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RESULTS
Validation tests indicate that the 2-point LSS model developed for the reference formulation predicts accurately ( R2 > 0.90 ) : ( a ) the individual AUC0-72 for the test formulation in the same group of volunteers ; ( b ) the individual AUC0-72 for the same reference formulation in another bioequivalence study in Brazilian volunteers ; ( c ) the average AUC0-72 reported in seven additional international studies performed under protocols similar to the present investigation ; ( d ) the individual AUC0-72 corresponding to concentration data points provided by a first-order compartmental pharmacokinetic model , when the relative values of either the absorption rate ( Kabs ) or the bioavailability ( F ) model parameters were set at 0.85 or 0.6 , of their respective original values .
Validation tests indicate that the 2-point LSS model developed for the reference formulation predicts accurately (R2 > 0. 90) : (a) the individual AUC0-72 for the test formulation in the same group of volunteers ; (b) the individual AUC0-72 for the same reference formulation in another bioequivalence study in Brazilian volunteers ; (c) the average AUC0-72 reported in seven additional international studies performed under protocols similar to the present investigation ; (d) the individual AUC0-72 corresponding to concentration data points provided by a first-order compartmental pharmacokinetic model, when the relative values of either the absorption rate (Kabs) or the bioavailability (F) model parameters were set at 0. 85 or 0. 6, of their respective original values.
CONCLUSIONS
The 2-point LSS models developed in the current study predict accurately the AUC of amlodipine under a variety of experimental conditions and , thus , may be valuable for exploring the relationships between the pharmacokinetics and pharmacodynamics of this calcium antagonist , at reduced costs of sample acquisition and analysis , and avoiding sampling at `` unsociable '' hours .
The 2-point LSS models developed in the current study predict accurately the AUC of amlodipine under a variety of experimental conditions and, thus, may be valuable for exploring the relationships between the pharmacokinetics and pharmacodynamics of this calcium antagonist, at reduced costs of sample acquisition and analysis, and avoiding sampling at '' unsociable '' hours.
BACKGROUND
Few strategies are available for the prevention of cognitive impairment in elderly persons .
Few strategies are available for the prevention of cognitive impairment in elderly persons.
BACKGROUND
Serum lipoprotein levels may be important predictors of cognitive function , and drugs that lower cholesterol may be effective for the prevention of cognitive impairment .
Serum lipoprotein levels may be important predictors of cognitive function, and drugs that lower cholesterol may be effective for the prevention of cognitive impairment.
OBJECTIVE
To determine whether serum lipoprotein levels , the 4-year change in serum lipoprotein levels , and the use of statin drugs are associated with cognition in older women without dementia .
To determine whether serum lipoprotein levels, the 4-year change in serum lipoprotein levels, and the use of statin drugs are associated with cognition in older women without dementia.
METHODS
An observational study of 1037 postmenopausal women with coronary heart disease enrolled in the Heart and Estrogen/progestin Replacement Study ( participants at 10 of 20 centers ) .
An observational study of 1037 postmenopausal women with coronary heart disease enrolled in the Heart and Estrogen/progestin Replacement Study (participants at 10 of 20 centers).
METHODS
The Modified Mini-Mental State Examination was administered at the end of the study after 4 years of follow-up .
The Modified Mini-Mental State Examination was administered at the end of the study after 4 years of follow-up.
METHODS
Women whose score was less than 84 points ( > 1.5 SDs below the mean ) were classified as having cognitive impairment .
Women whose score was less than 84 points (> 1. 5 SDs below the mean) were classified as having cognitive impairment.
METHODS
Lipoprotein levels ( total , high-density lipoprotein , and low-density lipoprotein [ LDL ] cholesterol and triglycerides ) were measured at baseline and at the end of the study ; statin use was documented at each visit .
Lipoprotein levels (total, high-density lipoprotein, and low-density lipoprotein [LDL] cholesterol and triglycerides) were measured at baseline and at the end of the study ; statin use was documented at each visit.
