Objective : In the mid-1980s, interest in parenteral estrogen therapy for prostate cancer was renewed when it was found that it influenced liver metabolism only marginally and had very few ...cardiovascular side-effects. In this study high-dose polyestradiol phosphate (PEP; Estradurin ® ) was compared to combined androgen deprivation (CAD) for the treatment of patients with metastatic prostate cancer. The aim of the study was to compare anticancer efficacy and adverse events, especially cardiovascular side-effects. Material and Methods : A total of 917 patients with T0-4, NX, M1, G1-3 prostate cancer and an Eastern Cooperative Oncology Group performance status of 0-2 were randomized to treatment with either PEP 240 mg i.m. twice a month for 2 months and thereafter once a month or flutamide (Eulexin ® ) 250 mg t.i.d. per os in combination with either triptorelin (Decapeptyl ® ) 3.75 mg per month i.m. or, on an optional basis, bilateral orchidectomy. A total of 556 patients had died at the time of this analysis. Results : There was no difference between the treatment arms in terms of time to biochemical or clinical progression and overall or disease-specific survival. There was no increase in cardiovascular mortality in the PEP arm. The PEP group had a higher prevalence of cardiovascular disease prior to the study and a significantly higher incidence of non-fatal ischemic heart events and heart decompensation during the study. Conclusions : PEP has an equal anticancer efficacy to CAD and does not increase cardiovascular mortality. Final evaluation of cardiovascular morbidity is awaiting further analysis and follow-up. PEP is considerably cheaper than CAD.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Spinal muskelatrofi (SMA) med debut i barnealder er en nevromuskulær sykdom som medfører muskelsvinn, muskelsvakhet og redusert motorisk funksjon, men det er stor variasjon i alvorlighetsgrad mellom ...de ulike undergruppene. Barn og unge med SMA har økt risiko for å utvikle ernæringsrelaterte helseutfordringer. Artikkelen undersøker kunnskapsgrunnlaget for ernæringsbehandling av pasientgruppen. De ernæringsfaglige problemstillingene omfatter økt risiko for underernæring og overvekt men kan være utfordrende å avdekke da endret kroppssammensetning gjør at ordinære vekstkurver kan overestimere underernæring og underestimere overvekt. Tygge- og svelgevansker, redusert energibehov, redusert toleranse for faste, gastroøsofageal refluks og dysmotilitet i tarm er kompliserende faktorer for ernæringsbehandlingen. Aktuelle ernæringstiltak inkluderer enteral ernæring, konsistenstilpasset kost, energiberiket eller energiredusert kost og supplement av essensielle næringsstoffer
Thirty-nine vectorcardiographic (VCG) data from 45 patients with pure adult aortic stenosis have been tested as to their ability to reflect quantitatively the peak systolic left ventricular pressure ...(LVPSP), the left ventricular end diastolic pressure (LVEDP), and the X-ray estimated heart volume. VCG was recorded with the axial lead system and simple and multiple linear regression analyses were applied. Eight VCG data correlated significantly (p less than 0.001) with LVPSP, the best indicator being the maximum posterior dislocation in the Z lead (r = 0.65). Through multiple regression analysis a formula was derived which gave a correlation coefficient between observed and calculated pressures of 0.82. The best indicator of LVEDP was the maximum positive P amplitude in the X lead (r = 0.41). The relationship was, however, too poor to have practical significance. A good correlation was found between ST segment dislocation and heart volume (r = 0.65), in good accordance with previous observations as to the effect of right ventricular dilatation on the ECG. The study illustrates how ventricular volume and pressure exert different effects on the ECG, and how all the important hemodynamic aspects in aortic stenosis to some degree are reflected. Only the pressure correlations have, however, practical importance.
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