474 research outputs found
Colesevelam hydrochloride : usefulness of a specifically engineered bile acid sequestrant for lowering LDL-cholesterol
No full textSeveral recent meta-analyses of numerous lipid-lowering outcome trials confirm the direct relationship between low-density lipoprotein-cholesterol (LDL-C) lowering and cardiovascular risk reduction. As a consequence, LDL-C goals are continuously being set lower. To achieve lipid lowering, several efficient drugs are available, however, the current pharmacopoeia remains limited for some critical patient situations. Colesevelam hydrochloride is a specifically engineered bile acid sequestrant that features a more favourable tolerability and drug interaction profile than traditional bile acid sequestrants, because of a better affinity and binding capacity to bile acids. In addition, colesevelam retains the nonsystemic mode of action of bile acid sequestrants. Moreover, colesevelam lowers LDL-C by 15-19% and 10-16%, respectively, in monotherapy and in combination to various lipid-lowering drugs, such as statins, ezetimibe and fenofibrates. Along with an efficient and sustainable effect on lipid profiles, colesevelam - as other bile acid sequestrants - has been shown to lower the glycosylated haemoglobin HbA1c by 0.5% on average in patients with type 2 diabetes. Overall, colesevelam represents an interesting add-on treatment to be used in high-risk patients with hypercholesterolaemia for whom standard lipid-lowering therapies are not enough or not well tolerate
Ctenarytaina bipartita Burckhardt, Farnier, Queiroz, Taylor & Steinbauer, 2013, sp. n.
No full textCtenarytaina bipartita sp. n. (Figs 1–13) Material examined. Holotype 3, Australia: Victoria, Battery Creek, 146 ° 7 ’ 42.3 ”E, 38 ° 42 ’ 51.5 ”S, 144 m above sea level, 7 March 2012, planted Eucalyptus kitsoniana (K. Farnier & M.J. Steinbauer), bred in greenhouse in LTUV (ANIC, dry mounted). Paratypes. Australia: Australian Capital Territory: 1 3, 1 Ƥ, Canberra, 13 September 1959 (V.F. Eastop), 1960 - 144 (BMNH, slide mounted). – New South Wales: 6 3, 2 Ƥ, Orange, Dalton Street roundabout, 149 ° 6 ’ 25.8 ”E, 33 ° 16 ’ 31.1 ”S, 866 m above sea level, 15 March 2012, Eucalyptus viminalis (D. Burckhardt) (NHMB, dry mounted); – Tasmania: 3 3, 5 Ƥ, Hobart, 3 December 1986, Eucalyptus viminalis (D. Burckhardt) (MHNG, NHMB, dry and slide mounted); 4 3, 1 Ƥ, same but Marion Bay, West of Copping, 13 December 1986, various trees (MHNG, dry mounted); 2 Ƥ, same but 10 km South of Bronte, 10 December 1986, Eucalyptus spp. (MHNG, dry mounted); 1 Ƥ, Weegena, 9 June 1959, Eucalyptus (V.F. Eastop) VFE 7674, 1960- 144 (BMNH, slide mounted). – Victoria: 8 3, 12 Ƥ, 26 larvae, same data as holotype (ANIC, ELEF, LTUV, MHNG, NHMB, dry and slide mounted and in ethanol); 13 3, 12 Ƥ, same data but (G.S. Taylor & M.J. Steinbauer) (WINC, dry mounted and in ethanol); 8 Ƥ, 22 larvae (5 th instar 12, 4th instar 1, 3rd 4, 2nd 1, 1st 4), Hoddle Range, 146 ° 7 ’ 55.6 ”E, 38 ° 43 ’ 0.9 ”S, 254 m above sea level, 19 October 2011, planted E. kitsoniana (K. Farnier & M.J. Steinbauer) (LTUV, dry mounted); 5 3, 5 Ƥ, 125 larvae, nr Portland, Oakleys Rd, 141 ° 31 ’ 6.4 ”E, 38 ° 19 ’ 55.5 ”S, 7 May 2012, roadside reveg planting of E. kitsoniana and E. viminalis (M.J. Steinbauer), (WINC, in ethanol); 1 3, 110 larvae, same but 7 May 2012; 1 larva, nr Portland, Post Office Rd, 147 ° 20 ’ 33.1 ”E, 38 ° 12 ’6.0”S, 8 May 2012, naturally seeded seedling of E. kitsoniana (M.J. Steinbauer) (WINC, in ethanol). Description. Adult (Figs 1–4). Colouration. When alive bright orange to light brown (Fig. 14); eyes reddish. In dry mounted specimens head and pronotum light orange-brown, preocular tubercule and genal processes yellowish. Antennal segments 1 and 2 yellowish, 5–7 light brown, 8–10 dark brown to almost black. Thorax light reddish brown. Forewing with yellow to light brown veins; membrane semitransparent, indistinctly yellowish. Hindwing transparent, whitish. Legs brown, tibiae whitish, abdominal tergites brown, ventrites dirty whitish or yellowish, membranes