics and hospitals in Busan. In many cases, cisapride was co-prescribed with contraindicated drugs, which is associated with increased mortality rates

FESD: a Functional Element SNPs Database in human

We have created the Functional Element SNPs Database (FESD) that categorizes functional elements in human genic regions and provides a set of single nucleotide polymorphisms (SNPs) located within each area. In the FESD, the human genic regions were divided into 10 different functional elements, such as promoter regions, CpG islands, 5′-untranslated regions (5′-UTRs), translation start sites, splice sites, coding exons, introns, translation stop sites, polyadenylation signals and 3′-UTRs, and subsequently, all the known SNPs were assigned to each functional element at their respective position. With the FESD web interface, users can select a set of SNPs in the specific functional elements and get their flanking sequences for genotyping experiments, which will help in finding mutations that contribute to the common and polygenic diseases. A web interface for the FESD is freely available at http://combio.kribb.re.kr/ksnp/resd/

Thermal Effects of Microwave Reduced-Graphene-Oxide Coated Polyester Fabric on a Simulated Human Skin in Cool and Neutral Air Temperatures

Batteryless wearable technology has wide applications. In particular, human body surface temperature controlling fabrics can help regulate skin temperature in heat or cold. This study investigated surface temperature distribution of the fabrics coated with reduced graphene oxide (rGO) on simulated human body skin conditions at 18 degrees C (cool) and 27 degrees C (neutral) ambient air temperatures. Polyester fabrics were spin-coated with a graphene-oxide (GO) solution of 0.2 wt%. Preparation of rGO was processed by using a microwave oven (MW-rGO). Non-treated fabric (CON) was compared to GO and MW-rGO. The surface temperature of a hot plate was maintained at 35 degrees C or 40 degrees C. The test fabrics were put on the heated hot plate or non-heated-outer portions of the hot plate. Surface temperatures of MW-rGO on the heated hot plate at an air temperature of 18 degrees C (cool) were higher than those of non-treated fabric (CON) under the same conditions (p < 0.01). No effects from the graphene treatment were found on non-heated portions of the graphene oxide fabric (GO) or the reduced graphene oxide fabric (MW-rGO). On the non-heated portions, surface temperatures were higher at the location closer to the hot plate compared to the location farther from the hot plate (p < 0.05). These results partially represent thermal effects of MW-rGO under a specific environment and heat source. Our findings enable an application of reduced graphene oxide to body temperature regulating clothing.

Nonaspirin nonsteroidal anti-inflammatory drugs and hemorrhagic stroke risk: the Acute Brain Bleeding Analysis study

BACKGROUND AND PURPOSE: The relationship between nonaspirin nonsteroidal anti-inflammatory drugs (NANSAIDs) and hemorrhagic stroke (HS) remains unclear. We examined the risk of HS associated with the use of NANSAIDs in Koreans. METHODS: We performed a nationwide, multicenter case-control study from 2002 to 2004. This study included 940 nontraumatic acute HS cases in patients aged 30 to 84 years, with an absence of a history of stroke or hemorrhage-prone brain lesions, alongside 940 community controls, matched to each case by age and sex. Pretrained interviewers obtained information on prescription drugs as well as over-the-counter drugs taken within 14 days before the onset of stroke. We adjusted potential confounders, including family histories of stroke, histories of hypertension, smoking, alcohol consumption, high salt intake, and laborious work hours. The adjusted ORs and their 95% CIs were calculated by conditional logistic regression. RESULTS: The proportion of NANSAIDs exposure within 14 days was 2.9% for HS patients and 2.0% for the controls. The adjusted odds ratios of stroke in NANSAIDs users compared with nonusers was 1.12 (95% CI, 0.77 to 1.65) for all HS, 1.03 (95% CI, 0.49 to 2.18) for subarachnoid hemorrhage, and 1.19 (95% CI, 0.76 to 1.87) for intracerebral hemorrhage. CONCLUSIONS: No increased risk of HS either subarachnoid hemorrhage or intracerebral hemorrhage was found among NANSAIDs users.This study was partially supported by the Korean Food and Drug Administration

WATCHFUL OBSERVATION VERSUS EARLY AORTIC VALVE REPLACEMENT FOR SYMPTOMATIC PATIENTS WITH LOW-GRADIENT SEVERE AORTIC STENOSIS AND PRESERVED EJECTION FRACTION

Brief Communications Arising: arising from X. Dong, B. Milholland & J. Vijg Nature 538, 257–259 (2016); doi:10.1038/nature19793. Comments by: Beer, J.A.A. de, Bardoutsos, A. & Janssen, F. (2017)

The origin of proinflammatory cytokines in patients with idiopathic dilated cardiomyopathy.

Proinflammatory cytokines and their receptors are increased in the peripheral blood of patients with heart failure. We measured cytokines and their receptors in systemic artery (SA), coronary sinus (CS) and infra-renal inferior vena cava (IVC), in order to investigate their origin and influential factors. Thirty patients with idiopathic dilated cardiomyopathy were performed echocardiography at admission, and right heart catheterization after stabilization. Blood was drawn from 3 sites for measurement of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and soluble tumor necrosis factor-alpha receptor (sTNFR) I, II. TNF-alpha at CS (3.25 +/- 0.34 pg/mL) was higher than those of SA (1.81 +/- 0.39 pg/mL) and IVC (1.88 +/- 0.38 pg/mL, p<0.05). IL-6 at CS (18.3 +/- 3.8 pg/mL) was higher than that of SA (5.8 +/- 1.2 pg/mL, p<0.01). The levels of sTNFR I, II showed increasing tendency in sequence of SA, IVC and CS. TNF-alpha and sTNFR I, II from all sites were proportional to worsening of functional classes at admission (p<0.05). E/Ea by Doppler study at admission, which reflects left ventricular end-diastolic pressure (LVEDP) was positively correlated with TNF-alpha from SA (R=0.71, p<0.01), CS (R=0.52, p<0.05) and IVC (R=0.46, p<0.05). Thus, elevated LVEDP during decompensation might cause cytokine release from myocardium in patients with idiopathic dilated cardiomyopathy