Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Mar 2004
Review[Should patients with severe sepsis be treated with activated protein C?].
Xigris (recombinant human activated protein C) has recently been introduced as a treatment for severe sepsis following a large multicentre trial (the PROWESS trial). ⋯ Although activated protein C may have beneficial effects in some patients with severe sepsis, the effect on different subgroups of patients remains to be clarified. We conclude that there is at present insufficient documentation for a recommendation of activated protein C in patients with severe sepsis.
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Tidsskr. Nor. Laegeforen. · Mar 2004
Review[Angioplasty or fibrinolytic therapy in acute myocardial infarction with ST elevation?].
Early and complete opening of the thrombotic occluded coronary artery is the best treatment of acute myocardial infarction with ST-segment elevation in ECG. Mechanical reperfusion with coronary angioplasty and pharmacological opening with fibrinolytic drugs are alternative therapies. Primary coronary angioplasty is the best therapy in hospitals with the necessary facilities, giving lower mortality, less reinfarction and stroke. ⋯ The patient should be given analgesics and acetylsalicylic acid before transport to hospital. The value of prehospital fibrinolytic therapy and the use of glucoprotein IIb/IIIa receptor inhibitors before transport are disputed. After failed fibrinolytic treatment, rescue angioplasty can be done with good outcomes.