Injection of Steroid in Nasal Polyps: A Systematic Review

2020 ◽  
Vol 34 (6) ◽  
pp. 838-845
Author(s):  
Maria B. Hansen ◽  
Mikkel C. Alanin
Keyword(s):  
Systematic Review ◽  
Nasal Polyps ◽  
Randomized Clinical Trials ◽  
Steroid Injection ◽  
Treatment Options ◽  
Nasal Symptom ◽  
Steroid Injections ◽  
Dosage Regimens ◽  
Total Nasal Symptom Score ◽  
New Treatment

Background Chronic rhinosinusitis (CRS) is a common chronic condition classically divided into two phenotypes according to the presence or absence of nasal polyps. The effects of both medical and surgical treatment are often temporary, encouraging research into new treatment options. Methods We performed a systematic review related to dosages, effects, side effects, and safety of intrapolyp steroid injection in patients with nasal polyps. We identified five studies with a total of 386 patients and 2490 intrapolyp steroid injections. Results Treatment with intrapolyp steroid injection leads to a decrease in the Total Nasal Polyps Score (TNPS), Total Nasal Symptom Score (TNSS), and Lund-Mackay Score. The dosage regimens vary from 10 to 40 mg triamcinolone acetonide. Only two cases of temporary visual complications were reported. Conclusion This review found that intrapolyp steroid injection may be an effective and safe treatment for patients with nasal polyps. However, there exist no large, randomized, clinical trials. We found no association between dose and effect, or dose and the risk of visual complications.

scholarly journals New Therapeutic Perspectives in the Treatment of Uveal Melanoma: A Systematic Review

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1311
Author(s):  
Mario Damiano Toro ◽  
Lucia Gozzo ◽  
Luciano Tracia ◽  
Marco Cicciù ◽  
Filippo Drago ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Phase I ◽  
Uveal Melanoma ◽  
Metastatic Disease ◽  
Treatment Options ◽  
Therapeutic Options ◽  
Treatment Modalities ◽  
New Therapeutic Approaches ◽  
New Treatment

Uveal melanoma (UM) is a rare disease, but the most common primary intraocular cancer, mostly localized in the choroid. Currently, the first-line treatment options for UM are radiation therapy, resection, and enucleation. However, although these treatments could potentially be curative, half of all patients will develop metastatic disease, whose prognosis is still poor. Indeed, effective therapeutic options for patients with advanced or metastatic disease are still lacking. Recently, the development of new treatment modalities with a lower incidence of adverse events, a better disease control rate, and new therapeutic approaches, have merged as new potential and promising therapeutic strategies. Additionally, several clinical trials are ongoing to find new therapeutic options, mainly for those with metastatic disease. Many interventions are still in the preliminary phases of clinical development, being investigated in phase I trial or phase I/II. The success of these trials could be crucial for changing the prognosis of patients with advanced/metastatic UM. In this systematic review, we analyzed all emerging and available literature on the new perspectives in the treatment of UM and patient outcomes; furthermore, their current limitations and more common adverse events are summarized.

Global research trend in the treatment of the new Coronavirus diseases (COVID-19) : bibliometric analysis. (Preprint)

2020 ◽  
Author(s):  
Maxime Descartes Mbogning Fonkou ◽  
Abdourahamane YACOUBA
Keyword(s):  
Randomized Clinical Trials ◽  
Treatment Options ◽  
The United States ◽  
Progressive Increase ◽  
Medical Problem ◽  
Research Trend ◽  
Publication Type ◽  
Medical Virology ◽  
New Treatment ◽  
Number Of Publications

