No abstract

No abstract

To study the safety and efficacy of the thrombolytic agent saruplase as a bolus, the angiographic and clinical outcomes of three bolus regimens were investigated in a pilot study conducted in 192 patients with an acute myocardial infarction and were compared with the standard regimen. Fifty-two patients received a double bolus of 40 mg and 40 mg after 30 minutes, 51 patients a bolus of 80 mg, and 36 patients a bolus of 60 mg. Fifty-three patients received the standard regimen (a bolus of 20 mg and 60 mg IV infusion over 1 hour). At 60 minutes TIMI 2 and 3 flow were, respectively, 9.6% and 61.5% with the 40/40-mg bolus, 15.7% and 51.0% with the 80-mg bolus, 16.7% and 30.6% with the 60-mg bolus, and 7.5% and 54.7% with the standard 20/60-mg infusion. At 90 minutes TIMI 2 and 3 flow improved to 9.6% and 73.1%, 15.7% and 56.9%, 13.9% and 36.1%, and 5.7% and 71.7%, respectively. The primary endpoint, persistent patency (TIMI 2 + 3) at 24-45 hours, was seen in 69.2%, 64.7%, 44.4%, and 67.9% of patients who had no rescue PTCA, respectively. Inclusion in the 60-mg bolus group was prematurely stopped because of their low patency rates. The 40/40-mg bolus group had the highest mortality rate (13.5%), whereas the 60-mg bolus group had no deaths. Other adverse event rates were similar in the four groups. This clinical outcome is highly influenced by rescue PTCA of patients with insufficient TIMI flow. This pilot study indicates that in patients with an acute myocardial infarction, a double bolus of 40/40 mg resulted in the highest patency but also had the highest complication rate. The 80-mg single bolus is an attractive alternative for further evaluation because of its acceptable patency and event profile, and its easy form of administration.

ZusammenfassungRückenschmerzen gehören zu den häufigsten Beschwerden in der deutschen Bevölkerung und stellen ein großes gesundheitliches wie gesundheitsökonomisches Problem dar. Die in der Rehabilitation von chronischen Rückenschmerzen erzielten Erfolge können nur nachhaltig gesichert werden, wenn die körperlich-sportlichen Aktivitäten im Alltag der Patienten regelmäßig und dauerhaft weitergeführt werden. Deshalb wurde das multimediale Trainingsprogramm „DigiTrain“ entwickelt. Das Programm soll durch einen interaktiven Trainer (Avatar) die weitergehende individuelle Betreuung und Begleitung (Coaching) des Patienten über den stationären Aufenthalt hinaus sicherstellen.In dem Beitrag werden die Zielgruppe sowie die Inhalte und die Struktur des Programms „DigiTrain“ dargestellt. Ebenso wird ein Einblick in die technische Umsetzung und Produktion des Programms gegeben, bevor abschließend das Studiendesign für die wissenschaftliche Evaluation von DigiTrain vorgestellt wird.

No abstract