scholarly journals A Focus on the Nowadays Potential Antiviral Strategies in Early Phase of Coronavirus Disease 2019 (Covid-19): A Narrative Review

Life ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 146
Author(s):  
Caterina Monari ◽  
Valeria Gentile ◽  
Clarissa Camaioni ◽  
Giulia Marino ◽  
Nicola Coppola ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Severe Acute Respiratory Syndrome ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Antiviral Agents ◽  
Narrative Review ◽  
Definitive Evidence ◽  
Treatment Regimens ◽  
Related Disease ◽  
Critical Issues

Background: The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the related disease (COVID-19) has rapidly spread to a pandemic proportion, increasing the demands on health systems for the containment and management of COVID-19. Nowadays, one of the critical issues still to be pointed out regards COVID-19 treatment regimens and timing: which drug, in which phase, for how long? Methods: Our narrative review, developed using MEDLINE and EMBASE, summarizes the main evidences in favor or against the current proposed treatment regimens for COVID-19, with a particular focus on antiviral agents. Results: Although many agents have been proposed as possible treatment, to date, any of the potential drugs against SARS-CoV-2 has shown to be safe and effective for treating COVID-19. Despite the lack of definitive evidence, remdesivir remains the only antiviral with encouraging effects in hospitalized patients with COVID-19. Conclusions: In such a complex moment of global health emergency, it is hard to demand scientific evidence. Nevertheless, randomized clinical trials aiming to identify effective and safe drugs against SARS-CoV-2 infection are urgently needed in order to confirm or reject the currently available evidence.

Spa-therapy can improve quality of life in chronic musculoskeletal disorder subjects: a narrative review

2020 ◽  
Vol 96 (2) ◽  
pp. 3-6
Author(s):  
M.C. Maccarone ◽  
G. Magro ◽  
U. Solimene ◽  
S. Masiero
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Thermal Environment ◽  
Narrative Review ◽  
Spa Therapy ◽  
Age Related ◽  
Therapy Interventions ◽  
The Impact

Chronic Musculoskeletal Disorders (MSDs) are age-related conditions, linked to functional impairment and decreased quality of life (QoL). As a result of the increased life expectancy in Europe, great attention has been focused on investigating the impact of these diseases on QoL. Thermal environment is a suitable place for providing interventions (mud therapy, bath, exercise, etc.) for chronic MSD patients. Our narrative review aims to assess if Spa therapy may improve QoL in patients with chronic MSDs. We searched randomized clinical trials and clinical trials screening PubMed and Google Scholar databases from 2016 up to March 2020. We included 14 trials testing Spa therapy interventions concerning osteoarthritis, rheumatoid arthritis, chronic shoulder pain and fibromyalgia. In conclusion, even though limitations must be considered, evidence shows that Spa therapy, especially in combination with rehabilitation approach, can significantly improve QoL of patients with chronic MSDs.

Transplantation

2016 ◽  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Antiviral Agents ◽  
Graft Loss ◽  
Graft Function ◽  
Surgical Techniques ◽  
Chronic Allograft Rejection ◽  
Early Graft ◽  
End Stage

Organ transplantation is now a well-established therapy for patients with end-stage organ failure. Over the last 20 years, the results of transplantation have improved incrementally for many reasons, including better recipient selection, improved anaesthetic and surgical techniques, the introduction of more effective antiviral agents, and better post-transplant immunosuppressive management. The problem of early graft loss from acute rejection is now uncommon, and the main challenges today are chronic allograft rejection and the side effects of non-specific suppression of the immune response. Randomized clinical trials continue to inform and further improve clinical practice. Because transplantation today is largely successful, the traditional endpoints of 1-year patient and graft survival are no longer sufficient, and more sophisticated endpoints are needed that reflect graft function and quality of life after transplantation. This chapter brings together studies which recognize this need for clinical trials which improve practice and focus on more broadly defined endpoints.

Fundamental dilemmas of the randomized clinical trial process: results of a survey of the 1,737 Eastern Cooperative Oncology Group investigators.

1994 ◽  
Vol 12 (9) ◽  
pp. 1796-1805 ◽  
Author(s):  
K M Taylor ◽  
M L Feldstein ◽  
R T Skeel ◽  
K J Pandya ◽  
P Ng ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Eastern Cooperative Oncology Group ◽  
Oncology Group ◽  
Future Design ◽  
Actual Patient ◽  
Critical Issues ◽  
Accrual Rate ◽  
The Impact ◽  
Patient Accrual

