How Will Our Practice Change After the CLEAR Outcomes Trial?

Purpose Of Review: Bempedoic acid is a novel therapeutic agent that is designed to reduce levels of low-density lipoprotein cholesterol (LDL-C). The purpose of this review is to provide the background for development of bempedoic acid, findings from clinical trials and to discuss clinical implications.

Recent Findings: Bempedoic acid inhibits ATP citrate lyase within the liver and reduces cholesterol synthesis, with the potential to avoid muscle symptoms experienced by patients treated with statins.

The effect of discontinuation of maintenance therapy in Chinese patients with MPO-ANCA associated vasculitis who were in long-term stable remission.

There is a consensus that maintenance therapy should be used to prevent relapse of myeloperoxidase-anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (MPO-AAV), but there is a debate about the optimal duration of maintenance therapy. Therefore, the purpose of this study was to determine whether discontinuation of maintenance therapy in MPO-AAV patients who were in long-term stable remission affects relapse, renal survival and patient survival. Seventy-nine patients with MPO-AAV diagnosed at Xiangya hospital from June 2010 to June 2019 who were in stable remission for at least 18 months following maintenance therapy were included.

Predicting outcomes in traumatic out-of-hospital cardiac arrest: the relevance of Utstein factors.

Background: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA.

Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014.

Solving the second-order free rider problem in a public goods game: An experiment using a leader support system.

Punishment of non-cooperators-free riders-can lead to high cooperation in public goods games (PGG). However, second-order free riders, who do not pay punishment costs, reduce the effectiveness of punishment. Here we introduce a "leader support system," in which one group leader can freely punish group followers using capital pooled through the support of group followers.

Screening for prostate cancer.

Background: Any form of screening aims to reduce disease-specific and overall mortality, and to improve a person's future quality of life. Screening for prostate cancer has generated considerable debate within the medical and broader community, as demonstrated by the varying recommendations made by medical organizations and governed by national policies. To better inform individual patient decision-making and health policy decisions, we need to consider the entire body of data from randomised controlled trials (RCTs) on prostate cancer screening summarised in a systematic review.

Lycopene for the prevention of prostate cancer.

Background: Prostate cancer is a common cause of death in developed countries, yet the benefits of screening for prostate cancer still remain controversial. A prostate-specific antigen (PSA) test result greater than 4 ng/mL (nanograms/millilitre) has commonly been used as the cut-off level for seeking further tests to diagnose the presence (or absence) of prostate cancer. An increase in PSA levels may not necessarily be associated with an increased risk of prostate cancer, as PSA levels may also be increased in men with benign prostatic hyperplasia and prostatitis.

The impact of smoke on respiratory hospital outcomes during the 2002-2003 bushfire season, Victoria, Australia.

Background And Objective: Uncontrolled bushfires produce copious amounts of smoke that can result in adverse effects on human health and so are important considerations for emergency, public health and environmental protection agencies. During January to March 2003, the north-east and Alpine regions of the state of Victoria experienced major bushfires that created a blanket of smoke over the entire state for extended periods of time. This study aimed to explore the daily trends in air pollutants and temporal correlations with changes in respiratory outcomes and to determine whether variation in particulate matter < 10 microm (PM(10)), visibility-reducing particles and ozone produced by bushfires could explain variation in respiratory outcomes.

Democracy, embryonic stem cell research, and the Roman Catholic church.

The Roman Catholic Church in Australia has lobbied politicians to prohibit embryonic stem cell research, on the grounds that such research violates the sanctity and inherent dignity of human life. I suggest, however, that reasoned reflection does not uniquely support such conclusions about the morality of stem cell research. A recent parliamentary standing committee report recommended that embryonic stem cell research be allowed to proceed in certain circumstances, and there appears to be widespread support in the Australian community for this position.