A meta-analysis on the prophylactic use of macrolide antibiotics for the prevention of disease exacerbations in patients with Chronic Obstructive Pulmonary Disease

SummaryIntroductionMacrolides are of unique interest in preventing COPD exacerbations because they possess a variety of antibacterial, antiviral and anti-inflammatory properties. Recent research has generated renewed interest in prophylactic macrolides to reduce the risk of COPD exacerbations. Little is known about how well these recent findings fit within the context of previous research on this subject. The purpose of this article is to evaluate, via exploratory meta-analysis, whether the overall consensus favors prophylactic macrolides for prevention of COPD exacerbations.MethodsEMBASE, Cochrane and Medline databases were searched for all relevant randomized controlled trials (RCTs). Six RCTs were identified. The primary endpoint was incidence of COPD exacerbations. Secondary endpoints including mortality, hospitalization rates, adverse events and likelihood of having at least one COPD exacerbation were also examined.ResultsThere was a 37% relative risk reduction (RR = 0.63, 95% CI: 0.45–0.87, p value = 0.005) in COPD exacerbations among patients taking macrolides compared to placebo. Furthermore, there was a 21% reduced risk of hospitalization (RR = 0.79, 95% CI: 0.69–0.90, p-value = 0.01) and 68% reduced risk of having at least one COPD exacerbation (RR = 0.34, 95% CI 0.21–0.54, p-value = 0.001) among patients taking macrolides versus placebo. There was also a trend toward decreased mortality and increased adverse events among patients taking macrolides but these were not statistically significant.ConclusionsProphylactic macrolides are an effective approach for reducing incident COPD exacerbations. There were several limitations to this study including a lack of consistent adverse event reporting and some degree of clinical and statistical heterogeneity between studies

An assembly oriented design framework for product structure engineering and assembly sequence planning

The paper describes a novel framework for an assembly-oriented design (AOD) approach as a new functional product lifecycle management (PLM) strategy, by considering product design and assembly sequence planning phases concurrently. Integration issues of product life cycle into the product development process have received much attention over the last two decades, especially at the detailed design stage. The main objective of the research is to define assembly sequence into preliminary design stages by introducing and applying assembly process knowledge in order to provide an assembly context knowledge to support life-oriented product development process, particularly for product structuring. The proposed framework highlights a novel algorithm based on a mathematical model integrating boundary conditions related to DFA rules, engineering decisions for assembly sequence and the product structure definition. This framework has been implemented in a new system called PEGASUS considered as an AOD module for a PLM system. A case study of applying the framework to a catalytic-converter and diesel particulate filter sub-system, belonging to an exhaust system from an industrial automotive supplier, is introduced to illustrate the efficiency of the proposed AOD methodology

Annales de chimie et de physique.

Mode of access: Internet.Es continuación de: Annales de chimie ou Recueil de mémoires concernant la chimie et les arts qui en dépendent, ISSN 0003-3936 . - Escindida en: Annales de chimie (Paris, 1914) = ISSN 0003-3956 ; y en: Annales de physique (París) = ISSN 0003-4169Mención de responsabilidad: par MM. Arago, Bertollet, Biot, [et. al.] ; rédigées par MM. Gay-Lussac et Arago.A partir de la tercera serie (1841) los impresores son: Fortin, Masson et Cie.La 2ª serie abarca del t. 1 (1816) - t. 75 (1840) ; la 3ª del t. 1 (1841) - t. 69 (1863) ; la 4ª del t. 1 (1864) - t. 30 (1873) ; la 5ª del t. 1 (1874) - t. 30 (1883) ; la 6ª del t. 1 (1884) - t. 30 (1893) ; la 7ª del del t. 1 (1894) - t. 30 (1903) ; y la 8ª del t. 1 (1904) - t. 30 (1913

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Inscripción: "Le héraut d' armes de Murcie.

Venerabilis Patris Domini Ludovici Blosij Monasterij Laetiensis Ord. S. Benedicti Abbatis Opera

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