PURPOSE We studied oncologists' attitudes and behavior with regard to their participation in randomized clinical trials. METHODS We surveyed the 1,737 physician members of the Eastern Cooperative Oncology Group (ECOG) using the Physician Orientation Profile (POP), a self-administered mailed questionnaire. A response rate of 86% was achieved (1,485 of 1,737); each physician's actual patient accrual was recorded. RESULTS All respondents indicated that they had a systematic pattern of patient preselection for entry onto trials beyond the formal inclusion/exclusion trial criteria. Eighty-nine percent stated that improving patient quality of life rather than prolonging survival was more personally satisfying. Sixty-two percent did not enter a single patient during the 12-month period following the survey, while 10% entered 80% of all patients during that time. Physicians overestimated their accrual rate by a factor of 6. Eighty-three percent defined randomization and adherence to trial protocol as a serious challenge to their ability to make individualized treatment decisions. CONCLUSION This study raises questions regarding the following: (1) the perceived generalizability of trial findings, (2) the role of end points other than survival for clinical trials, (3) the consequences of physician overestimation of patient accrual, and (4) the impact of randomized trials on the behavior of clinicians. Further investigation into these critical issues will provide meaningful recommendations to enhance the future design, implementation, and conduct of randomized clinical trials in cancer.

scholarly journals Orthopedic Treatment Outcomes in Class III Malocclusion

2008 ◽  
Vol 78 (3) ◽  
pp. 561-573 ◽  
Author(s):  
Laura De Toffol ◽  
Chiara Pavoni ◽  
Tiziano Baccetti ◽  
Lorenzo Franchi ◽  
Paola Cozza
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Quality Standard ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Medical Subject Headings ◽  
Orthopedic Treatment ◽  
High Quality Research ◽  
Facial Mask

Abstract Objective: To assess the scientific evidence on the effectiveness of early orthopedic treatment in Class III subjects. Materials and Methods: A literature survey was performed by applying the Medline database (Entrez PubMed). The survey covered the period from January 1966 to December 2005 and used the Medical Subject Headings (MeSH). The following study types that reported data on the effects of Class III treatment with orthopedic appliances (facial mask, chincup, FR-3) on intermaxillary sagittal and vertical relationships were included: randomized clinical trials (RCTs), and prospective and retrospective longitudinal controlled clinical trials (CCTs) with untreated Class III controls. Results: The search strategy resulted in 536 articles. After selection according to criteria for inclusion and exclusion, 19 articles qualified for the final review analysis. One RCT and 18 CCTs were retrieved. Conclusion: The quality standard of the retrieved investigations ranged from low (four studies) to medium/high (five studies). Data derived from medium/high quality research described over 75% of success of orthopedic treatment of Class III malocclusion (RME and facial mask therapy) at a follow-up observation 5 years after the end of orthopedic treatment.

scholarly journals Current Potential Antiviral Agents for Coronavirus Disease 2019 (COVID-19) Therapy

2020 ◽  
Vol 7 (1A) ◽  
pp. 249-252
Author(s):  
Prayogi Kramy
Keyword(s):  
Clinical Trials ◽  
Monoclonal Antibodies ◽  
Severe Acute Respiratory Syndrome ◽  
Literature Review ◽  
Respiratory Tract ◽  
Antiviral Agents ◽  
Specific Treatment ◽  
Hubei Province ◽  
Herbal Plants ◽  
Current Potential

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first discovered in Wuhan, Hubei Province, China. SARS-CoV-2 infects the respiratory tract, which causes coronavirus disease 2019 (COVID-19). Various studies have been conducted to find effective therapies. However, there is still no specific treatment or therapy for COVID-19. This literature review, summarizes some recent research on several potential antiviral agents, both drugs that are commonly used in the medical world such as ivermectin, to medicine from herbal plants and some drugs that are in the process of clinical trials such as remdesivir, lopinavir/ritonavir, Interferon ?, ribavirin, convalescent plasma, and monoclonal antibodies  for COVID-19 therapy. KEYWORDS: SARS-CoV-2, COVID-19, Antiviral Agents, Potential therapy.

Mandibular propulsion appliance for adults with Class II malocclusion: a systematic review and meta-analysis

2019 ◽  
Vol 42 (2) ◽  
pp. 163-173 ◽  
Author(s):  
Daybelis González Espinosa ◽  
Milena Santos ◽  
Sissy Maria dos Anjos Mendes ◽  
David Normando
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Herbst Appliance ◽  
Skeletal Changes ◽  
Before And After ◽  
Mandibular Retrusion

