Background and aims
Clinical trials have shown that intensive low‐density lipoprotein cholesterol (LDL‐C) lowering improves cardiovascular outcomes among patients with atherosclerotic cardiovascular ...disease (ASCVD), but data are limited in real clinical practice, particularly for patients with ASCVD informing different territories.
Methods
FRENA was a prospective registry of consecutive outpatients with coronary, cerebrovascular or peripheral artery disease. We compared the incidence of recurrent events in patients with sustained LDL‐C levels <70 mg/dl compared with those with ≥70 mg/dl.
Results
As of December 2018, 1182 patients were eligible for this study. Among them, 172 (14.5%) had mean LDL‐C levels ≤70 mg/dl, and 1010 (85.5%) had <70 mg/dl. Their clinical characteristics at baseline were similar. During 5 years of follow‐up, 252 patients (21%) suffered major adverse cardiovascular events (MACE). The incidence rates of MACE were 3.42 events per 100 patient‐years (95% confidence interval 95% CI 2.17–5.14) in patients with levels <70 mg/dl and 5.57 (95% CI, 4.87–6.34) in those with ≥70 mg/dl; the rate ratio was 0.61 (95% CI, 0.39–0.92), p = 0.019. On multivariable analysis, patients with LDL‐C levels <70 mg/dl were at lower risk for MACE (hazard ratio HR: 0.61 95% CI, 0.39–0.93 p < 0.05). MACE reduction was driven by a decrease in coronary and peripheral events with no significant effect on stroke.
Conclusions
Long‐term sustained LDL‐C <70 mg/dl in the clinical practice is associated with reduction in cardiovascular and peripheral vascular events with no apparent effect on stroke.
Background
The relationship between anticardiolipin (aCL) antibodies and cardiovascular events is uncertain and may vary according to arterial location.
Materials and methods
FRENA is an ongoing ...registry of stable outpatients with symptomatic coronary artery disease (CAD), cerebrovascular disease (CVD) or peripheral artery disease (PAD). The rate of subsequent ischaemic events was cross‐referenced with the presence of aCL antibodies (any isotype, IgG or IgM).
Results
As of June 2017, 1387 stable outpatients were recruited. Of these, 120 (8.7%) showed positive levels of aCL antibodies. Over an average follow‐up of 18 months, 250 patients developed subsequent events: 101 myocardial infarction, 57 ischaemic stroke and 92 critical leg events. Patients with positive aCL antibodies had a higher risk of distal artery events (a composite of ischaemic stroke or critical leg events) than patients with undetectable or low levels (rate ratio: 1.66; 95% CI: 1.07‐2.60). However, an association with central coronary events was not found. The multivariate Cox analysis after adjustment for relevant clinical covariates showed that positivity of aCL antibodies is an independent risk factor for distal events (hazard ratio: 1.60; 95% CI: 1.01‐2.55; P < .05).
Conclusions
Positivity of aCL antibodies is associated with an increased risk of subsequent distal artery ischaemic events (cerebral or leg arteries) but not coronary artery events. Anticardiolipin antibodies appear to have a different relationship on the localisation of ischaemic events in patients with symptomatic artery disease.
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•Antioxidant extracts were obtained from tangerine peels by SFE using CO2-EtOH.•The total flavanone content was correlated with in vitro antioxidant capacity.•The most active extract ...was obtained at 22.0 MPa, 80 °C and 5.0 % w/w EtOH.•Some flavonoids in tangerine peels were tentatively identified using UHPLC-DAD.•The best extract protected a mayonnaise against lipid oxidation like the BHA synthetic antioxidant.
By supercritical fluid extraction (SFE) it was possible to obtain an antioxidant extract from tangerine peels (TPs) which was then tested on a mayonnaise. The TPs were submitted to SFE using CO2-EtOH as solvent. A central composite design was set up to evaluate the effect of temperature, pressure and %EtOH on the yield, the total phenolic content (TPC), the total flavanone content (TFC) and the in vitro antioxidant capacity (AC) by DPPH method. SFE extracts showed high TPC, TFC and AC. These extracts were analyzed by UHPLC-DAD, tentatively identifying eight flavonoids. The most active extract was obtained at 22.0 MPa, 80 °C, 5.0 %EtOH. This extract was tested as a mayonnaise´s antioxidant, monitoring produced TBARS (Thiobarbituric Acid Reactive Substances). It was shown to protect the mayonnaise against lipid oxidation and was as effective as the synthetic antioxidant BHA. These results profile the TPs as an applicable biomass in the food industry.
Se presenta una propuesta de enseñanza de la soldadura que incluye modelo pedagógico aplicado, metodología de desarrollo y una guía para la elaboración de proyectos de aula, dirigido a estudiantes de ...Ingeniería Mecánica e Industrial, dentro del contexto de la formación por competencias. Se muestra un proyecto desarrollado en una empresa del sector de la soldadura, dirigido al control y aseguramiento de la unión soldada, usando la metodología propuesta. La aplicación del modelo motivó significativamente a los estudiantes en el estudio de la soldadura y procesos afines, vinculó a las empresas del sector con la universidad, generó documentos de trabajo desarrollado por estudiantes con asesorías de docentes y expertos de las empresas.
The Basic Safety Standard (BSS) Directive 2013/59/EURATOM of the European Union (EU) has stated the need for member states to establish national action plans to mitigate their general population's ...long-term risks of exposure to radon gas. Maps of radon-prone areas provide a useful tool for the development of such plans. This paper presents the maps of radon-prone areas in the Eastern Canary Islands (Gran Canaria, Fuerteventura and Lanzarote) obtained from assessment of Geogenic Radon Potential (GRP) distribution in the territory. GRP constitutes a magnitude that is contingent on both radon activity concentration and gas permeability of soils. An extensive campaign covering all geological formations of the Eastern Canary Islands was undertaken to locally sample these parameters. Geostatistical analysis of the spatial distribution of radon concentration in soils, permeability and GRP was performed on each of the islands, and the relationship between these magnitudes and the characteristic geological formations of the volcanic islands was investigated. Areas dominated by basic volcanic and plutonic rocks (originated by both recent and ancient volcanism) exhibit relatively low levels of radon in soils, and with the exception of specific cases of very high permeability, these areas are not classified as prone to radon risk according to international criteria. Areas in which intermediate or acidic volcanic and plutonic rocks predominate are characterised by greater radon activity concentration in soils, rendering them radon-prone. Given these results, Lanzarote is classified as an island with low radon risk all over its surface; Fuerteventura presents low-medium risk; and Gran Canaria contains extensive areas in the centre and north where the risk is medium or high. This classification is consistent with the risk maps obtained by National and European agencies from indoor radon measurements conducted on these islands.
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•EU Member states have to establish action plans to mitigate radon exposure risks.•A study of Soil radon gas concentration and gas permeability of soils were performed.•Geogenic Radon Potential (GRP) distribution in the territory have been assessed.•Maps of radon prone areas in the Eastern Canary Islands are displayed based on GRP.•The subsequent zonal classification agrees with those provided by the authorities.
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