Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)

MARCU, Silvia: El Mar Negro. Geopolítica de una Región Encrucijada de Caminos. Valladolid: Secretariado de Publicaciones e Intercambio Editorial, Universidad de Valladolid, 2007, 298 pp.

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MARCU, Silvia: El Mar Negro. Geopolítica de una Región Encrucijada de Caminos. Valladolid: Secretariado de Publicaciones e Intercambio Editorial, Universidad de Valladolid, 2007, 298 pp.

Reseñ

Electronic and structural evidences for charge transfer and localization in iodine-doped pentacene

We have investigated the doping mechanism of pentacene with iodine and its impact on the structure and on the electronic properties of single crystals, powders, and thin films in a large range of iodine concentration up to six iodine per pentacene (PEN) molecule (I/PEN = 6). Three regimes of doping have been identified. In the low doping regime I/PEN + cations and related species, for example, cation dimers (PEN+)2 and typical Raman signatures of the I3- and I5- species. Spin pairing of pentacene cation radicals is further supported by the observation of a thermally activated behavior of the ESR spin susceptibility. In the heavy doping regime (2 < I/PEN <= 6), all traces of structural order vanish, indicating that iodine penetrates within the (a,b) planes of the intercalate in a disordered manner, forming an amorphous-like material. This high degree of disorder results in increased charge localization. Most spin/charge species are ESR-silent and only a limited fraction (a few percents) exhibits a Curie-like susceptibility. Because of disorder, the macroscopic conductivity of doped pentacene single crystals does not exceed a few S/cm at 300