RESULTS
Compared with women in the lower quartiles , women in the highest LDL cholesterol quartile at cognitive testing had worse mean plus minus SD Modified Mini-Mental State Examination scores ( 93.7 plus minus 6.0 vs 91.9 plus minus 7.6 ; P = .002 ) and an increased likelihood of cognitive impairment ( adjusted odds ratio , 1.76 ; 95 % confidence interval , 1.04-2 .97 ) .
Compared with women in the lower quartiles, women in the highest LDL cholesterol quartile at cognitive testing had worse mean plus minus SD Modified Mini-Mental State Examination scores (93. 7 plus minus 6. 0 vs 91. 9 plus minus 7. 6 ; P =. 002) and an increased likelihood of cognitive impairment (adjusted odds ratio, 1. 76 ; 95 % confidence interval, 1. 04-2. 97).
RESULTS
A reduction in the LDL cholesterol level during the 4 years tended to be associated with a lower odds of impairment ( adjusted odds ratio , 0.61 ; 95 % confidence interval , 0.36-1 .03 ) compared with women whose levels increased .
A reduction in the LDL cholesterol level during the 4 years tended to be associated with a lower odds of impairment (adjusted odds ratio, 0. 61 ; 95 % confidence interval, 0. 36-1. 03) compared with women whose levels increased.
RESULTS
Higher total and LDL cholesterol levels , corrected for lipoprotein ( a ) levels , were also associated with a worse Modified Mini-Mental State Examination score and a higher likelihood of impairment , whereas high-density lipoprotein cholesterol and triglyceride levels were not associated with cognition .
Higher total and LDL cholesterol levels, corrected for lipoprotein (a) levels, were also associated with a worse Modified Mini-Mental State Examination score and a higher likelihood of impairment, whereas high-density lipoprotein cholesterol and triglyceride levels were not associated with cognition.
RESULTS
Compared with nonusers , statin users had higher mean plus minus SD Modified Mini-Mental State Examination scores ( 92.7 plus minus 7.1 vs 93.7 plus minus 6.1 ; P = .02 ) and a trend for a lower likelihood of cognitive impairment ( odds ratio , 0.67 ; 95 % confidence interval , 0.42-1 .05 ) , findings that seemed to be independent of lipid levels .
Compared with nonusers, statin users had higher mean plus minus SD Modified Mini-Mental State Examination scores (92. 7 plus minus 7. 1 vs 93. 7 plus minus 6. 1 ; P =. 02) and a trend for a lower likelihood of cognitive impairment (odds ratio, 0. 67 ; 95 % confidence interval, 0. 42-1. 05), findings that seemed to be independent of lipid levels.
CONCLUSIONS
High LDL and total cholesterol levels are associated with cognitive impairment , and lowering these lipoprotein levels may be a strategy for preventing impairment .
High LDL and total cholesterol levels are associated with cognitive impairment, and lowering these lipoprotein levels may be a strategy for preventing impairment.
CONCLUSIONS
The association between statin use and better cognitive function in women without dementia requires further study .
The association between statin use and better cognitive function in women without dementia requires further study.
OBJECTIVE
Analysing and presenting data on different outcomes after sick-leave is challenging .
Analysing and presenting data on different outcomes after sick-leave is challenging.
OBJECTIVE
The use of extended statistical methods supplies additional information and allows further exploitation of data .
The use of extended statistical methods supplies additional information and allows further exploitation of data.
METHODS
Four hundred and fifty-seven patients , sick-listed for 8-12 weeks for low back pain , were randomized to intervention ( n = 237 ) or control ( n = 220 ) .
Four hundred and fifty-seven patients, sick-listed for 8-12 weeks for low back pain, were randomized to intervention (n = 237) or control (n = 220).
METHODS
Outcome was measured as : `` sick-listed '' , `` returned to work '' , or `` disability pension '' .
Outcome was measured as : '' sick-listed '', '' returned to work '', or '' disability pension ''.
METHODS
The individuals shifted between the three states between one and 22 times ( mean 6.4 times ) .
The individuals shifted between the three states between one and 22 times (mean 6. 4 times).
METHODS
In a multi-state model , shifting between the states was set up in a transition intensity matrix .
In a multi-state model, shifting between the states was set up in a transition intensity matrix.
METHODS
The probability of being in any of the states was calculated as a transition probability matrix .
The probability of being in any of the states was calculated as a transition probability matrix.
