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European Association (european + association)
Selected AbstractsThiazolidinediones: effects on the development and progression of type 2 diabetes and associated vascular complicationsDIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2009Andrew Krentz Abstract In addition to reducing hyperglycaemia, the metabolic actions of TZDs (pioglitazone and rosiglitazone) in theory might improve the prognosis of patients with type 2 diabetes. However, it appears from recent data that pioglitazone and rosiglitazone have different cardiovascular risk profiles. The scope of this paper is to examine the benefits and risks of pioglitazone and rosiglitazone. Three large clinical studies (DREAM, and ADOPT with rosiglitazone; PROactive with pioglitazone) have recently been reported. A lower annual rate of decline of ß-cell function observed with rosiglitazone in the ADOPT study, compared with metformin and glyburide (glibenclamide), along with a reduced progression to insulin use seen with pioglitazone in the PROactive study, provides evidence that TZDs are effective in treating progressive hyperglycaemia. In PROactive, although the primary endpoint was not met, pioglitazone was associated with a reduction in a secondary composite endpoint of clinical cardiovascular events in high-risk patients with existing macrovascular disease who were already receiving other glycaemic and cardiovascular medications. Further evidence supporting an anti-atherogenic effect of pioglitazone was gained from the PERISCOPE study of carotid intima-media thickness. Recent controversy concerning a possible increased risk of myocardial infarction associated with rosiglitazone has fuelled uncertainty about the risk,benefit profile of this agent. In 2008, an update of an American Diabetes Association,European Association for the Study of Diabetes consensus statement on initiation and adjustment of therapy in patients with type 2 diabetes advised clinicians against using rosiglitazone. Skeletal fractures have recently emerged as a side effect of both TZDs. Available data suggest that cardiovascular benefits observed with pioglitazone might not be a class effect of TZDs. Copyright © 2009 John Wiley & Sons, Ltd. [source] Estimated average glucose derived from HbA1c (eAG): report from European Association for the Study of Diabetes (EASD), Amsterdam 2007DIABETIC MEDICINE, Issue 2 2008S. E. Manley No abstract is available for this article. [source] Abstracts of the 3rd Annual Congress of the European Association for Haemophilia and Allied DisordersHAEMOPHILIA, Issue 2 2010Article first published online: 25 FEB 2010 First page of article [source] Abstracts of the 2nd Annual Congress of the European Association for Haemophilia and Allied DisordersHAEMOPHILIA, Issue 2 2009Article first published online: 23 MAR 200 First page of article [source] Drug-eluting bead therapy in primary and metastatic disease of the liverHPB, Issue 7 2009Stewart Carter Abstract Background:, Drug-eluting bead transarterial chemoembolization (DEB-TACE) is a novel therapy for the treatment of hypervascuarized tumours. Through the intra-arterial delivery of microspheres, DEB-TACE allows for embolization as well as local release of chemotherapy in the treatment of hepatic malignancy, providing an alternative therapeutic option in unresectable tumours. Its role as an adjunct to surgical resection or radiofrequency ablation (RFA) is less clear. The purpose of this review is to summarize recent studies investigating DEB-TACE in order to better define safety, efficacy and outcomes associated with its use. Methods:, A systematic review of all published articles and trials identified nine clinical trials and 23 abstracts. These were reviewed for tumour histology, stage of treatment, delivery technique, outcome at follow-up, complications and mortality rates. Results:, Publications involved treatment of hepatocellular carcinoma (HCC), metastatic colorectal carcinoma (MCRC), metastatic neuroendocrine (MNE) disease and cholangiocarcinoma (CCA). Using Response Evaluation Criteria in Solid Tumours (RECIST) or European Association for the Study of the Liver (EASL) criteria, studies treating HCC reported complete response (CR) rates of 5% (5/101) at 1 month, 9% (8/91) at 4 months, 14% (19/138) at 6 months and 25% (2/8) at 10 months. Partial response (PR) was reported as 58% (76/131) at 1 month, 50% (67/119) at 4 months, 57% (62/108) at 6,7 months and 63% (5/8) at 10 months. Studies involving MCRC, CCA and MNE disease were less valuable in terms of response rate because there is a lack of comparative data. The most common procedure-associated complications included fever (46,72%), nausea and vomiting (42,47%), abdominal pain (44,80%) and liver abscess (2,3%). Rather than reporting individual symptoms, two studies reported rates of post-embolic syndrome (PES), consisting of fever, abdominal pain, and nausea and vomiting, at 82% (75/91). Six of eight studies reported length of hospital stay, which averaged 2.3 days per procedure. Mortality was reported as occurring in 10 of 456 (2%) procedures, or 10 of 214 (5%) patients. Conclusions:, Drug-eluting bead TACE is becoming more widely utilized in primary and liver-dominant metastatic disease of the liver. Outcomes of success must be expanded beyond response rates because these are not a reliable surrogate for progression-free survival or overall survival. Ongoing clinical trials will further clarify the optimal timing and strategy of this technology. [source] Clinical and metabolic evaluation of subjects with erectile dysfunction: a review with a proposal flowchartINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 3 2009C. Foresta Summary Erectile function is a haemodynamic phenomenon depending on the integrity of neurological, vascular, endocrinological, tissue (corpora cavernosa), psychological and relational factors; changes in any one of these components may lead to erectile dysfunction (ED). ED and its comorbid conditions share common risk factors such as endothelial dysfunction, atherosclerosis and metabolic and hormonal abnormalities. Furthermore, although cross-sectional studies have shown a clear age-dependent association between ED, diabetes mellitus, hypertension, metabolic syndrome (MetS) and cardiovascular diseases, longitudinal evidence has recently emphasized that ED could be an early marker of these conditions. Recently, the European Association of Urology and American Urology Association provided consensus guidelines for the management of ED patients. However, the metabolic aspect of ED is rather neglected or not sufficiently treated. In this study, more emphasis will be placed on the presence of ED comorbid metabolic factors. The primary and secondary goals of therapy, according to current guidelines and to prevent their clinical evolution, will also be provided. We review the concepts of metabolic diseases related to ED and their treatment. Criteria for the diagnosis and treatment of hypogonadism, metabolic and vascular disease related to ED were analysed. ED can mark the starting point for the evaluation and prevention of significant severe diseases (such as diabetes, MetS, dyslipidaemia, arteriosclerosis, hypertension, ischaemic cardiopathy, neuropathy, etc.) hitherto unknown by the patients. Most widely used criteria for the diagnosis and treatment of these diseases were reported. We suggest a clinical approach which allows the identification of metabolic and others systemic pathologies contributing to the development of ED. This approach may constitute an improvement in disease prognosis and either induce a spontaneous reduction of ED or facilitate its specific therapy. [source] The impact of publishing medical specialty society guidelines on subsequent adoption of best practices: a case study with type 2 diabetesINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2010E. A. Huang Summary Aims:, Our goal was to determine the effect of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consensus algorithm for the initiation and adjustment of type 2 diabetes (T2D) therapy, published in 2006, on the incidence of early metformin monotherapy (EMM), defined as the prescription of metformin and no other antidiabetic medications within 30 days of initial T2D diagnosis. Methods:, The incidence of EMM in the United States (US) from January 2005 to December 2007 was estimated using data from the i3 InVisionÔ Data Mart, an integrated database of enrolment dates, inpatient and outpatient medical claims, pharmaceutical claims, and laboratory results from a diverse group of US health plans. The trend in the incidence of EMM was analysed using joinpoint regression modelling. Results:, A statistically significant joinpoint was found in July 2006 (p < 0.05). From January 2005 to July 2006, EMM increased at an annualised rate of 15.6%. From July 2006 to December 2007, EMM increased at an annualised rate of 66.0%. Conclusions:, Our findings suggest that publication of the ADA/EASD algorithm caused a significant acceleration in the incidence of EMM. [source] Controversies in perioperative management and antimicrobial prophylaxis in urologic surgeryINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2008Shingo Yamamoto Abstract: The Japanese Urological Association (JUA) recently published guidelines for the prevention of perioperative urologic infections. Although the general remarks in the JUA guidelines are almost similar to those in guidelines previously published by the Centers for Disease Control and Prevention (CDC) and in the European Association of Urology (EAU) guidelines, their differences leave several questions that need to be answered. To clarify agreements and differences in guidelines for perioperative management in urologic interventions for development of more optimal guidelines, reports and reviews previously published were overlooked and discussed. In terms of surgical site infections (SSI) in urologic surgery, consensus for open and endoscopic-instrumental procedures is still somewhat controversial, while a consensus has not yet emerged for its use in laparoscopic procedures. Further research is required to determine what is an optimal prophylactic protocol to effectively prevent both SSI and remote infections (RI). [source] A