Gnanenthiran SR et al. – Acute gout episodes in hospital are variably investigated and treated with frequent suboptimal management. The authors recommend establishment of a hospital–wide protocol to support decision–making regarding investigations, treatment and follow up.

• Case–file review of all episodes of acute gout occurring in a large tertiary hospital over a 20–month period.

• Of 134 acute gout episodes identified, the large majority (118) occurred in patients not admitted under the rheumatology unit.
• Baseline anti–gout medications were frequently ceased on admission and in 9% of episodes, no pharmacotherapy was prescribed.
• Delays in initiation of treatment occurred in up to 29% of patients.
• Acute management included anti–inflammatory monotherapy, or combinations of colchicine, non–steroidal anti–inflammatory drugs (NSAIDs) and corticosteroids.
• Of patients prescribed colchicine, 26% received >1.5 mg/day and a strong correlation was found between colchicine dose and the occurrence of diarrhoea.
• NSAIDs were prescribed in 29% of patients with pre–existing renal impairment.
• Overall, 25% of patients received inappropriate pharmacological management.
• In patients not under the direct care of the rheumatology unit, in–hospital rheumatology consultation was sought by the treating unit in 34% of episodes.
• Consultation was sought more frequently in patients with multiple joint involvement, but there were no other obvious differences in ...read more

Gokturk HS et al. – The data suggest that H pylori eradication rate with standard triple eradication regimen is significantly higher among long–term aspirin users than in controls.

• The study population consisted of 77 aspirin using patients with dyspeptic symptoms and 79 age– and sex–matched dyspeptic patients without aspirin use as a control group.
• Both the study group and control patients were given lansoprazole (30 mg twice a day), clarithromycin (500 mg twice a day) and amoxicillin (1 g twice a day) (LCA) for 14 days as the eradication regimen.
• Patients on the study group were allowed to take aspirin during the eradication regimen (LCAAsp).
• Eradication was defined as the absence of H pylori as assessed with the 13C–urea breath test and H pylori stool antigen test 8 weeks after the end of the antimicrobial therapy.

Jia–hua Z et al. – Resveratrol provides a promising anti–tumor stratagy to fight against pancreatic cancer.

• Several pancreatic cancer cell lines were screened by resveratrol, and its toxicity was tested by normal pancreatic cells.
• Western blotting was then performed to analyze the molecular mechanism of resveratrol induced apoptosis of pancreatic cancer cell lines.

• In the screened pancreatic cancer cell lines, capan–2 and colo357 showed high sensitivity to resveratrol induced apoptosis.
• Resveratrol exhibited insignificant toxicity to normal pancreatic ...read more

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Kawut SM et al. – Neither aspirin nor simvastatin had a significant effect on the 6–minute walk distance, although patients randomized to simvastatin tended to have a lower 6–minute walk distance at 6 months. These results do not support the routine treatment of patients with PAH with these medications.

• A randomized, double–blind, placebo–controlled
• 2x2 factorial clinical trial of aspirin and simvastatin in patients with PAH receiving background therapy at 4 centers
• A total of 92 patients with PAH were to be randomized to aspirin 81 mg or matching placebo and simvastatin 40 mg or matching placebo
• Sixty–five subjects had been randomized when the trial was terminated by the Data Safety and Monitoring Board after an interim analysis showed futility in reaching the primary end point for simvastatin
• The primary outcome was 6–minute walk distance at 6 months

Schoenenberger AW et al. - Young patients with Acute coronary syndromes (ACS) differed from older patients in that the younger often presented with ST-segment elevation myocardial infarction (STEMI), received early aggressive treatment, and had favourable outcomes. Primary prevention of smoking, dyslipidemia and overweight should be more aggressively promoted in adolescence.

• In this prospective cohort study, 76 hospitals treating ACS in Switzerland enrolled 28,778 patients with ACS between January 1, 1997, and October 1, 2008.
• ACS definition included ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA).

Jowett S et al. – Warfarin is cost–effective compared with aspirin in atrial fibrillation patients age ≥75 years. These data support the anticoagulant therapy option in this high–risk patient population. However, the small differences in costs and effects indicate the importance of exploring patient preferences.

• An economic evaluation was conducted alongside a randomized, controlled trial; 973 patients ≥75 years of age with atrial fibrillation were recruited from primary care and randomly assigned to either take warfarin or aspirin.
• Follow-up was for a mean of 2.7 years. Costs of thrombotic and hemorrhagic events, anticoagulation clinic visits, and primary care utilization were determined.
• Clinical benefits were expressed in terms of a primary event avoided: fatal/nonfatal disabling stroke, intracranial hemorrhage, or systemic embolism.
• A cost-utility analysis was performed using quality-adjusted life years as the benefit measure.