METHODS
The effects of the intervention were modelled using a non-parametric model .
The effects of the intervention were modelled using a non-parametric model.
RESULTS
There was an effect of the intervention for leaving the state sick-listed and shifting to returned to work ( relative risk ( RR ) = 1.27 , 95 % confidence interval ( CI ) 1.09 - 1.47 ) .
There was an effect of the intervention for leaving the state sick-listed and shifting to returned to work (relative risk (RR) = 1. 27, 95 % confidence interval (CI) 1. 09 - 1. 47).
RESULTS
The nonparametric estimates showed an effect of the intervention for leaving sick-listed and shifting to returned to work in the first 6 months .
The nonparametric estimates showed an effect of the intervention for leaving sick-listed and shifting to returned to work in the first 6 months.
RESULTS
We found a protective effect of the intervention for shifting back to sick-listed between 6 and 18 months .
We found a protective effect of the intervention for shifting back to sick-listed between 6 and 18 months.
RESULTS
The analyses showed that the probability of staying in the state returned to work was not different between the intervention and control groups at the end of the follow-up ( 3 years ) .
The analyses showed that the probability of staying in the state returned to work was not different between the intervention and control groups at the end of the follow-up (3 years).
CONCLUSIONS
We demonstrate that these alternative analyses give additional results and increase the strength of the analyses .
We demonstrate that these alternative analyses give additional results and increase the strength of the analyses.
CONCLUSIONS
The simple intervention did not decrease the probability of being on sick-leave in the long term ; however , it decreased the time that individuals were on sick-leave .
The simple intervention did not decrease the probability of being on sick-leave in the long term ; however, it decreased the time that individuals were on sick-leave.
OBJECTIVE
The purpose of this study was to compare the cost of percutaneous coronary intervention ( PCI ) using bivalirudin with provisional platelet glycoprotein ( GP ) IIb/IIIa inhibition with that of heparin + routine GP IIb/IIIa inhibition .
The purpose of this study was to compare the cost of percutaneous coronary intervention (PCI) using bivalirudin with provisional platelet glycoprotein (GP) IIb/IIIa inhibition with that of heparin + routine GP IIb/IIIa inhibition.
BACKGROUND
Although GP IIb/IIIa inhibition has been shown to reduce ischemic complications in a broad range of patients undergoing PCI , many patients currently do not receive such therapy because of concerns about bleeding complications or cost .
Although GP IIb/IIIa inhibition has been shown to reduce ischemic complications in a broad range of patients undergoing PCI, many patients currently do not receive such therapy because of concerns about bleeding complications or cost.
BACKGROUND
Recently , bivalirudin with provisional GP IIb/IIIa inhibition has been validated as an alternative to heparin + routine GP IIb/IIIa inhibition for patients undergoing PCI .
Recently, bivalirudin with provisional GP IIb/IIIa inhibition has been validated as an alternative to heparin + routine GP IIb/IIIa inhibition for patients undergoing PCI.
BACKGROUND
However , the cost-effectiveness of this novel strategy is unknown .
However, the cost-effectiveness of this novel strategy is unknown.
METHODS
In the Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events ( REPLACE ) -2 trial , 4,651 U.S. patients undergoing non-emergent PCI were randomized to receive bivalirudin with provisional GP IIb/IIIa ( n = 2,319 ) versus heparin + routine GP IIb/IIIa ( n = 2,332 ) .
In the Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events (REPLACE) -2 trial, 4, 651 U. S. patients undergoing non-emergent PCI were randomized to receive bivalirudin with provisional GP IIb/IIIa (n = 2, 319) versus heparin + routine GP IIb/IIIa (n = 2, 332).
METHODS
Resource utilization data were collected prospectively through 30-day follow-up on all U.S. patients .
Resource utilization data were collected prospectively through 30-day follow-up on all U. S. patients.
METHODS
Medical care costs were estimated using standard methods including bottom-up accounting ( for procedural costs ) , the Medicare fee schedule ( for physician services ) , hospital billing data ( for 2,821 of 4,862 admissions ) , and regression-based approaches for the remaining hospitalizations .
