Effectiveness of perindopril/amlodipine fixed-dose combination in the treatment of hypertension: a systematic review

Background: Uncontrolled blood pressure is a major risk factor for cardiovascular diseases. Fixed-dose combination (FDC) therapy offers a promising approach to addressing this challenge by providing a convenient single-tablet solution that enhances the effectiveness of blood pressure control. In our systematic review, we assess the effectiveness of perindopril/amlodipine FDC in managing blood pressure.Methods: We conducted a comprehensive search across four primary electronic databases, namely, PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of 8 February 2022. Additionally, we performed a manual search to find relevant articles. The quality of the selected articles was evaluated using the Study Quality Assessment Tools (SQAT) checklist from the National Institute of Health and the ROB2 tool from Cochrane.Results: Our systematic review included 17 eligible articles. The findings show that the use of perindopril/amlodipine FDC significantly lowers blood pressure and enhances the quality of blood pressure control. Compared to the comparison group, the perindopril/amlodipine combination tablet resulted in a higher rate of blood pressure response and normalization. Importantly, perindopril/amlodipine FDC contributes to improved patient adherence with minimal side effects. However, studies conducted to date have not provided assessments of the cost-effectiveness of perindopril/amlodipine FDC.Conclusion: In summary, our analysis confirms the effectiveness of perindopril/amlodipine FDC in lowering blood pressure, with combination therapy outperforming monotherapy and placebo. Although mild adverse reactions were observed in a small subset of participants, cost-effectiveness assessments for this treatment remain lacking in the literature

An Outbreak of Severe Infections with Community-Acquired MRSA Carrying the Panton-Valentine Leukocidin Following Vaccination

Background: Infections with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are emerging worldwide. We investigated an outbreak of severe CA-MRSA infections in children following out-patient vaccination. Methods and Findings: We carried out a field investigation after adverse events following immunization (AEFI) were reported. We reviewed the clinical data from all cases. S. aureus recovered from skin infections and from nasal and throat swabs were analyzed by pulse-field gel electrophoresis, multi locus sequence typing, PCR and microarray. In May 2006, nine children presented with AEFI, ranging from fatal toxic shock syndrome, necrotizing soft tissue infection, purulent abscesses, to fever with rash. All had received a vaccination injection in different health centres in one District of Ho Chi Minh City. Eight children had been vaccinated by the same health care worker (HCW). Deficiencies in vaccine quality, storage practices, or preparation and delivery were not found. Infection control practices were insufficient. CA-MRSA was cultured in four children and from nasal and throat swabs from the HCW. Strains from children and HCW were indistinguishable. All carried the Panton-Valentine leukocidine (PVL), the staphylococcal enterotoxin B gene, the gene complex for staphylococcal-cassette-chromosome mec type V, and were sequence type 59. Strain HCM3A is epidemiologically unrelated to a strain of ST59 prevalent in the USA, althoughthey belong to the same lineage. Conclusions. We describe an outbreak of infections with CA-MRSA in children, transmitted by an asymptomatic colonized HCW during immunization injection. Consistent adherence to injection practice guidelines is needed to prevent CA-MRSA transmission in both in- and outpatient settings

Do intangible assets stimulate firm performance? Empirical evidence from Vietnamese agriculture, forestry and fishery small- and medium-sized enterprises

Innovation and intangible asset (IA) management have not received adequate attention amongst labour- and capital-intensive sectors. This study investigates the effect of IAs on firms’ performance and the internal and external determinants of firms’ IA development amongst small- and medium-sized enterprises (SMEs) in the Vietnamese sectors of agriculture, forestry and fishery (AFF). The study adopts a stochastic frontier analysis to estimate firms’ performance and propensity score matching to examine the difference between firms with and without IAs. Ten hypotheses of innovation determinants including firms’ internal and external factors are also investigated. The results reveal three notable findings. (1) For Vietnamese AFF sectors, IAs diminish firms’ performance. (2) Internal factors such as age, size and financial robustness have positive effects on the formation of IAs, while investments in land, labour and research and development impose mixed effects. (3) External factors, such as regional and province-specific characteristics, have significant impacts on IAs. These results suggest a review of current policies on innovation and IA management amongst SMEs

Optimization Study on Turning Process by Using Taguchi-copras Method

In this article, a multi-objective optimization of turning process study is presented. Two output parameters of the turning process taken into consideration are surface roughness and Material Removal Rate (MRR). Taguchi method has been applied to design the experimental matrix with four input parameters including nose radius, cutting velocity, feed rate and cutting depth. Copras method has been employed to solve the multi-objective optimization problem. Finally, the optimal values of the input parameters have been determined to simultaneously ensure the two criteria of the minimum surface roughness and the maximum MRR

Vorticity contour at Ur = 5.84 (m* = 11, ζ = 0.001, Re = 10000).

<p>Vorticity contour at Ur = 5.84 (m* = 11, ζ = 0.001, Re = 10000).</p

(a) Force coefficients and corresponding (b) Strouhal number for flow past fixed cylinder at Re = 10000.

<p>(a) Force coefficients and corresponding (b) Strouhal number for flow past fixed cylinder at Re = 10000.</p

Power spectra non-dimensional amplitude and lift coefficient at Re = 10000 (m* = 11, ζ = 0.001).

<p>Power spectra non-dimensional amplitude and lift coefficient at Re = 10000 (m* = 11, ζ = 0.001).</p

Vorticity contour at Ur = 3.78 (m* = 11, ζ = 0.001, Re = 10000).

<p>Vorticity contour at Ur = 3.78 (m* = 11, ζ = 0.001, Re = 10000).</p

Vorticity contour at Ur = 7.52 (m* = 11, ζ = 0.001, Re = 10000).

<p>Vorticity contour at Ur = 7.52 (m* = 11, ζ = 0.001, Re = 10000).</p

Comparison of mean pressure coefficient distribution at cylinder surface for fixed cylinder at Re = 10000.

<p>Comparison of mean pressure coefficient distribution at cylinder surface for fixed cylinder at Re = 10000.</p