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Impactful clinical trials

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https://www.readbyqxmd.com/read/28449205/impact-of-pharmacist-involved-collaborative-care-on-the-clinical-humanistic-and-cost-outcomes-of-high-risk-patients-with-type-2-diabetes-impact-a-randomized-controlled-trial
#1
M Y L Siaw, Y Ko, D C Malone, K Y K Tsou, Y-J Lew, D Foo, E Tan, S C Chan, A Chia, S S Sinaram, K C Goh, J Y-C Lee
WHAT IS KNOWN AND OBJECTIVE: With the increasing prevalence of diabetes, the physician-centred model is challenged to deliver holistic care in Asia. Diabetes may be managed effectively within a multidisciplinary collaborative care model; however, evidence on its effectiveness in Asian patients is lacking. Therefore, the primary objective was to evaluate the clinical outcomes of multidisciplinary collaborative care vs physician-centred care in diabetes. The secondary objectives were to evaluate humanistic and economic outcomes among the two types of care...
April 27, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28448950/promoting-innovation-in-small-markets-evidence-from-the-market-for-rare-and-intractable-diseases
#2
Toshiaki Iizuka, Gyo Uchida
In many medical care markets with limited profit potential, firms often have little incentive to innovate. These include the market for rare diseases, "neglected" tropical diseases, and personalized medicine. Governments and not-for-profit organizations promote innovation in such markets but empirical evidence on the policy effect is limited. We study this issue by analyzing the impact of a demand-side policy in Japan, which reduces the cost sharing of patients with some rare and intractable diseases and attempts to establish and promote the treatment of those diseases...
April 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28448856/impact-of-a-risk-based-follow-up-in-patients-affected-by-gastrointestinal-stromal-tumour
#3
Lorenzo D'Ambrosio, Erica Palesandro, Paola Boccone, Francesco Tolomeo, Sara Miano, Danilo Galizia, Antonio Manca, Gabriele Chiara, Ilaria Bertotto, Filippo Russo, Delia Campanella, Tiziana Venesio, Dario Sangiolo, Ymera Pignochino, Dimitrios Siatis, Michele De Simone, Alessandro Ferrero, Alberto Pisacane, Angelo Paolo Dei Tos, Sandra Aliberti, Massimo Aglietta, Giovanni Grignani
BACKGROUND: Follow-up aims to precociously identify recurrences, metastases or treatment-related adverse events so as to undertake the appropriate therapy. Guidelines admit lack of knowledge on optimal surveillance schedule, but suggest follow-up based on experts' opinion and risk stratification. To identify the impact, if any, of regular follow-up, we interrogated our prospectively collected database whether early detection of recurrences affected both clinical management and, likely, the outcome...
April 24, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28448503/etiologic-effects-and-optimal-intakes-of-foods-and-nutrients-for-risk-of-cardiovascular-diseases-and-diabetes-systematic-reviews-and-meta-analyses-from-the-nutrition-and-chronic-diseases-expert-group-nutricode
#4
Renata Micha, Masha L Shulkin, Jose L Peñalvo, Shahab Khatibzadeh, Gitanjali M Singh, Mayuree Rao, Saman Fahimi, John Powles, Dariush Mozaffarian
BACKGROUND: Dietary habits are major contributors to coronary heart disease, stroke, and diabetes. However, comprehensive evaluation of etiologic effects of dietary factors on cardiometabolic outcomes, their quantitative effects, and corresponding optimal intakes are not well-established. OBJECTIVE: To systematically review the evidence for effects of dietary factors on cardiometabolic diseases, including comprehensively assess evidence for causality; estimate magnitudes of etiologic effects; evaluate heterogeneity and potential for bias in these etiologic effects; and determine optimal population intake levels...
2017: PloS One
https://www.readbyqxmd.com/read/28447569/a-new-treatment-strategy-for-parkinson-s-disease-through-the-gut-brain-axis-the-glucagon-like-peptide-1-receptor-pathway
#5
Dong Seok Kim, Ho-Il Choi, Yun Wang, Yu Luo, Barry J Hoffer, Nigel H Greig
Molecular communications in the gut-brain axis, between the central nervous system and the gastrointestinal tract, arecritical for maintaining healthy brain function particularly in aging. Epidemiological analyses indicate type 2 diabetes mellitus (T2DM) is a risk factor for neurodegenerative disorders, including Alzheimer's disease (AD) and Parkinson's diseases (PD) for which aging shows a major correlative association. Common pathophysiological features exist between T2DM, AD and PD, including oxidative stress, inflammation, insulin resistance, abnormal protein processing and cognitive decline, and suggest that effective drugs for T2DM that positively impact the gut-brain axis could provide an effective treatment option for neurodegenerative diseases...
