A randomized placebo-controlled study on the effect of nifedipine on coronary endothelial function and plaque formation in patients with coronary artery disease: the ENCORE II study†

Aims Endothelial dysfunction and plaque formation are features of atherosclerosis. Inhibition of L-type calcium channels or HMG-CoA pathway improves endothelial function and reduces plaque size. Thus, we investigated in stable coronary artery disease (CAD) the effects of a calcium antagonist on coronary endothelial function and plaque size. Methods and results In 454 patients undergoing PCI, acetylcholine (10−6 to 10−4 M) was infused in a coronary segment without significant CAD. Changes in coronary diameter were measured and an intravascular ultrasound examination (IVUS) was performed. On top of statin therapy, patients were randomized in a double-blind fashion to placebo or nifedipine GITS 30-60 mg/day and followed for 18-24 months. Blood pressure was lower on nifedipine than on placebo by 5.8/2.1 mmHg (P < 0.001) as was total and LDL cholesterol (4.8 mg/dL; P = 0.495), while HDL was higher (3.6 mg/dL; P = 0.026). In the most constricting segment, nifedipine reduced vasoconstriction to acetylcholine (14.0% vs. placebo 7.7%; P < 0.0088). The percentage change in plaque volume with nifedipine and placebo, respectively, was 1.0 and 1.9%, ns. Conclusion The ENCORE II trial demonstrates in a multi-centre setting that calcium channel blockade with nifedipine for up to 2 years improves coronary endothelial function on top of statin treatment, but did not show an effect of nifedipine on plaque volum

Regulation of peripheral blood flow in Complex Regional Pain Syndrome: clinical implication for symptomatic relief and pain management

Background. During the chronic stage of Complex Regional Pain Syndrome (CRPS), impaired microcirculation is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Several mechanisms may be responsible for the ischemia and pain in chronic cold CPRS. Discussion. The diminished blood flow may be caused by either sympathetic dysfunction, hypersensitivity to circulating catecholamines, or endothelial dysfunction. The pain may be of neuropathic, inflammatory, nociceptive, or functional nature, or of mixed origin. Summary. The origin of the pain should be the basis of the symptomatic therapy. Since the difference in temperature between both hands fluctuates over time in cold CRPS, when in doubt, the clinician should prioritize the patient's report of a persistent cold extremity over clinical tests that show no difference. Future research should focus on developing easily applied methods for clinical use to differentiate between central and peripheral blood flow regulation disorders in individual patients

Hydrogen Recovery by Novel Solvent Systems. Final Report

The objective of this work is to develop a novel method for purification of hydrogen from coal-derived synthesis gas. The study involved a search for suitable mixtures of solvents for their ability to separate hydrogen from the coal derived gas stream in significant concentration near their critical point of miscibility. The properties of solvent pairs identified were investigated in more detail to provide data necessary for economic evaluation and process development

Hydrogen Recovery by Novel Solvent Systems

The objective of this work is to develop a novel method for purification of hydrogen from coal-derived synthesis gas. The study involved a search for suitable mixtures of solvents for their ability to separate hydrogen from the coal derived gas stream in significant concentration near their critical point of miscibility. The properties of solvent pairs identified were investigated in more detail to provide data necessary for economic evaluation and process development

Solvent Extraction of Metal Ions from Contaminated Soils

The most important result of this work is to show that water-insoluble chelators have the same yield at extracting metal ions from contaminated soils when they are dissolved in a mostly aqueous, non-toxic solvent solution (e.g. a 99% water-1% ethanol mixture), as when more toxic systems (e.g. a 50% water-50% acetone mixture) are used. In addition, the solvent solution can be composed mainly of water, with only a very small amount (1% in our case) of solvent added to dissolve the complexing agent. These results extend and generalize those previously presented by Mauri and coworkers