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At least 73 records · Page 4Linked to original sources
PubMed1995

Design of a placebo-controlled clinical trial of long-acting diltiazem and aspirin versus aspirin alone in patients receiving thrombolysis with a first acute myocardial infarction. Incomplete Infarction Trial of European Research Collaborators Evaluating Prognosis Post-Thrombolysis (diltiazem) (INTERCEPT) Research Group.

Several pharmacologic forms of adjunctive therapy, designed to enhance the efficacy of thrombolysis following acute myocardial infarction (AMI), are being explored. However, few studies have assessed the use of standard secondary prevention therapies (beta-blockers, angiotensin-converting enzyme inhibitors, magnesium, calcium antagonists, etc.) for antecedent thrombolysis. Although calcium antagonists have not been shown to alter post-AMI mortality, diltiazem has been shown to reduce recurrent nonfatal infarction and myocardial ischemia following non-Q-wave AMI. Because both non-Q-wave AMI and AMI treated with thrombolytic therapy result in early reperfusion and clinical manifestations of "incomplete infarction" (i.e., aborted transmural infarction), we hypothesize that prophylactic administration of diltiazem to AMI patients who receive thrombolysis before other therapies might decrease ischemic complications. We have initiated a multicenter, randomized, placebo-controlled, double-blind, parallel-group comparison of long-acting diltiazem 300 mg/day and aspirin 160 mg/day versus aspirin 160 mg/day alone in up to 920 patients with an uncomplicated first AMI (no heart failure or left ventricular dysfunction) within 36 to 96 hours of receiving thrombolysis. Active enrollment is under way at 46 centers in the United Kingdom, Belgium, The Netherlands, and Denmark. This trial (known as the Incomplete INfarction Trial of European Research Collaborators Evaluating Prognosis Post-Thrombolysis [diltiazem], or INTERCEPT) represents the first long-term, large-scale, prospective study of a calcium antagonist administered post-thrombolysis as adjunctive therapy to AMI patients in which the primary trial objective is to assess the effect of blinded therapy on the 6-month cumulative occurrence of a combined clinical end point (cardiac death, recurrent nonfatal AMI, and medically refractory ischemia).

Adolescent↗
PubMed1991

The Independent Health Facilities Act.

The Independent Health Facilities Act represents an attempt by the Ontario Government to control the unplanned proliferation of health clinics in the community offering specialized services often seen as competing with public hospitals, and to provide mechanisms to ensure that standards and quality care are maintained in these clinics. Although the Act was originally aimed at about 25 ambulatory surgi-centers performing such procedures as cataract surgery and abortions, amendments have broadened the Act's scope to include most clinics offering such diagnostic services as x-ray and ultra sound. The legislation was opposed by some medical specialties and proved very controversial. Other provinces have looked to this legislation as a means of controlling health care costs by reducing reliance on hospitals for certain kinds of procedures and by moving from fee for service to various alternative funding mechanisms for those procedures provided by out-of-community clinics as approved and licensed in a place and manner decided upon by government. The papers in this issue of the journal reflect a conference sponsored by the Canadian Institute of Law and Medicine to examine this legislation one year after it came into force. The comments of government, physicians, lawyers and others most directly affected by this new statute are set out in a selected number of presentations.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care Facilities↗
PubMed2001

Progesterone as an immunomodulatory molecule.

Increased progesterone sensitivity of pregnancy lymphocytes is due to activation-induced appearance of progesterone binding sites in the lymphocytes. Following recognition of fetally derived antigens gamma/delta TCR+ cells develop progesterone receptors. Progesterone binding results in the synthesis of a mediator protein named the progesterone-induced blocking factor (PIBF). PIBF by acting on the phospholipase A2 enzyme interferes with arachidonic acid metabolism, induces a Th2 biased immune response, and by controlling NK activity exerts an anti-abortive effect.

Adjuvants, Immunologic↗
PubMed2003

[The impact of stress in the maternofetal relationship: an immunological approach].