Medical care costs were estimated using standard methods including bottom-up accounting (for procedural costs), the Medicare fee schedule (for physician services), hospital billing data (for 2, 821 of 4, 862 admissions), and regression-based approaches for the remaining hospitalizations.
RESULTS
Among the bivalirudin group , 7.7 % required provisional GP IIb/IIIa .
Among the bivalirudin group, 7. 7 % required provisional GP IIb/IIIa.
RESULTS
Thirty-day ischemic outcomes including death or myocardial infarction were similar for the bivalirudin and GP IIb/IIIa groups , but bivalirudin resulted in lower rates of major bleeding ( 2.8 % vs. 4.5 % , p = 0.002 ) and minor bleeding ( 15.1 % vs. 28.1 % , p < 0.001 ) .
Thirty-day ischemic outcomes including death or myocardial infarction were similar for the bivalirudin and GP IIb/IIIa groups, but bivalirudin resulted in lower rates of major bleeding (2. 8 % vs. 4. 5 %, p = 0. 002) and minor bleeding (15. 1 % vs. 28. 1 %, p < 0. 001).
RESULTS
Compared with routine GP IIb/IIIa , in-hospital and 30-day costs were reduced by $ 405 ( 95 % confidence interval [ CI ] $ 37 to $ 773 ) and $ 374 ( 95 % CI $ 61 to $ 688 ) per patient with bivalirudin ( p < 0.001 for both ) .
Compared with routine GP IIb/IIIa, in-hospital and 30-day costs were reduced by $ 405 (95 % confidence interval [CI] $ 37 to $ 773) and $ 374 (95 % CI $ 61 to $ 688) per patient with bivalirudin (p < 0. 001 for both).
RESULTS
Regression modeling demonstrated that , in addition to the costs of the anticoagulants themselves , hospital savings were due primarily to reductions in major bleeding ( cost savings = $ 107/patient ) , minor bleeding ( $ 52/patient ) , and thrombocytopenia ( $ 47/patient ) .
Regression modeling demonstrated that, in addition to the costs of the anticoagulants themselves, hospital savings were due primarily to reductions in major bleeding (cost savings = $ 107/patient), minor bleeding ($ 52/patient), and thrombocytopenia ($ 47/patient).
CONCLUSIONS
Compared with heparin + routine GP IIb/IIIa inhibition , bivalirudin + provisional GP IIb/IIIa inhibition resulted in similar acute ischemic events and cost savings of $ 375 to $ 400/patient depending on the analytic perspective .
Compared with heparin + routine GP IIb/IIIa inhibition, bivalirudin + provisional GP IIb/IIIa inhibition resulted in similar acute ischemic events and cost savings of $ 375 to $ 400/patient depending on the analytic perspective.
OBJECTIVE
To explore the effect of isoflurane preconditioning on the plasma concentration of matrix metalloproteinase ( MMP ) -9 and myocardial ultramicrostructure in patients undergoing cardiac valve replacement .
To explore the effect of isoflurane preconditioning on the plasma concentration of matrix metalloproteinase (MMP) -9 and myocardial ultramicrostructure in patients undergoing cardiac valve replacement.
METHODS
Thirty patients undergoing elective cardiac valve replacement with cardiopulmonary bypass ( CPB ) were randomly assigned to a control group ( n15 ) and an isoflurane group ( n15 ) .
Thirty patients undergoing elective cardiac valve replacement with cardiopulmonary bypass (CPB) were randomly assigned to a control group (n15) and an isoflurane group (n15).
METHODS
In the isoflurane group , isoflurane of 1.0 minimum alveolar concentration end-tidal ( 1.1 % approximately 1.2 % ) was administered for 30 min followed by a 15 min washout period before the CPB .
In the isoflurane group, isoflurane of 1. 0 minimum alveolar concentration end-tidal (1. 1 % approximately 1. 2 %) was administered for 30 min followed by a 15 min washout period before the CPB.
METHODS
The control group did not inhale isofurane , and there was no difference in the other drugs in the 2 groups .
The control group did not inhale isofurane, and there was no difference in the other drugs in the 2 groups.
