Aloysia citriodora Palau

Aloysia citriodora Palau, cedron or lemon verbena, is a South American aromatic species widespread in North America, Eurasia, and Africa. It is appreciated because it therapeutic and food (condiment, flavoring) uses. Also is valued as ornamental, insect repellent, and sometimes in perfumery. Its popular culinary and medicinal uses have been expanded from Latin America to the rest of the Western world. Its main active constituents are essential oils, to which owes its aroma and flavor similar to lemon, but also contain flavonoids, verbascosides, iridoids heterosides, and others. It most disseminated uses in folk medicine include those to treat gastrointestinal disorders (digestive, antispasmodic, carminative, antidiarrheal), mild sedative, cardiotonic, febrifuge, analgesic, and antiseptic. Various experimental studies validate different effects, as eupeptic, spasmolytic, antimicrobial, anti-inflammatory, analgesic, hypotensive, among others. Its sedative/anxiolytic activity requires deeper further studies. Of particular interest are its cancer-related effects analyzed to date (antimutagenic, antigenotoxic, and antiangiogenic), and its antioxidant activity linked in various ways to our health.Fil: Hurrell, Julio Alberto. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Etnobotánica y Botánica Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentin

Evolocumab and clinical outcomes in patients with cardiovascular disease

BACKGROUND Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. METHODS We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years. RESULTS At 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P<0.001). Relative to placebo, evolocumab treatment significantly reduced the risk of the primary end point (1344 patients [9.8%] vs. 1563 patients [11.3%]; hazard ratio, 0.85; 95% confidence interval [CI], 0.79 to 0.92; P<0.001) and the key secondary end point (816 [5.9%] vs. 1013 [7.4%]; hazard ratio, 0.80; 95% CI, 0.73 to 0.88; P<0.001). The results were consistent across key subgroups, including the subgroup of patients in the lowest quartile for baseline LDL cholesterol levels (median, 74 mg per deciliter [1.9 mmol per liter]). There was no significant difference between the study groups with regard to adverse events (including new-onset diabetes and neurocognitive events), with the exception of injection-site reactions, which were more common with evolocumab (2.1% vs. 1.6%). CONCLUSIONS In our trial, inhibition of PCSK9 with evolocumab on a background of statin therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. These findings show that patients with atherosclerotic cardiovascular disease benefit from lowering of LDL cholesterol levels below current targets