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At least 109 records · Page 6Linked to original sources
PubMed2002

PENTA guidelines for the use of antiretroviral therapy in paediatric HIV infection. Pediatric European Network for Treatment of AIDS.

OBJECTIVE: To produce European Guidelines for the use of antiretroviral therapy (ART) in HIV-infected children. DESIGN: Systematic literature review using Medline, the major antiretroviral conference reports, and IDSA recommendations on guideline production. SETTING: Pediatric European Network for Treatment of AIDS (PENTA) Steering Committee. OUTCOME MEASURE: Guidelines have been produced for the use of antiretroviral therapy in HIV-infected children in Europe. Recommendations on when to start ART and which ART to start, with dosages and a summary of the relevant literature, have been produced. CONCLUSIONS: These guidelines are aimed at assisting paediatricians in Europe with ART prescribing, and provide a more cautious approach to starting therapy than current paediatric USA guidelines.

Anti-HIV Agents↗
PubMed2001

The measurement of health-related quality of life (HRQL) in children with cerebral palsy.

The measurement of health-related quality of life (HRQL) in children with cerebral palsy is part of an emerging discipline. Theoretical models of disability and chronic illness developed by the World Health Organization, the National Center for Medical Rehabilitation Research and others are being adapted for children. Development of HRQL measures in paediatrics lags behind the work completed with adults due to challenges unique to children, such as what domains to measure, whose perspective to address and the developmental changes inherent to children. The descriptive HRQL studies of children with moderate to severe cerebral palsy and comparisons of children with quadriplegia vs. diplegia and hemiplegia are presented. Consistent with the functional measures, no significant difference in HRQL by treatment was documented in children with spastic diplegia participating in a randomized clinical trial of selective dorsal rhizotomy. HRQL measures that are specifically tailored to cerebral palsy need to be developed. Generic and individualized measures of HRQL are currently available and while limited, may be useful for evaluating the effect of different treatments for spasticity on the quality of life in children with cerebral palsy.

Botulinum Toxins, Type A↗
PubMed2001

Suboptimal prescribing in older inpatients and outpatients.

Investigators searched Medline and HealthSTAR databases from January 1, 1985 through June 30, 1999 to identify articles on suboptimal prescribing in those age 65 years and older. A manual search of the reference lists from identified articles and the authors' article files, book chapters, and recent reviews was conducted to identify additional articles. The definitions for various types of suboptimal prescribing (polypharmacy, inappropriate, and underutilization) are numerous, and measurement varies from study to study. The literature suggests that suboptimal prescribing is common in older outpatients and inpatients. Moreover, there is significant morbidity and mortality associated with suboptimal prescribing for these older patients. Evidence from well-controlled studies suggests that multidisciplinary teams and clinical pharmacy interventions can modify suboptimal drug use in older people. Future research is necessary to measure and test other methods for tackling this major public health problem facing older people.

Aged↗
PubMedDate not supplied

Does your clinical investigator understand the consequences of non-compliance?

The increasing number and complexity of clinical trials, coupled with the recent increase in attention and enforcement from the U.S. Food and Drug Administration, arguably makes it more important than ever before that clinical investigators understand the regulatory requirements with which they must comply. This article outlines some of these requirements, common areas of non-compliance and FDA's enforcement options in dealing with such non-compliance. Finally, the article provides some suggestions for attaining and managing investigator compliance.

Attitude of Health Personnel↗
PubMedDate not supplied

A new approach to assessing ethical conduct in scientific work.

The intent of the current article is to describe the development of a new approach to the study of ethical conduct in scientific research settings. The approach presented in this article has two main components. The first component entails the development of a taxonomy of ethical events as they occur across a broad range of scientific disciplines. The second involves the identification of proximate criteria that will allow systematic and objective evaluation of ethical behaviors through low-fidelity performance simulations. Two proposed measures based on the new approach are intended to identify and measure variations in the scientific environment that might predispose certain individuals to make unethical decisions.

Biological Science Disciplines↗
PubMed2002

Practical dosimetry of 131I in patients with thyroid carcinoma.

Radioiodine treatments of patients with well-differentiated thyroid carcinoma have generally been safe and beneficial. Safety can be ensured while efficacy is increased through practical methods of dosimetry that measure body retention of 131I. Prescriptions for therapeutic 131I can be decreased when the retention level is high and increased when the level is low. Assays of serum free T4 will alert the physician to possible increased radiation to blood and bone marrow, and appreciable concentrations of free T4 are indications to reduce the therapeutic 131I. Carcinomas > or = 1 cm in diameter that are not visible on diagnostic scintigraphy are unlikely to respond to the commonly prescribed mCi of 131I. Biologic responses to commonly prescribed levels of therapeutic 131I, as seen in toxic changes of normal tissues and in indices of tumor size, will be the final dosimeters. With lower levels of prescribed diagnostic 131I, stunning should not impair dosimetry. Thus, readily obtained measurements make dosimetry a practical method for improving carcinoma therapy with 131I.

Adenocarcinoma↗
PubMed1997

The Pittsburgh Reference Laboratory Alliance: a model for laboratory medicine in the 21st century.

The Pittsburgh Reference Library Alliance (RLA) represents a successful response by hospital laboratories to the new realities of medical economics and practice. By using informatics technology to integrate the laboratory resources of community hospitals and academic medical centers across western Pennsylvania, the RLA has created a large virtual laboratory that can compete for price with large national referral laboratories. More significantly, the combination of medical expertise, the ties to academic and community centers, and the regional medical database of the RLAs allows laboratory medicine to be practiced in a new proactive way. This should provide better and more cost-effective patient care. The success of the RLA is a model for regional cooperation in pathology and potentially in other medical specialties and demonstrates the importance of informatics in the future of medical practice.

Academic Medical Centers↗
PubMed1995

Setting the White House Conference on Aging agenda: recommendations from an expert panel.

The next White House Conference on Aging (WHCoA) will take place in May, 1995. In preparation for the conference, a panel of expert policy researchers was convened to develop recommendations regarding the WHCoA theme and agenda. This article presents in summary form the key findings of this panel. Six major themes are proposed for the agenda. In addition, a strategy is proposed for organizing and prioritizing recommendations that emerge from the 1995 WHCoA.

Aged↗