April 26, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28447072/a-randomized-trial-of-the-effects-of-the-no-carrageenan-diet-on-ulcerative-colitis-disease-activity
#6
Sumit Bhattacharyya, Theresa Shumard, Hui Xie, Amar Dodda, Krista A Varady, Leo Feferman, Allan G Halline, Jay L Goldstein, Stephen B Hanauer, Joanne K Tobacman
BACKGROUND: Carrageenan is a very common food additive in Western diets, but predictably causes inflammation in thousands of cell-based and animal experiments. OBJECTIVE: To assess the impact of carrageenan exposure on the interval to relapse in patients with ulcerative colitis in remission. METHODS: A randomized, double-blind, placebo-controlled, multicenter, clinical trial was conducted to assess if patients with ulcerative colitis in remission would have a longer interval to relapse if they followed a diet with no carrageenan...
March 31, 2017: Nutrition and Healthy Aging
https://www.readbyqxmd.com/read/28447020/impact-of-educational-intervention-on-knowledge-attitude-and-awareness-of-good-clinical-practice-among-health-care-providers
#7
Divya Goel, Rani Walia, Poonam Sharma, Harmanjeet Kaur, Pallak Agnihotri
BACKGROUND: Clinical trials play an important role in the generation of evidence-based data in health care practices. To ensure the credibility of data and the safety and well-being of the patients Good clinical practice (GCP) guidelines play an important role. At present, we have little knowledge about awareness of GCP guidelines among health care providers in India. AIM: To assess the level of awareness, and perception of the health care providers toward GCP and subsequent change in these after a dayer training session on GCP guidelines...
April 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/28446734/iron-deficiency-and-anemia-in-heart-failure
#8
Yüksel Çavuşoğlu, Hakan Altay, Mustafa Çetiner, Tolga Sinan Güvenç, Ahmet Temizhan, Dilek Ural, Dilek Yeşilbursa, Nesligül Yıldırım, Mehmet Birhan Yılmaz
Heart failure is an important community health problem. Prevalence and incidence of heart failure have continued to rise over the years. Despite recent advances in heart failure therapy, prognosis is still poor, rehospitalization rate is very high, and quality of life is worse. Co-morbidities in heart failure have negative impact on clinical course of the disease, further impair prognosis, and add difficulties to treatment of clinical picture. Therefore, successful management of co-morbidities is strongly recommended in addition to conventional therapy for heart failure...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28446383/development-and-validation-of-the-parenteral-nutrition-impact-questionnaire-pniq-a-patient-centric-outcome-measure-for-home-parenteral-nutrition
#9
Jeanette Wilburn, Stephen P McKenna, Alice Heaney, Matthew Rouse, Michael Taylor, Alison Culkin, Simon Gabe, Sorrel Burden, Simon Lal
BACKGROUND & AIMS: Patients with Type 3 Intestinal Failure (IF) who need Home Parenteral Nutrition (HPN) face several clinical, psychological and social problems. The study was designed to produce and test the first patient-centric measure for HPN ('PNIQ: Parenteral Nutrition Impact Questionnaire'). The new measure focused on the extent to which patients were able to fulfil their human needs. METHODS: Questionnaire content was derived from the analysis of transcripts of interviews conducted with UK HPN patients...
April 12, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28446244/ketogenic-diet-in-the-treatment-of-epilepsy-in-children-under-the-age-of-2-years-study-protocol-for-a-randomised-controlled-trial
#10
Siobhan Titre-Johnson, Natasha Schoeler, Christin Eltze, Ruth Williams, Katharina Vezyroglou, Helen McCullagh, Nick Freemantle, Simon Heales, Rachel Kneen, Louise Marston, Tim Martland, Irwin Nazareth, Elizabeth Neal, Andrew Lux, Alasdair Parker, Shakti Agrawal, Penny Fallon, J Helen Cross
BACKGROUND: The incidence of epilepsy is greatest in the first 2 years of life, an age group where there is generally a poor prognosis for both seizure control and neurodevelopmental outcome. Early control of seizures can be associated with better developmental outcome but many of the epilepsies presenting in infancy are poorly responsive to antiepileptic medication. The ketogenic diet (KD) is a high-fat, low-carbohydrate diet designed to mimic the effects of starvation on the body. Dietary fat is converted into ketones in the body and used as an energy source by the brain...
