865 resultados para Kuisma, Markku


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Luettelo Kansalliskirjastossa olevan Markku Lassanderin arkiston sisällöstä

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Kirjallisuusarvostelu

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Background The protease-activated receptor 1 (PAR-1), the main platelet receptor for thrombin, represents a novel target for treatment of arterial thrombosis, and SCH 530348 is an orally active, selective, competitive PAR-1 antagonist. We designed TRA.CER to evaluate the efficacy and safety of SCH 530348 compared with placebo in addition to standard of care in patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) and high-risk features. Trial design TRA.CER is a prospective, randomized, double-blind, multicenter, phase III trial with an original estimated sample size of 10,000 subjects. Our primary objective is to demonstrate that SCH 530348 in addition to standard of care will reduce the incidence of the composite of cardiovascular death, myocardial infarction (MI), stroke, recurrent ischemia with rehospitalization, and urgent coronary revascularization compared with standard of care alone. Our key secondary objective is to determine whether SCH 530348 will reduce the composite of cardiovascular death, MI, or stroke compared with standard of care alone. Secondary objectives related to safety are the composite of moderate and severe GUSTO bleeding and clinically significant TIMI bleeding. The trial will continue until a predetermined minimum number of centrally adjudicated primary and key secondary end point events have occurred and all subjects have participated in the study for at least I year. The TRA.CER trial is part of the large phase III SCH 530348 development program that includes a concomitant evaluation in secondary prevention. Conclusion TRA.CER will define efficacy and safety of the novel platelet PAR-1 inhibitor SCH 530348 in the treatment of high-risk patients with NSTE ACS in the setting of current treatment strategies. (Am Heart J 2009; 158:327-34.)

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Background Patients with early age-related maculopathy ( ARM) do not necessarily show obvious morphological signs or functional impairment. Many have good visual acuity, yet complain of decreased visual performance. The aim of this study was to investigate the aging effects on performance of parafoveal letter recognition at reduced contrast, and defects caused by early ARM and normal fellow eyes of patients with unilateral age-related macular degeneration (nfAMD). Methods Testing of the central visual field (8 radius) was performed by the Macular Mapping Test (MMT) using recognition of letters in 40 parafoveal target locations at four contrast levels (5, 10, 25 and 100%). Effects of aging were investigated in 64 healthy subjects aged 23 to 76 years (CTRL). In addition, 39 eyes (minimum visual acuity of 0.63; 20/30) from 39 patients with either no visible signs of ARM, while the fellow eye had advanced age-related macular degeneration (nfAMD; n=12), or early signs of ARM (eARM; n=27) were examined. Performance was expressed summarily as a ""field score"" (FS). Results Performance in the MMT begins to decline linearly with age in normal subjects from the age of 50 and 54 years on, at 5% and 10% contrast respectively. The differentiation between patients and CTRLs was enhanced if FS at 5% was analyzed along with FS at 10% contrast. In 8/12 patients from group nfAMD and in 18/27 from group eARM, the FS was statistically significantly lower than in the CTRL group in at least one of the lower contrast levels. Conclusion Using parafoveal test locations, a recognition task and diminished contrast increases the chance of early detection of functional defects due to eARM or nfAMD and can differentiate them from those due to aging alone.

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A workshop was convened to discuss best practices for the assessment of drug-induced liver injury (DILI) in clinical trials. In a breakout session, workshop attendees discussed necessary data elements and standards for the accurate measurement of DILI risk associated with new therapeutic agents in clinical trials. There was agreement that in order to achieve this goal the systematic acquisition of protocol-specified clinical measures and lab specimens from all study subjects is crucial. In addition, standard DILI terms that address the diverse clinical and pathologic signatures of DILI were considered essential. There was a strong consensus that clinical and lab analyses necessary for the evaluation of cases of acute liver injury should be consistent with the US Food and Drug Administration (FDA) guidance on pre-marketing risk assessment of DILI in clinical trials issued in 2009. A recommendation that liver injury case review and management be guided by clinicians with hepatologic expertise was made. Of note, there was agreement that emerging DILI signals should prompt the systematic collection of candidate pharmacogenomic, proteomic and/or metabonomic biomarkers from all study subjects. The use of emerging standardized clinical terminology, CRFs and graphic tools for data review to enable harmonization across clinical trials was strongly encouraged. Many of the recommendations made in the breakout session are in alignment with those made in the other parallel sessions on methodology to assess clinical liver safety data, causality assessment for suspected DILI, and liver safety assessment in special populations (hepatitis B, C, and oncology trials). Nonetheless, a few outstanding issues remain for future consideration.

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Tämän insinöörityön tavoitteena oli suunnitella ja toteuttaa selainpohjainen käyttäjienhallintaohjelma GateKeeper Karttakeppi.com-työryhmälle. GateKeeper-ohjelma kuuluu osana laajempaan ohjelmistoprojektiin, jonka tarkoituksena on tuottaa opetusmateriaalia etäopiskelijoille Internetissä. Etäopetusmateriaalin tuottamisessa käytetään useita ohjelmia, joille on määriteltävä eritasoisia käyttäjätunnuksia ja käyttöoikeuksia. Ohjelmien käyttäjienhallintamekanismit ovat erilaisia, mikä osaltaan lisää järjestelmän ylläpitäjien työtä ja vastuuta. GateKeeper-ohjelman tavoitteena on nopeuttaa, helpottaa ja yksinkertaistaa käyttäjienhallintaan liittyviä toimintoja tietoturvallisesti. GateKeeper-ohjelma on suunniteltu siten, että uusien käyttäjien ja ohjelmien lisäämiselle ei ole asetettu rajoja. Jokaisen lisättävän ohjelman yhteydessä on kuitenkin selvitettävä kyseisen ohjelman käyttäjienhallintamekanismi. Tässä insinöörityössä tutkittiin, miten versionhallintaohjelma Subversionin, julkaisujärjestelmä Mambon, sekä oppimisalusta Moodlen käyttäjiä voidaan keskitetysti hallinnoida GateKeeper-ohjelman avulla. GateKeeper-ohjelma noudattaa arkkitehtuuriltaan kolmikerrosmallia, jossa käyttöliittymä, sovelluslogiikka ja tietovarasto on erotettu toisistaan. Ohjelma koostuu joukosta PHP-kielellä toteutettuja dynaamisia web-sivuja. Tietovarastona käytetään tietokantapalvelimella sijaitsevaa MySQL-tietokantaa.

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Summary: In our nation's best interest : eugenics in Finland until the promulgation of the sterilization law of 1935

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Tiivistelmä: Neulasten pääravinnepitoisuuksien muutokset turvekankaan alikasvoskuusikossa ylispuuhakkuun jälkeen

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Markku Koivusalo