BACKGROUND The Coronavirus 2019 (COVID-19) pandemic has caused worldwide concern and has become a major medical problem. Vaccines and therapeutics are important interventions for the management of this outbreak. OBJECTIVE This study aims to used bibliometric methods to identify research trends in the domain of therapeutics and vaccines to cure patients with COVID-19 since the beginning of the pandemic. METHODS The Web of Science Core Collection database was retrieved for articles on therapeutic approaches to coronavirus disease management published between January 1, 2020 and May 20, 2020. Identified and analyzed the data included title, corresponding author, language, publication time, publication type, research focus. RESULTS A total of 1569 articles on coronavirus therapeutic means from 84 countries were published in 620 journals. We note the remarkable progressive increase in the number of publications related to research on therapies and vaccines for COVID-19. The United States provided the largest number of articles (405), followed by China (364). Journal of Medical Virology published most of them (n=40). 1005 (64.05%) were articles, 286 (18.23%) were letters, 230 (14.66%) were reviews. The terms "COVID- 19" or "SARS-CoV-2" or "Coronavirus" or "hydroxychloroquine" or "chloroquine" or "2019-nCOV" or "ACE2" or "treatment" or "remdesivir" or "pneumonia" were most frequently used, as shown in the density visualization map. A network analysis based on keyword co-occurrence revealed five distinct types of studies: clinical, biological, epidemiological, pandemic management, and therapeutics (vaccines and treatments). CONCLUSIONS COVID-19 is a major disease that has had an impact on international public health at the global level. Several avenues for treatment and vaccines have been explored. Most of them focus on older drugs used to treat other diseases that have been effective for other types of coronaviruses. There is a discrepancy in the results obtained from the studies of the drugs included in this study. Randomized clinical trials are needed to evaluate older drugs and develop new treatment options.

Interpreting Randomized Clinical Trials in Gynecologic Oncology Surgery: Does One Size Fit All?

2019 ◽  
pp. 342-350
Author(s):  
Leigh A. Cantrell ◽  
Jacobus Pfisterer ◽  
John Boggess ◽  
Linda R. Duska
Keyword(s):  
Clinical Trials ◽  
Clinical Research ◽  
Randomized Clinical Trials ◽  
Early Stage ◽  
Treatment Options ◽  
Gynecologic Oncology ◽  
Advanced Ovarian Cancer ◽  
Clinical Scenarios ◽  
Early Stage Cervical Cancer ◽  
New Treatment

Randomized clinical trials (RCTs) are considered the gold standard of clinical research. They are designed to eliminate bias and to produce objective and generalizable results about new treatment paradigms. Although RCTs have recognized limitations, including long completion time and high cost, they also have transformed clinical research and improved the quality of health care by rigorously evaluating countless new treatment options. Surgical RCTs present their own unique set of limitations including an inability to standardize surgical technique and expertise; an inability to overcome enrollment bias by enrolling surgeons; and a lack of generalizability with respect to institutional resources and abilities. Here, we discuss surgical RCTs in two domains: upfront management of advanced ovarian cancer and surgical management of early-stage cervical cancer. Familiarity with the abundant retrospective data available for both of these clinical scenarios as well as recognition of the strengths and limitations of surgical RCTs are critical to determine the best treatment for an individual patient.

scholarly journals INNV-20. A SYSTEMATIC REVIEW OF TUMOR TREATING FIELDS THERAPY FOR PRIMARY FOR RECURRENT AND GLIOBLASTOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi134-vi135
Author(s):  
Pavan Shah ◽  
Taija White ◽  
Carrie Price ◽  
Debraj Mukherjee
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Electric Fields ◽  
Treatment Modality ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Recurrent Glioblastoma ◽  
Skin Reactions ◽  
Tumor Treating Fields ◽  
Novel Treatment

Abstract BACKGROUND Glioblastoma is an aggressive primary central nervous system malignancy with poor prognosis and limited treatment options. Tumor treating fields (TTFs) are a novel treatment modality utilizing alternating electric fields that have demonstrated promise in randomized clinical trials for primary and recurrent glioblastomas. In addition to these studies, a multitude of smaller investigations have been performed examining their efficacy in a variety of combination therapies. This systematic review of available literature aims to summarize and evaluate the efficacy and safety of TTFs for primary and recurrent glioblastoma patients. METHODS A systematic review of the literature was performed according to PRISMA guidelines from database inception through 2/27/2019. Databases queried include PubMed, Embase, Cochrane, Scopus, Web of Science, and ClinicalTrials.gov. 856 unique studies were initially identified in this search, 9 of which met final inclusion criteria. 2 authors independently performed the screening and data extraction of the studies. RESULTS Excluding historical controls, 1569 patients were identified in these studies, 1191 of which received TTFs therapy. TTFs were evaluated in single-arm clinical trials (n = 2), randomized clinical trials (n = 2), and retrospective studies (n = 5). These 9 studies are presented based on treatments provided, baseline patient characteristics, and patient outcomes. No adverse events appear to be associated with TTFs other than adverse skin reactions. Given the heterogeneity in the presented studies, a quantitative meta-analysis was not performed. CONCLUSIONS TTFs are a novel treatment modality that have demonstrated safety and efficacy in a number of settings and study designs. However, further investigation is needed to continue characterizing treatment outcomes and assessing TTFs interactions with various drug regimens.

