Kaplan-Meier curves to evaluate outcomes of two interventional therapies.

<p>Curves show survival rate (<b>A</b>), rate of exacerbation of right heart failure (<b>B</b>), rate of additional re-vascularization (<b>C</b>), and these composite endpoints (<b>D</b>) from the time when each interventional therapy (PTPA or PEA) was performed in patients in PTPA-group (red line) and PEA-group (blue line).</p

Changes in 6-minute-walk distance (6MWD) and plasma B-type natriuretic peptide (BNP) level in PTPA-group (red boxes) and PEA-group (blue boxes).

<p>Open boxes indicate data before each therapy and solid boxes at follow-up. Data are shown as boxplot distributions. <b>*</b>: statistically significant (p<0.05) difference between before and after each therapy.</p

Baseline Characteristics at Diagnosis.

<p>Data show baseline characteristics at time of diagnosis. Drug-group, patients treated with medical therapy alone; Interventions-group, patients treated with pulmonary endarterectomy (PEA) and/or percutaneous transluminal pulmonary angioplasty (PTPA); NYHA, New York Heart Association; RAP, right atrial pressure; PAP, pulmonary arterial pressure; TPR, total pulmonary resistance; BNP, B-type natriuretic peptide; 6MWD, six-minute-walk distance; PDE-5 inhibitor, phosphodiesterase-5 inhibitor; ERA, endothelin-receptor antagonist; NS, not significant (p>0.05).</p

Characteristics before Interventional Therapies.

<p>Data are values just before each interventional therapy. PTPA-group, patients treated with PTPA; PEA-group, patients treated with PEA. Other abbreviations are defined in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094587#pone-0094587-t001" target="_blank">Table 1</a>.</p

Kaplan-Meier curves showing outcome from diagnosis.

<p>Curves show outcome in patients treated with medical therapy alone (Drug-group) (green line) and patients treated with interventional therapy (Interventions-group) (orange line). Patients in the Interventions-group were treated with pulmonary endarterectomy (PEA) and/or percutaneous transluminal pulmonary angioplasty (PTPA). This analysis shows a significantly better outcome in the Interventions-group than in the Drug-group (log-rank test, p<0.01).</p

Hemodynamic changes in patients treated with PTPA (PTPA-group) (red boxes) and in patients with PEA (PEA-group) (blue boxes).

<p>Open boxes indicate data before each therapy and solid boxes indicate data at follow-up. Data are shown as boxplot distributions. <b>*</b>: statistically significant (p<0.05) difference between before and after each therapy; †: statistically significant (p<0.05) difference between changes of variables in the two groups; RAP: right atrial pressure; PAP: pulmonary arterial pressure; TPR: total pulmonary resistance.</p

Changes of distribution of New York Heart Association functional class in PTPA-group and PEA-group.

<p>*: statistically significant (p<0.05) difference between before and after each therapy; NS, not significant (p>0.05).</p

Temperature Variations around Medication Cassette and Carry Bag in Routine Use of Epoprostenol Administration in Healthy Volunteers

<div><h3>Background</h3><p>According to several treatment guidelines, epoprostenol is an important treatment option for pulmonary arterial hypertension. However, the pharmacokinetic characteristics and poor stability of epoprostenol at room temperature make its administration challenging. We therefore studied temperature fluctuations between the drug administration cassette and atmosphere to promote the safe use of epoprostenol.</p> <h3>Methods and Findings</h3><p>Five healthy volunteers carried a portable intravenous infusion pump attached to a medication cassette containing saline in a bag during their ordinary activities over 16 days during which the mean atmospheric temperature was 29.6±1.5°C. The temperature around the medication cassette was not less than 25°C on any occasion, and the mean period over 24 h during which the temperature around the cassette exceeded 35°C and 40°C was 96.9±156.4 min and 24.4±77.3 min, respectively. Significant correlations were observed between the temperatures outside the bag and around the cassette, as well as between temperatures around the cassette and of the saline solution in the cassette (r = 0.9258 and 0.8276, respectively). There were no differences in the temperatures outside the bag or around the cassette with respect to the bag material.</p> <h3>Conclusions</h3><p>Temperatures around a medication cassette and outside the bag containing the medication increase with sunlight exposure. The temperature around cassettes used for administering epoprostenol must therefore be kept low for as long as possible during hot summer conditions to maintain the drug stability.</p> </div

Difference in temperature correlation by material of the bag.

<p>Correlations between temperature outside the bag and temperature around the cassette in (A) cloth bags and (B) leather/synthetic leather bags in daytime (×) and nighttime (○). The relativity of temperatures within groups was analyzed using the CORR procedure. Regression curves from plotted graphs were calculated using the GLM procedure.</p

Temperature changes around the medication cassette.

<p>Temperature changes around the medication cassette.</p