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  • 1
    Electronic Resource
    Electronic Resource
    Letrozole, a new oral aromatase inhibitor: Randomised trial comparing 2.5 mg daily, 0.5 mg daily and aminoglutethimide in postmenopausal women with advanced breast cancer (1998)
    Springer
    Annals of oncology 9 (1998), S. 639-645 
    Details
    ISSN: 1569-8041
    Keywords: advanced breast cancer ; aminoglutethimide ; aromatase inhibitors ; letrozole
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The study compares letrozole and aminoglutethimide (AG), astandard therapy for postmenopausal women with advanced breast cancer,previously treated with anti-oestrogens. Patients and methods: 555 women were randomly assigned letrozole 2.5 mgonce daily (n = 185), letrozole 0.5 mg once daily (n = 192) oraminoglutethimide 250 mg twice daily with corticosteroid support (n = 178)in an open-label, multicentre trial. The primary endpoint was objectiveresponse rate (ORR), with time events as secondary. ORR was analysed ninemonths after enrolment of the last patient, while survival was analysed 15months after the last patient was enrolled. We report the results of theseanalyses plus an extended period of observation (covering a total durationof approximately 45 months) to determine the duration of response andclinical benefit. Results: Overall objective response rates (complete + partial) of19.5%, 16.7% and 12.4% were seen for letrozole 2.5 mg,0.5 mg and AG respectively. Median duration of response and stable diseasewas longest for letrozole 2.5 mg (21 months) compared with letrozole 0.5 mg(18 months) and AG (14 months). Letrozole 2.5 mg was superior to AG in timeto progression, time to treatment failure and overall survival. Treatment-related adverse events occurred in fewer patients on letrozole(33%) than on AG (46%). Transient nausea was the most frequentevent with letrozole (7% on 0.5 mg, 10% on 2.5 mg, 10%on AG), rash with AG (11%, 1% on 0.5 mg, 3% on 2.5 mgletrozole). Conclusions: Letrozole 2.5 mg offers longer disease control thanaminoglutethimide and letrozole 0.5 mg in the treatment of postmenopausalwomen with advanced breast cancer, previously treated with anti-oestrogens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008226721932
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  • 2
    Electronic Resource
    Electronic Resource
    Intracranial hypertension in head injury: management and results (1999)
    Springer
    Intensive care medicine 25 (1999), S. 371-376 
    Details
    ISSN: 1432-1238
    Keywords: Key words Cerebral extraction of oxygen ; Cerebral perfusion pressure ; Head injury ; Intracranial pressure ; Outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: (1) To describe the pattern of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in a group of severe head-injured patients, (2) to quantify complications of ICP monitoring, and (3) to describe a management protocol and its results. Design: Prospective observational study. Setting: General intensive care unit in a teaching hospital. Patients: 138 comatose patients, selected according to the following criteria: age 〉 16 years, coma [Glasgow Coma Scale (GCS) K 8] with at least one pupil reactive after resuscitation, digital recording of intracranial and arterial pressure, and jugular saturation measurements. Measurements and results: Median GCS was 5, and 62 patients had significant extracranial injuries; 71 had intracranial hematomas, which were urgently evacuated. Mean ICP was 20.5 mm Hg (SD 8.34), mean CPP was 71.86 mm Hg (SD 11.22); cerebral extraction of oxygen averaged 29 %. Medical therapy was used to control ICP in 130 cases; 93 patients required hyperventilation. Vasopressors were infused in 16 cases; in 14 cases a barbiturate infusion was started. In 6 patients all pharmacological treatments failed and surgical decompression was done. The only complication of ICP monitoring was meningitis in 3 patients. Outcome at 6 months was a good recovery and moderate disability for 82 patients (59.4 %), severe disability and vegetative status for 37 (26.8 %), and 19 patients died (13.7 %). The severity of intracranial hypertension was related to poorer results at 6 months. Conclusions: Intracranial hypertension is very frequent in severe head injury but can be reasonably well controlled by combined surgical and medical therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050860
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Cyclic hormonal replacement therapy after the menopause: Transdermal versus oral treatment (1991)
    Springer
    European journal of clinical pharmacology 41 (1991), S. 555-559 
    Details
    ISSN: 1432-1041
    Keywords: menopause — oestradiol ; conjugated oestrogens ; transdermal delivery ; postmenopausal women ; medroxyprogesterone ; acetate ; plasma lipids ; adverse effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In an open, randomized, comparative, between-patient trial, 45 postmenopausal women were treated for 4 months with cyclical transdermal oestradiol 0.05 mg per day or oral conjugated equine oestrogens 0.625 mg per day, in both cases, plus, medroxyprogesterone acetate 10 mg per day on the last 8 days of each cycle. Similar relief from postmenopausal symptoms was obtained with both treatments. Post-treatment histological evaluation of the endometrium did not reveal neoplastic or hyperplastic change in any patient. Early follicular-phase plasma oestradiol levels were observed only after transdermal oestradiol. There was a significant reduction in serum total cholesterol and LDL cholesterol in both treatment groups, with no difference between treatments, whereas serum triglyceride levels were decreased only by transdermal oestradiol. Plasma calcium and phosphorus fell significantly and serum intact parathyroid hormone rose significantly, with no difference between the therapies. No significant changes were observed in clotting factors. Transdermal oestradiol appears to be an effective and safe hormonal replacement therapy, and this route of administration may be responsible for the more useful action of the drug on serum lipids and plasma oestradiol levels.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314984
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    Paper (German National Licenses)
    Fulltext
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