Reviews on recent clinical trials
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The Gastrointestinal (GI) tract is one of the most affected systems by alcohol consumption. Alcohol can affect the esophagus in several ways: induces mucosal inflammation, increases the risk for Barrett esophagus and esophageal cancer, and also impairs the esophageal motility. Numerous studies have reported an increased prevalence of Gastroesophageal Reflux Disease (GERD) or erosive esophagitis in alcoholics. ⋯ The effect of alcohol on small bowel motility differs according to the type of consumption (acute or chronic). Acute administration of alcohol has been found to inhibit small bowel transit and chronic administration of a large dose of alcohol accelerates small bowel transit. This article reviews some of the below findings.
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Rev Recent Clin Trials · Jan 2015
ReviewRole of Carboplatin in the Treatment of Triple Negative Early- Stage Breast Cancer.
Triple negative breast cancer (TNBC) is more prevalent in younger patients and those carrying BRCA mutations. Although the incidence of breast cancer in general has dropped during the last years, TNBC has shown a relative increase. It is recognized as a breast cancer subtype with a high risk of tumor relapse and mortality. ⋯ Recently, two randomized phase 2 clinical trials support this presumption. However, improvement in pCR rates does not come free of toxicity. Given the potential change in practice associated with the generalized use of carboplatin in the neoadjuvant setting for TNBC patients, the aim of this review is to discuss the benefits as well as the potential drawbacks linked with the use of this strategy.
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Rev Recent Clin Trials · Jan 2014
Choice of Fluids in Severe Septic Patients - A Cost-effectiveness Analysis Informed by Recent Clinical Trials.
Fluid resuscitation with colloids is an established second line therapy for septic patients. Evidence of relative efficacy outcomes is tempered by considerations of the relative costs of the individual fluids. An assessment of recent large clinical trials was performed, resulting in a ranking in the efficacy of these therapies. ⋯ One-way sensitivity analysis showed that the model's outcomes were sensitive to the cost of RRT but not to the costs of the actual fluids or any other costs. We conclude that albumin may be the most cost-effective treatment in these patients when the total medical costs and iatrogenic morbidities involved in treating sepsis with fluids are considered. These results should assist and inform decision making in the choice of these drugs.
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Rev Recent Clin Trials · Jun 2013
ReviewEmerging evidence that radial is safer than femoral percutaneous coronary intervention in subjects with ST segment elevation myocardial infarction.
Bleeding complications in patients with acute coronary syndromes are a significant predictor of mortality. Trans-radial approach (TRA) is a promising strategy to reduce bleedings in patients undergoing invasive coronary procedures. Recently, two multicentre prospective randomized trials aimed to test whether TRA, compared to trans-femoral approach (TFA), may improve clinical outcome in patients with ST-elevation myocardial infarction: the RIFLE STEAC and STEMI-RADIAL. ⋯ The rate of MACE at 30 days was 4.2 percent in the TFA group, and 3.5 percent in the TRA group (p=0.7). The results of two recent trials support the systematic adoption of TRA instead of TFA approach to improve the clinical outcome of STEMI patients. In the present paper, we overview the results of these two trials and put them in the context of previous scientific evidences collected in this field.
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Rev Recent Clin Trials · Jun 2013
ReviewSelumetinib in advanced non small cell lung cancer (NSCLC) harbouring KRAS mutation: endless clinical challenge to KRAS-mutant NSCLC.
During the past few years, oncologists have witnessed the reclassification of non small cell lung cancer (NSCLC) as not one disease, but several molecularly defined subsets of disease with relevant therapeutic implications in the field of molecularly targeted therapies. Two not very common genetically defined subsets of NSCLC, including those with EGFR or ALK activating mutations, and show high sensitivity to tyrosine-kinase inhibitors such that patients frequently have sustained clinical responses to therapy. However, the largest subset harbours an activating KRAS mutation and up to now, no successful targeted therapy has been developed for RAS-mutant lung cancer, with few compounds being assessed by clinical trials. ⋯ Selumetinib (AZD6244; ARRY-142886) is an oral, tight-binding, uncompetitive inhibitor of mitogen-activated protein kinase kinases (MEK) 1 and 2, downstream of KRAS, with preclinical evidence of synergistic activity with docetaxel in KRAS-mutant cancers and currently in clinical development. The Ras/RAF/MEK/ERK pathway is frequently deregulated in cancer and a number of inhibitors that target this pathway are currently in clinical development. Recently, in a randomised, phase II trial selumetinib plus docetaxel has proven to improve progression free survival compared to docetaxel alone in previously treated patients with advanced KRAS-mutant NSCLC.