Divalproex Sodium Therapy in Elderly with Dementia-Related Agitation

2002 ◽  
Vol 36 (10) ◽  
pp. 1625-1628 ◽  
Author(s):  
Crystal E Pratt ◽  
Steven M Davis
Keyword(s):  
Clinical Trials ◽  
Elderly Patients ◽  
Statistical Significance ◽  
Data Sources ◽  
Controlled Trials ◽  
Divalproex Sodium ◽  
Data Synthesis ◽  
Medline Search ◽  
Potential Benefits

OBJECTIVE: To review available literature regarding the use of divalproex sodium in the treatment of agitation in elderly patients with dementia. DATA SOURCES: Clinical trials and review articles were identified by MEDLINE search (1966 — March 2002). DATA SYNTHESIS: The literature provides information regarding the potential benefits and tolerability of divalproex sodium in the treatment of dementia-related agitation. This article analyzes 7 studies to better understand the role of divalproex sodium in the treatment of dementia. CONCLUSIONS: Divalproex sodium may offer a slight benefit to elderly patients suffering from dementia-related agitation. Until better-controlled trials demonstrate statistical significance and comparisons with established treatments are performed, practitioners should use divalproex sodium cautiously.

Nicotine Transdermal Systems

1993 ◽  
Vol 27 (6) ◽  
pp. 742-750 ◽  
Author(s):  
Mary Lea Gora
Keyword(s):  
Smoking Cessation ◽  
Controlled Trials ◽  
Behavior Support ◽  
Data Synthesis ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Quit Smoking ◽  
Transdermal Nicotine ◽  
Study Selection

OBJECTIVE: To review the role of transdermal nicotine as an aid to smoking cessation. DATA SOURCES: A MEDLINE search was performed that included clinical studies published in English involving transdermal nicotine; references used in those articles were screened for additional published information. STUDY SELECTION: Published clinical trials were reviewed with particular emphasis on controlled trials that evaluated safety and efficacy. DATA SYNTHESIS: Transdermal nicotine therapy has been shown to be a safe and effective pharmacologic aid in a smoking cessation program when used in conjunction with a psychologic or behavior support system. Habitrol, Nicoderm, Nicotrol, and PROSTEP differ in some characteristics (i.e., delivery systems, total nicotine content and amount absorbed, rate of delivery, recommended duration of application); however, the clinical implication of these differences has not been determined. CONCLUSIONS: Transdermal nicotine is effective for patients who are motivated to quit smoking and receive concomitant behavior support.

Tamoxifen for Prevention of Breast Cancer

2003 ◽  
Vol 37 (2) ◽  
pp. 268-273 ◽  
Author(s):  
Robert J Cersosimo
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Literature Search ◽  
Data Sources ◽  
Data Synthesis ◽  
Increased Risk ◽  
Key Words Tamoxifen ◽  
Not At Risk ◽  
Prevention Of Breast Cancer ◽  
Common Malignancy

OBJECTIVE: To review data on the use of tamoxifen for primary prevention of breast cancer. DATA SOURCES: A literature search was performed through MEDLINE (1992–May 2002) using the key words tamoxifen, breast cancer, and prevention. DATA SYNTHESIS: Breast cancer is the most common malignancy detected in American women. Attempts to reduce morbidity and mortality include early detection programs and chemoprevention. Clinical trials of tamoxifen for reduction of breast cancer risk are reviewed. CONCLUSIONS: Tamoxifen may reduce the risk of primary breast cancer in women at increased risk. The benefit of tamoxifen in women who are not at risk is uncertain. The risks of developing thromboembolic disorders or endometrial cancer must be considered before tamoxifen is prescribed. Women should be given all of the information about the benefits and risks of tamoxifen use so that they can make an informed decision based on the best data available.

Trends in randomized controlled trials in ENT: a 30-year review

1997 ◽  
Vol 111 (7) ◽  
pp. 611-613 ◽  
Author(s):  
K. W. Ah-See ◽  
N. C. Molony ◽  
A. G. D. Maran
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Randomized Controlled Trials ◽  
Gold Standard ◽  
Controlled Trials ◽  
Evidence Based ◽  
Controlled Clinical Trials ◽  
Medline Search ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled

AbstractThere is a growth in the demand for clinical practice to be evidence based. Recent years have seen a rise in the number of randomized controlled clinical trials (RCTS). Such trials while acknowledged as the gold standard for evidence can be difficult to perform in surgical specialities. We have recently identified a low proportion of RCTS in the otolaryngology literature. Our aim was to identify any trend in the number of published RCTS within the ENT literature over a 30-year period and to identify which areas of our speciality lend themselves to this form of study design. A Medline search of 10 prominent journals published between 1966 and 1995 was performed. Two hundred and ninety-six RCTS were identified. Only five were published before 1980. Two hundred (71 per cent) of RCTS were in the areas of otology and rhinology. An encouraging trend is seen in RCTS within ENT literature.

scholarly journals Treatment with CPAP in Elderly Patients with Obstructive Sleep Apnoea

