scholarly journals Therapy of Mucormycosis

2018 ◽  
Vol 4 (3) ◽  
pp. 90 ◽  
Author(s):  
Nikolaos V. Sipsas ◽  
Maria N. Gamaletsou ◽  
Amalia Anastasopoulou ◽  
Dimitrios P. Kontoyiannis
Keyword(s):  
Clinical Trials ◽  
Amphotericin B ◽  
Opportunistic Infection ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Management Plan ◽  
Current Status ◽  
Pharmacological Properties ◽  
Different Types ◽  
Individualized Management

Despite the recent introduction of mold-active agents (posaconazole and isavuconazole), in addition to amphotericin B products, to our armamentarium against mucormycosis, many uncertainties remain for the management of this uncommon opportunistic infection, as there are no data from prospective randomized clinical trials to guide therapy. In this mini-review, we present the current status of treatment options. In view of the heterogeneity of the disease (different types of affected hosts, sites of infection, and infecting Mucorales), mucormycosis management requires an individualized management plan that takes into account the net state of immunosuppression of the host, including comorbidities, certainty of diagnosis, site of infection, and antifungal pharmacological properties.

scholarly journals Efficacy and safety of maxillary sinus lifting with various types of grafting with implants insertion purposes: A review of the literature

2020 ◽  
pp. 31-45
Author(s):  
João de Paula Martins Júnior ◽  
Álvaro Nagib Atallah
Keyword(s):  
Clinical Trials ◽  
Maxillary Sinus ◽  
Bone Grafting ◽  
Randomized Clinical Trials ◽  
Bone Volume ◽  
Local Inflammatory Response ◽  
Average Percentage ◽  
Significant Difference ◽  
Different Types ◽  
Sinus Lifting

Context: Edentulous patients under the use of removable prosthesis face important restrictions, including sociocultural ones and, for this reason, the insertion of implants has become frequent in clinical dental practice. However, the success of the method will depend on the sort of different types of bone grafting, quality of donor area and the residual amount of bone left in insertion site. Purpose: the purpose of this study was to evaluate the effectiveness and safety of different types of bone grafts used in maxillary sinus lifting surgeries for implant insertion. Methods: systematic review of randomized clinical trials or quasi-randomized. We used the guidelines of the manual of systematic reviews from Cochrane Collaboration and a sensitive search strategy in three electronic databases has been built. Results: We included six randomized clinical trials from different regions of the world with 135 participants. Bone volume was 3% higher on the grafted site with autogenic bone pure, but not a statistically significant difference DM: 3 (-8.48-14.48), the average percentage between the vital and non-vital bone showed up 0.82% higher on the grafted site with FDBA + PRP. The average percentage of vital tissue was also 15.8% higher on the side where PRP was used. Conclusion: the available evidence is insufficient to recommend a specific type of bone grafting in sinus augmentation (lift) procedures to place a dental implant. There was no statistically significant difference for bone volume, sensory loss, local inflammatory response and loss of implants, among others. For this reason, new randomized controlled trials that evaluate the effectiveness and safety of different types of bone graft for lifting of the maxillary sinus are necessary. Key-words: Maxillary sinus. Grafting, survey, technique, materials.

scholarly journals Current approaches to the management of diabetic retinopathy

2014 ◽  
Vol 17 (3) ◽  
pp. 122-128 ◽  
Author(s):  
Tatiana Yul'evna Demidova ◽  
Yulia Alexandrovna Trakhtenberg
Keyword(s):  
Risk Factors ◽  
Clinical Trials ◽  
Diabetic Retinopathy ◽  
Mechanism Of Action ◽  
Treatment Options ◽  
Current Status ◽  
Antiangiogenic Agents

This review reflects the current status of the diabetic retinopathy treatment problem and describes the results of the largest trials on epidemiology, screening and the risk factors for complications. In addition, this article describes the current approaches and treatment options for diabetic retinopathy, including a description of fenofibroic acid with its mechanism of action and data from clinical trials. This article also contains information on antiangiogenic agents for intravitreal administration.

FOCUS

2019 ◽  
pp. 130-148
Author(s):  
Laurel Northouse ◽  
Clayton Shuman ◽  
Moira Visovatti ◽  
Bonnie Dockham ◽  
Marita Titler
Keyword(s):  
Clinical Trials ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Randomized Clinical Trials ◽  
Positive Outcomes ◽  
Web Based ◽  
Cancer Support ◽  
Different Types

This chapter describes the development and testing of the FOCUS program with patient-caregiver dyads (i.e., pairs) as the unit of care. The chapter reviews studies that examined (1) the efficacy of the FOCUS program when tested in randomized clinical trials, (2) the effectiveness of the program when implemented in Cancer Support Community affiliates in three states, and (3) outcomes when translated to a tailored, web-based program. Results indicate that FOCUS consistently produced positive outcomes for cancer patients and their caregivers in these studies. The program also improved patient and caregiver outcomes when delivered to patients with different types and stages of cancer, to spousal and nonspousal family caregivers, and in various intervention doses (three-, five-, and six-session programs). The chapter concludes with plans for further implementation of FOCUS and existing dissemination activities.

scholarly journals Case Commentary: the Need for Cefiderocol Is Clear, but Are the Supporting Clinical Data?

