Outcomes of Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Receiving an Oral Anticoagulant and Dual Antiplatelet Therapy: A Comparison of Clopidogrel Versus Prasugrel From the TRANSLATE-ACS Study

ObjectivesThe purpose of this study was to determine whether bleeding risk varies depending on which P2Y₁₂ receptor inhibitor agent is used.BackgroundPrior studies have shown significant bleeding risk among patients treated with triple therapy (i.e., oral anticoagulant, P2Y₁₂ receptor inhibitor, and aspirin).MethodsWe evaluated patients with acute myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) at 233 hospitals in the United States enrolled in the TRANSLATE-ACS (Treatment with Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) study (April 2010 to October 2012). Using inverse probability-weighted propensity modeling, we compared 6-month adjusted risks of Bleeding Academic Research Consortium (BARC) bleeding, stratifying by whether or not bleeding was associated with rehospitalization among patients discharged on aspirin + anticoagulant + clopidogrel (triple-C), aspirin + anticoagulant + prasugrel (triple-P), aspirin + clopidogrel (dual-C), or aspirin + prasugrel (dual-P).ResultsOf 11,756 MI patients, 526 (4.5%) were discharged on triple-C, 91 (0.8%) on triple-P, 7,715 (66%) on dual-C, and 3,424 (29%) on dual-P. Compared with dual-therapy patients, triple-therapy patients had significantly higher any BARC-defined bleeding. Triple-P was associated with a greater risk of any BARC-defined bleeding events compared with triple-C. This finding was driven mostly by an increased risk of bleeding events that were patient-reported only and did not require rehospitalization. There were no significant differences in bleeding requiring rehospitalization between the triple-P and -C groups.ConclusionsAmong MI patients, the addition of an oral anticoagulant was associated with a significantly greater risk of any BARC-defined bleeding relative to dual antiplatelet therapy, regardless of which P2Y₁₂ receptor inhibitor was selected. Among patients on triple therapy, prasugrel use was associated with higher patient-reported–only bleeding, but not bleeding requiring rehospitalization, than clopidogrel-treated patients.     

The Rh Antigen D: Partial D Antigens and Associated Low Incidence Antigens

The expression of the Rh antigen D varies quantitatively and qualitatively (partial D); published information and 15 years' work studying D variants are discussed in this review. D epitopes correspond to the reaction patterns of monoclonal anti-D with partial D antigens. Partial D antigens can be reported in terms of their D epitopes but the epitope profile of cells with a quantitative variant of D (weak D) is difficult to determine reliably by haemagglutination tests. Nine partial D antigens, categories II-VII, DFR and two not previously reported, are identified by their epitope profiles and by association with low incidence antigens. Monoclonal anti-D recognize 16 D epitopes and more epitopes are anticipated. The specificities of polyclonal anti-D made by people with partial D antigens are considered in terms of possible D epitope specificities: recognized epitope specificities, or combination thereof, were not able to account for all observed reaction patterns of anti-D made by immunized individuals with partial D pheno-types. An attempt is made to understand partial D antigens and their associated low incidence antigens in terms of the molecular genetic information available.     

1956-2012年文登市百日咳疫苗接种与发病分析

目的探讨控制和消除百日咳的防制措施。方法对山东省文登市1956-2012年不同时期百日咳疫苗接种和发病情况进行流行病学分析。结果百日咳疫苗接种前期百日咳年平均发病率为68.77/10万,疫苗接种初期、常规接种期、计划免疫期百日咳年平均发病率分别为28.30/10万、17.93/10万、1.97/10万,比疫苗接种前期分别下降了58.85%、73.93%、97.14%。2001-2012年无病例发生。结论山东省文登市百日咳疫苗后,百日咳年平均发病率明显下降,加强疫苗接种管理,提高和保持接种率是控制、消除百日咳的有效措施。     

消化系癌症并发抑郁症发病情况及相关因素分析

目的了解消化系癌症（DC）患者抑郁症发病情况并探讨其相关因素。方法收集2008年6月～2011年3月两所三级甲等医院多个科室的DC患者321例,进行抑郁自评量表（SDS）和Hamilton抑郁量表（HAMD）的评定及抑郁相关因素调查,收回有效问卷315份,研究DC并发抑郁症的发病情况,进行相关因素分析。结果DC患者抑郁发生率为44．76％,以轻、中度程度为主,与文化程度和TNM分期有关。结论DC患者抑郁发生率较高,与文化程度和TNM分期相关,临床应加以辨识。     

新疆疏附县2005-2012年炭疽流行病学分析

目的 分析疏附县炭疽流行病学特征,为制订炭疽防控策略提供依据和参考.方法 对疏附县2005-2012年网络报告的炭疽发病资料进行描述性流行病学分析.结果 2005-2012年疏附县共报告炭疽137例,占同期全国病例总数的5.09％,年平均发病率为5.34/10万.病例全部为皮肤型炭疽,多为散发;夏秋两季高发,7月为高峰月份;男女性别比为1.36∶1,男性发病率高于女性.超过54％的病例为20岁以下儿童和青年,10-14岁高发.病例职业多为农牧民和学生,民族以维吾尔族为主（99.27％）.结论 疏附县炭疽发病率极高且呈低龄化特点,应采取针对性措施进一步加强其预防控制.     

