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Antegrade/retrograde cardioplegia for valve replacement: A prospective study

ANNALS OF THORACIC SURGERY 1999年第5期68卷 1681-1685页

作者： Dagenais, F Pelletier, LC Carrier, M Univ Montreal Montreal Heart Inst Dept Surg Montreal PQ H1T 1C8 Canada

Background. From 1994 to 1996, 75 patients undergoing valve replacement were randomized to antegrade (36 patients, group 1) or antegrade/retrograde (39 patients, group 2) administration of cold blood cardioplegia. Methods. Groups were comparable for age, sex, valve disease, and ventricular dysfunction. The aortic valve was replaced in 27 patients from group 1 and 24 patients from group 2, the mitral valve in 8 and 15 patients, and 1 patient in group 1 underwent double valve replacement (p = not significant). Results. Lengths of cardiopulmonary bypass and aortic cross-clamp averaged, respectively, 10 minutes (p = not significant) and 12 minutes (p = < 0.05) shorter in group 2. Total amount of cardioplegia solution infused averaged 1,279 +/- 406 mt and 1,341 +/- 379 mt (p = not significant), respectively, in groups 1 and 2, and the period of infusion averaged 44% and 72% (p = < 0.01) of the total period of aortic cross-clamping. No death occurred in group 1 compared to two in group 2 (p = not significant). The perioperative myocardial infarction and stroke rates were comparable in both groups. Peak enzyme release at 24 hours was similar both for creatine kinase-MB fraction (26 versus 37 IU/L) and for troponin T (2.1 versus 2.5 IU/L). Conclusions. Our study shows no significant advantage of the antegrade/retrograde administration of cardioplegia over the antegrade route in routine valvular replacement, other than a slightly shorter aortic cross-clamping time. (C) 1999 by The Society of Thoracic Surgeons.

关键词：主动脉瓣/外科学心麻痹液/投药和剂量用药计划表心脏瓣膜假体植入医院死亡率低温人工二尖瓣/外科学心肌梗死/病因学心肌梗死/死亡率手术后并发症/病因学手术后并发症/死亡率前瞻性研究危险因素卒中/病因学卒中/死亡率存活率治疗结果老年人女(雌)性人类男(雄)性中年人

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Life-style and medication compliance in elderly patients

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AGE AND AGEING 1998年第5期27卷 657-657页

作者： von Renteln-Kruse, W Reha Zentrum Reuterstr Geriatr Klin D-51467 Bergisch Gladbach Germany

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Management of schizophrenia in children and adolescents: The role of clozapine

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Paediatric Drugs 2000年第4期2卷 253-262页

作者： Remschmidt, H. Fleischhaker, C. Hennighausen, K. Schulz, E. Department of Child and Adolescent Psychiatry Philipps-University Marburg Germany Department of Child and Adolescent Psychiatry Albert-Ludwigs-University Freiburg Germany

Clozapine is a dibenzodiazepine derivative with established antipsychotic efficacy in adult patients with schizophrenic psychoses. There are more than 15 studies that have also demonstrated the antipsychotic efficacy of clozapine in childhood and adolescent schizophrenia. The main advantages of clozapine treatment in this age group in comparison with typical antipsychotics are: (i) high antipsychotic efficacy during an acute schizophrenic episode;(ii) better improvement in chronic cases with a high load of negative symptoms;and (iii) markedly fewer extrapyramidal adverse effects and, therefore, fairly good tolerability. However, because of its possible adverse effects on the haemopoetic system (granulocytopenia, agranulocytosis), clozapine should not be used as first-line antipsychotic medication. Other adverse effects are related to the cardiovascular system (hypotonia, tachycardia or arrhythmia), the central nervous system (epileptic seizures, fever) and liver function (transient increases in levels of hepatic transaminases). Two other frequent adverse effects are hypersalivation and body-weight gain, which may present a particular problem in adolescents and young adults. Careful monitoring of haematological parameters and other adverse effects are preconditions for a successful treatment programme. Clozapine is an atypical antipsychotic medication with established efficacy in adults with schizophrenic psychoses. The term 'atypical antipsychotic' originated in the first clinical descriptions of the then unique properties of clozapine. Clozapine could be differentiated from 'typical antipsychotics' by the absence of extrapyramidal adverse effects (EPS), which were formerly thought to be inseparable from antipsychotic efficacy. More recently, other substances have been included in the group of atypical antipsychotics.