2020 ◽  
Vol 64 (4) ◽  
Author(s):  
Ryan K. Shields
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Salvage Therapy ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Gram Negative Bacteria ◽  
Potential Utility ◽  
Gram Negative

ABSTRACT Cefiderocol is a newly approved siderophore cephalosporin that demonstrates expanded in vitro activity against multidrug-resistant Gram-negative bacteria. In two challenging cases reported here, cefiderocol shows potential utility as salvage therapy against difficult-to-treat pathogens with limited or no treatment options; however, two multicenter, randomized clinical trials have yielded mixed results among cefiderocol-treated patients. Taken together, clinicians must balance a clear need for cefiderocol in clinical practice with the uncertainties that have stemmed from the available data.

scholarly journals Systemic treatment options for advanced biliary tract carcinoma

2020 ◽  
Vol 55 (10) ◽  
pp. 944-957
Author(s):  
Changqing Xie ◽  
Nicole A. McGrath ◽  
Cecilia Monge Bonilla ◽  
Jianyang Fu
Keyword(s):  
Clinical Trials ◽  
Targeted Therapy ◽  
Biliary Tract ◽  
Treatment Options ◽  
Single Agent ◽  
Current Status ◽  
Dna Mismatch ◽  
First Line Therapy ◽  
Molecular Landscape ◽  
Line Setting

Abstract Advanced biliary tract cancers (BTC) include a diverse collection of rare and heterogenous tumors with poor prognosis. The combination of gemcitabine and cisplatin is the established first-line therapy for advanced BTC. There are no accepted standard treatments in the second line setting, though there are several ongoing clinical trials that implement chemotherapy as a therapeutic strategy. The understanding of the molecular landscape of BTC has offered hope of targeted therapies to the identified actionable genomic aberrations, such as FGFR2 gene fusions, mutations of IDH1/2, HER2, BRAC1/2 and BRAF. Pembigatinib has become the first approved targeted therapy for BTC with FGFR2 fusion or other rearrangements. Recent immunotherapy has opened new therapy avenues in BTC with pembrolizumab approved for either microsatellite instability high (MSI-H) or DNA mismatch repair deficient (dMMR) advanced solid tumors, including BTC. The combination of immunotherapy with other modalities is currently being evaluated in different clinical trials, since single agent immunotherapy appears to provide modest benefits in advanced BTC. In this review, we summarize the current status of treatment options, including systemic chemotherapy, targeted therapy, immunotherapy, and various combinations in advanced BTC.

Comparative effects of different types of tree nut consumption on blood lipids: a network meta-analysis of clinical trials

2019 ◽  
Vol 111 (1) ◽  
pp. 219-227
Author(s):  
Kai Liu ◽  
Suocheng Hui ◽  
Bin Wang ◽  
Kanakaraju Kaliannan ◽  
Xiaozhong Guo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Blood Lipids ◽  
Randomized Clinical Trials ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Control Diet ◽  
Sensitivity Analyses ◽  
Second Best ◽  
Different Types

ABSTRACT Background Recent evidence has confirmed that nuts are one of the best food groups at reducing LDL cholesterol and total cholesterol (TC). However, the comparative effects of different types of nuts on blood lipids are unclear. Objectives This network meta-analysis of randomized clinical trials aimed to assess the comparative effects of walnuts, pistachios, hazelnuts, cashews, and almonds on typical lipid profiles. Methods We conducted literature searches to identify studies comparing ≥2 of the following diets—walnut-enriched, pistachio-enriched, hazelnut-enriched, cashew-enriched, almond-enriched, and control diets—for the management of triglycerides (TGs), LDL cholesterol, TC, and HDL cholesterol. Random-effects network meta-analyses, ranking analyses based on the surface under the cumulative ranking (SUCRA) curves, and sensitivity analyses according to the potential sources of heterogeneity across the included studies were performed for each outcome. Results Thirty-four trials enrolling 1677 participants were included in this study. The pistachio-enriched diet was ranked best for TG (SUCRA: 85%), LDL cholesterol (SUCRA: 87%), and TC (SUCRA: 96%) reductions. For TG and TC reductions, the walnut-enriched diet was ranked as the second-best diet. Regarding LDL cholesterol reduction, the almond-enriched diet was ranked second best. The pistachio-enriched and walnut-enriched diets were more effective at lowering TG, LDL cholesterol, and TC compared with the control diet. Regarding TG and TC reductions, the pistachio-enriched diet was also more effective than the hazelnut-enriched diet. For TG reduction, the walnut-enriched diet was better than the hazelnut-enriched diet. However, these findings are limited by the low quality of evidence ratings. In addition, the quality of this network meta-analysis was limited by the small number and generally poor reporting of available studies. Conclusions The pistachio-enriched and walnut-enriched diet could be better alternatives for lowering TGs, LDL cholesterol, and TC compared with other nut-enriched diets included in this study. The findings warrant further evaluation by more high-quality studies. This network meta-analysis was registered at www.crd.york.ac.uk/PROSPERO as CRD42019131128.

