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Relevant Clinical Trials (relevant + clinical_trials)
Selected AbstractsTreatment of schizoaffective disorder , a challenge for evidence-based psychiatryACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2010M. Jäger Objective:, Schizoaffective disorder is a common diagnosis in mental health services. The aim of the present article was to review treatment studies for schizoaffective disorder and draw conclusions for clinical decision making. Method:, We searched MEDLINE and Cochrane Library for relevant clinical trials and review articles up to the year 2008. Results:, Thirty-three studies using standardized diagnostic criteria, 14 of which were randomized controlled trials, could be identified. The comparability of studies is limited by the use of different diagnostic criteria. The studies reviewed do not permit consistent recommendations as to whether schizoaffective disorder should be treated primarily with antipsychotics, mood stabilizers or combinations of these drugs. The relevance of diverse subtypes of schizoaffective disorder for treatment recommendations is unclear. Conclusion:, The pertinent empirical database is small and heterogeneous. The lack of conclusive recommendations is related to issues of nosological status, plurality of diagnostic criteria and validity of the concept of schizoaffective disorder. [source] Meta-analysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoeaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2005H. SZAJEWSKA Summary Background :,Antibiotic-associated diarrhoea occurs in up to 30% of patients who receive antibiotics but can be prevented with probiotics. Aim :,To systematically evaluate the effectiveness of Saccharomyces boulardii in preventing antibiotic-associated diarrhoea in children and adults. Methods :,Using medical subject headings and free-language terms, the following electronic databases were searched for studies relevant to antibiotic-associated diarrhoea and S. boulardii: MEDLINE, EMBASE, CINAHL and The Cochrane Library. Additional sources were obtained from references in reviewed articles. Only randomized-controlled trials were considered for study inclusion. Results :,Of 16 potentially relevant clinical trials identified, five randomized-controlled trials (1076 participants) met the inclusion criteria for this systematic review. Treatment with S. boulardii compared with placebo reduced the risk of antibiotic-associated diarrhoea from 17.2% to 6.7% (RR: 0.43; 95% CI: 0.23,0.78; random effect model). The number needed to treat to prevent one case of antibiotic-associated diarrhoea was 10 (95% CI: 7,16). No side-effects were reported. Conclusions :,A meta-analysis of data from five randomized-controlled trials showed that S. boulardii is moderately effective in preventing antibiotic-associated diarrhoea in children and adults treated with antibiotics for any reason (mainly respiratory tract infections). For every 10 patients receiving daily S. boulardii with antibiotics, one fewer will develop antibiotic-associated diarrhoea. [source] Magnification devices for endodontic therapyAUSTRALIAN DENTAL JOURNAL, Issue 4 2009M Del Fabbro Background:, After the introduction of microsurgical principles in endodontics, involving new techniques for root canal treatment, there has been a continuous search for enhancing the visualization of the surgical field. It would be interesting to know if the technical advantages for the operator brought in by magnification devices like surgical microscope, endoscope and magnifying loupes, are also associated with advantages for the patient, in terms of improvement of clinical and radiographic outcomes. Objectives:, The purpose of this systematic review was to evaluate and compare the effects of endodontic treatment performed with the aid of magnification devices versus endodontic treatment without magnification devices. We also aimed at comparing among them the different magnification devices used in endodontics (microscope, endoscope, magnifying loupes). Search strategy:, The Cochrane Oral Health Group Trials Register, CENTRAL, MEDLINE and EMBASE were searched with appropriate search strategies. Handsearching included nine dental journals. The bibliographies of relevant clinical trials and relevant articles were checked for identifying studies outside the handsearched journals. Seven manufacturers of instruments in the field of endodontics and/or endodontic surgery, as well as the authors of the identified randomized controlled trials (RCTs) were contacted in order to identify unpublished or ongoing RCTs. There were no language restrictions. The last electronic search was conducted on 2nd April 2009, and the last handsearching was undertaken on 31st January 2009. Selection criteria:, All randomized and quasi-randomized trials comparing endodontic therapy performed with or without using one or more types of magnification device, as well as randomized and quasi-randomized trials comparing two or more magnification devices used as an adjunct to endodontic therapy were considered. Data collection and analysis:, Screening of studies and data extraction were conducted independently and in duplicate. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis. Main results:, No trial could be included in the present review. All of the prospective trials that were identified, all dealing with endodontic surgery, had to be excluded for various reasons. Only one RCT was identified comparing three magnificators (magnifying loupes, surgical microscope, endoscope) in endodontic surgery. No RCT was found that compared the outcome of endodontic therapy using or without using a given magnification device. Authors' conclusions:, No objective conclusion can be drawn from the results of this review as no article was identified in the current literature that satisfied the criteria for inclusion. It is unknown if and how the type of magnification device affects the treatment outcome, considering the high number of factors that may have a significant impact on the success of endodontic surgical procedure. This should be investigated by further long-term RCTs with large sample size. Technical advantages of magnificators have been widely reported in low evidence level studies, but they should be systematically addressed to know if there can be the clinical indication for using a given magnification device for specific clinical situations, such as for molar teeth, or if they can all be used interchangeably. Well-designed RCTs should also be performed to determine the true difference in terms of treatment success rates between using or not using a magnification device in both conventional and surgical endodontic treatment, if any exist. Plain language summary:, Magnification devices for endodontic therapy. There are no data to draw a sound conclusion on the effect of adopting either a microscope, an endoscope, or magnifying loupes for better visualization in endodontic therapy, in terms of clinical outcomes. Though the use of magnification devices has often been associated with technical advantages for the operator and with an improved management of the root canal due to a better visualization of the operative field, it still has to be demonstrated that their use may lead to an improved treatment success rate. More long-term well-designed randomized trials with a large sample size are urgently needed to address the issues of the present review. [source] Clinical Use and Molecular Mechanisms of Action of Extract of Ginkgo biloba Leaves in Cardiovascular DiseasesCARDIOVASCULAR THERAPEUTICS, Issue 4 2004Wei Zhou ABSTRACT Ginkgo biloba is one of the oldest living tree species that has been referred to as a living fossil. Extract from Ginkgo biloba leaves (GBE) is among the most commonly used herbal drugs and is popularized for its alleged tonic effect and possible curative and restorative properties. There is an increasing evidence of the potential role of GBE in treating cardiovascular diseases. We examined the history of GBE usage and reviewed the literature on its effects on the cardiovascular system. In the extensive studies involving cell cultures and animal models, GBE has been shown to exert its action through diverse mechanisms. GBE has been reported to have antioxidatant properties, to modify vasomotor function, to reduce adhesion of blood cells to endothelium, to inhibit activation of platelets and smooth muscle cells, to affect ion channels, and to alter signal transduction. In addition, relevant clinical trials with CBE are being carried out, particularly in the treatment of arterial and venous insufficiency and in the prevention of thrombosis. Finally, the controversial clinical findings and the possible adverse interactions between GBE and other drugs are discussed. This review underscores the potential benefits of Ginkgo biloba in cardiovascular diseases, highlights the gaps in our current research, and suggests the necessity for more rigorous systematic investigation of cardiovascular properties of CBE. [source] | ||||||||||