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At least 487 records · Page 27Linked to original sources
PubMed2006

Prevention of atrial fibrillation in patients with symptomatic chronic heart failure by candesartan in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) program.

BACKGROUND: Atrial fibrillation (AF) is frequent in patients with chronic heart failure (CHF). Experimental and small patient studies have demonstrated that blocking the renin-angiotensin-aldosterone system may prevent AF. In the CHARM program, the effects of the angiotensin receptor blocker candesartan on cardiovascular mortality and morbidity were evaluated in a broad spectrum of patients with symptomatic CHF. CHARM provided the opportunity to prospectively determine the effect of candesartan on the incidence of new AF in this CHF population. METHODS: 7601 patients with symptomatic CHF and reduced or preserved left ventricular systolic function were randomized to candesartan (target dose 32 mg once daily, mean dose 24 mg) or placebo in the 3 component trials of CHARM. The major outcomes were cardiovascular death or CHF hospitalization and all-cause mortality. The incidence of new AF was a prespecified secondary outcome. Median follow-up was 37.7 months. A conditional logistic regression model for stratified data was used. RESULTS: 6379 patients (83.9%) did not have AF on their baseline electrocardiogram. Of these, 392 (6.15%) developed AF during follow-up, 177 (5.55%) in the candesartan group and 215 (6.74%) in the placebo group (odds ratio 0.812, 95% CI 0.662-0.998, P = .048). After adjustment for baseline covariates, the odds ratio was 0.802 (95% CI 0.650-0.990, P = .039). There was no heterogeneity of the effects of candesartan in preventing AF between the 3 component trials (P = .57). CONCLUSIONS: Treatment with the angiotensin receptor blocker candesartan reduced the incidence of AF in a large, broadly-based, population of patients with symptomatic CHF.

Aged↗
PubMed2005

Evaluation of the accuracy of gadolinium-enhanced cardiovascular magnetic resonance in the diagnosis of cardiac sarcoidosis.

OBJECTIVES: This study analyzed the accuracy of gadolinium-enhanced cardiovascular magnetic resonance (CMR) for the diagnosis of cardiac sarcoidosis (CS). BACKGROUND: The diagnosis of CS was made according to the guidelines of the Japanese Ministry of Health and Welfare (1993); CMR has not been incorporated into the guidelines, and the diagnostic accuracy of CMR for the diagnosis of CS has not yet been evaluated. METHODS: We performed an analysis of 12-lead electrocardiograms (ECGs), 24-h ambulatory ECGs, echocardiograms, thallium scintigrams, and gadolinium-enhanced CMR studies in 58 biopsy-proven pulmonary sarcoidosis patients assessed for CS. The diagnostic accuracy of CMR for CS was determined using modified Japanese guidelines as the gold standard. RESULTS: The diagnosis of CS was made in 12 of 58 patients (21%); CMR revealed late gadolinium enhancement (LGE), mostly involving basal and lateral segments (73%), in 19 patients. In 8 of the 19 patients, scintigraphy was normal, while patchy LGE was present. The sensitivity and specificity of CMR were 100% (95% confidence interval, 78% to 100%) and 78% (95% confidence interval, 64% to 89%), and the positive and negative predictive values were 55% and 100%, respectively, with an overall accuracy of 83%. CONCLUSIONS: In patients with sarcoidosis, CMR is a useful diagnostic tool to determine cardiac involvement. New diagnostic guidelines should include CMR.

Adult↗
PubMedDate not supplied

Tissue engineering and the development of Apligraf, a human skin equivalent.

In recent years, skin grafting has evolved from the initial autograft and allograft preparations to biosynthetic and tissue-engineered living skin replacements. This review details the pioneering work of numerous investigators that led to the following precursors of tissue-engineered skin replacement: cultured autologous keratinocyte grafts, cultured allogeneic keratinocyte grafts, autologous/allogeneic composites, acellular collagen matrices, and cellular matrices. It also discusses the rationale for the development of the newer products and describes the technical advances leading to the development of Apligraf, a tissue-engineered human skin product.

