125,273 research outputs found

    Coronary-artery bypass surgery in patients with ischemic cardiomyopathy

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    BACKGROUND The survival benefit of a strategy of coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with medical therapy alone, in patients with coronary artery disease, heart failure, and severe left ventricular systolic dysfunction remains unclear. METHODS From July 2002 to May 2007, a total of 1212 patients with an ejection fraction of 35% or less and coronary artery disease amenable to CABG were randomly assigned to undergo CABG plus medical therapy (CABG group, 610 patients) or medical therapy alone (medical-therapy group, 602 patients). The primary outcome was death from any cause. Major secondary outcomes included death from cardiovascular causes and death from any cause or hospitalization for cardiovascular causes. The median duration of follow-up, including the current extended-follow-up study, was 9.8 years. RESULTS A primary outcome event occurred in 359 patients (58.9%) in the CABG group and in 398 patients (66.1%) in the medical-therapy group (hazard ratio with CABG vs. medical therapy, 0.84; 95% confidence interval [CI], 0.73 to 0.97; P=0.02 by log-rank test). A total of 247 patients (40.5%) in the CABG group and 297 patients (49.3%) in the medical-therapy group died from cardiovascular causes (hazard ratio, 0.79; 95% CI, 0.66 to 0.93; P=0.006 by log-rank test). Death from any cause or hospitalization for cardiovascular causes occurred in 467 patients (76.6%) in the CABG group and in 524 patients (87.0%) in the medical-therapy group (hazard ratio, 0.72; 95% CI, 0.64 to 0.82; P<0.001 by log-rank test). CONCLUSIONS In a cohort of patients with ischemic cardiomyopathy, the rates of death from any cause, death from cardiovascular causes, and death from any cause or hospitalization for cardiovascular causes were significantly lower over 10 years among patients who underwent CABG in addition to receiving medical therapy than among those who received medical therapy alone. (Funded by the National Institutes of Health; STICH [and STICHES] ClinicalTrials.gov number, NCT00023595.

    Effects of precipitation conditions on the membrane morphology and permeation characteristics

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    [[abstract]]The permeability and permselectivity of asymmetric and particulate membranes towards glucose and proteins of various molecular sizes were studied. It was found that the skin layer of asymmetric membranes was permeable to glucose and insulin but effectively prevent the permeation of immunoglobulins. This result parallels our interest for the development of artificial pancreas. It was also found that skinless particulate membranes exhibited not only high permeation rates with respect to albumin and immunoglobulins but also good selectivity between these components. Thus, particulate membranes has the potential to be used in separating albumin from immunoglobulins for treating disorders related to immunoglobulin abnormalities.[[notice]]補正完畢[[journaltype]]國外[[incitationindex]]SCI[[incitationindex]]E

    Simulation study on light ions identification methods for carbon beams from 95 to 400 MeV/A

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    Monte Carlo simulations have been performed in order to evaluate the efficiencies of several light ions identification techniques. The detection system was composed with layers of scintillating material to measure either the deposited energy or the time-of-flight of ions produced by nuclear reactions between 12C projectiles and a PMMA target. Well known techniques such as (DELTA) E--Range, (DELTA) E--E--ToF and (DELTA)E--E are presented and their particle identification efficiencies are compared one to another regarding the generated charge and mass of the particle to be identified. The simulations allowed to change the beam energy matching the ones proposed in an hadron therapy facility, namely from 95 to 400 MeV/A