These new guidelines represent a significant departure from previous recommendations that promoted specific lipid-level goals for patients that depended on level of risk. The new guidelines rely heavily on randomized, controlled trials involving fixed doses of statin medications in patients at risk for atherosclerotic cardiovascular disease. Four subgroups of patients were identified where benefits of statins outweigh risk. These included (1) those with clinically evident atherosclerotic cardiovascular disease; (2) primary low-density lipoprotein (LDL) cholesterol levels $190 mg/dL; (3) patients with type 1 or type 2 diabetes and LDL cholesterol levels $70 mg/dL; and (4) patients with a 10-year risk of atherosclerotic cardiovascular disease of at least 7.5% and an LDL cholesterol level $70 mg/dL. In addition, the new guidelines identify patients for whom data do not support statin therapy. These include those aged $75 years unless clinical atherosclerotic cardiovascular disease is present, those with a need for hemodialysis, or patients with New York Heart Association class II, III, or IV heart failure. In addition, the panel noted that there was no evidence to support use of nonstatin cholesterol-lowering drugs combined with statin therapy or in statin-intolerant patients.Comment: Adherence to the new guidelines will result in considerable changes in practice patterns that include avoidance of cholesterollowering therapy in certain patient groups and elimination of routine assessments of LDL cholesterol levels in patients receiving statin therapy because target levels are no longer emphasized. Additional changes include avoidance of nonstatin LDL cholesterol-lowering agents, more conservative use of statins in patients aged >75 years, and diminished use of surrogate markers, such as C-reactive protein or calcium scores, for selection of patients for statin therapy. Finally, the use of a new risk calculator in the new guidelines is likely to target larger numbers of patients for statin therapy.
Single nucleotide polymorphism (SNP) is the most abundant DNA sequence variation present in plant genomes. Here, we report the design and validation of a unique genic-SNP genotyping chip for genetic and evolutionary studies as well as molecular breeding applications in rice. The chip incorporates 50,051 SNPs from 18,980 different genes spanning 12 rice chromosomes, including 3,710 single-copy (SC) genes conserved between wheat and rice, 14,959 SC genes unique to rice, 194 agronomically important cloned rice genes and 117 multi-copy rice genes. Assays with this chip showed high success rate and reproducibility because of the SC gene based array with no sequence redundancy and cross-hybridisation problems. The usefulness of the chip in genetic diversity and phylogenetic studies of cultivated and wild rice germplasm was demonstrated. Furthermore, its efficacy was validated for analysing background recovery in improved mega rice varieties with submergence tolerance developed through marker-assisted backcross breeding.
Transient retinal ischemia results in a delayed cell death of the inner retinal layers. This study demonstrates that this ischemic cell death occurs, at least in part, through apoptosis. The general endonuclease inhibitor, aurintricarboxylic acid, protected rat retinal cells from ischemic cell damage when administered before the onset of ischemia and, more importantly, when administered 6 hr after the insult. Thus, the demonstration that transient retinal ischemia results in cell damage as a result of apoptosis opens new therapeutic strategies aimed at lessening retinal damage as a result of this process.
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