The climate deception dossiers: internal fossil fuel industry memos reveal decades of corporate disinformation

This report presents seven “deception dossiers”—collections containing some 85 internal company and trade association documents that have either been leaked to the public, come to light through lawsuits, or been disclosed through Freedom of Information Act (FOIA) requests. While many of these documents have been analyzed by others (Oreskes 2011; Oreskes and Conway 2010; Gelbspan 1998), these dossiers offer the most complete and up-to-date collection yet available. Excerpts of the documents are provided in the report’s appendices; the complete dossiers—totaling some 336 pages— are available online. Each collection of internal documents reviewed here reveals a separate glimpse of a coordinated campaign underwritten by the world’s major fossil fuel companies and their allies to spread climate misinformation and block climate action. The campaign began decades ago and continues today. The fossil fuel industry—like the tobacco industry before it—is noteworthy for its use of active, intentional disinformation and deception to support its political aims and maintain its lucrative profits. The following case studies show that: Fossil fuel companies have intentionally spread climate disinformation for decades. The roots of the fossil fuel companies’ deception and disinformation run deep. Internal documents dating back to the early 1990s show a series of carefully planned campaigns of deception organized by companies and by trade groups representing the industry. As the scientific evidence concerning climate change became clear, some of the world’s largest carbon producers—including BP, Chevron, ConocoPhillips, ExxonMobil, Peabody Energy, and Shell—developed or participated in campaigns to deliberately sow confusion and block policies designed to reduce the heat-trapping emissions that cause global warming. Fossil fuel company leaders knew that their products were harmful to people and the planet but still chose to actively deceive the public and deny this harm. The letters, memos, and reports in the dossiers show that company executives have known for at least two decades that their products—coal, oil, and natural gas—cause harm to people and the climate. The campaign of deception continues today. With documents made public as recently as 2014 and 2015, the evidence is clear that a campaign of deception about global warming continues to the present. Today, most major fossil fuel companies acknowledge the main findings of climate science. Many even say they support policies to cut emissions. And yet, some of these same companies continue to support groups that spread misinformation designed to deceive the public about climate science and climate policy

A Randomized Comparison of High Clopidogrel Loading Doses in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes The ALBION (Assessment of the Best Loading Dose of Clopidogrel to Blunt Platelet Activation, Inflammation and Ongoing Necrosis) Trial

ObjectivesWe sought to compare the antiplatelet effects of three clopidogrel loading doses (LDs).BackgroundAdministration of a 300-mg clopidogrel LD is beneficial in situations requiring rapid platelet inhibition. Whether higher LDs can provide further benefits remains unknown.MethodsPatients (n = 103) with non–ST-segment elevation acute coronary syndromes were randomized to receive a 300-mg, 600-mg, or 900-mg clopidogrel LD, given on top of other standard therapy (including acetylsalicylic acid). The main outcome measure was inhibition of adenosine diphosphate-induced inhibition of platelet aggregation (IPA); inhibition of platelet activation, inflammatory markers, troponin I release, and major adverse cardiac events also were evaluated; all measures were blindly evaluated.ResultsCompared with the 300-mg LD, greater doses were associated with significantly greater platelet inhibition, with dose-effect relationships observed for onset of action, maximal plateau, 24-h areas under the curves of IPA, and rates of low IPA (<10% at 6 h), using 20 μmol/l major adverse cardiac events. A significant dose-response was also observed for the vasodilator-stimulated phosphoprotein index, a measure of P2Y12receptor inhibition. Similar but nonsignificant trends were observed for troponin release and major adverse cardiac events. Bleeding rates were similar in each group.ConclusionsIn low-to-moderate risk patients with non–ST-elevation acute coronary syndromes, clopidogrel LDs >300 mg provide a faster onset of action, a higher IPA plateau, and greater reductions in platelet activation during the first 24 h. A 900-mg LD may induce a greater antiplatelet effect than 600 mg, when compared with the standard 300-mg regimen. These findings require further clinical confirmation

