BACKGROUND Guidelines recommend nonstatin lipid-lowering agents in patients at very high risk for major adverse cardiovascular events (MACE) if low-density lipoprotein cholesterol (LDL-C) remains ≥70 mg/dL on maximum tolerated statin treatment. It is uncertain if this approach benefits patients with LDL-C near 70 mg/dL. Lipoprotein(a) levels may influence residual risk. OBJECTIVES In a post hoc analysis of the ODYSSEY Outcomes (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) trial, the authors evaluated the benefit of adding the proprotein subtilisin/kexin type 9 inhibitor alirocumab to optimized statin treatment in patients with LDL-C levels near 70 mg/dL. Effects were evaluated according to concurrent lipoprotein(a) levels. METHODS ODYSSEY Outcomes compared alirocumab with placebo in 18,924 patients with recent acute coronary syndromes receiving optimized statin treatment. In 4,351 patients (23.0%), screening or randomization LDL-C was <70 mg/dL (median 69.4 mg/dL; interquartile range: 64.3–74.0 mg/dL); in 14,573 patients (77.0%), both determinations were ≥70 mg/dL (median 94.0 mg/dL; interquartile range: 83.2–111.0 mg/dL). RESULTS In the lower LDL-C subgroup, MACE rates were 4.2 and 3.1 per 100 patient-years among placebo-treated patients with baseline lipoprotein(a) greater than or less than or equal to the median (13.7 mg/dL). Corresponding adjusted treatment hazard ratios were 0.68 (95% confidence interval [Cl]: 0.52–0.90) and 1.11 (95% Cl: 0.83–1.49), with treatment-lipoprotein(a) interaction on MACE ( P interaction = 0.017). In the higher LDL-C subgroup, MACE rates were 4.7 and 3.8 per 100 patient-years among placebo-treated patients with lipoprotein(a) >13.7 mg/dL or ≤13.7 mg/dL; corresponding adjusted treatment hazard ratios were 0.82 (95% Cl: 0.72–0.92) and 0.89 (95% Cl: 0.75–1.06), with P interaction = 0.43. CONCLUSIONS In patients with recent acute coronary syndromes and LDL-C near 70 mg/dL on optimized statin therapy, proprotein subtilisin/kexin type 9 inhibition provides incremental clinical benefit only when lipoprotein(a) concentration is at least mildly elevated. (ODYSSEY Outcomes: Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab; NCT01663402 )
Objetivou-se avaliar com este trabalho a utilização da ervasal (Atriplex nummularia) irrigada com o resíduo da dessalinização, como alternativa alimentar em dietas para engorda de frangos Caipira Francês. Aos 28 dias de idade, foram selecionados, de forma individual e por peso, 120 frangos (60 machos e 60 fêmeas) que foram distribuídos em delineamento inteiramente casualizado, com quatro tratamentos, cinco repetições e seis aves por unidade experimental. As dietas experimentais foram isonutritivas e formuladas à base de feno da parte aérea da mandioca (FM), feno de Atriplex (FA), milho em grão moído e farelo de soja. Foram utilizados quatro tratamentos: 0%; 35%; 65%; e 100% de substituição do FM pelo FA na ração base. Não houve diferença significativa para o consumo de matéria seca, consumo de proteína bruta e consumo de energia bruta em relação à substituição do FM pelo FA que apresentaram médias de 133,9g/ave/dia, 19,8g/ave/dia e 543,3Kcal/ave/dia, respectivamente. A conversão alimentar das dietas testadas obteve comportamento linear crescente. Com substituição de 17,7% do FM pelo FA podemse obter ganhos máximos de 432,4g e 14,4g/dia, respectivamente para ganho médio total e diário. A substituição do FM pelo FA em intervalo de 46,4 a 50% apresentou melhores resultados para peso de carcaça e valores econômicos nas dietas testadas.
Fat burners are a category of nutritional supplements that are claimed to increase the metabolism and promote greater energy expenditure, leading to weight loss. However, little is known about the side effects on gastrointestinal motility. In this study, we evaluated the effect of ingestion with a fat burner named Thermbuterol® (THERM) on the gastric motility and food behavior of mice. THERM compounds were identified using nuclear magnetic resonance (NMR). Mice received variable doses of THERM (10, 50, 100 or 300 mg/kg, p.o.) or NaCl 0.15 M (control). Gastric emptying (GE) was assessed using the phenol red technique. Another set of mice was pretreated with intraperitoneal administration of hexamethonium (HEXA, 10 mg/kg), prazosin (PRAZ, 0.25 mg/kg), propranolol (PROP, 2 mg/kg), parachlorophenylalanine (PCPA, 300 mg/kg) or ondansetron (ONDA, 50 μg/kg) 30 min before THERM treatment for evaluation of GE. We assessed the gastrointestinal responsiveness in vitro as well as THERM's effects on food behavior. Caffeine was the major compound of THERM, identified by NMR. THERM 100 and 300 mg/kg decreased GE compared to the respective controls. Pretreatment with PRAZ or PROP did not prevent gastric dysmotility induced by THERM 100 mg/kg. However, the pretreatment with HEXA, ONDA or PCPA prevented GE delay induced by THERM. In vitro , THERM relaxed contractions in strips of longitudinal gastric fundus and duodenum. THERM also increased food intake, which was prevented by PCPA and ONDA treatments. THERM decreased GE of a liquid and increased food intake in mice, a phenomenon mediated by the autonomic nicotinic receptors and serotoninergic receptor.
Abstract:The prevalence of obesity is, worldwide, in wide intensification. This increase stimulates the search for new hypotheses that explain the genesis of the metabolic syndrome. This article seeks to clarify the obesogenic hypothesis of bisphenol A (BPA), based on its endocrine disrupting potential. Methodology: For the development of the present study, the Scopus and PubMed databases were used, from descriptors generated by the DeCS: Endocrine Disruptors; Foods; Obesity; Bisphenol A and its correspondents in English. Randomized and controlled trials were considered eligible, focusing on publications in English and Portuguese. The survey was conducted on April 11, 2017, with publications of the last five years being leaked. Based on this, 87 articles were obtained and, from the reading of the title and its abstracts, 26 publications were selected. After the complete reading of the 26 articles selected, 18 articles were obtained that served as a basis for this bibliographic review. Bisphenol A appears as an important agent that causes obesity in the contemporary world, interfering in the signaling mechanism of the endocrine system, being its high exposure linked to many of the habits present in the current context. Conclusion: Based on the possible consequences of bisphenol A, the reduction of human exposure to the compound should be considered. Based on this, alternatives to BPA in the production of industrial plastic polymers have to be considered since increased exposure to the endocrine disruptor is closely related to industrial production.
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