April 26, 2017: Trials
https://www.readbyqxmd.com/read/28446190/recognition-of-plasmodium-falciparum-mature-gametocyte-infected-erythrocytes-by-antibodies-of-semi-immune-adults-and-malaria-exposed-children-from-gabon
#11
Tamirat Gebru, Anthony Ajua, Michael Theisen, Meral Esen, Ulysse Ateba Ngoa, Saadou Issifou, Ayola A Adegnika, Peter G Kremsner, Benjamin Mordmüller, Jana Held
BACKGROUND: Transmission of malaria from man to mosquito depends on the presence of gametocytes, the sexual stage of Plasmodium parasites in the infected host. Naturally acquired antibodies against gametocytes exist and may play a role in controlling transmission by limiting the gametocyte development in the circulation or by interrupting gamete development and fertilization in the mosquito following ingestion. So far, most studies on antibody responses to sexual stage antigens have focused on a subset of gametocyte-surface antigens, even though inhibitory Ab responses to other gametocyte antigens might also play a role in controlling gametocyte density and fertility...
April 26, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28446119/neurobionics-and-the-brain-computer-interface-current-applications-and-future-horizons
#12
Jeffrey V Rosenfeld, Yan Tat Wong
The brain-computer interface (BCI) is an exciting advance in neuroscience and engineering. In a motor BCI, electrical recordings from the motor cortex of paralysed humans are decoded by a computer and used to drive robotic arms or to restore movement in a paralysed hand by stimulating the muscles in the forearm. Simultaneously integrating a BCI with the sensory cortex will further enhance dexterity and fine control. BCIs are also being developed to: provide ambulation for paraplegic patients through controlling robotic exoskeletons; restore vision in people with acquired blindness; detect and control epileptic seizures; and improve control of movement disorders and memory enhancement...
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28444736/selective-progesterone-receptor-modulators-sprms-for-uterine-fibroids
#13
REVIEW
Ally Murji, Lucy Whitaker, Tiffany L Chow, Mara L Sobel
BACKGROUND: Uterine fibroids are smooth muscle tumours arising from the uterus. These tumours, although benign, are commonly associated with abnormal uterine bleeding, bulk symptoms and reproductive dysfunction. The importance of progesterone in fibroid pathogenesis supports selective progesterone receptor modulators (SPRMs) as effective treatment. Both biochemical and clinical evidence suggests that SPRMs may reduce fibroid growth and ameliorate symptoms. SPRMs can cause unique histological changes to the endometrium that are not related to cancer, are not precancerous and have been found to be benign and reversible...
April 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28444704/how-does-lower-urinary-tract-dysfunction-lutd-affect-sexual-function-in-men-and-women-ici-rs-2015-part-2
#14
REVIEW
Apostolos Apostolidis, Angie Rantell, Ralf Anding, Ruth Kirschner-Hermanns, Linda Cardozo
AIM: To discuss available data on the links between LUTD and sexual dysfunction, what is still unknown about the causative effect of disease processes on sexual function (SF), and to suggest proposals for further research. METHODS: At the 2015 International Consultation on Incontinence-Research Society (ICI-RS), a multi-disciplinary group presented a literature search of what is known about the effect of LUTD on SF in men and women. Wider discussions regarding knowledge gaps, and ideal research methodology ensued and are presented...
April 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28444622/a-brief-review-of-the-management-of-platinum-resistant-platinum-refractory-ovarian-cancer
#15
REVIEW
Bryan Oronsky, Carolyn M Ray, Alexander I Spira, Jane B Trepel, Corey A Carter, Hope M Cottrill
Ovarian cancer, which ranks fifth in cancer deaths among women, is the most lethal gynecologic malignancy. Epithelial ovarian cancer (EOC) is the most common histologic type, with the 5-year survival for all stages estimated at 45.6%. This rate increases to more than 70% in the minority of patients who are diagnosed at an early stage, but declines to 35% in the vast majority of patients diagnosed at advanced stage. Recurrent EOC is incurable. Platinum sensitivity (or lack thereof) is a major determinant of prognosis...
