scholarly journals Amtolmetin: A Reappraisal of NSAID with Gastroprotection

Arthritis ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Amit Garg ◽  
Ahsan Shoeb ◽  
Latha Subramanya Moodahadu ◽  
Akhilesh Sharma ◽  
Arul Gandhi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
English Language ◽  
Literature Search ◽  
Lower Number ◽  
The Other ◽  
Duodenal Ulcers ◽  
Safety And Efficacy ◽  
Language Studies ◽  
Inflammatory Drugs ◽  
Baseline Characteristics

Aim. To assess the gastrosparing effect of amtolmetin guacyl (AMG) against other nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with osteo-/rheumatoid arthritis. Methods. A literature search was done in the electronic databases (PubMed, Google Scholar, Embase, and Scopus) with key words “amtolmetin guacyl”, “amtolmetin”, and “arthritis”; filters were applied to obtain publications between 01-Jan-1985 and 01-Oct-2015, which were “clinical trials” in osteo-/rheumatoid arthritis patients and in “English language.” Studies were assessed using the Jadad criteria and trials with score ≥ 3 were included in the analysis to compare the safety and efficacy of AMG against other NSAIDs. Results. Search yielded 19 publications of which 3 were included for analysis. Baseline characteristics of patients were comparable between the AMG group and other NSAIDs (diclofenac, celecoxib, and piroxicam) groups in all trials. Efficacy of AMG was similar to the other NSAIDs compared in the trials. The number of adverse events (AEs) reported was similar between both the groups; however, severe AEs reported were significantly lower in the AMG group. Of note was the significant lower number of duodenal ulcers after treatment in the AMG group. Conclusions. AMG has efficacy similar to other NSAIDs and a safer gastrointestinal AE profile when compared to the other NSAIDs.

scholarly journals Role of Nutrition and Exercise Programs in Reducing Blood Pressure: A Systematic Review

2019 ◽  
Vol 8 (9) ◽  
pp. 1393 ◽  
Author(s):  
Jurik ◽  
Stastny
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Arterial Pressure ◽  
English Language ◽  
Literature Search ◽  
The Other ◽  
Moderate Intensity ◽  
Pressure Reduction ◽  
Language Studies

The combined effect of diet and strength training (ST) on blood pressure (BP) seems to be very important for the treatment of prehypertension and hypertension (HT). Therefore, the aim of this study was to determine whether ST alone or combined with nutrition or supplementation has an impact on the arterial pressure reduction in normotensive and hypertensive populations. A systematic computerized literature search was performed according to the PRISMA guidelines using PubMed, Scopus and Google Scholar; only English language studies published from 1999 until 2018 were included. This systematic search identified the results of 303 individuals from nine studies. The ST program alone had a similar effectiveness as the nutrition program (NP) alone; however, their combination did not result in increased effectiveness in terms of a high BP reduction. The consumption of L-citrulline had a similar effect as ST on lowering BP; on the other hand, caffeine led to an increase in BP during the ST session. Our data suggest that a combination of ST 2–3 times a week at moderate intensity and a NP seems to be equally effective in terms of lowering BP (systolic and diastolic) as ST and NP alone.

Treatment Options for Rheumatoid Arthritis: Celecoxib, Leflunomide, Etanercept, and Infliximab

2000 ◽  
Vol 34 (6) ◽  
pp. 743-760 ◽  
Author(s):  
Brigitte T Luong ◽  
Barbara S Chong ◽  
Dionne M Lowder
Keyword(s):  
Rheumatoid Arthritis ◽  
English Language ◽  
Data Extraction ◽  
Treatment Options ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Antiinflammatory Drugs ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Pertinent Data

OBJECTIVE: To review new pharmacologic agents approved for use in the management of rheumatoid arthritis (RA). DATA SOURCES: A MEDLINE search (1966–January 2000) was conducted to identify English-language literature available on the pharmacotherapy of RA, focusing on celecoxib, leflunomide, etanercept, and infliximab. These articles, relevant abstracts, and data provided by the manufacturers were used to collect pertinent data. STUDY SELECTION: All controlled and uncontrolled trials were reviewed. DATA EXTRACTION: Agents were reviewed with regard to mechanism of action, efficacy, drug interactions, pharmacokinetics, dosing, precautions/contraindications, adverse effects, and cost. DATA SYNTHESIS: Traditional pharmacologic treatments for RA have been limited by toxicity, loss of efficacy, or both. Increasing discoveries into the mechanisms of inflammation in RA have led to the development of new agents in hopes of addressing these limitations. With the development of celecoxib, a selective cyclooxygenase-2 inhibitor, the potential exists to minimize the gastrotoxicity associated with nonsteroidal antiinflammatory drugs. Leflunomide has been shown to be equal to or less efficacious than methotrexate, and may be beneficial as a second-line disease-modifying antirheumatic drug (DMARD). The biologic response modifiers, etanercept and infliximab, are alternatives that have shown benefit alone or in combination with methotrexate. However, they should be reserved for patients who fail to respond to DMARD therapy. Further studies should be conducted to evaluate the long-term safety and efficacy of these agents as well as their role in combination therapy. CONCLUSIONS: Celecoxib, leflunomide, etanercept, and infliximab are the newest agents approved for RA. Clinical trials have shown that these agents are beneficial in the treatment of RA; however, long-term safety and efficacy data are lacking.

