A 21-Gene Expression Assay in Breast Cancer

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1、CorrespondenceTheauthorsreply:Timingoftheinductionofshowthattheincreaseintheratesofdeathandtherapeutichypothermiaaftertraumaticbrainpooroutcomewasconsistentovertimeandwasinjurycanbeearly(<6hours)toprovideprophy-greatestamongthepatientswiththelowestlactic“neu

2、roprotection”orlatertoreduceintra-risksofdeathanddisabilityinthehypothermiacranialpressure.Earlyinductioniswelltestedingroup(seetheSupplementaryAppendix,avail-trialswithalowriskofbiasinvolvingadultsandablewiththefulltextofthearticleatNEJM.org)childrenwithasi

3、gnaltowardharmandisbeingbutwerenotprespecifiedinourstatisticalfurthertestedinPOLAR.Therapeutichypother-analysisplan.Baselinedatawereassessedformiaforthereductionofintracranialpressurehasdifferencesbetweengroups,andtherewerenonotbeenextensivelytestedbefore,1b

4、utourtrialsignificantdifferencesdetected,includinginthepresentsevidenceagainsttheintervention.Marshallclassificationandmasslesions.WeseenoplausibleexplanationwhywaitingItremainsunclearwhethertheEurotherm3235untilallothertherapieshavefailedtocontrolin-Trialre

5、sultswereduetoabiologiceffectofhy-tracranialpressurewouldresultinbenefitfrompothermiaortheeffectofanimbalancebetweentherapeutichypothermia,whenthepathophysiol-groupsinthevariousbutnecessarycointerven-ogyofbrainswellingissimilar.tions.Webelievethattherapeutic

6、hypothermiaThethresholdfortherapytoreduceintracra-shouldnotbeusedaftertraumaticbraininjury,nialpressureisbasedonlevelIIevidence,andexceptinclinicaltrials.20mmHgisthethresholdrecommendedbytheThresholdsforintracranial-pressureinterven-currentguidelines.2Therea

7、reevenfewerdatationaftertraumaticbraininjuryurgentlyrequiresupportingapermissivestrategyofanintracra-reconsideration.Otherwise,thefateoftheintra-nialpressureoflessthan25mmHgorlessthancranial-pressuremonitorwillemulatethede-30mmHg,evenwithmanagementofcerebral

8、miseofthepulmonary-arterycatheter.perfusionpressure.PeterJ.D.Andrews,M.D.,M.B.,Ch.B.Stage2treatmentsfailedtocontrolintracra-BridgetA.Harris,R.G.N.,Ph.D.nialpressureinmorethanhalftheparticipantsG