reddish. Terminalia yellowish to light ochreous. Young specimens generally lighter in colour. Structure. Head (Fig. 5) strongly deflexed from longitudinal body axis; preocular sclerite forming distinct tubercule; genal processes about one third as long as vertex along mid-line, conical, subacute, contiguous in the middle in basal half; completely enveloping the median ocellus basally. Antenna short, 0.87–0.95 times head width, with a single subapical rhinarium on each of segments 4, 6, 8 and 9; segment 10 with one long curved apical seta, which is about as long as segment 10, and a very short truncate seta. Forewing (Fig. 6) oblong-oval, 2.54–2.84 times as long as head width, 2.64 – 2.28 times as long as broad, more or less evenly rounded apically; pterostigma relatively broad, broadest near the middle; costal break present. Vein C+Sc very weakly, evenly curved, cell c+sc narrow; vein Rs almost straight, vein M long with short, widely diverging branches, vein Cu 1 b relatively long, evenly curved, in males reaching the margin at the point of bifurcation of vein M, in females often beyond point of bifurcation. Surface spinules present in all cells, forming irregular cellular pattern. Mesotibia with a subapical, longitudinal row of stout setae. Metacoxa with small, straight, weakly narrowing, apically blunt meracanthus. Metatibia longer than metafemur, 0.54–0.56 times as long as head width, with 5 almost equidistant short, strongly sclerotised apical spurs. Metabasitarsus with 2 small lateral sclerotised spurs. Male terminalia (Figs. 7, 8) with basal segment of proctiger, in profile, without conspicuous stout pointed seta at the distal posterior angle; apical segment thin, tubular, 0.54–0.62 times length of basal segment; subgenital plate relatively small, triangular, in profile, with concave dorsal margin and longitudinal row of lateral setae. Paramere (Figs. 9, 14) lamellar, weakly curved forward with small finger-like process in basal third of hind margin, subacute apically; outer face sparsely covered in long setae, inner face with a group of thick setae apically and along fore margin, as well as a row of closely spaced peg-like setae starting from about apical third of the hind margin to the base; from behind, fingerlike process visible as narrow lobe with straight inner margin. Distal portion of aedeagus (Figs. 10, 15) with apical third or half imperceptibly inflated, apex narrowly rounded, sclerotised end tube of ductus ejaculatorius small, sshaped. Female terminalia (Fig. 11) with proctiger 0.77 – 0.70 times as long as head width, 2.83–3.27 times as long as circumanal ring, 1.75–1.89 times as long as subgenital plate; dorsal margin of proctiger strongly concave, apical half of proctiger forming narrow process, truncate at apex, and bearing two lateral rows of small peg-like setae over four fifths of its length. Subgenital plate 0.44–0.57 times as long as proctiger, in profile broadly triangular at base, strongly narrowing in apical third. Valvulae dorsalis and ventralis moderately curved. Measurements in mm (3 3, 3 Ƥ). Head width 0.49–0.58, Antenna length 0.46–0.51, forewing length 1.29–1.60, length of basal segment of male proctiger 0.16, length of distal segment of male proctiger 0.09–0.10, paramere length 0.11–0.14, length of distal portion of aeeagus 0.18–0.21, female proctiger length 0.43–0.45. Fifth instar larva (Fig. 16). Coloration. Larvae orange when alive; dirty whitish with yellowish or greyish sclerites when preserved in 70 % ethanol. Tip of antenna and tarsi dark brown, compound eyes red. Dorsum of head yellowish anteriorly. Abdomen with yellow mycetome visible in basal third. Structure. Body (Fig. 13) elongate, weakly sclerotised, 1.63–1.72 times as long as wide. Antenna indistinctly 9 -segmented, a single rhinarium present on each of segments 3, 5, 7 and 8. Forewing pad 1.58–1.60 times as long as antenna. Tarsal arolium oval, lacking pedicel and unguitractor, shorter than claws. Caudal plate (Fig. 12) angular, truncate apically, 0.71–0.91 times as long as wide. Circumanal ring terminal, small, consisting