Safety and Efficacy of Oral Nonsteroidal Anti-Inflammatory Drugs in Patients with Rheumatoid Arthritis

2004 ◽  
Vol 24 (2) ◽  
pp. 89-101 ◽  
Author(s):  
Wen Shi ◽  
Yong Ming Wang ◽  
Li Shao Li ◽  
Min Yan ◽  
Duan Li ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Safety And Efficacy ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Maxillary Growth and Speech Outcome in Patient with Cleft Lip and Palate after Two-Stage Palate Repair: A Systematic Review

1970 ◽  
Vol 1 (4) ◽  
Author(s):  
Mulyadi Mulyadi ◽  
Prasetyanugraheni Kreshanti ◽  
Siti Handayani ◽  
Kristaninta Bangun
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Literature Search ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Protocol ◽  
Two Stage ◽  
Language Studies ◽  
Palate Repair ◽  
Maxillary Growth

Background: The management of patients with cleft lip and palate is complex, where the treatment outcome is judged on the balance between aesthetics, speech, and maxillary growth. Up to now, there is no generally accepted treatment protocol. Every center must find the best-suited protocol treatment for their population. Methods: A systematic review through literature search was conducted for English-language studies in PubMed. This search was conducted in September 2011 using EndNote X3 with keywords: Two-stage Palate Repair and Maxillary Growth and Two-stage Palate Repair and Speech Outcome. Both retrospective and prospective studies on maxillary growth and speech outcome in patient with cleft lip and palate after two-stage palate repair published from 2001 to 2012 were included. Result: From the reviewed of 37 articles, only 14 articles fit the inclusions criteria, three articles discussed the outcome of maxillary growth and speech outcome, eight articles only discussed the maxillary growth and the rest of articles only discussed the speech outcome. Conclusion:From this review we found that most of the two-stage palate repair results in better maxillary growth, but only few of them results in good speech outcome. We will perform further study based on this review to discover a new protocol for the management of palate repair in our center.

scholarly journals Certolizumab pegol (CIMZIA®) for the treatment of rheumatoid arthritis

2010 ◽  
Vol 14 (Suppl 2) ◽  
pp. 1-10
Author(s):  
M Connock ◽  
S Tubeuf ◽  
K Malottki ◽  
A Uthman ◽  
J Round ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Treatment Option ◽  
English Language ◽  
Certolizumab Pegol ◽  
Clinical Effectiveness ◽  
Quality Of Life Measures ◽  
Language Studies

