Defining the Place of Ezetimibe/Atorvastatin in the Management of Hyperlipidemia

Statin-ezetimibe combinations are a potentially advantageous therapeutic option for high-risk patients who need additional lowering of low-density lipoprotein cholesterol (LDL-C). These combinations may overcome some of the limitations of statin monotherapy by blocking both sources of cholesterol. Recently, a fixed-dose combination with atorvastatin, one of the most extensively studied statins, was approved and launched in several countries, including the USA. Depending on atorvastatin dose, this combination provides LDL-C reductions of 50-60%, triglyceride reductions of 30-40%, and high-density lipoprotein cholesterol (HDL-C) increases of 5-9%. Studies comparing the lipid-lowering efficacy of the atorvastatin-ezetimibe combination with the alternatives of statin dose titration or switching to a more potent statin consistently showed that combination therapy provided greater LDL-C reduction, translating into a greater proportion of patients achieving lipid goals. Simvastatin-ezetimibe combinations have been shown to reduce the incidence of major atherosclerotic events in several clinical settings to a magnitude that seems similar to that observed with statins for the same degree of absolute LDL-C lowering. The atorvastatin-ezetimibe combination has also been shown to induce the regression of coronary atherosclerosis measured by intravascular ultrasound in a significantly greater proportion of patients than atorvastatin alone. Atorvastatin-ezetimibe combinations are generally well tolerated. Previous concerns of a possible increase in the incidence of cancer with ezetimibe were dismissed in large trials with long follow-up periods. In this paper, we examine the rationale for an atorvastatin-ezetimibe combination, review the evidence supporting it, and discuss its potential role in the management of dyslipidemia.info:eu-repo/semantics/acceptedVersio

Roaming service for electric vehicle charging using blockchain-based digital identity

We present a suitable approach to address the electric vehicle charging roaming problem (e-roaming). Blockchain technologies are applied to support the identity management process of users charging their vehicles and to record energy transactions securely. At the same time, off-chain cloud-based storage is used to record the transaction details. A user wallet settled on a mobile application stores user verified credentials; a backend application in the vehicle charging station validates the user credentials to authorize the energy transaction. The current model can be applied to similar contexts where the user may be required to keep several credentials from different providers to authenticate digital transactions.info:eu-repo/semantics/publishedVersio

Avaliação de cultivares de aveia branca em Dourados, MS, no período de 2002 a 2004.

A aveia branca é uma importante espécie para produção de grãos e forragens no período de outono/inverno, mas é pouco cultivada em Mato Grosso do Sul. Identificar e indicar cultivares com boa adaptação às condições edafoclimáticas da Região Sul de Mato Grosso do Sul podem contribuir para a expansão da área semeada com este cereal.bitstream/item/38722/1/BP200631.pdfDocumento on-line

Avaliação de cultivares de triticale em Dourados, MS, no período de 2002 a 2004.

O triticale, híbrido natural entre o trigo e o centeio, é uma importante espécie para produção de grãos para consumo humano e animal, além de palha para a cobertura do solo, mas é pouco cultivado no período outono/inverno em Mato Grosso do Sul. Identificar e indicar cultivares com boa adaptação às condições edafoclimáticas da Região Sul de Mato Grosso do Sul podem contribuir para a Expansão da área semeada com este cereal.bitstream/item/38724/1/BP200632.pdfDocumento on-line