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PubMed2004

Prospective validity of measuring angina severity with Canadian Cardiovascular Society class: The ACRE study.

BACKGROUND: Although the prevalence of angina remains high, the importance of grading angina severity is unclear. OBJECTIVES: To determine the extent to which angina severity is associated with angiographic findings, and the rate of revascularization, mortality and nonfatal myocardial infarction. METHODS: Prospective, population-based study with a 2.5-year follow-up of 2849 consecutive patients with angina undergoing coronary angiography at Barts and the London NHS Trust, London, United Kingdom, in the Appropriateness of Coronary Revascularisation (ACRE) study. Angina severity was assessed with the Canadian Cardiovascular Society (CCS) classification, ranging from class I (mild) to IV (severe). Outcome measures were revascularization rates, and all-cause mortality and nonfatal myocardial infarction. RESULTS: In age-adjusted analyses, a higher CCS class was linearly associated (P<0.001) with a higher number of diseased vessels and impaired left ventricular function. When adjusting for age, sex, smoking, history of hypertension, diabetes, number of diseased vessels, left ventricular function, use of acetylsalicylic acid, beta-blockers or statins, and revascularization status (for death and nonfatal myocardial infarction), a higher CCS class was linearly associated with higher coronary angioplasty (P<0.001) and bypass graft (P=0.03) rates, and lower all-cause mortality and nonfatal myocardial infarction (P<0.001; CCS IV versus I: hazard ratio 2.44, 95% CI 1.46 to 4.09). CONCLUSION: CCS class was linearly associated with angiographic findings, revascularization rates, mortality and nonfatal myocardial infarction. These findings support the importance of a four-level grading of symptom severity among angina patients.

Angina Pectoris↗

PubMedDate not supplied

Radiographic exposure supplement to the ACR Diagnosis Index.

The principles of radiographic exposure are not included in the American College of Radiology Index for Radiological Diagnoses. A supplement covering such information would permit consistent indexing and integration of principles of radiographic exposure teaching case files with the comprehensive and well-accepted ACR anatomical and pathological index. This article proposes and describes such a supplement, along with an alphabetical index.

Abstracting and Indexing↗

PubMed1989

In vitro drug sensitivity of Plasmodium falciparum in Acre, Brazil.

In Acre, the westernmost state of Brazil in the Amazon region, the sensitivity of Plasmodium falciparum to chloroquine, amodiaquine, mefloquine, quinine and sulfadoxine/pyrimethamine was determined in vitro by the Rieckmann microtechnique. The study was performed between January and June 1987; the in vitro parasite responses to all antimalarial drugs were determined according to the recommendations of WHO. Of 83 isolates of P. falciparum, all were sensitive to mefloquine and of 87 isolates of P. falciparum, 84 (97%) were sensitive to quinine. The EC50 for mefloquine was 0.27 mumol/l and for quinine 4.60 mumol/l. In contrast, 65 of 89 (73%) and 70 of 83 (84%) isolates were resistant to amodiaquine and chloroquine, respectively; 11 isolates even grew at 6.4 mumol chloroquine/l. The EC50 for amodiaquine was 0.34 mumol/l and for chloroquine 0.73 mumol/l. Sulfadoxine/pyrimethamine resistance was seen in 23 of 25 (92%) cases. These data clearly indicate that in the western part of the Amazon region the 4-aminoquinolines, as well as sulfadoxine/pyrimethamine, can no longer be recommended for the treatment of P. falciparum infections.

Adolescent↗

PubMed1988

[Effects of cepharanthin on leukopenia and thrombocytopenia caused by CDDP-ACR-CPA therapy of ovarian cancer].

