Postoperative fondaparinux versus preoperative enoxaparin for prevention of venous thromboembolism in elective hip-replacement surgery: a randomised double-blind comparison.

Background: Despite use of thromboprophylaxis, elective hip-replacement surgery carries a high risk of venous thromboembolic complications. We aimed to assess the ability of the pentasaccharide fondaparinux, the first of a new class of synthetic antithrombotic agents, to further reduce this risk.

Methods: In a double-blind study, we randomly assigned 2309 consecutive patients aged 18 years or older who were undergoing elective hip-replacement surgery to once daily, subcutaneous injections of either 2.

Evaluation of psycho-social support to parents with an infant born preterm.

The birth of a preterm child is a trauma that causes crisis reactions in parents. The hypothesis was that parents need psycho-social support in order to manage this trauma. Psycho-social support was defined as both medical and social information, processing the emotional feelings, social support and starting the bonding process.

Treatment of malignant endocrine pancreatic tumors with a combination of alpha-interferon and somatostatin analogs.

Somatostatin analogs and alpha-interferon induce good responses as single drugs in the treatment of endocrine pancreatic tumors. We examined the efficacy and tolerability of the combination of alpha-interferon and somatostatin analogs in 16 patients with metastatic endocrine pancreatic tumors. All patients except one had received prior treatment and were in a progressive state.

Effect of surgery on the outcome of midgut carcinoid disease with lymph node and liver metastases.

We have evaluated survival and tumor-related symptoms in the presence of mesenteric lymph node and liver metastases in relation to surgical procedures in 314 patients (148 women, mean age at diagnosis 61 years; 249 with liver metastases) treated for midgut carcinoid tumors. Of the operated patients, 46% presented with severe abdominal pain and intestinal obstruction and were operated on before the diagnosis. Medical treatment (somatostatin analogs, interferon-a) was initiated in 67% and 86%, respectively.

Kinematics and laxity of the knee joint after anterior cruciate ligament reconstruction: pre- and postoperative radiostereometric studies.

Background: Injury of the anterior cruciate ligament changes the kinematics of the knee joint. In studies of cadaveric knees, investigators have examined the effect of anterior cruciate ligament reconstruction on knee kinematics, but the effect on dynamic knee motion is not known.

Hypothesis: Reconstruction of the anterior cruciate ligament restores knee kinematics to normal.

Factor V Leiden (G1691A) and prothrombin gene G20210A mutations as potential risk factors for venous thromboembolism after total hip or total knee replacement surgery.

Patients (n = 1600) from 12 European countries, scheduled for elective orthopaedic hip or knee surgery, were screened for Factor V Leiden and prothrombin gene G20210A mutations, found in 5.5% and 2.9% of the populations, respectively.

Beneficial therapeutic effects of physical training and relaxation therapy in women with coronary syndrome X.

Background And Purpose: New types of illness are being identified continuously. Owing to the demands for evidence-based practice, physiotherapeutic interventions need to be investigated scientifically prior to application in a new patient population. Coronary syndrome X (syndrome X) is a chronic pain disorder with exercise-induced chest pain despite angiographically normal coronary arteries.

The presence of elafin, SLPI, IL1-RA and STNFalpha RI in head and neck squamous cell carcinomas and their relation to the degree of tumour differentiation.

Biopsy samples of head and neck carcinomas were investigated with regard to elafin, secretory leukocyte protease inhibitor (SLPI), interleukin 1-receptor antagonist [(IL)1-RA] and soluble tumour necrosis factor alpha receptor antagonist (STNFalpha RI). SLPI and elafin are serine protease inhibitors produced in the serous cells of the upper respiratory airways and in the keratinocytes, respectively. We have now found the presence of elafin and SLPI in squamous cell carcinomas of the upper respiratory tract (tonsillar, hypopharyngeal, tongue, mouth floor, gingival and laryngeal cancer).

Levels of angiogenic peptides in sera from patients with carcinoid tumours during alpha-interferon treatment.

Background: Alpha-interferon, a known inhibitor of angiogenesis and cell proliferation, is used in the standard treatment of patients with carcinoid tumors. We studied the levels of two angiogenic peptides (bFGF and VEGF) in sera from patients with carcinoid tumours before and during treatment with alpha-interferon. The aim was to investigate if the antitumoral effect of alpha-interferon in these patients could be at least in part explained by a reduction in the measured angiogenetic peptides.

Capacitation status and in vitro fertility of boar spermatozoa: effects of seminal plasma, cumulus-oocyte-complexes-conditioned medium and hyaluronan.

In the present study, the effects of seminal plasma (SP), cumulus-oocyte-complexes (COCs) conditioned medium (CCM) and hyaluronan (HA) on functional changes and in vitro fertilizing ability of porcine spermatozoa were examined. In in vitro fertilization (IVF) experiments, 10% (v/v) of exogenous SP in the fertilization medium prevented sperm penetration (using fresh-extended and frozen-thawed ejaculated spermatozoa). Analysis of frozen-thawed CCM revealed a HA content to levels of 30 ng/mL per incubated COC.

Health-related quality of life, anxiety and depression in patients with midgut carcinoid tumours.

In earlier studies it has been reported that patients with carcinoid tumours have a relatively good health-related quality of life (HRQoL) and low levels of anxiety and depression. The aims of this study were (a) to investigate the extent to which psychosocial function changes in patients with carcinoid tumours with time from diagnosis and its possible relation to tumour markers, and (b) to compare the HRQoL of patients with carcinoid tumours with that of healthy Swedish adults. Twenty-four patients reported on HRQoL (the EORTC QLQ-C30), anxiety and depression (the Hospital Anxiety and Depression Scale) five times during their first year of treatment.

