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At least 73 records · Page 4Linked to original sources
PubMed1996

Long-term blood pressure control in older Chinese patients with isolated systolic hypertension: a progress report on the Syst-China trial.

This report on the ongoing double-blind placebo-controlled Syst-China trial investigated whether antihypertensive drug treatment based mainly on a calcium entry blocker and a converting enzyme inhibitor, would be suitable for maintaining long-term blood pressure (BP) control in older Chinese patients (average age: 67 years) with isolated systolic hypertension (systolic pressure 160-219 mm Hg and diastolic pressure < 95 mm Hg). Active treatment consisted of nitrendipine (10- 40 mg/day) with the possible addition of captopril (12.5- 50 mg/day) and hydrochlorothiazide (12.5-50 mg/day), as necessary to reduce systolic pressure to a level of 150 mm Hg or lower and by at least 20 mm Hg. Matching placebos were used in the control group. This progress analysis was restricted to BP control up to 3 years of follow-up. The placebo (n = 1134) and active treatment n = 1245) groups had similar characteristics at enrolment. The sitting BP averaged 170/86 mm Hg. Systolic pressure fell (P < 0.001) on average 8 mm Hg more on active treatment than on placebo and diastolic pressure 3 mm Hg more. Fewer patients remained on monotherapy in the placebo than in the active treatment group (P < 0.001); on placebo the second and third line medications were started more frequently (P < 0.001). This progress report showed that significant BP reduction can be achieved and maintained in older Chinese patients treated with a calcium antagonist, associated with a converting-enzyme inhibitor and a thiazide, as necessary. Whether this BP reduction would result in a clinically meaningful decrease of cardiovascular complications is still under investigation.

Aged↗
PubMed1997

Therapy in old patients with isolated systolic hypertension: fourth progress report on the Syst-Eur trial.

The Syst-Eur trial is a multicentre, randomized, double-blind, placebo controlled therapeutical trial in patients at least 60 years old and with isolated systolic hypertension. Its scope is to investigate the effects of modern antihypertensive drug treatment on morbidity and mortality and to assess possible adverse effects of the drugs used. Patients were recruited in 22 countries in western and eastern Europe and Israel. At three run-in visits 1 month apart their sitting systolic blood pressure (SBP) on single-blind placebo treatment averaged 180-219 mm Hg with diastolic blood pressure (DBP) lower than 95 mm Hg. After stratification for sex and the presence of cardiovascular complications, the patients were randomized either to active treatment or placebo. Active treatment consisted of nitrendipine (10-40 mg/day) with the possible addition of enalapril (5-20 mg/day) and/or hydrochlorothiazide (12.5-25 mg/day), titrated or combined to reduce the sitting SBP by at least 20 mm Hg to below 150 mm Hg. Matching placebos were employed similarly. The present progress report is based on the data received at the Coordinating Office before 1 March 1996. At that time 3433 subjects had been randomized. A total of 2015 patients had been followed for at least 1 year on double-blind treatment and 1298 patients for at least 2 years. At baseline BP was similar in both treatment groups and averaged 174/86 mm Hg. According to a per-protocol analysis at 1 year, BP fell (P < 0.001) on average by 22.6 +/- 15.7/6.0 +/- 8.0 mm Hg in the active treatment group and by 12.2 +/- 15.9/1.7 +/- 7.3 mm Hg in the placebo group. At 2 years BP was 10.2/5.7 mm Hg lower (P < 0.001) on active treatment than on placebo. At 1 year the percentage of patients who had reached goal BP was 19.9% in the placebo group and 41.4% in the active treatment group. At 2 years these percentages were 20.9 and 43.2 respectively.

Aged↗
PubMed2005

Linking clinical audit in general dental services to primary care trust clinical governance -- progress report of an approach used in Southend.

Clinical audit has been defined as the systematic, critical analysis of the quality of dental care, including the procedures and processes used for diagnosis, intervention and treatment, the use of resources and the resulting outcome and quality of life as assessed by both professionals and patients. The aim of clinical audit is to encourage dentists to self-examine different aspects of their practices, to implement improvements where the need is identified and to reexamine, from time to time, those areas that have been audited to ensure that a high quality of service is being maintained or further improved. Since 1st April 2001, all general dental practitioners (principals and assistants) working in the General Dental Services (GDS) have been required to participate in a rolling programme of at least 15 hours of clinical audit or peer review every three years. The first three-year cycle ended on 31st March 2004. By the end of December 2003, 96% of dentists had either under- taken or committed to undertake clinical audit/peer review activities. This initiative, in conjunction with the voluntary clinical audit and peer review schemes which preceded it, has provided opportunities for dentists and their practices to use these activities to assist in quality improvements in their practices, for the benefit of their patients. However, there are other methods for carrying out clinical audit and, in the NHS, there is a need to link it to clinical governance. This paper gives a progress report on an approach that has been piloted by Southend Primary Care Trust (PCT). It deals with the rationale for the project and outlines the methods used. It does not report results. These will follow in a subsequent paper.

