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BACKGROUND: The older patient with inflammatory bowel diseases (IBD) is particularly vulnerable to consequences of disease and therapy-related side effects but little is known about the best treatment options in this population. AIM: To compare safety and efficacy of tumor necrosis factor α antagonist (anti-TNF) or vedolizumab (VDZ) in patients with IBD ≥ 60 years of age. METHODS: This retrospective study included patients with Crohn’s disease (CD) or ulcerative (UC) initiating anti-TNF or VDZ therapy at ≥ 60 years of age at 3 study sites. We examined occurrence of infection or malignancy within 1 year after therapy as our primary outcome. Our efficacy outcomes included clinical remission at 3, 6, and 12 months. Multivariable logistic regression models adjusting for relevant confounders estimated odds ratios (OR) and 95% confidence intervals. RESULTS: The study included 131 anti-TNF and 103 VDZ initiated patients (age range 60 – 88 years). Approximately half had CD. At 1 year, there were no significant differences in safety profile between the two therapeutic classes. Infections were observed in 20% of anti-TNF treated and 17% of VDZ treated patients (p=0.54). Pneumonia was the most common infection in both groups. While more anti-TNF treated CD patients were in remission at 3 months compared to VDZ (OR 2.82, 95% CI 1.18 – 6.76), this difference was not maintained at 6 and 12 months suggesting similar efficacy of both classes. CONCLUSIONS: Both anti-TNF and VDZ therapy were similarly effective and safe in elderly IBD patients.

Objective To explore the predictors of deferred lesion failure (DLF) in patients with diabetes mellitus (DM) and lesions with a fractional flow reserve (FFR) >0.80 and to examine whether a predictive relationship between negative FFR values (>0.80–1.00) and DLF exists. Background DM is associated with rapidly progressive atherosclerosis and predictors of DLF in FFR negative lesions in this high-risk group are unknown. Methods All DM patients who underwent FFR-assessment between 1/01/2010 and 31/12/2013 were included, and followed until 1/7/2015. Patients carrying ≥1 FFR negative lesion(s) were assessed for DLF, and multivariate models used to identify independent factors associated with DLF. Results A total of 205 patients with 252 FFR >0.80 lesions were identified. At a mean follow-up of 3.1 ± 1.4 years, DLF occurred in 29/205 (14.1%) patients, 31/252 (12.3%) lesions. Using marginal Cox regression multivariate analysis, insulin requiring DM [HR 2.24 (95%CI; 1.01–4.95), P = 0.046] and prior revascularization [HR 2.70 (95%CI 1.21–6.01), P = 0.015] were identified as being associated with a higher incidence of DLF. Absolute FFR values in FFR negative lesions in DM patients are not predictive of DLF (receiver operating characteristics curve analysis: area under the curve: 0.57 ± 0.06, 95%CI 0.46–0.69). Conclusions In DM patients with FFR negative lesions, insulin requiring DM and prior revascularization are predictors for DLF. In contrast to non-DM patients, no predictive relationship between absolute negative FFR values (ranging >0.80–1.00) and the risk of DLF exists in DM patients. © 2017 Wiley Periodicals, Inc.

A new route to access low-coordinate (β-diketiminato)cadmium complexes has been developed. Treatment of [Cd(HMDS)2] with BDI-H (HMDS = [N(SiMe3)2]; BDI = [{N(2,6-iPr2C6H3)C(Me)}2CH]) forms [(BDI)Cd(HMDS)], which is a useful synthon for the generation of other low-coordinate cadmium complexes such as anilido complex [(BDI)Cd(NH{N(2,6-iPr2C6H3})(THF)], aryloxo complex [(BDI)Cd(O-2,6-tBu2C6H3)], as well as chloro complex [{(BDI)CdCl}2]. [(BDI)Cd(HMDS)] is extremely sensitive to hydrolysis, generating [{(BDI)Cd(OH)}2] upon exposure to “dry” tert-butyl alcohol.

Borren, I., Tambs, K., Idstad, M., Ask, H. & Sundet, J. M. (2012). Psychological distress and subjective well-being in partners of somatically ill or physically disabled: The Nord-Trondelag Health Study. Scandinavian Journal of Psychology 53, 475–482. This study investigated the cross-sectional associations between various somatic conditions in one partner and the level of distress and well-being in the spouse. The study is based on survey data from the Norwegian Nord-Trondelag Health Study, HUNT II (1995–1997). A sample of 9,797 married or cohabiting couples with valid data on subjective well-being (SWB), psychological distress (Hopkins Symptom Check List (SCL)-10) and somatic illness were identified. Regression analyses stratified by sex were conducted with SCL-10 and SWB scores as dependent variables and a joint somatic score as predictor, including; stroke, cancer, angina, myocardial infarction and physical disability (PD). The contribution of each somatic condition was also explored. Spouses of persons previously diagnosed with at least one somatic condition scored significantly lower on SWB and significantly higher on SCL-10 than spouses of healthy persons, though effect sizes were small. The effect seems to be at least partly mediated by the ill partner’s psychological distress. Of the specific conditions, PD had the most significant contribution for both genders, though an association between male angina and spousal distress/SWB was also demonstrated.

