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排序方式: 共有580条查询结果,搜索用时 15 毫秒
1.
R. C. Williams M. K. Jeffcoat T. H. Howell C. M. Hall H. G. Johnson W. J. Wechter P. Goldhaber 《Journal of periodontal research》1987,22(5):403-407
The effect of two non-steroidal anti-inflammatory drugs, indomethacin and flurbiprofen, on the progression of periodontal disease was studied in 16 beagle dogs over a 12-month period. Standardized radiographs were used to measure the rate of bone loss. Following a 6-month pretreatment baseline period, 5 dogs were dosed daily with 1.0 mg/kg indomethacin, 5 dogs were dosed daily with 0.02 mg/kg flurbiprofen, and 6 dogs were dosed with empty gelatin capsules for a 6-month period. In the untreated control dogs, the rate of bone loss in the treatment period significantly increased from baseline. In contrast, the rate of bone loss significantly decreased from baseline in the flurbiprofen-treated dogs. In the indomethacin-treated dogs, rate of bone loss in the treatment period was not significantly different from baseline. The data indicate that both flurbiprofen and indomethacin inhibit alveolar bone loss in beagles compared to untreated controls. The data also indicate that with the dosages employed flurbiprofen is overall more effective. 相似文献
2.
Objective: Venous thromboembolism (VTE) is associated with almost 300,000 deaths per year in the United States. Novel oral anticoagulants (NOACs) offer an alternative to warfarin-based therapy without monitoring requirements and with fewer drug and food interactions. Edoxaban, a direct Xa inhibitor, is approved by the Food and Drug Administration (FDA), based upon results of the Hokusai-VTE Phase 3 trial. The trial demonstrated that edoxaban administered once daily after initial treatment with heparin was non-inferior in reducing the risk of VTE recurrence and caused significantly less major and clinically relevant non-major (CRNM) bleeding compared to warfarin. The objective of this study was to evaluate the cost-effectiveness of edoxaban versus warfarin for the treatment of adults with VTE. Methods: A cost-effectiveness model was developed using patient-level data from the Hokusai-VTE trial, clinical event costs from real-world databases, and drug acquisition costs for warfarin of $0.36 and edoxaban of $9.24 per tablet. Results: From a U.S. health-care delivery system perspective, the incremental cost-effectiveness ratio (ICER) was $22,057 per quality adjusted life year (QALY) gained. Probabilistic sensitivity analysis showed that edoxaban had an ICER <$50,000 per QALY gained relative to warfarin in 67% of model simulations. The result was robust to variation in key model parameters including the cost and disutility of warfarin monitoring. Conclusion: Despite its higher drug acquisition cost, edoxaban is a cost-effective alternative to warfarin for the treatment of VTE. 相似文献
3.
G20210A mutation in the prothrombin gene and the risk of recurrent venous thromboembolism 总被引:6,自引:0,他引:6
Miles JS Miletich JP Goldhaber SZ Hennekens CH Ridker PM 《Journal of the American College of Cardiology》2001,37(1):215-218
OBJECTIVES: The study was done to determine whether the G20210A mutation in the prothrombin gene increases the risk of recurrent venous thromboembolism (VTE), both alone and in combination with factor V Leiden. BACKGROUND: Several inherited defects of coagulation are associated with increased risk of first VTE, including a recently identified G20210A mutation in the prothrombin gene. However, whether the presence of this mutation confers an increased risk of recurrent venous thromboembolism is controversial. METHODS: A total of 218 men with incident venous thromboembolism were genotyped for the prothrombin mutation and for factor V Leiden and were followed prospectively for recurrent VTE over a follow-up period of 7.3 years. RESULTS: A total of 29 men (13.3%) suffered recurrent VTE. Five of the 14 carriers of the prothrombin mutation developed recurrent VTE (35.7%; incidence rate = 8.70 per 100 person-years), while 24 of 204 individuals who did not carry the prothrombin mutation developed recurrent VTE (11.8%; incidence rate = 1.76 per 100 person-years). Thus, presence of the G20210A mutation was associated with an approximate fivefold increased risk for recurrent VTE (crude relative risk [RR] 4.93; 95% confidence interval [CI] 1.9-12.9; p = 0.001; age-, smoking-, and body mass index-adjusted RR 5.28; 95% CI 2.0-14.0; p = 0.001). In these data, recurrence rates were similar among those with an isolated mutation in the prothrombin gene (18.2%) as compared to those with an isolated factor V Leiden mutation (19.2%). However, all three study participants who carried both mutations (100%) suffered a recurrent event during follow-up. CONCLUSIONS: In a prospective evaluation of 218 men, the presence ofprothrombin mutation was associated with a significantly increased risk of recurrent VTE, particularly among those who co-inherited factor V Leiden. 相似文献
4.
