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Once-daily (od), low-dose aspirin (75–100 mg) is recommended to reduce the thrombotic risk of patients with essential thrombocytemia (ET). This practice is based on data extrapolated from other high-risk patients and an aspirin trial in polycythemia vera, with the assumption of similar aspirin pharmacodynamics in the two settings. However, the pharmacodynamics of low-dose aspirin is impaired in ET, reflecting accelerated renewal of platelet cyclooxygenase (COX)-1. ARES is a parallel-arm, placebo-controlled, randomized, dose-finding, phase II trial enrolling 300 ET patients to address two main questions. First, whether twice or three times 100 mg aspirin daily dosing is superior to the standard od regimen in inhibiting platelet thromboxane (TX)A2 production, without inhibiting vascular prostacyclin biosynthesis. Second, whether long-term persistence of superior biochemical efficacy can be safely maintained with multiple vs. single dosing aspirin regimen. Considering that the primary study end point is serum TXB2, a surrogate biomarker of clinical efficacy, a preliminary exercise of reproducibility and validation of this biomarker across all the 11 participating centers was implemented. The results of this preliminary phase demonstrate the importance of controlling reproducibility of biomarkers in multicenter trials and the feasibility of using serum TXB2 as a reliable end point for dose-finding studies of novel aspirin regimens.

The RUVIVAL Publication Series is part of the open source learning project RUVIVAL. All topics of RUVIVAL Volume 1 are related on several levels and are part of restoration engineering. Each contribution in this publication is connected to further interactive multimedia material, which can be reached under http://www.hoou.de. The literature review papers are a collaboration of Master students, PhD students and researchers at the Institute of Wastewater Management and Water Protection (AWW) at Hamburg University of Technology. This volume consists of 3 literature review papers. The first reviews agroforestry, the practice of including trees or other woody perennial plants into agricultural systems, including crop and livestock production. It explains the challenges and benefits of this practice and provides an example of its implementation within the Slope Farming Project in Arba Minch, Ethiopia. The second paper introduces the concept of living terraces, which constitute a combination of erosion control measures on slopes. They are similar to contour hedgerows, but are constructed with the aim of accumulating soil on the uphill side of the tree row, so that in the long run, bench terraces are formed on their own. Their role as part of rainwater harvesting practices is explained in more depth in the paper. Finally, the third literature review provides insight into check dams, structures built across channels to reduce erosion by lowering water speed and accumulating sediments during floods. Check dams are often introduced in degraded areas and they represent one of the most used stabilisation measures worldwide, because of their relative simplicity and easy implementation. This paper also introduces a well-known case study in the Loess Plateau, China. Die RUVIVAL-Publikationsreihe ist Teil des Open-Source-Lernprojekts RUVIVAL. Alle Themen von RUVIVAL Volume 1 stehen auf mehreren Ebenen miteinander in Beziehung und sind Teil des Restaurierungsingenieurwesens. Jeder Beitrag in dieser Publikation ist mit weiteren interaktiven Lerninhalten verbunden, die unter http://www.hoou.de eingesehen werden können. Die Literaturübersichten sind eine Zusammenarbeit von Masterstudent*innen, Doktorand*innen und Forschenden des Instituts für Abwasserwirtschaft und Gewässerschutz (AWW) der Technischen Universität Hamburg. Diese Ausgabe besteht aus 3 Literaturübersichten. Die erste befasst sich mit der Agroforstwirtschaft, der Praxis der Einbeziehung von Baumarten oder anderen mehrjährigen Holzpflanzen in landwirtschaftliche Systeme, einschließlich der Nutzpflanzen- und Tierproduktion. Erläutert werden die Herausforderungen und Vorteile dieser Praxis, ergänzt durch ein Beispiel für ihre Umsetzung im Rahmen des Slope Farming Project in Arba Minch, Äthiopien. Der zweite Beitrag stellt das Konzept der lebenden Terrassen vor, die eine Kombination von Erosionsschutzmaßnahmen an Hängen darstellen. Sie ähneln den Kontur-Hecken, werden aber mit dem Ziel konstruiert, an der Hangseite der Gehölzreihen Boden anzustauen, so dass sich auf lange Sicht selbständig Terassenbänke bilden. Ihre Rolle als Teil der Regenwassernutzung wird in der Publikation näher erläutert. Schließlich gibt die dritte Literaturübersicht Einblicke in die Thematik der Geröllsprerren, die über Wasserläufe gebaut werden, um die Erosion durch Senkung der Wassergeschwindigkeit und Anhäufung von Sedimenten bei Überschwemmungen zu verringern. Geröllsprerren werden häufig in von Erosion beeinträchtigten Gegenden angewandt und stellen aufgrund ihrer relativen Einfachheit und leichten Umsetzbarkeit eine der weltweit am häufigsten verwendeten Stabilisierungsmaßnahmen dar. Des weiteren stellt diese Publikation auch eine Fallstudie im Löss-Plateau in China vor.

