Results of the major randomized clinical trials of renal stenting and implications for future treatment strategies

2013 ◽  
Vol 26 (4) ◽  
pp. 161-164
Author(s):  
Matthew A. Corriere ◽  
Matthew S. Edwards
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Treatment Strategies ◽  
Future Treatment

scholarly journals The Prospects of tumor necrosis factor α inhibitors use in patients with COVID-19

2021 ◽  
Vol 15 (2) ◽  
pp. 89-93
Author(s):  
E. S. Aronova ◽  
B. S. Belov
Keyword(s):  
Clinical Trials ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Randomized Clinical Trials ◽  
Treatment Strategies ◽  
Current Data ◽  
Tnf Α ◽  
Factor Α ◽  
Necrosis Factor

The review highlights the problem of finding new effective treatment strategies for COVID-19. Tumor necrosis factor α (TNF-α) is considered as a therapeutic target. The theoretical basis for the successful use of TNF-α inhibitors (ITNFα) for the treatment of COVID-19 is presented, as well as data on existing practical developments, including ongoing clinical trials. Two drugs from the group of ITNFα – infliximab and adalimumab – are currently being considered as possible options. The safety issues of ITNFα treatment in patients with immunophaling rheumatic diseases and COVID-19 are discussed. The review also provides current data on vaccination against COVID-19, in particular on the vaccines currently available in Russia, which are at different stages of clinical trials. We conclude that randomized clinical trials of the effectiveness and safety of ITNF-α in patients with the new coronavirus infection are needed. Such trials will promote transition from theoretical speculations to real clinical practice.

scholarly journals ENSAT registry-based randomized clinical trials for adrenocortical carcinoma

2021 ◽  
Vol 184 (2) ◽  
pp. R51-R59
Author(s):  
Joakim Crona ◽  
Eric Baudin ◽  
Massimo Terzolo ◽  
Alexandra Chrisoulidou ◽  
Anna Angelousi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Adrenocortical Carcinoma ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Legal Aspects ◽  
Orphan Disease ◽  
Novel Approach ◽  
Ethical Approval ◽  
Significant Cost Reduction

Adrenocortical carcinoma (ACC) is an orphan disease lacking effective systemic treatment options. The low incidence of the disease and high cost of clinical trials are major obstacles in the search for improved treatment strategies. As a novel approach, registry-based clinical trials have been introduced in clinical research, so allowing for significant cost reduction, but without compromising scientific benefit. Herein, we describe how the European Network for the Study of Adrenal Tumours (ENSAT) could transform its current registry into one fit for a clinical trial infrastructure. The rationale to perform randomized registry-based trials in ACC is outlined including an analysis of relevant limitations and challenges. We summarize a survey on this concept among ENSAT members who expressed a strong interest in the concept and rated its scientific potential as high. Legal aspects, including ethical approval of registry-based randomization were identified as potential obstacles. Finally, we describe three potential randomized registry-based clinical trials in an adjuvant setting and for advanced disease with a high potential to be executed within the framework of an advanced ENSAT registry. Thus we, therefore, provide the basis for future registry-based trials for ACC patients. This could ultimately provide proof-of-principle of how to perform more effective randomized trials for an orphan disease.

scholarly journals Early Orthodontic Treatments of Unilateral Posterior Crossbite: A Systematic Review

2020 ◽  
Vol 10 (1) ◽  
pp. 33
Author(s):  
Francesco Caroccia ◽  
Francesco Moscagiuri ◽  
Luigi Falconio ◽  
Felice Festa ◽  
Michele D’Attilio
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Treatment Strategies ◽  
Mixed Dentition ◽  
Control Group ◽  
Maxillary Expansion ◽  
Posterior Crossbite ◽  
Quad Helix

We aimed to report an update of the systematic review by Petrén et al. (2003). The objective was to evaluate how orthodontic treatments can affect unilateral posterior crossbite (UPXB) in primary and early mixed dentition. Several databases were consulted, and articles published between January 2002 and March 2020 were selected. This review examines the following studies: randomized clinical trials, prospective and retrospective studies with concurrent untreated or normal control groups, and clinical trials comparing at least two treatment strategies. Among the 1581 articles retrieved from the searches, 11 studies were included. Quad-helix (QH) and expansion plate (EP) appliances were compared in three studies. One study compared rapid maxillary expansion (RME) treatment anchored on primary dentition otherwise on permanent molars. One study compared RME and a modified RME with arms extended until deciduous canine and EP. Four studies evaluated the effects of expansion appliances compared with a control group. Compared with the previous review, the quality of the included studies is higher. However, heterogeneity of treatments, different strategies in measurements, lack of a similar follow-up length, and absence of a cost-effectiveness analysis preclude the possibility of providing reliable scientific evidence on the most effective UPXB treatment in primary and early mixed dentition.