Background and purpose: Increased activity of the Na+/H+-exchanger (NHE-1) in heart failure underlies raised [Na+]i causing disturbances of calcium handling. Inhibition of NHE-1, initiated at the onset of pressure/volume overload, prevents development of hypertrophy, heart failure and remodelling. We hypothesized that chronic inhibition of NHE-1, initiated at a later stage, would induce regression of hypertrophy, heart failure, and ionic and electrophysiological remodelling. Experimental approach: Development of heart failure in rabbits was monitored electrocardiographically and echocardiographically, after one or three months. Cardiac myocytes were also isolated. One group of animals were treated with cariporide (inhibitor of NHE-1) in the diet after one month. Cytoplasmic calcium, sodium and action potentials were measured with fluorescent markers and sarcoplasmic reticulum calcium content by rapid cooling. Calcium after-transients were elicited after rapid pacing. Sodium channel current (INa) was measured using patch-clamp techniques. Key results: Hypertrophy and heart failure developed after one month and progressed during the next two months. After one month, dietary treatment with cariporide was initiated. Two months of treatment reduced hypertrophy and heart failure, duration of action potential QT-interval and QRS, and restored sodium and calcium handling and the incidence of calcium after-transients. In cardiac myocytes, parameters of INa were not changed by cariporide. Conclusion and implications: In rabbit hearts with hypertrophy and signs of heart failure one month after induction of pressure/volume overload, two months of dietary treatment with the NHE-1 inhibitor cariporide caused regression of hypertrophy, heart failure and ionic and electrophysiological remodelling. British Journal of Pharmacology (2008) 154, 1266–1275; doi:10.1038/bjp.2008.189; published online 19 May 2008

Using the latest published data from Tobacco Advisory Council surveys, this paper re-evaluates the question of whether or not increases in cigarette taxation are regressive in the United Kingdom. The extended data set shows no evidence of increasing price-elasticity by social class as found in a major previous study. To the contrary, there appears to be no clear pattern in the price responsiveness of smoking behaviour across different social classes. Increases in cigarette taxation, while reducing smoking levels in all groups, fall most heavily on men and women in the lowest social class. Men and women in social class five can expect to pay eight and eleven times more of a tax increase respectively, than their social class one counterparts. Taken as a proportion of relative incomes, the regressive nature of increases in cigarette taxation is even more pronounced.

Durch die Integration einer chemischen oder biochemischen Reaktion und einer chromatographischen Trennung in einem gemeinsamen Apparat ist es moglich, die Gleichgewichtslimitierung der Reaktion zu uberwinden und die Trenneffektivitat zu erhohen. Verschiedene prozesstechnische Varianten des chromatographischen Reaktors werden vorgestellt. Aufgrund der komplexen Zusammenhange sind Modellierung und Simulation wichtige Werkzeuge bei der Entwicklung und Gestaltung der Prozesse. Eine Ubersicht uber die zur Verfugung stehenden Modellansatze wird gegeben. Ein Vergleich der verschiedenen chromatographischen Simulated Moving Bed (SMB)-Reaktoren erfolgt am Beispiel der Glucose-Isomerisierung. In Abhangigkeit von der jeweiligen Reinheitsanforderung an den gewonnenen Fructose-Sirup bieten unterschiedliche Integrationsgrade von Reaktion und Trennung Vorteile. Comparison of Chromatographic Reactor Concepts The integration of a chemical or biochemical reaction and a chromatographic separation in a single apparatus offers the opportunity to overcome chemical equilibrium as well as an increase in the separation efficiency. The different possibilities to design such a chromatographic reactor are discussed. Due to the complex behaviour modelling and simulation are powerful tools for process development and design. Therefore an overview over the different modelling approaches is given. Applying the example of the glucose isomerisation, the different processes based on the chromatographic simulated moving bed (SMB) reactor are compared. Different purity restrictions of the produced fructose syrup lead to different degrees of integration of reaction and separation in respect to a favourable process design.