Risk factors in the development of adverse reactions in HIV-1-infected patients treated with highly active antiretroviral therapy (HAART) containing protease inhibitors are poorly understood. To identify predictors of protease inhibitor-associated adverse events, we are conducting a prospective, cohort, multicenter study on HIV-positive patients starting treatment with at least one protease inhibitor. Rate ratios (RR) of adverse events were calculated, and logistic regression was used to adjust simultaneously for the potentially confounding effects of selected variables, according to the Cox model. A total of 1477 patients have been enrolled up to April 2000, having an average age of 37.1 years (SD ± 8.1); 1066 (72.2%) were male. Where risk factors for HIV infection are concerned, the distribution was as follows: 48.1% intravenous drug users, 31.6% heterosexual contacts, 16.2% homosexual males and 0.7% blood transfusion. Average CD4+ lymphocyte count at enrollment was 265 cells/mmc (SD ± 201). Average follow-up time is equal to 17.8 months (range 1–32). The risk of developing adverse reactions is significantly increased in female patients, older patients, hemophiliac subjects and in subjects with hepatitis. Patients treated with ritonavir, the association ritonavir-saquinavir HGC, stavudine and efavirenz have significantly increased incidence of adverse reactions in PI-containing regimens; conversely, saquinavir HGC, zidovudine and lamivudine use was associated with a lower risk of developing adverse reactions.

OBJECTIVE: The study aimed to assess prevalence and risk factors for nosocomial infection (NI) in 21 hospitals of the Veneto Region (Italy). METHODS: In May 2003, a one-week-period prevalence study of NI was carried out in 21 hospitals, representing 63% of all hospital beds for acute patients of the Veneto Region. Intensive care units represented 84% of all intensive care beds of the Region. Long term care, neonatal intensive care, burn, psychiatric and dermatology units were excluded. RESULTS: Overall, 6,352 patients were surveyed. The prevalence of NI was 7.6% (range 2.6%-17.7%), while 6.9% of patients (range 2.6%-15.5%) were affected by at least one NI. The prevalence of patients with NI in medical, surgical and intensive care areas was 6.6%, 5.0% and 25.8%, respectively. The sites most frequently affected were the following: urinary tract (28.4%), surgical site (20.3%), blood stream (19.3%), pulmonary and lower respiratory tract (17.6%). At multivariate analysis risk factors independently associated to NI were: Charlson index score >1, severity of underlying disease, exposure to antibiotics, surgical intervention, trauma at admission, presence of central venous catheter >24 h, urinary catheter, intubation, tracheostomy, and duration since admission >15 days. CONCLUSION: The study provided baseline data of NI in the Veneto Region hospitals. It showed that NI are frequent, and display a wide inter-hospital variability of rates. The highest prevalence has been reported in intensive care units. The unusual high frequency of blood stream infections and the relatively lower prevalence rate of surgical site infections highlighted the limits of prevalence studies.