short history of the development studies associationJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 6 2009Michael Tribe Abstract This paper outlines the origins of the Development Studies Association (DSA) in the 1960s together with the main features of the association since its formation in 1978. Some of the leading individuals in this evolution are identified, but it is made clear that institutional pressures have also been important over the years. Issues which threaten the Association include ,free-riding' (the obverse of which is ,externalities') as well as the linked question of those involved in ,development' who are neither members nor involved in the activities of the association. The paper also considers whether the DSA has ,made a difference', links the DSA to its European sister association, the European Association of Development Research and Training Institutes (EADI), and describes recent and prospective future developments. Copyright © 2009 John Wiley & Sons, Ltd. [source] European Manifesto on Basic Standards of Health Care For People with Intellectual DisabilitiesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2004M. M. Meijer Abstract An invitational conference organized by the Netherlands Society of Physicians for Persons with Intellectual Disabilities (NVAVG) and the European Association of Intellectual Disability Medicine (MAMH), in collaboration with the Erasmus Medical Center's Department of Specialist Training for Physicians for People with Intellectual Disabilities, had as its aim the development and issuance of an European manifesto on adequate health care for people with intellectual disabilities (ID). This paper provides an overview of the basis for the conference and the manifesto and lays out recommendations for the implementation of the manifesto's main points. The group's product, the European Manifesto on Basic Standards of Health Care for People with Intellectual Disabilities, summarizes the core elements of adequate health care for individuals with ID, and offers guidance on how Europe's nations may address deficiencies in health provision for people with ID. The manifesto's main points include a call for greater available and accessible health care, increasing the competencies in ID of health professionals, educators, and researchers, a greater reliance on a multidisciplinary approach to health care, more specialist services, and a proactive emphasis on personal health management. [source] European Association for the Study of Liver (EASL) 37th Annual MeetingLIVER INTERNATIONAL, Issue 5 2001April 1, Madrid, Spain [source] Uncovering Southeast Asia's Past: Selected Papers from the 10th International Conference of the European Association of Southeast Asian Archaeologists edited by Elisabeth A. Bacus, Ian C. Glover, and Vincent C. PigottAMERICAN ANTHROPOLOGIST, Issue 1 2008DOUGLAS D. ANDERSON No abstract is available for this article. [source] Global nutritional recommendations: a combination of evidence and food availability?PRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 1 2008K Kapur BSc, PGDipDiet Dietitian/Diabetes Educator Abstract Diet and exercise are vital diabetes management strategies. Health professionals (HPs) use dietary guidelines to advise their clients but the current macronutrient recommendation in the guidelines varies. The aim of this study was to explore the similarities and differences in macronutrient dietary advice in different parts of the world and suggest some reasons for any differences identified. The study was undertaken in two phases: (1) a one-shot cross-sectional survey of HPs and global diabetes organisations using self-completed, anonymous questionnaires (n=40), and (2) a review of dietary guidelines from relevant diabetes associations (the American Diabetes Association [ADA], the Diabetes and Nutrition Study Group [DNSG] of the European Association for the Study of Diabetes [EASD], the Canadian Diabetes Association [CDA], the Joslin Diabetes Center, Diabetes UK, and the Indian Council of Medical Research [ICMR]). Dietary recommendations differed among countries and from the guidelines, and reflected socioeconomic factors and local food availability. With regard to macronutrient recommendations, carbohydrate ranged from 40,70%, protein 12,20% and fat 15,40% of total energy intake. Nations with higher gross domestic product (GDP) based on purchasing-power-parity (PPP) per capita tended to recommend a much lower ratio of carbohydrate than those with lower GDP PPP per capita. However, all guidelines stressed the importance of healthy eating. It was concluded that socioeconomic factors and local food availability appear to influence HPs' dietary recommendations. Copyright © 2008 John Wiley & Sons. [source] Highlights from the 38th annual meeting of the European Association for the Study of Diabetes (EASD)PRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 9 2002Article first published online: 7 JAN 200 First page of article [source] Premature Ejaculation: On Defining and Quantifying a Common Male Sexual DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 2006Gregory A. Broderick MD ABSTRACT