International journal of clinical practice
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Int. J. Clin. Pract. · Aug 2011
Review Meta AnalysisAutologous transplantation of blood-derived stem/progenitor cells for ischaemic heart disease.
Early clinical trials suggest that blood-derived stem/progenitor cells (including peripheral blood-derived stem cells and circulating progenitor cells) may have a positive impact on patients with ischaemic heart disease (IHD). The therapeutic effects of these cells remain unclear, considering the inconsistent results of several clinical trials. The objective of this meta-analysis was to evaluate the effects of autologous blood-derived stem/progenitor cells on improvement of cardiac functional parameters on the basis of a synthesis of the data generated by randomised controlled clinical trials (RCTs) of patients with IHD. ⋯ Available evidence showed moderate improvements over conventional therapy in LVEF of blood-derived stem/progenitor cells transplantation in patients with IHD, and supports further RCTs with higher quality.
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Int. J. Clin. Pract. · Aug 2011
Multicenter StudyThe Migraine Intervention Score - a tool to improve efficacy of triptans in acute migraine therapy: the ALADIN study.
The 'Migraine Intervention Score' (MIS) is a new self-administered scale that can be used to quantify the severity of specific migraine symptoms. The objective of this study was to determine if MIS could be used to improve the efficacy of frovatriptan 2.5 mg in the early treatment of migraine attacks for clinical practice. ⋯ The initiation of attack treatment with frovatriptan at low severity of migraine symptoms is more effective than starting therapy at higher symptom levels. Together with the low recurrence headache rate, the decreased necessity for escape medication and the low number of tablets needed, these data demonstrate that operationalised intervention with frovatriptan 2.5 mg is a valuable method for improving the treatment of migraine attacks.
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Int. J. Clin. Pract. · Aug 2011
ReviewA comprehensive review of predictive and prognostic composite factors implicated in the heterogeneity of treatment response and outcome across disease areas.
To assess and present the current body of evidence regarding composite measures associated with differential treatment response or outcome as a result of patient heterogeneity and to evaluate their consistency across disease areas. ⋯ Composite measures can play an important role in characterising heterogeneity of treatment response and outcome in patients suffering from various medical conditions. These measures can help clinicians to better distinguish between patients with high likelihood to respond well to treatment and patients with minimal chances of positive therapeutic outcomes. Herein, the individual factors identified can be used to develop novel predictive or prognostic composite measures that can be applicable across disease areas. Reflecting these cross-disease measures in clinical and public health decisions has the distinctive appeal to enable targeted treatment for patients suffering from multiple medical conditions, which may ultimately yield significant gains in individual outcomes, population health and cost-effective resource allocation.
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Int. J. Clin. Pract. · Jul 2011
Review Meta Analysis Comparative StudyBudesonide/formoterol vs. salmeterol/fluticasone in COPD: a systematic review and adjusted indirect comparison of pneumonia in randomised controlled trials.
This analysis was designed to provide a comparison between budesonide/formoterol and salmeterol/fluticasone for the relative incidence of pneumonia adverse events, pneumonia serious adverse events and pneumonia-related mortality in patients being treated for chronic obstructive pulmonary disease. ⋯ The results of the indirect comparison support the hypothesis that budesonide/formoterol is associated with fewer pneumonia events than salmeterol/fluticasone in chronic obstructive pulmonary disease. The limitations of the analysis are that the results from a single study, TORCH, have a large bearing on the overall findings of the analysis, and that there is heterogeneity in the length and the dosing of the included studies, although it does not appear that heterogeneity affected the reported results. Another important limitation is the lack of predefined diagnostic standards for pneumonia in these studies.