Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study: Clinical Implications for Cardiovascular Practice

1999 ◽  
pp. 191-208
Keyword(s):  
Clinical Implications ◽  
Ischemic Disease

scholarly journals Symposium report: breast cancer in India—trends, environmental exposures and clinical implications

2021 ◽  
Vol 32 (6) ◽  
pp. 567-575
Author(s):  
Jasmine A. McDonald ◽  
Roshni Rao ◽  
Marley Gibbons ◽  
Rajiv Janardhanan ◽  
Surinder Jaswal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Environmental Exposures ◽  
Population Based ◽  
Clinical Implications ◽  
Think Tank ◽  
Case Control Studies ◽  
Short Term

Abstract Purpose Incidence of breast cancer (BC), particularly in young women, are rising in India. Without population-based mammography screening, rising rates cannot be attributed to screening. Investigations are needed to understand the potential drivers of this trend. Methods An international team of experts convened to discuss the trends, environmental exposures, and clinical implications associated with BC in India and outlined recommendations for its management. Results Panels were structured across three major BC themes (n = 10 presentations). The symposium concluded with a semi-structured Think Tank designed to elicit short-term and long-term goals that could address the challenges of BC in India. Conclusion There was consensus that the prevalence of late-stage BC and the high BC mortality rates are associated with the practice of detection, which is primarily through clinical and self-breast exams, as opposed to mammography. Triple-Negative BC (TNBC) was extensively discussed, including TNBC etiology and potential risk factors, the limited treatment options, and if reported TNBC rates are supported by rigorous scientific evidence. The Think Tank session yielded long-term and short-term goals to further BC reduction in India and included more regional etiological studies on environmental exposures using existing India-based cohorts and case–control studies, standardization for molecular subtyping of BC cases, and improving the public’s awareness of breast health.

Musical murmurs: Clinical implications, long-term prognosis, and echo-phonocardiographic features

1984 ◽  
Vol 108 (2) ◽  
pp. 377-386 ◽  
Author(s):  
Mazhar U. Sheikh ◽  
Won R. Lee ◽  
Robert J. Mills ◽  
Kenneth Dais
Keyword(s):  
Clinical Implications ◽  
Long Term Prognosis

scholarly journals Opiate dependence and pregnancy: 20-year follow-up study

2007 ◽  
Vol 31 (12) ◽  
pp. 450-453 ◽  
Author(s):  
Marie Whitty ◽  
John O'Connor
Keyword(s):  
Psychosocial Functioning ◽  
Substance Misuse ◽  
Opiate Dependence ◽  
Drug Misuse ◽  
Clinical Implications ◽  
Follow Up Study ◽  
Treatment Centre ◽  
Long Term Follow Up

AIMS AND METHODThis study examined the 20-year outcome of 55 women who were pregnant and using opiates in 1985 and were attending the Drug Treatment Centre and Advisory Board, Dublin. We established outcome across a number of variables, including mortality, psychiatric and physical morbidity, psychosocial functioning, ongoing drug misuse and outcome of offspring.RESULTSAt 20-year follow-up 29 women (53%) were deceased. HIV was the commonest cause of death, accounting for 17 deaths (59%). Those who were alive at follow-up displayed high rates of unemployment (84%), illicit substance misuse (74%) and most were dependent on state-subsidised accommodation (78%).CLINICAL IMPLICATIONSMortality was higher in our group compared with other long-term follow-up samples. These findings suggest that such participants and their offspring require intensive long-term support and treatment.

Reassessing Carbamazepine in the Treatment of Bipolar Disorder Clinical Implications of New Data

CNS Spectrums ◽  
2005 ◽  
Vol 10 (6) ◽  
pp. 1-2 ◽  
Author(s):  
Terence A. Ketter ◽  
David L. Ginsberg ◽  
Hagop S. Akiskal ◽  
Paul E. Keck ◽  
Richard H. Weisler ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Weight Gain ◽  
Drug Interactions ◽  
Bipolar Depression ◽  
Panel Discussion ◽  
Current Data ◽  
Clinical Implications ◽  
Good Tolerability ◽  
Long Term Treatment

