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Clinical Comparison (clinical + comparison)

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Medical Sciences	100%

Selected Abstracts

CLINICAL COMPARISON OF LORAZEPAM VS.

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue S1 2004
DIAZEPAM IN THE CONTROL OF CANINE SEIZURES
Lorazepam is a long-acting benzodiazepine that interacts with a high degree of affinity for the GABA receptor complex. This high affinity binding in turn leads to a prolonged duration of action. There are no published clinical studies documenting its duration of action in dogs or its ability to control seizures. The purpose of this study was to compare the duration of seizure control of lorazepam with diazepam in 16 dogs presenting in status epilepticus or with active cluster seizures. Previous seizure history and anticonvulsant therapy was not a consideration for inclusion into this study. Animals were excluded if there was a known metabolic, toxic or traumatic cause of the seizure. Dogs were randomly assigned to receive either lorazepam (0.2 mg/kg IV) or diazepam (0.5 mg/kg IV), and the clinicians were blinded as to which drug they were administering. The duration of the study was 12 hours from the time of drug administration, and the animals were monitored for any indication of seizure activity, including generalized motor activity, focal motor activity (e.g., movement of facial or limb musculature) and change in the level of consciousness. The study ended at 12 hours post-study drug administration or when the dog seized before the end of the 12 hour study period. The results indicated no significant difference between lorazepam versus diazepam with regard to median seizure-free interval (2.8 h for diazepam versus 3.4 h for lorazepam, p=0.58 by log rank test), or with regard to percent seizure-free for the duration of the observation period (1/8 for lorazepam versus 3/8 for diazepam, p=0.51 by Fisher's exact test). There was also no difference between the 2 drugs regarding the number of animals in which seizures were initially controlled (6/8 in each group). Lorazepam used at this dose does not appear to result in a significant increase in duration of seizure control for dogs with status epilepticus and cluster seizures. Additional studies may be warranted using higher doses of lorazepam. [source]

Clinical comparison of two self-directed bleaching systems

JOURNAL OF PROSTHODONTICS, Issue 4 2003
Katherine Karpinia DMD
Purpose This randomized clinical trial compared the clinical efficacy and tolerability of 2 marketed self-directed vital tooth-whitening systems. Materials and Methods Balancing for baseline tooth color, self-reported coffee/tea use, and age, 57 adult volunteers were randomized to either a whitening strip containing 6% hydrogen peroxide or a tray-based 10% carbamide peroxide/dentifrice/mouth rinse combination system. Following the manufacturer' s directions, the strip group bleached twice daily for 30 minutes, whereas the tray group bleached twice daily for 20,30 minutes, preceded by tooth brushing with a whitening dentifrice and followed by mouth rinsing with a whitening solution. Treatment extended for 14 days, with evaluation at day 7 and again at day 14. Whitening response was measured objectively as L*a*b* from standardized digital images of maxillary anterior teeth. Tolerability was assessed by oral examination and subject interview. Efficacy comparisons were made using analysis of covariance, whereas tolerability was compared using the nonparametric Wilcoxon rank-sum test. Results Both treatments resulted in statistically significant (P < 0.01) improvements from baseline for all color parameters. For between-group comparisons, the 6% hydrogen peroxide strips yielded a nearly 3-fold reduction in yellowness (,b*), a nearly 2-fold improvement in lightness (,L*), 2.6 times greater redness reduction (,a*), and a more than 2-fold change in overall color (,E*) compared to the tray-based combination system. Between-group comparisons were statistically significant for the all color parameters at both the day 7 and day 14 evaluations (P < 0.001). In general, 7-day use of the whitening strips provided significantly greater color improvement relative to the combination dentifrice/gel/rinse system at day 14. In addition, the groups differed significantly (P < 0.05) in bleaching tolerability severity-days, with the strip system demonstrating better overall tolerability compared to the combination system. Conclusions The single-step 6% hydrogen peroxide strips demonstrated better overall clinical response, in terms of both tooth-whitening efficacy and tolerability, than the multiple-step tray-based combination system. [source]

Incidental Lewy body disease: Clinical comparison to a control cohort,

MOVEMENT DISORDERS, Issue 5 2010
Charles H. Adler MD
Abstract Limited clinical information has been published on cases pathologically diagnosed with incidental Lewy body disease (ILBD). Standardized, longitudinal movement and cognitive data was collected on a cohort of subjects enrolled in the Sun Health Research Institute Brain and Body Donation Program. Of 277 autopsied subjects who had antemortem clinical evaluations within the previous 3 years, 76 did not have Parkinson's disease, a related disorder, or dementia of which 15 (20%) had ILBD. Minor extrapyramidal signs were common in subjects with and without ILBD. Cognitive testing revealed an abnormality in the ILBD group in the Trails B test only. ILBD cases had olfactory dysfunction; however, sample size was very small. This preliminary report revealed ILBD cases have movement and cognitive findings that for the most part were not out of proportion to similarly assessed and age-similar cases without Lewy bodies. Larger sample size is needed to have the power to better assess group differences. © 2010 Movement Disorder Society [source]

Clinical analysis of patients with azoospermia factor deletions by microdissection testicular sperm extraction

