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- Zannad, F., et al.
(författare)
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Mineralocorticoid receptor antagonists for heart failure with reduced ejection fraction: integrating evidence into clinical practice
- 2012
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 33:22, s. 2782-2795
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Tidskriftsartikel (refereegranskat)abstract
- Mineralocorticoid receptor antagonists (MRAs) improve survival and reduce morbidity in patients with heart failure, reduced ejection fraction (HF-REF), and mild-to-severe symptoms, and in patients with left ventricular systolic dysfunction and heart failure after acute myocardial infarction. These clinical benefits are observed in addition to those of angiotensin converting enzyme inhibitors or angiotensin receptor blockers and beta-blockers. The morbidity and mortality benefits of MRAs may be mediated by several proposed actions, including antifibrotic mechanisms that slow heart failure progression, prevent or reverse cardiac remodelling, or reduce arrhythmogenesis. Both eplerenone and spironolactone have demonstrated survival benefits in individual clinical trials. Pharmacologic differences exist between the drugs, which may be relevant for therapeutic decision making in individual patients. Although serious hyperkalaemia events were reported in the major MRA clinical trials, these risks can be mitigated through appropriate patient selection, dose selection, patient education, monitoring, and follow-up. When used appropriately, MRAs significantly improve outcomes across the spectrum of patients with HF-REF.
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| 3. |
- Austin, John, et al.
(författare)
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Chemistry-climate model simulations of spring Antarctic ozone
- 2010
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Ingår i: Journal of Geophysical Research. - 0148-0227 .- 2156-2202. ; 115, s. D00M11-
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Tidskriftsartikel (refereegranskat)abstract
- Coupled chemistry-climate model simulations covering the recent past and continuing throughout the 21st century have been completed with a range of different models. Common forcings are used for the halogen amounts and greenhouse gas concentrations, as expected under the Montreal Protocol (with amendments) and Intergovernmental Panel on Climate Change A1b Scenario. The simulations of the Antarctic ozone hole are compared using commonly used diagnostics: the minimum ozone, the maximum area of ozone below 220 DU, and the ozone mass deficit below 220 DU. Despite the fact that the processes responsible for ozone depletion are reasonably well understood, a wide range of results is obtained. Comparisons with observations indicate that one of the reasons for the model underprediction in ozone hole area is the tendency for models to underpredict, by up to 35%, the area of low temperatures responsible for polar stratospheric cloud formation. Models also typically have species gradients that are too weak at the edge of the polar vortex, suggesting that there is too much mixing of air across the vortex edge. Other models show a high bias in total column ozone which restricts the size of the ozone hole (defined by a 220 DU threshold). The results of those models which agree best with observations are examined in more detail. For several models the ozone hole does not disappear this century but a small ozone hole of up to three million square kilometers continues to occur in most springs even after 2070.
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| 4. |
- Struthers, Hamish, et al.
(författare)
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Climate-induced changes in sea salt aerosol number emissions : 1870 to 2100
- 2013
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Ingår i: Journal of Geophysical Research-Atmospheres. - : American Geophysical Union (AGU). - 2169-897X. ; 118:2, s. 670-682
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Tidskriftsartikel (refereegranskat)abstract
- Global climate model output is combined with an emission parameterization to estimate the change in the global and regional sea salt aerosol number emission from 1870 to 2100. Global average results suggest a general increase in sea salt aerosol number emission due to increasing surface wind speed. However, the emission changes are not uniform over the aerosol size spectrum due to an increase in sea surface temperature. From 1870 to 2100 the emission of coarse mode particles (dry diameter D-P > 655 nm) increase by approximately 10 % (global average), whereas no significant change in the emission of ultrafine mode aerosols (dry diameter D-p < 76 nm) was found over the same period. Significant regional differences in the number emission trends were also found. Based on CAM-Oslo global climate model output, no straight-forward relationship was found between the change in the number emissions and changes in the sea salt aerosol burden or optical thickness. This is attributed to a change in the simulated residence time of the sea salt aerosol. For the 21st century, a decrease in the residence time leads to a weaker sea salt aerosol-climate feedback that what would be inferred based on changes in number emissions alone. Finally, quantifying any potential impact on marine stratocumulus cloud microphysical and radiative properties due to changes in sea salt aerosol number emissions is likely to be complicated by commensurate changes in anthropogenic aerosol emissions and changes in meteorology.
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