of a single row of pores. Additional pore fields present in the form of circular groups of 6–20 pores each; groups arranged in two irregular half circles on either side of caudal plate (Figs. 12 (large arrows), 16), anterior semicircle in anterior third of caudal plate, posterior in posterior third. Lanceolate marginal setae (Figs. 12 (small arrows), 16) forming three irregular groups in about basal third, in the middle and adjacent to circumanal ring. Measurements in mm (4 larvae). Body length 1.04–1.29, antenna length 0.28–0.31. Etymology. From Latin bipartitus = divided in two parts, referring to the paramere consisting of two lobes. Biology. In southern Victoria, adults were found on native and planted Eucalyptus kitsoniana and E. viminalis between October (mid spring) and early May (mid autumn). In Tasmania, adults were collected in December on Eucalyptus viminalis and by general sweeping on various plants including Eucalyptus pauciflora and unidentified eucalypt species. A single female was collected in June on Eucalyptus sp. The series from the ACT was found in September and that from New South Wales in March on E. viminalis. Adults appear feeding on juvenile foliage and are usually most abundant in opening leaf buds and on very recently expanded leaves. Adults spend most of the time feeding and usually disperse only when disturbed. Mating occurs at feeding sites (Fig. 17). Eggs are most often deposited inside closed apical buds. Females may be induced to lay by insertion of the ovipositor into tight crevices, e.g. between pairs of leaves. In the field, on planted hosts in Victoria, larvae were found between October and May inside apical buds and never on expanding leaves. Densities are typically low (5.9 ± 0.8 larvae per bud, n = 63 observations from seven trees), only rarely reaching high numbers (e.g. 38 larvae in a bud). Larvae produce wax strands (Figs. 18, 19) similar to those of C. eucalypti. Honeydew is encapsulated in the flocculent waxy material (Figs. 18, 19). High numbers of larvae in closed apical leaf pairs induce leaf rolls (Fig. 20). Condensation can be observed inside leaf rolls when opened indicating that they provide larvae with high humidity microhabitats in which to develop. Severely distorted young leaves often do not expand normally (Fig. 20). Leaf rolling was not observed in the field when larval densities were low, e.g. <5 larvae per leaf. In the laboratory larvae reach maturity within three weeks when reared under a 20: 10 °C for 12: 12 hours temperature regime. Mummified larvae with serrated exit holes have been observed in the wild suggesting that the species is attacked by parasitoid wasps. A regular psyllid infestation of small E. kitsoniana seedlings was observed in a nursery (F. Smolders, pers comm.). This population is currently in greenhouse culture at LTUV.Published as part of Burckhardt, Daniel, Farnier, Kevin, Queiroz, Dalva L., Taylor, Gary S. & Steinbauer, Martin J., 2013, Ctenarytaina bipartita sp. n. (Hemiptera, Psylloidea), a new eucalypt psyllid from Southeast Australia, pp. 589-596 in Zootaxa 3613 (6) on pages 590-594, DOI: 10.11646/zootaxa.3613.6.5, http://zenodo.org/record/22171
Ctenarytaina bipartita sp. n. (Hemiptera, Psylloidea), a new eucalypt psyllid from Southeast Australia
No full textCtenarytaina bipartita sp.n., associated with Eucalyptus kitsoniana and E. viminalis, is described from the Australian Capital Territory, New South Wales, Tasmania and Victoria. It differs from other described Ctenarytaina species in the paramere which bears a small posterior lobe. Taxonomically relevant morphological details are illustrated and the species is diagnosed from other eucalypt inhabiting congeners. Information on the biology is also given. C. bipartita has the potential to become an exported pest species to countries with significant eucalypt plantations.Daniel Burckhardt, Kevin Farnier, Dalva L. Queiroz, Gary S. Taylor & Martin J. Steinbauerhttp://www.mapress.com/zootaxa/2013/f/z03613p596f.pd
Combination therapy in dyslipidemia : where are we now?