scholarly journals Therapy of clinical stage IIA and IIB seminoma: a systematic review

2021 ◽  
Author(s):  
Julia Heinzelbecker ◽  
Stefanie Schmidt ◽  
Julia Lackner ◽  
Jonas Busch ◽  
Carsten Bokemeyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Comparative Studies ◽  
Randomized Clinical Trials ◽  
Clinical Stage ◽  
Treatment Options ◽  
Survival Rates ◽  
Treatment Modalities ◽  
Retroperitoneal Lymph Node Dissection ◽  
Cancer Specific Survival

Abstract Purpose The optimal treatment for clinical stage (CS) IIA/IIB seminomas is still controversial. We evaluated current treatment options. Methods A systematic review was performed. Only randomized clinical trials and comparative studies published from January 2010 until February 2021 were included. Search items included: seminoma, CS IIA, CS IIB and therapy. Outcome parameters were relapse rate (RR), relapse-free (RFS), overall and cancer-specific survival (OS, CSS). Additionally, acute and long-term side effects including secondary malignancies (SMs) were analyzed. Results Seven comparative studies (one prospective and six retrospective) were identified with a total of 5049 patients (CS IIA: 2840, CS IIB: 2209). The applied treatment modalities were radiotherapy (RT) (n = 3049; CS IIA: 1888, CSIIB: 1006, unknown: 155) and chemotherapy (CT) or no RT (n = 2000; CS IIA: 797, CS IIB: 1074, unknown: 129). In CS IIA, RRs ranged from 0% to 4.8% for RT and 0% for CT. Concerning CS IIB RRs of 9.5%–21.1% for RT and of 0%–14.2% for CT have been reported. 5-year OS ranged from 90 to 100%. Only two studies reported on treatment-related toxicities. Conclusions RT and CT are the most commonly applied treatments in CS IIA/B seminoma. In CS IIA seminomas, RRs after RT and CT are similar. However, in CS IIB, CT seems to be more effective. Survival rates of CS IIA/B seminomas are excellent. Consequently, long-term toxicities and SMs are important survivorship issues. Alternative treatment approaches, e.g., retroperitoneal lymph node dissection (RPLND) or dose-reduced sequential CT/RT are currently under prospective investigation.

scholarly journals Global research trend in the treatment of the new Coronavirus diseases (COVID-19): bibliometric analysis

2020 ◽  
Author(s):  
Maxime Descartes Mbogning Fonkou ◽  
Abdourahamane Yacouba
Keyword(s):  
Randomized Clinical Trials ◽  
Treatment Options ◽  
The United States ◽  
Progressive Increase ◽  
Medical Problem ◽  
Research Trend ◽  
Publication Type ◽  
Medical Virology ◽  
New Treatment ◽  
Number Of Publications

AbstractThe Coronavirus 2019 (COVID-19) pandemic has caused worldwide concern and has become a major medical problem. Vaccines and therapeutics are important interventions for the management of this outbreak. This study aims to used bibliometric methods to identify research trends in the domain of therapeutics and vaccines to cure patients with COVID-19 since the beginning of the pandemic.The Web of Science Core Collection database was retrieved for articles on therapeutic approaches to coronavirus disease management published between January 1, 2020 and May 20, 2020. Identified and analyzed the data included title, corresponding author, language, publication time, publication type, research focus.A total of 1569 articles on coronavirus therapeutic means from 84 countries were published in 620 journals. We note the remarkable progressive increase in the number of publications related to research on therapies and vaccines for COVID-19. The United States provided the largest number of articles (405), followed by China (364). Journal of Medical Virology published most of them (n = 40). 1005 (64.05%) were articles, 286 (18.23%) were letters, 230 (14.66%) were reviews. The terms “COVID- 19” or “SARS-CoV-2” or “Coronavirus” or “hydroxychloroquine” or “chloroquine” or “2019-nCOV” or “ACE2” or “treatment” or “remdesivir” or “pneumonia” were most frequently used, as shown in the density visualization map. A network analysis based on keyword co-occurrence revealed five distinct types of studies: clinical, biological, epidemiological, pandemic management, and therapeutics (vaccines and treatments).COVID-19 is a major disease that has had an impact on international public health at the global level. Several avenues for treatment and vaccines have been explored. Most of them focus on older drugs used to treat other diseases that have been effective for other types of coronaviruses. There is a discrepancy in the results obtained from the studies of the drugs included in this study. Randomized clinical trials are needed to evaluate older drugs and develop new treatment options.

