GPIIb/IIIa Receptor Antagonism Using Small Molecules Provides no Additive Long-Term Protection after Percutaneous Coronary Intervention as Compared to Clopidogrel Plus Aspirin

Background: There is some controversy as to whether tirofiban or eptifibatide, two small anti-aggregating drugs (AAD), may reduce the incidence of composite ischemic events within one year in patients undergoing percutaneous coronary intervention (PCI) in the real clinical world. Methods: We compared consecutive patients on oral double AAD (with clopidogrel and aspirin) who underwent PCI (n=207) and patients who were on single AAD and received a second AAD, just prior to PCI, and either high-dose tirofiban or double-bolus eptifibatide (double AAD plus small molecules group, n=666). The primary end point (incidence of composite ischemic events within one year) included death, acute myocardial infarction, unstable angina, stent thrombosis or repeat PCI or coronary bypass surgery (related to the target vessel PCI failure) and was modelled by Cox's regression. Results: There were 89 composite ischemic events: 24 (11.6%) in double AAD alone and 65 (9.8%) in double AAD plus small molecules groups (log-rank test: p=0.36). Incidences by type of ischemic events were similar between the 2 groups. Based on 21 potential covariates fitted simultaneously, adjusted hazard ratios (HR and 95% confidence intervals) showed that age (HR 1.03, 1.01-1.06, p=0.01), diabetes (HR 1.68, 1.01-2.79, p=0.05) and intra aortic balloon pump (HR 5.12, 2.36-11.10, p=0.0001) were significant risk factors whereas thrombolysis by tenecteplase (HR 0.35, 0.13-0.98, p=0.05) and having had hypertension or anti-hypertensive treatment (HR 0.58, 0.36-0.93, p=0.03) were significant protectors for events. Whether small molecules were present provided a non significant additional benefit as compared to double AAD alone (HR 0.83, 0.51-1.36, p=0.46). Pre-PCI CK-MB were not useful to predict events (HR 1.01, 0.99-1.01, p=0.17). Conclusions: In clinical world patients undergoing PCI (rescue plus primary <13%) while on double AAD, based on clopidogrel plus aspirin, small molecules (tirofiban or eptifibatide) provided no additive long-term protection against the occurrence of composite ischemic events whereas thrombolysis by tenecteplase did. © Schiariti et al

The assessment of population exposure to chlorination by-products: a study on the influence of the water distribution system

<p>Abstract</p> <p>Background</p> <p>The relationship between chlorination by-products (CBPs) in drinking water and human health outcomes has been investigated in many epidemiological studies. In these studies, population exposure assessment to CBPs in drinking water is generally based on available CBP data (e.g., from regulatory monitoring, sampling campaigns specific to study area). Since trihalomethanes (THMs) and haloacetic acids (HAAs) are the most documented CBP classes in drinking water, they are generally used as indicators of CBP exposure.</p> <p>Methods</p> <p>In this paper, different approaches to spatially assign available THM and HAA concentrations in drinking water for population exposure assessment purposes are investigated. Six approaches integrating different considerations for spatial variability of CBP occurrence within different distribution systems are compared. For this purpose, a robust CBP database (i.e., high number of sampling locations selected according to system characteristics) corresponding to nine distribution systems was generated.</p> <p>Results and conclusion</p> <p>The results demonstrate the high impact of the structure of the distribution system (e.g., presence of intermediary water infrastructures such as re-chlorination stations or reservoirs) and the spatial variability of CBPs in the assigned levels for exposure assessment. Recommendations for improving the exposure assessment to CBPs in epidemiological studies using available CBP data from water utilities are also presented.</p

Is Infant Carrying a Courtship Strategy in Captive Callitrichids?

Three predictions arising from the proposal that infant-carrying serves as a form of courtship in callitrichid primates were tested, using data from captive common marmosets,Callithrix jacchusand cotton-top tamarins,Saguinus oedipus. The first prediction, that males would be more likely to successfully copulate while carrying infants than while not carrying infants, was not supported in either species. In common marmosets, males were less likely to copulate while carrying infants. This relation may reflect the lower activity levels and increased vigilance required by those individuals transporting infants. The second prediction, that the overall percentage of time that males spent carrying infants would be related to overall frequency of copulations during fertile periods, was also not supported for either species. The third prediction was that, if females selected mates relative to their infant-care ‘performance’, males should be more solicitous of the breeding female's efforts to relinquish the infant to another carrier than to the efforts of other group members. If so, then males should retrieve harassed infants from mothers more frequently than from other group members; this prediction was not supported. The results of this study offer no support for the contention that infant care serves as a form of courtship in callitrichid primates

Is Infant Carrying a Courtship Strategy in Captive Callitrichids?

Three predictions arising from the proposal that infant-carrying serves as a form of courtship in callitrichid primates were tested, using data from captive common marmosets,Callithrix jacchusand cotton-top tamarins,Saguinus oedipus. The first prediction, that males would be more likely to successfully copulate while carrying infants than while not carrying infants, was not supported in either species. In common marmosets, males were less likely to copulate while carrying infants. This relation may reflect the lower activity levels and increased vigilance required by those individuals transporting infants. The second prediction, that the overall percentage of time that males spent carrying infants would be related to overall frequency of copulations during fertile periods, was also not supported for either species. The third prediction was that, if females selected mates relative to their infant-care ‘performance’, males should be more solicitous of the breeding female's efforts to relinquish the infant to another carrier than to the efforts of other group members. If so, then males should retrieve harassed infants from mothers more frequently than from other group members; this prediction was not supported. The results of this study offer no support for the contention that infant care serves as a form of courtship in callitrichid primates

Growth Variation in Common Marmoset Monkeys (Callithrix jacchus) fed a Purified Diet: Relation to Care-giving and Weaning Behaviors

Significant relations were observed between select infant-care and weaning behaviors and growth in body weight in common marmoset monkeys (Callithrix jacchus). The patterns of these relations suggest that earlier occurrence of developmental milestones, such as cessation of transport (being off carriers) and weaning to solid food, were associated with slower growth during the subsequent period. In contrast, more frequent nursing bouts during the period in which weaning was initiated were associated with higher growth rates. In the case of being off carriers, these effects did not carry over to older ages, suggesting that any deficits in growth were temporary. In the case of earlier, more frequent consumption of solid food, there was some suggestion that there were longer-term effects, followed by catch-up growth. The knee-to-heel length of subjects was not related to the measured behaviors. There was no relation between early weaning to solid food and leanness at day 75, suggesting that, although this behavior was affecting overall weight, it did not affect relative gains of fat versus lean mass. There were, however, significant correlations between cessation of transport or frequency of nursing bouts during the weaning period and leanness, with earlier cessation of transport and less frequent nursing associated with leaner infants, after weaning. Our results differed from those of a previous study that found a relation between linear growth and abuse in this species, with abuse defined as physical injury by other members of the group. We found no differences in growth between abused and nonabused infants. However, abused infants had lower birth weight