A dose-ranging study of the oral direct thrombin inhibitor, ximelagatran, and its subcutaneous form, melagatran, compared with dalteparin in the prophylaxis of thromboembolism after hip or knee replacement: METHRO I. MElagatran for THRombin inhibition in Orthopaedic surgery.

The novel, oral direct thrombin inhibitor, ximelagatran (formerly H 376/95), represents an advance in antithrombotic therapy through its oral availability. After oral administration, ximelagatran is converted to its active form, melagatran. Melagatran can also be administered subcutaneously (s.

Phase I clinical and pharmacologic trial of intravenous estramustine phosphate.

Purpose: To determine the dose-limiting toxicities, maximum-tolerated dose, and pharmacokinetics of intravenous estramustine phosphate (IV EMP).

Patients And Methods: A total of 31 patients with hormone-refractory prostate cancer received IV EMP as a 30- to 90-minute infusion weekly (n = 28) or for 3 consecutive days followed by a single weekly dose (n = 3). IV EMP dose was escalated from 500 to 3,000 mg/m(2).

Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after elective major knee surgery.

Background: Despite thromboprophylaxis, major knee surgery carries a high risk of venous thromboembolism. Fondaparinux, the first of a new class of synthetic antithrombotic agents, may reduce this risk.

Methods: In a double-blind study, we randomly assigned 1049 consecutive patients undergoing elective major knee surgery to receive subcutaneous doses of either 2.

Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery.

Background: Surgery for hip fracture carries a high risk of venous thromboembolism, despite the use of current thromboprophylactic treatments. Fondaparinux, a synthetic pentasaccharide, is a new antithrombotic agent that may reduce this risk.

Methods: In a double-blind study, were randomly assigned 1711 consecutive patients undergoing surgery for fracture of the upper third of the femur to receive subcutaneous doses of either 2.

Experience in treatment of metastatic pulmonary carcinoid tumors.

Background: The only cure for patients with pulmonary carcinoids is surgery. In the present paper, we report the results of medical treatment of patients with metastatic tumors, their circulating hormone markers, and immunohistochemical profile of the tumors.

Patients And Methods/results: The response to systemic antitumoral treatment was studied in 31 patients with metastatic pulmonary carcinoids.

Private pharmacy practice and regulation. A randomized trial in Lao P.D.R.

Objectives: The objective of this study was to assess the effectiveness of government regulation of private pharmacy practice in a low-income country.

Methods: The intervention comprised inspections of the pharmacies, information, and distribution of documents to drug sellers and sanctions. It was implemented at two different intensity levels, active and regular intervention.

Bubble contrast echocardiography in detecting pulmonary arteriovenous malformations after modified Fontan operations.

The development of pulmonary arteriovenous malformations is a well-known complication after Fontan operations, and may result in significant morbidity due to increasing arterial desaturation. We compared the use of bubble contrast echocardiography and pulmonary angiography in detecting such malformations. We also examined which anatomical and haemodynamic variables were associated with their development.

CMV disease in CMV-mismatched renal transplant recipients with prophylactic low dose valaciclovir.

Background: Valaciclovir (VACV) 2 g q.i.d.

Kinematics after tear in the anterior cruciate ligament: dynamic bilateral radiostereometric studies in 11 patients.

We studied the kinematics of both knees using radiostereometry in 11 patients with unilateral injury of the anterior cruciate ligament and normal contralateral knee. Continuous radiostereometric exposures at a speed of 24 exposures a second were performed, when the patients ascended an 8 cm high platform. The tibial center was more dorsally displaced and the tibia more externally rotated on the injured side.

[Rheumatic fever behind acute chorea in a young girl. A case report].

This article presents the case of a 13-year old girl who was admitted to the emergency department because of rapidly evolving, seriously disabling impairments in movement and speech. Investigation led to the conclusion that her problems were caused by Sydenham's chorea as a manifestation of rheumatic fever. A neuropsychiatric examination performed one year after the onset of disease revealed a hitherto unknown mild mental retardation.

Treatment with cisplatin and etoposide in patients with neuroendocrine tumors.

Background: Patients with malignant endocrine pancreatic tumors (EPTs) are responsive to combinations of chemotherapy with streptozotocin and 5-fluorouracil/doxorubicin, whereas patients with malignant carcinoids are not. For both categories of patients, alpha-interferon and/or somatostatin analogs can produce long-lasting responses. Cisplatin in combination with etoposide has been suggested to be effective in patients with malignant neuroendocrine carcinomas.

Allergic rhinoconjunctivitis, eczema, and sensitization in two areas with differing climates.

In this 5-year follow-up study we compared the prevalence of allergic rhinoconjunctivitis, eczema, and sensitization, in relation to several background factors, in two Swedish regions (Göteborg and Kiruna). In Göteborg, a city on the southwest coast, the climate is mild and humid. Kiruna is a town north of the Arctic Circle.

CSF-neurofilament and levodopa tests combined with discriminant analysis may contribute to the differential diagnosis of Parkinsonian syndromes.

The differentiation between Parkinson's disease (PD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) is important for prognostic and therapeutic purposes. In order to evaluate the diagnostic capability of two tests reflecting these items, patients fulfilling strict clinical criteria for PD (n=35), MSA (n=36) and PSP (n=14), were consecutively included. An analysis of neurofilament protein (NFL), a marker of axonal degeneration in the cerebrospinal fluid (CSF) and a levodopa test, recorded with optoelectronic technique were performed.

Viral safety of B-domain deleted recombinant factor VIII.

The possible transmission of blood-borne pathogens has been the impetus behind the development of recombinant products formulated in the absence of human-derived components. The viral safety of Chinese hamster ovary (CHO)-cell-based pharmaceuticals is well established. Over 100 million infusions have been administered without a single known incident of CHO-related viral transmission.