关键词：青春期精神病学抗精神病药/药理学抗精神病药/治疗应用儿童精神病学氯氮平/药理学氯氮平/治疗应用用药计划表预后精神分裂症/药物疗法青少年成年人老年人儿童女(雌)性人类男(雄)性中年人

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Single-day loading dose of oral amiodarone for the prevention of new-onset atrial fibrillation after coronary artery bypass surgery.

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American heart journal 2001年第5期141卷 5A页

作者： Maras, D. Bosković, S.D. Popović, Z. Nesković, A.N. Kovacević, S. Otasević, P. Marinković, J. Vuk, L. Borzanović, M. Nastasić, S. Jovanović, T. Bojić, M. Babić, R. Popović, A.D. Department of Cardiology the "Dr Aleksandar D. Popović "Cardiovascular Research Center the Department of Cardiac Surgery Dedinje Cardiovascular Institute Belgrade Yugoslavia.

BACKGROUND: Various regimens have been proposed for the prevention of postoperative atrial fibrillation, including the use of intravenous and oral amiodarone. The purpose of this study was to determine the effectiveness of a single-day loading dose of oral amiodarone in prophylaxis of atrial fibrillation during the 7 days after coronary artery bypass surgery. METHODS: We conducted a double-blind, randomized, placebo-controlled study encompassing 315 consecutive patients who underwent coronary artery bypass surgery. They received either amiodarone (159 patients) or placebo (156 patients). Therapy consisted of a single oral loading dose of 1200 mg of amiodarone 1 day before surgery, followed by the maintenance dose of 200 mg daily during the next 7 days. Only episodes of atrial fibrillation lasting more than 1 hour or associated with hemodynamic compromise were taken into consideration. RESULTS: Overall, the incidence of atrial fibrillation was similar in patients who received amiodarone (31/159, 19.5%) and placebo (33/156, 21.2%) (P = .78). However, amiodarone reduced the incidence of atrial fibrillation in elderly patients (age > or = 60 years): it occurred in 20 of 75 (26.7%) patients on amiodarone and in 28 of 65 (43.1%) patients in the placebo group (P = .05). There were no differences between the study groups regarding the postoperative intrahospital morbidity and mortality and the duration of hospital stay. CONCLUSIONS: A single-day loading dose of oral amiodarone (1200 mg) does not prevent postoperative atrial fibrillation in a general population of patients undergoing coronary artery bypass surgery. However, it appears that this regimen reduces the occurrence of postoperative atrial fibrillation in elderly patients.

关键词：投药口服胺碘酮/投药和剂量抗心律失常药/投药和剂量心房颤动/流行病学心房颤动/病因学心房颤动/预防和控制冠心病/外科学双盲法用药计划表医院死亡率发病率住院时间人类中年人

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Atrial fibrillation in the elderly: Anticoagulation strategies and indications in the very elderly

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American Journal of Geriatric Cardiology 2002年第6期11卷 357-362页

作者： Kamath, Sridar Lip, Gregory Y.H. Vascular Biology Unit University Department of Medicine City Hospital Birmingham B18 7QH United Kingdom

With increasing life expectancy and the older mean age of the general population, the prevalence of atrial fibrillation is likely to increase, making this arrhythmia an even more important public health problem, especially in the elderly. While atrial fibrillation is increasingly common in the elderly, paradoxically, the data on intervention trials in atrial fibrillation among the elderly are limited. When considering anticoagulation in the elderly patient with atrial fibrillation, the following five questions should be addressed. 1) Is there a definite indication (for example, atrial fibrillation plus risk factor[s])? 2) Is there a high risk of bleeding or strong contraindication against anticoagulation? 3) Will concurrent medication or disease states significantly increase bleeding risk or interfere with anticoagulation control? 4) Is drug compliance and attendance at anticoagulant clinic for monitoring likely to be a problem? 5) Will there be regular review of the patient, especially with regard to risks and benefits of anticoagulation? Careful and continuing evaluation of the elderly patient with atrial fibrillation is necessary to ensure that the risks of bleeding do not outweigh the benefits from anticoagulation. © 2002 CVRR, Inc.