This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of certolizumab pegol (CZP) for adults with active rheumatoid arthritis (RA) that have not responded adequately to treatment with conventional disease modifying anti-rheumatic drugs (DMARDs) including methotrexate (MTX), in accordance with the licensed indication, based upon the evidence submission from the manufacturer to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal (STA) process. The outcome measures included American College of Rheumatology (ACR) 20, 50 and 70 response rates and quality of life measures after 3 months and 6 months of treatment. The ERG examined the submission’s search strategies and considered they appeared comprehensive and that it was unlikely that relevant studies would have been missed. Only English language studies were considered in the submission and non-English language studies relevant to the decision problem may possibly have been ignored. The ERG analysed the first submitted economic model so as to itemise in detail clarification points that were brought to the attention of the manufacturer. In response the manufacturer submitted a modified cost-effectiveness analysis. The ERG undertook further analysis of this second model and other additional submitted evidence. The clinical evidence was derived from two multicentre blinded randomised controlled trials (RCTs) comparing CZP + MTX to placebo + MTX (the RAPID 1 and RAPID 2 trials). RAPID 1 lasted 52 weeks with 982 patients and RAPID 2 24 weeks with 619 patients. Evidence for clinical effectiveness of CZP in mono-therapy came from the 24-week FAST4WARD trial with 220 patients that compared CZP (400 mg every 4 weeks) versus placebo. The three key RCTs demonstrated statistically significant superiority of CZP + MTX versus placebo + MTX and of CZP versus placebo with respect to a variety of outcomes including ACR 20, ACR 50 and ACR 70 measures and quality of life measures at 3 and 6 months. On the basis of results from the indirect comparison meta-analyses, the manufacturer suggested that CZP may be at least as effective as other ‘biological’ DMARD (bDMARD) comparators and, in a few ACR measures at 3 and 6 months, more effective. CZP is an effective therapy for adult RA patients whose disease has failed to respond adequately to cDMARDs including MTX or who are intolerant of MTX. The cost-effectiveness of CZP relative to other bDMARDs is unclear because the economic modelling undertaken may have ignored relevant effectiveness data and potential differences between trial populations, and so may have included effectiveness results that were biased in favour of CZP; underestimated uncertainty in the relative effectiveness of compared DMARDs; and ignored the potential influence of differences between bDMARDs with regard to adverse events and their related costs and health impacts. The NICE guidance issued in October 2009 states that: the Committee is minded not to recommend certolizumab pegol as a treatment option for people with RA; and the Committee recommends that NICE asks the manufacturer of CZP for more information on the clinical effectiveness and cost-effectiveness of CZP for the treatment of people with RA. On receipt of this information and details of a patient access scheme NICE issued final guidance recommending CZP, under certain criteria, as a treatment option for people with RA.

Nurse-led Care for Patients with Rheumatoid Arthritis: A Systematic Review of the Effect on Quality of Care

2017 ◽  
Vol 44 (6) ◽  
pp. 757-765 ◽  
Author(s):  
Stephanie Garner ◽  
Elena Lopatina ◽  
James A. Rankin ◽  
Deborah A. Marshall
Keyword(s):  
Rheumatoid Arthritis ◽  
Quality Of Care ◽  
Nurse Practitioners ◽  
Narrative Analysis ◽  
English Language ◽  
Safety Data ◽  
Current Evidence ◽  
Clinical Nurse Specialists ◽  
Language Studies

Objective.In the nurse-led care (NLC) model, nurses take on the primary responsibility for patient management. We systematically assessed the effect of NLC for patients with rheumatoid arthritis (RA) on multiple dimensions of quality of care from the Alberta Quality of Care Matrix for Health.Methods.We searched MEDLINE, EMBASE, and CINAHL from 1950 to January 2015. English-language studies were included if they reported on NLC for patients with RA and assessed 1 or more dimensions of quality (effectiveness, acceptability, efficiency, accessibility, appropriateness, and safety). Data were synthesized using narrative analysis.Results.We included 10 studies. The NLC models varied in terms of nurses’ professional designation (clinical nurse specialists or nurse practitioners); however, their role in the clinic was fairly consistent. Disease activity was the most common measure of effectiveness, with NLC being equal (n = 2) or superior (n = 3) to the comparator. NLC was equal (n = 1) or superior (n = 5) versus the comparator in terms of patient satisfaction (i.e., acceptability of care). NLC was equally safe as other models (n = 2). Regarding efficiency, results varied across studies (n = 6) and did not allow for conclusions about models’ cost-effectiveness. In qualitative studies, patients found NLC to be superior in terms of accessibility [i.e., continuity of care (n = 3) and appropriateness measured with education and support (n = 4)]; however, no quantitative measures were found.Conclusion.NLC for patients with RA is effective, acceptable, and safe as compared with other models. However, current evidence is insufficient to draw conclusions about its efficiency, accessibility, and appropriateness.

scholarly journals Chinese traditional medicine (GuiZhi-ShaoYao-ZhiMu decoction) as an add-on medication to methotrexate for rheumatoid arthritis: a meta-analysis of randomized clinical trials

2021 ◽  
Vol 12 ◽  
pp. 204062232199343
Author(s):  
Chenxi Feng ◽  
Rongrong Chen ◽  
Keer Wang ◽  
Chengping Wen ◽  
Zhenghao Xu
Keyword(s):  
Rheumatoid Arthritis ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Effective Rate ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Tender Joint ◽  
American College Of Rheumatology ◽  
Language Studies