Measuring clinical practice: science and methods

2013 ◽  
Vol 34 (1) ◽  
pp. E3 ◽  
Author(s):  
Peter D. Angevine ◽  
Paul C. McCormick
Keyword(s):  
Clinical Trials ◽  
Clinical Data ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Routine Practice ◽  
Clinical Settings ◽  
Clinical Registries ◽  
Basic Understanding

The routine practice of neurosurgery generates a large amount of clinical data. The structured, systematic capture of this information using clinical registries or other rigorously designed observational studies can yield useful evidence to help improve the care of patients. Registries in particular can be designed to measure outcomes in real-world clinical settings and to study differences in outcomes between subgroups. This information can help clinicians to advise patients regarding their treatment options. To provide valid, generalizable evidence, however, registries and other observational studies must be designed and conducted with a rigor similar to that of randomized clinical trials. Neurosurgeons with a basic understanding of the potential advantages and pitfalls of nonrandomized trials and the methods of statistical analysis will be able to assess the quality of clinical data and to incorporate the findings appropriately into their patients' care.

scholarly journals Professional Vital Bleaching Using a Thin and Concentrated Peroxide Gel on Whitening Strips: An Integrated Clinical Summary

2004 ◽  
Vol 5 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Robert W. Gerlach ◽  
Matthew L. Barker
Keyword(s):  
Hydrogen Peroxide ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
New Paradigm ◽  
Tooth Color ◽  
Number Of Treatment ◽  
Advanced System ◽  
Better Than ◽  
Positive Controls

Abstract Rapid innovation in vital bleaching continues to expand the number of treatment options available to patients, particularly in the area of at-home whitening. The development of bleaching strips represented a new paradigm in the delivery of peroxide. The efficacy and safety of bleaching strip systems delivering up to 6.5% hydrogen peroxide has been established in numerous randomized clinical trials. In 2003, a novel bleaching strip with 14% hydrogen peroxide (Crest® Whitestrips® Supreme) was introduced. This advanced system carries a thinner but more concentrated gel on each strip, resulting in a relatively similar total amount of peroxide as compared to other strip systems. This 2-variable change, higher concentration gel with lowered gel volume translates to improved whitening without adversely affecting oral soft tissue tolerability and irritation. This paper provides an integrated review of 9 comparative clinical trials evaluating the whitening response (six trials) and safety (nine trials) of this novel vital bleaching system. Efficacy results for the 14% hydrogen peroxide strips were significantly (p<0.05) better than the placebo or pooled positive controls evaluated in the clinical trials assessing tooth color or shade. Adverse events were similar in type to the other vital bleaching systems. Overall, the research of 408 patients showed generally better efficacy and similar to or better tolerability for the 14% hydrogen peroxide strips compared to a selected group of marketed positive bleaching controls. Citation Gerlach RW, Barker ML. Professional Vital Bleaching Using a Thin and Concentrated Peroxide Gel on Whitening Strips: An Integrated Clinical Summary. J Contemp Dent Pract 2004 February;(5)1:001-017.

scholarly journals An overview of treatment options for COVID-19

2020 ◽  
Vol 9 (11) ◽  
pp. 1770
Author(s):  
Madhusmita Mohanty Mohapatra ◽  
Manju Rajaram ◽  
Dharm Prakash Dwivedi ◽  
Vishnukant Govindraj ◽  
Pratap Upadhya
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Unknown Origin ◽  
The Novel ◽  
Clinical Trial Registry ◽  
Repurposed Drugs ◽  
Novel Coronavirus ◽  
Meta Analyses ◽  
Effective Drugs

Severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) which emerged in Wuhan initially as pneumonia of unknown origin in December 2019, later spread to whole world and became pandemic on 11th March, 2020. Many drugs have been proposed but are backed without clinical evidence. Scientific bodies are in the row to discover a reliable vaccine and effective drugs against the novel coronavirus. Many antiviral and anti-parasitic drugs which were thought to have some effect on Coronavirus disease 2019 (COVID-19) have been tried during the crisis but none have shown concrete evidence of action. Randomized clinical trials on the repurposed drugs are now registered under clinical trial registry to look at the safety profile and efficacy of the drugs to be used against SARS-CoV-2. Many meta-analyses are being conducted worldwide to frame evidence for the fight against this novel coronavirus. We are providing below a review of various drugs that have been tried for treatment of COVID-19 as well as different clinical trials which are underway.

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