PubMed · 6146782
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S M Gore. 1984-07-28. Zelen randomisation.. https://doi.org/10.1016/s0140-6736(84)90512-9
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A set of cognitive behavioral psychotherapies (CBT) has been developed for schizophrenia. These interventions have been used for the treatment of both recent onset patients and those with treatment-refractory symptoms. This article reviews clinical trials of CBT for schizophrenia since 1990. The CBT interventions appear to be beneficial in reducing overall symptom levels, especially the severity of delusions. The relative efficacy of CBT is more evident when CBT is compared with routine care than when it is compared with other therapies matched for therapist attention. Further studies are needed to objectively determine the active ingredients of CBT and to better identify the interactions of CBT with concurrent psychosocial and medication treatments.
This study was undertaken to characterize residual stenosis after thrombolytic administration and to evaluate clinical and angiographic features and early outcomes of patients with mild residual obstruction after thrombolytic administration. Patients who underwent angiography at 90 minutes after thrombolytic administration in the Thrombolysis In Myocardial Infarction 4, 10A, 10B, and 14 trials were divided into 3 groups according to the degree of residual stenosis measured by quantitative coronary angiography: patients with a patent culprit artery with <50% stenosis, patients with patent arteries and residual stenosis > or =50%, and patients with occluded arteries. Only 8.9% of the patients (188 of 2,119) had an infarct-related artery luminal diameter stenosis of <50% 90 minutes after thrombolysis. Compared with patients with patent arteries and > or =50% stenosis, patients with mild residual obstruction were younger (56.8 vs 58.6 years; p = 0.03), had fewer prior myocardial infarctions (6.9% vs 13.3%; p = 0.01), fewer eccentric (19.8% vs 42.1%; p <0.0001), ulcerated (7.5% vs 13.2%; p = 0.03), and collateralized (6.6% vs 13.2%, p = 0.01) lesions, but a greater thrombus burden (29.7% vs 18.3%, p = 0.0002). Among patients with patent arteries, a residual stenosis of <50% was associated with a significantly lower composite of in-hospital death, myocardial infarction, and congestive heart failure (2.8% vs 7.1%, p = 0.03). Thus, a minority of patients have a mild residual obstruction at 90 minutes after thrombolytic administration. These patients have less complex lesions with greater thrombus burdens and better clinical outcomes.