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grammaire anglaise > conjonctions > while

 

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Coating on Buffered Aspirin

May Hide Its Heart-Protective Effects

 

December 4, 2012
The New York Times
By KATIE THOMAS

 

While aspirin may prevent heart attacks and strokes, a commonly used coating to protect the stomach may obscure the benefits, leading doctors to prescribe more expensive prescription drugs, according to a study published Tuesday in the journal Circulation.

The conclusion about coated aspirin was only one finding in the study, whose main goal was to test the hotly disputed idea that aspirin does not help prevent heart attacks or stroke in some people.

For more than a decade, cardiologists and drug researchers have posited that anywhere from 5 to 40 percent of the population is “aspirin resistant,” as the debated condition is known. But some prominent doctors say that the prevalence of the condition has been exaggerated by companies and drug makers with a commercial interest in proving that aspirin — a relatively inexpensive, over-the-counter drug whose heart benefits have been known since the 1950s — does not always work.

The authors of the new study, from the University of Pennsylvania, claim that they did not find a single case of true aspirin resistance in any of the 400 healthy people who were examined. Instead, they claim, the coating on aspirin interfered with the way that the drug entered the body, making it appear in tests that the drug was not working.

The study was partly financed by Bayer, the world’s largest manufacturer of brand-name aspirin, much of which is coated.

Aside from whether coating aspirin conceals its effects in some people, there is little evidence that it protects the stomach better than uncoated aspirin, said Dr. Garret FitzGerald, chairman of pharmacology at the University of Pennsylvania and one of the study’s authors.

“These studies question the value of coated, low-dose aspirin,” he said in a statement accompanying the article. “This product adds cost to treatment, without any clear benefit. Indeed, it may lead to the false diagnosis of aspirin resistance and the failure to provide patients with an effective therapy.”

In a statement, Bayer took issue with some of the study’s conclusions and methods and said previous studies of coated aspirin, also called enteric-coated aspirin, have been shown to stop blood platelets from sticking together — which can help prevent heart attacks and stroke — at levels comparable to uncoated aspirin. Bayer also noted that the price difference between its coated and uncoated aspirin was negligible, although Dr. FitzGerald argued there was no reason patients should use anything other than uncoated generic aspirin, which is cheaper.

“When used as directed,” the company said, “both enteric and nonenteric coated aspirin provides meaningful benefits, is safe and effective and is infrequently associated with clinically significant side effects.”

Although researchers had long observed that, as is true with most drugs, aspirin’s effects varied among patients, the existence of “aspirin resistance” gained currency in the 1990s and early 2000s. One often-cited study, published in 2003, found that about 5 percent of cardiovascular patients were aspirin-resistant and that that group was more than three times as likely as those not aspirin-resistant to suffer a major event like a heart attack.

But some said the popularity of aspirin resistance got a boost in part because of the development of urine and blood tests to measure it and the arrival on the market of drugs like Plavix, a more expensive prescription drug sold by Bristol-Myers Squibb that also thins the blood.

In the most recent study, the patients who initially tested positive for aspirin resistance later tested negative for it and by the end of the study, Dr. FitzGerald said, none of the patients showed true resistance. “Nobody had a stable pattern of resistance that was specific to coated aspirin,” he said. If resistance to aspirin exists, he said, “I think that the incidence is vanishingly small.”

Dr. Eric Topol, one of the authors of the 2003 study, said he strongly disagreed with Dr. FitzGerald’s conclusions, noting that it looked only at healthy volunteers, “which is very different than studying people who actually have heart disease or other chronic illnesses who are taking various medications.” Those conditions or medications could affect the way aspirin works in the body, he said.

But Dr. Topol and Dr. FitzGerald did agree that there was little value in testing for whether someone was aspirin-resistant, in part because there was little evidence that knowing someone is resistant to aspirin will prevent a heart attack or stroke.

Representatives for Accumetrics, which sells a blood test, and Corgenix, which sells a urine test, maintained that there was value in determining how well aspirin worked in individual patients, and said more recent research on the issue has moved away from a stark determination of whether someone is resistant to aspirin. “This whole concept of drug resistance has moved past that term and moved into the level of response that someone has,” said Brian Bartolomeo, market development manager at Accumetrics.

