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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 487 records · Page 27Linked to original sources
PubMed2002

Soy-based formulae and infant growth and development: a review.

Soy-based infant formulae, initially developed for infants who were lactose intolerant or allergic to cow's milk-based formulae, now account for >25% of the infant formulae sold in the United States. Formulations have changed over the years to improve digestibility, the stability and availability of minerals, and protein quality. Recent concerns have been raised regarding the phytoestrogenic isoflavone content of soy-based formulae. A systematic review of the literature was conducted to evaluate various measures of infant health and development in clinical studies comparing modern soy-based formulae with other diets and to document areas in which further research seems warranted. Results suggest that modern soy-based formulae support normal growth and nutritional status in healthy term infants in y 1 of life. However, there are very limited data on sexual and reproductive development or outcomes such as immune function, visual acuity/cognitive development and thyroid function. Available data do not provide evidence of meaningful differences in timing of maturation, sexual development or fertility in adolescents or adults. Nonetheless, given evidence suggesting that early exposure to soy and/or isoflavones might have long-term effects, further research following infants fed soy-based formulae into adulthood is warranted.

Clinical Trials as Topic↗
PubMedDate not supplied

Manual therapies for pain control: chiropractic and massage.

OBJECTIVES: To evaluate the effectiveness of chiropractic and massage therapy for the reduction of any type of pain. METHODS: Systematic reviews of chiropractic and massage as a means of pain control were located and evaluated. RESULTS: Six systematic reviews were found, 4 of chiropractic and 2 of massage therapy. Promising evidence emerged from some of these reviews but neither for chiropractic nor for massage was there fully convincing evidence for effectiveness in controlling musculoskeletal or other pain. DISCUSSION: The notion that chiropractic or massage are effective interventions for pain control has not been demonstrated convincingly through rigorous clinical trials.

Back Pain↗
PubMed2001

The efficacy of conservative treatment in patients with whiplash injury: a systematic review of clinical trials.

STUDY DESIGN: A systematic review of the literature. OBJECTIVES: To assess the efficacy of conservative treatment in patients with whiplash injuries. SUMMARY OF BACKGROUND DATA: Many treatments are available for patients with whiplash injury, but there continues to be no evidence for their accepted use. METHODS: A computerized literature search of Medline, Embase, Cinahl, Psychlit, and the Cochrane Controlled Trial Register was performed. Studies were selected if the design was a (randomized) clinical trial; if all patients had sustained a whiplash injury; if the type of intervention was a conservative one; if pain, global perceived effect, and participation in daily activities were used as one of the outcome measures, and if the publication was written in English, French, German, or Dutch. The methodologic quality was independently assessed by two reviewers by using the Maastricht-Amsterdam list. Three quality scores were calculated using this criteria list: the Overall Methodologic Quality Score, the Internal Validity Score, and the Delphi Quality Score. The conclusion of the review was based on articles that scored a quality score of at least 50% of the maximum available score on two of three quality scores. RESULTS: Eleven studies met the inclusion criteria. Only three studies satisfied at least 50% on two of three ways of calculating a quality score, indicating overall poor methodology. There was a high rank correlation among the three ways of calculating a quality score. No statistical pooling was performed because of the heterogeneity of the interventions. This review indicates that active treatments show a beneficial long-term effect on at least one of the primary outcome measures. CONCLUSION: Caution is needed when drawing a valid conclusion on the efficacy of conservative treatments in patients with whiplash injury. It appears that "rest makes rusty," whereas active interventions have a tendency to be more effective in patients with whiplash injury.

Bed Rest↗
PubMed2001

Dopamine receptors in the brains of schizophrenia patients: a meta-analysis of the findings.

Controversy surrounds the question of whether there are dopamine (DA) receptor abnormalities in the brains of schizophrenia patients; in particular, whether DA receptors of the D2 family are elevated in density. Methodological factors and sample characteristics have been postulated to account for differences in study outcome, but there has been no systematic analysis of the contribution of these factors to study effect sizes. This meta-analysis of the research findings sought to determine the influence of methodologic factors and sample characteristics on the magnitude of diagnostic group differences in DA D2 density (Bmax) and affinity (Kd). The analysis suggests at least moderate effects, such that schizophrenia patients show an elevation in both values when compared to controls. These effects are amplified in medicated patients, but not solely attributable to antipsychotics. The group differences in DA D2 receptor density and affinity increase with age among nonmedicated patients. The use of a butyrophenone ligand also yields larger effects. It is concluded that a subgroup of schizophrenia patients manifests increased DA D2 receptor density and decreased receptor affinity. In the absence of medication, these changes may become more pronounced with age. Differences in study outcome are also partially due to methodologic factors, including the ligand.

Antipsychotic Agents↗
PubMed2003

Has the time come to rename the Blalock-Taussig shunt?