METHODS
Blood samples for MMP-9 were obtained before incision ( T ( 0 ) ) and at 30 min ( T ( 1 ) ) ,6 h ( T ( 2 ) ) ,12 h ( T ( 3 ) ) , and 24 h ( T ( 4 ) ) after the reperfusion .
Blood samples for MMP-9 were obtained before incision (T (0)) and at 30 min (T (1)), 6 h (T (2)), 12 h (T (3)), and 24 h (T (4)) after the reperfusion.
METHODS
Right atrial biopsies were collected before and after the CPB to observe the myocardial ultramicrostructure .
Right atrial biopsies were collected before and after the CPB to observe the myocardial ultramicrostructure.
RESULTS
Compared with T ( 0 ) , the mean MMP-9 level significantly increased at T ( 1 ) , T ( 2 ) and T ( 3 ) in the control group ( P < 0.01 ) , while the MMP-9 level only at T ( 1 ) significantly increased in the isoflurane group ( P < 0.01 ) .
Compared with T (0), the mean MMP-9 level significantly increased at T (1), T (2) and T (3) in the control group (P < 0. 01), while the MMP-9 level only at T (1) significantly increased in the isoflurane group (P < 0. 01).
RESULTS
The mean MMP-9 level was significantly reduced in the isoflurane group at T ( 2 ) compared with each time point in the control group .
The mean MMP-9 level was significantly reduced in the isoflurane group at T (2) compared with each time point in the control group.
RESULTS
The difference in MMP-9 levels between T ( 1 ) , T ( 2 ) , T ( 3 ) and T ( 0 ) was significantly lower in the isoflurane group than that in the control group ( P < 0.01 ) .
The difference in MMP-9 levels between T (1), T (2), T (3) and T (0) was significantly lower in the isoflurane group than that in the control group (P < 0. 01).
RESULTS
The ultramicrostructure injury of myocardium under electron microscope in the control group was worse than that in the isoflurane group .
The ultramicrostructure injury of myocardium under electron microscope in the control group was worse than that in the isoflurane group.
CONCLUSIONS
The plasma concentration of MMP-9 is inhibited by isoflurane preconditioning in patients undergoing cardiac valve replacement after CPB , which might be part of its protective mechanism against myocardium injury after CPB .
The plasma concentration of MMP-9 is inhibited by isoflurane preconditioning in patients undergoing cardiac valve replacement after CPB, which might be part of its protective mechanism against myocardium injury after CPB.
OBJECTIVE
Frame-based stereotactic surgical planning systems ( SSPSs ) have been used for deep brain stimulation and radioneurosurgery .
Frame-based stereotactic surgical planning systems (SSPSs) have been used for deep brain stimulation and radioneurosurgery.
OBJECTIVE
Here , we evaluated the feasibility , safety and efficacy of using a SSPS to aid spontaneous intracerebral haematoma ( ICH ) treatment .
Here, we evaluated the feasibility, safety and efficacy of using a SSPS to aid spontaneous intracerebral haematoma (ICH) treatment.
METHODS
Patients with moderate spontaneous putamen haematomas were randomized into two groups : treatment ( group A ) and control ( group B ) .
Patients with moderate spontaneous putamen haematomas were randomized into two groups : treatment (group A) and control (group B).
METHODS
In group B , the catheter for evacuating haematomas was inserted into a target point , located at the centre of the haematoma , using conventional frame-based stereotactics ; urokinase thrombolysis was subsequently delivered through the catheter .
In group B, the catheter for evacuating haematomas was inserted into a target point, located at the centre of the haematoma, using conventional frame-based stereotactics ; urokinase thrombolysis was subsequently delivered through the catheter.
METHODS
In group A , this procedure was assisted by a SSPS , which designed both the target point and trajectory in the haematoma through virtual reality .
In group A, this procedure was assisted by a SSPS, which designed both the target point and trajectory in the haematoma through virtual reality.
METHODS
Duration of evacuating haematomas and number of urokinase injections was compared between groups .
Duration of evacuating haematomas and number of urokinase injections was compared between groups.
RESULTS
In total , 65 patients were recruited : in group A ( n = 30 ) , the duration of evacuating haematomas ( 35.279.17 h ) was shorter than in group B ( n = 35 ; 67.7713.82 h ) .
