Background Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin inhibitor. Methods In this noninferiority trial, we randomly assigned 18,113 patients who had atrial fibrillation and a risk of stroke to receive, in a blinded fashion, fixed doses of dabigatran — 110 mg or 150 mg twice daily — or, in an unblinded fashion, adjusted-dose warfarin. The median duration of the follow-up period was 2.0 years. The primary outcome was stroke or systemic embolism. Results Rates of the primary outcome were 1.69% per year in the warfarin group, as compared with 1.53% per year in the group that received 110 mg of dabigatran (relative risk with dabigatran, 0.91; 95% confidence interval [CI], 0.74 to 1.11; P<0.001 for noninferiority) and 1.11% per year in the group that received 150 mg of dabigatran (relative risk, 0.66; 95% CI, 0.53 to 0.82; P<0.001 for superiority). The rate of major bleeding was 3.36% per year in the warfarin group, as compared with 2.71% per year in the group receiving 110 mg of dabigatran (P = 0.003) and 3.11% per year in the group receiving 150 mg of dabigatran (P = 0.31). The rate of hemorrhagic stroke was 0.38% per year in the warfarin group, as compared with 0.12% per year with 110 mg of dabigatran (P<0.001) and 0.10% per year with 150 mg of dabigatran (P<0.001). The mortality rate was 4.13% per year in the warfarin group, as compared with 3.75% per year with 110 mg of dabigatran (P = 0.13) and 3.64% per year with 150 mg of dabigatran (P = 0.051). Conclusions In patients with atrial fibrillation, dabigatran given at a dose of 110 mg was associated with rates of stroke and systemic embolism that were similar to those associated with warfarin, as well as lower rates of major hemorrhage. Dabigatran administered at a dose of 150 mg, as compared with warfarin, was associated with lower rates of stroke and systemic embolism but similar rates of major hemorrhage. (ClinicalTrials.gov number, NCT00262600.)

/pdf/dabigatran-versus-warfarin-in-patients-with-atrial-it337cdbto.pdf

Dabigatran versus warfarin in patients with atrial fibrillation

Sidney C. Smith, Jr, MD, FACC, FAHA, FESC, Chair; Alice K. Jacobs, MD, FACC, FAHA, Vice-Chair; Cynthia D. Adams, MSN, APRN-BC, FAHA; Jeffery L. Anderson, MD, FACC, FAHA; Elliott M. Antman, MD, FACC, FAHA[‡][1]; Jonathan L. Halperin, MD, FACC, FAHA; Sharon Ann Hunt, MD, FACC, FAHA; Rick Nishimura,

/pdf/acc-aha-esc-2006-guidelines-for-the-management-of-patients-5fc8py53ut.pdf

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society

https://genoplivning.dk/wp-content/uploads/2013/07/european-resuscitation-council-guidelines-for-resuscitation-2010-section-4-adult-advanced-life-support.pdf

European Resuscitation Council Guidelines for Resuscitation 2010 Section 4 Adult advanced life support

http://www.biblioteca.uma.es/bbldoc/articulos/16689835.pdf?origin=publication_detail

Antioxidant enzymes and human diseases

Cellular protection against the deleterious effects of reactive oxidants generated in aerobic metabolism, called oxidative stress, is organized at multiple levels. Defense strategies include three levels of protection; prevention, interception, and repair. Regulation of the antioxidant capacity includes the maintenance of adequate levels of antioxidant and the localization of antioxidant compounds and enzymes. Short-term and long-term adaptation and cell specialisation in these functions are new areas of interest. Control over the activity of prooxidant enzymes, such as NADPH oxidase and NO synthases, is crucial. Synthetic antioxidants mimic biological strategies.

https://febs.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1432-1033.1993.tb18025.x

Strategies of antioxidant defense

THE ECTOPIC TACHYCARDIAS are currently treated by either vagal stimulation or drugs. The 3 most effective drugs are quinidine, procainamide hydrochloride, and the digitalis glycosides. When the ectopic mechanism drives the ventricles at rates above 160 per minute, cardiac output falls and coronary blood flow is compromised. This is most likely to occur with ventricular tachycardia which constitutes a serious cardiac emergency requiring immediate treatment. Frequently, however, the arrhythmia cannot be terminated promptly. Reversion with drugs generally involves a time-consuming biologic titration. Since it is impossible in any one patient to predict either the effective or the toxic dose, small increments of antiarrhythmic drugs are given at frequent intervals until a therapeutic end point is reached. The interval between doses is determined by the gravity of the patient's illness as well as by the rapidity of action of the particular agent. It may thus take minutes, days, or even weeks

New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge.

Human Mn-superoxide dismutase in pulmonary epithelial cells of transgenic mice confers protection from oxygen injury.

In an attempt to associate oropharyngeal excretion of Epstein-Barr (EB) virus with lymphoproliferative disorders other than infectious mononucleosis, we tested throat gargles collected fro...

Oropharyngeal Excretion of Epstein-Barr Virus by Patients with Lymphoproliferative Disorders and by Recipients of Renal Homografts

Landmark article Nov 3, 1962: New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. By Bernard Lown, Raghavan Amarasingham, and Jose Neuman.

J. Neuman

Papers

New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge.

Human Mn-superoxide dismutase in pulmonary epithelial cells of transgenic mice confers protection from oxygen injury.

Oropharyngeal Excretion of Epstein-Barr Virus by Patients with Lymphoproliferative Disorders and by Recipients of Renal Homografts

Landmark article Nov 3, 1962: New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. By Bernard Lown, Raghavan Amarasingham, and Jose Neuman.

Diazoxide for the acute control of severe hypertension complicating pregnancy: a pilot study.