关键词：年龄因素抗凝药/投药和剂量心房颤动/诊断心房颤动/药物疗法心房颤动/死亡率剂量效应关系药物用药计划表心电描记术老年人身心健康评价大不列颠监测生理学/方法凝血酶原时间危险因素疾病严重程度指数存活率老年人老年人 80以上女(雌)性人类男(雄)性

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Active phase labor arrest: oxytocin augmentation for at least 4 hours.

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Journal of midwifery & women's health 2000年第2期45卷 185-186页

作者： Riedmann, G. Female Health Associates Oak Park Illinois United States

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Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion: A randomised trial

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BJOG: An International Journal of Obstetrics and Gynaecology 2000年第4期107卷 524-530页

作者： Wu, Y.M. Gomez-Alzugaray, M. Haukkamaa, M. Ngoc, N.T.N. Ho, P.C. Pretnar-Darovec, A. Healy, D.L. Sotnikova, E. Shah, R.S. Pavlova, N.G. Chen, J.K. Song, S. Bygdeman, M. Kovács, L. Khomassuridze, A. Song, L.J. Hamzaoui, R. Alexaniants, S. Van Look, P.F.A. von Hertzen, H. Piaggio, G. Peregoudov, A. Vucurevic, M. Grimes, D. Peking Union Medical College Hospital Beijing China National Institute of Endocrinology Havana Cuba City Maternity Hospital and Helsinki University Central Hospital Helsinki Finland Hung Vuong Hospital Ho Chi Minh City Viet Nam University of Hong Kong Hong Kong University Department of Obstetrics and Gynaecology Ljubljana Slovenia Monash University Melbourne Australia Research Centre of Obstetrics Gynaecology and Perinatology Academy of Medical Sciences of Russia Moscow Russian Federation Institute for Research in Reproduction Indian Council of Medical Research Mumbai India Institute of Obstetrics and Gynaecology named after D. O. Ott Russian Academy of Medical Sciences St Petersburg Russian Federation Shanghai Institute of Planned Parenthood Research Shanghai China Karolinska Hospital Stockholm Sweden Albert Szent- Györgyi Medical University Szeged Hungary Zhordania Institute of Human Reproduction Tbilissi Georgia Tianjin Municipal Research Institute for Family Planning Tianjin China Centre d’Etude et de Recherche en Reproduction Humaine de l’ONFP Tunis Tunisia Armenian Research Centre of Maternal and Child Health Protection Yerevan Armenia Development and Research Training in Human Reproduction World Health Organization Geneva Switzerland University of California San Francisco General Hospital San Francisco CA United States

Objectives To compare the efficacy of two different regimens of mifepristone followed by misoprostol for medical abortion in women with menstrual delay of ≤ 35 days. Design Double-blind, randomised controlled trial. Setting Seventeen centres internationally. Participants We enrolled 1589 healthy pregnant women with menstrual delay of ≤ 35 days who were requesting nonsurgical abortion. Interventions Within gestational age strata, we randomly assigned women to receive a single oral dose of mifepristone, either 200 mg or 600 mg, followed in 48 h by misoprostol 400 μg by mouth. We concealed the allocation assignments from investigators and participants and maintained double-blinding throughout the study. Main outcome measures Complete abortion was the principal outcome measure. We also compared rates of side effects such as abdominal pain. Results The complete abortion rate with the lower dose of mifepristone was similar to that with the higher dose (89.3%vs 88.1%) The crude relative risk of failure to achieve complete abortion with the 200 mg dose compared with the 600 mg dose was 0.9 (95% CI 0.7 to 1.2). The likelihood of complete abortion was inversely related to gestational age, although this finding is exploratory in nature. Among failures the percentage of women with continuing pregnancies increased from 1.4% at menstrual delay of two weeks or less to 9.0% when the delay was 4–5 weeks. Low efficacy led to stopping enrolment at 29 to 35 days' menstrual delay. Stopping criteria were also met at completion of the study in the group with 22–28 days' menstrual delay. No significant differences emerged in the frequency of side effects between the two mifepristone groups. Conclusions Both regimens had similar efficacy. Women with a menstrual delay of four to five weeks had twice the risk of failure to abort compared with those who received treatment within two weeks of the expected menses. The efficacy of the mifepristone-prostaglandin regimen was not reduced by decreasi

