Reviews on recent clinical trials
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Rev Recent Clin Trials · Jan 2010
ReviewThe role of continuous positive airway pressure in the treatment of hypertension in patients with obstructive sleep apnea-hypoapnea syndrome: a review of randomized trials.
Obstructive sleep apnea-hypoapnea syndrome (OSA) is a disorder that results in repetitive occlusion of the airway and hypoxemia during sleep. Epidemiologic studies have associated this disorder with increased cardiovascular morbidity and mortality. Systemic hypertension is prevalent among patients with OSA and has been recognized as a common identifiable cause of hypertension. ⋯ The use of nCPAP ventilation to treat hypertension in patients with OSA has been studied extensively. However, whether it is effective in treating hypertension in this population remains unclear. This review evaluates the recent literature that investigates the effects of nCPAP ventilation on hypertension in patients with OSA.
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Infection with hepatitis C virus (HCV) is a global health problem that affects approximately 170 million people worldwide. The current standard therapy with peginterferon alpha plus ribavirin for 48 weeks results in a sustained virologic response in less than 50% of patients with chronic hepatitis C genotype 1--the most prevalent type of HCV in North America and Europe. Development of new antiviral medicines has been hampered by the lack of an effective cell culture system and small-animal model. Herein we review recent progress in the development of new treatments under investigation in clinical trials, including specifically targeted antiviral therapy for HCV such as NS3/4A protease and NS5B polymerase inhibitors.
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Rapid sequence intubation is an essential bullet in the maintenance of patency of the airway during intubation in emergency. It is a valid method in all those situations where you can not determine whether the patient is fasting or not. But RSI is not applicable in all critically ill patients. ⋯ The problem that limits the use of Rocuronium is the fact that its duration of action is much longer than that of Succinylcholine, especially when used at higher doses. This problem can be solved through the use of Sugammadex. As a muscle relaxant chelating Sugammadex antagonizes the effects induced by Rocuronium on muscle tissue and quickly resolve the blockade.
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Rev Recent Clin Trials · May 2009
ReviewLong-term bronchodilator inhaled therapy in COPD: the role of tiotropium bromidum.
Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the lungs in which airways inflammation related mainly to smoking causes progressive airflow obstruction and chronic respiratory symptoms such as dyspnea or cough. COPD therapy in stable state is mainly inhalatory with bronchodilators and inhaled corticosteroids and the regimen depends on disease severity. ⋯ Current therapeutic guidelines are based on data from studies assessing long-term impact of such therapies on outcome measures such as lung function, survival, exacerbations or health-related quality of life (HRQoL). This is a review discussing the data regarding to inhaled bronchodilators with a focus on a long-acting anticholinergic, tiotropium bromide.
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Targeted alpha therapy is an advancing experimental therapy that holds promise to deliver high cytotoxicity to targeted cancer cells. Initially thought to be indicated for leukaemia and micrometastases, there is now evidence that solid tumours can also be regressed. Alpha therapy may be molecular or physiological in its targeting. ⋯ Alternatively, radium-233 is used for palliative therapy of breast and prostate cancers as it is a bone seeking element. Progress in the development of clinical trials of alpha therapy is examined for leukaemia, lymphoma, melanoma, glioblastoma multiforme, bone metastases, ovarian cancer, pancreatic cancer and other cancers. Results of past and current trials are reviewed, and the bases of some proposed trials are presented.