Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

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IntroductionDespite the high incidence of posttransplant diabetes mellitus (PTDM) among high-risk recipients, no studies have investigated its prevention by immunosuppression optimization.MethodsWe conducted an open-label, multicenter, randomized trial testing whether a tacrolimus-based immunosuppression and rapid steroid withdrawal (SW) within 1 week (Tac-SW) or cyclosporine A (CsA) with steroid minimization (SM) (CsA-SM), decreased the incidence of PTDM compared with tacrolimus with SM (Tac-SM). All arms received basiliximab and mycophenolate mofetil. High risk was defined by age >60 or >45 years plus metabolic criteria based on body mass index, triglycerides, and high-density lipoprotein–cholesterol levels. The primary endpoint was the incidence of PTDM after 12 months.ResultsThe study comprised 128 de novo renal transplant recipients without pretransplant diabetes (Tac-SW: 44, Tac-SM: 42, CsA-SM: 42). The 1-year incidence of PTDM in each arm was 37.8% for Tac-SW, 25.7% for Tac-SM, and 9.7% for CsA-SM (relative risk [RR] Tac-SW vs. CsA-SM 3.9 [1.2–12.4; P = 0.01]; RR Tac-SM vs. CsA-SM 2.7 [0.8–8.9; P = 0.1]). Antidiabetic therapy was required less commonly in the CsA-SM arm (P = 0.06); however, acute rejection rate was higher in CsA-SM arm (Tac-SW 11.4%, Tac-SM 4.8%, and CsA-SM 21.4% of patients; cumulative incidence P = 0.04). Graft and patient survival, and graft function were similar among arms.ConclusionIn high-risk patients, tacrolimus-based immunosuppression with SM provides the best balance between PTDM and acute rejection incidence.

ABSTRACT. Studies of drill cores from the Pasos Blancos area at El Laco in the central Andes, northern Chile, give evidence of an intense and extensive subvolcanic contact-metasomatic process. This process resulted from shallow-level emplacement of very volatile-rich iron-oxide magma, with discharge of volatiles that resulted in extensive fracturing of overlying volcanic rocks. The brecciated rocks were altered (mainly extensive scapolitization and formation of pyroxene) by hot magmatic fluids emitted from the cooling intrusion, and accompanied by magnetite deposition. With time and decreasing temperature, the metasomatic fluids evolved to fluids of hydrothermal character, and a final recent geothermal event took place that deposited superficial gypsum over a large part of the El Laco Volcanic Complex. RESUMEN. Metasomatismo de contacto subvolcánico en el Complejo Volcánico El Laco, Andes centrales.Estudios realizados en testigos de sondajes en el área de Pasos Blancos en El Laco, en los Andes Centrales del norte de Chile, dan evidencias de un intenso y extenso proceso subvolcánico de metasomatismo de contacto. Este proceso es el resultado de un emplazamiento a poca profundidad de un magma de óxido de fierro muy rico en volátiles y cuya descarga de gases produjo un intenso fracturamiento de las rocas sobrepuestas. Las rocas brechizadas fueron alteradas (principalmente una extensa escapolitización y formación de piroxeno), junto con la depositación de magnetita, por los fluidos magmáticos calientes emitidos por la intrusión durante su enfriamiento. Los fluidos metasomáticos evolucionaron en el tiempo y con la disminución de temperatura, a fluidos de carácter hidrotermal y finalmente tuvo lugar un evento geotérmico reciente, el cual depositó yeso superficial en gran parte del Complejo Volcánico El Laco.

The aim of this study was to compare the psychometric properties of the "Word" and "Picture" versions of the Spanish FCSRT across the same sample of mild Alzheimer disease (AD) patients and controls. Mild AD patients (N = 50, 27 CDR = 0.5; 23 CDR = 1) and controls (N = 42, CDR = 0) were assessed with an extensive clinical and neuropsychological evaluation. Psychometric characteristics for both versions of the FCSRT were compared. Free recall (FR) and total recall (TR) across both versions of the FCSRT showed areas under the curve >0.9 and did not significantly differ between them. The scores of both versions were well correlated, although the scores for the Picture version were greater than those for the Word version, particularly for the TR scores of the mild AD group. Both versions of the FCSRT showed an appropriate accuracy to distinguish mild AD patients and controls. Visual cues were easier to recall than verbal cues, especially in the memory impaired patients.

The Neuropsychiatric Inventory Questionnaire (NPI-Q) is an informant-based instrument that measures the presence and severity of 12 Neuropsychiatric Symptoms (NPS) in patients with dementia, as well as informant distress.ObjectiveTo measure the psychometric properties of the NPI-Q and the prevalence of NPS in patients with Alzheimer's disease (AD) in Chile.Methods53 patients with AD were assessed. Subjects were divided into two different groups: mild AD (n=26) and moderate AD (n=27). Convergent validity was estimated by correlating the outcomes of the NPI-Q with Neuropsychiatric Inventory (NPI) scores and with a global cognitive efficiency test (Addenbrooke's Cognitive Examination - Revised - ACE-R). Reliability of the NPI-Q was analysed by calculating its internal consistency. Prevalence of NPS was estimated with both the NPI and NPI-Q.ResultsPositive and significant correlations were observed between the NPI-Q, the NPI, and the ACE-R (r=0.730; p<0.01 and 0.315; p<0.05 respectively). The instrument displayed an adequate level of reliability (Cronbach's alpha=0.783). The most prevalent NPS were apathy/indifference (62.3%) and dysphoria/depression (58.5%).ConclusionThe NPI-Q exhibited acceptable validity and reliability indicators for patients with AD in Chile, indicating that it is a suitable instrument for the routine assessment of NPS in clinical practice.