Abstract:
:The place of balloon dilatation of the aortic valve in the treatment of calcific aortic stenosis is controversial. Thirty two patients (mean age 76) in whom valve replacement was contraindicated were followed up for three to 24 months (mean 8); 25 were in functional class III or IV according to the New York Heart Association's classification. Major complications of the procedure occurred in four patients. Echocardiography and Doppler studies were performed before operation and before discharge in 28 patients, and the area of the valve was measured again six to 50 (mean 23) weeks after operation in 11 patients. The peak to peak aortic pressure gradient fell from a mean of 65 (SD 24) to 46 (20) mm Hg, but the area of the aortic valve, measured by Doppler echocardiography, in 18 patients showed a modest but significant increase, from 0.61 (0.16) to 0.74 (0.23) cm2. One month after dilatation, 29 patients were alive, of whom 17 had improved symptoms. Only two had lasting clinical benefit. Sixteen patients died, 12 of a cardiac cause. The estimated one year survival rate was 49%. Six patients underwent or required valve replacement because of persisting symptoms. In view of its limited long term efficacy balloon dilatation of the aortic valve should be used only for patients with severe symptoms whose life expectancy is limited by other disease or who are considered to be unsuitable for valve replacement. It may have a role in improving the condition of patients who present with cardiogenic shock or pulmonary oedema before valve replacement is undertaken.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Sprigings DC,Jackson G,Chambers JB,Monaghan MJ,Thomas SD,Meany TB,Jewitt DEdoi
10.1136/bmj.297.6655.1007subject
Has Abstractpub_date
1988-10-22 00:00:00pages
1007-11issue
6655eissn
0959-8138issn
1756-1833journal_volume
297pub_type
杂志文章abstract::A doctor who performed an abortion in Poland faces two years in prison and the loss of his medical license for up to 10 years if he is found guilty of violating the new abortion laws introduced in 1993 after a lengthy campaign by the Catholic church and the Christian Democratic Union party. The new laws permit aborti...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.310.6994.1556a
更新日期:1995-06-17 00:00:00
abstract:OBJECTIVE:To quantify the association between stressful life events and exacerbations of multiple sclerosis. DATA SOURCES:PubMed, PsychInfo, and Psychological Abstracts searched for empirical papers from 1965 to February 2003 with terms "stress", "trauma", and "multiple sclerosis". REVIEW METHODS:Three investigators ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38041.724421.55
更新日期:2004-03-27 00:00:00
abstract::Objective To determine whether educational attainment is a causal risk factor in the development of coronary heart disease.Design Mendelian randomisation study, using genetic data as proxies for education to minimise confounding.Setting The main analysis used genetic data from two large consortia (CARDIoGRAMplusC4D an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3542
更新日期:2017-08-30 00:00:00
abstract:OBJECTIVE:To assess the association between genotype at the insertion or deletion polymorphism of the angiotensin converting enzyme gene and risk of coronary restenosis after percutaneous coronary intervention. DESIGN:Meta-analysis of studies before July 2001 that reported on these genotypes and risk of coronary reste...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.325.7363.517
更新日期:2002-09-07 00:00:00
abstract:OBJECTIVES:To assess incidence of and mortality from cancer in hypertensive patients taking atenolol, comparing the findings with two control populations and with hypertensive patients taking other drugs. DESIGN:Retrospective analysis of patients first seen in the Glasgow Blood Pressure Clinic between 1972 and 1990. P...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6878.609
更新日期:1993-03-06 00:00:00
abstract:OBJECTIVES:To investigate the consequences of longstanding obesity on left ventricular mass and structure and to examine the effects of weight loss on these variables. DESIGN:Cross sectional survey and controlled intervention study. SETTING:City of Gothenburg and surrounding areas. Sweden. SUBJECTS:41 obese patients...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7113.912
更新日期:1997-10-11 00:00:00
abstract::Fetomaternal haemorrhage was studied after 68 consecutive fetal intravascular transfusions performed in 20 patients with Rh isoimmunisation. alpha Fetoprotein concentration was assayed in maternal blood taken before, and immediately after each transfusion and three and 24 hours later. An increase of 50% or more in the...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6660.1379