In total, 65 patients were recruited : in group A (n = 30), the duration of evacuating haematomas (35. 279. 17 h) was shorter than in group B (n = 35 ; 67. 7713. 82 h).
RESULTS
There were fewer urokinase injections in group A ( 3.631.16 ) than in group B ( 6.401.29 ) .
There were fewer urokinase injections in group A (3. 631. 16) than in group B (6. 401. 29).
CONCLUSIONS
The feasibility , efficacy and safety of spontaneous ICH treatment were optimized by the use of a frame-based SSPS .
The feasibility, efficacy and safety of spontaneous ICH treatment were optimized by the use of a frame-based SSPS.
BACKGROUND
Displacement of the heart to expose the posterior vessels during off-pump coronary artery bypass ( OPCAB ) may cause hemodynamic instability .
Displacement of the heart to expose the posterior vessels during off-pump coronary artery bypass (OPCAB) may cause hemodynamic instability.
BACKGROUND
Deep pericardial traction suture ( DPTS ) and vacuum-assisted apical suction ( VAS ) with the Starfish positioning device help to provide good exposure without relevant hemodynamic changes .
Deep pericardial traction suture (DPTS) and vacuum-assisted apical suction (VAS) with the Starfish positioning device help to provide good exposure without relevant hemodynamic changes.
BACKGROUND
Our aim was to compare these two methods in patients undergoing multivessel OPCAB .
Our aim was to compare these two methods in patients undergoing multivessel OPCAB.
METHODS
We prospectively randomized 20 patients undergoing multivessel OPCAB to the use of VAS or DPTS .
We prospectively randomized 20 patients undergoing multivessel OPCAB to the use of VAS or DPTS.
METHODS
The Octopus device was used in both groups to stabilize the target vessel .
The Octopus device was used in both groups to stabilize the target vessel.
METHODS
Hemodynamic parameters , including venous oxygen content ( SvO ( 2 ) ) , cardiac index ( CI ) , central venous pressure ( CVP ) , mean arterial pressure ( MAP ) , pulmonary artery pressure ( PAP ) , and pulmonary capillary wedge pressure ( PCWP ) , were measured before grafting ( baseline ) , after heart positioning , and during performance of peripheral anastomoses .
Hemodynamic parameters, including venous oxygen content (SvO (2)), cardiac index (CI), central venous pressure (CVP), mean arterial pressure (MAP), pulmonary artery pressure (PAP), and pulmonary capillary wedge pressure (PCWP), were measured before grafting (baseline), after heart positioning, and during performance of peripheral anastomoses.
RESULTS
Perioperative data for the two groups were similar .
Perioperative data for the two groups were similar.
RESULTS
During exposure of the lateral wall , there were fewer hemodynamic changes in the DPTS group ( increase in CVP ) than in the VAS group ( increases in CVP , PAP , and PCWP ) ; the CVP was significantly higher in the DPTS group ( P < .05 ) .
During exposure of the lateral wall, there were fewer hemodynamic changes in the DPTS group (increase in CVP) than in the VAS group (increases in CVP, PAP, and PCWP) ; the CVP was significantly higher in the DPTS group (P <. 05).
RESULTS
During exposure of the posterior wall , significant hemodynamic changes occurred only in the DPTS group ( increase in PCWP ) .
During exposure of the posterior wall, significant hemodynamic changes occurred only in the DPTS group (increase in PCWP).
RESULTS
Values for all other parameters were similar , including anastomosis time , graft flow , postoperative myocardial enzymes , and inotropic support .
Values for all other parameters were similar, including anastomosis time, graft flow, postoperative myocardial enzymes, and inotropic support.
CONCLUSIONS
Heart positioning during OPCAB with either VAS or DPTS is a safe and effective maneuver for exposure of coronary arteries .
Heart positioning during OPCAB with either VAS or DPTS is a safe and effective maneuver for exposure of coronary arteries.
CONCLUSIONS
In our study , the use of the VAS device produced less hemodynamic impairment during exposure of the lateral and posterior walls .
In our study, the use of the VAS device produced less hemodynamic impairment during exposure of the lateral and posterior walls.