Biomedical Engineering↗
PubMed1999

Rationale and design of The National Emphysema Treatment Trial: a prospective randomized trial of lung volume reduction surgery. The National Emphysema Treatment Trial Research Group.

The National Emphysema Treatment Trial is a multicenter, randomized clinical trial of medical therapy vs medical therapy plus lung volume reduction surgery (LVRS) for the treatment of patients with severe bilateral emphysema. LVRS will be accomplished by bilateral stapled excision via median sternotomy or video-assisted thoracoscopic surgery. Every patient will complete 6 to 10 weeks of pulmonary rehabilitation prior to randomization and will participate in a maintenance program of pulmonary rehabilitation after randomization. The primary outcome to be assessed by the trial is survival. Additional outcomes to be assessed are maximum exercise capacity, pulmonary function, oxygen requirement, distance walked in 6 min, quality of life, respiratory symptoms, and health-care utilization and costs. In addition, selected clinics will evaluate lung mechanics and respiratory muscle function, partial and maximal flow-volume curves, gas exchange during maximal exercise, and right heart function. The trial is targeted to enroll patients with severe emphysema who have no significant comorbid conditions; each patient will be randomized to one of the two treatment groups. The study duration is 4.5 years with a close-out period of 6 months.

Humans↗
PubMedDate not supplied

Tissue engineering and the development of Apligraf a human skin equivalent.

In recent years, skin grafting has evolved from the initial autograft and allograft preparations to biosynthetic and tissue-engineered living skin replacements. This review details the pioneering work of numerous investigators that led to the following precursors of tissue-engineered skin replacement: cultured autologous keratinocyte grafts, cultured allogeneic keratinocyte grafts, autologous/allogeneic composites, acellular collagen matrices, and cellular matrices. It also discusses the rationale for the development of the newer products and describes the technical advances leading to the development of Apligraf, a tissue-engineered human skin product.

Biomedical Engineering↗
PubMed1989

A multicenter, randomized, double-blind study comparing once-daily bedtime administration of famotidine and ranitidine in the short-term treatment of active duodenal ulcer.

The efficacy and safety of famotidine and ranitidine in the treatment of active duodenal ulcer were compared in a multicenter, randomized double-blind study. The study was carried out at 5 centers and involved a total of 143 patients with endoscopically documented active duodenal ulcer. The patients received either famotidine (1 40 mg tablet at night) or ranitidine 2 150 mg tablets at night). Endoscopic examinations were performed at 4 and 6 weeks of active treatment. Day and nocturnal pain were also monitored, and the laboratory and clinical profiles evaluated. One hundred and thirty-three patients fulfilled the evaluation criteria (66 patients in the famotidine group and 67 in the ranitidine group). Healing rates at weeks 4 or 6 of treatment showed no significant differences between the famotidine group and the ranitidine group. The healing rates were 78% at week 4 and 96% at week 6 in the famotidine group, and 76% at week 4 and 95% at week 6 in the ranitidine group. Similar results were observed in both treatment groups with regard to pain resolution, decrease in antacid intake and safety profile.

Adult↗
PubMed1998

Tissue engineering and the development of Apligraf, a human skin equivalent.

In recent years, skin grafting has evolved from the initial autograft and allograft preparations to biosynthetic and tissue-engineered living skin replacements. This review details the pioneering work of numerous investigators that led to the following precursors of tissue-engineered skin replacement: cultured autologous keratinocyte grafts, cultured allogeneic keratinocyte grafts; autologous/allogeneic composites, acellular collagen matrices, and cellular matrices. It also discusses the rationale for the development of the newer products and describes the technical advances leading to the development of Apligraf, a tissue-engineered human skin product.

Biomedical Engineering↗
PubMed2005

Biomechanical evaluation of an expansive pedicle screw in calf vertebrae.