更新日期:1988-11-26 00:00:00
abstract:OBJECTIVE:To provide a comprehensive survey of the content and quality of intervention studies relevant to the treatment of schizophrenia. DESIGN:Data were extracted from 2000 trials on the Cochrane Schizophrenia Group's register. MAIN OUTCOME MEASURES:Type and date of publication, country of origin, language, size o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7167.1181
更新日期:1998-10-31 00:00:00
abstract:OBJECTIVES:To determine the accuracy and acceptability to patients of non-endoscopic screening for Barrett's oesophagus, using an ingestible oesophageal sampling device (Cytosponge) coupled with immunocytochemisty for trefoil factor 3. DESIGN:Prospective cohort study. SETTING:12 UK general practices, with gastroscopi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c4372
更新日期:2010-09-10 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN:Matched cohort study. SETTING:Population based, electronic primary healthcare databases before 31 December 2015 from four European coun...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l5367
更新日期:2019-10-08 00:00:00
abstract:OBJECTIVE:To investigate whether breast feeding is related to subsequent risk of breast cancer. DESIGN:Population based case-control study designed primarily to investigate the relation between oral contraceptives and risk of breast cancer; data obtained from questionnaires administered by interviewers, general practi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6895.17
更新日期:1993-07-03 00:00:00
abstract:OBJECTIVES:To compile a register of diabetic patients within the catchment area of a district general hospital and evaluate the characteristics of the population using aggregated data from a general practice audit. DESIGN:Cross sectional study. Practices identified all known diabetics and completed a questionnaire fro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6911.1046
更新日期:1993-10-23 00:00:00
abstract:OBJECTIVE:To determine the prevalence of sexually transmitted diseases in patients with normal and abnormal cervical smears. DESIGN:A prospective study of asymptomatic women with normal cervical smears attending their general practitioner and newly referred patients with abnormal smears attending a colposcopy clinic. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6768.82
更新日期:1991-01-12 00:00:00
abstract::The aim of the study was to determine the outcome in 181 diabetic patients with advanced, previously untreated renal impairment who had been identified in a survey conducted in six health regions in the United Kingdom in 1985. Late in 1987 questionnaires were sent to the consultant physicians, geriatricians, and nephr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6708.1135
更新日期:1989-11-04 00:00:00
abstract:OBJECTIVE:To investigate any long term effects of traumatic birth and obstetric procedures in relation to suicide by violent means in offspring as adults. DESIGN:Prospective case-control study. SETTING:Stockholm, Sweden. SUBJECTS:242 adults who committed suicide by violent means from 1978 to 1995, and who were born ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7169.1346
更新日期:1998-11-14 00:00:00
abstract:OBJECTIVES:To identify risk factors predisposing to the development of flucloxacillin associated jaundice. DESIGN:Case-control study. Medical records of cases and controls were reviewed and information recorded on standard data collection forms. SETTING:Alfred Hospital recruiting subjects from Melbourne, Sydney, and ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6872.233
更新日期:1993-01-23 00:00:00
abstract:OBJECTIVE:To assess the cost effectiveness of different screening strategies for abdominal aortic aneurysm in men, from the perspective of a national health service. SETTING:Screening units at regional hospitals. PARTICIPANTS:Hypothetical cohort of 65 year old men from the general population. MAIN OUTCOME MEASURES:C...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e4276
更新日期:2012-07-05 00:00:00
abstract:OBJECTIVE:To examine whether the association of inadequate or unclear allocation concealment and lack of blinding with biased estimates of intervention effects varies with the nature of the intervention or outcome. DESIGN:Combined analysis of data from three meta-epidemiological studies based on collections of meta-an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39465.451748.AD
更新日期:2008-03-15 00:00:00