2020 ◽  
Vol 9 (2) ◽  
pp. 546 ◽  
Author(s):  
Tomas Posadas ◽  
Grace Oscullo ◽  
Enrique Zaldívar ◽  
Alberto Garcia-Ortega ◽  
José Daniel Gómez-Olivas ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Elderly Patients ◽  
Obstructive Sleep Apnoea ◽  
The Elderly ◽  
Sleep Apnoea ◽  
Age Group ◽  
Obstructive Sleep ◽  
Receive Treatment ◽  
Therapeutic Tools

The population pyramid is changing as a result of the ever-increasing life expectancy, which makes it crucial to acquire an in-depth understanding of the diseases that most often affect the elderly. Obstructive sleep apnoea (OSA) affects 15%–20% of the population aged over 65 years. Despite this prevalence, there have been very few specific studies on the management of OSA in this age group, even though over 60% of the patients aged over 65-70 years who attend sleep units with suspicion of OSA receive treatment with continuous positive airway pressure (CPAP), on the basis of an extrapolation of the positive results achieved by CPAP in clinical trials involving middle-aged males. However, the latter’s form of presentation, evolution and, probably, prognosis comparing with OSA are not the same as those of elderly patients. Recent clinical trials performed on an exclusive series of elderly patients have shed light on the possible role of CPAP treatment in elderly patients with OSA, but there are still many questions that need to be answered. The physiological increase in the number of sleep-related disorders with the passing of years, and the lack of validated diagnostic and therapeutic tools for this age group are probably the greatest obstacles to define, diagnose and treat OSA in the elderly.

Isoniazid-Associated Psychosis: Case Report and Review of the Literature

1993 ◽  
Vol 27 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Karen A. Pallone ◽  
Morton P. Goldman ◽  
Matthew A. Fuller
Keyword(s):  
Case Report ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Data Sources ◽  
Review Of The Literature ◽  
Data Synthesis ◽  
Medline Search ◽  
Study Selection ◽  
Language Literature

Objective To describe a case of isoniazid-associated psychosis and review the incidence of this adverse effect. Data Sources Information about the patient was obtained from the medical chart. A MEDLINE search of the English-language literature published from 1950 to 1992 was conducted and Index Medicus was manually searched for current information. Study Selection All case reports describing isoniazid-associated psychosis were reviewed. Data Extraction Studies were evaluated for the use of isoniazid, symptoms of psychosis, onset of symptoms, and dosage of isoniazid. Data Synthesis The case report is compared with others reported in the literature. The incidence of isoniazid-associated psychosis is rare. Conclusions The mechanism of isoniazid-associated psychosis is uncertain. It appears that isoniazid was associated with the psychosis evident in our patient and in the cases reviewed.

5-Azacytidine and Decitabine Monotherapies of Myelodysplastic Disorders

2005 ◽  
Vol 39 (10) ◽  
pp. 1700-1709 ◽  
Author(s):  
Jim R Kuykendall
Keyword(s):  
Clinical Trials ◽  
Data Extraction ◽  
Supportive Therapy ◽  
Clinical Effectiveness ◽  
Data Sources ◽  
Hypomethylating Agents ◽  
Medline Search ◽  
Study Selection ◽  
Response To Chemotherapy ◽  
Leukemia Treatment

OBJECTIVE: To review and differentiate the pharmacology, toxicology, pharmacokinetics, and results of major clinical trials of 5-azacytidine (5-AzaC) and 5-aza-2'-deoxycytidine (decitabine) therapy of myelodysplastic disorders. DATA SOURCES: A PubMed/MEDLINE search was conducted (1966–October 2004) using the following terms: DNA methylation, myelodysplastic disorders, 5-azacytidine, and 5-aza-2'-deoxycytidine (decitabine). Additional data sources included bibliographies from identified articles and manufacturer information. STUDY SELECTION AND DATA EXTRACTION: Clinical trials for the treatment of various malignancies by hypomethylating agents were selected from data sources. All published, major clinical trials evaluating 5-AzaC or decitabine in myelodysplastic disorders and transformed myeloid leukemia treatment were included. DATA SYNTHESIS: Myelodysplastic disorders are a group of bone marrow stem cell hyperplasias and dysplasias that result in ineffective hematopoiesis. Myelodysplastic disorders and transformed leukemia have poor prognosis and minimal response to chemotherapy. DNA hypomethylating agents have been shown to improve overall response rates (increased neutrophil, leukocyte, and platelet counts), time to leukemic progression, and quality of life compared with supportive therapy. The incidence of the most common adverse effects (nausea, vomiting, myelosuppression) can be reduced by low-dose, continuous, or extended-interval infusion. CONCLUSIONS: Since appropriate dosing schedules of decitabine are being investigated, comparison of the clinical effectiveness of 5-AzaC and decitabine would be premature at this time. DNA hypomethylating agents show promise as monotherapies of myelodysplastic disorders and transformed leukemia and may be useful as a component of combination chemotherapy of various malignancies.