    Coating on Buffered Aspirin May Hide Its Heart-Protective Effects, NYT, 4.12.2012,
    http://www.nytimes.com/2012/12/05/business/
    coating-on-buffered-aspirin-may-hide-its-heart-protective-effects.html

 

 

 

 

 

While Fuel Is Promised,

Drivers Wait Hours for Gas

 

November 4, 2012
The New York Times
By WINNIE HU and VIVIAN YEE

 

As long lines persisted at pumps across the region, government officials and gas station owners in New York and New Jersey said Sunday that the fuel shortage could last for several more days as stations struggled to maintain supplies or reopen after losing power.

Gov. Andrew M. Cuomo reported that tankers and barges laden with fuel were en route to New York-area ports, but he also called on drivers to help by staying off the roads. “Now is not the time to be using the car, if you don’t need to,” he said at a news briefing. “Now is not the time to be hoarding fuel,” he added.

On Long Island, the Northville fuel distribution terminal at Port Jefferson was scheduled to get up to nine million gallons of gasoline by the end of Monday, according to state officials. A second Long Island terminal, in Inwood, was also open and ready to accept deliveries, the officials said.

The federal Energy Department said Sunday that only 27 percent of gas stations in the New York area reported being out of gas, down from 67 percent on Friday. The improvement was attributed to the continued restoration of power to the area and the reopening of the Port of New York and New Jersey and other pipelines and terminals handling fuel delivery. The Defense Department also started delivering fuel over the weekend.

“Things are getting a little better, not tremendously,” said Kevin Beyer, president of the Long Island Gasoline Retailers Association. Mr. Beyer’s own gas station in Smithtown, N.Y., reopened Saturday after electricity was restored. “It’s going to be a long process,” he said.

In New Jersey, where Gov. Chris Christie has imposed a rationing system limiting gas sales to even-numbered license plates on even days, and odd-numbered license plates on odd days, lines were noticeably shorter in some places, including Essex County, though many stations remained closed around the state.

Near Newark Liberty Airport, Havier Nazario, 36, a school principal, said he stood in line with dozens of people to fill up a five-gallon container for his car, which was parked in front of his house with an empty tank. After two hours, and with two people ahead of him, the station ran out.

Mr. Nazario said that one man had helped deplete the supply by filling a 25-gallon container with $101 worth of gas. “I don’t know what he’s trying to power,” Mr. Nazario said. “But I think folks should pretty much just take what they need for their vehicle, otherwise the ration doesn’t have its effect.”

He finally found gas at another station — after four more hours in line. The story was the same at many stations: long waits, uncertain results. Even stations that were tapped out found that people kept coming.

In New Dorp on Staten Island, Cassie Arizmendy, 23, said she had been waiting in line at a Hess station for more than 17 hours by Sunday afternoon for the next delivery of gas. “I’m here and I’m not leaving because I’m in the front,” said Ms. Arizmendy, who wore pajamas under her coat.

In Westchester County on Sunday, a Mobil station reopened in Larchmont after receiving a delivery of 5,000 gallons from a distributor in Newburgh, N.Y., less than half of its normal delivery, the owner said. The line — cash-only with a $40 limit — was four blocks long and had a police officer directing customers.

“I lived through the 1970s so I’ve been there,” said Rainor Sick, 69, who spent a half-hour waiting to fill up.

At a Getty station in Pelham Manor, in Westchester, the owner, Dave Randhawa, stood outside telling drivers that he had nothing left after selling about 8,000 gallons in the two previous days. He said there had only been one minor confrontation, when a woman who said her car had run out of gas tried to jump the line.

“I was told it will come today but I doubt it,” he told one woman in a van that rolled up.

    While Fuel Is Promised, Drivers Wait Hours for Gas, NYT, 4.11.2012,
    http://www.nytimes.com/2012/11/05/nyregion/while-fuel-is-promised-drivers-wait-hours-for-gas.html