Effects of cepharanthin (50 mg/day, i.v.) an alkaloid of bis-coclaurin type, were studied on leucopenia and thrombocytopenia caused by CDDP-ACR-CPA (CAP) therapy against ovarian cancer. The study was carried out with 44 therapy courses on 17 patients of ovarian cancer receiving CAP administration. Nineteen of the 44 courescin loaded cepharanthin. The minimum number of leucocytes was found on 15.2 +/- 4.4 and 17.2 +/- 2.1 days after CAP-administration with and without cepharanthin, respectively. Leucocyte count 21 days after CAP-administration compared to that before the administration were 90.1 and 56.8% in cepharanthin and non-cepharanthin groups, respectively, which indicate a significant difference (p less than 0.05). As to the platelet count, cepharanthin group also showed attendant toward earlier recovery of thrombocytopenia than non-cepharanthin group. We conclude that the administration of cepharanthin during CAP therapy promotes the recovery from leucopenia and thrombocytopenia.

Adult↗

PubMed1987

[Treatment of advanced bladder cancer with intra-arterial infusion of cisplatinum (CDDP) and aclacinomycin (ACR), combined with angiotensin II].

Ten patients with advanced bladder cancer were treated with intra-arterial infusion therapy. The patients consisted of nine males and one female between 55 and 82 years old (median: 70 years). In all patients, cisplatinum (CDDP) (2 mg/kg), aclacinomycin (ACR) (0.5 mg/kg) and Angiotensin II (25 mg) were infused via the internal iliac artery for a period of about 30 minutes. Seven patients also received X-ray therapy with a linac. The efficacy of this therapy was assessed by computed tomographic scanning, sonography and cystoscopy. As a result of this assessment, 2 patients were rated complete response "(CR)", 6 partial response (PR) (showing 50% or more reduction in the lesion) and 2 no change "(NC)". To compare the efficacy of this therapy for two histopathologically defined groups of patients (patients with grades 2 and 3 cancer), one patient was rated "CR", four "PR" and two "NC" in the grade 3 group (total 7 patients), while one was rated "CR" and two "PR", in the grade 2 group (total 3 patients). In effective cases, pollakiuria and miction pain disappeared shortly following intra-arterial infusion therapy. As for side effects of the therapy, mild nausea or vomiting was observed in all patients, while leukopenia was noted in one patient.

Aclarubicin↗

PubMed1985

[Combination effects of CDDP, ACR and HCFU on progressive urothelial tumors].

Nine patients with progressive urothelial tumors treated with combination chemotherapy were evaluated. The median age of the patients was fifty-four; 6 men and 3 women; 7 of the tumors were of the renal pelvis and/or ureter and at stage C or D at the time of initial chemotherapy. Another of the tumors was triple cancer (bladder, prostate, sigmoid) and the remaining case was of bladder cancer. The stage of the two bladders cancers was T4. All patients were treated with CDDP (cis-platinum), ACR (aclarubicin hydrochloride) and HCFU (carmoful) and given from one to 3 courses repeated at three-week intervals (mean 2.3 courses). Seven patients were evaluable while two had no evaluable lesions. The response with this chemotherapy was 2 cases of PR (28.5%), 4 cases of NC and one case of PD. No severe toxicities such as nephrotoxicity or cardiotoxicity, were revealed with this combination chemotherapy.

Aclarubicin↗

PubMed1970

The effectiveness of ultra-low-volume applications of malathion at a rate of 3 US fluid ounces per acre in controlling Aedes aegypti in Thailand.

Ultra-low-volume (ULV) aerial applications of malathion at a rate of 3 US fl oz per acre (219 ml/ha) for the control of Aedes aegypti and Culex pipiens fatigans were evaluated in 2 areas near Bangkok, Thailand. A housing project of the Royal Thai Air Force received 2 applications a week apart while the village of Bang Khen received 1 application. Bioassays, oil-sensitive red dye cards, landing-rate counts, ovitraps, and light-traps were used to evaluate the effects of the treatment. A comparison of pre- and post-treatment indices indicated good control of A. aegypti following all treatments. The results of these tests when compared with those of an earlier study using 6 US fl oz/acre (438 ml/ha) showed that the higher rate of application rate was more effective. Only fair control of C. p. fatigans was obtained. A comparison of light-trap collections before and after treatment demonstrated fairly good over-all control of other species of mosquitos for 3-4 days following each of the 2 treatments on the Air Force housing area.

Aedes↗

PubMed1999