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At least 451 records · Page 25Linked to original sources
PubMed2005

Propylthiouracil for alcoholic liver disease.

BACKGROUND: Randomised clinical trials have addressed the question whether propylthiouracil has any beneficial effects in patients with alcoholic liver disease. OBJECTIVES: To assess the beneficial and harmful of propylthiouracil for patients with alcoholic liver disease. SEARCH STRATEGY: The Cochrane Hepato-Biliary Group Controlled Trials Register (May 2005), The Cochrane Central Register of Controlled Trials in The Cochrane Library (Issue 2, 2005), MEDLINE (1950 to May 2005), EMBASE (1980 to May 2005), and The Web of Science (May 2005) were searched. These electronic searches were combined with full text searches. Manufacturers and researchers in the field were also contacted. SELECTION CRITERIA: Randomised clinical trials studying patients with alcoholic steatosis, alcoholic fibrosis, alcoholic hepatitis, and/or alcoholic cirrhosis were included irrespective of blinding, publication status, or language. Interventions encompassed propylthiouracil at any dose versus placebo or no intervention. DATA COLLECTION AND ANALYSIS: All analyses were performed according to the intention-to-treat method in RevMan Analyses. The methodological quality of the randomised clinical trials was evaluated by components (generation of the allocation sequence; allocation concealment; double blinding; follow-up). MAIN RESULTS: Combining the results of six randomised clinical trials including 710 patients demonstrated no significant effects of propylthiouracil versus placebo on all-cause mortality (relative risks (RR) 0.93, 95% confidence interval (CI) 0.66 to 1.30), liver-related mortality (RR 0.80, 95% CI 0.50 to 1.29), complications of the liver disease, or liver histology. Propylthiouracil was associated with a non-significant increased risk of non-serious adverse events and with the seldom occurrence of serious adverse events (leukopenia). AUTHORS' CONCLUSIONS: We could not demonstrate any significant beneficial effect of propylthiouracil on all-cause mortality, liver-related mortality, liver complications, and liver histology of patients with alcoholic liver disease. Propylthiouracil was associated with adverse events. Confidence intervals were wide. Accordingly, there is no evidence for using propylthiouracil for alcoholic liver disease outside randomised clinical trials.

Antimetabolites↗
PubMed2004

Antibodies in the prevention of renal allograft rejection.

The rejection of renal allografts is mediated largely by the intragraft accumulation of alloreactive T lymphocytes. Current immunosuppressive drugs impair lymphocyte function, but also have specific toxicities and lead to nonspecific impairment of immune responses, resulting in an increased risk of infections and malignancy. Initial studies examined the usefulness of antibodies that depleted lymphocytes in preventing rejection. More recently, antibodies that impair lymphocyte function by blocking the interleukin-2 receptor-alpha (IL-2Ralpha), thereby reducing IL-2-mediated activation of T cells, were shown to reduce the risk of rejection. As an additional strategy, antibodies that impair lymphocyte trafficking have been investigated for their effect on acute rejection. This review describes the results of clinical trials of depleting antilymphocyte antibodies, IL-2Ralpha blockers and antibodies to intercellular adhesion molecule-1, lymphocyte function-associated antigen-1, CD154 and CD52 in the prevention of allograft rejection. Particular emphasis has been placed on therapies for which there is evidence obtained from good, randomised, controlled trials or registry data.

Animals↗
PubMed2005

Endocrine tumours of the gastrointestinal tract. Introduction: definition, historical aspects, classification, staging, prognosis and therapeutic options.

Synonyms for gastroenteropancreatic endocrine tumours are 'endocrine tumours' and 'neuroendocrine tumours', and for pancreatic tumours 'islet cell tumours'. The term 'carcinoid' should only be used for endocrine tumours of the gastrointestinal tract and not for those of the pancreas. Endocrine tumours should be classified according to a recent World Health Organization proposal that provides clinically and prognostically important information. The prognosis of well-differentiated endocrine tumours is variable and, in general, favourable. However, we have few histological data from which to predict tumour growth and long-term prognosis in well-differentiated tumours. Poorly differentiated, small-cell tumours have an unfavourable prognosis. Patients with endocrine tumours have an increased risk of developing synchronous and metachronous non-endocrine malignancies. Most current treatment options are not supported by prospective, randomised and controlled trials.

Carcinoma, Neuroendocrine↗
PubMed1990

Calcium antagonists in the management of subarachnoid haemorrhage.

The development of delayed cerebral ischaemia and hence neurological deficit remains a serious problem following subarachnoid haemorrhage. Over recent years, attention has focussed on the use of the dihydropyridine class of calcium channel blocking agents ("calcium antagonists"), in particular nimodipine, as drug therapy in the prophylaxis and treatment of this condition. The theoretical basis for this is briefly discussed and then the clinical experience of the use of calcium antagonists following subarachnoid haemorrhage reviewed. In particular, attention is focussed on the randomised controlled trials that have eventually been able to show that such treatment is beneficial, both in terms of reduction of ischaemic deficit attributable to cerebral "vasospasm" and in clinical outcome, when given prophylactically, although not apparently therapeutically once deficit has developed. The evidence of the mode of action of calcium antagonists in this situation is discussed, again with particular reference to clinical data obtained in situ in the course of such trials. Although the mechanism of action remains unclear, it appears likely that it is at least in part due to the selective cerebral vasodilation induced by these compounds. The necessity for large well-controlled, prospective, randomised clinical trials in the assessment of therapeutic efficacy is stressed.

Brain Ischemia↗