Amlodipine versus angiotensin II receptor blocker; control of blood pressure evaluation trial in diabetics (ADVANCED-J)

BACKGROUND: The coexistence of type 2 diabetes mellitus and hypertension increases the risk of cardiovascular diseases. The U.K. Prospective Diabetes Study has shown that blood pressure control as well as blood glucose control is efficient for prevention of complications in hypertensive patients with diabetes mellitus. However, some reports have shown that it is difficult to control the blood pressure and the concomitant use of a plurality of drugs is needed in hypertensive patients with diabetes mellitus. In recent years renin-angiotensin system depressants are increasingly used for the blood pressure control in diabetic patients. Particularly in Japan, angiotensin II (A II) antagonists are increasingly used. However, there is no definite evidence of the point of which is efficient for the control, the increase in dose of A II antagonist or the concomitant use of another drug, in hypertensive patients whose blood pressure levels are inadequately controlled with A II antagonist. METHODS/DESIGN: Hypertensive patients of age 20 years or over with type 2 diabetes mellitus who have been treated by the single use of AII antagonist at usual doses for at least 8 weeks or patients who have been treated by the concomitant use of AII antagonist and an antihypertensive drug other than calcium channel blockers and ACE inhibitors at usual doses for at least 8 weeks are included. DISCUSSION: We designed a multi-center, prospective, randomized, open label, blinded-endpoint trial, ADVANCED-J, to compare the increases in dose of A II antagonist and the concomitant use of a Ca-channel blocker (amlodipine) and A II antagonist in hypertensive patients with diabetes mellitus, whose blood pressure levels were inadequately controlled with A II antagonist. This study is different from the usual previous studies in that home blood pressures are assessed as indicators of evaluation of blood pressure. The ADVANCED-J study may have much influence on selection of antihypertensive drugs for treatment in hypertensive patients with diabetes mellitus. It is expected to give an important hint for considering the validity of selection of antihypertensive drugs from the aspects not only of the antihypertensive effect but medical cost-effectiveness

Molecular phylogeny of the blind cavefish Phreatichthys andruzzii and Garra barreimiae within the family Cyprinidae

The phylogenetic relationships of two cavefish, Phreatichthys andruzzii and Garra barreimiae, belonging to the family Cyprinidae, were investigated by sequencing the mitochondrial cytochrome b gene. These cavefish species are native to Somalia (eastern Africa) and Oman (southeastern Arabian peninsula), respectively, and so far no molecular support to their taxonomy and phylogenetic position was ever provided. The analysis of cytochrome b sequences showed that the species are monophyletic taxa, closely related to each other and to other species of the genus Garra. Molecular clock calculations allowed to date the origin of these hypogaean species back to the Plio-Pleistocene and support the hypothesis that African cyprinids originated from Miocenic immigrations of Asian ancestors

Mid-Pliocene climate change amplified by a switch in Indonesian subsurface throughflow

The tectonically driven closure of tropical seaways during the Pliocene epoch (approx5–2 million years (Myr) ago) altered ocean circulation and affected the evolution of climate. Plate tectonic reconstructions show that the main reorganization of one such seaway, the Indonesian Gateway, occurred between 4 and 3 Myr ago. Model simulations have suggested that this would have triggered a switch in the source of waters feeding the Indonesian throughflow into the Indian Ocean, from the warm salty waters of the South Pacific Ocean to the cool and relatively fresh waters of the North Pacific Ocean. Here we use paired measurements of the delta18O and Mg/Ca ratios of planktonic foraminifera to reconstruct the thermal structure of the eastern tropical Indian Ocean from 5.5 to 2 Myr ago. We find that sea surface conditions remained relatively stable throughout the interval, whereas subsurface waters freshened and cooled by about 4 °C between 3.5 and 2.95 Myr ago. We suggest that the restriction of the Indonesian Gateway led to the cooling and shoaling of the thermocline in the tropical Indian Ocean. We conclude that this tectonic reorganization contributed to the global shoaling of the thermocline recorded during the Pliocene epoch, possibly contributing to the development of the equatorial eastern Pacific cold tongue