BACKGROUND
The prognosis for locally advanced gastric cancer is poor despite advances in adjuvant chemotherapy .
The prognosis for locally advanced gastric cancer is poor despite advances in adjuvant chemotherapy.
BACKGROUND
We did the Stomach cancer Adjuvant Multi-Institutional group Trial ( SAMIT ) to assess the superiority of sequential treatment ( paclitaxel then tegafur and uracil [ UFT ] or paclitaxel then S-1 ) compared with monotherapy ( UFT or S-1 ) and also the non-inferiority of UFT compared with S-1 .
We did the Stomach cancer Adjuvant Multi-Institutional group Trial (SAMIT) to assess the superiority of sequential treatment (paclitaxel then tegafur and uracil [UFT] or paclitaxel then S-1) compared with monotherapy (UFT or S-1) and also the non-inferiority of UFT compared with S-1.
METHODS
We did this randomised phase 3 trial with a two-by-two factorial design at 230 hospitals in Japan .
We did this randomised phase 3 trial with a two-by-two factorial design at 230 hospitals in Japan.
METHODS
We enrolled patients aged 20-80 years with T4a or T4b gastric cancer , who had had D2 dissection and a ECOG performance score of 0-1 .
We enrolled patients aged 20-80 years with T4a or T4b gastric cancer, who had had D2 dissection and a ECOG performance score of 0-1.
METHODS
Patients were randomly assigned to one of four treatment groups with minimisation for tumour size , lymph node metastasis , and study site .
Patients were randomly assigned to one of four treatment groups with minimisation for tumour size, lymph node metastasis, and study site.
METHODS
Patients received UFT only ( 267 mg/m ( 2 ) per day ) , S-1 only ( 80 mg/m ( 2 ) per day ) for 14 days , with a 7-day rest period or three courses of intermittent weekly paclitaxel ( 80 mg/m ( 2 ) ) followed by either UFT , or S-1 .
Patients received UFT only (267 mg/m (2) per day), S-1 only (80 mg/m (2) per day) for 14 days, with a 7-day rest period or three courses of intermittent weekly paclitaxel (80 mg/m (2)) followed by either UFT, or S-1.
METHODS
Treatment lasted 48 weeks in monotherapy groups and 49 weeks in the sequential treatment groups .
Treatment lasted 48 weeks in monotherapy groups and 49 weeks in the sequential treatment groups.
METHODS
The primary endpoint was disease-free survival assessed by intention to treat .
The primary endpoint was disease-free survival assessed by intention to treat.
METHODS
We assessed whether UFT was non-inferior to S-1 with a non-inferiority margin of 133 .
We assessed whether UFT was non-inferior to S-1 with a non-inferiority margin of 133.
METHODS
This trial was registered at UMIN Clinical Trials Registry , number C000000082 .
This trial was registered at UMIN Clinical Trials Registry, number C000000082.
RESULTS
We randomly assigned 1495 patients between Aug 3 , 2004 , and Sept 29 , 2009.374 patients were assigned to receive UFT alone , 374 to receive S-1 alone , 374 to received paclitaxel then UFT , and 373 to receive paclitaxel then S-1 .
We randomly assigned 1495 patients between Aug 3, 2004, and Sept 29, 2009. 374 patients were assigned to receive UFT alone, 374 to receive S-1 alone, 374 to received paclitaxel then UFT, and 373 to receive paclitaxel then S-1.
RESULTS
We included 1433 patients in the primary analysis after at least 3 years of follow-up ( 359 , 364 , 355 , and 355 in each group respectively ) .
We included 1433 patients in the primary analysis after at least 3 years of follow-up (359, 364, 355, and 355 in each group respectively).
RESULTS
Protocol treatment was completed by 215 ( 60 % ) patients in the UFT group , 224 ( 62 % ) in the S-1 group , 242 ( 68 % ) in the paclitaxel then UFT group , and 250 ( 70 % ) in the paclitaxel then S-1 group .
Protocol treatment was completed by 215 (60 %) patients in the UFT group, 224 (62 %) in the S-1 group, 242 (68 %) in the paclitaxel then UFT group, and 250 (70 %) in the paclitaxel then S-1 group.
