Three-year Follow-up of Patients With Bifurcation Lesions Treated With Sirolimus- or Everolimus-eluting Stents: SEAside and CORpal Cooperative Study

Introduction and objectives

To compare the 3-year incidence of major events in patients with bifurcation lesions treated with provisional sirolimus-eluting stents vs everolimus-eluting stents.

Methods

A pooled analysis of 2 prospective randomized trials with similar methodology (SEAside and CORpal) was performed. In these trials, 443 patients with bifurcation lesions were randomly assigned to treatment with either sirolimus-eluting stents or everolimus-eluting stents. The clinical follow-up was extended up to 3 years to assess major adverse cardiovascular events (death or acute myocardial infarction or target vessel revascularization).

Results

At 3 years, survival free of major adverse cardiovascular events was 93.2% vs 91.3% in the everolimus-eluting stent group vs the sirolimus-eluting stent group (P = .16). Exploratory land-mark analysis for late events (occurring after 12 months) showed significantly fewer major adverse cardiovascular events in the everolimus-eluting stent group: 1.4% vs 5.4% in the sirolimus-eluting stent group (P = .02).

Conclusions

Provisional stenting with either sirolimus-eluting stents or everolimus-eluting stents in bifurcation lesions is associated with low rates of major adverse events at 3-years’ follow-up. The results of a subanalysis of events beyond 1 year, showing a lower event rate with everolimus-eluting stents than with sirolimus-eluting stents, suggest that studies exploring the long-term clinical benefit of the latest generation of drug-eluting stents are warranted.     

The prevalence of caries and tooth loss among participants in the Hispanic Community Health Study/Study of Latinos

Background.The Hispanic and Latino population is projected to increase from 16.7 percent to 30.0 percent by 2050. Previous U.S. national surveys had minimal representation of Hispanic and Latino participants other than Mexicans, despite evidence suggesting that Hispanic or Latino country of origin and degree of acculturation influence health outcomes in this population. In this article, the authors describe the prevalence and mean number of cavitated, decayed and filled surfaces, missing teeth and edentulism among Hispanics and Latinos of different national origins.Methods.Investigators in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)—a multicenter epidemiologic study funded by the National Heart, Lung, and Blood Institute with funds transferred from six other institutes, including the National Institute of Dental and Craniofacial Research—conducted in-person examinations and interviews with more than 16,000 participants aged 18 to 74 years in four U.S. cities between March 2008 and June 2011. The investigators identified missing, filled and decayed teeth according to a modified version of methods used in the National Health and Nutrition Examination Survey. The authors computed prevalence estimates (weighted percentages), weighted means and standard errors for measures.Results.The prevalence of decayed surfaces ranged from 20.2 percent to 35.5 percent, depending on Hispanic or Latino background, whereas the prevalence of decayed and filled surfaces ranged from 82.7 percent to 87.0 percent, indicating substantial amounts of dental treatment. The prevalence of missing teeth ranged from 49.8 percent to 63.8 percent and differed according to Hispanic or Latino background. Significant differences in the mean number of decayed surfaces, decayed or filled surfaces and missing teeth according to Hispanic and Latino background existed within each of the age groups and between women and men.Conclusions.Oral health status differs according to Hispanic or Latino background, even with adjustment for age, sex and other characteristics.Practical Implications.These data indicate that Hispanics and Latinos in the United States receive restorative dental treatment and that practitioners should consider the association between Hispanic or Latino origin and oral health status. This could mean that dental practices in areas dominated by patients from a single Hispanic or Latino background can anticipate a practice based on a specific pattern of treatment needs.     

