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At least 343 records · Page 19Linked to original sources
PubMed2006

[Practical experiences of applying TCM intervention along principle of evidence-based medicine on restenosis after percutaneous coronary intervention].

As traditional Chinese medicine (TCM) attach importance to clinic, shortage of objective and quantitative criteria in evaluating therapeutic effect is one of the largest obstacles for TCM to move toward the world and win wide approval. The introduction of evidence-based medicine (EBM) concept brings favorable opportunity to research on TCM. The authors have conducted clinical studies on restenosis after percutaneous coronary intervention (PCI) intervened by TCM, in the period of Tenth Five-Year Project, and realized EBM was indeed a vital principle for clinical study on TCM. However, randomized controlled trial should be applied reasonably, attention should be paid to the standardized design of research, including estimation of sample size, concealment of randomized sequence, extension of blindness and selection of control, and stress should be put on the quality control in implementation, so as to provide objective evidence for effect evaluation of TCM treatment.

Angioplasty, Balloon, Coronary↗
PubMed2006

Economic and clinical outcomes of a physician-led continuous quality improvement intervention in the delivery of percutaneous coronary intervention.

OBJECTIVE: To compare clinical and economic outcomes associated with percutaneous coronary intervention (PCI) in cohorts before and after continuous quality improvement (CQI) was instituted. STUDY DESIGN: Observational study. METHODS: Clinical, angiographic, procedural, and outcome data on 1441 pre-CQI and 1760 post-CQI PCIs (performed in 1997 and 1998, respectively) were derived from an institutional PCI registry. Administrative data were used to estimate total procedural and postprocedural costs and length of stay (LOS). Logistic and generalized linear modeling was used to adjust in-hospital clinical and economic outcomes, respectively, for differences in patient characteristics. RESULTS: The 2 cohorts were similar in terms of age, sex, and rate of diabetes. Post-CQI patients more often received intracoronary stents, had urgent PCIs, had a history of prior PCI, and received glycoprotein IIb/IIIa inhibitors. Procedural success without in-hospital complications occurred in 90% of both cohorts and did not differ statistically in adjusted analyses. Compared with patients treated pre-CQI, those treated post-CQI had a reduced adjusted odds ratio for in-hospital death or any myocardial infarction (odds ratio = 0.66; 95% confidence interval = 0.46, 0.95). Models predicted a mean postprocedural LOS difference of 0.8 days (2.8 days pre-CQI vs 2.0 days post-CQI; P <.001) and an average post-CQI cost savings of $5430 (P <.001). CONCLUSION: Physician-led, multidisciplinary practice management efforts were successful at significantly reducing PCI-related costs in an era of rapid technological advances while maintaining and perhaps improving quality of care.

Aged↗
PubMed1987

The Lopressor Intervention Trial: multicentre study of metoprolol in survivors of acute myocardial infarction. Lopressor Intervention Trial Research Group.

The Lopressor Intervention Trial (LIT) was a double-blind, randomized, placebo-controlled, multicentre study designed to evaluate the effect of oral metoprolol on overall mortality in patients surviving a recent acute myocardial infarction. Patient enrollment began in August 1979 and ended on 15 April 1982, with 2395 patients (1200 on placebo and 1195 on metoprolol). Hospitalized patients, 45 to 74 years of age, began therapy from 6 to 16 days after their myocardial infarction. Following a short titration period, maintenance therapy with metoprolol 100 mg b.i.d. or placebo was continued for up to 1 year. Enrollment was prematurely terminated because of a progressive and marked decline in patient accession; it was not feasible to reach the original goal of 3200 patients in a practical period of time. This target sample size was based on an anticipated 1 year placebo mortality rate of 10%, a 50% reduction in total mortality with metoprolol and premature discontinuation of study medication in no more than 15% of patients in the metoprolol group. Two primary analyses were planned: total mortality among all randomized patients at 7 and at 12 months of trial entry. After 7 months of treatment there were 54 deaths in the placebo group and 42 deaths in the metoprolol group. After 1 year there were 62 deaths in the placebo group and 65 in the metoprolol group. Thus, the 1 year placebo mortality rate of 5.2% was half that predicted at the outset. In addition, study medication was prematurely discontinued in over 30% of patients in the metoprolol group.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Treatment of elderly hypertensives in Japan: National Intervention Cooperative Study in Elderly Hypertensives. The National Intervention Cooperative Study Group.

PREVALENCE OF HYPERTENSION IN ELDERLY JAPANESE PATIENTS: Data collected from post-mortem information at the Tokyo Metropolitan Geriatric Hospital showed that the overall prevalence of hypertension in Japanese patients aged over 60 years was 53%; one-third of these elderly hypertensives had isolated systolic hypertension. Isolated systolic and systolodiastolic hypertension were each associated with a similar degree of increased atherosclerosis and cardiovascular complications. In a placebo-controlled study antihypertensive treatment produced a reduction in withdrawal from treatment in elderly patients with mild hypertension. INTERIM TRIAL RESULTS: Some interim results have been obtained from a new trial which is currently under way in Japan, the National Intervention Cooperative Study for the Treatment of Elderly Hypertensives, a long-term study comparing the effects of a calcium antagonist (nicardipine) and a thiazide diuretic (trichlormethiazide) on cardiovascular complications in elderly patients with mild to moderate hypertension.

Aged↗
PubMed2006

ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): executive summary a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease) endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation.

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Aorta, Abdominal↗
PubMed2006

ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology.

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Cardiovascular Diseases↗
PubMed2006

ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)--summary of recommendations.

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Aortic Aneurysm, Abdominal↗
PubMed2006

ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation.

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Adolescent↗
PubMed2006

Indications for renal arteriography at the time of coronary arteriography: a science advisory from the American Heart Association Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Councils on Cardiovascular Radiology and Intervention and on Kidney in Cardiovascular Disease.

Atherosclerotic renal artery stenosis is commonly present in patients with clinically manifest atherosclerosis in other vascular beds and is independently associated with increased cardiovascular morbidity and mortality. Screening tests such as renal angiography should be selectively applied to patients at high risk for renal artery stenosis who are potential candidates for revascularization. This multispecialty consensus document describes the rationale for patient selection for screening renal angiography at the time of cardiac catheterization.

Angiography↗
PubMedDate not supplied

[Interventional radiology in the treatment of the complications from interventions on the lower urinary excretory tract].

Ureteral diversions may be complicated by strictures, hydronephrosis, pyelonephritis, lithiasis, fistulas, etc. In the last 10 years, 103 patients with 133 urological postoperative complications underwent percutaneous treatment. Most of the patients had been treated by percutaneous antegrade drainage; afterwards, stricture dilatation, ureteral stenting and stone extraction were performed. In one case a Strecker metallic stent was employed. We have successfully treated 101 of 133 complications (75.9%), with only 27 failures (20.3%). Five cases (3.8%) of lithiasis did not require percutaneous treatment. The good results obtained, the absence of major complications, the low cost and the little discomfort for the patients confirm the leading role of percutaneous treatment in complicated ureteral diversions.

Adolescent↗