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Review Evidence (review + evidence)
Selected AbstractsAugmentation with sulpiride for a schizophrenic patient partially responsiveto clozapineACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2000Jean H. Stubbs Objective:,Schizophrenic patients who are only partially responsive to clozapine pose a therapeutic challenge. In these circumstances some clinicians would consider adding in a second antipsychotic. We present a case report and review evidence for the efficacy of such augmentation strategies. Method:,Single case report and literature review. Results:,The total number of patients in studies and case reports of combining clozapine with other antipsychotics is small. There has been only one randomized controlled trial. This found the addition of sulpiride to clozapine resulted in clinical improvement in some patients. Conclusion:,Further randomized controlled studies of augmentation of clozapine therapy are needed to provide scientific justification for this clinical practice. [source] Indoleamine 2,3-dioxygenase in T-cell tolerance and tumoral immune escapeIMMUNOLOGICAL REVIEWS, Issue 1 2008Jessica B. Katz Summary: Indoleamine 2, 3-dioxygenase (IDO) degrades the essential amino acid tryptophan in mammals, catalyzing the initial and rate-limiting step in the de novo biosynthesis nicotinamide adenine dinucleotide (NAD). Broad evidence implicates IDO and the tryptophan catabolic pathway in generation of immune tolerance to foreign antigens in tissue microenvironments. In particular, recent findings have established that IDO is overexpressed in both tumor cells and antigen-presenting cells in tumor-draining lymph nodes, where it promotes the establishment of peripheral immune tolerance to tumor antigens. In the normal physiologic state, IDO is important in creating an environment that limits damage to tissues due to an overactive immune system. However, by fostering immune suppression, IDO can facilitate the survival and growth of tumor cells expressing unique antigens that would be recognized normally as foreign. In preclinical studies, small-molecule inhibitors of IDO can reverse this mechanism of immunosuppression, complementing classical cytotoxic cancer chemotherapeutic agents' ability to trigger regression of treatment-resistant tumors. These results have encouraged the clinical translation of IDO inhibitors, the first of which entered phase I clinical trials in the fall of 2007. In this article, we survey the work defining IDO as an important mediator of peripheral tolerance, review evidence of IDO dysregulation in cancer cells, and provide an overview of the development of IDO inhibitors as a new immunoregulatory treatment modality for clinical trials. [source] Dietetic guidelines on food and nutrition in the secondary prevention of cardiovascular disease , evidence from systematic reviews of randomized controlled trials (second update, January 2006)JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 6 2006A. Mead Abstract Aim, To update dietetic guidelines based on systematic review evidence on dietary advice to prevent further events in people with existing cardiovascular disease (CVD) (secondary prevention). Methods, The Cochrane Library, MEDLINE and EMBASE were comprehensively searched to January 2005 for systematic reviews on aspects of diet and heart health. Reviews were included if they searched systematically for randomized controlled trials relating to diet and secondary prevention of CVD. Each review was critically appraised by at least two members of the UK Heart Health and Thoracic Dietitians Group. The quality and results of each review were discussed and summarized at a group meeting. Results, Evidence-based strategies that reduce cardiovascular events in those with CVD include reduction in saturated fat and substitution with unsaturated fats. Individuals who have suffered a myocardial infarction may also benefit from adopting a Mediterranean type diet and increasing intake of omega 3 fats, but it is not clear whether they are beneficial for all patients with CVD. There is no systematic review evidence to support the use of antioxidant vitamins supplements, low glycaemic index diets, or homocysteine lowering therapies in this group. Conclusion, There remains good evidence that reducing saturated fat reduces morbidity in patients with CVD. This advice is consistent for most manifestations of CVD, with the addition of Mediterranean dietary advice and increased omega 3 fats for those who have had a myocardial infarction. [source] From language to reading and dyslexia,DYSLEXIA, Issue 1 2001Margaret J. Snowling Abstract This paper reviews evidence in support of the phonological deficit hypothesis of dyslexia. Findings from two experimental studies suggest that the phonological deficits of dyslexic children and adults cannot be explained in terms of impairments in low-level auditory mechanisms, but reflect higher-level language weaknesses. A study of individual differences in the pattern of reading skills in dyslexic children rejects the notion of ,sub-types'. Instead, the findings suggest that the variation seen in reading processes can be accounted for by differences in the severity of individual children's phonological deficits, modified by compensatory factors including visual memory, perceptual speed and print exposure. Children at genetic risk who go on to be dyslexic come to the task of reading with poorly specified phonological representations in the context of a more general delay in oral language development. Their prognosis (and that of their unaffected siblings) depends upon the balance of strengths and difficulties they show, with better language skills being a protective factor. Taken together, these findings suggest that current challenges to the phonological deficit theory can be met. Copyright © 2001 John Wiley & Sons, Ltd. [source] Crop traits and the tolerance of wheat and barley to foliar diseaseANNALS OF APPLIED BIOLOGY, Issue 2 2009I.J. Bingham Abstract The relationship between yield loss and disease severity can differ widely between crops. This has given rise to the concept of disease tolerance, with some crops exhibiting a smaller yield loss under a given severity of disease than others. Genetic improvement to minimise yield loss under disease is an attractive goal, as it exerts little or no selection pressure on pathogen populations, and could form a useful component of durable disease management programmes. However, progress towards this end requires a thorough understanding of the phenotypic traits that influence the response of yield to disease, their genetic control and the possible trade-offs involved with other desirable agronomic characteristics. This paper examines the candidate crop traits that may confer tolerance of foliar disease in wheat and barley and reviews evidence of genetic variation in their expression. In wheat grown under the relatively low light conditions of North-West Europe, post-anthesis source (assimilate supply) and grain sink capacity (capacity for dry matter accumulation) appear to be closely balanced. Traits associated with maintaining post-anthesis radiation interception and radiation use efficiency in spite of disease may confer tolerance. The most promising traits include a larger flag leaf and compensatory increases in photosynthetic rate in non-infected parts of leaves. In barley, yield is often more strongly sink limited, and early-season disease management is required to protect the formation of potential grain sites. A wider range of potential traits may influence tolerance including compensatory adjustments in leaf growth and morphology, and differences in the sensitivity of tiller and spikelet mortality to photoassimilate supply. Different methods for quantifying tolerance are suggested depending on the trait of interest. [source] Clinical practice guidelines in clinical psychology and psychotherapyCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2003Glenys Parry Evidence-based clinical practice guidelines have proliferated over the past two decades. Few are limited to psychological therapies or are targeted at clinical psychologists and psychotherapists , the UK guideline Treatment Choice in Psychotherapy and Counselling is a major exception. However, psychological therapies will increasingly be considered alongside medical treatments in diagnosis-specific guidelines. There has been interest and debate about the place of guidelines in the psychological therapies, with views ranging from scepticism to enthusiasm. This paper defines clinical practice guidelines, describes major guideline programmes internationally, examines guidelines of specific interest to psychologists and psychotherapists, explores issues in their implementation, reviews evidence for their effectiveness in changing practice and improving therapy outcomes and draws out implications for practice. Guidelines are only one aspect of informing psychologists and psychotherapists about best practice. They need to be supplemented by other clinical support methods and with methods of monitoring what is actually done in practice.,Copyright © 2003 John Wiley & Sons, Ltd. [source] | |||||||||||||