Abstract:
INTRODUCTION:D-Dimer (DD) has been described as a useful predictor of both morphologic changes in acute thoracic aortic dissection (TAD) and of TAD-associated mortality. This study analyzed the use of DD screening to screen patients with chest pain for acute (TAD) to determine if it improves diagnosis and cost effectiveness. This study also looked at the association of DD levels with diagnoses frequently seen in patients with dyspnea or chest pain. METHODS:At the Helios Hospital, Krefeld, the authors analyzed the data of all patients (n = 1053, age (mean, SD) 62 ± 19 years, 49% males) admitted for chest pain to the nonsurgical emergency department (ED) in February 2010. Chest pain was the second most frequent symptom causing 138 (13.1%) admissions, 102 of which had DD testing (Inniovance® D-Dimer Assay, Dade Behring/Siemens, Germany). To assess the diagnostic reliability of DD testing, the sensitivity, specificity, and odds ratio, including 95% confidence interval, were estimated. RESULTS:None of the patients admitted were found to have acute TAD. Had the authors used a computerized tomography (CT) scan to rule out TAD in every patient with chest pain, actual costs would have been euro 12,328. A restriction of CT scans to patients with elevated DD levels would have lowered costs to euro 5360. The actual costs were euro 670.30 for CT scans and euro 540.60 for DD tests. On analyzing the association with other diagnoses, both sensitivity and specificity were low, with the exception of pneumonia. CONCLUSION:Owing to the low incidence of TAD, DD screening increases diagnostic efforts and costs but it remains unclear whether it would actually speed up TAD diagnosis. In a clinical setting DD did not help to discriminate other relevant diagnoses. Despite the high sensitivity of DD for aortic dissection published in the literature, the physician's clinical judgment remains paramount.
journal_name
Adv Therjournal_title
Advances in therapyauthors
Moysidis T,Lohmann M,Lutkewitz S,Kemmeries G,Kröger Kdoi
10.1007/s12325-011-0069-2subject
Has Abstractpub_date
2011-11-01 00:00:00pages
1038-44issue
11eissn
0741-238Xissn
1865-8652journal_volume
28pub_type
杂志文章abstract::Despite the results from clinical trials in patients with hypertension and the development of a long list of guidelines for the management of hypertension, many physicians and other healthcare professionals still manage hypertension using approaches that clearly diverge at least partially from the recommendations of t...
journal_title:Advances in therapy
pub_type: 共识发展会议,杂志文章,评审
doi:10.1007/BF02849881
更新日期:2005-03-01 00:00:00
abstract::This prospective study was performed to determine whether gentamicin can be prescribed routinely to patients with spinal cord injury undergoing urologic procedures, or whether antibiotic therapy must be selected on the basis of recent urine microbiologic test results. Between January 2004 and June 2005, procedures wer...
journal_title:Advances in therapy
pub_type: 临床试验,杂志文章
doi:10.1007/BF02850350
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Adherence to diabetes medication has been linked to improved glycemic levels and lower costs, but previous research on adherence has typically involved oral antidiabetic medication or insulin. This study examines how adherence and persistence to once-daily liraglutide impact glycemic control and economic o...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-015-0199-z
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:An 8-week trial of amlodipine/valsartan/hydrochlorothiazide (Aml/Val/HCTZ) for moderate or severe hypertension demonstrated more-pronounced blood pressure (BP)-lowering effects compared with dual-component therapies. To elucidate the effects of time and baseline BP on the observed responses, exploratory an...
journal_title:Advances in therapy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s12325-009-0077-7
更新日期:2009-11-01 00:00:00
abstract:INTRODUCTION:Accumulating studies indicate that melatonin is a natural oncostatic agent capable of mediating the influence of the psychoneuroendocrine system on cancer growth. Although there is increasing evidence to show that the pineal gland may play a role in human non-small cell lung cancer (NSCLC), there is uncert...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-009-0068-8
更新日期:2009-09-01 00:00:00
abstract:INTRODUCTION:The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. METHODS:The authors revi...
journal_title:Advances in therapy
pub_type: 杂志文章,评审
doi:10.1007/s12325-017-0560-5
更新日期:2017-07-01 00:00:00
abstract::Bacterial translocation is the passage of bacteria or endotoxins from the gastrointestinal tract to extraintestinal sites, such as mesenteric lymph nodes, liver, spleen, and bloodstream. In this study, the investigators examined the effects of various enteral nutrients on bacterial translocation and intestinal morphol...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/BF02849991
更新日期:2007-01-01 00:00:00
abstract::Chronic constipation (CC) and irritable bowel syndrome with constipation (IBS-C) are common gastrointestinal (GI) disorders. Current treatment options, either prescription or nonprescription medications, have limited efficacy in a subset of patients. There is significant demand for more efficacious medications for the...
