No abstract

No abstract

Elevated FPA in the early phase of myocardial infarction identifies patients with increased risk for subsequent cardiac death. This association appears to be independent of residual left ventricular function after infarction.

No abstract

In order to assess the incidence of significant venous thrombosis after transvenous permanent pacemaker implantation, transcutaneous ultrasound studies were performed in 109 consecutive patients with single-polyurethane-lead pacemakers. Ultrasonic evaluation was found to be a good noninvasive method in assessing the veins. Six patients (5.5%) were found to have significant venous obstruction in the subclavian vein. However, none of them were symptomatic. No difference in the incidence of venous obstruction was found, based on the age, duration of implantation, operative technique, potentially thrombogenic factors including atrial fibrillation, diabeties mellitus, hypertension, heart failure and end-stage renal disease.

(+/-)-Dobutamine is a positive inotropic drug usually used to improve ventricular function in patients with congestive heart failure (CHF). However, it has been found that haemodynamic responses to dobutamine become blunted during continuous treatment. In this study we determined the time-dependent changes of beta-adrenergic receptors in CHF patients treated with dobutamine. Seven CHF patients received a continuous intravenous infusion of dobutamine (5 micrograms.kg-1 x min-1) for 96 h. Blood samples were obtained before and every 24 h after starting the therapy. The density of beta-adrenergic receptors on mononuclear leukocytes and the plasma concentrations of norepinephrine and epinephrine were determined. During dobutamine treatment the receptor density (fmol.mg-1, mean +/- SEM) gradually decreased from 42.8 +/- 4.4 (baseline) to 31.4 +/- 3.3 (P < 0.05), 25.2 +/- 4.0 (P < 0.01), 18.8 +/- 5.5 (P < 0.01) and 13.4 +/- 3.4 (P < 0.01) at 24, 48, 72 and 96 h, respectively. However, the plasma concentrations of norepinephrine and epinephrine were not significantly changed during the 96 h period of treatment. Thus, the beta-adrenergic receptors down-regulated as early as 24 h after the dobutamine treatment was begun in CHF patients. This receptor down-regulation was not associated with changes of plasma catecholamine concentrations, but was related rather to the development of drug tolerance to dobutamine.

The objective of this study was to describe adults initiating dupilumab for AD, in terms of sociodemographics, comorbidity burden, AD treatment patterns, and persistence on dupilumab. From Truven US MarketScan data, we identified adults with AD with 1 dupilumab dispensation (Rx) between 28 March 2017 (US market launch) and 31 January 2018 with continuous enrolment during the baseline period (12 months prior to index Rx). Patients were followed from first dupilumab Rx until 31 July 2018 or disenrollment. Kaplan-Meier curves were used to estimate persistence at 6 and 12 months, using a 30-day grace period and assuming 14-day injection frequency. 1,637 adults initiated dupilumab (mean[SD] age 42.2[15.8]; 49.9% women, 94.7% commercially insured) and 53.2% had 1 atopic comorbidity (allergic rhinitis [33.7%] and asthma [26.8%] were most prevalent). AD treatments during baseline included: systemic corticosteroids (71.9%), PDE-4 inhibitors (15.8%), phototherapy (10.1%), immunosuppressants (24.7%; 10.8% cyclosporine), topical corticosteroids (81.1%). Over a mean (SD) follow-up of 287.5 (106.2) days, dupilumab persistence (95% CI) at 6 and 12 months was 92.2% (90.9-93.6%) and 78.5% (75.9-81.1%), respectively. Among patients discontinuing dupilumab, 66.9% reinitiated treatment within a mean of 111.5 (65.5) days. Most dupilumab initiators were persistent at 12 months; among those discontinuing, a majority reinitiated treatment. We conclude that 12month persistence on dupilumab in AD is higher than reported persistence for the most commonly used first-line biologic treatment for psoriasis, adalimumab (53.4% 1 ). These findings suggest patient satisfaction with dupilumab effectiveness and tolerability. 1

No abstract