Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients

Background Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. Methods Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. Results A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). Conclusions Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218. opens in new tab.

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

Safety of intravenous ferric carboxymaltose versus oral iron in patients with nondialysis-dependent CKD: an analysis of the 1-year FIND-CKD trial.

Background: The evidence base regarding the safety of intravenous (IV) iron therapy in patients with chronic kidney disease (CKD) is incomplete and largely based on small studies of relatively short duration. Methods: FIND-CKD (ClinicalTrials.gov number NCT00994318) was a 1-year, open-label, multicenter, prospective study of patients with nondialysis-dependent CKD, anemia and iron deficiency randomized (1:1:2) to IV ferric carboxymaltose (FCM), targeting higher (400-600 µg/L) or lower (100-200 µg/L) ferritin, or oral iron. A post hoc analysis of adverse event rates per 100 patient-years was performed to assess the safety of FCM versus oral iron over an extended period. Results: The safety population included 616 patients. The incidence of one or more adverse events was 91.0, 100.0 and 105.0 per 100 patient-years in the high ferritin FCM, low ferritin FCM and oral iron groups, respectively. The incidence of adverse events with a suspected relation to study drug was 15.9, 17.8 and 36.7 per 100 patient-years in the three groups; for serious adverse events, the incidence was 28.2, 27.9 and 24.3 per 100 patient-years. The incidence of cardiac disorders and infections was similar between groups. At least one ferritin level ≥800 µg/L occurred in 26.6% of high ferritin FCM patients, with no associated increase in adverse events. No patient with ferritin ≥800 µg/L discontinued the study drug due to adverse events. Estimated glomerular filtration rate remained the stable in all groups. Conclusions: These results further support the conclusion that correction of iron deficiency anemia with IV FCM is safe in patients with nondialysis-dependent CKD

Scanning and decoding car’s wheels codes during production process

W artykule przedstawiono sposób realizacji odczytu kodów felg samochodowych. Opracowane stanowisko zostało wdrożone przez pracowników Przemysłowego Instytutu Automatyki i Pomiarów PIAP w zakładach firmy ATS Stahlschmidt & Maiworm w Stalowej Woli. W artykule omówiono zastosowane algorytmy identyfikacji kodów oraz przedstawiono problemy, jakie napotkano podczas realizacji tej pracy.This article presents station for scanning codes of car’s wheels, which was built by Industrial Research Institute for Automation and Measurements PIAP for ATS plant in Stalowa Wola. It includes information about algorithms used for identification and discusses some problems during realization of this work

Selection and Software Implementation of Palletizing Schemes for Bags with Loose Contents Made by an Industrial Robot

W artykule opisano uniwersalny algorytm sterowania robotem przemysłowym paletyzującym worki z luźną zawartością. Algorytm ten zastosowano w zrobotyzowanej linii naważania i paletyzacji worków z cukrem w Cukrowni Nakło. Przedstawiono powody, dla których zdecydowano się na takie rozwiązanie, opisano sposób definiowania narzędzi, układów współrzędnych użytkownika i punktów referencyjnych, wykorzystywanych w aplikacji. Przedstawiono sposób przygotowania danych umozliwiających paletyzację dwóch rodzajów worków układanych zgodnie z dwoma różnymi schematami paletyzacji.The article describes a universal algorithm for controlling an industrial robot that performs the palletization of bags with loose content. This algorithm was used in a robotic line of weighing and palletizing sugar bags in the Sugar Factory Nakło on Noteć River. It presents the reasons why this solution was decided, describes how the tools, user coordinate systems and reference points used in the application were defined. The paper presents the method of preparation of data enabling the palletization of two types of bags arranged in accordance with two different palletizing schemes

Software Solutions in the Control Systems of Advanced Vision Applications

W artykule zawarto informacje o rozwiązaniach softwarowych zastosowanych w sterowaniu zaawansowanymi aplikacjami wizyjnymi dla przemysłu samochodowego, jakie zrealizowano w Przemysłowym Instytucie Automatyki i Pomiarów PIAP w Warszawie. Opisano kryteria wyboru oprogramowania wizyjnego, wymagany format obsługiwany przez programy wizyjne, sposób uruchamiania ich w trybie pracy automatycznej oraz definiowania sposobu interpretacji ich wyników i formatowania raportu końcowego. Przedstawiono dwie metody indywidualnego konfigurowania kontroli wizyjnych złożonych wyrobów, w zależności od zastosowanego układu sterowania. Omówiono opis współpracy aplikacji sterującej wykonywaniem kontroli wizyjnych a robotem przemysłowym zastosowanym do przemieszczania kamery w jednej z przedstawionych aplikacji.The article contains information about the software solutions used in the control of advanced vision applications for the automotive industry realized in the Industrial Research Institute for Automation and Measurements PIAP. Author describes what criteria guided the selection of vision software, what must be the format of vision programs, how they are run in automatic mode, andhow to define the interpretation of the results and a final report format. Two methods of configuring individual vision control of complex product depending on the control system used are presented. The article contains a description of the cooperation between the application controlled vision programs with industrial robot used to move the camera in one of the submitted application

Hardware and software solutions in the control of rehabilitation robots Renus

W artykule opisano sposób realizacji sterowania oraz rozwiązań software’owych wykorzystanych podczas opracowywania dwóch robotów Renus-1 i Renus-2, przeznaczonych do wspomagania rehabilitacji ruchowej pacjentów po przebytych udarach mózgu lub ze schorzeniami ortopedycznymi. Sterowanie obu robotów wykonano na bazie komercyjnych elementów firmy Mitsubishi Electric stosowanych w automatyce przemysłowej. Ich wykorzystanie umożliwiło zbudowanie w pełni funkcjonalnych modeli obu robotów w stosunkowo krótkim czasie. W artykule przedstawiono strukturę układu sterowania i rozwiązania software’owe zastosowane przy opracowaniu oprogramowania obu robotów. Opisano interfejs użytkownika człowiek–robot zarówno dla pacjenta, jak i operatora-fizjoterapeuty. Opis interfejsu zilustrowano obrazami okien dialogowych. Roboty Renus-1 i Renus-2 opracowano i wykonano w Przemysłowym Instytucie Automatyki i Pomiarów PIAP w Warszawie.This paper descibes how the control and software solutions in the Renus 1 and Renus 2 robots for support patients after strokes and orthopedic diseases were implemented. Control of both robots was performed on the basis of commercial elements of Mitsubishi Electric used in industrial automation. Their use has allowed to build a fully functional models of the two robots in a relatively short time. The paper presents the structure and control software solutions used in developing software both robots. Describes the user interface human–robot for both the patient and the operator – a physiotherapist. Interface description is illustrated by the prints screens. Both devices Renus have been developed in the Industrial Research Institute for Automation and Measurements