Reviews on Recent Clinical Trials - Volume 7, Issue 3, 2012

Brachytherapy nowadays has become a widely accepted treatment modality in the management of localized prostate cancer. With recent improvements in ultra-sound technology, imaging, treatment planning and post-implant dosimetry, permanent implantation has become minimally invasive, well tolerated, and safe and most importantly has progressed to a treatment modality comparable to external beam radiation Read More

We reviewed the comparative trials of the Flotrac/VigileoTM versus the thermodilution method, published in the last five years. The results about the agreement between the two methods measuring cardiac output are contrasting. We also noticed that almost the whole pertinent literature include studies conducted without a correct statistical design, particularly about the sample size. For this reason we consider that results Read More

Anemia is a very common complication of chronic kidney disease (CKD). Anemia confers significant risk of cardiovascular disease and contributes to decreased quality of life. Anemia in CKD patients can be multi-factorial, including but not invariably due to the underlying renal insufficiency. Identifying the type of anemia is important in this group of patients and can often be challenging. Diagnosing anemia of renal disease du Read More

Although clinical trials evaluating therapy with implantable cardioverter defibrillators (ICD) have had clear limitations, there are few interventions in which multiple trial settings over a long period have consistently produced a 20% to 30% reduction in total mortality in patients with left ventricular dysfunction. Substantial differences between the Guidelines on ICD implantation have resulted and the number of patients actually impla Read More

Spurred by remarkable findings in animal studies, there has been strong interest in evaluating the potential of adult stem cells to improve left ventricular function in the past decade. Driven by the need to treat the increasing number of patients with coronary artery disease, numerous studies have attempted to define a role for bone marrow cell therapy in clinical use. However, the conflicting results of these studies ca Read More

Till date the synthetic hepato-protective agents used in clinical practices are therapeutically non-promising and may itself lead to hepatotoxicity. Herbal medicines and their bioactives are considered to be relatively safe and have been used in the treatment of liver diseases for a long time. The 21st century has seen a paradigm shift towards therapeutic standardization of herbal drugs in hepatic disorders by evidence-based Read More

Standard chemotherapy can cure only a fraction (30-40%) of younger and very few older patients with acute myeloid leukemia (AML). While conventional allografting can extend the cure rates, its application remains limited mostly to younger patients and those in remission. Limited efficacy of current therapies and improved understanding of the disease biology provided a spur for clinical trials examining novel agent Read More

Background: In the 21st century, tubal ectopic pregnancies (EPs) are diagnosed earlier in their natural history due to transvaginal ultrasound technology. More women are haemodynamically stable and therefore can be offered non-invasive outpatient management with systemic Methotrexate (MTX). However there is no evidence that MTX is necessary in all these early EPs, as many may resolve spontaneously in t Read More

A randomised controlled trial (RCT) is considered the hierarchical peak of evidence-based medicine and a general demand for any result to be evaluated by RCTs has evolved. Yet, many advances in operative surgery do not result from RCTs and many controversies remain without an RCT being conducted. A randomised comparison of laparoscopic versus open liver resection has recently been called for. Using such a trial a Read More

Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignancies and has significant mortality. Its multi-step cumulative features strongly support early management. Cancer chemoprevention has been accepted as a promising intervention for early management, and has made enormous progresses over the past 30 years due to the large number of research studies including many randomized clinical Read More