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33 papers 0 to 25 followers letrozol y placebo ca mama
Patrick G P Charles, Rory Wolfe, Michael Whitby, Michael J Fine, Andrew J Fuller, Robert Stirling, Alistair A Wright, Julio A Ramirez, Keryn J Christiansen, Grant W Waterer, Robert J Pierce, John G Armstrong, Tony M Korman, Peter Holmes, D Scott Obrosky, Paula Peyrani, Barbara Johnson, Michelle Hooy, M Lindsay Grayson
BACKGROUND: Existing severity assessment tools, such as the pneumonia severity index (PSI) and CURB-65 (tool based on confusion, urea level, respiratory rate, blood pressure, and age >or=65 years), predict 30-day mortality in community-acquired pneumonia (CAP) and have limited ability to predict which patients will require intensive respiratory or vasopressor support (IRVS). METHODS: The Australian CAP Study (ACAPS) was a prospective study of 882 episodes in which each patient had a detailed assessment of severity features, etiology, and treatment outcomes...
August 1, 2008: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Paul E Goss, James N Ingle, Kathleen I Pritchard, Nicholas J Robert, Hyman Muss, Julie Gralow, Karen Gelmon, Tim Whelan, Kathrin Strasser-Weippl, Sheldon Rubin, Keren Sturtz, Antonio C Wolff, Eric Winer, Clifford Hudis, Alison Stopeck, J Thaddeus Beck, Judith S Kaur, Kate Whelan, Dongsheng Tu, Wendy R Parulekar
BACKGROUND: Treatment with an aromatase inhibitor for 5 years as up-front monotherapy or after tamoxifen therapy is the treatment of choice for hormone-receptor-positive early breast cancer in postmenopausal women. Extending treatment with an aromatase inhibitor to 10 years may further reduce the risk of breast-cancer recurrence. METHODS: We conducted a double-blind, placebo-controlled trial to assess the effect of the extended use of letrozole for an additional 5 years...
July 21, 2016: New England Journal of Medicine
Massimo Imazio, Yehuda Adler
Pericardial effusion is a common finding in clinical practice either as incidental finding or manifestation of a systemic or cardiac disease. The spectrum of pericardial effusions ranges from mild asymptomatic effusions to cardiac tamponade. The aetiology is varied (infectious, neoplastic, autoimmune, metabolic, and drug-related), being tuberculosis the leading cause of pericardial effusions in developing countries and all over the world, while concurrent HIV infection may have an important promoting role in this setting...
April 2013: European Heart Journal
Ian D Pavord, Paul W Jones, Pierre-Régis Burgel, Klaus F Rabe
Exacerbations of chronic obstructive pulmonary disease (COPD) are defined as sustained worsening of a patient's condition beyond normal day-to-day variations that is acute in onset, and that may also require a change in medication and/or hospitalization. Exacerbations have a significant and prolonged impact on health status and outcomes, and negative effects on pulmonary function. A significant proportion of exacerbations are unreported and therefore left untreated, leading to a poorer prognosis than those treated...
2016: International Journal of Chronic Obstructive Pulmonary Disease
L Cicconi, F Lo-Coco
The management of acute promyelocytic leukemia (APL) has considerably evolved during the past two decades. The advent of all-trans retinoic acid (ATRA) and its inclusion in combinatorial regimens with anthracycline chemotherapy has provided cure rates exceeding 80%; however, this widely adopted approach also conveys significant toxicity including severe myelosuppression and rare occurrence of secondary leukemias. More recently, the advent of arsenic trioxide (ATO) and its use in association with ATRA with or without chemotherapy has further improved patient outcome by allowing to minimize the intensity of chemotherapy, thus reducing serious toxicity while maintaining high anti-leukemic efficacy...
August 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Gwen Murphy, Angelika Michel, Philip R Taylor, Demetrius Albanes, Stephanie J Weinstein, Jarmo Virtamo, Dominick Parisi, Kirk Snyder, Julia Butt, Katherine A McGlynn, Jill Koshiol, Michael Pawlita, Gabriel Y Lai, Christian C Abnet, Sanford M Dawsey, Neal D Freedman
UNLABELLED: Helicobacter have been detected in human bile and hepatobiliary tissue. Despite evidence that Helicobacter species promote gallstone formation and hepatobiliary tumors in laboratory studies, it remains unclear whether Helicobacter species contribute to these cancers in humans. We used a multiplex panel to assess whether seropositivity to 15 Helicobacter pylori proteins was associated with subsequent incidence of hepatobiliary cancers in the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study...