abstract:OBJECTIVE:To evaluate the association between use of hormone replacement therapy and the risk of idiopathic venous thromboembolism. DESIGN:Population based case-control study. SETTING:Population enrolled in the General Practice Research Database, United Kingdom. SUBJECTS:A cohort of 347,253 women aged 50 to 79 witho...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7083.796
更新日期:1997-03-15 00:00:00
abstract:OBJECTIVE:To study different nutrients and food additives as risk factors for insulin dependent diabetes mellitus in childhood. DESIGN:Prospective case-control study. Parents of the children being studied were asked to fill in a questionnaire regarding the children's frequency of consumption of various foods. Parents ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6735.1302
更新日期:1990-05-19 00:00:00
abstract:OBJECTIVES:To provide a contemporary account of the treatment and outcomes of acute coronary attacks in England and Wales and to identify strategies that might improve the outcome. DESIGN:Two year community and hospital based study in three British health districts. SETTING:Health districts of Brighton (population 28...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:
更新日期:1998-04-04 00:00:00
abstract:OBJECTIVES:To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweete...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.h3576
更新日期:2015-07-21 00:00:00
abstract:OBJECTIVE:To examine the effect of the method of data display on physician investigators' decisions to stop hypothetical clinical trials for an unplanned statistical analysis. DESIGN:Prospective, mixed model design with variables between subjects and within subjects (repeated measures). SETTING:Comprehensive cancer c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.318.7197.1527
更新日期:1999-06-05 00:00:00
abstract::The relations among parental reports of respiratory symptoms, bronchospasm measured after exercise, and the presence of visible fungal mould in the home was assessed in a population sample of 7 year old children (n = 873). Wheeze in the past year was the symptom most closely associated with reported dampness and parti...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6658.1223
更新日期:1988-11-12 00:00:00
abstract:OBJECTIVES:To assess aspects of the internal validity of recently published cluster randomised trials and explore the reporting of information useful in assessing the external validity of these trials. DESIGN:Review of 34 cluster randomised trials in primary care published in 2004 and 2005 in seven journals (British M...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.39517.495764.25
更新日期:2008-04-19 00:00:00
abstract:OBJECTIVE:To establish the extent to which systematic reviews and meta-analyses of individual participant data (IPD) are being used to inform the recommendations included in published clinical guidelines. DESIGN:Descriptive study. SETTING:Database maintained by the Cochrane IPD Meta-analysis Methods Group, supplement...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h1088
更新日期:2015-03-06 00:00:00
abstract:OBJECTIVE:To assess the risk of adverse perinatal events of vaccination of pregnant women with an MF59 adjuvanted vaccine. DESIGN:Cross sectional multicentre study. SETTING:49 public hospitals in major cities in Argentina, from September 2010 to May 2011. PARTICIPANTS:30,448 mothers (7293 vaccinated) and their 30,76...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.f393
更新日期:2013-02-04 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of a monovalent rotavirus vaccine against severe rotavirus disease and to assess its impact on diarrhoea in children aged less than 2 years after national introduction in El Salvador, a low-middle income country in Central America. DESIGN:Matched case-control study. SETTING:Sev...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c2825
更新日期:2010-06-15 00:00:00
abstract:OBJECTIVE:To investigate the results of resuscitation of patients with cardiac arrest by ambulance staff with extended training in West Yorkshire. DESIGN:Study of all such attempts at resuscitation over 32 months, based on the standard report form for each call made by the ambulance staff and the electrocardiogram tha...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6752.600
更新日期:1990-09-22 00:00:00
abstract::Two patients with acute major, disabling cerebral infarction with presumed middle cerebral artery occlusion were treated with the clot specific thrombolytic agent tissue plasminogen activator roughly three and a half hours after the onset of symptoms. Both patients had a normal computed tomography (CT) scan before tre...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6663.1571
更新日期:1988-12-17 00:00:00