journal_title:Advances in therapy
pub_type: 杂志文章,评审
doi:10.1007/s12325-013-0012-9
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:A recent successful clinical trial demonstrated that a less invasive cell-injection procedure is a viable medical modality for treating corneal endothelial dystrophy. This medical advance still relies on human corneal endothelial cell (HCEC) sources derived from rare cornea donations. The progenitor of the corn...
journal_title:Advances in therapy
pub_type: 杂志文章,评审
doi:10.1007/s12325-020-01237-w
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:New biosimilars of monoclonal antibodies are anticipated to bring significant cost savings and increase access to treatment. The rituximab biosimilar CT-P10 has recently been approved in Europe in all indications held by reference rituximab (RTX), including rheumatoid arthritis, non-Hodgkin's lymphoma, and...
journal_title:Advances in therapy
pub_type: 杂志文章,多中心研究
doi:10.1007/s12325-017-0522-y
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak is a serious health concern. Repurposing of existing drugs indicated for other conditions seems to be the first choice for immediate therapeutic management. The quality of early evidence favoring the different treatment options needs t...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-020-01460-5
更新日期:2020-10-01 00:00:00
abstract::Multiple, potentially practice-changing cardiology trials have been presented or published over the past year. In this paper, we summarize and place in clinical context, new data regarding management of acute coronary syndrome and ST-elevation myocardial infarction (copeptin assessment, otamixaban, cangrelor, prasugre...
journal_title:Advances in therapy
pub_type: 杂志文章,评审
doi:10.1007/s12325-014-0141-9
更新日期:2014-08-01 00:00:00
abstract:INTRODUCTION:The anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor (TKI) alectinib was approved in Japan in 2014 for the treatment of ALK fusion gene-positive advanced non-small cell lung cancer (NSCLC). With the approvals of crizotinib in 2012 and ceritinib in 2017, Japan became the first country with multipl...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-020-01392-0
更新日期:2020-07-01 00:00:00
abstract::The present study, which was designed as a prospective, double-masked, randomized, controlled, single-site study, was conducted to compare the effects of 3 approved ophthalmic nonsteroidal anti-inflammatory drugs-nepafenac ophthalmic suspension 0.1% (Nevanac; Alcon Laboratories, Inc., Fort Worth, Tex), ketorolac trome...
journal_title:Advances in therapy
pub_type: 杂志文章,随机对照试验
doi:10.1007/BF02877774
更新日期:2007-11-01 00:00:00
abstract::Pregnancy in adolescence has been and continues to be a problem in public health. The purpose of this study was to investigate obstetric outcomes of adolescent pregnancies in Samsun, Turkey. A cross-sectional study was conducted between January 1 and December 31, 2004, at 3 hospitals in Samsun, Turkey. Of the 10,100 w...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/BF02849957
更新日期:2005-11-01 00:00:00
abstract::Real-world studies have become increasingly important in providing evidence of treatment effectiveness in clinical practice. While randomized clinical trials (RCTs) are the "gold standard" for evaluating the safety and efficacy of new therapeutic agents, necessarily strict inclusion and exclusion criteria mean that tr...
journal_title:Advances in therapy
pub_type: 杂志文章,评审
doi:10.1007/s12325-018-0805-y
更新日期:2018-11-01 00:00:00
abstract:INTRODUCTION:Well- or moderately differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are often slow-growing, and some patients with unresectable, asymptomatic, non-functioning tumors may face the choice between watchful waiting (WW), or somatostatin analogues (SSA) to delay progression. We developed ...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-017-0653-1
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTION:The Medicare Part D prescription plan has a coverage gap from $2250 to $5100 per year (2006 thresholds) in which patients pay full drug costs (the "donut hole"). We examined prescription costs in patients aged >or=65 years with atrial fibrillation (AF), and the proportions entering/exiting the donut hole i...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-009-0054-1
更新日期:2009-08-01 00:00:00
abstract:INTRODUCTION:Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. It is vitally important to predict prognosis and restrict unnecessary adjuvant treatments for patients with ACC. This study aims to confirm the prognostic value of Ki-67 and provide a prognostic evaluation on ACC after primary surgery...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-019-01050-0
更新日期:2019-10-01 00:00:00
abstract::In an open-label 12-week study, the safety and efficacy of bimatoprost 0.03% was evaluated in 55 patients with open-angle glaucoma or ocular hypertension inadequately controlled by topical beta-blocker monotherapy. Patients discontinued their topical beta-blocker therapy at the baseline visit and began bimatoprost mon...