Introduction., Premature ejaculation (PE) and its individual and relationship consequences have been recognized in the literature for centuries. PE is one of the most common male sexual dysfunctions, affecting nearly one in three men worldwide between the ages of 18 and 59 years. Until recently, PE was believed to be a learned behavior predominantly managed with psychosexual therapy; however, the past few decades have seen significant advances in understanding its etiology, diagnosis, and management. There is, as yet, no one universally agreed upon definition of PE. Aim., To review five currently published definitions of PE. Methods., The Sexual Medicine Society of North America hosted a State of the Art Conference on Premature Ejaculation on June 24,26, 2005 in collaboration with the University of South Florida. The purpose was to have an open exchange of contemporary research and clinical information on PE. There were 16 invited presenters and discussants; the group focused on several educational objectives. Main Outcome Measure., Data were utilized from the World Health Organization, the American Psychiatric Association, the European Association of Urology, the Second International Consultation on Sexual Dysfunctions, and the American Urological Association. Results., The current published definitions of PE have many similarities; however, none of these provide a specific "time to ejaculation," in part because of the absence of normative data on this subject. While investigators agree that men with PE have a shortened intravaginal ejaculatory latency time (IELT; i.e., time from vaginal penetration to ejaculation), there is now a greater appreciation of PE as a multidimensional dysfunction encompassing several components, including time and subjective parameters such as "control,""satisfaction," and "distress." Conclusion., There is a recent paradigm shift away from PE as a unidimensional disorder of IELT toward a multidimensional description of PE as a biologic dysfunction with psychosocial components. Broderick GA. Premature ejaculation: On defining and quantifying a common male sexual dysfunction. J Sex Med 2006;3(suppl 4):295,302. [source] Proceedings of the XXVIIIth congress of the European Association of Veterinary Anatomists Paris, France July 28,31, 2010ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 4 2010Article first published online: 12 JUL 2010 First page of article [source] CANCER INPATIENTS MORPHINE USAGE: A NEW ENGLAND AREA SURVEYAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2003John Trollor ABSTRACT:,This is a one year study of the use of morphine in cancer patients in 10 inpatient facilities in the New England Area Health Service in the north-west of New South Wales. The study explored 170 admissions relating to 122 patients, most of whom were cared for by their general practitioners. The use of morphine in these cancer patients was compared with the recommendations made by the expert working group of the European Association of Palliative Care.1 Those items which matched the recommendations included the initial doses for new users of morphine and the subcutaneous route being the preferred parenteral route. The data in this study differed from the recommendations in that only half of the patients received the immediate release morphine when first given oral morphine, only 43% had orders for immediate release oral morphine for breakthrough pain (with a variable frequency) and a significant number of orders for parenteral and immediate release oral morphine for breakthrough pain were outside the recommended doses (100% and 86.2%, respectively). Written orders for immediate release oral and parenteral morphine involved a dose range in significant numbers while only 30% of patients had orders for parenteral morphine for breakthrough pain. There was a low use of fixed interval variable dose (FIVD) morphine charts despite these being available in most facilities. (See summary Appendix A.) [source] Educating European (Junior) Doctors for Safe PrescribingBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 6 2007Simon R. J. Maxwell Junior doctors who have recently graduated are responsible for much of the prescribing that takes place in hospitals and are implicated in many of the adverse medication events. Analysis of such events suggests that lack of knowledge and training underlies many of them and it has been shown that dedicated training can increase prescribing performance. In the context of these problems, it is a matter of increasing concern that recent changes to undergraduate medical education may have reduced exposure to clinical pharmacology, a discipline dedicated to optimal practice in relation to medicines. For this reason, the European Association of Clinical Pharmacology and Therapeutics (EACPT) and British Pharmacological Society (BPS) jointly organized a meeting to explore (i) the state of undergraduate education in clinical pharmacology in Europe, (ii) the knowledge and competencies in relation to medicines that should be expected of a new graduate, (iii) assessments that might demonstrate that this minimum standard had been reached, (iv) a