AbstractThis monograph summarizes the proceedings of a roundtable meeting convened to discuss the role of carbamazepine in the treatment of bipolar disorder, in light of new data and the recent indication of carbamazepine extended-release capsules (CBZ ERC) for use in the treatment of acute manic and mixed episodes. Two lectures were presented, followed by a panel discussion among all 6 participants. A summary of the two pivotal trials of CBZ ERC and their pooled data along with other relevant data is presented first. Next, historical trends of carbamazepine and the agent's use in acute mania, bipolar depression, and maintenance are reviewed, emphasizing clinical implications of efficacy, safety, tolerability, and drug interactions. Finally, the panel discussion provides recommendations for the use of carbamazepine in different phases of the illness, taking into account adverse effects and drug-drug interactions.Panel discussants agree that current data confirm the utility of CBZ ERC as an effective treatment for acute manic and mixed episodes in bipolar disorder. Carbamazepine may also prove to be an option for maintenance treatment. Tolerability of the drug is related to dose and titration, and overall safety limitations regarding carbamazepine usage are comparable to other medications. For some patients, the main challenges to use of carbamazepine may be common drug-drug interactions and increased side effects related to aggressive introduction during treatment of acute manic and mixed episodes. Thus, carbamazepine may be a lower priority option for patients who are taking multiple medications, such as elderly individuals with medical comorbidity, due to the potential for drug interactions. Important benefits of carbamazepine include the low propensity toward weight gain and evidence of good tolerability with long-term treatment. (At present there are no available data from long-term, placebo-controlled studies evaluating the effects of carbamazepine or CBZ ERC on weight.) Thus, carbamazepine may be a good option for patients who are concerned about weight gain or who are intolerant of or respond poorly to other medications. Further efforts are needed to update physicians on the use of carbamazepine relative to other medications in the treatment of bipolar disorder.

scholarly journals Reflections on melatonin: focus on child mental health

2008 ◽  
Vol 32 (12) ◽  
pp. 444-448 ◽  
Author(s):  
Oluwole Famuyiwa ◽  
Abiodun Adewuya
Keyword(s):  
Side Effects ◽  
Child And Adolescent Psychiatry ◽  
Cochrane Library ◽  
Clinical Implications ◽  
Quality Of Sleep ◽  
Intervention Programme ◽  
Library Resource ◽  
The Cochrane Library

Aims and MethodTo examine the propriety of the use of melatonin in child and adolescent psychiatry based on findings retrieved from multiple electronic databases including the Cochrane Library resource, covering 1950–2007.ResultsThere is evidence for the effectiveness of melatonin in the initiation of sleep in children with a variety of neurodevelopmental disorders but its value in improving quality of sleep is doubtful. Like hormones in general, melatonin has multifarious action sites and hence potential for many side-effects. Posological issues and long-term side-effects are yet to be validly determined.Clinical ImplicationsSleep hygiene should be a major component of the routine intervention programme for insomnia and melatonin judiciously prescribed until the safety of long-term use is known.

Impact of Peritoneal Membrane Function on Long Term Clinical Outcome in Peritoneal Dialysis Patients

1999 ◽  
Vol 19 (2_suppl) ◽  
pp. 91-94 ◽  
Author(s):  
Simon J. Davies ◽  
Louise Phillips ◽  
Anne M. Griffiths ◽  
Lesley H. Russell ◽  
Patrick F. Naish ◽  
...  
Keyword(s):  
Renal Function ◽  
Solute Transport ◽  
Residual Renal Function ◽  
Clinical Implications ◽  
Water Removal ◽  
Peritoneal Membrane ◽  
Dialysis Patients ◽  
Membrane Function

It is increasingly clear that peritoneal membrane transport status has clinical implications. The role of the peritoneum in dialysis delivery becomes para mount once residual renal function is lost, particularly as the membrane characteristics may change for the worse with time on treatment. These findings have several important implications: Clinicians need to take solute transport character istics into account as they assess their patients. Adverse effects of high solute transport include reduced ultrafiltration, solute removal (in particular, sodium), and increased peritoneal protein losses. A need exists to replace lost residual renal function, not just with enhanced solute removal, but also with adequate salt and water removal. The interpretation of urea and creatinine clear ances in anuric PD patients needs further consideration and validation. Hypoalbuminemia in PD patients will result from the combined effects of high protein losses, over hydration, comorbidity, and malnutrition.

scholarly journals Non-Helicobacter pylori Gastric Intestinal Metaplasia in Children: A Series of Cases and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Sandra Mabel Camacho-Gomez ◽  
Anas Bernieh ◽  
Ali G. Saad ◽  
Neelesh Ajit Tipnis
Keyword(s):  
Helicobacter Pylori ◽  
Intestinal Metaplasia ◽  
Pediatric Population ◽  
Duodenogastric Reflux ◽  
Clinical Implications ◽  
Review Of The Literature ◽  
Gastric Intestinal Metaplasia ◽  
The Individual ◽  
Time Required

In the pediatric population, Gastric Intestinal Metaplasia (GIM) is a finding with unknown frequency and, more importantly, unknown clinical implications. The relationship between Helicobacter pylori (HP) infection and GIM is well documented, as well as an association between duodenogastric reflux and GIM. We present two cases of pediatric patients with GIM along with a review of the literature. The diagnosis of GIM may have adverse clinical implications and should be made with caution in a child. The association of GIM and adenoma/dysplasia and carcinoma is rarely seen in children, primarily because the time required for these to develop takes the individual into adulthood. Treatment, long-term consequences, and surveillance protocols are not well established in the pediatric population. Studies to evaluate the long-term natural history, treatment, and surveillance protocols in children with GIM are needed.

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