No full textLowering low-density lipoprotein cholesterol (LDL-C) reduces the risk of cardiovascular disease: each 1.0mmol/L (38.7mg/dL) reduction in LDL-C reduces the incidence of major coronary events, coronary revascularizations, and ischemic stroke by approximately 20%. Statins are a well-established treatment option for dyslipidemia, with LDL-C reduction in the range of 27-55%.Several lipid goal-driven guidelines recommend reducing LDL-C to <2.59mmol/L (100mg/dL) or <1.81mmol/L (70mg/dL) in very high-risk patients. Many patients treated with statins do not reach these goals, and remain at risk of future cardiovascular events. The 2013 American College of Cardiology/American Heart Association guidelines move away from advocating LDL-C treatment targets with focus placed on identifying patients most likely to benefit from high-intensity or moderate-intensity statin therapy.While increasing the statin dose can prove efficacious in some patients, this approach typically offers limited additional LDL-C lowering, and is associated with increased incidence of adverse side effects. Indeed, this has led to the investigation of statins in combination with other lipid-modifying agents for the treatment of dyslipidemia.This review of the evidence for statin use in combination with fibrates, niacin, bile acid sequestrants, and the cholesterol absorption inhibitor, ezetimibe, in dyslipidemic patients at increased risk of cardiovascular disease, explores the impact of such combination therapies on lipids, attainment of lipid targets, inflammatory markers, and on cardiovascular outcomes and pathology. Additionally, new and emerging dyslipidemia treatments are summarized
Anoeconeossa bundoorensis sp n., a new psyllid (Hemiptera: Psylloidea) from Eucalyptus camaldulensis (Myrtaceae) from Southeast Australia
No full textAnoeconeossa bundoorensis sp. n. is described from Eucalyptus camaldulensis (Myrtaceae) from southern Victoria in Southeast Australia. It is placed in the A. communis Taylor species-group as the paramere lacks combs of black rods. It differs from other members of the species-group, A. communis and A. bullata Taylor as it lacks an anterobasal expansion on the paramere and from A. unicornuta Taylor as the inner horn-shaped process of the paramere is reduced to a short spine and the apical expansion is more elongate, with a corresponding greater length of equidistant setae. Taxonomically relevant morphological details are illustrated and the species is diagnosed from other eucalypt inhabiting congeners. In-formation on the biology is presented.Gary S. Taylor, Kevin Farnier, Daniel Burckhardt & Martin J. Steinbaue
Lipid-Altering Efficacy of Ezetimibe/Simvastatin 10/20 mg Compared to Rosuvastatin 10 mg in High-Risk Patients with and without Type 2 Diabetes Mellitus Inadequately Controlled Despite Prior Statin Monotherapy.
No full textAIMS:
This post hoc analysis compared the effects of switching to ezetimibe/simvastatin 10/20 mg (EZE/SIMVA) or rosuvastatin 10 mg (ROSUVA) in uncontrolled high-risk hypercholesterolemic patients with/without type 2 diabetes mellitus (T2DM) despite statin monotherapy.
METHODS:
Patients (n = 618) at high risk for coronary vascular disease with elevated LDL-C ≥100 and ≤190 mg/dL despite use of statins were randomized 1:1 to double-blind EZE/SIMVA 10/20 mg or ROSUVA 10 mg for 6 weeks. Patients were classified as having T2DM based on ≥1 of the following: diagnosis of T2DM, antidiabetic medication, or FPG ≥126 mg/dL. This analysis evaluated percent changes from baseline in lipids among patients with (n = 182) and without T2DM (n = 434).
RESULTS:
EZE/SIMVA was more effective than ROSUVA at lowering LDL-C, TC, non-HDL-C, and apo B in the overall study population and within both subgroups. Numerically, greater between-treatment reductions in LDL-C, TC, non-HDL-C, and apo B were seen in patients with T2DM versus those without T2DM. A significant interaction (P= 0.015) was seen for LDL-C indicating that patients with T2DM achieved larger between-group reductions versus those without T2DM.
CONCLUSIONS:
Switching to EZE/SIMVA 10/20 mg versus ROSUVA 10 mg provided superior lipid reductions in patients with/without T2DM
Lipid-altering efficacy of ezetimibe/simvastatin 10/20 mg compared with rosuvastatin 10 mg in high-risk hypercholesterolaemic patients inadequately controlled with prior statin monotherapy - The IN-CROSS study.
No full textAIMS:
To evaluate the efficacy of switching from a previous statin monotherapy to ezetimibe/simvastatin (EZE/SIMVA) 10/20 mg vs. rosuvastatin (ROSUVA) 10 mg.
METHODS:
In this randomised, double-blind study, 618 patients with documented hypercholesterolaemia [low-density lipoprotein cholesterol (LDL-C) > or = 2.59 and or = 6 weeks prior to the study randomisation visit entered a 6-week open-label stabilisation/screening period during which they continued to receive their prestudy statin dose. Following stratification by study site and statin dose/potency, patients were randomised to EZE/SIMVA 10/20 mg (n = 314) or ROSUVA 10 mg (n = 304) for 6 weeks.