The main objective of the present study is to evaluate biomechanically a newly designed expansive pedicle screw (EPS) using fresh pedicles from calf lumber vertebrae in comparison with conventional pedicle screws, (CDH) CD Horizon, Universal Spine System pedicle screw (USS) and Tenor (Sofamor Denek). Pull-out and turning-back tests were performed on these pedicle screws to compare their holding strength. Additionally, revision tests were undertaken to evaluate the mechanical properties of EPS as a "rescue" revision screw. A fatigue simulation test using a perpendicular load up to 1,500,000 cycles was also carried out. The results showed that the turning back torque (Tmax) and pull-out force (Fmax) of EPS screws were significantly greater than those of USS, Tenor and CDH screws (6.5x40 mm). In revision tests, the Fmax of both types of EPS screws (6.5x40 mm; 7.0x40 mm) were significantly greater than that of CDH, USS, and Tenor screws (P<0.05). Furthermore, no screws were broken or bent at the end of fatigue tests. The findings from the current study suggest that expansive pedicle screws can significantly improve the bone purchase and the pull-out strength compared to USS, Tenor and CDH screws of similar dimensions before and after a failure simulation.

Animals↗
PubMed1989

A multicenter, randomized, double-blind study comparing a daily bedtime administration of famotidine and ranitidine in short-term treatment of active duodenal ulcer.

The efficacy and safety of famotidine and ranitidine in the treatment of active duodenal ulcer were compared in a multicenter, randomized double-blind study. The study was carried out in 5 centers which included a total of 143 patients with endoscopically documented active duodenal ulcer. The patients received either famotidine (1 tablet of 40 mg at night) or ranitidine (2 tablets of 150 mg at night). Endoscopic examinations were performed at 4 and 6 weeks of active treatment. Day and nocturnal pain were also monitored and the laboratory and clinical profiles evaluated. One hundred and thirty-three patients fulfilled the evaluation criteria (66 patients in the famotidine group and 67 in the ranitidine group). Healing rates at weeks 4 or 6 of treatment showed no significant differences between the famotidine and the ranitidine groups. The healing rates were 79% at week 4 and 96% at week 6 in the famotidine group, and 77% at week 4 and 95% at week 6 in the ranitidine group. Similar results were observed in both treatment groups with regard to pain resolution, decrease in antacid intake and safety profile.

Adult↗
PubMed2005

Biomechanical evaluation of an expansive pedicle screw in calf vertebrae.

OBJECTIVE: To obtain a comprehensive understanding of the effect of the improvement of fixation strength of a newly designed expansive pedicle screw through biomechanical analyses. METHODS: 100 (200 pedicles) fresh calf lumber vertebrae were used. A total of four instrumentation systems were tested including CDH (CD Horizon), USS (Universal Spine System pedicle screw), Tenor (Sofamor Denek) and expansive pedicle screw (EPS). Pullout and turning-back tests were performed to compare the holding strength of the expansive pedicle screw with conventional screws, i.e. USS, CDH and Tenor. Revision tests were performed to evaluate the mechanical properties of the expansive pedicle screw as a "rescue" revision screw. A fatigue simulation using perpendicular load up to 1,500,000 cycles was carried out. RESULTS: The turning back torque (Tmax) and pull-out force (Fmax) of EPS were significantly greater than those of USS, Tenor and CDH screws (6.5 mm x 40 mm). In revision tests, the Fmax of both kinds of EPS (6.5 mm x 40 mm; 7.0 mm x 40 mm) were greater than that of CDH, USS and Tenor screws significantly (P<0.05). No screws were broken or bent at the end of fatigue tests. CONCLUSIONS: EPS can significantly improve the bone purchase and the pull-out strength compared to USS, Tenor and CDH screws with similar dimensions before and after failure simulation. The fatigue characteristic of EPS is similar to that of CDH, USS and Tenor screws.

Animals↗