019 Interest of the SYNTAX Score to predict cardiovascular outcomes after stenting of unprotected left main coronary artery stenosis: 2 Years Follow-up of the ALMA registry

AimsThe SYNTAX (SX) score, an interesting tool to characterize the severity of the coronary artery disease was designed to predict cardiovascular outcomes in patients with three-vessel or unprotected left main coronary artery (ULMCA) disease in the SYNTAX study. However, the prognostic value of SX score in patients undergoing percutaneous coronary intervention (PCI) of ULMCA stenosis needs to be validated in the “real world”. The aim of our study was to evaluate the clinical outcome of all the patients undergoing PCI for ULMCA stenosis according to the SX score in a monocentric registry.Methods and resultsForty-five patients with de novo ULMCA stenosis (mean age 72±10 years; 76% of male) underwent PCI with bare metal stent (BMS) or drug eluting stent (DES) from January 2006 to December 2008 and were included in the ALMA (Angioplasty of Left Main at lAriboisière hospital) registry. Twenty nine percent of patients were diabetics, mean ejection fraction (EF) was 54±10%. EuroSCORE value was 5.4±3.2 and SX score was 22±8. Ostial ULMCA stenosis was involved in 27% and distal ULMCA lesion in 62% of cases. Distal ULMCA stenoses were treated by provisional T stenting in most of the cases, with one stent implantation in 48% of patients and with two stents in 44%. Clinical follow-up was achieved in all patients (25±10 months). In-hospital MACCE occurred in 6.7% of patients (2 death and 1 myocardial infarction). The rate of major adverse cardiac or cerebrovascular events (MACCE) was 35.6%. Cardiac mortality in the registry was 8.8% at two years. Target lesion revascularisation occurred in 15.6% of patients (7.1% in the DES group vs. 19.4% in the BMS group; p=0.31). None of the patients showing restenosis died. SX score was correlated to MACCE and cardiovascular death. A higher SX score (≥33) compared to the lower group (SX score between 0 to 32) is significantly associated with MACCE (83,3% vs. 28,1%; p<0.01) and cardiac mortality (33.3% vs. 7.7%; p=0.04).ConclusionsThe SX score is a useful tool to predict MACCE and cardiac mortality in patients undergoing percutaneous revascularization of the left main coronary artery

Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature: Part 2: Hematologic, cutaneous and vascular syndromes

The development of new immune treatment in oncology and particularly for lung cancer may induce new complications, particularly activation or reactivation of auto-immune diseases. In this context, a systematic review on the auto-immune paraneoplastic syndromes associated with lung cancer appears useful. This article is the second of a series of five and deals with hematologic, cutaneous and vascular syndromes.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Impaired biological response to aspirin in therapeutic hypothermia comatose patients resuscitated from out-of-hospital cardiac arrest

International audienc

Coronary Computed Tomography Angiography Analysis of Calcium Content to Identify Non-culprit Vulnerable Plaques in Patients With Acute Coronary Syndrome

International audienceBackground: Aside from the culprit plaque, the presence of vulnerable plaques in patients with acute coronary syndrome (ACS) may be associated with future cardiac events. A link between calcification and plaque rupture has been previously described.Aim: To assess whether analysis of the calcium component of coronary plaques using CT angiography, coronary computed tomographic angiography (CCTA) can help to detect additional vulnerable plaques in patients with non-ST elevation myocardial infarction (NSTEMI).Materials and methods: Cross sectional study of consecutive patients referred for NSTEMI from 30 July to 30 August 2018 with CCTA performed before coronary angiography with systematic optical coherence tomography (OCT) analysis of all coronary arteries within 24 h of clinical onset of NSTEMI. Three types of plaques were defined: culprit plaques defined by angiography (vulnerable culprit plaques-VCP) - plaques with a fibrous cap thickness < 65 microns or thrombus in OCT (vulnerable non-culprit plaque-VNCP) - plaques with a fibrous cap thickness ≥ 65 microns in OCT (stable plaque-SP).Results: A total of 134 calcified plaques were identified in 29 patients (73% male, 59 ± 14 years) with 29(22%) VCP, 28(21%) VNCP and 77(57%) SP. Using CCTA analysis of the calcium component, factors associated with vulnerable plaques were longer calcification length, larger calcification volume, lower calcium mass, higher Agatston score plaque-specific (ASp), presence of spotty calcifications and an intimal position in the wall. In multivariate analysis, ASp, calcification length and spotty calcifications were independently associated to vulnerable plaques. There was no difference between VCP and VNCP.Conclusions: CCTA analysis of calcium component of the plaque could help to identify additional vulnerable plaques in NSTEMI patients