journal_title:Advances in therapy
pub_type: 临床试验,杂志文章
doi:10.1007/BF02850101
更新日期:2004-11-01 00:00:00
abstract::This double-blind, randomized, prospective study was conducted to compare the analgesic and sedative efficacy of fentanyl and meperidine in orthopedic closed reduction of fractures and dislocations undertaken in the emergency department. Seventy consecutive adult patients with fractures or dislocations suitable for re...
journal_title:Advances in therapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02850035
更新日期:2004-09-01 00:00:00
abstract::Patients with reversible bronchospasm benefit from the use of inhaled beta-adrenergic agents. In this retrospective study of 24 older patients with a variety of conditions associated with reversible bronchospasm--asthma, asthma with emphysema, chronic bronchitis, and asthmatic bronchitis--symptomatic improvement was n...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:
更新日期:1995-05-01 00:00:00
abstract::Diabetes mellitus is one of the most serious heterogeneous endocrinologic diseases; more than 90% of those given this diagnosis have type 2 diabetes mellitus, usually accompanied by macrovascular and microvascular complications. Because most cases include a 7- to 10-y latency period before disease onset, however, it i...
journal_title:Advances in therapy
pub_type: 杂志文章,评审
doi:10.1007/BF02877709
更新日期:2007-09-01 00:00:00
abstract::Resistance to first- and second-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) and development and progression of central nervous system metastases remain significant issues in the treatment of ALK-positive non-small-cell lung cancer. Lorlatinib is a novel third-generation ALK TKI that i...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-020-01365-3
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Osteoarthritis is a chronic rheumatoid disease mediated by metalloproteinases and inflammatory cytokines. Methylsulfonylmethane (MSM) and boswellic acids (BA) each show promise in the treatment of inflammatory processes, but the efficacy of combined treatment with these substances in the treatment of arthr...
journal_title:Advances in therapy
pub_type: 杂志文章,随机对照试验
doi:10.1007/s12325-011-0068-3
更新日期:2011-10-01 00:00:00
abstract::Propolis is a natural product produced by bees that was discovered through the study of traditional cures and knowledge of indigenous people throughout the world. It is rich in vitamins A, B, C, and E, and in amino acids, copper, iron, manganese, and zinc. The investigators studied the duration-dependent hepatoprotect...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/BF02877719
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:The purpose of the study was to conduct a cost-effectiveness analysis and budget impact analysis comparing lopinavir with ritonavir (LPV/r) and atazanavir plus ritonavir (ATV+RTV) for antiretroviral-naïve patients with a baseline CD4+ T-cell distribution and total cholesterol (TC) profile as reported in th...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-008-0141-8
更新日期:2009-02-01 00:00:00
abstract::Nonketotic hyperosmolar coma (NHC) is characterized by severe hyperglycemia; absence of, or only slight ketosis; nonketotic acidosis; severe dehydration; depressed sensorium or frank coma; and various neurologic signs. This condition is uncommon in type 1 diabetes. Because of little or no osmotic diuresis in patients ...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/BF02849861
更新日期:2005-09-01 00:00:00
abstract:INTRODUCTION:Arteriosclerosis obliterans (ASO) causes ischemic symptoms of the lower limbs, reducing quality of life (QOL), and has a poor prognosis. Early diagnosis and treatment are necessary. In this study, the effects of long-term administration of beraprost sodium (beraprost) to treat ASO were investigated. METHO...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-013-0030-7
更新日期:2013-05-01 00:00:00
abstract:INTRODUCTION:Pigmented villonodular synovitis (PVNS), also known as giant-cell tumour of the tendon sheath (GCTT), is a rare, benign proliferative tumour affecting the inner lining of synovial joints and tendon sheets. Information on treatment needs of PVNS patients to inform drug development is currently scarce. We co...
journal_title:Advances in therapy
pub_type: 杂志文章
doi:10.1007/s12325-020-01364-4
更新日期:2020-06-01 00:00:00