Expert opinion on pharmacotherapy
-
Expert Opin Pharmacother · Dec 2005
The 41st Annual Meeting of the American Society of Clinical Oncology. Orlando, FL, USA, 13-17 May, 2005.
Nearly 29,000 scientists from all over the world gathered at the 41st Annual Meeting of the American Society of Clinical Oncology (ASCO). The programme included the presentation of new data encompassing all the fields of cancer research, including cancer prevention, treatment and biology. Special sessions were added to summarise and discuss achievements in the field of translational research on biologically targeted therapies. ⋯ Increased knowledge in the field of molecular oncology, genetics and progress in technology are revolutionising tumour classification, prognostication, prediction and therapy. However, at present, for most of the diseases, improvements brought about by the newer therapies are small, although clinically meaningful. This review will briefly address some of the most interesting data presented at ASCO 2005.
-
Expert Opin Pharmacother · Nov 2005
ReviewManagement of adrenal insufficiency in different clinical settings.
Adrenal insufficiency is a rare disease, but its prevalence is increasing. The most frequent cause of primary adrenal insufficiency in western countries is autoimmune adrenalitis, whereas secondary adrenal insufficiency is most often caused by pituitary tumours and their treatment (e.g., surgery). Chronic glucocorticoid replacement consists of hydrocortisone 15-25 mg/day in divided doses and dose monitoring is largely based on clinical judgement. ⋯ Careful and repeated education of patients and their partners is the best strategy to avoid this life-threatening emergency. Some recent studies suggest that during sepsis some patients with intact adrenal function may develop transient relative adrenal insufficiency and benefit from administration of hydrocortisone plus fludrocortisone. However, the pathophysiology and diagnosis criteria of relative adrenal insufficiency and its treatment remain unsettled issues.
-
Expert Opin Pharmacother · Sep 2005
Review Meta Analysis Comparative StudyFluvastatin: efficacy and safety in reducing cardiac events.
The importance of statin therapy in lipid-lowering and its role in primary and secondary prevention has been borne out of numerous clinical trials conducted over the last two decades. Concurrently, much concern has been expressed over the safety and tolerability of these drugs. Fluvastatin has demonstrated good clinical efficacy and safety. This paper reviews the various pharmacological properties and evidence supporting its use in the prevention of cardiac events.
-
In recent years, increased attention to women's sexual health has propelled basic scientific research and clinical trials investigating treatment paradigms for improving sexual well-being. As the prevalence of female sexual dysfunction has become manifest, knowledge of the intricate pathophysiological role of androgens in maintaining sexual function has fostered a clearer understanding of the effect of age on androgen status, the role of androgens in the postmenopausal ovary, and aetiological mechanisms of androgen insufficiency in premenopausal and postmenopausal women. Understanding the long-term safety and efficacy of physiological androgen replacement and the development of sensitive testosterone assays for specific use in women will better characterise women who are most likely to respond to androgen therapy and, thereby, optimise their quality of life.
-
Expert Opin Pharmacother · Aug 2005
Review Comparative StudyReducing risk of cardiovascular events in noncardiac surgery.
Cardiac adverse events are a major cause of complications in noncardiac surgery. The benefit of preventive coronary artery revascularisation in stable patients before noncardiac surgery has recently been clarified: in the short-term there is no reduction in the number of postoperative myocardial infarction, deaths or hospital length of stay. Coronary artery revascularisation should be limited to these patients who have a well-defined need for the procedure, independent of the need of noncardiac surgery. ⋯ This review presents the studies that support the beneficial effect of beta-blockers, pharmacological effects and some practical aspects in noncardiac surgery. In the management of most of these patients, the use of beta-blockers can aid in the avoidance of a preoperative stress test. The remaining problem to solve is the cost-effective identification of the small group of patients in which the protective effect of beta-blocker therapy is insufficient and a cardiac revascularisation should be considered.