Can simvastatin reduce COPD exacerbations? A randomised double-blind controlled study.

BACKGROUND: Several studies have shown that statins have beneficial effects in COPD regarding lung function decline, rates and severity of exacerbation, hospitalisation and need for mechanical ventilation. METHODS: We performed a randomised double-blind placebo-controlled single-centre trial of simvastatin at a daily dose of 40 mg versus placebo in patients with Global Initiative for Chronic Obstructive Lung Disease criteria grades 2-4 at a tertiary care pulmonology department in Austria. Scheduled treatment duration was 12 months and the main outcome parameter was time to first exacerbation. RESULTS: Overall, 209 patients were enrolled. In the 105 patients taking simvastatin, time to first exacerbation was significantly longer compared to the 104 patients taking placebo: median 341 versus 140 days (log-rank test p<0.001). Hazard ratio for risk of first exacerbation for the simvastatin group was 0.51 (95% CI 0.34-0.75; p=0.001). Rate of exacerbations was significantly lower with simvastatin: 103 (41%) versus 147 (59%) (p=0.003). The annualised exacerbation rate was 1.45 events per patient-year in the simvastatin group and 1.9 events per patient-year in the placebo group (incidence rate ratio 0.77, 95% CI 0.60-0.99). We found no effect on quality of life, lung function, 6-min walk test and high-sensitivity C-reactive protein. More patients dropped out in the simvastatin group compared to the placebo group (39 versus 29). CONCLUSION: In our single-centre RCT, simvastatin at a dose of 40 mg daily significantly prolonged time to first COPD exacerbation and reduced exacerbation rate.

Sympathoadrenal balance and physiological stress response in cattle at spontaneous and PGF2α-induced calving.

Increased cortisol release in parturient cows may either represent a stress response or is part of the endocrine changes that initiate calving. Acute stress elicits an increase in heart rate and decrease in heart rate variability (HRV). Therefore, we analyzed cortisol concentration, heart rate and HRV variables standard deviation of beat-to-beat interval (SDRR) and root mean square of successive beat-to-beat intervals (RMSSD) in dairy cows allowed to calve spontaneously (SPON, n = 6) or with PGF2α-induced preterm parturition (PG, n = 6). We hypothesized that calving is a stressor, but induced parturition is less stressful than term calving. Saliva collection for cortisol analysis and electrocardiogram recordings for heart rate and HRV analysis were performed from 32 hours before to 18.3 ± 0.7 hours after delivery. Cortisol concentration increased in SPON and PG cows, peaked 15 minutes after delivery (P < 0.001) but was higher in SPON versus PG cows (P < 0.001) during and within 2 hours after calving. Heart rate peaked during the expulsive phase of labor and was higher in SPON than in PG cows (time × group P < 0.01). The standard deviation of beat-to-beat interval and RMSSD peaked at the end of the expulsive phase of labor (P < 0.001), indicating high vagal activity. Standard deviation of beat-to-beat interval (P < 0.01) and RMSSD (P < 0.05) were higher in SPON versus PG cows. Based on physiological stress parameters, calving is perceived as stressful but expulsion of the calf is associated with a transiently increased vagal tone which may enhance uterine contractility.

[Relationship and repeatability of body condition scoring and backfat thickness measurement in dairy cows by different investigators]. / Korrelation und Vergleich der Wiederholbarkeit von Body Condition Scoring und Rückenfettdicken-Messung unterschiedlicher Untersucher bei Milchkühen.

The determination of the body condition of dairy cows is a helpful instrument to assess the energy situation of individual cows and herds. Two methods for determining the body condition are well established in bovine practice, body condition scoring (BCS) and measurement of backfat thickness (BFT). The objectives of this study were to evaluate the repeatability of BCS on a five-point scale with 0.25-points increments and the measurement of BFT by ultrasound (5 MHz linear probe) as well as the repeatability of measuring BFT at both sides of the cows back. Five investigators with different experience with BCS and BFT assessed a total of 94 cows repeatedly, resulting in 1806 BCS-measurements and 1723 (left) and 1733 (right) BFT-values. Weighted kappa coefficient was used to evaluate the agreement of repeated measurements and correlations were calculated for linear associations. Within-observer agreement of BCS and BFT was good for both methods (K = 0.67 and 0.78, respectively). Agreement was moderate to substantial for BCS and BFT depending on the investigator. Within-observer agreement of BFT at the right and left body side was substantial (K = 0.75). There was a high correlation between repeated measurements of BCS and BFT (r = 0.93 and r(c) = 0.91, respectively), and between BFT measured at the left and right body side (r(c) = 0.90). The correlation between BCS and BFT was moderate (r = 0.67). Overall, both methods demonstrated good repeatability applied by different investigators. In summary, BCS and BFT measurements are practical tools to contribute beneficially to herd health management.

Activation of PPARgamma by pioglitazone does not attenuate left ventricular hypertrophy following aortic banding in rats.

Sustained left ventricular hypertrophy (LVH) accelerates cardiac dysfunction and heart failure. Previous reports have suggested that activation of the peroxisome proliferator-activated receptor gamma (PPARgamma)-dependent pathway is involved in development of cardiac hypertrophy. Thiazolidinediones (TZDs) such as pioglitazone activate PPARgamma and are clinically used as antidiabetics. Given inconsistent reports regarding effects of TZDs on LVH, we examined in the present study the influence of pioglitazone on LVH in a rat model of aortic banding. Aortic banding was induced in rats by clipping the ascending aorta. Animals received pioglitazone (3 mg/kg/day) or placebo. Echocardiographic, hemodynamic, histological, and biochemical measurements were performed after 2 and 4 weeks. Pressure gradient was comparable between pioglitazone- and placebo-treated animals after 2 and 4 weeks. Left ventricular function was not different between the groups. In sham as well as in banded animals, LV/body weight ratio was increased in pioglitazone- as compared to placebo-treated animals after 2 and 4 weeks. Furthermore, an increase in myocyte size and atrial natriuretic factor was observed in pioglitazone- compared to placebo-treated animals 4 weeks after aortic banding as well. The results of this study demonstrate that activation of PPARgamma via pioglitazone does not protect the myocardium from pressure overload-induced LVH in a rat model of aortic banding. The findings rather indicate a pro-hypertrophic effect of pioglitazone treatment after aortic banding.