Comparison of the Effects of Ezetimibe-Statin Combination Therapy on Major Adverse Cardiovascular Events in Patients with and without Diabetes: A Meta-Analysis

BACKGROUND: Ezetimibe-statin combination therapy has been found to reduce low density lipoprotein cholesterol levels and the risk of major adverse cardiovascular events (MACEs) in large trials. We sought to examine the differential effect of ezetimibe on MACEs when added to statins according to the presence of diabetes. METHODS: Randomized clinical trials with a sample size of at least 50 participants and at least 24 weeks of follow-up that compared ezetimibe-statin combination therapy with a statin- or placebo-controlled arm and reported at least one MACE, stratified by diabetes status, were included in the meta-analysis and meta-regression. RESULTS: A total of seven trials with 28,191 enrolled patients (mean age, 63.6 years; 75.1% men; 7,298 with diabetes [25.9%]; mean follow-up, 5 years) were analysed. MACEs stratified by diabetes were obtained from the published data (two trials) or through direct contact (five trials). No significant heterogeneity was observed among studies (I 2=14.7%, P=0.293). Ezetimibe was associated with a greater reduction of MACE risk in subjects with diabetes than in those without diabetes (pooled relative risk, 0.84 vs. 0.93; P heterogeneity=0.012). In the meta-regression analysis, the presence of diabetes was associated with a greater reduction of MACE risk when ezetimibe was added to statins (β=0.87, P=0.038). CONCLUSION: Ezetimibe-statin combination therapy was associated with greater cardiovascular benefits in patients with diabetes than in those without diabetes. Our findings suggest that ezetimibe-statin combination therapy might be a useful strategy in patients with diabetes at a residual risk of MACEs.

Myt1L Promotes Differentiation of Oligodendrocyte Precursor Cells and is Necessary for Remyelination After Lysolecithin-Induced Demyelination / 神经科学通报·英文版

The differentiation and maturation of oligodendrocyte precursor cells (OPCs) is essential for myelination and remyelination in the CNS. The failure of OPCs to achieve terminal differentiation in demyelinating lesions often results in unsuccessful remyelination in a variety of human demyelinating diseases. However, the molecular mechanisms controlling OPC differentiation under pathological conditions remain largely unknown. Myt1L (myelin transcription factor 1-like), mainly expressed in neurons, has been associated with intellectual disability, schizophrenia, and depression. In the present study, we found that Myt1L was expressed in oligodendrocyte lineage cells during myelination and remyelination. The expression level of Myt1L in neuron/glia antigen 2-positive (NG2) OPCs was significantly higher than that in mature CC1 oligodendrocytes. In primary cultured OPCs, overexpression of Myt1L promoted, while knockdown inhibited OPC differentiation. Moreover, Myt1L was potently involved in promoting remyelination after lysolecithin-induced demyelination in vivo. ChIP assays showed that Myt1L bound to the promoter of Olig1 and transcriptionally regulated Olig1 expression. Taken together, our findings demonstrate that Myt1L is an essential regulator of OPC differentiation, thereby supporting Myt1L as a potential therapeutic target for demyelinating diseases.

Aortoduodenal syndrome: a rare cause of intestinal obstruction

No abstract available.

Precipitation of carbonates crystals by bacteria isolated from a submerged fixed-film bioreactor used for the treatment of urban wastewater

The precipitation of calcium carbonate by bacteria isolated from submerged fixed-film bioreactor used for the treatment of urban wastewater in both natural and artificial media was studied. However, carbonate precipitation was detected only when the bacteria grow in media added with calcium. Precipitation took place rapidly, and crystal formation began 3 d after inoculation and the percentage of carbonate-forming bacteria was slightly higher than 90%. Seventeen dominant colonies with carbonate precipitation capacity were the dominant heterotrophic platable bacteria growing aerobically in media added with calcium acetate and calcium chloride. According to their taxonomic affiliations [based on partial sequencing of the 16S-rRNA], the seventeen strains belonged to the following genera of Gram-positive and Gram-negative bacteria: Artrobacter, Bacillus, Enterococcus, Pseudomonas, Agromyces and Rhodococcus. All of these strains formed calcium carbonate crystals, precipitated always as calcite crystals which showed large amounts of bacterial fingerprints or bacteria calcification. In addition all the seventeen bacterial strains showed carbonic anhydrase activity. The results of this research suggest that in submerged fixed-film bioreactors used for the treatment of urban wastewater, the precipitation of carbonates through bacterial action could take place in situ in the presence of certain concentrations of calcium. Moreover, this biological activity could be useful in the CO, and calcium capture in urban wastewater treatments

