A Paclitaxel-Eluting Stent for the Prevention of Coronary Restenosis

Background Intimal hyperplasia and resulting restenosis limit the efficacy of coronary stenting. We studied a coronary stent coated with the antiproliferative agent paclitaxel as a means of preventing restenosis. Methods We conducted a multicenter, randomized, controlled, triple-blind study to evaluate the ability of a paclitaxel-eluting stent to inhibit restenosis. At three centers, 177 patients with discrete coronary lesions (<15 mm in length, 2.25 to 3.5 mm in diameter) underwent implantation of paclitaxel-eluting stents (low dose, 1.3 µg per square millimeter, or high dose, 3.1 µg per square millimeter) or control stents. Antiplatelet therapies included aspirin with ticlopidine (120 patients), clopidogrel (18 patients), or cilostazol (37 patients). Clinical follow-up was performed at one month and four to six months, and angiographic follow-up at four to six months. Results Technical success was achieved in 99 percent of the patients (176 of 177). At follow-up, the high-dose group, as compared with the control group, had significantly better results for the degree of stenosis (mean [±SD], 14±21 percent vs. 39±27 percent; P<0.001), late loss of luminal diameter (0.29±0.72 mm vs. 1.04±0.83 mm, P<0.001), and restenosis of more than 50 percent (4 percent vs. 27 percent, P<0.001). Intravascular ultrasound analysis demonstrated a dose-dependent reduction in the volume of intimal hyperplasia (31, 18, and 13 mm3, in the high-dose, low-dose, and control groups, respectively). There was a higher rate of major cardiac events in patients receiving cilostazol than in those receiving ticlopidine or clopidogrel. Among patients receiving ticlopidine or clopidogrel, event-free survival was 98 percent and 100 percent in the high-dose and control groups, respectively, at one month, and 96 percent in both at four to six months. Conclusions Paclitaxel-eluting stents used with conventional antiplatelet therapy effectively inhibit restenosis and neointimal hyperplasia, with a safety profile similar to that of standard stents.published_or_final_versio

The main features of issue and circulation of exchange bonds in the Russian Federation

The main features of stock exchange bonds were considered in the article, as well as the difference between stock exchange bonds and classical bonds. Two new types which appeared in the Russian federation in 2015-2016, such as single-day stock exchange bonds, and bonds issued within programs of exchange bonds. As the result, a conclusion was drawn on the future development of stock exchange bonds in Russian financial markets

SchussenAktivplus: reduction of micropollutants and of potentially pathogenic bacteria for further water quality improvement of the river Schussen, a tributary of Lake Constance, Germany

The project focuses on the efficiency of combined technologies to reduce the release of micropollutants and bacteria into surface waters via sewage treatment plants of different size and via stormwater overflow basins of different types. As a model river in a highly populated catchment area, the river Schussen and, as a control, the river Argen, two tributaries of Lake Constance, Southern Germany, are under investigation in this project. The efficiency of the different cleaning technologies is monitored by a wide range of exposure and effect analyses including chemical and microbiological techniques as well as effect studies ranging from molecules to communities

The Proliferation REduction with Vascular ENergy Trial (PREVENT)

PREVENT was the first prospective, randomized placebo-controlled study of intracoronary beta radiotherapy with (32)P. A total of 105 patients with de novo or restenotic lesions, treated by stenting or balloon angioplasty, received 0 (control), 16, 20, or 24 Gy to a depth of 1 mm beyond the lumen surface. Rates of restenosis (50% diameter stenosis or more) were significantly lower in radiotherapy patients at the target site (8% compared with 39%, P = 0.012) and at the target site plus adjacent segments (22% compared with 50%, P = 0.018). Stenosis adjacent to the target site and late thrombotic events reduced the overall clinical benefit of radiotherapy

Presentation of Severe Acute Respiratory Syndrome-Coronavirus 2 Infection as Cholestatic Jaundice in Two Healthy Adolescents

© 2020 Elsevier Inc. Liver abnormalities in severe acute respiratory syndrome-coronavirus 2 infection, including hepatitis and cholestasis, have been observed in adults and are associated with worse outcomes. We describe 2 adolescents with cholestasis and hepatitis with mild presentation of severe acute respiratory syndrome-coronavirus 2 lacking typical symptoms. Our intention is to raise index of suspicion for testing and protective equipment use

Epidemiological observations on pastern dermatitis in young horses and evaluation of essential fatty acid spot-on applications with or without phytosphingosine as prophylactic treatment

Background - Equine pastern dermatitis (EPD) is a common multifactorial clinical syndrome in horses. Treatment can be difficult;pathogenesis and triggering factors cannot always be determined. Objectives - To assess risk factors for developing EPD in a large group of horses kept under the same conditions and to analyse whether or not a spot-on containing essential fatty acids and antimicrobial agents is able to prevent the development of EPD or accelerate the healing process. Animals - Each year 50 young, privately owned, warmblood horses were prospectively included. Methods - All horses were examined weekly between August and October for the presence of typical EPD skin lesions. Additionally, in the first year, horses were randomly divided into three subgroups of intervention. The pastern areas were treated once weekly either with 0.6 mL of a spot-on containing essential fatty acids and aromatic oils, or a preparation containing additional antibacterial phytosphingosine, or not at all. Results - Nonpigmented pastern areas were affected significantly more often than pigmented pastern areas (P < 0.0001). The interaction between moisture and opportunistic pathogens seemed to be a major triggering factor for EPD. There was no difference in the occurrence of EPD in the three subgroups. The lesion scores of affected limbs in both spot-on groups were significantly lower compared to the control group. Conclusion and clinical importance - Moisture and lack of pigmentation predisposed to EPD. Topical application of the tested spot-on once weekly did not prevent the disease. A positive effect of both spot-on products on the severity of EPD lesions was detected