The Fourth Tomoh Masaki Award.

Doctor David J. Webb MD, DSc, FRCP, FRSE, FMedSci, a clinical pharmacologist specialising in the management of cardiovascular disease, is the recipient of The Fourth Tomoh Masaki Award, a bi-annual prize presented on the occasion of the International Conferences on Endothelin to scientists for outstanding contributions and achievements in the field of endothelin research. The Fourth Tomoh Masaki Award was presented to Doctor Webb at the Fifteenth International Conference on Endothelin which was held at Duo Hotel, Prague, Czech Republic, in October 2017. The award was granted to Dr. Webb during the Award Ceremony in Troja Chateau "In Recognition of his Outstanding Contributions to Science and Endothelin Research in Particular". This article summarises the career and the scientific achievements of David J. Webb viewed by his former student Dr. Neeraj Dhaun, known to everybody as 'Bean'.

Renal function is associated with arterial stiffness and predicts outcome in patients with coronary artery disease.

BACKGROUND: Arterial stiffness (AS) is associated, and a predictor of, outcome in patients with cardiovascular and renal disease. AIM: In this study, we estimated glomerular filtration rate (eGFR) and measured indices of AS in patients with suspected coronary artery disease (CAD), and assessed their predictive value on outcome. DESIGN: Prospective cohort study. METHODS: AS was measured using pulse wave velocity (PWV) and pulse wave analysis in patients with no known renal disease who had recently undergone coronary angiography. Renal function was assessed using serum creatinine concentration [creat](sr) and eGFR (Cockcroft & Gault, C&G). The primary endpoint was a combination of hospitalization due to cardiovascular disease and all-cause mortality. RESULTS: Two hundred eighty-four subjects (210 men, 74 women, mean age 62 years) were followed-up for a mean of 1.5 years. PWV was negatively associated with eGFR (r(2) = 0.09, P < 0.001), even in patients with an eGFR > or =60 ml/min/m(2) (r(2) = 0.04, P < 0.01). PWV was determined by age, heart rate, systolic blood pressure, body mass index and [creat](sr) (r(2) = 0.38, P < 0.001). A lower eGFR (P < 0.01), PWV above the median (P < 0.05) and degree of CAD (P < 0.001) predicted a shorter time to the primary endpoint. eGFR and degree of CAD remained independent determinants of outcomes (P < 0.01), even in patients with normal renal function (P < 0.01). CONCLUSION: This study suggests that even minor reductions in eGFR, within the normal range, are an additional independent risk marker in patients with CAD.

Comparative toxicity of citalopram and the newer antidepressants after overdose.

OBJECTIVE: To compare the toxicity of citalopram, venlafaxine, mirtazapine, and nefazadone after overdose. METHODS: Two-year retrospective review of consecutive patients admitted to the toxicology unit of Edinburgh Royal Infirmary. Outcome measure included physiological variables, ECG recordings, peak creatine kinase, development of arrhythmias, seizure, tremor or agitation, and the need for admission to a critical care facility. RESULTS: A total of 225 patients were studied. Venlafaxine was associated with a significantly higher pulse rate (p < 0.0001) and tremor (p = 0.007) than other antidepressants. Citalopram was associated with a significantly longer QT interval on ECG recording (p < 0.0001) but mean QTc durations were not significantly different between all drugs studied. No arrhythmias were recorded. Only venlafaxine and citalopram caused seizures and were associated with the need for admission to Intensive Care, but there was no significant difference between them. CONCLUSIONS: Mirtazapine and nefazadone appear safe in overdose and were associated with minimal features of neurological or cardiovascular toxicity. Citalopram is more likely to cause QT prolongation but other features of cardiovascular toxicity were uncommon. Both citalopram and venlafaxine are proconvulsants. Venlafaxine also causes more frequent features of the serotonin syndrome.