Abstract:
STUDY OBJECTIVE:To determine the efficacy of continuous intravenous infusion of prostacyclin (epoprostenol) in primary pulmonary hypertension. DESIGN:Randomized trial with 8-week treatment periods and nonrandomized treatment for up to 18 months. SETTING:Four referral centers. PATIENTS:Sequential sample of 24 patients with primary pulmonary hypertension. Nineteen patients completed the study. Four patients died and one left the study because of adverse effects (pulmonary edema). INTERVENTIONS:Continuous intravenous prostacyclin administered by portable infusion pump at doses determined by acute responses during baseline catheterization in ten patients. Nine patients were treated with anticoagulants, oral vasodilators, and diuretics. MEASUREMENTS AND MAIN RESULTS:Starting with a baseline value for total pulmonary resistance of 21.6 units, there was a decrease of 7.9 units (95% CI, -13.1 to -2.2; P = 0.022) in the prostacyclin-treated group after 8 weeks; there was virtually no change in the conventional therapy group (from 20.6 to 20.4 units, not significant). Six of ten prostacyclin-treated patients who completed the 8-week study period had reductions in mean pulmonary artery pressure of greater than 10 mm Hg, whereas only one of nine in the conventional treatment group had a similar response (P = 0.057). Nine patients receiving prostacyclin for up to 18 months have persistent hemodynamic effects, although dose requirements have increased with time. Complications have been attributable to the drug delivery system. CONCLUSIONS:Prostacyclin produces substantial and sustained hemodynamic and symptomatic responses in severe primary pulmonary hypertension and may be useful in the management of some patients with this disease.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Rubin LJ,Mendoza J,Hood M,McGoon M,Barst R,Williams WB,Diehl JH,Crow J,Long Wdoi
10.7326/0003-4819-112-7-485subject
Has Abstractpub_date
1990-04-01 00:00:00pages
485-91issue
7eissn
0003-4819issn
1539-3704journal_volume
112pub_type
临床试验,杂志文章,随机对照试验abstract:STUDY OBJECTIVE:To evaluate the tolerance and safety of oral dextran sulfate (UA001), a potent in-vitro inhibitor of human immunodeficiency virus (HIV) in patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. DESIGN:Unblinded, dose-escalation 8-week trial. SETTING:An AIDS outpatient cl...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-110-3-183
更新日期:1989-02-01 00:00:00
abstract::Hepatitis is a significant complication of the treatment of hemophilia A with factor VIII concentrates. Chronic liver disease in these patients is infrequently documented in the literature. The results of percutaneous liver biopsy, under the coverage of glycine-precipitated factor VIII, in six patients with hemophilia...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-703
更新日期:1977-06-01 00:00:00
abstract:OBJECTIVE:To determine whether prolonging the duration of tamoxifen administration beyond the cessation of a combined chemotherapy regimen benefits patients with primary breast cancer with positive findings in axillary nodes who benefit initially from the combined regimen. DESIGN:Nonrandomized, nonconcurrent cohort st...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-106-5-649
更新日期:1987-05-01 00:00:00
abstract::Coronary artery spasm is an important pathogenetic mechanism in some forms of myocardial ischemic disease. Factors that may be important in the genesis of spasm include the autonomic nervous system, prostaglandins, endoperoxides, thromboxanes, and the calcium availability to the contractile apparatus. Spasm results in...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-91-3-441
更新日期:1979-09-01 00:00:00
abstract::Advances through basic research have elucidated the disturbances of neurotransmitter function in Parkinson's Dopamine has replaced acetylcholine and norepinephrine as the most studied neurotransmitter, with both conceptual and practical developments, exemplified by the hypothesis of cyclic adenosine monophosphate as a...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
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更新日期:1984-07-01 00:00:00
abstract::In September 1978, cases of hepatitis B in two patients treated by the same dentist led to investigation of a dental practice in Baltimore, Maryland. The dentist had had acute hepatitis B in June 1978 and had remained positive for hepatitis B surface antigen and hepatitis B e antigen over the ensuing 6 months. He had ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-2-133
更新日期:1981-08-01 00:00:00
abstract::Impairment of penicillin G excretion in renal failure may result in life-threatening, dose-related toxicity. We report a method for achieving a desired mean serum penicillin G concentration in patients with renal failure, with minimal risk of both undertreatment and drug toxicity. The method is based on the linear rel...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-2-189
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-4-560
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pub_type: 杂志文章
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更新日期:2013-02-05 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1991-09-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-2-139
更新日期:1982-02-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-5-704
更新日期:1980-11-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1982-12-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-5-577
更新日期:1983-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-08-21 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.7326/0003-4819-144-11-200606060-00004
更新日期:2006-06-06 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-2-183
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
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更新日期:2008-05-06 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:1988-08-01 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2001-07-03 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1987-09-01 00:00:00
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journal_title:Annals of internal medicine
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更新日期:1995-12-01 00:00:00
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更新日期:1988-06-01 00:00:00
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更新日期:1984-01-01 00:00:00
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更新日期:2005-06-07 00:00:00