December 2014: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Richard H Sterns, Marvin Grieff, Paul L Bernstein
Treatment options for hyperkalemia have not changed much since the introduction of the cation exchange resin, sodium polystyrene sulfonate (Kayexalate, Covis Pharmaceuticals, Cary, NC), over 50 years ago. Although clinicians of that era did not have ready access to hemodialysis or loop diuretics, the other tools that we use today-calcium, insulin, and bicarbonate-were well known to them. Currently recommended insulin regimens provide too little insulin to achieve blood levels with a maximal kalemic effect and too little glucose to avoid hypoglycemia...
March 2016: Kidney International
Jeffrey H William, John Danziger
Since the early reports nearly a decade ago, proton-pump inhibitor-induced hypomagnesemia (PPIH) has become a well-recognized phenomenon. While many observational studies in the inpatient and outpatient populations have confirmed the association of PPI exposure and serum magnesium concentrations, there are no prospective, controlled studies to support causation. Molecular mechanisms of magnesium transporters, including the pH-dependent regulation of transient receptor potential melastatin-6 transporters in the colonic enterocyte, have been proposed to explain the effect of PPIs on magnesium reabsorption, but may be a small part of a more complicated interplay of molecular biology, pharmacology, and genetic predisposition...
March 6, 2016: World Journal of Nephrology
Andrew L Frelinger, Ronald D Lee, Darcy J Mulford, Jingtao Wu, Sai Nudurupati, Anu Nigam, Julie K Brooks, Deepak L Bhatt, Alan D Michelson
OBJECTIVES: The aim of this study was to assess the effects of different proton pump inhibitors (PPIs) on the steady-state pharmacokinetics and pharmacodynamics of clopidogrel. BACKGROUND: Metabolism of clopidogrel requires cytochrome P450s (CYPs), including CYP2C19. However, PPIs may inhibit CYP2C19, potentially reducing the effectiveness of clopidogrel. METHODS: A randomized, open-label, 2-period, crossover study of healthy subjects (n = 160, age 18 to 55 years, homozygous for CYP2C19 extensive metabolizer genotype, confined, standardized diet) was conducted...
April 3, 2012: Journal of the American College of Cardiology
Deepak L Bhatt, Byron L Cryer, Charles F Contant, Marc Cohen, Angel Lanas, Thomas J Schnitzer, Thomas L Shook, Pablo Lapuerta, Mark A Goldsmith, Loren Laine, Benjamin M Scirica, Sabina A Murphy, Christopher P Cannon
BACKGROUND: Gastrointestinal complications are an important problem of antithrombotic therapy. Proton-pump inhibitors (PPIs) are believed to decrease the risk of such complications, though no randomized trial has proved this in patients receiving dual antiplatelet therapy. Recently, concerns have been raised about the potential for PPIs to blunt the efficacy of clopidogrel. METHODS: We randomly assigned patients with an indication for dual antiplatelet therapy to receive clopidogrel in combination with either omeprazole or placebo, in addition to aspirin...
November 11, 2010: New England Journal of Medicine
A A Klein, P Arnold, R M Bingham, K Brohi, R Clark, R Collis, R Gill, W McSporran, P Moor, R Rao Baikady, T Richards, S Shinde, S Stanworth, T S Walsh
Blood transfusion can be life-saving. Anaesthetists regularly request and administer blood components to their patients. All anaesthetists must be familiar with indications and appropriate use of blood and blood components and their alternatives, but close liaison with haematology specialists and their local blood sciences laboratory is encouraged. Considerable changes in approaches to optimal use of blood components, together with the use of alternative products, have become apparent over the past decade, leading to a need to update previous guidelines and adapt them for the use of anaesthetists working throughout the hospital system...
July 2016: Anaesthesia
Michael B Streiff, Giancarlo Agnelli, Jean M Connors, Mark Crowther, Sabine Eichinger, Renato Lopes, Robert D McBane, Stephan Moll, Jack Ansell
This guidance document focuses on the diagnosis and treatment of venous thromboembolism (VTE). Efficient, cost effective diagnosis of VTE is facilitated by combining medical history and physical examination with pre-test probability models, D dimer testing and selective use of confirmatory imaging. Clinical prediction rules, biomarkers and imaging can be used to tailor therapy to disease severity. Anticoagulation options for acute VTE include unfractionated heparin, low molecular weight heparin, fondaparinux and the direct oral anticoagulants (DOACs)...