Clinical Competence↗
PubMed2004

Cancer care. Cancer plan--progress report: must try even harder.

Despite progress in some areas, major obstacle achieving a uniformly good service for cancer patients remain. PCTs' lack of expertise is holding back progress ending delays in diagnosis and treatment. SHAs need to be clearer with PCTs about the importance of meeting national targets.

Benchmarking↗
PubMed1987

Development of antiretroviral therapy for the acquired immunodeficiency syndrome and related disorders. A progress report.

We review the rationale for, and progress in, the development of antiviral therapy for the acquired immunodeficiency syndrome (AIDS). A consideration of the replicative cycle of the human immunodeficiency virus (HIV) can lead to the identification of several steps that represent potential targets for antiretroviral therapy, and several substances that can inhibit the replication of HIV in vitro have already been identified. The 2',3'-dideoxynucleosides are a class of nucleoside analogues in which the 3'-hydroxy group is modified so that it cannot form phosphodiester linkages for nucleic acid chains. Some are potent in vitro inhibitors of HIV replication, possibly acting as chain terminators of viral DNA during reverse transcription. One of these dideoxynucleoside analogues, 3'-azido-2',3'-dideoxythymidine (AZT), has now been administered for up to 18 months to patients with AIDS. The drug has been shown to improve immunologic function, to reverse, at least partially, HIV-induced neurologic dysfunction in some patients, and to improve certain other clinical abnormalities associated with AIDS. The principal toxic effect associated with AZT is dose-dependent suppression of bone marrow, resulting particularly in anemia and leukopenia; however, most patients in whom this toxic effect occurs can subsequently tolerate a lower dose of the drug. The demonstration that AZT can be beneficial in patients with AIDS has removed some of the uncertainty about the rationale for an antiretroviral intervention in HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1987

ACT-asthma control y tratamiento para niños: a progress report.

A randomized clinical trial is in progress to evaluate an asthma educational program for Latino children and their parents. The intervention, "ACT-Asma Control y Tratamiento Para Niños," was adapted from ACT for Kids, an asthma self-management program for English-speaking families. Results of a pilot study indicated that socioeconomic status was a critical variable to be considered in the design of such programs. Latino children and parents encounter significant barriers to access and continuity of medical care. Therefore, the intervention was redesigned to include "linkages" using a nurse to reduce barriers and to coordinate care. The lesson plans emphasize concrete, experimental learning experiences, with repetition of key points in each session.

Asthma↗
PubMed2001

Human pluripotent stem cells: a progress report.

The derivation of diploid human pluripotent stem cell lines from either human blastocysts or embryonic gonads in 1998 attracted a great deal of interest because of the widespread potential applications of these cells in research and in regenerative medicine. Since the initial reports, there has been some progress in the characterisation of blastocyst-derived stem cells, and some technical advances in their manipulation. Conditions for differentiation in vitro of pluripotent stem cells from either blastocysts or gonads have been defined. In some studies, committed progenitor cell populations have been isolated from mixed cultures of differentiating ES cells.

Bioethics↗
PubMed2003

Engineering of the extracellular matrix: working toward neural stem cell programming and neurorestoration--concept and progress report.