Chopard Romain Campia Umberto Morin Lucas Jering Karola S. Almarzooq Zaid I. Snyder Julia Elizabeth Rizzo Samantha Waxman Aaron B. Goldhaber Samuel Z. Piazza Gregory 《Journal of thrombosis and thrombolysis》2022,54(3):449-460
Journal of Thrombosis and Thrombolysis - Multidisciplinary pulmonary embolism (PE) response teams have garnered widespread adoption given the complexities of managing acute PE and provide a... 相似文献
5.
Weitz Jeffrey I. Haas Sylvia Ageno Walter Goldhaber Samuel Z. Turpie Alexander G. G. Goto Shinya Angchaisuksiri Pantep Nielsen Jørn Dalsgaard Kayani Gloria Farjat Alfredo E. Schellong Sebastian Bounameaux Henri Mantovani Lorenzo G. Prandoni Paolo Kakkar Ajay K. 《Journal of thrombosis and thrombolysis》2020,50(2):267-277
Journal of Thrombosis and Thrombolysis - Venous thromboembolism (VTE) is common in cancer patients and is an important cause of morbidity and mortality. The Global Anticoagulant Registry in the... 相似文献
6.
7.
P M Ridker J E Manson J E Buring S Z Goldhaber C H Hennekens 《American heart journal》1991,122(6):1588-1592
Low-dose aspirin has been postulated to decrease risks of cardiovascular disease by affecting atherosclerotic progression as well as acute thrombosis. In the Physicians' Health Study, a randomized double-blind placebo-controlled trial of alternate day aspirin (325 mg), 22,071 apparently healthy male physicians were treated and followed over a period of 5 years for the occurrence of myocardial infarction and of new angina pectoris. In an analysis of the cumulative incidence and cumulative relative risks of these end points, it was found that the full protective effect of aspirin in reducing the risk of myocardial infarction is apparent soon after initiation of therapy and does not change over time. In contrast, long-term aspirin therapy has no apparent role in decreasing the risk of developing future angina pectoris. Taken together, these clinical observations support the hypothesis that the primary effect of prophylactic low-dose aspirin therapy is to inhibit acute thrombosis, but do not support the hypothesis that long-term platelet inhibition for a duration of up to 5 years slows the initiation and progression of atherosclerosis. 相似文献
8.
S Z Goldhaber F E Reardon D T Goulart I L Rubin 《The American journal of medicine》1985,79(4):403-406
In summary, cardiac surgery for adults with mental retardation raises a series of controversial legal, economic, ethical, medical, and nursing dilemmas. During the past 20 years, many improvements have taken place in the care of these patients. However, in the future, judicial and statutory mandates requiring high-quality medical care for persons with mental retardation may conflict increasingly with hospital cost-control legislation and thereby affect clinical decisions. For example, it is conceivable that elective repair of an ostium secundum atrial septal defect in an asymptomatic patient will expend the limited resources necessary to carry out emergency revascularization in a symptomatic patient with impending myocardial infarction. This issue becomes even more delicate when the asymptomatic patient is a mentally retarded ward of the state, and the symptomatic patient is a middle-aged man supporting a wife and several college-age children. There may be no easy solution to this problem, and it will provide the grist for many bioethicists. Fortunately, from a practical point of view, we do not currently have to choose between these patients to receive treatment. Our hope is that health care for mentally retarded patients will not be compromised. We believe that decisions about patient management should be based on enlightened clinical judgment rather than on preconceived notions about this population. In the quest for optimal health care delivery, the special needs of these patients should be considered when cardiac catheterization and possible cardiac surgery are contemplated. Although we have presented an approach to a patient with cardiac disease requiring cardiac surgery, we believe that this approach can be utilized for any retarded patient requiring acute medical care. Currently, because there has not been much training in this area, many physicians and nurses lack first-hand experience in caring for the mentally retarded. This inexperience may lead to difficulty in making appropriate decisions. Therefore, we advocate additional exposure in medical and nursing school curricula to the complex health care needs of this population. In conclusion, there appear to be two major issues that pose dilemmas: first, acceptance of the rights of this population to optimal medical management and, second, implementation of appropriate diagnostic and therapeutic strategies. 相似文献
9.