Effect of prenatal cocaine on respiration, heart rate, and sudden infant death syndrome.

We studied 114 neonates by pneumocardiogram recordings in order to examine the effects of cocaine with and without opiate exposure on neonatal respiration, heart rate, apparent life threatening events (ALTE), and sudden infant death syndrome (SIDS). In full-term infants exposed to cocaine without opiates we found increased longest apnea duration and more episodes of bradycardia, but decreased periodic breathing and average heart rate than in control full-term infants. Term infants prenatally exposed to cocaine with opiates also had less periodic breathing. Preterm infants exposed to cocaine with and without opiates had decreased apnea density and periodic breathing compared with preterm controls. Discriminant analysis to determine whether perinatal asphyxia or exposure to other drugs could predict cardiorespiratory abnormalities showed no consistent relationship. In 72 of 114 infants available for follow-up, no ALTE occurred but two were lost to SIDS. Our data support the hypothesis that prenatal cocaine exposure may perturb, albeit subtly, the maturation of respiratory control, resulting in disruption of postnatal respiration.     

Cell-kinetic analysis of pancreatic cancers in syrian golden hamsters

Cell-kinetic analysis of pancreatic cancers using bromodeoxyuridine (BrdU) was performed on four transplantable pancreatic ductal adenocarcinomas, which were experimentally induced by givingN-nitrosobis (2-hydroxypropyl) amine (BHP) to Syrian golden hamsters. The volume-doubling time (Td)of the tumor was 0.43, 1.03, 2.30, and 3.50 d for tumor lines J, D, B, and F, respectively. In the pulse-labeling study, the labeling index was 15.8, 23.3, 27.9, and 31.7, respectively. The most rapidly growing tumor line, J, unexpectedly showed the lowest BrdU-labeling index (LI). The further study of tumor using the cumulative-labeling method revealed that the duration of S phase (Ts), the generation time (Tg) and the growth fraction (GF) were 2 h, 14 h, and 90% for tumor J and 12 h, 37 h, and 85% for slowly growing tumor B, respectively. Cells of limited life span (CLLS) of these lines did not differ from each other. These results conclude that the marked difference ofTg between tumor lines J and B resulted in a distinction of their growth rates. The disagreement ofTs/Tg also lead to a reversion of LI between the two lines. Furthermore, LI of BrdU with one-point pulse labeling did not seem to be a sufficient indicator of the growth characteristics, at least, in the present experiment.     

Complication and failure rates in patients treated for chronic periodontitis and restored with single crowns on teeth and/or implants

Objectives: To assess the biological and technical complication rates of single crowns on vital teeth (SC‐V), endodontically treated teeth without post and core (SC‐E), with a cast post and core (SC‐PC) and on implants (SC‐I). Material and methods: From 392 patients with chronic periodontitis treated and documented by graduate students during the period from 1978 to 2002, 199 were reexamined during 2005 for this retrospective cohort study, and 64 of these patients were treated with SCs. Statistical analysis included Kaplan–Meier survival functions and event rates per 100 years of object‐time. Poisson regression was used to compare the four groups of crowns with respect to the incidence rate ratio of failures, and failures and complications combined over 10 years and the entire observation period. Results: Forty‐one (64%) female and 23 (36%) male patients participated in the reexamination. At the time of seating the crowns, the mean patient age was 46.8 (range 24–66.3) years. One hundred and sixty‐eight single unit crowns were incorporated. Their mean follow‐up time was 11.8 (range 0.8–26.4) years. During the time of observation, 22 biological and 11 technical complications occurred; 19 SC were lost. The chance for SC‐V (56) to remain free of any failure or complication was 89.3% (95% confidence interval [CI] 76.1–95.4) after 10 years, 85.8% (95% CI 66–94.5) for SC‐E (34), 75.9% for SC‐PC (39), (95% CI 58.8–86.7) and 66.2% (95% CI 45.1–80.7) for SC‐I (39). Over 10 years, 95% of SC‐I remained free of failure and demonstrated a cumulative incidence of failure or complication of 34%. Compared with SC‐E, SC‐I were 3.5 times more likely to yield failures or complications and SC‐PC failed 1.7 times more frequently than did SC‐E. SC‐V had the lowest rate of failures or complications over the 10 years. Conclusions: While SCs on vital teeth have the best prognosis, those on endodontically treated teeth have a slightly poorer prognosis over 10 years. Crowns on teeth with post and cores and implant‐supported SCs displayed the highest incidence of failures and complications. To cite this article :
Schmidlin K, Schnell N, Steiner S, Salvi GE, Pjetursson B, Matuliene G, Zwahlen M, Brägger U, Lang NP. Complication and failure rates in patients treated for chronic periodontitis and restored with single crowns on teeth and/or implants
Clin. Oral Impl. Res. 21 , 2010; 550–557.
doi: 10.1111/j.1600‐0501.2009.01907.x