Mediroyal Prevention Center

Background: Atrial fibrillation (AF) is an emerging epidemic, often treated with medications for rate or rhythm control. Adherence to these medications is important since patients may not receive optimal benefit if not taken as intended. Our study assessed patient adherence to AF medications in the Veterans Administration (VA), the largest US integrated healthcare system. Methods: The Retrospective Evaluation and Assessment of Therapies in AF (TREAT-AF) study is a retrospective cohort study of patients with newly diagnosed AF treated in the VA. National inpatient, outpatient, pharmacy claims and lab data were used to identify patients between 10/1/04 - 9/30/08 and who survived at least one year following diagnosis. We identified drug prescriptions for all antiarrhythmic (AA) and rate control drugs (RC) dispensed within 90 days after first AF diagnosis (index date). For each drug, we estimated adherence by calculating the 1-year medication possession ratio (MPR) and persistence by calculating continuous use within 1 year. Results: In 115,081 patients with newly diagnosed AF, the most common initially prescribed AAs were amiodarone, sotalol, and propafenone, and RCs were metoprolol, digoxin, and diltiazem. Among AAs, adherence was highest with sotalol (MPR 0.82+/-0.31) (Table) . Among RCs, adherence was highest with metoprolol (MPR 0.85+/-0.32) (Table). Good adherence (>80% MPR) was variable for AAs (27%-68%) and for RCs (44%-66%). At 1-year, persistence to AAs and RCs was low in general, with persistence ≤70% for each of the top three medications in each category. Conclusion: Among patients with newly diagnosed AF, adherence and persistence rates with AAs and RCs are variable and low in general. Continuous persistence is lower for both AAs and RCs compared with mean adherence using the MPR measure. Effectiveness of AF therapies may be compromised by poor medication adherence and persistence to these commonly prescribed medications. Future studies on predictors and outcomes of poor adherence in AF are needed.

<div class="htmlview paragraph">EPDM - Silicone Blends. A High Performance Elastomeric Composition For Automotive Applications</div> <div class="htmlview paragraph">Styling and design changes have dramatically altered performance requirements for elastomers. High performance engines with electronic fuel injection have increased temperatures under the hood. Therefore, high performance elastomers are required to meet today's service conditions.</div> <div class="htmlview paragraph">New technology has been developed to compatibilize EPDM and silicone into high performance elastomeric compositions. These blends have physical, electrical and mechanical properties, for 175°C service. Formulations will be discussed for applications which require heat and weather resistance.</div>

<div class="htmlview paragraph">The scanning electron microscope is a tool which, when applied to the study of fracture surface, will assist the rapid and accurate identification of the source of a fracture. It is also useful in the interpretation of the structure and properties of filled polymers and multicomponent blends.</div>