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Research round-up

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New York, July 5, 2000 (Praxis Press) The 6-month results of the FRISC II (Fast Revascularisation during Instability in Coronary artery disease) invasive trial show a reduction in the composite endpoint of death or myocardial infarction, contradicting previous large-scale randomized trials. The recent one-year follow-up of this randomized trial published in the Lancet confirms that the invasive strategy rapidly transforms unstable coronary-artery disease into a stable condition, lowering long-te

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New York, July 5, 2000 (Praxis Press) Continuous renal replacement therapies (CRRT) are increasingly replacing intermittent hemodialysis or peritoneal dialysis in the treatment of acute renal failure in critically ill patients. However, there is no consensus on the appropriate treatment dose or the impact of dose delivery on outcome. In a prospective randomized trial, Ronco et al determined that an increase in the rate of ultrafiltration in continuous veno-venous hemofiltration significantly im

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New York, June 30, 2000 (Praxis Press) Mortality rates from coronary artery disease (CAD), abnormal ventricular function and unsustained ventricular tachycardia are high. In patients with a history of myocardial infarction, cardiac arrest is often the result of reentrant ventricular tachycardia or fibrillation. Studies have not clearly assessed the prognostic value of electrophysiologic testing for these cases. In the Multicenter Unsustained Tachycardia Trial, Buxton et al performed electrophys

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New York, June 30, 2000 (Praxis Press) In familial adenomatous polyposis (FAP), a genetic disease that spurs the formation of hundreds of adenomatous polyps in the colon, the risk of developing colorectal cancer verges on 100 percent. Nonsteroidal antiinflammatory drugs (NSAIDs) are linked to a lower incidence of adenomatous polyps and lower colon cancer mortality, possibly due to their inhibition of the cyclooxygenase enzyme family, but their gastrointestinal toxicity limits their long-term use

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Warfarin and cancer

June 30, 2000

New York, June 30, 2000 (Praxis Press) - The incidence of cancer increases after the diagnosis of venous thromboembolism, which is usually treated with vitamin K antagonists such as warfarin. Few randomized trials have examined the relation between the development of metastases and the clotting mechanism. During a prospective, randomized study that lasted eight years, Schulman and Lindmarker have compared the effects on the incidence of cancer of a six-week and a six-month warfarin treatment giv

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Amiodarone guidelines

June 28, 2000

New York, June 28, 2000 (Praxis Press) Clinical trials demonstrate the efficacy, broad anti-arrhythmic and anti-fibrillatory action, and complex array of adverse effects of amiodarone. The absence of general recommendations for proper patient management likely leads to both overuse and underuse of this drug. Practical guidelines from the North American Society of Pacing and Electrophysiology provide the physician with a consensus approach to the prescription of amiodarone (see paper). Based on t

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New York, June 28, 2000 (Praxis Press) Within a few weeks of initiating antihypertensive therapy, physicians often escalate the dosage because of insufficient result, or discontinue the medication because of its perceived adverse side effects. Some studies suggest that hypertension is not an asymptomatic condition and may be responsible for some adverse effects. In a parallel-group clinical trial with randomized participants starting with a 20-mg daily dosage of the angiotensin-converting enzy

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Chest pain and mortality

June 28, 2000

NEW YORK, June 28 (Praxis Press) Although chest pain is widely considered a key symptom of myocardial infarction (MI), not all patients with MI present with chest pain. To determine the frequency with which patients with MI present without chest pain and to examine their subsequent management and outcome, Canto and colleagues performed an observational study of patients with MI (see paper). They examined a total of 434,877 patients and evaluated mortality among MI patients without chest pain and

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New York, June 28, 2000 (Praxis Press) Interstitial lung disease is a major cause of death in patients with systemic sclerosis (scleroderma). Studies have not precisely evaluated the association between alveolitis and lung fibrosis, and the subsequent deterioration of pulmonary function. A recent retrospective cohort study compared the outcomes of three patient groups with scleroderma lung disease: patients without alveolitis, and alveolitis patients with and without cyclophosphamide treatment a

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GERD treatment

June 28, 2000

New York, June 28, 2000 (Praxis Press) Clinical studies showing the superiority of proton pump inhibitors over histamine-2 receptor antagonists (H2RAs) in the treatment of severe gastroesophageal reflux disease (GERD) have not been extended to patients with the milder nonerosive form of the condition, which accounts for the majority of GERD cases. According to a new study, the proton pump inhibitor lansoprazole is more effective than the H2RA ranitidine or a placebo for milder (nonerosive) form

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