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Results for “Human Challenge Trials as Topic”

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At least 127 records · Page 7Linked to original sources
PubMed1998

Supportive therapy in COPD.

Supportive therapy in COPD includes long-term oxygen therapy (LTOT) and patient support groups as two cornerstones in a comprehensive program of care known as pulmonary rehabilitation. The rich history of LTOT dating to the early 1960s and bolstered by excellent controlled clinical trials of the 1970s, along with additional advances, provided an effective therapy which improved both the quality and length of life in patients with COPD. Many patients with oxygen gain insight into coping with advanced COPD through patient support groups. The need for more cosmetically pleasing oxygen delivery systems to the nose, and future directions in providing oxygen in the home, remain challenges.

Adaptation, Psychological↗
PubMedDate not supplied

Immune monitoring of human gene therapy trials: potential application to leukemia and lymphoma.

Therapeutic genetically modified vaccines administered to patients with cancer are expected to induce and sustain tumor-specific immune responses. To measure these responses, monitoring strategies including a range of antibody-based and cellular assays have been developed. Single-cell cellular assays capable of detecting fewer than 1/10,000 of antigen-specific T lymphocytes in the tested population are currently in demand. ELISPOT assay, cytokine flow cytometry, and tetramer binding were recently compared by us in the context of monitoring of a dendritic cell-based multi-peptide vaccination trial in patients with metastatic melanoma. These single-cell assays were not found to be concordant in measurements of the frequency of peptide-specific T cells or in detecting pre- to post-vaccine changes in the frequency of these T cells. Implications of the results for monitoring of genetically modified vaccines are discussed, and the plan for a rational approach to monitoring and for selection of monitoring assays is proposed. Monitoring of human gene therapy or vaccination trials in patients with advanced cancers, who are often immunocompromised and thus poorly responsive, is a challenge. This challenge is best met by utilizing experienced reference laboratories for immune monitoring of clinical trials.

Cancer Vaccines↗
PubMed1976

Vaccination against typhoid fever with a live oral vaccine.

A Salmonella typhi gal E mutant, designated Ty 21a, has been developed on the basis of virulence and protection studies with similar Salmonella typhimurium mutants in mice. Gal E mutants are characterized by a block in the enzyme UDP-4-galactose-epimerase. They owe their outstanding immunizing capacity when used in live oral vaccine to the fact that when galactose is supplied exogenously, as occurs in vivo, wild-type cell wall structures are synthesized. On the other hand, avirulence of these mutants is based upon the fact that when galactose is taken up it is partly accumulated as galactose-1-phosphate and UDP-galactose, which induces lysis of the bacteria. Strain S. typhi Ty 21a does not revert to wild type in vivo and in vitro. Its safety for man has been demonstrated in studies involving 137 adults and 370 children. S. typhi Ty 21a also has been shown to protect against challenge with virulent S. typhi in human volunteers.

Administration, Oral↗
PubMed1999

Clinical relevance of prodromal angina before acute myocardial infarction.

The term preconditioning was applied to the observation made in 1986 by Murry and colleagues that canine myocardium subjected to brief episodes of ischemia and reperfusion would tolerate a more prolonged episode of ischemia better than myocardium not previously exposed to ischemia. Since that seminal observation, protective effect of preconditioning was demonstrated in all animal species tested, resulting in the strongest form of in vivo protection against myocardial injury other than early reperfusion. Angina heralding acute myocardial infarction may represent the clinical correlate of preconditioning phenomenon in humans. Data from small pathophysiological studies demonstrated that prodromal angina (<48 hours prior to index myocardial infarction) causes a reduction of infarct size and consequently a better left ventricular function compared with patients without such clinical feature before myocardial infarction. The protective effect of prodromal angina was also confirmed in larger prospective studies; its presence translates into a significant reduction of a combination of death, cardiogenic shock and pulmonary edema during hospital stay. The exact mechanism of such clinical phenomenon is however not known, but it may include preconditioning. Other mechanisms have been also claimed to play an important role, like a more rapid lysis of the occlusive thrombus within the infarct-related artery, or a rapid opening of intramural collateral not visible at angiography. Whatever the mechanism, it appears that patients with prodromal angina before myocardial infarction exhibit, when rapidly reperfused, a better post-infarction clinical outcome. At the present "optimal preconditioning-mimetic agents" are yet to be found, and "putting preconditioning in a bottle" still remains a pharmacologic challenge.

Angina, Unstable↗
PubMed2005

How to induce remission in primary systemic vasculitis.

Systemic vasculitis is treatable but not curable. Combination therapy with corticosteroids and immune suppressives induces remission in approximately 90% of cases, and therapeutic regimens have been standardised by randomised controlled trials. Patient subgrouping at presentation reflects prognosis and influences the design of induction regimens. Ongoing problems are therapeutic toxicity, especially in the elderly, the quality of remission obtained and the need for long-term therapy to prevent relapse. Cyclophosphamide remains the most effective immune suppressive, and more recent protocols have minimised its toxicity. An increasing range of newer immune suppressives, and therapeutic recombinant proteins aimed at cytokine blockade or lymphocyte depletion, is emerging. Their correct evaluation and integration with current regimens to improve long-term outcome is the major challenge in clinical vasculitis research today.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed2003

Retinopathy of prematurity.

PURPOSE OF REVIEW: This review highlights recent advances in basic science and clinical research on retinopathy of prematurity (ROP). RECENT FINDINGS: The modern concept of ROP pathophysiology is discussed, as are studies investigating anti-angiogenic agents for treatment. Results of the largest clinical trials are summarized. Current screening criteria, potential modifications to them, and telephotoscreening are discussed. SUMMARY: ROP is a challenging and involving area of pediatric ophthalmology.

Angiogenesis Inhibitors↗
PubMed2003

Women's health and clinical trials.

Women have traditionally been underrepresented in clinical trials. In order to translate recent advances in our understanding of the molecular and physiological bases of sex differences into new therapeutics and health practices, sound sex-specific clinical data are imperative. Since the founding of the Office of Research on Women's Health within the Office of the Director at the NIH in 1990, inequities in federally funded biomedical research, diagnosis, and treatment of diseases affecting women in the US have been reviewed. Discussed herein is the evolution of gender-related research innovations, primarily within the last decade, and strategies and challenges involved in the success of this recent development.

Clinical Trials as Topic↗
PubMed1990

Assertive community treatment: an evaluation of the experimental evidence.

Experimental studies of assertive community treatment programs based on the Training in Community Living model are reviewed. In most of the programs studied, interdisciplinary treatment teams met with patients in the community, taught them to take care of basic needs, and ensured that they received adequate material support and medical care. Across the service settings and patient populations studied, assertive community treatment reduced hospital utilization. Although early researchers provided evidence that the approach was more effective than conventional treatment in controlling symptoms, promoting social functioning, and improving occupational performance, recent studies have generally not replicated these findings. Defining the conditions under which assertive community treatment achieves superior functional outcomes remains an important challenge for future research.

Clinical Trials as Topic↗
PubMed1978

Double-blind confirmation and treatment of milk sensitivity.

A nine-year-old boy had seasonal and perennial allergic nasal and eye symptoms, as well as the allergic-tension-fatigue syndrome. The presence of milk sensitivity was demonstrated by repeated non-blind and double-blind dietary challenge. He responded well to sublingual milk therapy. The efficacy of this technique was confirmed twice by double-blind challenges.

Animals↗