International (NL-UK) double-blind study of Sinemet CR and standard Sinemet (25/100) in 170 patients with fluctuating Parkinson's disease

One hundred and seventy patients with fluctuating Parkinson's disease participated in an international clinical trial to compare the effects of controlled-released Sinemet 50/200 (mg carbidopa/mg levodopa; Sinemet CR) with standard Sinemet 25/100 (Sinemet STD). The study design involved an 8-week open-label titration (dose-finding) phase (STD and CR preparations given individually during weeks 1–4 and 5–8 respectively) followed by a 24-week double-blind, double-dummy (placebo) treatment period. Drug efficacy was assessed using: (a) data from patients' diaries (i.e. on-off periods) (b) the functional disability profile (Northwestern University Disability Scale), (c) the neurological signs and symptoms (New York University Parkinson's Disease Scale, NYUPDS), (d) global evaluations made by the patient and treating physician and (e) the patient's evaluation of sleep. The results indicate that the number of off periods and the total NYUPDS score decreased significantly in the patients treated with Sinemet CR compared with those treated with Sinemet STD. Furthermore, the patient's global evaluation was significantly better in the Sinemet CR group. The number of drug-related adverse experiences was similar in the two groups, and only one serious event of this nature was reported.     

Primary Angioplasty Is the Optimal Approach to Early Reperfusion in Patients with Acute Myocardial Infarction

Primary angioplasty offers several advantages to thrombolysis for the treatment of acute myocardial infarction. First, most patients are candidates for primary angioplasty. In contrast, only 20--30% meet eligibility criteria for thrombolysis. Second, angioplasty is superior to thrombolysis in achieving infarct artery patency, restoring normal coronary blood flow, and preventing temporary or permanent reocclusion. Third, angioplasty results in lower rates of mortality, recurrent ischemia, or stroke than thrombolysis. Finally, the cost of an angioplasty strategy is lower than the thrombolysis strategy due to earlier hospital discharge, fewer expensive complications, and fewer subsequent procedures and hospitalizations.     

Rapid curing of acrylic denture-base materials

A rapid-cure polymerization of cure, including a terminal boil, with respect to transparency, residual monomer, mechanical properties, and generation of gaseous porosity. It was found that in order for porosity-free resin to be produced during rapid curing, a low concentration (approximately 0.26%) of benzoyl peroxide initiator in the powder component is vital, and a very small concentration (approximately 0.025%) of the chemical activator dimethyl-p-toluidine in the monomer component is an advantage. Mechanical properties were only influenced where substantial porosity existed, but it was recognized that a material "tailor-made" for rapid curing would be most welcome.     

Community hospital administration of intravenous tissue plasminogen activator in acute myocardial infarction: improved timing, thrombolytic efficacy and ventricular function

As an investigational fibrinolytic agent for acute myocardial infarction, intravenous recombinant tissue-type plasminogen activator (rt-PA) has been administered primarily in tertiary care and university centers. To determine the value of early initiation of such therapy, two satellite community hospital emergency rooms were established for use of rt-PA and the experience was compared among 142 consecutive patients who were transferred to a regional center for acute cardiac catheterization after intravenous rt-PA therapy. In Group I (n = 19), patients received rt-PA after interhospital transport to the regional center, but before cardiac catheterization. In Group II (n = 70), rt-PA therapy was initiated by the helicopter physician and nurse team after their arrival at the local community hospital emergency room. Group III patients (n = 53) had rt-PA administered in the local community hospital by the emergency room physician. Group III patients had earlier initiation of therapy (2.1 +/- 0.8 hours in Group III versus 3.8 +/- 1.2 hours in combined Groups I and II, p less than 0.001) and an increased rate of infarct vessel recanalization on the 90 minute coronary angiogram (81 in Group III versus 67% in combined Groups I and II, p = 0.057). The patients in Group III had a higher acute left ventricular ejection fraction (54 +/- 8% versus 50 +/- 9.5% in combined Groups I and II, p less than 0.01) and a trend toward an increased 7 day ejection fraction (55.5 +/- 9% versus 51.7 +/- 9.5%, respectively, p = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)