Angiotensin-Converting Enzyme Inhibitors and Angioedema

PURPOSE: To investigate the incidence and clinical characteristics of angioedema associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) in an outpatient allergy department. METHODS: A retrospective review of medical records of new patients seen in an allergy clinic. Demographic and clinical data of patients with ACEI-induced angioedema were analyzed. RESULTS: Nine (0.37%) out of 2,421 new patients attending the allergy clinic developed ACEI-associated angioedema. Enalapril was the drug most frequently incriminated. The onset of the angioedema was as early as after the first dose or as late as 2 years after beginning treatment. Six patients experienced life-threatening angioedema involving the tongue, oropharynx, or larynx, and two patients required transfer to the intensive care unit. One patient required a tracheostomy. CONCLUSIONS: Angiotensin-converting enzyme inhibitor treatment is often responsible for angioedema, especially involving the upper airways. Due to the high proportion of the population exposed to ACEIs and to the severity of this adverse effect, it is important that physicians consider ACEIs as possible inducers when evaluating patients with acute or recurrent angioedema.

Determination of lead, naphthalene, phenanthrene, anthracene and pyrene in street dust

Street dust is a potential source of lead exposure to humans, however scarce information about the pollution levels with lead and polyromatic hydrocarbons exists in Venezuela, limiting the appropriate evaluation of the levels of risk of the people. This work was aimed in the determination of the concentrations of lead, naphtalene, anthracene, phenanthrene and pyrene in the street dust of the most transited avenues and streets of Maracay city. Thirty street dust samples were collected at the streets and avenues, troll and bus main station. Lead was determined by atomic absorption spectrometry after acid digestion [Pb-total], also the fractions of lead soluble in 1 M MgCI2 and 0.5 M ammonium acetate [pH = 7] were quantified. The polyaromatic hydrocarbons concentrations were determined by capillary gas chromatography equipped with a flame ionization detector. The Pb-total ranged between 734 and 11.439 micro g/g with the higher values at the most transited streets and avenues. About 60% of samples exhibited concentrations between 1.000 and 2.500 micro g/g, similar to the values reported in the literature for soils of urban areas. The fraction of lead soluble in magnesium accounted for less than 3% of Pb-Total, while the 0.5 M ammonium acetate solution represented more than the 75% of the total loads of the pollutant. The most contaminated samples were those taken at the toll with concentrations of 695.5 and 252.1 micro g/g phenanthrene and anthracene were the most abundant, while at the bus station all compounds were detected

Fc receptor gamma subunit polymorphisms and systemic lupus erythematosus

To investigate the possible association between Fc receptor [FcR] gamma polymorphisms and systemic lupus erythematosus [SLE]. We have investigated the full FcR gamma gene for polymorphisms using polymerase chain reaction [PCR]-single strand conformational polymorphism and DNA sequencing. The polymorphisms identified were genotype using PCR-restriction fragment length polymorphism. Systemic lupus erythematosus cases and controls were available from 3 ethnic groups: Turkish, Spanish and Caucasian. The study was conducted in the year 2001 at the Arthritis Research Campaign, Epidemiology Unit, Manchester University Medical School, Manchester, United Kingdom. Five single nucleotide polymorphisms were identified, 2 in the promoter, one in intron 4 and, 2 in the 3 UTR. Four of the 5 single nucleotide polymorphisms [SNPs] were relatively common and investigated in the 3 populations. Allele and genotype frequencies of all 4 investigated SNPs were not statistically different between cases and controls. Fc receptor gamma gene does not appear to contribute to SLE susceptibility. The identified polymorphisms may be useful in investigating other diseases where receptors containing the FcR gamma subunit contribute to the pathology

Factores de riesgo relacionados con la enfermedad de Hansen en San Francisco Libre. Managua, Nicaragua, 1995" / Risk factors about with diseases

Se realizó un estudio análitico retrospectivo de casos y controles a todos los pacientes registrados con la enfermedad de Hansen bajo tratamiento en diciembre de 1994, escogiéndose dos controles para cada caso, estos controles fueron: un primer contacto del paciente y un poblador )que reside en otra casa). El universo lo constituía un total de 114 persona a los que se dividio en dos grupos: Grupos de "casos" cosistente en aquellos pacientes en los que previamente se les había determinado la enfermedad y que tomaban tratamiento, y el grupo "testigo" en los que se incluyó a aquellos individuos que no tenían ningun antecedente personal de lepra ya sea contacto o persona vecina que cumplieran o se asemejaran edades comparables al caso. En el 51.8 porciento de los casos estudiados habían antecedentes de lepra en la familia; encontrando una mayor proporción en los de del Grupo de "casos" 80.6 porciento en comparación con los "testigos" 19.4 porciento. En el estudio se encontró diversos factores como el biologico que aumenta la susceptibilidad de los individuos sobretodo en los niños, así mismo se determinó que la mayoría de los factores de contacto son domésticoslos que fortalecen la transmisión de humano a humano, sobretodo cuando se habla de contacto familiar en donde el riesgo reportado es el doble (3) y que puede aumentar de 8 a 10 veces más en la lepra Lepromatosa