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Current Standard Therapy (current + standard_therapy)
Selected AbstractsThe Role of Enoxaparin in Interventional Management of Patients with Acute Coronary SyndromesJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2003CINDY L. GRINES M.D., F.A.C.C. Interventional management strategies involving early angiography and percutaneous coronary intervention (PCI) are increasingly widespread in the management of patients with acute coronary syndromes (ACS). Notwithstanding the benefits of early intervention, there is a significant risk of postprocedural thrombotic complications and a need to optimize antithrombotic regimens for use before and during PCI. It is clear that the current standard therapy with unfractionated heparin (UFH) and aspirin can be improved upon, in terms of both efficacy and safety. The low-molecular-weight heparin(s) (LMWHs) offer pharmacologic and practical advantages over UFH. The LMWH enoxaparin has recently emerged as the anticoagulant of choice for the acute management of ACS. Enoxaparin has also demonstrated sustained benefits over UFH in patients proceeding to PCI, and as a procedural anticoagulant. Combination therapy with enoxaparin and a glycoprotein IIb/IIIa inhibitor may further improve the efficacy and safety of antithrombotic treatment during coronary interventions, as a result of the drugs' complementary mechanisms of action. Early clinical evidence supports the use of enoxaparin in combination with glycoprotein IIb/IIIa inhibitors in high-risk patients with ACS. Ongoing, large-scale, randomized controlled studies will help to clarify the role of enoxaparin in interventional cardiology, either as the primary anticoagulant or as part of a combination regimen, and to define optimal regimens for treatment. (J Interven Cardiol 2003;16:357,366) [source] Many asthma patients experience persistent symptoms despite appropriate clinical and guideline-based treatment with inhaled corticosteroidsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 9 2007Joan Mogil MSN, NP-C (Nurse Practitioner) Abstract Purpose: To review possible reasons for persistence of asthma symptoms despite appropriate use of clinical and guideline-based treatments, including the use of inhaled corticosteroids. Data sources: Review of the worldwide scientific literature on factors related to persistent symptoms in patients with asthma. Conclusions: Patients with asthma may not respond as expected to therapy because of factors that include poor adherence, improper inhaler technique, persistent exposure to symptom triggers, and limitations of current standard therapy, including steroid insensitivity or the steroid plateau effect. Persistent symptoms may also be associated with IgE-mediated airway inflammation, as current standard asthma therapies do not directly address the IgE-mediated component of the inflammatory cascade. Asthma is a complex disease and its treatment requires the full cooperation and participation of the patient. Implications for practice: Healthcare professionals can play a key role by educating patients and their family members about the nature of asthma and rationale for treatment, supporting the importance of strict adherence to prevention measures and the prescribed treatment regimen. [source] Making Efficient Use of Patients in Designing Phase III Trials Investigating Simultaneously a Set of Targeted Therapies with Different TargetsBIOMETRICAL JOURNAL, Issue 6 2006Werner Vach Abstract Targeted therapies are a recent development in cancer treatment research. As these therapies can only be administered to patients with certain individual characteristics, it is a straightforward idea to investigate several of such therapies simultaneously in a given patient population in order to compare each targeted therapy with the current standard therapy. This raises the question how patients satisfying several characteristics should be handled. We consider in this paper several designs to allocate treatments in a random manner to these patients, such that the evaluation of each single targeted therapy can be based on a simple comparison of patients receiving the targeted therapies versus those receiving the standard therapy within a well defined subgroup of patients satisfying the corresponding characteristic. We show how one can ensure that patients with several characteristics can contribute simultaneously to the evaluation of several targeted therapies and that this is the key point for an efficient use of the patients available. We further discuss some ethical and practical issues in applying the new designs and outline strategies to evaluate the overall effect of all targeted therapies together. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Clinical characteristics and outcome of current standard management of central retinal artery occlusionCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 5 2010Adam K Rudkin BMBS Abstract Background:, To investigate the visual outcomes in acute central retinal artery occlusion (CRAO) with current standard therapy at two university teaching hospitals. Methods:, Retrospective analysis of two cohorts of CRAO patients from John Hopkins Hospital (JHH; USA), and Flinders Medical Centre (FMC; Australia), treated with current standard therapy. The outcome measures were visual acuity, and subsequent ocular and systemic ischaemic events. Results:, The mean follow-up period was 11.2 ± 13.1 months in the JHH cohort and 35.4 ± 34.9 months in the FMC cohort. The frequency distribution of vascular risk factors and the incidence of subsequent ischaemic events were similar for the patients from both institutions. All patients from JHH were treated as inpatients, whereas 79% of patients from FMC were treated as outpatients. More patients in the JHH cohort underwent paracentesis, ocular massage or were treated with intraocular hypotensive agents (76%) than in the FMC cohort (26%); however, there was no significant difference in visual outcome between the two cohorts (P = 0.114). Conclusion:, Despite differences in management of CRAO between two institutions in different countries, visual outcomes were similar. This suggests a lack of efficacy of current standard treatment in acute CRAO. [source] | ||||||||||