Embracing the polypill as a cardiovascular therapeutic: is this the best strategy?

INTRODUCTION: Cardiovascular disease (CVD) is an important cause of mortality and morbidity worldwide. CVD morbidity and mortality are associated with significant financial costs related to hospitalization, medication, and lost productivity. The concept of the 'polypill' for the reduction of cardiovascular risk was proposed in 2000. A polypill is a fixed combination of drugs in a single tablet or capsule. The initial polypill consisted of three different classes of antihypertensive drugs (each at half dose), in addition to aspirin, a statin, and folic acid. The challenge today is to produce polypills containing drugs with established efficacy and complementary actions. Areas covered: The authors provide their expert perspectives on the polypill and consider the randomized clinical trials that have evaluated the safety, efficacy, adherence, and cost-effectiveness of polypills. Expert opinion: The polypill makes prescribing easier by reducing the need for complex treatment algorithms and dose titration. It also appears to be cost-effective. However, there are several issues that need to be addressed before the polypill can be used routinely. A single polypill formulation may not be suitable for all patients. It may be necessary to develop several types of polypill to meet the needs of different patient groups

Dispersion management in nonlinear photonic crystal fibres with nanostructured core

The subwavelength structure of the core of a photonic crystal fibre can modify its dispersion characteristic and significantly shift the zero dispersion wavelength. The dispersion properties of photonic crystal fibres with core structures made of a 2D lattice of subwavelength air holes and various glass inclusions are studied. We show that a modification of the core structure can give flat dispersion over a range of over 300 nm and can shift the zero dispersion wavelength over 700 nm while the core diameter and photonic cladding remain unchanged. The developed photonic crystal fibre with nanorod core has successfully demonstrated supercontinuum generation in NIR

Primary bony non-Hodgkin lymphoma of the cervical spine: a case report

<p>Abstract</p> <p>Introduction</p> <p>Non-Hodgkin lymphoma primarily originating from the bone is exceedingly rare. To our knowledge, this is the first report of primary bone lymphoma presenting with progressive cord compression from an origin in the cervical spine. Herein, we discuss the unusual location in this case, the presenting symptoms, and the management of this disease.</p> <p>Case presentation</p> <p>We report on a 23-year-old Caucasian-American man who presented with two months of night sweats, fatigue, parasthesias, and progressive weakness that had progressed to near quadriplegia. Magnetic resonance (MR) imaging demonstrated significant cord compression seen primarily at C7. Surgical management, with corpectomy and dorsal segmental fusion, in combination with adjuvant chemotherapy and radiation therapy, halted the progression of the primary disease and preserved neurological function. Histological analysis demonstrated an aggressive anaplastic large cell lymphoma.</p> <p>Conclusion</p> <p>Isolated primary bony lymphoma of the spine is exceedingly rare. As in our case, the initial symptoms may be the result of progressive cervical cord compression. Anterior corpectomy with posterolateral decompression and fusion succeeded in preventing progressive neurologic decline and maintaining quality of life. The reader should be aware of the unique presentation of this disease and that surgical management is a successful treatment strategy.</p

Evaluation of spatial-temporal variations and trends in surface water quality across a rural-suburban-urban interface

Water quality degradation is often a severe consequence of rapid economic expansion in developing countries. Methods to assess spatial-temporal patterns and trends in water quality are essential for guiding adaptive management efforts aimed at water quality remediation. Temporal and spatial patterns of surface water quality were investigated for 54 monitoring sites in the Wen-Rui Tang River watershed of eastern China to identify such patterns in water quality occurring across a rural-suburban-urban interface. Twenty physical and chemical water quality parameters were analyzed in surface waters collected once every 4-8 weeks from 2000 to 2010. Temporal and spatial variations among water quality parameters were assessed between seasons (wet/dry) and among major land use zones (urban/suburban/rural). Factor analysis was used to identify parameters that were important in assessing seasonal and spatial variations in water quality. Results revealed that parameters related to organic pollutants (dissolved oxygen (DO), chemical oxygen demand (manganese) (COD(Mn)), and 5-day biochemical oxygen demand (BOD₅)), nutrients (ammonia nitrogen (NH₄ ⁺-N), total nitrogen (TN), total phosphorus (TP)), and salt concentration (electrical conductivity (EC)) were the most important parameters contributing to water quality variation. Collectively, they explained 70.9 % of the total variance. A trend study using the seasonal Kendall test revealed reductions in COD(Mn), BOD₅, NH₄ ⁺-N, petrol, V-phen, and EC concentrations over the 11-year study period. Cluster analysis was employed to evaluate variation among 14 sampling sites representative of dominant land use categories and indicated three, three, and four clusters based on organic, nutrient, and salt water quality characteristics, respectively. Factors that are typically responsible for water quality degradation (including population, topography, and land use) showed no strong correlation with water quality trends implying considerable point source inputs in the watershed. The results of this study help inform ongoing water quality remediation efforts by documenting trends in water quality across various land use zones