 |
|
March 1, 2001
|
|
|
|
|
|
A Synthetic Pentasaccharide for the Prevention of Deep-Vein Thrombosis
In patients at risk for deep venous thrombosis, prophylaxis usually consists of standard heparin, low-molecular-weight heparin, or warfarin. This study assessed a new synthetic pentasaccharide, which binds to antithrombin and potentiates its effect. At several doses, the pentasaccharide was superior to low-molecular-weight heparin in the prevention of deep venous thrombosis after total hip replacement, and the risk of bleeding was not increased except at the higher doses.
Use of the pentasaccharide is an interesting, novel approach to anticoagulation and the prevention of deep venous thrombosis, but since this investigation was designed as a dose-ranging study, a larger trial will be needed to confirm the clinical efficacy and safety of this agent.
Related Editorial
|
|
|
|
Effects of a Low-Molecular-Weight Heparin in Patients with Deep-Vein Thrombosis
In this study of patients with deep venous thrombosis, therapy with standard intravenous heparin was compared with the subcutaneous administration of reviparin, a low-molecular-weight heparin. Reviparin was more effective than standard heparin in reducing the size of the thrombus on venography and in preventing recurrent thromboembolism. Major bleeding episodes occurred with similar frequency in all treatment groups.
By examining the effect of reviparin on the regression of thrombus, this study adds to the evidence that low-molecular-weight heparins are valuable treatment options for deep venous thrombosis. The low-molecular-weight heparin reviparin was superior to standard heparin in facilitating regression of thrombus and in preventing recurrent venous thrombosis.
Related Editorial
|
|
|
|
Green Tea and the Risk of Gastric Cancer in Japan
Green tea is widely consumed in Japan and other Asian countries. Studies have suggested that green tea may protect against the development of gastric cancer. This population-based, prospective cohort study was conducted in a region of northern Japan that has a high incidence of gastric cancer. The study found no association between green-tea consumption and the risk of gastric cancer.
Data from studies in animals as well as case-control studies indicate that green tea may have a protective effect against the development of gastric cancer. In this prospective, population-based study, which identified 419 cases of gastric cancer, green tea was not found to protect against gastric cancer.
Related Editorial
|
|
|
|
Transmission of HHV-8 in Women
Human herpesvirus 8 (HHV-8) is associated with Kaposi's sarcoma and is known to be transmitted sexually among homosexual men. This study found that HHV-8 seropositivity in women was independently associated with daily injection-drug use, HIV infection, and a positive test for syphilis. Among the women with a low risk of sexual transmission, HHV-8 seroprevalence was strongly associated with injection-drug use.
This study of women provides evidence that HHV-8 is transmitted through heterosexual sex and through exposure to blood from needle sharing. However, blood-borne transmission appears to be less efficient for HHV-8 than it is for hepatitis B virus, hepatitis C virus, and HIV.
|
|
|
|
Underuse of Clinically Appropriate Coronary Revascularization Procedures
There is widespread variation among physicians in terms of their recommendation of patients for coronary revascularization. In this study, an expert panel was asked to rate a number of clinical indications in terms of the appropriateness of revascularization. These criteria were then applied to a large series of patients undergoing coronary angiography. Of those considered appropriate candidates for angioplasty, 34 percent did not undergo this procedure; their clinical outcomes were worse than those of patients who did. Similarly, among those classified as appropriate candidates for coronary bypass surgery, 26 percent did not undergo it and also had poorer outcomes.
This study suggests that there is substantial underuse of coronary revascularization procedures and that underuse is associated with poorer clinical outcomes. The implication is that explicit measures of appropriateness should be incorporated into clinical decision making regarding the use of coronary revascularization procedures.
Related Editorial
|