Pregnancy is controlled primarily, though not exclusively, by a delicate equilibrium between locally acting growth factors and cytokines, some under steroid control. The hypothesis considered here is that stress is able to influence the equilibrium between cytokines and thus lead to abortions or implantation failure. We thus detailed the studies on that topic in order to explore the psycho-neuro-immunological mechanisms concerned. The duration of stress, the patient's strategy for coping with this and the social context might be able to produce some opposite immunological effects. Thus, the link between stress and the immunological events induced is complex, and much care is needed for such patients.

Abortion, Spontaneous↗
PubMed1975

Psychiatry: the battered child of medicine.

Psychiatry has had a troubled history. After the French Revolution "moral treatment" brought to America a period of effective and humane hospital treatment, but this progress was corrupted by the Industrial Revolution, and psychiatry was rejected by society as well as by medicine. Although the Freudian enlightenment and the introduction of social psychiatry have led to greater acceptance, today's criticisms are strident. Psychiatry is criticized for imprecise diagnosis, conceptual vagaries, jargon, therapeutic impotence and class bias. The American system of mental-health care is seen by many as a disaster. The federal comprehensive Community Mental Health Act has been aborted at an early stage. Skills involved in the practice of psychotherapy are not unique to the profession. Social ills, over which psychiatry has little control, play a large part in causing mental disability and retardation. Nevertheless, though embattled, psychiatry has contributed to medical practice and to the humane consciousness of society.

Attitude of Health Personnel↗
PubMed1988

A comparison of nalbuphine with fentanyl for postoperative pain relief following termination of pregnancy under day care anaesthesia.

A double-blind investigation was undertaken to compare the efficacy of nalbuphine and fentanyl in the prevention of pain after day case termination of pregnancy. Forty patients were allocated randomly to receive nalbuphine 0.25 mg/kg or fentanyl 1.5 micrograms/kg immediately before induction of anaesthesia. The patients completed scores for pain and nausea, and performed a reaction time test to assess recovery. An observer assessed patient appearance at 1, 2 and 4 hours postoperatively. Patients who received nalbuphine had significantly lower pain scores at 1 hour (p less than 0.01) and 2 hours (p less than 0.05) and required significantly (p less than 0.05) less postoperative analgesia. No significant differences were found between the groups for incidence of nausea or for observer assessment of appearance. There was some evidence of psychomotor impairment at 2 hours in the nalbuphine group. Freedom from Controlled Drug Act regulations and improved analgesia with nalbuphine, render it more satisfactory for day case surgery than the more commonly used fentanyl.

Abortion, Induced↗
PubMed1980

Efficacy of a long-acting oxytetracycline against chlamydial ovine abortion.

The treatment of ovine abortifacient chlamydias with Terramycin/LA 200 was examined in three successive experiments in which ewes were inoculated intradermally with 6 x 10(5) PFU chlamydia at 80 days of pregnancy. The efficacy of the treatment was estimated by comparing a control group with a treated group for number of live lambs, number of abnormal lambings, length of pregnancy, average weight of lambs at birth and genital excretion of chlamydia at lambing. Sixty to eighty per cent of the ewes in the control group aborted. Under these conditions a single treatment of 20 mg/kg of Terramycin/LA at day 105 of pregnancy, i.e. four weeks after the inoculation, is not effective. On the other hand, a combination of injections, one three weeks and one five weeks after the inoculation, result in longer pregnancies on average, fewer abortions and more liveborn lambs. However, the treatment does not modify either the weight of liveborn lambs or the vaginal excretion of chlamydia at lambing. The adaptation of this treatment to practical conditions and its interest are discussed.

Abortion, Veterinary↗
PubMed2006

Who's calling the shots? Intentional content and feelings of control.

Based on Pacherie's dynamic theory of intentions, this study investigated how the way an intention is formed and sustained affects action performance and the experience of control during acting. In Experiment 1, task-irrelevant verbal commands were given while participants responded to stimuli in a two-choice reaction time (RT) task. The commands referred to an action goal congruent or incongruent with the actor's current intention, or ordered the initiation or abortion of the action. In Experiment 2, the same commands were given as participants freely chose between two actions. The distractors affected performance in the reactive task only. In both experiments, feelings of control were based on movement parameters as well as perceived (mis)matches between distractors and intended actions. These findings suggest that the way an intention is implemented affects how well it can be shielded against external perturbations and how much one feels in control.

Adult↗