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- Fellström, Bengt, et al.
(author)
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Effect of fluvastatin on renal end points in the Assessment of Lescol in Renal Transplant (ALERT) trial
- 2004
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In: Kidney International. - : Elsevier BV. - 0085-2538 .- 1523-1755. ; 66:4, s. 1549-1555
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Journal article (peer-reviewed)abstract
- BACKGROUND: Hyperlipidemia is a risk factor for long-term renal transplant dysfunction, but no prospective clinical trials have investigated the effects of statin treatment on graft function in renal transplant recipients. The aim of the present study was to evaluate the effect of fluvastatin on long-term renal transplant function and development of chronic allograft nephropathy in the ALERT (Assessment of Lescol in Renal Transplantation) study. METHODS: ALERT was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin, 40 mg and 80 mg daily, in renal transplant recipients. Patients were randomized to receive either fluvastatin (N= 1050) or placebo (N= 1052) and followed for five to six years. Renal end points included graft loss or doubling of serum creatinine or death; glomerular filtration rate (GFR) was also measured during follow-up in a subset of patients (N= 439). RESULTS: There were 283 patients (13.5%) with graft loss, mainly due to chronic rejection (82%), yielding an annual rate of 2.4%. Fluvastatin treatment significantly lowered mean low-density lipoprotein (LDL)-cholesterol levels by 32% (95% CI -33 to -30) compared with placebo, but had no significant effect on the incidence of renal graft loss or doubling of serum creatinine, or decline in GFR throughout follow-up in the whole study population. Neither was any treatment effect by fluvastatin found in any of the subgroups analyzed. CONCLUSION: Fluvastatin treatment significantly improves lipid values in renal transplant recipients but has no effect on graft loss or doubling of serum creatinine.
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| 2. |
- Hausner, Vera Helene, et al.
(author)
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Impacts of climate change and climate extremes on Arctic livelihoods and communities
- 2021. - 1
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In: Amap arctic climate update 2021. - Tromsö : Arctic Monitoring and Assessment Programme (AMAP). - 9788279712015 ; , s. 107-143
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Book chapter (other academic/artistic)abstract
- Key findings:• Climate change is impacting the subsistence harvestbased livelihoods of many small Arctic communities, affecting the quality or supply of traditional food and drinking water, including availability of species to be harvested, and altering transportation access.• Rain-on-snow, extreme snowfall, and variable freezethaw cycles have resulted in severe impacts for reindeer herders. In 2020, multiple snowstorms combined with a late spring thaw resulted in high newborn calf mortality and, together with other social stresses related to Covid-19, created severe crises for reindeer herders in Fennoscandia.• Commercial fisheries are expanding in Arctic shelf ecosystems with warmer oceans and less sea ice. This could benefit local economies and job creation, but may also challenge traditional livelihoods and culture and impact vulnerable Arctic ecosystems. Large uncertainties are associated with the effects of ocean acidification, which could potentially counteract increased commercial fishing opportunities. Commercial fishing is currently prohibited by international agreement in the Central Arctic Ocean.• Warmer water is enabling a northward expansion of salmon farming in the ice-free European Arctic. The aquaculture industry brings employment opportunities and positive ripple effects for local economies, but also has environmental and societal costs that need to be considered in marine spatial planning and regulatory measures.• Arctic cruise tourism is increasing and is attracted to the wildlife associated with the marginal ice zone. Although increased cruise tourism brings the potential for local economic development, adverse local impacts have been reported, including impacts on culture, local hunting and fishing, crowding, and revenue largely benefitting foreign-based individuals and corporations.• Permafrost thaw, flooding, and coastal erosion are causing damage to buildings, roads, and other infrastructure, and pose serious financial and health risks to Arctic residents.• Wildfire occurrence near populated regions in North America and Sweden, and throughout Siberia, in the past five years has resulted in significant economic loss from property damage as well as physical and mental health impacts.• Fishing, cruise tourism, and increased oil and gas operations near the marginal ice zone could increase demand on search and rescue operations and may represent a considerable risk for vulnerable ecosystems. The extent of ice cover is important for determining the fate of an Arctic oil spill and research indicates longer term and more severe ecological impacts from oil spills in the Arctic than in other regions.• Understanding and studying integrated socio-ecological systems, including cumulative and cascading impacts, is important not only in terms of research, but also in terms of risk mitigation, hazard response, climate adaptation,
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| 5. |
- Jardine, Alan G., et al.
(author)
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Fluvastatin prevents cardiac death and myocardial infarction in renal transplant recipients : post-hoc subgroup analyses of the ALERT Study
- 2004
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In: American Journal of Transplantation. - : Elsevier BV. - 1600-6135 .- 1600-6143. ; 4:6, s. 988-995
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Journal article (peer-reviewed)abstract
- Renal transplant recipients have a greatly increased risk of premature cardiovascular disease. The ALERT study was a multicenter, randomized, double-blind, placebo-controlled trial of fluvastatin (40-80 mg/day) in 2102 renal transplant recipients followed for 5-6 years. The main study used a composite cardiac end-point including myocardial infarction, cardiac death and cardiac interventions. Although reduced by fluvastatin, this primary end-point failed to achieve statistical significance thus precluding analysis of predefined subgroups. Therefore, in the present survival analysis, we used an alternative primary end-point of cardiac death or definite nonfatal myocardial infarction (as used in other cardiac outcome trials) which was significantly reduced by Fluvastatin therapy and permits subgroup analysis. Fluvastatin reduced LDL-cholesterol by 1 mmol/L compared with placebo, and the incidence of cardiac death or definite myocardial infarction was reduced from 104 to 70 events (RR 0.65; 95% CI 0.48, 0.88; p = 0.005). Fluvastatin use was associated with reduction in cardiac death or nonfatal myocardial infarction, which achieved statistical significance in many subgroups. The subgroups included patients at lower cardiovascular risk, who were younger, nondiabetic, nonsmokers and without pre-existing CVD. These data support the early introduction of statins following renal transplantation.
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| 6. |
- Skaret, Georg, et al.
(author)
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Diel vertical movements determine spatial interactions between cod, pelagic fish and krill on an Arctic shelf bank
- 2020
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In: Marine Ecology Progress Series. - : Inter-Research Science Center. - 0171-8630 .- 1616-1599. ; 638, s. 13-23
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Journal article (peer-reviewed)abstract
- Predator-prey spatial interactions are essential to understand ecosystem processes like predation rates and trophic interaction strength. In marine systems, such spatial interactions are highly dynamic and difficult to observe, as predators, prey and resources are mobile and responsive to each other, and also since shifting vertical light gradients strongly affect the space use of visual predators and their prey. We visited a bank area in the northern Barents Sea with cold bottom waters (similar to 1 degrees C), and combined conventional trawl and acoustic sampling with broad-band hydroacoustics to obtain long-range, fine-scale observations of interactions between cod, their planktivore prey (capelin and polar cod) and krill. We caught cod in demersal trawl hauls but could not detect them with the vessel acoustics. However, broadband acoustics mounted on a submersible probe allowed us to track individual cod, revealing that they remained mostly within 10 m of the bottom throughout the diel cycle. In the morning, cod lifted slightly from the seabed indicating feeding activity, which corresponded with more fresh prey in cod stomachs in the morning. During daylight, krill pushed towards the bottom, sharing habitat with cod, while the planktivores aggregated in pelagic schools at the cost of lost feeding opportunities, overlapping with their hill prey only during twilight hours. The diel light cycle was an important driver of the spatial movements and aggregations, and krill appear to hide from capelin among the cod near bottom, while cod take advantage of descending pelagic fish after dawn to feed with a minimum of effort.
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