Reviews on Recent Clinical Trials - Volume 9, Issue 2, 2014

Heart failure remains the main cause of death in children with heart disease. In USA and Europe hospital mortality of children with heart failure is about 7% of children, nearly twice as high as in adults. In this review a group of authors report about their experience with beta-blockers in childhood heart failure. Most of them start to treat children with severe heart failure at a time - 20 years ago - when beta blockers seem Read More

Patients with chronic heart failure have prolonged sympathetic stimulation and subsequent worsening of the failing heart function. Beta-blockers (non-selective, cardio-selective, and non-selective with ancillary properties) counteract the effects of prolonged sympathetic stimulation. Beta-blocker therapy results in the improvement of the left ventricular systolic and diastolic function, reversal remodeling, heart rate control, Read More

The prevalence of heart failure in patients with congenital heart disease, mainly due to large left to right shunts, is as high as 20%. Heart failure has a high impact on prognosis, growth and neurodevelopment. Prior to surgery or after palliative procedures children need a medical heart failure therapy. The traditional therapy with digoxin, diuretics and ACE-inhibitors is not supported by prospective randomized trials. Propranolol Read More

Thanks to the enormous progress in the field of cardiac surgery and paediatric cardiology since the mid of 20th century, more and more children with congenital heart defects reach the adulthood. This on the other hand encounter physician and patients various problems due to late complications after the heart surgery like congestive heart failure, arrhythmia and sudden death. One of the challenging area is the me Read More

Background: Numerous prospective randomized clinical trials demonstrated favorable effect of beta-blockers in adults with chronic heart failure. However, effectiveness of beta blockers in pediatric patients with systemic ventricle systolic dysfunction was not recognized sufficiently. Limited number of pediatric patients might be the course of unrecognized carvediolol treatment benefit. Currently, no meta-analysis has exami Read More

Respiratory failure and heart failure are inevitable complications in Duchenne muscular dystrophy (DMD). Respiratory failure and heart failure undergo simultaneously and affect each other. After dissemination of mechanical ventilation, heart failure is the main cause of death in DMD. Regular assessment of cardiopulmonary function, early introduction of cardioprotective therapy and intensive respiratory care are the k Read More

Congestive cardiac failure accounts for 36% of childhood deaths in hypertrophic cardiomyopathy, and in infants with heart failure symptoms before two years of age, the mortality is extremely high unless treatment with betareceptor antagonists is instituted. The mechanism of heart failure is not systolic dysfunction, but rather extreme diastolic dysfunction leading to high filling pressures. Risk factors for development of heart failu Read More

The exact prevalence of heart failure among children of developing countries is not known, as the data is limited. The relative frequency of different causes of pediatric heart failure varies widely across different countries and even among different parts of large countries like India. Children of developing countries face a double burden of etiologies. Conditions such us congenital heart disease, myocarditis and cardio Read More

Objective: Induction of labour for reasons that medical professionals do not consider “medically indicated” is a difficult subject, both for women requesting it, as well as the medical professionals involved in their care. There is often a prejudice that induction will increase risks for mothers and babies, and therefore they try to avoid it. We aimed to look at this group of patients who request induction for a number of “non-medica Read More

Indacaterol was introduced as an agent of the new generation of very long acting beta2-agonists (VLABA) that provides a 24-hour activity of bronchodilation and allows a once-daily OD dosing. The first trial showed a significantly higher efficacy of indacaterol vs. placebo in patients with chronic obstructive pulmonary disease (COPD). The following trials were aimed at evaluating its performance compared with other bron Read More

In recent years an increasing attention is focused on the potential effects of drugs on cancer incidence and/or cancer survival. Many medications of common use, developed for a variety of medical non-cancer situations, have been found to have potential anti- cancer effects. In this article, we performed an overview of the literature evidence for several commonly used non-cancer medications, such as aspirin, beta-blockers, m Read More

Hepatitis C virus (HCV) chronically infects about 2% of the world’s population. Approximately a quarter of these patients will develop, during their life, liver cirrhosis, which entails a high risk of complications and death. Successful antiviral therapy can reduce the risk of disease progression, but it is feasible only in a minority of patients because it includes interferon which is contraindicated in the most advanced stages of the dise Read More