The Risk of Adverse Cardiac and Bleeding Events Following Noncardiac Surgery Relative to Antiplatelet Therapy in Patients With Prior Percutaneous Coronary Intervention

Noncardiac surgery (NCS) may be required within the first year after percutaneous coronary intervention (PCI) in approximately 4% of patients and is the second most common reason for premature discontinuation of antiplatelet therapy (APT),which may, in turn, increase the risk of perioperative ischemic events, particularly stent thrombosis. Its continuation may increase the risk of perioperative bleeding. We review current information on the incidence of these events, particularly related to APT, describe potentially useful strategies to minimize the risks of adverse outcomes, and provide recommendations on APT use

MDL 17,043 therapy in severe congestive heart failure: Characterization of the early and late hemodynamic, pharmacokinetic, hormonal and clinical response

MDL 17,043, an agent with both inotropic and vasodilator properties, was evaluated in the treatment of chronic severe heart failure. The early and late hemodynamic, hormonal, pharmacokinetic and clinical responses to oral MDL 17,043 were studied in 20 patients. MDL 17,043 acutely increased cardiac output from 3.6 ± 0.9 to 4.6 ± 1.0 liters/min ( + 28%, p < 0.001) and decreased mean pulmonary artery wedge pressure from 24 ± 8 to 13 ± 8 mm Hg (−46%, p < 0.001), mean right atrial pressure from 10 ± 5 to 4 ± 4 mm Hg (−60%, p < 0.001) and mean arterial pressure from 78 ± 9 to 70 ± 11 mm Hg (−10%, p < 0.001). Hemodynamic improvement was sustained for 8 hours. Plasma renin activity tended to increase (0.10 < p > 0.05), plasma norepinephrine tended to decrease (0.10 < p > 0.05) and arginine vasopressin did not show any directional change. Elimination half-life for MDL 17,043 was approximately 20 hours.Hemodynamic responsiveness was maintained in six patients undergoing restudy at 4 weeks. Initial subjective improvement in the 20 patients occurred in 90%, was present at 4 weeks in 50% and continued longer than 3 months in 25%. Side effects occurred in 75% and required cessation of treatment in 10%. Thirteen (93%) of 14 patients on long-term therapy died (median time after start of MDL 17,043 therapy 39 days). Deaths were sudden in 69%.It is concluded that oral MDL 17,043 produces early and late hemodynamic improvement in patients with severe heart failure. The clinical response suggests caution in its use and controlled trials to ascertain whether MDL 17,043 is safe and efficacious in chronic severe heart failure

AAV2/8-hSMAD3 gene delivery attenuates aortic atherogenesis, enhances Th2 response without fibrosis, in LDLR-KO mice on high cholesterol diet

BACKGROUND: Inflammation is a key etiologic component in atherogenesis and transforming growth factor beta 1 (TGFβ1) is a well known anti-inflammatory cytokine which potentially might be used to limit it. Yet TGFβ1 is pleiomorphic, causing fibrosis, cell taxis, and under certain circumstances, can even worsen inflammation. SMAD3 is an important member of TGFβ1′s signal transduction pathway, but is a fully intracellular protein. OBJECTIVES: With the hope of attenuating TGFβ1′s adverse systemic effects (eg. fibrosis) and accentuating its anti-inflammatory activity, we proposed the use of human (h)SMAD3 as an intracellular substitute for TGFβ1. STUDY DESIGN: To test this hypothesis adeno-associated virus type 2/8 (AAV)/hSMAD3 or AAV/Neo (control) was tail vein injected into the low density lipoprotein receptor knockout (LDLR-KO) mice, then placed on a high-cholesterol diet (HCD). RESULTS: The hSMAD3 delivery was associated with significantly lower atherogenesis as measured by larger aortic cross sectional area, thinner aortic wall thickness, and lower aortic systolic blood velocity compared with Neo gene-treated controls. HSMAD3 delivery also resulted in fewer aortic macrophages by immunohistochemistry for CD68 and ITGAM, and quantitative reverse transcriptase polymerase chain reaction analysis of EMR and ITGAM. Overall, aortic cytokine expression showed an enhancement of Th2 response (higher IL-4 and IL-10); while Th1 response (IL-12) was lower with hSMAD3 delivery. While TGFβ1 is often associated with increased fibrosis, AAV/hSMAD3 delivery exhibited no increase of collagen 1A2 or significantly lower 2A1 expression in the aorta compared with Neo-delivery. Connective tissue growth factor (CTGF), a mediator of TGFβ1/SMAD3-induced fibrosis, was unchanged in hSMAD3-delivered aortas. In the liver, all three of these genes were down-regulated by hSMAD3 gene delivery. CONCLUSION: These data strongly suggest that AAV/hSMAD3 delivery gave anti-atherosclerosis therapeutic effect without the expected undesirable effect of TGFβ1-associated fibrosis

Involvement of private investors on the financial market of the Russian Federation: analysis of problems and actions of regulating authorit

In this article, the problems of attracting private investment in the financial markets of the Russian Federation are examined. The analysis of measures carried out by the regulator of the financial market on achievement of positive dynamics in attraction of savings of the population in the financial markets is carried out. Conclusions have been made about the need for additional instruments of impact on the population and on the pfessional market participants who would help stimulate the population in choosing the Russian stock market

Разработка и исследование автономной системы управления солнечной батареи

В данной работе выполнен анализ динамических характеристик системы ориентации солнечной батареи, осуществляющей слежение за перемещением солнца с использованием MatLab-моделирования. Отслеживание таких объектов возможно при условии знания его координат. Одним из требований, предъявляемых к следящему электроприводу, являются требования минимума статической и динамической ошибок позиционирования устройства. При эксплуатации систем слежения в удаленных местах так же появляется требование по сокращению потребления электроэнергии самой системы. Для снижения электропотребления необходимо уменьшать колебания антенны в режиме слежения.In this work, an analysis is made of the dynamic characteristics of a solar battery orientation system that monitors the movement of the sun using MatLab modeling. Tracking of such objects is possible under condition of knowledge of its coordinates. One of the requirements for a servomotor drive is the requirements of a minimum of static and dynamic device positioning errors. When operating tracking systems in remote locations, there is also a requirement to reduce the electricity consumption of the system itself. To reduce power consumption, it is necessary to reduce antenna oscillations in tracking mode

Asomuar

Émile Zola'nın Tanin'de yayımlanan Asomuar adlı romanının ilanıRoman forma şeklinde gazeteyle beraber verilmiştir. Taranan arşivlerde formalara rastlanmamıştır