efficacy and safety of amtolmetin guacyl in the symptomatic treatment of the osteoarthritis

Forty-two patients affected by osteoarthritis have been treated with two parallel schemes, in double blind, according to parallel groups, to have a correct evaluation of the efficacy and safety of Amtolmetin Guacyl administration on at full stomach or empty stomach. As parameters of efficacy the spontaneus pain and the pain caused by movements, the function and joint pain have been considered, while gastric tolerance has been evaluated by means of daily records made by patients and the general tolerance through an annotation of adverse events, vital signs as well as parameters of laboratory. The drug worked for both groups, but it has been particulary efficent in those who have assumed the drug on a empty stomach. The general tolerance has been good and some adverse side effects, concerning the gastric tolerance, have disappeared by reducing the dosage of the drug. As a result of this study we can assume that amtolmetin guacyl is much more efficent when it is assumed on a empty stomach, with its conseguent advantages in terms of compliance and its possible utilization in case of need

Thermal Properties of Two-Dimensional Advection Dominated Accretion Flow

We study the thermal structure of the widely adopted two-dimensional advection dominated accretion flow (ADAF) of Narayan & Yi (1995a). The critical radius for a given mass accretion rate, outside of which the optically thin hot solutions do not exist in the equatorial plane, agrees with one-dimensional study. However, we find that, even within the critical radius, there always exists a conical region of the flow, around the pole, which cannot maintain the assumed high electron temperature, regardless of the mass accretion rate, in the absence of radiative heating. This could lead to torus-like advection inflow shape since, in general, the ions too will cool down. We also find that Compton preheating is generally important and, if the radiative efficiency, defined as the luminosity output divided by the mass accretion rate times the velocity of light squared, is above sim 4x10^-3, the polar region of the flow is preheated above the virial temperature by Compton heating and it may result in time-dependent behaviour or outflow while accretion continues in the equatorial plane. Thus, under most relevant circumstances, ADAF solutions may be expected to be accompanied by polar outflow winds. While preheating instabilities exist in ADAF, as for spherical flows, the former are to some extent protected by their characteristically higher densities and higher cooling rates, which reduce their susceptibility to Compton driven overheating.Comment: 18 pages including 4 figures. AASTEX. Submitted to Ap

Risk of hospitalization for heart failure in patients with type 2 diabetes newly treated with DPP-4 inhibitors or other oral glucose-lowering medications: A retrospective registry study on 127,555 patients from the Nationwide OsMed Health-DB Database

Aims Oral glucose-lowering medications are associated with excess risk of heart failure (HF). Given the absence of comparative data among drug classes, we performed a retrospective study in 32 Health Services of 16 Italian regions accounting for a population of 18 million individuals, to assess the association between HF risk and use of sulphonylureas, DPP-4i, and glitazones. Methods and results We extracted data on patients with type 2 diabetes who initiated treatment with DPP-4i, thiazolidinediones, or sulphonylureas alone or in combination with metformin during an accrual time of 2 years. The endpoint was hospitalization for HF (HHF) occurring after the first 6 months of therapy, and the observation was extended for up to 4 years. A total of 127 555 patients were included, of whom 14.3% were on DPP-4i, 72.5% on sulphonylurea, 13.2% on thiazolidinediones, with average 70.7% being on metformin as combination therapy. Patients in the three groups differed significantly for baseline characteristics: age, sex, Charlson index, concurrent medications, and previous cardiovascular events. During an average 2.6-year follow-up, after adjusting for measured confounders, use of DPP-4i was associated with a reduced risk of HHF compared with sulphonylureas [hazard ratio (HR) 0.78; 95% confidence interval (CI) 0.62-0.97; P = 0.026]. After propensity matching, the analysis was restricted to 39 465 patients, and the use of DPP-4i was still associated with a lower risk of HHF (HR 0.70; 95% CI 0.52-0.94; P = 0.018). Conclusion In a very large observational study, the use of DPP-4i was associated with a reduced risk of HHF when compared with sulphonylureas

The possible impact of \u201csequential co-exposure\u201d on ozone associated adverse health effects. Preliminary data from cumulative cross sectional and prospective studies in Milan

Ozone effect on human health is assessed in relation to other stress factors and sequential co-exposure is analyzed. Data are also taken from previous studies

Cerebral Venous Thrombosis. A Challenging Diagnosis; A New Nonenhanced Computed Tomography Standardized Semi-Quantitative Method

Cerebral venous sinus thrombosis (CVST) on non-contrast CT (NCCT) is often challenging to detect. We retrospectively selected 41 children and 36 adults with confirmed CVST and two age-matched control groups with comparable initial symptoms. We evaluated NCCT placing four small circular ROIs in standardized regions of the cerebral dural venous system. The mean and maximum HU values were considered from each ROI, and the relative percentage variations were calculated (mean % variation and maximum % variation). We compared the highest measured value to the remaining three HU values through an ad-hoc formula based on the assumption that the thrombosed sinus has higher attenuation compared with the healthy sinuses. Percentage variations were employed to reflect how the attenuation of the thrombosed sinus deviates from the unaffected counterparts. The attenuation of the affected sinus was increased in patients with CVST, and consequently both the mean % and maximum % variations were increased. A mean % variation value of 12.97 and a maximum % variation value of 10.14 were found to be useful to distinguish patients with CVST from healthy subjects, with high sensitivity and specificity. Increased densitometric values were present in the site of venous thrombosis. A systematic, blind evaluation of the brain venous system can assist radiologists in identifying patients who need or do not need further imaging