RESULTS:
EZE/SIMVA produced greater reductions in LDL-C (-27.7% vs. -16.9%; p < or = 0.001), total cholesterol (-17.5% vs. -10.3%; p < or = 0.001), non-high-density lipoprotein cholesterol (HDL-C) (-23.4% vs. -14.0%; p < or = 0.001) and apolipoprotein B (-17.9% vs. -9.8%; p < or = 0.001) compared with ROSUVA, while both treatments were equally effective at increasing HDL-C (2.1% vs. 3.0%; p = 0.433). More patients achieved LDL-C levels < 2.59 mmol/l (73% vs. 56%), < 2.00 mmol/l (38% vs. 19%) and < 1.81 mmol/l (25% vs. 11%) with EZE/SIMVA than ROSUVA (p < or = 0.001). A borderline significantly greater reduction in triglycerides (p = 0.056) was observed for EZE/SIMVA (-11.0%) vs. ROSUVA (-5.3%). There were no between-group differences in the incidences of adverse events or liver transaminase and creatine kinase elevations.
CONCLUSION:
EZE/SIMVA 10/20 mg produced greater improvements in LDL-C, total cholesterol, non-HDL-C and apoB with a similar safety profile as for ROSUVA 10 mg
Efficacy and safety of adding alirocumab to rosuvastatin versus adding ezetimibe or doubling the rosuvastatin dose in high cardiovascular-risk patients:The ODYSSEY OPTIONS II randomized trial
No full textOBJECTIVE: To compare lipid-lowering efficacy of adding alirocumab to rosuvastatin versus other treatment strategies (NCT01730053).METHODS: Patients receiving baseline rosuvastatin regimens (10 or 20 mg) were randomized to: add-on alirocumab 75 mg every-2-weeks (Q2W) (1-mL subcutaneous injection via pre-filled pen); add-on ezetimibe 10 mg/day; or double-dose rosuvastatin. Patients had cardiovascular disease (CVD) and low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL (1.8 mmol/L) or CVD risk factors and LDL-C ≥100 mg/dL (2.6 mmol/L). In the alirocumab group, dose was blindly increased at Week 12 to 150 mg Q2W (also 1-mL volume) in patients not achieving their LDL-C target. Primary endpoint was percent change in calculated LDL-C from baseline to 24 weeks (intent-to-treat).RESULTS: 305 patients were randomized. In the baseline rosuvastatin 10 mg group, significantly greater LDL-C reductions were observed with add-on alirocumab (-50.6%) versus ezetimibe (-14.4%; p < 0.0001) and double-dose rosuvastatin (-16.3%; p < 0.0001). In the baseline rosuvastatin 20 mg group, LDL-C reduction with add-on alirocumab was -36.3% compared with -11.0% with ezetimibe and -15.9% with double-dose rosuvastatin (p = 0.0136 and 0.0453, respectively; pre-specified threshold for significance p < 0.0125). Overall, ∼80% alirocumab patients were maintained on 75 mg Q2W. Of alirocumab-treated patients, 84.9% and 66.7% in the baseline rosuvastatin 10 and 20 mg groups, respectively, achieved risk-based LDL-C targets. Treatment-emergent adverse events occurred in 56.3% of alirocumab patients versus 53.5% ezetimibe and 67.3% double-dose rosuvastatin (pooled data).CONCLUSIONS: The addition of alirocumab to rosuvastatin provided incremental LDL-C lowering versus adding ezetimibe or doubling the rosuvastatin dose.</p
SWITCHING FROM STATIN MONOTHERAPY TO EZETIMIBE/SIMVASTATIN OR ROSUVASTATIN MODIFIES THE RELATIONSHIPS BETWEEN APOLIPOPROTEIN B, LDL CHOLESTEROL, ANC NON-HDL CHOLETEROL IN PATIENTS AT HIGH RISK OF CORONARY DISEASE
No full textOBJECTIVE:
To evaluate relationships between apolipoprotein B (Apo B), LDL cholesterol (LDL-C), and non-HDL-C in high-risk patients treated with lipid-lowering therapy.
DESIGN AND METHODS:
This post-hoc analysis calculated LDL-C and non-HDL-C levels corresponding to an Apo B of 0.9 g/L following treatment with 1) statin monotherapy (baseline) and 2) ezetimibe/simvastatin 10/20mg or rosuvastatin 10mg (study end). The percentages of patients reaching LDL-C, non-HDL-C, and Apo B targets were calculated at study end.
RESULTS:
After switching to ezetimibe/simvastatin or rosuvastatin, the LDL-C and non-HDL-C corresponding to Apo B=0.9 g/L were closer to the more aggressive LDL-C and non-HDL-C goals (1.81 and 2.59 mmol/L, respectively). Only slightly >50% of the patients who reached minimum recommended LDL-C or non-HDL-C at study end also had an Apo B level <0.9 g/L with both treatments.
CONCLUSION:
The use of Apo B for monitoring the efficacy of lipid-altering therapy would likely lead to more stringent criteria for lipid lowering
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