Soins Intensifs Oncologiques :revue des années 2013 et 2014

L’objectif de l’article est de revoir la littérature publiée en 2013 et 2014 dans le domaine des soins intensifs et des urgences en rapport avec l’oncologie. Sont envisagés en raison de nouvelles publications originales le pronostic, les techniques de support vital, le choc septique et les complications infectieuses, le traitement anticancéreux en soins intensifs, le syndrome de lyse tumorale, les complications pulmonaires, thromboemboliques et vasculaires, digestives et hépatiques, neurologiques, les urgences oncologiques, les limitations thérapeutiques.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

257 Prevalence of aspirin resistance in stable coronary heart diseased patients and correlation with platelet turn-over

BackgroundAspirin resistance has been widely reported but the underlying mechanisms remain unclear. Previous studies have suggested a relationship between accelerated platelet turn-over and aspirin resistance in patients with coronary artery disease. The purpose of this study was to determine whether aspirin resistance could be linked to accelerated platetet turn-over.MethodsWe performed a prospective monocentric study including 50 consecutive patients with stable coronary artery disease treated by aspirin (75 to 250mg/day) without any other antiaggregant treatment. Aspirin resistance was characterized 24 hours after aspirin intake by light transmission aggregometry using 0.5mg/mL arachidonic acid. Aspirin resistance was defined as >20% residual agregation. Platelet turn-over was estimated at the same time by measurement of mean platelet volume, % of reticulated platelets, serum P-selectin, platelet P-selectin and serum thrombopoietin.ResultsAmong 50 patients (70 ± 11 y.o. mean ± 1,5, 76% male, 52% type 2 diabetes mellitus, 16% active smokers), 18 (36%) were identified as aspirin resistants. Table 1 shows the mean value of markers currently linked to platelet turn-over depending on the presence of aspirin resistance. Serum thrombopoietin was significantly increased in patients with aspirin resistance compared to patients with no aspirin resistance. No statistical difference was demonstrated for mean platelet volume, reticulated platelets, platelet P-selectin and serum P-selectin. Serum thrombopoietin values were not correlated with other platelet turn-over parameters. There was no significant correlation between serum thrombopoietin and inflammatory markers.ConclusionSerum thrombopoietin is associated with aspirin resistance, but no other parameters currently linked to platelet turn-over. Further studies are needed to determine whether serum thrombopoietin can predict aspirin resistance in a larger cohort.Aspirin sensitiveAspirin resistantpPlatelet volume (fl)8.78 ± 0.268.82 ± 0.300.92Reticulated platelet (%)8.4 ± 0.528.6 ± 0.760.82Serup P selectin (ng/ml)42.6 ± 4.2942.9 ± 4.750.97Platelet P selectin (%)11.1 ± 1.09.5 ± 1.50.35Serum thrombopoietin (pg/ml)130.6 ± 11.3319.9 ± 97.80.0

Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature Part 4: Neurological paraneoplastic syndromes, involving the peripheral nervous system and the neuromuscular junction and muscles

The development of new immune treatment in oncology and particularly for lung cancer may induce new complications, particularly activation or reactivation of auto-immune diseases. In this context, a systematic review on the auto-immune paraneoplastic syndromes that can complicate lung cancer appears useful. This article is the fourth of a series of five and deals mainly with neurological paraneoplastic syndromes involving the peripheral nervous system and the neuromuscular junction and muscles.SCOPUS: re.jinfo:eu-repo/semantics/publishe