January 2016: Journal of Thrombosis and Thrombolysis
Anthony S Fauci, David M Morens
The explosive pandemic of Zika virus infection occurring throughout South America, Central America, and the Caribbean (see map) and potentially threatening the United States is the most recent of four unexpected arrivals of important arthropod-borne viral diseases in the Western Hemisphere over the..
February 18, 2016: New England Journal of Medicine
Gilles Montalescot, Filippo Crea
No abstract text is available yet for this article.
January 14, 2016: European Heart Journal
J H Pexman, P A Barber, M D Hill, R J Sevick, A M Demchuk, M E Hudon, W Y Hu, A M Buchan
BACKGROUND AND PURPOSE: Clinicians are insecure reading CT scans by using the one-third rule for acute middle cerebral artery stroke (1/3 MCA rule) before treating patients with recombinant tissue plasminogen activator. The 1/3 MCA rule is a poorly defined volumetric estimate of the size of cerebral infarction of the MCA. A 10-point quantitative topographic CT scan score, the Alberta Stroke Program Early CT Score (ASPECTS), is described and illustrated. A sharp increase in dependence and death occurs with an ASPECTS of 7 or less...
September 2001: AJNR. American Journal of Neuroradiology
Jens D Lundgren, Abdel G Babiker, Fred Gordin, Sean Emery, Birgit Grund, Shweta Sharma, Anchalee Avihingsanon, David A Cooper, Gerd Fätkenheuer, Josep M Llibre, Jean-Michel Molina, Paula Munderi, Mauro Schechter, Robin Wood, Karin L Klingman, Simon Collins, H Clifford Lane, Andrew N Phillips, James D Neaton
BACKGROUND: Data from randomized trials are lacking on the benefits and risks of initiating antiretroviral therapy in patients with asymptomatic human immunodeficiency virus (HIV) infection who have a CD4+ count of more than 350 cells per cubic millimeter. METHODS: We randomly assigned HIV-positive adults who had a CD4+ count of more than 500 cells per cubic millimeter to start antiretroviral therapy immediately (immediate-initiation group) or to defer it until the CD4+ count decreased to 350 cells per cubic millimeter or until the development of the acquired immunodeficiency syndrome (AIDS) or another condition that dictated the use of antiretroviral therapy (deferred-initiation group)...
August 27, 2015: New England Journal of Medicine
Peter G Pappas, Carol A Kauffman, David R Andes, Cornelius J Clancy, Kieren A Marr, Luis Ostrosky-Zeichner, Annette C Reboli, Mindy G Schuster, Jose A Vazquez, Thomas J Walsh, Theoklis E Zaoutis, Jack D Sobel
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
February 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Shane Nanayakkara, David M Kaye
PURPOSE: The purpose of this article was to review the clinical management of patients with heart failure with preserved ejection fraction (HFPEF). METHODS: For this critical review, electronic databases (MEDLINE, EMBASE, PubMed) were searched for relevant basic research studies and randomized clinical trials recently published or presented at major meetings. Details of in-progress or planned studies were obtained from the website. The range of publication dates was the year 2000 to 2015...
October 1, 2015: Clinical Therapeutics
Raphael R Bruno, Norbert Donner-Banzhoff, Wolfgang Söllner, Thomas Frieling, Christian Müller, Michael Christ
BACKGROUND: Acute chest pain of non-traumatic origin is a common reason for presentation to physician's offices and emergency rooms. Coronary heart disease is the cause in up to 25% of cases. Because acute chest pain, depending on its etiology, may be associated with a high risk of death, rapid, goal-oriented management is mandatory. METHODS: This review is based on pertinent articles and guidelines retrieved by a selective search in PubMed. RESULTS: History-taking, physical examination, and a 12-lead electrocardiogram (ECG) are the first steps in the differential diagnostic process and generally allow the identification of features signifying a high risk of lifethreatening illness...
November 6, 2015: Deutsches Ärzteblatt International
2015-12-31 04:38:51
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