Ida Ehlers Albertsen Peter Brønnum Nielsen Mette Søgaard Samuel Zachary Goldhaber Thure Filskov Overvad Lars Hvilsted Rasmussen Torben Bjerregaard Larsen 《The American journal of medicine》2018,131(9):1067-1074.e4
Purpose
In this study, we aimed to estimate recurrence risk after incident venous thromboembolism, stratified according to unprovoked, provoked, and cancer-related venous thromboembolism in a prospective cohort of inpatients and outpatients receiving routine care.Methods
We linked nationwide Danish health registries to identify all patients with incident venous thromboembolism from January 2000 through December 2015. Rates of recurrence were calculated and Cox regression was used to compute hazard ratios (HRs) with 95% confidence intervals (CIs) by incident venous thromboembolism type after adjusting for coexisting risk factors.Results
The study included 73,993 patients with incident venous thromboembolism (54.1% females; mean age, 62.3 years). At 6-month follow-up, rates per 100 person-years were 6.80, 6.92, and 9.06 for provoked, unprovoked, and cancer-related venous thromboembolism, respectively. At 10-year follow-up, corresponding rates were 2.22, 2.84, and 3.70, respectively. Additionally, at 6-month follow-up, hazard rates of recurrence were comparable for patients with unprovoked venous thromboembolism 1.01 (95% CI, 0.92-1.11) and provoked. At 10-year follow-up, unprovoked venous thromboembolism (HR, 1.17; 95% CI, 1.12-1.23) and cancer-related venous thromboembolism (HR, 1.21; 95% CI, 1.12-1.32) were associated with higher risk of recurrence compared with that found in provoked venous thromboembolism.Conclusions
In this nationwide cohort, patients with cancer-related venous thromboembolism had the highest risk of recurrence. At 6-month follow-up, there were similar risks of recurrence for patients with unprovoked and provoked venous thromboembolism. At 10-year follow-up, recurrence risks were similar for patients with unprovoked venous thromboembolism and patients with cancer-related venous thromboembolism. High recurrence risks in all categories indicate that further research is needed to optimize duration of extended anticoagulation for these patients. 相似文献10.
Gregory Piazza Samuel Z. Goldhaber Aimee Kroll Robert J. Goldberg Catherine Emery Frederick A. Spencer 《The American journal of medicine》2012,125(10):1010-1018
ObjectiveOur aim was to compare the clinical characteristics, prophylaxis, treatment, and outcomes of venous thromboembolism in patients with and without previously diagnosed chronic obstructive pulmonary disease.MethodsWe analyzed the population-based Worcester Venous Thromboembolism Study of 2488 consecutive patients with validated venous thromboembolism to compare clinical characteristics, prophylaxis, treatment, and outcomes in patients with and without chronic obstructive pulmonary disease.ResultsOf 2488 patients with venous thromboembolism, 484 (19.5%) had a history of clinical chronic obstructive pulmonary disease and 2004 (80.5%) did not. Patients with chronic obstructive pulmonary disease were older (mean age 68 vs 63 years) and had a higher frequency of heart failure (35.5% vs 12.9%) and immobility (53.5% vs 43.3%) than patients without chronic obstructive pulmonary disease (all P < .0001). Patients with chronic obstructive pulmonary disease were more likely to die in hospital (6.8% vs 4%, P = .01) and within 30 days of venous thromboembolism diagnosis (12.6% vs 6.5%, P < .0001). Patients with chronic obstructive pulmonary disease demonstrated increased mortality despite a higher frequency of venous thromboembolism prophylaxis. Immobility doubled the risk of in-hospital death (adjusted odds ratio, 2.21; 95% confidence interval, 1.35-3.62) and death within 30 days of venous thromboembolism diagnosis (adjusted odds ratio, 2.04; 95% confidence interval, 1.43-2.91).ConclusionPatients with chronic obstructive pulmonary disease have an increased risk of dying during hospitalization and within 30 days of venous thromboembolism diagnosis. Immobility in patients with chronic obstructive pulmonary disease is an ominous risk factor for adverse outcomes. 相似文献