Combined treatment with memantine and galantamine-CR compared with galantamine-CR only in antidementia drug naive patients with mild-to-moderate Alzheimer's disease

Introduction: Several studies have tested the N-methyl-D-aspartate–receptor antagonist memantine as an add-on to pre-existing treatment with acetylcholinesterase inhibitors. The objective of this study was to evaluate the efficacy and safety of a combined memantine and galantamine-CR de novo regimen compared with galantamine-CR only treatment in never treated patients with mild-to-moderate Alzheimer's disease (AD). Methods: Antidementia drug–naïve participants (n = 232) with probable, mild-to-moderate AD, and mini-mental state examination scores between 15 and 26 (inclusive) were randomized to receive either 20 mg/day memantine plus 24 mg/day galantamine-CR or 24 mg/day galantamine-CR plus placebo in a 52-week, prospective, double-blind, controlled trial. The primary outcome measurement was the change on the Alzheimer's disease assessment scale-cognition score. Secondary measures comprised the Alzheimer's Disease Cooperative Study-activities of daily living inventory and the clinical dementia rating. Results: At the end of the trial, there were no statistically significant differences between the galantamine-CR/memantine combination and galantamine-CR only group in primary and secondary outcome measurements. The incidence and the severity of adverse events were similar between the groups. Discussion: In this trial, memantine in combination with galantamine-CR did not show an advantage with respect to cognition, function, and behavior in previously never treated patients with mild-to-moderate AD. There were no significant differences in tolerability and safety between the groups. Thus, a de novo combination treatment results in no significant improvement in disease progression (current controlled trials number: NCT01921972)

ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma a

Survival of the Sawfly Athalia rosae Upon Infection by an Entomopathogenic Fungus and in Relation to Clerodanoid Uptake

Larvae of the turnip sawfly 'Athalia rosae' are a pest of Brassicacae plants, as their feeding can cause defoliation of various crops of economic importance. The larvae and the adults of this sawfly species are known to take up different classes of chemical compounds from their respective host plants, with potentially deterrent functions against predators. In addition, compounds taken up by the adults, the clerodanoids, are known for their antimicrobial activity. These features could be a challenge to biocontrol strategies. Several natural enemies of 'A. rosae' have been identified, targeting larval and pupal stages of 'A. rosae', which could potentially be used as biocontrol agents. However, targeting the adult stage of a larval pest in addition to targeting the juvenile stages may improve population control. In this study, we ask whether a strain of the entomopathogenic fungus Beauveria bassiana shows biological activity against 'A. rosae' adults. We also investigate whether the behavior of clerodanoid uptake by the adults, which is commonly found, affects their survival in response to a 'B. bassiana' exposure. We found a clear dose-response relationship, i.e., with increasing fungal conidia concentrations survival of 'A. rosae' decreased. However, there was only a low incidence of mycelial growth and sporulation from 'A. rosae' cadavers, indicating that either the fungus is not successfully developing inside this host, or it is not able to re-emerge from it. Clerodanoid uptake decreased the survival of healthy adults; however, it did not increase their survival to 'B. bassiana'. Our results revealed that this strain of 'B. bassiana' if applied alone is probably not suitable for biocontrol of this sawfly species, because 'A. rosae' showed a high baseline resistance against this fungus. The behavior of clerodanoid uptake is unlikely to have evolved as a defense against this entomopathogenic fungus

Correlation of florbetaben PET imaging and the amyloid peptide Aβ42 in cerebrospinal fluid

Today, the use of biomarkers such as amyloid-specific positron emission tomography (PET) tracers and information derived from cerebrospinal fluid (CSF) can support the diagnosis of Alzheimer's disease (AD) as an indicator for the presence of amyloid pathology. We here show that the PET signal of the (18)F-labelled tracer florbetaben (NeuraCeq™), that binds to amyloid-beta plaques, inversely correlates with CSF levels of A{beta}42, another biomarker for AD. Results from the two biomarkers were concordant in 35 out of 38 subjects. In 7 AD subjects (20%) at least one biomarker was inconsistent with the clinical diagnosis. This confirms known limitations of the clinical AD diagnosis and highlights the potential of biomarker-assisted diagnosis to improve accuracy

Transcatheter valve implantation for patients with aortic stenosis: A position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Aims: To critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development. Methods and results: A committee of experts including European Association of Cardio-Thoracic Surgery and European Society of Cardiology representatives met to reach a consensus based on the analysis of the available data obtained with transcatheter aortic valve implantation and their own experience. The evidence suggests that this technique is feasible and provides haemodynamic and clinical improvement for up to 2 years in patients with severe symptomatic aortic stenosis at high risk or with contraindications for surgery. Questions remain mainly concerning safety and long-term durability, which have to be assessed. Surgeons and cardiologists working as a team should select candidates, perform the procedure, and assess the results. Today, the use of this technique should be restricted to high-risk patients or those with contraindications for surgery. However, this may be extended to lower risk patients if the initial promise holds to be true after careful evaluation. Conclusion: Transcatheter aortic valve implantation is a promising technique, which may offer an alternative to conventional surgery for high-risk patients with aortic stenosis. Today, careful evaluation is needed to avoid the risk of uncontrolled diffusion

Suitability and use of poplars as bioindicators

The introduction of the 3-way catalytic converter is presently being acclaimed by different sources in Germany as the solu- tion to the ozone problem. This hypothesis is viewed with scep- ticism: studies conducted in the USA, where the 3-way cata- lytic converter was introduced as early as 1975, show that the ozone problem has not been resolved by any means in that country. Moreover, the employment of the catalytic converter is associated with the emission of various elements occurring otherwise at extremely low background concentrations, e.g. the elements in the platinum group (Pt, Pd and Rh). A brief review of the literature reveals, for example, that platinum exhibited an unexpectedly high rate of accumulation in upper soil layers near highways in Germany within a few years of the introduction of catalytic converters. The focus of this paper is on impact research. My own studies have shown that water-soluble Pt4. accumulates at a high rate in poplar roots. A six-week exposure of poplar cuttings to 34.8 ppb Pt4 results in disturbances affecting the water bal- ance of the plants and, in conjunctionwith this, typical symp- toms of moderate water stress. Cerium (Ce), another element released by catalytic converters, also displays a high degree of accumulation in plant roots. Water-soluble Pt4§ accumulates to an even greater degree in soil, giving rise to the following series arranged in order of decreasing affinity to platinum:soil \u3e fine roots \u3e coarse roots. In long-term experiments, even the metallic platinum contained in the active layer of catalytic converters accumulated in plant roots; the resulting distribu- tion among soil, fine roots and coarse roots was comparable to that of water-soluble platinum. Possible uptake mechanisms are discussed. The first results of this study indicate that plati- num apparently belongs to the elements with a strong affinity to humic matter, a fact which could possibly explain its espe- cially heavy accumulation in upper soil layers