scholarly journals Treating COVID-19 with Anticoagulation based on Kabir Bleeding Risk Score

2021 ◽  
Author(s):  
Azad A Kabir
Keyword(s):  
Clinical Trials ◽  
Risk Score ◽  
Randomized Clinical Trials ◽  
Treatment Strategies ◽  
Bleeding Risk ◽  
Organ Support ◽  
Critical Stage ◽  
Respiratory Organ ◽  
Probability Of Survival ◽  
Therapeutic Anticoagulation

Three large randomized clinical trials named the ATTACC, ACTIV-4a, and REMAP-CAP were terminated early as these trials showed use of therapeutic anticoagulation among non-critical COVID-19 patients increased the probability of survival to hospital discharge as well as reduced the need for cardiovascular or respiratory organ support. These clinical trials also showed when a COVID-19 patient presents with a critical stage, therapeutic anticoagulation does not provide any benefit. The authors also had approx. two thousand five hundred COVID-19 encounters and found that anticoagulation doses can be titrated up or down based on D-Dimer trends and many patients do not need therapeutic anticoagulation, rather an intermediate dose (Lovenox 0.5mg/kg subQ BID or equivalent) anticoagulation can be sufficient for those who have a higher risk of bleeding. The author developed the Kabir bleeding risk score-based treatment strategies for COVID-19 patients which can be visited by clicking on the following link: .

scholarly journals Treating COVID-19 with Anticoagulation Based on Kabir Bleeding Risk Score

2021 ◽  
Author(s):  
Azad A Kabir
Keyword(s):  
Clinical Trials ◽  
Risk Score ◽  
Randomized Clinical Trials ◽  
Treatment Strategies ◽  
Bleeding Risk ◽  
Organ Support ◽  
Critical Stage ◽  
Respiratory Organ ◽  
Probability Of Survival ◽  
Therapeutic Anticoagulation

Three large randomized clinical trials named the ATTACC, ACTIV-4a, and REMAP-CAP were terminated early as these trials showed use of therapeutic anticoagulation among non-critical COVID-19 patients increased the probability of survival to hospital discharge as well as reduced the need for cardiovascular or respiratory organ support. These clinical trials also showed when a COVID-19 patient presents with a critical stage, therapeutic anticoagulation does not provide any benefit. This study retrospectively evaluated the COVID-19 admission at Jackson Hospital, Alabama, USA from June 15th, 2020, to June 15th, 2021. The study developed COVID-19 mechanism of death and found that anticoagulation doses can be titrated up or down based on D-Dimer trends and many patients do not need therapeutic anticoagulation, rather an intermediate dose (Lovenox 0.5mg/kg subQ BID or higher dose) anticoagulation can be sufficient for those who have a higher risk of bleeding. The author developed the Kabir bleeding risk score-based treatment strategies for COVID-19 patients which can be visited by clicking on the following link: .

scholarly journals Treating COVID-19 with Anticoagulation Based on Kabir Bleeding Risk Score

2021 ◽  
Author(s):  
Azad A Kabir
Keyword(s):  
Clinical Trials ◽  
Risk Score ◽  
Randomized Clinical Trials ◽  
Treatment Strategies ◽  
Bleeding Risk ◽  
Organ Support ◽  
Critical Stage ◽  
Respiratory Organ ◽  
Probability Of Survival ◽  
Therapeutic Anticoagulation

Three large randomized clinical trials named the ATTACC, ACTIV-4a, and REMAP-CAP were terminated early as these trials showed use of therapeutic anticoagulation among non-critical COVID-19 patients increased the probability of survival to hospital discharge as well as reduced the need for cardiovascular or respiratory organ support. These clinical trials also showed when a COVID-19 patient presents with a critical stage, therapeutic anticoagulation does not provide any benefit. This study retrospectively evaluated the COVID-19 admission at Jackson Hospital, Alabama, USA from June 15th, 2020, to June 15th, 2021. The study developed COVID-19 mechanism of death and found that anticoagulation doses can be titrated up or down based on D-Dimer trends and many patients do not need therapeutic anticoagulation, rather an intermediate dose (Lovenox 0.5mg/kg subQ BID or higher dose) anticoagulation can be sufficient for those who have a higher risk of bleeding. The author developed the Kabir bleeding risk score-based treatment strategies for COVID-19 patients which can be visited by clicking on the following link: .

L-arginine effect on inflammatory mediators: A systematic review of randomized controlled clinical trials

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Seyed Reza Mirhafez ◽  
Mitra Hariri
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Inflammatory Mediators ◽  
Randomized Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Patients With Cancer ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Human Adults ◽  
Factor Α

Abstract. L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.

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