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1.
Jeff Unger MD Dale C. Allison MD Margit Kaltoft MD Kavitha Lakkole MBA Jayant K. Panda MD Chethana Ramesh MSc Mehmet Sargin MD Elena Smolyarchuk MD Melissa Twine BS Benjamin Wolthers MD Gizem Yarimbas MSc Marouan Zoghbi MD the LIRA-PRIME investigators 《Diabetes, obesity & metabolism》2022,24(2):204-211
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Matteo Lambertini Francesca Poggio Marco Bruzzone Benedetta Conte Claudia Bighin Evandro de Azambuja Mario Giuliano Michele De Laurentiis Francesco Cognetti Alessandra Fabi Giancarlo Bisagni Antonio Durando Anna Turletti Ylenia Urracci Ornella Garrone Fabio Puglisi Filippo Montemurro Marcello Ceppi Lucia Del Mastro the GIM investigators 《International journal of cancer. Journal international du cancer》2020,147(1):160-169
Dose-dense adjuvant chemotherapy is standard of care in high-risk early breast cancer patients. However, its role in HER2-positive patients is still uncertain. In this exploratory analysis of the GIM2 trial, we investigated the efficacy of dose-dense chemotherapy in HER2-positive breast cancer patients with or without exposure to trastuzumab. In the GIM2 trial, node-positive early breast cancer patients were randomized to receive four cycles of (fluorouracil)epirubicin/cyclophosphamide followed by four cycles of paclitaxel administered every 2 (dose-dense) or 3 (standard-interval) weeks. After approval of adjuvant trastuzumab, protocol was amended in April 2006 to allow use of trastuzumab for 1 year after chemotherapy completion in HER2-positive patients. The efficacy of dose-dense chemotherapy in terms of disease-free survival (DFS) and overall survival (OS) was assessed according to HER2 status and trastuzumab use. Out of 2,003 breast cancer patients, HER2 status was negative/unknown in 1,551 patients; among the 452 patients with HER2-positive breast cancer, chemotherapy alone or followed by trastuzumab was given to 320 and 132 patients, respectively. Median follow-up was 8.1 years. No significant interaction between HER2 status, trastuzumab use and chemotherapy treatment was observed for both DFS (p = 0.698) and OS (p = 0.708). Nevertheless, there was no apparent benefit in the HER2-positive group treated with trastuzumab (DFS: HR, 0.99; 95% CI 0.52–1.89; OS: HR, 0.95; 95% CI 0.37–2.41). Although dose-dense chemotherapy was associated with a significant survival improvement in high-risk breast cancer patients, its benefit appeared to be smaller (if any) in patients with HER2-positive disease who received adjuvant trastuzumab. 相似文献
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Randomised clinical trial: gastrointestinal events in arthritis patients treated with celecoxib,ibuprofen or naproxen in the PRECISION trial 下载免费PDF全文
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Hirotoshi IMAMURA Nobuyuki SAKAI Chiaki SAKAI Toshiyuki FUJINAKA Akira ISHII for the JR-NET investigators 《Neurologia medico-chirurgica》2014,54(2):81-90
To distinguish the characteristics of ruptured cerebral aneurysm that are suitable for endovascular treatment from those that are not, we evaluated factors that influenced the results of aneurysm embolization in patients with ruptured cerebral aneurysm, based on data from the Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2. The multivariate analysis revealed that young patients, patients with low modified Rankin Scale (mRS) scores before onset, and patients with low World Federation of Neurosurgical Societies (WFNS) grades had good outcome. Compared to proximal internal carotid artery (ICA) aneurysms, the odds ratio of middle cerebral artery (MCA) aneurysms was 1.67, indicating poorer outcome for MCA aneurysms, and patients with small, wide-neck cerebral aneurysms had poor outcome. Patients treated after 15 days had better outcome than during other periods. The timing of treatment, however, did not influence the outcome in patients treated within 14 days. The outcome was poorer when the responsible doctor for the treatment was a specialist or a non-specialist than a supervisory doctor. The outcome of patients treated with bare platinum coils, and three dimensional (3D) rotational angiography was better, and the outcome of patients who completed treatment with body filling was poorer than in patients with complete occlusion. Perioperative hemorrhagic complications, all ischemic complications, and rebleeding occurred in 4.5%, 6.4%, and 1.4% of patients, respectively. All these complications had poor outcome factors on day 30, with odds ratios of 2.72, 2.96, and 25.49, respectively. We must be fully aware of these risk factors and determine indications for the treatment when endovascular treatment is performed as the treatment of choice for ruptured cerebral aneurysm. 相似文献
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Myburgh JA Higgins A Jovanovska A Lipman J Ramakrishnan N Santamaria J;CAT Study investigators 《Intensive care medicine》2008,34(12):2226-2234
Objective To determine whether there was a difference between epinephrine and norepinephrine in achieving a mean arterial pressure (MAP)
goal in intensive care (ICU) patients.