Summary Background The effects of mandibular propulsion appliances in adults have some controversial results. While some authors claim that its use in non-growing patients could produce some dentoskeletal effects, other studies indicate that Class II correction occurs only through significant dental effects. Objective To evaluate the effects in non-growing Class II patients with mandibular retrusion, promoted by the treatment with mandibular propulsion appliances and determine if they produce mandibular changes. Methods The research was carried out in nine electronic databases and additional manual searches up to July 2019. Selection criteria were no restriction was placed on date and publication language. Randomized or non-randomized clinical trials with/without control were included. They must evaluated non-growing patients with Class II malocclusion, treated with mandibular propulsion appliances; outcomes were assessed before and after treatment. Data collection and analysis Data were extracted by two independent examiners in duplicate. The ROBINS-I tool was used to assess the methodological quality of the included studies. Results Of the 2824 articles identified, 11 non-randomized clinical articles were selected for qualitative analysis and 8 for quantitative analysis. SNB (0.87°, CI 95% 0.08, 1.66), ANB (−0.82°, CI 95% −1.24 to 0.40) and Pg/OLp [2.3 to 1.2 mm (P < 0.001)] presented smallest but significant mandibular changes with some differences regarding the used appliance. The Herbst appliance showed the largest mandibular changes followed by the SUS appliance when evaluated through Ar-Pg. SNA showed non-significant changes. Overbite (−2.85. CI 95% −3.06, −2.64), Overjet (−5.00.CI 95% −5.45, −4.55) showed significant changes in all devices. Class II correction occurs through a significant labial movement of the mandibular incisors, some lingual inclination of the maxillary incisors and minor skeletal changes. Conclusions All mandibular propulsion appliances examined, showed efficiency in normalizing the Class II malocclusion in adult patients; however, changes were acquired mainly through dentoalveolar changes. Some minor mandibular forward changes was noted, mainly in patients treated with the Herbst appliance. Randomized clinical trials are needed to improve scientific evidence. Registration PROSPERO (code CRD42017067384).

Efficacy of acupuncture in the management of fatigue related to breast cancer antineoplastic treatment: a systematic review

2019 ◽  
Vol 9 (2) ◽  
pp. 264-272
Author(s):  
Ana Carolina Moraes Costa ◽  
Alena Peixoto Medrado
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Total Sample ◽  
Inclusion Criteria ◽  
Antineoplastic Treatment

INTRODUCTION: Breast cancer is the most prevalent cancer among women worldwide. Similar to chemotherapy, antineoplastic treatment is associated with many side effects, with fatigue being one of the most common. It is important to investigate potential treatments, especially non-pharmacological alternatives, to control symptoms that directly affect women’s quality of life. OBJECTIVE: The objective of this study was to provide scientific evidence to verify the efficacy of acupuncture in the management of fatigue in patients with breast cancer. METHODS: This study involved a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. Randomized clinical trials published in indexed scientific journals were compiled. The literature search was performed using the electronic databases, PubMed, PEDro, and BIREME, using the descriptors ‘breast cancer’, ‘fatigue’, ‘acupuncture’, and ‘randomized trial’. Inclusion criteria included fully available online articles that were classified as randomised clinical trials published from 2012 to 2017 in either English or Portuguese. Study eligibility was based on the Population, Intervention, Control, Outcome, and Study (PICO) design criteria, in which the (1) population included women 18–65 years of age with breast cancer, (2) intervention was acupuncture, (3) comparison referred to standard care or sham acupuncture, and (4) outcome was the evaluation of fatigue. The PEDro scale was applied to evaluate the quality of the studies. WebQualis was also used to evaluate the quality of the journals of the selected articles. RESULTS: In total, 66 articles were selected, but only four fulfilled all inclusion criteria, giving a total sample size of 620 women. All trials evaluated the effect of acupuncture on fatigue and other symptoms related to the treatment of breast cancer with different treatment durations. Three articles reported statistically significant results, and all articles described clinical improvement in fatigue after the application of acupuncture. The average PEDro score of the manuscripts was 6.25. All articles were published in non-Brazilian journals with WebQualis scores that ranged from B2 to A1. CONCLUSION: Scientific evidence confirms the efficacy of acupuncture in the management of fatigue reported by women with breast cancer. Acupuncture was effective in reducing fatigue in the studies selected for this review.

scholarly journals Potential specific therapies in COVID-19

2020 ◽  
Vol 14 ◽  
pp. 175346662092685 ◽  
Author(s):  
Muhammad Hamdan Gul ◽  
Zin Mar Htun ◽  
Nauman Shaukat ◽  
Muhammad Imran ◽  
Ahmad Khan
Keyword(s):  
Clinical Trials ◽  
Severe Acute Respiratory Syndrome ◽  
Randomized Clinical Trials ◽  
Middle Eastern ◽  
The Other ◽  
Potential Treatment ◽  
Blood Products ◽  
Material Section ◽  
Global Pandemic ◽  
The World

COVID-19 has grown into a global pandemic that has strained healthcare throughout the world. There is a sense of urgency in finding a cure for this deadly virus. In this study, we reviewed the empiric options used in common practice for COVID-19, based on the literature available online, with an emphasis on human experiences with these treatments on severe acute respiratory syndrome-associated coronavirus (SARS-COV-1) and other viruses. Convalescent blood products are the most promising potential treatment for use in COVID-19. The use of chloroquine or hydroxychloroquine (HCQ), remdesivir, and tocilizumab are some of the other promising potential therapies; however, they are yet to be tested in randomized clinical trials (RCTs). The use of lopinavir-ritonavir did not prove beneficial in a large RCT. The use of corticosteroids should be avoided in COVID-19 pneumonia unless used for other indications, based on the suggestion of harm in patients with SARS-COV-1 and Middle Eastern Respiratory Syndrome (MERS) infection. The reviews of this paper are available via the supplemental material section.

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