Blood pressure-lowering effects of nifedipine/candesartan combinations in high-risk individuals: Subgroup analysis of the DISTINCT randomised trial

The DISTINCT study (reDefining Intervention with Studies Testing Innovative Nifedipine GITS - Candesartan Therapy) investigated the efficacy and safety of nifedipine GITS/candesartan cilexetil combinations vs respective monotherapies and placebo in patients with hypertension. This descriptive sub-analysis examined blood pressure (BP)-lowering effects in high-risk participants, including those with renal impairment (estimated glomerular filtration rate<90 ml min-1, n=422), type 2 diabetes mellitus (n=202), hypercholesterolaemia (n=206) and cardiovascular (CV) risk factors (n=971), as well as the impact of gender, age and body mass index (BMI). Participants with grade I/II hypertension were randomised to treatment with nifedipine GITS (N) 20, 30, 60 mg and/or candesartan cilexetil (C) 4, 8, 16, 32 mg or placebo for 8 weeks. Mean systolic BP and diastolic BP reductions after treatment in high-risk participants were greater, overall, with N/C combinations vs respective monotherapies or placebo, with indicators of a dose-response effect. Highest rates of BP control (ESH/ESC 2013 guideline criteria) were also achieved with highest doses of N/C combinations in each high-risk subgroup. The benefits of combination therapy vs monotherapy were additionally observed in patient subgroups categorised by gender, age or BMI. All high-risk participants reported fewer vasodilatory adverse events in the pooled N/C combination therapy than the N monotherapy group. In conclusion, consistent with the DISTINCT main study outcomes, high-risk participants showed greater reductions in BP and higher control rates with N/C combinations compared with respective monotherapies and lesser vasodilatory side-effects compared with N monotherapy

Mechanical properties of welded joints in 24Kh2Nach steel with a granular bainite structure

Translated from Russian (Svar. Prizvod. 1997 (2) p. 41-46)Available from British Library Document Supply Centre-DSC:9023.190(VR-Trans--8809)T / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Revisited diagnostics of true (acantholytic) pemphigus

True (acantholytic) pemphigus is an autoimmune disease characterized by blisters and erosions in the skin and/or mucous tunics. True (acantholytic) pemphigus can be diagnosed based on an assessment of clinical manifestations and results of cytology, histology and immunology tests. The current diagnostics methods are characterized by certain advantages and shortcomings yet none of them has 100% sensitivity and specificity. To diagnose pemphigus, a complex of studies is needed taking into consideration the body of clinical symptoms and laboratory indices