Design Prospective, double-blind, randomised-controlled trial.
Setting Four Australian university-affiliated multidisciplinary ICUs.
Patients and participants Patients who required vasopressors for any cause at randomisation. Patients with septic shock and acute circulatory failure
were analysed separately.
Interventions Blinded infusions of epinephrine or norepinephrine to achieve a MAP ≥70 mmHg for the duration of ICU admission.
Measurements Primary outcome was achievement of MAP goal >24 h without vasopressors. Secondary outcomes were 28 and 90-day mortality. Two
hundred and eighty patients were randomised to receive either epinephrine or norepinephrine. Median time to achieve the MAP
goal was 35.1 h (interquartile range (IQR) 13.8–70.4 h) with epinephrine compared to 40.0 h (IQR 14.5–120 h) with norepinephrine
(relative risk (RR) 0.88; 95% confidence interval (CI) 0.69–1.12; P = 0.26). There was no difference in the time to achieve MAP goals in the subgroups of patients with severe sepsis (n = 158; RR 0.81; 95% CI 0.59–1.12; P = 0.18) or those with acute circulatory failure (n = 192; RR 0.89; 95% CI 0.62–1.27; P = 0.49) between epinephrine and norepinephrine. Epinephrine was associated with the development of significant but transient
metabolic effects that prompted the withdrawal of 18/139 (12.9%) patients from the study by attending clinicians. There was
no difference in 28 and 90-day mortality.
Conclusions Despite the development of potential drug-related effects with epinephrine, there was no difference in the achievement of
a MAP goal between epinephrine and norepinephrine in a heterogenous population of ICU patients.
This study was presented at the Annual Congress of the European Society of Intensive Care Medicine in Berlin on October 10
2007. The presentation received the International Sepsis Forum prize for best abstract and paper. This study has been published
in abstract form: Myburgh J.A., Higgins A., Jovanovska A., Lipman J., Ramakrishnan N., Santamaria J and the CAT Study Investigators.
(2007). A comparison of epinephrine and norepinephrine on reversal of shock. Intensive Care Medicine 33 (Supplement 2): S197.
Trial registration: The study was registered with Current Controlled Studies: ISRCTN number 92846592. 相似文献
9.
Introduction
The guidelines recommend a beta-blocker or calcium channel blocker as the first-line medication for angina, supplemented by other agents for additional symptoms. One such agent is trimetazidine (TMZ), which has been shown to reduce the frequency of anginal episodes and improve exercise performance without affecting haemodynamic parameters. However, extensive real-world evidence for its efficacy in combination with first-line therapies has been lacking.Methods
The aim of this large-scale, Russian, multicentre, 6-month, open-label, prospective observational study was to assess the effect of adding TMZ modified release 35 mg bid to background antianginal therapy in the real-world clinical setting.Results
The study included 896 patients: 54% women, aged 29–90 years (42.6% >65 years), 63% with class II angina, and receiving beta-blockers alone or in combination (93%). Add-on TMZ reduced angina frequency and short-acting nitrate use within 2 weeks (both p < 0.0001) regardless of background therapy and maintained this effect over 6 months. It increased the proportion of patients with class I angina sixfold while decreasing that of class 3 angina almost fourfold. It also improved walking distance and well-being at 6 months (both p < 0.0001). Treatment was well tolerated.Conclusion
Add-on TMZ is a safe and rapidly effective treatment for reducing angina attacks and nitrate use in the real-world clinical setting. It also increases exercise capacity and well-being. These effects are observed within 2 weeks and persist for at least 6 months.10.
Nizar Elleuch Hichem Zidi Zied Bellamine Abdelaziz Hamdane Mondher Guerchi Nabil Jellazi On behalf of the CVD study investigators 《Advances in therapy》2016,33(9):1536-1549