June 2017: Medical Oncology
https://www.readbyqxmd.com/read/28444509/impact-of-an-endoscopic-quality-improvement-program-focused-on-adenoma-detection-on-sessile-serrated-adenoma-polyp-detection
#16
Ronald G Racho, Murli Krishna, Susan G Coe, Colleen S Thomas, Julia E Crook, Nancy N Diehl, Michael B Wallace
BACKGROUND: Sessile serrated adenomas/polyps (SSA/P) are an under-recognized disease with a unique malignant pathway. Improved endoscopic recognition and pathological interpretation is needed. AIMS: To determine whether an educational intervention that improved adenoma detection rate (ADR) could improve SSA/P detection rate after reclassification of previously termed "hyperplastic" polyps. METHODS: We reanalyzed data from a prospective randomized trial of an educational intervention aimed at increasing ADR...
April 25, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28444116/effectiveness-of-in-hospital-geriatric-co-management-a-systematic-review-and-meta-analysis
#17
Bastiaan Van Grootven, Johan Flamaing, Bernadette Dierckx de Casterlé, Christophe Dubois, Katleen Fagard, Marie-Christine Herregods, Miek Hornikx, Annouschka Laenen, Bart Meuris, Steffen Rex, Jos Tournoy, Koen Milisen, Mieke Deschodt
Background: geriatric consultation teams have failed to impact clinical outcomes prompting geriatric co-management programmes to emerge as a promising strategy to manage frail patients on non-geriatric wards. Objective: to conduct a systematic review of the effectiveness of in-hospital geriatric co-management. Data sources: MEDLINE, EMBASE, CINAHL and CENTRAL were searched from inception to 6 May 2016. Reference lists, trial registers and PubMed Central Citations were additionally searched...
April 24, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28443355/investigational-dopamine-antagonists-for-the-treatment-of-schizophrenia
#18
Sheng-Min Wang, Changsu Han, Soo-Jung Lee, Tae-Youn Jun, Ashwin A Patkar, Prakash S Masand, Chi-Un Pae
Introduction Schizophrenia is a debilitating illness with a chronic impact on social function and daily living. Although various antipsychotics are available, there are still many challenges and unmet needs. Thus, many compounds with diverse mechanisms have been investigated, but all approved antipsychotics still require interactions with dopamine D2 receptors. Areas Covered We searched for investigational drugs using the key words 'dopamine' and 'schizophrenia' in American and European clinical trial registers (clinicaltrials...
April 26, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28443282/imprecision-in-the-era-of-precision-medicine-in-non-small-cell-lung-cancer
#19
REVIEW
Raghav Sundar, Maxime Chénard-Poirier, Dearbhaile Catherine Collins, Timothy A Yap
Over the past decade, major advances have been made in the management of advanced non-small cell lung cancer (NSCLC). There has been a particular focus on the identification and targeting of putative driver aberrations, which has propelled NSCLC to the forefront of precision medicine. Several novel molecularly targeted agents have now achieved regulatory approval, while many others are currently in late-phase clinical trial testing. These antitumor therapies have significantly impacted the clinical outcomes of advanced NSCLC and provided patients with much hope for the future...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28442838/wound-outcome-following-primary-and-delayed-primary-skin-closure-techniques-after-laparotomy-for-non-traumatic-ileal-perforation-a-randomized-clinical-trial
#20
Vivek Agrawal, Mohit Kumar Joshi, Ashish Kumar Gupta, Bhupendra Kumar Jain
To study the effect of primary and delayed primary closure of skin incision on wound outcome in patients with non-traumatic ileal perforation, 68 patients of ileal perforation were studied in a prospective randomized clinical trial. Patients fulfilling inclusion criteria were divided into ileostomy and non-ileostomy groups, both of which were then randomized into two subgroups each depending on whether skin was closed primarily or in a delayed primary manner. Wound infection and dehiscence were the main outcome parameters studied...
April 2017: Indian Journal of Surgery
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