4 research outputs found
A multicentre, prospective, randomised controlled trial to assess the safety and effectiveness of cooling as an adjunctive therapy to percutaneous intervention in patients with acute myocardial infarction: the COOL AMI EU Pivotal
Despite primary PCI (PPCI), ST-elevation myocardial infarction (STEMI) can still result in large infarct size (IS). New technology with rapid intravascular cooling showed positive signals for reduction in IS in anterior STEMI.We investigated the effectiveness and safety of rapid systemic intravascular hypothermia as an adjunct to PPCI in conscious patients, with anterior STEMI, without cardiac arrest.Hypothermia was induced using the ZOLL® Proteus™ intravascular cooling system. After randomisation of 111 patients, 58 to hypothermia and 53 to control groups, the study was prematurely discontinued by the sponsor due to inconsistent patient logistics between the groups resulting in significantly longer total ischaemic delay in the hypothermia group (232 vs 188 minutes; p<0.001).There were no differences in angiographic features and PPCI result between the groups. Intravascular temperature at wire crossing was 33.3+0.9°C. Infarct size/left ventricular mass (IS/LV) by cardiac magnetic resonance (CMR) at day 4-6 was 21.3% in the hypothermia group and 20.0% in the control group (p=0.540). Major adverse cardiac events at 30 days increased non-significantly in the hypothermia group (8.6% vs 1.9%; p=0.117) while cardiogenic shock (10.3% vs 0%; p=0.028) and paroxysmal atrial fibrillation (43.1% vs 3.8%; p<0.001) were significantly more frequent in the hypothermia group.The ZOLL Proteus intravascular cooling system reduced temperature to 33.3°C before PPCI in patients with anterior STEMI. Due to inconsistent patient logistics between the groups, this hypothermia protocol resulted in a longer ischaemic delay, did not reduce IS/LV mass and was associated with increased adverse events
Synthesis and in vitro Antitumor Effect of New Vindoline Derivatives Coupled with Triphenylphosphine
Update on protein biomarkers in traumatic brain injury with emphasis on clinical use in adults and pediatrics
Purpose This review summarizes protein biomarkers in
mild and severe traumatic brain injury in adults and
children and presents a strategy for conducting rationally
designed clinical studies on biomarkers in head trauma.
Methods We performed an electronic search of the National
Library of Medicine’s MEDLINE and Biomedical Library
of University of Pennsylvania database in March 2008
using a search heading of traumatic head injury and protein
biomarkers. The search was focused especially on protein
degradation products (spectrin breakdown product, c-tau,
amyloid-β1–42) in the last 10 years, but recent data on
“classical” markers (S-100B, neuron-specific enolase, etc.)
were also examined.
Results We identified 85 articles focusing on clinical use of
biomarkers; 58 articles were prospective cohort studies with
injury and/or outcome assessment.
Conclusions We conclude that only S-100B in severe
traumatic brain injury has consistently demonstrated the
ability to predict injury and outcome in adults. The number
of studies with protein degradation products is insufficient
especially in the pediatric care. Cohort studies with welldefined
end points and further neuroproteomic search for
biomarkers in mild injury should be triggered. After
critically reviewing the study designs, we found that large
homogenous patient populations, consistent injury, and
outcome measures prospectively determined cutoff values,
and a combined use of different predictors should be
considered in future studies