Testosterone Replacement Therapy for Bone Loss Prevention in HIV-Infected Males

2003 ◽  
Vol 37 (4) ◽  
pp. 582-585 ◽  
Author(s):  
Patrick G Clay ◽  
Amy I Lam
Keyword(s):  
Bone Loss ◽  
Hiv Infection ◽  
Data Sources ◽  
Hormone Deficiency ◽  
Testosterone Replacement Therapy ◽  
Data Synthesis ◽  
Medline Search ◽  
Prevention Of Bone Loss ◽  
Endocrine Abnormality ◽  
Hiv Negative

OBJECTIVE: To review the use of testosterone for the prevention of bone loss in men with HIV infection. DATA SOURCES: A MEDLINE search (1966–May 2002) on the use of testosterone in osteoporosis/HIV infection was performed. A reference bibliography search was also completed. DATA SYNTHESIS: Osteopenia/osteoporosis is reported in HIV-infected men due to a myriad of factors. Sex hormone deficiency is a frequent endocrine abnormality in this population. CONCLUSIONS: In HIV-negative men, testosterone may be beneficial for preventing bone loss and hastening the resolution of fractures. Testosterone's role in preventing bone loss in HIV-infected men remains to be defined.

Bismuth Subgallate–Epinephrine Paste in Adenotonsillectomies

2000 ◽  
Vol 34 (4) ◽  
pp. 522-525 ◽  
Author(s):  
Randy C Hatton
Keyword(s):  
Active Ingredient ◽  
Science Citation Index ◽  
Citation Index ◽  
Postoperative Bleeding ◽  
Data Sources ◽  
Data Synthesis ◽  
Search Terms ◽  
Bismuth Subgallate ◽  
Minimal Evidence

OBJECTIVE: To evaluate the role of bismuth subgallate–epinephrine (BSE) paste as a hemostatic in adenotonsillectomies. DATA SOURCES: MEDLINE (January 1966–October 1999) and Current Contents (January 1997–October 1999) were searched, using bismuth subgallate, adenoidectomy, tonsillectomy, and adenotonsillectomy as search terms. A citation search was performed using Science Citation Index (January 1977–October 1999). DATA SYNTHESIS: Adenotonsillectomies are common procedures; although there are few complications, hemorrhage is a concern. Bismuth subgallate has historically been used as an astringent and hemostatic. An evaluation of studies of bismuth subgallate and BSE paste was conducted. CONCLUSIONS: There is minimal evidence to support this practice, but data suggest that epinephrine may be the active ingredient in BSE paste. BSE paste is inexpensive, poses little risk, and may decrease postoperative bleeding; therefore, it may be a reasonable hemostatic agent.

Etiology of Patellar Tendinopathy in Athletes

2005 ◽  
Vol 14 (3) ◽  
pp. 259-272 ◽  
Author(s):  
Sheri A. Hale
Keyword(s):  
Clinical Management ◽  
Data Sources ◽  
Patellar Tendinopathy ◽  
Extrinsic Factors ◽  
Data Synthesis ◽  
Medline Search ◽  
Complex Process ◽  
Study Selection ◽  
Joint Dynamics ◽  
Type Data

Objective:To review the etiology of patellar tendinopathy as it relates to clinical management of chronic patellar-tendon disease in athletes.Data Sources:Information was gathered from a MEDLINE search of literature in English using the key wordspatellar tendinitis, patellar tendonitis, patellar tendinosis, patellar tendinopathy,andjumper’s knee.Study Selection:All relevant peer-reviewed literature in English was reviewed.Data Synthesis:The etiology of patellar tendinopathy is multifactorial, incorporating both intrinsic and extrinsic factors. Age, muscle flexibility, training program, and knee-joint dynamics have all been associated with patellar tendinopathy. The roles of gender, body morphology, and patellar mobility in patellar tendinopathy are unclear.Conclusions:The pathoetiology of patellar tendinopathy is a complex process that results from both an inflammatory response and degenerative changes. There is a tremendous need for research to improve our understanding of the pathoetiology of patellar tendinopathy and its clinical management.

Safety and Efficacy of Influenza Vaccine in Children

2003 ◽  
Vol 37 (11) ◽  
pp. 1712-1715 ◽  
Author(s):  
Leslie GB Goldstein
Keyword(s):  
Influenza Vaccine ◽  
Asthma Exacerbation ◽  
Data Sources ◽  
Influenza Vaccines ◽  
Data Synthesis ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Asthmatic Children ◽  
Search Terms

OBJECTIVE: To describe the safety and efficacy of influenza vaccines in asthmatic children. DATA SOURCES: Literature was identified by a MEDLINE search (2002–March 2003). Key search terms included asthma, exacerbation, children, vaccine, and influenza. DATA SYNTHESIS: Concerns that the influenza vaccine may exacerbate asthma attacks have kept many asthmatic children from receiving this immunization. Researchers have conducted studies to determine the burden of influenza on asthmatic children, the safety of influenza vaccines, and their benefit in the presence of glucocorticoid burst therapy in the same population. CONCLUSIONS: Influenza vaccines tested are safe and efficacious in asthmatic children.

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