Dual antiplatelet therapy for more than 12 months after percutaneous coronary intervention: insights from the Guthrie PCI Registry.

OBJECTIVE: To assess the impact of dual antiplatelet (DAP) therapy of >12 months on long-term death and myocardial infarction (MI) after percutaneous coronary intervention (PCI). DESIGN, SETTING AND PATIENTS: Prospective, single-centre, observational study of 1859 consecutive patients who underwent successful PCI of a native coronary artery and survived event-free for at least 12 months. MAIN OUTCOME MEASURES: Combined end point of death or non-fatal MI determined by survival analysis and propensity-adjusted multivariable Cox regression. Similar analyses were performed in the two stent subsets: bare metal stents (n = 835), drug-eluting stents (n = 1024); and three high-risk subsets: diabetic patients (n = 486), patients presenting with MI (n = 713), and those with ACC/AHA type C lesions (n = 717). RESULTS: Baseline characteristics were as follows: mean (SD) age 64 (12) years, male 69%, diabetic 26%, presentation with MI 38%, mean (SD) ejection fraction 49 (12)%, mean (SD) vessel diameter 3.1 (0.5) mm. Duration of DAP was 27 (11) months in "DAP >12 months" and 4.1 (4.1) months in "DAP < or =12 months" (p<0.001). At a median follow-up of 3.4 years after PCI, "DAP >12 months" vs "DAP < or =12 months" had similar incidence of death or MI (9.4% vs 10.3%, log-rank p = 0.83). After multivariable adjustment, DAP therapy >12 months was not associated with lower incidence of death or MI than DAP therapy < or =12 months (adjusted HR = 1.01; 95% CI 0.74 to 1.37, p = 0.95). Analysis of each of the five predefined subsets showed similar results. CONCLUSIONS: In patients who undergo successful native coronary PCI and survive event-free for at least 12 months, continuation of dual antiplatelet therapy beyond 12 months does not confer long-term protection from death or MI.

Oral glucosamine and the management of feline idiopathic cystitis.

Oral glucosamine was compared to a placebo for the management of cats with feline idiopathic cystitis (FIC) in a randomised, double-blinded, placebo-controlled, study. Forty cats with a history of recurrent cystitis due to FIC were divided into two groups and treated daily per os with either 125 mg N-acetyl glucosamine or a placebo for six months. Owners graded their cats' clinical signs at the beginning and end of the study, and kept daily diaries documenting signs of cystitis using visual analogue scales. Further episodes of cystitis were seen in 26 (65%) of the cats during the study. Affected cats experienced a mean of five recurrences (range 1-19) with each recurrence lasting a mean of four days (range 1-64 days). There were no significant differences between the two groups when considering the owners assessments of the mean health score (P>0.5), the average monthly clinical score (P=0.22) or the average number of days with clinical signs (P=0.28). Two cats suffered from such severe recurrent urethral obstruction that they were euthanased; they were both in the placebo group. Compared to the start of the study the majority of cats in both groups improved significantly (P<0.001) (mean health score of each group at the start was 0.5+/-SD 0.5, compared to glucosamine 4.4+/-0.7 and placebo 3.9+/-1.6 at the end). This is believed to have occurred because the owners of 36 of the 40 cats (90%) started feeding more canned cat food. The urine specific gravity at the start of the trial was significantly higher (mean 1.050+/-SD 1.007) than when reassessed one month later (1.036+/-1.010, P<0.01).

Hypoglycemic activity of bio-tea in mice.

Administration of bio-tea (1.71 ml/kg) to normal albino mice caused hypoglycemia after 30 min which reached to maximum after 2 hr with a significant decrease in blood sugar level (BSL) and became normal beyond 8 hr. In alloxan-induced diabetic albino mice, repeated treatments of bio-tea for 3 days (five doses) brought about a significant fall in mean BSL. Continuous decrease in BSL was observed after 4 hr of administration of last dose of bio-tea. Hypoglycemic effect was persistent in alloxan-induced diabetic mice. Effect on glucose tolerance test showed a significant fall in BSL of bio-tea treated animals after 1 hr of glucose treatment indicating hypoglycemic effect of bio-tea.

Augmentation of cisplatin cytotoxicity using cytokines on cervical carcinoma cell lines.

We investigated whether the biological response modifiers like IFN-alpha, IFN-gamma and TNF-alpha could enhance the cytotoxic action of cisplatin on cervical carcinoma cell lines in vitro. The sensitivity of three cell lines SiHa, ME 180 and C33A to these agents was tested using colorimetric MTT assay as well as tritiated thymidine uptake. All the three cell lines demonstrated range of sensitivity to cisplatin and cytokines. Interferons and TNF when used in combination with lower dose of cisplatin showed a significant enhancement of cytotoxic action of the drug in all the cell lines. Thus these data indicate that cytokines in concert with the drug may have a potential to improve the 'in vivo' therapy in these patients.

Postirradiation utility of insulin in radiotherapy.

The radiobiological effect of insulin was studied under laboratory conditions to find its utility in radiotherapy. Balb/c mice receiving injections of insulin after irradiation exhibited rapid recovery from radiation effect. This was evident from the data on their life span, organ weights and spleen colony assay studies, carried out under conditions of whole body and partial body irradiation. This trend was absent in mice injected with insulin before irradiation. The results of experiments on E. coli B/r and HA cells irradiated in the presence of insulin under oxic conditions suggest radioprotective effect of insulin. The E. coli B/r cells irradiated in the presence of insulin under hypoxia, however, showed a moderate radiosensitizing effect of insulin.

Bone marrow findings in acquired immunodeficiency syndrome (AIDS).

Bone marrow aspirates and biopsies from 35 AIDS/AIDS-related complex patients, consisting primarily of intravenous drug abusers, were studied. The most common findings included hypercellularity (86%), plasmacytosis (63%), reticular fibrosis (50%), and lymphocytosis (37%) occasionally admixed with histiocytes. Granulocytic hyperplasia was present in 27 patients (77%). Erythrocytic hypoplasia was observed in 15 patients (43%). Megaloblastic changes of intermediate form were seen in two cases and serous fat atrophy was noted in another three patients. One M. tuberculosis granuloma, a foreign body granuloma and two granulomas of undetermined etiology were seen, each in separate patients. A previously unreported focal vascular proliferation was seen in one case. The majority of cases showed increased stainable iron. Some of our findings are at variance with previous reports. This may reflect differences in patient population, geographic distribution, risk factors and epidemiologic mode in our cases.

Study of mutagenic pollution in Bombay.

Airborne suspended particulate matter (SPM) from seven areas in and around Bombay city were collected over glass fibre filters (0.8 micrometer porosity). The chemicals from the SPM were extracted in dimethylsulfoxide and distilled water and were further tested for mutagenicity by Ames' test using for five mutants of Salmonella typhimurium. Of the seven areas studied, only four exhibited mutagenicity, which was confirmed by dose-response assays using the mutant strain TA 100. The very high mutagenicity observed in central Bombay correlates with the higher incidence of respiratory tract diseases in the resident population.

Use of ascorbic acid in the 51Cr labelling of mouse fibrosarcoma cells.

We have studied and discussed the significance of the use of ascorbic acid in 51Cr labelling of cells. The following two advantages seem credible if cells (mouse fibrosarcoma) in culture are incubated for about 2 h in a medium containing Na2 51CrO4 and then ascorbic acid is added to the medium and incubation continued for ten more minutes: (a) the natural intracellular conversion of Cr6+ to Cr3+ appears to be aided, (b) the incorporation of chromium by cells is higher.