RESULTS
3-year disease-free survival for monotherapy was 540 % ( 95 % CI 502-576 ) and that of sequential treatment was 572 % ( 534-608 ; hazard ratio [ HR ] 092 , 95 % CI 080-107 , p = 0273 ) .
3-year disease-free survival for monotherapy was 540 % (95 % CI 502-576) and that of sequential treatment was 572 % (534-608 ; hazard ratio [HR] 092, 95 % CI 080-107, p = 0273).
RESULTS
3-year disease-free survival for the UFT group was 530 % ( 95 % CI 492-566 ) and that of the S-1 group was 582 % ( 544-618 ; HR 081 , 95 % CI 070-093 , p = 00048 ; pnon-inferiority = 0151 ) .
3-year disease-free survival for the UFT group was 530 % (95 % CI 492-566) and that of the S-1 group was 582 % (544-618 ; HR 081, 95 % CI 070-093, p = 00048 ; pnon-inferiority = 0151).
RESULTS
The most common grade 3-4 haematological adverse event was neutropenia ( 41 [ 11 % ] of 359 patients in the UFT group , 48 [ 13 % ] of 363 in the S-1 group , 46 [ 13 % ] of 355 in the paclitaxel then UFT group , and 83 [ 23 % ] of 356 in the paclitaxel then S-1 group ) .
The most common grade 3-4 haematological adverse event was neutropenia (41 [11 %] of 359 patients in the UFT group, 48 [13 %] of 363 in the S-1 group, 46 [13 %] of 355 in the paclitaxel then UFT group, and 83 [23 %] of 356 in the paclitaxel then S-1 group).
RESULTS
The most common grade 3-4 non-haematological adverse event was anorexia ( 21 [ 6 % ] , 24 [ 7 % ] , seven [ 2 % ] , and 18 [ 5 % ] , respectively ) .
The most common grade 3-4 non-haematological adverse event was anorexia (21 [6 %], 24 [7 %], seven [2 %], and 18 [5 %], respectively).
CONCLUSIONS
Sequential treatment did not improve disease-free survival , and UFT was not non-inferior to S-1 ( and S-1 was superior to UFT ) , therefore S-1 monotherapy should remain the standard treatment for locally advanced gastric cancer in Japan .
Sequential treatment did not improve disease-free survival, and UFT was not non-inferior to S-1 (and S-1 was superior to UFT), therefore S-1 monotherapy should remain the standard treatment for locally advanced gastric cancer in Japan.
BACKGROUND
Epidemiological and Clinical Research Information Network .
Epidemiological and Clinical Research Information Network.
OBJECTIVE
To evaluate the effects of a lifestyle intervention programme in primary healthcare , targeted to patients with moderate to high risk of cardiovascular disease in terms of cardiovascular risk factors , physical activity , and quality of life .
To evaluate the effects of a lifestyle intervention programme in primary healthcare, targeted to patients with moderate to high risk of cardiovascular disease in terms of cardiovascular risk factors, physical activity, and quality of life.
METHODS
Randomized controlled trial with one-year follow-up , carried out in a primary healthcare centre in Northern Sweden .
Randomized controlled trial with one-year follow-up, carried out in a primary healthcare centre in Northern Sweden.
METHODS
A total of 151 middle-aged men and women , with hypertension , dyslipidemia , type 2 diabetes , or obesity were enrolled .
A total of 151 middle-aged men and women, with hypertension, dyslipidemia, type 2 diabetes, or obesity were enrolled.
METHODS
The subjects were randomized to either the intervention ( n = 75 ) or the control group ( n = 76 ) .
The subjects were randomized to either the intervention (n = 75) or the control group (n = 76).
METHODS
A total of 123 subjects completed the one-year follow-up .
A total of 123 subjects completed the one-year follow-up.
METHODS
Exercise : supervised endurance and circuit training in groups three times a week for three months .
Exercise : supervised endurance and circuit training in groups three times a week for three months.
METHODS
Diet : five group sessions of diet counselling with a dietitian .
Diet : five group sessions of diet counselling with a dietitian.
METHODS
Follow - up meetings with a physiotherapist were conducted monthly thereafter .
Follow - up meetings with a physiotherapist were conducted monthly thereafter.