Background: GuiZhi-ShaoYao-ZhiMu decoction (GSZD), a traditional Chinese herbal medication, has been frequently used as an add-on medication to methotrexate (MTX) for rheumatoid arthritis (RA) treatment in China. This meta-analysis evaluated the efficacy and safety of adding GSZD to MTX for RA treatment. Methods: We performed a systematic search of PubMed, Web of Science, EMBASE, and the Cochrane Library (all databases) for English-language studies and WanFang, VIP, and CNKI for Chinese-language studies up to 28 July 2020. Data from selected studies, mainly the response rates and rate of adverse events (AEs), were extracted independently by two authors, and a random-effects model (Mantel–Haenszel method) was used for the meta-analysis. Results: A total of 14 randomized controlled trials and 1224 patients were included (623 patients in the GSZD + MTX group and 601 patients in the MTX group). For efficacy, the meta-analysis found that combining GSZD with MTX increased the effective rate [relative risk (RR) = 1.24, 95% confidence interval (CI): 1.18–1.30, based on 1069 patients], defined as >30% efficacy, American College of Rheumatology 20, or a decrease of disease activity score 28 >0.6. Adding GSZD reduced the swollen and tender joint counts, the duration of morning stiffness, the levels of C-reactive protein and rheumatoid factor, and erythrocyte sedimentation rate. The adjuvant therapeutic effect of GSZD was independent of the dose of MTX or the combined utilization of other drugs in both groups. For safety, adding GSZD was associated with a lower rate of total AEs (RR = 0.46, 95% CI: 0.26–0.83, based on 615 patients) and gastrointestinal tract AEs (RR = 0.46, 95% CI: 0.24–0.88, based on 537 patients). Conclusion: Combining GSZD with MTX may be a more efficacious and safer strategy for treating RA compared with MTX alone. Further large studies are warranted to investigate the long-term efficacy and safety of adding GSZD to MTX for RA treatment.

scholarly journals Systematic review of prehospital haemostatic dressings

2019 ◽  
Vol 166 (3) ◽  
pp. 194-200 ◽  
Author(s):  
Matthew Welch ◽  
J Barratt ◽  
A Peters ◽  
C Wright
Keyword(s):  
Systematic Review ◽  
Animal Studies ◽  
English Language ◽  
Literature Search ◽  
Clinical Evidence ◽  
Grey Literature ◽  
High Quality ◽  
Exclusion Criteria ◽  
Military Forces ◽  
Language Studies

IntroductionHaemorrhage is one of the leading causes of battlefield and prehospital death. Haemostatic dressings are an effective method of limiting the extent of bleeding and are used by military forces extensively. A systematic review was conducted with the aim of collating the evidence on current haemostatic products and to assess whether one product was more effective than others.MethodsA systematic search and assessment of the literature was conducted using 13 health research databases including MEDLINE and CINAHL, and a grey literature search. Two assessors independently screened the studies for eligibility and quality. English language studies using current-generation haemostatic dressings were included. Surgical studies, studies that did not include survival, initial haemostasis or rebleeding and those investigating products without prehospital potential were excluded.Results232 studies were initially found and, after applying exclusion criteria, 42 were included in the review. These studies included 31 animal studies and 11 clinical studies. The outcomes assessed were subject survival, initial haemostasis and rebleeding. A number of products were shown to be effective in stopping haemorrhage, with Celox, QuikClot Combat Gauze and HemCon being the most commonly used, and with no demonstrable difference in effectiveness.ConclusionsThere was a lack of high-quality clinical evidence with the majority of studies being conducted using a swine haemorrhage model. Iterations of three haemostatic dressings, Celox, HemCon and QuikClot, dominated the studies, probably because of their use by international military forces and all were shown to be effective in the arrest of haemorrhage.

Working With Interpreters to Support Students Who Are English Language Learners

2016 ◽  
Vol 1 (16) ◽  
pp. 15-27 ◽  
Author(s):  
Henriette W. Langdon ◽  
Terry Irvine Saenz
Keyword(s):  
United States ◽  
English Language Learners ◽  
Language Learners ◽  
English Language ◽  
First Language ◽  
The United States ◽  
The Other ◽  
Primary Language ◽  
Second Best ◽  
Support Students

The number of English Language Learners (ELL) is increasing in all regions of the United States. Although the majority (71%) speak Spanish as their first language, the other 29% may speak one of as many as 100 or more different languages. In spite of an increasing number of speech-language pathologists (SLPs) who can provide bilingual services, the likelihood of a match between a given student's primary language and an SLP's is rather minimal. The second best option is to work with a trained language interpreter in the student's language. However, very frequently, this interpreter may be bilingual but not trained to do the job.

Sign in / Sign up

Export Citation Format

Share Document