Medication burden in the first 5 years following diagnosis of type 2 diabetes: findings from the ADDITION-UK trial cohort.

INTRODUCTION: Individuals with screen-detected diabetes are likely to receive intensified pharmacotherapy to improve glycaemic control and general cardiometabolic health. Individuals are often asymptomatic, and little is known about the degree to which polypharmacy is present both before, and after diagnosis. We aimed to describe and characterize the pharmacotherapy burden of individuals with screen-detected diabetes at diagnosis, 1 and 5 years post-diagnosis. METHODS: The prescription histories of 1026 individuals with screen-detected diabetes enrolled in the ADDITION-UK trial of the promotion of intensive treatment were coded into general medication types at diagnosis, 1 and 5 years post-diagnosis. The association between change in the count of several medication types and age, baseline 10-year UK Prospective Diabetes Study (UKPDS) cardiovascular disease (CVD risk), sex, intensive treatment group and number of medications was explored. RESULTS: Just under half of individuals were on drugs unrelated to cardioprotection before diagnosis (42%), and this increased along with a rise in the number of prescribed diabetes-related and cardioprotective drugs. The medication profile over the first 5 years suggests multimorbidity and polypharmacy is present in individuals with screen-detected diabetes. Higher modeled CVD risk at baseline was associated with a greater increase in cardioprotective and diabetes-related medication, but not an increase in other medications. CONCLUSION: As recommended in national guidelines, our results suggest that treatment of diabetes was influenced by the underlying risk of CVD. While many individuals did not start glucose lowering and cardioprotective therapies in the first 5 years after diagnosis, more information is required to understand whether this represents unmet need, or patient-centered care. TRIAL REGISTRATION NUMBER: CNT00237549.This study was supported by the Welcome Trust (grant number G061895), the Medical Research Council (Grant numbers G0001164 and MC_UU_12015/4) and the National Institute for Health Research (Grant number RP-PG-0606-1259).This is the final version of the article. It first appeared from BMJ via http://dx.doi.org/10.1136/bmjdrc-2014-00007

Kinetics of 1,2-Dimethylbenzene Oxidation and Ignition: Experimental and Detailed Chemical Kinetic Modeling

International audienceNew experimental results were obtained for the oxidation of o-xylene studied in a jet-stirred reactor (JSR) at atmospheric pressure in dilute conditions over the temperature range 900-1400 K, and variable equivalence ratio (0.5 ≤ φ ≤ 1.5). The data consisted of concentration profiles vs. temperature of the reactants, stable intermediates and final products, measured by sonic probe sampling followed by on-line GC-MS analyses and off-line GC-TCD-FID and GC-MS analyses. The ignition of o-xylene-oxygen-argon mixtures was measured behind reflected shock waves over the temperature range 1400-1830 K, at 1 atm, and variable equivalence ratio (0.5 ≤ φ ≤ 2.0), using a shock tube (ST). The oxidation and ignition of o-xylene under respectively JSR and ST conditions were modeled using a detailed chemical kinetic reaction mechanism (189 species and 1359 reactions, most of them reversible) deriving from a previous scheme proposed for the ignition, oxidation, and combustion of simple aromatics (benzene, toluene, styrene, n-propyl-benzene, m-xylene, and p-xylene). Sensitivity analyses and reaction path analyses, based on rates of reaction, were used to interpret the results. This study showed the reactivity of o-xylene is higher than that of m-xylene and p-xylene under the present

Enthalpies of formation and bond dissociation energies of lower alkyl hydroperoxides and related hydroperoxy and alkoxy radicals

The enthalpies of formation and bond dissociation energies, D(ROO-H), D(RO-OH), D(RO-O), D(R-O-2) and D(R-OOH) of alkyl hydroperoxides, ROOH, alkyl peroxy, RO, and alkoxide radicals, RO, have been computed at CBS-QB3 and APNO levels of theory via isodesmic and atomization procedures for R = methyl, ethyl, n-propyl and isopropyl and n-butyl, tert-butyl, isobutyl and sec-butyl. We show that D(ROO-H) approximate to 357, D(RO-OH) approximate to 190 and D(RO-O) approximate to 263 kJ mol(-1) for all R, whereas both D(R-OO) and D(R-OOH) strengthen with increasing methyl substitution at the cc-carbon but remain constant with increasing carbon chain length. We recommend a new set of group additivity contributions for the estimation of enthalpies of formation and bond energies

Spatial stability of Avena sterilis ssp. ludoviciana populations under annual applications of low rates of imazamethabenz

9 páginas, ilustraciones y tablas estadísticas.Long-term experiments were conducted in two winter barley fields in central Spain to determine the spatial stability of Avena sterilis ssp. ludoviciana populations under annual applications of low rates of imazamethabenz herbicide. Weed density was sampled every year (over 5 years in the first field and over 3years in the second) on the same grid locations prior to herbicide application. Although weed patches were stable in their location, weed density decreased in most of the years. In the first field, the populations decreased exponentially over the 5-year period. The rates of population decline were dependent on the initial density of the population, being higher for the central core of the patches and lower for the low-density areas. Under the conditions present in this experiment, it was possible to reduce heavy weed patches (up to 1200 seedlings m)2) down to relatively safe levels (18 seedlings m)2) in a period of 3years using a density-specific control programme, applying low rates of herbicides when weed densities were below a given level (1000 seedlings m)2). However, under adverse environmental conditions, half rates of the herbicide failed to control the weed populations adequately. The stability of the location of patches of A.sterilis ssp. ludoviciana suggest that weed seedling distributions mapped in one year are good predictors of future seedling distributions. However, the actual densities established each year will depend on the control level achieved the previous year and the climatic conditions present during the establishment period.(project AGF99-1125), by the Consejerıa de Educacion of the Community of Madrid and by the European Social Programme.Peer reviewe