CONCLUSIONS

The rate of change in FEV1 among patients with COPD is highly variable, with increased rates of decline among current smokers, patients with bronchodilator reversibility, and patients with emphysema. (Funded by GlaxoSmithKline; ECLIPSE-ClinicalTrials.gov number, Pritelivir solubility dmso NCT00292552.)”
“Objective: Although chronic aortic dissection (CD) has traditionally been considered a predictor of perioperative morbidity and mortality after descending thoracic/thoracoabdominal aneurysm repair (thoracoabdominal aortic aneurysm [TAA]), recent reports have rejected this assertion.

Still, few contemporary studies document late outcomes after TAA for CD, which is the goal of this study.

Methods: From August 1987 to December 2005, 480 patients underwent TAA; 73 (15%) CD and 407(85%) degenerative aneurysms (DA). Operative management consisted of a clamp-and-sew technique with adjuncts in 53 (78%) CD and 355 (93%) DA patients (P < .001). Epidural cooling was used to prevent spinal cord injury (SCI) in 51 (70%) CD and 214 (53%) DA patients (P = .007). Study end points included perioperative SCl/mortality, freedom from reintervention, and long-term survival.

Results: CD patients were younger (mean age 64.5 years CD vs 72.5 years DA, P < .001) and more frequently had a family history of aneurysmal disease (23% CD vs 6% DA, P < .001). Forty-three (59%) CD patients had elective TAA selleck chemicals (vs 322

(79%) DA, P = .001). Eleven (15%) CD patients had Marfan’s syndrome (vs 0% DA, P < .001), and 17 (23%) CD patients

had a prior arch or ascending aortic repair (vs 16 [4%] DA, P < .001). CD patients were more likely to have Crawford type I & II thoracoabdominal aneurysms (44 [60%] vs 120 [29%] DA, P < .001), while only two (3%) CD patients had type IV aneurysms (vs 99 [24%] DA). There was no difference in perioperativc mortality between the two groups (11% CD vs 8.6% DA, P = .52), nor was there a difference in flaccid paralysis, which occurred in five (7%) CD and 22 (5%) DA patients (P = .92). At 5 years, 70% of CD patients were free from reintervention versus 74% of DA (P = .36). The actuarial Selleck SC75741 survival was 53% and 32% at 5 and 10 years for CD versus 47% and 17% for DA (P = .07).

Conclusions: Despite increased operative complexity, CD does not appear to increase perioperative SCI or mortality after TAA when compared with DA. Long-term freedom from aneurysm-related reintervention is similar for both groups as is survival, despite patients with CD being of younger age at presentation. (J Vasc Surg 2011;53:600-7.)”
“BACKGROUND

Cytisine, a partial agonist that binds with high affinity to the alpha(4)beta(2) nicotinic acetylcholine receptor, is a low-cost treatment that may be effective in aiding smoking cessation. This study assessed the efficacy and safety of cytisine as compared with placebo.