scholarly journals Treatment of coronavirus disease 2019: a comprehensive review

2020 ◽  
Vol 3 (4) ◽  
pp. 228-242
Author(s):  
Damla Sosyal ◽  
Ozge Ozmen ◽  
Muhammed Yunus Bektay ◽  
Fikret Vehbi Izzettin
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
New Drugs ◽  
World Health ◽  
Comprehensive Review ◽  
New Type ◽  
Governmental Institutions ◽  
New Treatment ◽  
Health Organization

The new type of Coronavirus (SARS-CoV-2) is a highly contagious pathogen that causes severe acute respiratory syndrome and can be transmitted from human to human. COVID-19, which has been declared as a pandemic by the world health organization and is infected with more than 50 million people, is also responsible for the death of more than 1 million people. There is no sufficient data from randomized clinical trials that any potential treatment improves outcomes in COVID-19 patients. Chloroquine and hydroxychloroquine, antivirals such as favipiravir, lopinavir/ritonavir, immunomodulatory agents tocilizumab, siltuximab, and sarilumab, and anti-inflammatory drugs such as steroids are used for the treatment of COVID-19. Repurposing drugs can provide new treatment options faster than discovering new drugs due to the known safety profiles of existing drugs. On the other hand, there are new drug and vaccine trials for COVID-19. Many researchers, governmental or non-governmental institutions having clinical trials for COVID-19 drugs and vaccines. In this comprehensive review, we investigate the clinical features, management, and treatment of COVID-19 and possible adverse effects and important information related to drugs used for COVID-19. For future preparedness and readiness, new laws and legislations should be constituted. Besides, emergency teams and budgets should be prepared as well. .

scholarly journals Efficacy and Safety of Injectable and Oral Antibiotics in Treating Gonorrhea: A Systematic Review and Network Meta-Analysis

2019 ◽  
Vol 8 (12) ◽  
pp. 2182 ◽  
Author(s):  
Jiaru Yang ◽  
Subhash Dhital ◽  
Thomas Naderer
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Drug Resistant ◽  
Efficacy And Safety ◽  
Oral Antibiotics ◽  
Sexually Transmitted ◽  
Injectable Drugs ◽  
Back Calculation

Gonorrhea is the second most frequently reported sexually transmitted infectious disease of bacterial origin in the world. Current empiric therapies rely on broad-spectrum antibiotics. However, treatment options are becoming limited due to the rise of drug-resistant gonorrhea. To control the rise of drug-resistant gonorrhea and to identify alternative treatment options, clinicians will have to increasingly rely on experimental evidence for the treatment of gonorrhea patients. Thus, we performed a systematic review and network meta-analysis of all randomized clinical trials about the efficacy and safety of various antibiotic regimens in adults with gonorrhea. We searched all references in Embase and PubMed from the date of their inception to January 2019, and then an updated search was performed in March 2019. Of the 28,843 identified references, 44 fulfilled our selection criteria. We used a network meta-analysis based on a frequentist approach to evaluate the efficacy and safety of 12 injectable and 11 oral antibiotics. The efficacy of treatments was ranked by p score and inconsistency was assessed by a back-calculation method. Certainty of evidence was evaluated by the GRADE system. For injectable drugs, there was no difference in efficacy between a reference antibiotic and other drugs. However, ceftriaxone had significantly better efficacy than cefuroxime (OR, 12.03; 95% CI 3.73–38.79), cephaloridine (OR, 42.41; 95% CI 8.77–205.07), kanamycin (OR, 5.45; 95% CI 1.25–23.70), penicillin (OR, 13.11; 95% CI 4.48–38.37), and spectinomycin (OR, 4.70; 95% CI 1.62–13.62). Thus, ceftriaxone was the most effective injectable drug (p score of 0.924). As for oral drugs, azithromycin was the most effective compound (p score of 0.8633). There were no significant differences in safety between injectable and oral treatments. In our systematic review of randomized controlled trials, we found azithromycin and ceftriaxone to be the most effective antibiotics for the treatment of gonorrhea. This is in line with current guidelines which recommend a combination therapy of azithromycin and ceftriaxone for the treatment of gonorrhea due to increased antimicrobial resistance. Our analysis identified gentamicin and ofloxacin as alternative therapeutics to treat drug-resistant gonorrhea.

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