关键词：堕胎药非甾类/投药和剂量流产人工/方法双盲法用药计划表孕龄 Logistic模型米索前列醇/投药和剂量治疗结果成年人女(雌)性人类妊娠

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Benefits of magnesium in acute myocardial infarction: timing is crucial.

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American heart journal 2000年第4期139卷 703-703页

作者： Gyamlani, G. Parikh, C. Kulkarni, A.G. Krishna Institute of Medical Sciences Karad India

OBJECTIVE: To evaluate magnesium deficiency during and after acute myocardial infarction (AMI) and the role of intravenous magnesium therapy given in the early postinfarction period. METHODS: One hundred patients with AMI were randomly assigned to 2 equal groups and monitored over a 4-week period. The placebo group received intravenous dextrose solution and the trial group was given 15 g intravenous magnesium (62 mmol) over a 48-hour period. Serum magnesium levels were measured on days 1, 2, 4, and 6 after admission by calorimetry with methyl thymol blue. RESULTS: The groups were comparable in prevalence of risk factors for coronary artery disease and other acute parameters of AMI. The serum magnesium levels of a group of 50 controls were higher (1.61 +/- 0. 21 vs 1.23 +/- 0.27mEq/L) than in patients with AMI (P <.001). There was an increase in serum magnesium levels in the trial group on day 2 (1.73 +/- 0.27 vs 1.29 +/- 0.28 mEq/L;P <.001) as well as on day 4 (1.62 +/- 0.25 vs 1.38 +/- 0.36 mEq/L;P <.001). The trial group also showed significantly lower incidence of arrhythmias (8% vs 34%) and death (4% vs 20%). The mortality rate from pump failure was reduced in the trial group (4% vs 14%). CONCLUSIONS: The serum magnesium levels in patients with AMI were lower compared with controls. The administration of intravenous magnesium to patients in the immediate postinfarction period is cardioprotective and decreases the incidence of arrhythmia, pump dysfunction, and death. Thus intravenous magnesium is a safe, effective, and inexpensive modality of treatment in AMI.

关键词：用药计划表输注静脉内镁/投药和剂量镁缺乏/药物疗法心肌梗死/药物疗法人类

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紫杉类药物每周对比三周治疗非小细胞肺癌的系统评价

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中国肺癌杂志 2009年第6期12卷 471-471页

作者：邵宜马力马彬田金徽杨克虎兰州大学循证医学中心兰州大学基础医学院兰州730000 天津医科大学总医院肿瘤科大津300052

背景与目的系统评价紫杉类药物每周与三周方案治疗非小细胞怖癌的疗效和安全性。方法检索1966年-2008年Cochrane、PubMed、EMBASE及CBM，搜集紫杉类药物每周对比三周治疗非小细胞肺癌的随机对照试验。根据Cochrane Handbook 4．2．6评... 详细信息

背景与目的系统评价紫杉类药物每周与三周方案治疗非小细胞怖癌的疗效和安全性。方法检索1966年-2008年Cochrane、PubMed、EMBASE及CBM，搜集紫杉类药物每周对比三周治疗非小细胞肺癌的随机对照试验。根据Cochrane Handbook 4．2．6评价标准进行方法学质量评价，使用RevMan5．0进行统计学分析．

关键词：紫杉醇多西紫杉醇用药计划表肺肿瘤 Meta分析

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Re: Time to normalization of serum testosterone after 3-month luteinizing hormone-releasing hormone agonist administered in the neoadjuvant setting: implications for dosing schedule and neoadjuvant study consideration

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The Journal of urology 1999年第1期162卷 170页

作者： D P Dearnaley A R Norman M Shahidi [a]Academic Unit of Radiotherapy The Royal Marsden NHS Trust Downs Road Sutton Surrey SM2 5PT England

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