INTERNATIONAL JOURNAL OF ANDROLOGY, Issue 2 2004
Akira Tsujimura
Summary Microdeletions of the azoospermia factor (AZF) locus on the Y chromosome have been implicated as a major genetic component of idiopathic male infertility, and the incidence of AZF deletions has been reported to be 15,20% in men with non-obstructive azoospermia (NOA). Numerous studies have described AZF deletion rates in patients with azoospermia; however, a clinical comparison of azoospermic patients with AZF deletion and those with no deletion has not been reported well. A new technique for testicular sperm extraction, microdissection testicular sperm extraction (TESE), has been used widely on NOA patients. Although testicular spermatozoa are reliably detected and retrieved from NOA patients by microdissection TESE, sperm retrieval rates for patients with AZF deletions are not well known. Therefore, characteristics of NOA patients with AZF deletion were investigated. Six of 60 patients (10%) who underwent microdissection TESE were found to have AZF deletions by genomic polymerase chain reaction. Testicular data, outcome of sperm retrieval and endocrinological profiles, were compared between patients with AZF deletions (n = 6) and those with no deletions (n = 54). Testicular size, varicocele rates and testicular histology were similar between the groups. Significant differences were not detected in the endocrinological profiles. Sperm retrieval rates were not significantly different between the groups. In conclusion, AZF deletions do not appear to confer specific characteristics to NOA patients. [source]

A new, minimally invasive technique for measuring cardiac index: clinical comparison of continuous cardiac dynamic monitoring and pulmonary artery catheter methods

ANAESTHESIA, Issue 9 2009
J. C. Berridge
Summary To assess the utility of a relatively simple bedside method of estimating cardiac index during major surgery or in the intensive care unit, we conducted a prospective study in patients undergoing elective cardiac bypass surgery where a pulmonary artery catheter was inserted as part of routine monitoring. The cardiac index was estimated using standard techniques and compared with estimates from continuous cardiac dynamic monitoring using heartsmart® software. Two hundred and seventy sets of measurements were suitable for comparison. The mean bias (95% limits of agreement), for the pre-bypass cardiac index was ,0.09 (,1.26 to 1.08) l.min,1.m,2, and post-bypass was 0.12 l.min,1.m,2 (,1.32 to 1.56). These results suggest that continuous cardiac dynamic monitoring using heartsmart® is sufficiently accurate for assessment of haemodynamic variables in critically ill patients, facilitating goal-directed therapies. [source]

Bimatoprost: A Novel Antiglaucoma Agent

CARDIOVASCULAR THERAPEUTICS, Issue 2 2004
D. F. Woodward
ABSTRACT The aim of glaucoma therapy is to preserve vision by reducing intraocular pressure (IOP). Following recent National Eye Institute sponsored studies, it is becoming increasingly apparent that every mmHg of extra IOP lowering counts. Bimatoprost is the newest and most effective addition to the physician's armamentarium of ocular hypotensive drugs. Direct clinical comparisons have demonstrated that it is more efficacious than the prostaglandin (PG) FP receptor agonist prodrugs, latanoprost and travoprost, as well as a ,-adrenoceptor antagonist, timolol, alone or in fixed combination with the carbonic anhydrase inhibitor, dorzolamide. Moreover, patients that are refractory to latanoprost therapy may be successfully treated with bimatoprost. Such evidence provides support, at the clinical level, for the contention that bimatoprost is pharmacologically distinct from PG FP receptor agonist prodrugs. Bimatoprost is a structural analog of PGF2, -ethanolamide (prostamide F2,), which is formed from the endocannabinoid anandamide by a biosynthetic pathway involving cyclooxygenase-2 (COX-2). Their pharmacology is remarkably similar, such that bimatoprost may be regarded as a prostamide mimetic. The target receptor for bimatoprost and the prostamides appears unique and unrelated to PG- and endocannabinoid-sensitive receptors. Extensive ocular distribution/metabolism studies in non-human primates demonstrate that bimatoprost is not a prodrug, it remains essentially intact. Its profound ocular hypotensive effects may, therefore, be attributed to its prostamide-mimetic properties. [source]

Can we differentiate the low-molecular-weight heparins?

CLINICAL CARDIOLOGY, Issue S1 2000
Alexander G.G. Turpie M.B., F.A.C.C., F.A.C.P., F.R.C.P.(LOND., F.R.C.P.C., GLASG.)
Abstract The low-molecular-weight heparins (LMWHs) have a number of therapeutic advantages, relative to standard unfractionated heparin (UFH). They are readily bioavailable when injected subcutaneously and can be given in fixed doses, allowing for far simpler administration. Several LMWHs are now commercially available, each demonstrating different physical and chemical properties and different activities in animal models of anticoagulation or hemorrhage. in clinical comparisons with placebo in the treatment of unstable coronary artery disease (UCAD), the LMWHs dal-teparin sodium and nadroparin calcium have demonstrated good anticoagulant efficacy. in comparisons with UFH, on the other hand, only enoxaparin has shown superior anticoagulant activity, as reported in the results of the Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events (ESSENCE) and Thrombolysis in Myocardial Infarction (TIMI) 1 IB trials. However, close scrutiny of the methodology of the clinical trials in UCAD reveals considerable differences in study designs, dosage regimens, duration of administration of active treatments, and the timing and definition of endpoints. Therefore, it would not be scientifically sound to compare results with the different LMWHs based on the current available studies. It is also not possible to draw any conclusions with regard to the relative efficacy of the different LMWHs, since there are no properly-sized comparative data between dal-teparin sodium, enoxaparin sodium, and nadroparin calcium. [source]