OBJECTIVE: To describe the contribution of Vivien Thomas to the scientific and technical development of the Blalock-Taussig shunt. DESIGN: Review of the literature and of the papers of Vivien Thomas, Alfred Blalock, and Helen Thomas. Literature review was done using MEDLINE, Ovid, and Library of Congress databases for topics including Vivien Thomas, Alfred Blalock, Helen Taussig, and tetralogy of Fallot. Bibliographies of articles were also searched. SETTING: The papers of Thomas, Blalock, and Taussig were reviewed at the Alan M. Chesney Medical Archives at the Johns Hopkins Medical Institutions. PATIENTS/SUBJECTS: None. INTERVENTIONS: None. RESULTS: Vivien Thomas was a primary contributor in both the scientific basis for and the surgical technical aspect of the Blalock-Taussig shunt. He did much of the fundamental studies in Dr. Blalock's laboratory by himself. Blalock was able to do only one practice procedure in the animal model before performing the first surgery in a 15-month-old girl with tetralogy of Fallot. Thomas stood behind Blalock during the procedure to provide advice to Blalock. CONCLUSIONS: Thomas' essential contributions to the development of the Blalock-Taussig shunt remain obscured by the stature of Alfred Blalock and Helen Taussig. This oversight should be corrected.

Heart Bypass, Right↗
PubMed2006

Therapeutic drug monitoring of mycophenolic acid in solid organ transplant patients treated with mycophenolate mofetil: review of the literature.

Mycophenolate mofetil (MMF) has conventionally been administered at a fixed dose without routinely monitoring blood levels of mycophenolic acid (MPA), the active metabolite. The contribution of therapeutic drug monitoring (TDM) during MMF therapy remains controversial. A literature review was performed to explore the usefulness of TDM for MPA in solid organ transplantation. In addition, emphasis was placed on the potential clinical benefits and limitations of TDM for MPA. Available studies have limitations and report conflicting results. Although early after transplantation MPA area under the curve might have predictive value for the risk of acute rejection, predose levels appear less reliable. With regard to MPA toxicity, most studies showed no correlation between MPA pharmacokinetics and adverse effects. TDM is hampered by several factors such as the considerable intra-subject variability of MPA pharmacokinetics and the increasing number of different drug combinations. Proposed target ranges are restricted to the early posttransplant period when MMF is used in combination with cyclosporine. The current review of the literature indicates no clear support for a substantial clinical benefit of TDM and more data from prospective randomized trials are needed.

Area Under Curve↗
PubMed2003

CommLog: a communication log system for clinical trials.

Thanks to the advent of information technologies, the emergence of commercial products for electronic clinical trials has improved many aspects of conducting clinical trials. While there are many new options available to facilitate the collection of patient data, little advancements have been made in the way in which information generated from the coordination of a clinical trial is managed. The coordination of a clinical trial has proven to have a significant impact on the quality and economy of clinical trials. The Vanderbilt Coordinating Center has designed and implemented a communication log system (CommLog) to streamline the coordination of clinical trials in order to improve the quality and economy of clinical trials. The CommLog has been operational for several industry-sponsored phase II/III clinical trails and has provided a knowledge base for the studies and repository for useful study information.

Abstracting and Indexing↗
PubMed2005

Gefitinib (ZD1839, Iressa) in non-small-cell lung cancer: a review of clinical trials from a daily practice perspective.

Gefitinib (ZD1839) is the most widely studied targeting agent in the area of non-small-cell lung cancer (NSCLC). Gefitinib is an orally active epidermal growth factor receptor (EGFR) tyrosine kinase (TK) inhibitor. In order to assess the role of gefitinib in the management of NSCLC patients, we systematically reviewed published clinical trials from a daily practice perspective. A systematic research was made in the international medical literature. Gefitinib demonstrated a good tolerance and an encouraging efficacy in pretreated NSCLC patients in preclinical studies. These results were then confirmed in two phase II trials (IDEAL 1 and 2) involving more than 400 patients mostly pretreated with a platinum-containing regimen and docetaxel. All these results were reinforced by those of retrospective studies on patients enrolled in a compassionate use programme. Thus, two phase III trials in chemo-naive patients were initiated (INTACT 1 and 2). Unfortunately, the use of gefitinib with standard combination chemotherapy provided no survival benefit nor response rate or progression-free survival improvement over placebo. Furthermore, we also reviewed the results of studies interested in the characterization of predictive clinical or biological markers for response to gefitinib and discussed the results obtained with other EGFR inhibitors. The efficacy of gefitinib in the first-line setting of each stage of NSCLC has to be further studied through clinical trials. Furthermore, translational studies characterizing the molecular features involved in the response to anti-EGFR-targeted therapies are needed.

Adult↗
PubMed2006

Cancer biomarkers--an invitation to the table.

The allure of the emerging genomic technologies in cancer is their ability to generate new biomarkers that predict how individual cancer patients will respond to various treatments. However, productive implementation of cancer biomarkers into patient care will require fundamental changes in how we consider approvals for cancer indications and how we track patient responses. Here we briefly describe ongoing efforts to identify and to validate cancer biomarkers, discuss the technological hurdles that lie ahead, and then focus on the more pressing political and cultural issues that, if left unheeded, could derail many of the anticipated benefits of biomarker research.

Academies and Institutes↗