Do upsetting life events explain the relationship between low socioeconomic status and systemic inflammation in childhood? Results from a longitudinal study

BackgroundChildren from families of low socioeconomic status (SES) are more likely to be exposed to upsetting situations and stressors. Such exposures have, in turn, been linked to inflammation in some studies. In this study we explore if low SES is related to inflammation in children via such stressful life events.MethodsData on 4525 children of the Avon Longitudinal Study of Parents and Children, a general population birth cohort, were used to explore associations between SES at ages 0–3 years, upsetting life events at ages 3–9 years and inflammatory markers [interleukin 6 (IL-6) and C-reactive protein (CRP)] at age 9 years. Confounders included body mass index, gender, financial problems, and upsetting life events at ages 0–3 years.ResultsUsing Structural Equation Modelling, we found that early socioeconomic disadvantage predicted higher levels of IL-6 (β = 0.034, 95% CI = 0.005, 0.063) even after adjusting for confounders. This association was partially mediated by upsetting life events (β = 0.003, 95% CI = 0.001, 0.006).ConclusionsIn the general child population, low SES is associated with increased exposure to stressful life events, in turn associated with later inflammation. These findings highlight the role of stressors associated with poverty and disadvantage in the development of inflammation among children in the general population.     

Social class correlations among adoptees and their biological and adoptive parents

Positive correlations for SES ratings are reported for a large sample of adoptees and their biological and adoptive parents. The possible effects of selective placement and late placement are examined, and the validity of the SES scale is discussed.This work was supported by Grant No. MH 31154 from the National Institute of Mental Health, and Grant No. MH 25311 United States Public Health Service.     

双相情感障碍的中医病因学初探

目的 对双相情感障碍的中医七情致病进行初步探讨.方法 选取2004～2005年因双相情感障碍发病入院的患者155例,其中78例双相障碍躁狂发作,77例双相障碍抑郁发作患者.采用回顾式查阅首次原始入院病历的方式,综合分析病人首次住院时诱因、病史、临床表现及精神检查所见.采用七情评定量表(Seven Emotions Scale, SES),应用五级评分制对双相情感障碍患者入院时的喜、怒、忧、思、悲、恐、惊七情的心理状况进行评定.结果 在155例双相情感障碍患者中,"忧""怒""悲""思""喜""恐"和"惊"为主要临床相的分别占29.7%,25.5%,12.9%,9.7%,7.1%,3.2%和1.3%,其中同时两种"七情"评分相等的占11.0%.在78例首次发病处于躁狂相的双相情感障碍(BPD)病人中,"怒""喜""忧""思""恐""惊"和"悲"为主要临床相的分别占50.0%,14.1%,9.0%,9.0%,1.3%,1.3%和0%,其中同时两种"七情"评分相等的占15.3%;在77例首次发病处于抑郁相的BPD病人中,"忧""悲""思""恐""惊""怒"和"喜"为主要临床相的分别占50.6%,26.0%,10.4%,5.2%,1.3%,0%和0%,其中同时两种"七情"评分相等的占6.5%.结论 双相情感障碍患者中,"忧"和"怒"为主要的七情致病因素.其中躁狂与怒更加相关,怒在躁狂中的发生率高于喜;抑郁与忧更加相关,忧在抑郁中的发生率高于悲,这可能是我国当前躁狂发作和抑郁发作的症状学特点.     

The use of antidepressants and introduction of new types in different socio-economic groups: A Danish registry-based cross-sectional study

Background: Danish registry-based studies have found socio-economic differences in drug use. The extent to which the use of antidepressants differs between socio-economic groups is unknown. Aim: 1) to examine the association between socio-economic status (SES) and use of antidepressants 2) to evaluate the introduction of new types of antidepressants. Methods: A registry-based cross-sectional study linking information from administrative registries in North Jutland County, Denmark, 1995–99. Main outcome measures: 1) the prevalence proportion for use of antidepressants in different SES groups and by sex, and the estimated prevalence proportion ratio; 2) the proportion using the new drugs in different socio-economic groups through the study period. Results: Women used antidepressants more than twice as often as men with an increasing tendency for both men and women. The use of antidepressants was highest in persons outside the labour market. Among employees, the proportion using new types of antidepressants increased from 1% to 18%. High SES seemed to correlate to higher use of new antidepressants. The new antidepressants were introduced faster among men compared with women. Conclusion: The study showed differences in purchase of antidepressants in different SES groups. Furthermore, it showed faster introduction of new antidepressants among men and employees with high SES.