curriculum that might help medical students to achieve this standard and (v) how competence can be developed in the postgraduate phase. It was agreed that the lack of exposure to clinical pharmacology is a cause for concern at a time when the challenges facing junior prescribers have never been greater. The potential for undertaking further research was discussed. [source] Tadalafil and vardenafil vs sildenafil: a review of patient-preference studiesBJU INTERNATIONAL, Issue 9 2009Vincenzo Mirone The immediate objective of phosphodiesterase type 5 (PDE5) inhibitor treatment is to restore the ability of a man to achieve and/or maintain an erection adequate for sexual intercourse. As erectile dysfunction (ED) generally develops in the second half of life, the ultimate objective generally is not procreation, but quality of sexual life. Indeed, ED is known to impair quality of life considerably; two-thirds of men report that ED has impaired their self-esteem and nearly a third claim that it has damaged the relationship with their partner. It follows that the therapeutic success of PDE5 inhibition has an important subjective component, which is compounded by the subjective nature and complexity of sexual life in humans. This makes it very difficult for physicians to be certain that they have selected the optimal therapy for a couple, even after a thorough evaluation. The 2007 European Association of Urology Guidelines stress the importance of educating the patient and claim that ,the patient will choose the final drug after his own experience'. However, PDE5 inhibitors are typically used twice a week, so a patient would have to spend ,3 months trying the various compounds and dosages to achieve adequate exposure to all three PDE5 inhibitors; this would seem an unrealistic strategy in normal clinical practice. The acknowledgement that the patient has an important role in therapeutic decisions for ED has fuelled interest in the concept of patient preference. It has been established that patient preference depends on three factors, i.e. personal characteristics, e.g. age, duration of ED, frequency and dynamics of sexual relations, and the characteristics of their partners, e.g. age, menopausal status and level of interest in sexual activity and medication profile. Medication features of interest include efficacy in terms of quality of erection, consistency of effects, rapid onset of action, long duration of action, side-effect profile and route of administration; drug costs must also be considered if the medicinal product is not reimbursed. [source] Evaluation of tumor response after locoregional therapies in hepatocellular carcinoma,CANCER, Issue 3 2009Are response evaluation criteria in solid tumors reliable? Abstract BACKGROUND: Evaluation of response to treatment is a key aspect in cancer therapy. Response Evaluation Criteria in Solid Tumors (RECIST) are used in most oncology trials, but those criteria evaluate only unidimensional tumor measurements and disregard the extent of necrosis, which is the target of all effective locoregional therapies. Therefore, the European Association for the Study of the Liver (EASL) guidelines recommended that assessment of tumor response should incorporate the reduction in viable tumor burden. The current report provides an assessment of the agreement/concordance between both RECIST and the EASL guidelines for the evaluation of response to therapy. METHODS: The authors evaluated a cohort of 55 patients within prospective studies, including 24 patients with hepatocellular carcinoma who underwent transarterial chemoembolization (TACE) with drug eluting beads (DEB-TACE) and 31 patients who underwent percutaneous ablation (percutaneous ethanol injection [PEI]/radiofrequency [RF]). Triphasic helical computed tomography scans were performed at baseline, at 1 month, and at 3 months after procedure, and 2 independent radiologists evaluated tumor response. RESULTS: Evaluating response according to RECIST criteria, no patients achieved a complete response (CR), 21.8% of patients achieved a partial response (PR) (none in the PEI/RF group), 47.3% of patients had stable disease (SD), and 30.9% of patients had progressive disease (PD). When response was evaluated according to the EASL guidelines, 54.5% of patients achieved a CR, 27.3% of patients achieved a PR, 3.6% of patients had SD, and 14.5% had PD. The , coefficient was 0.193 (95% confidence interval, 0.0893-0.2967; P < .0001). CONCLUSIONS: RECIST missed all CRs and underestimated the extent of partial tumor response because of tissue necrosis, wrongly assessing the therapeutic efficacy of locoregional therapies. This evaluation should incorporate the reduction in viable tumor burden as recognized by nonenhanced areas on dynamic imaging studies. Cancer, 2009. © 2008 American Cancer Society. [source] The 8th Annual Conference of the European Association of Dental Public Health (EADPH e.V.) 21st to 23rd August, 2003, Jyväskylä, FinlandCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2003Article first published online: 24 JAN 200 No abstract is available for this article. [source] | |||||||||||||||||||||||||