In the concept of neurorestoration, cellular and structural elements that have been lost are replaced, and their function is restored. Central to this therapeutic strategy is the transplantation of neural progenitor cells such as clonogenically expanded stem cells. Stem cells make decisions regarding fate and patterning in response to external environmental signals. The therapeutic effectiveness of neural stem cells may be facilitated by the ability to manipulate these signals in a temporal and spatially appropriate fashion. Artificial deoxyribonucleic acid and artificial protein technology combines elements of protein engineering, molecular biology, and recombinant deoxyribonucleic acid technology to produce proteins with functional domains derived from naturally occurring proteins and represents a potentially powerful tool to modulate stem cell behavior. To this end, we have developed three artificial extracellular matrix proteins that incorporate the active domain of hJagged1 and hDelta1 into an elastin backbone. hJagged1 and hDelta1 are members of the DSL family of ligands to the Notch receptor, a signaling system that is very important in development and is the strongest known signal to instruct neural progenitor cells to choose glial fates over neuronal fates. The successful cloning of the artificial genes was confirmed by test digestions with appropriate restriction enzymes as well as direct deoxyribonucleic acid sequencing. In addition, we have demonstrated that all three artificial extracellular matrix proteins express at a high level in a prokaryotic host. This report describes the concept and progress in an entirely novel and previously unreported approach to modulate neural stem cell behavior. Its future application could include in vitro processing of stem cells before transplantation, supporting and programming the cells after transplantation, as well as the development of bioactive biomaterials.

Cell Physiological Phenomena↗
PubMed1982

[Experience from palliative chemotherapy for advanced ovarian carcinoma - progress report on hospital with outpatient department at district level (author's transl)].

Reported in this paper is progress obtained from palliative treatment of patients with advanced ovarian carcinoma in an area under the control of a district hospital, between 1957 and 1978. Particular reference is made to the favourable effects of combination chemotherapy on survival rates and general condition. This study is intended to underline that the above therapeutic approach should not be restricted to few highly specialised centres and that it is practicable to the benefit of the patients concerned also under routine conditions at district hospitals. However, everything depends on high-continuity and persistent monitoring of these women on the basis of unity of hospital and outpatient attention.

Antineoplastic Agents↗
PubMed1968

Metropolitan Detroit's network. Detroit Medical Library group: five year progress report.

Over a five-year period, much progress has been made in meeting the needs of health care personnel in the Detroit metropolitan area through library cooperation. These cooperative relationships have stimulated implementation of the following projects: (1) publications, (2) research on medical library problems, and (3) library programs at both the city and state levels.

Information Services↗
PubMed2005

The Clinical Research Center of Hawaii: a nine year progress report.

The UH-CRC is an NIH minority funded infrastructure program at the University of Hawaii in partnership with Hawaii Pacific Health, now in its ninth year. The main purpose of the UH-CRC is to foster clinical research at UH in order to improve the health of the citizens of Hawaii, particularly those who suffer disproportionately from disorders affecting these communities. This status report documents the continued success and progress of the Center Manuscripts published or in press have increased from an average of 43 in years 1-3 to 54 in years 4-6 to 84 for years 7-9. Actual dollars received per year ranged from 1-7 million dollars the first 6 years, but reached 8-22 million dollars the last three years. This status report also documents the mandate for this clinical research infrastructure program to compete successfully for mainstream funding status by 2010.

Academic Medical Centers↗
PubMed1976

Evaluation of tamoxifen dose in advanced breast cancer: a progress report.

The results of an ongoing trial randomizing patients with progressive, metastatic breast carcinoma between tamoxifen (Tam, NSC-180973) and Tam plus fluoxymesterone (Flu) (7 mg/m2 bid) are reported. Each patient received a single dose level of Tam in the range of 2-100 mg/m2 bid. The combination had a higher response rate overall (45% vs 28%) and when only the patients' soft tissue sites were analyzed (54% vs 9%, P=0.04). The time to treatment failure was longer for the combination among those patients with a response or disease stabilization (P=0.08). Response rates with Tam doses less than 12 mg/m2 bid were also higher than with doses greater than or equal to 12 mg/m2 for all patients in the study (62% vs 30%, P=0.025) and for those where only soft tissue sites were evaluable (43% vs 29%, P=0.07). Side effects were mild and consisted primarily of transient hematologic suppression, nausea, masculinization, hepatic enzyme elevations, and edema. The latter three were observed only with the Flu regimen. Leukopenia and thrombocytopenia were more frequent at Tam doses less than 12 mg/m2 bid whereas nausea was more common at higher doses. Tam doses as high as 100 mg/m2 bid were well tolerated. Tam amy be more effective at low doses, has only mild side effects, and is well tolerated at doses up to 100 mg/m2 bid. Combining Tam with Flu appears to enhance the therapeutic effectiveness.

Adult↗
PubMed1999

A progress report of the Marshall Islands nationwide thyroid study: an international cooperative scientific study.

The objective of this report is to present a summary of progress of the Marshall Islands Nationwide Thyroid Study. As well known, the US atomic weapons testing program in the Pacific was conducted primarily between 1946 and 1958 in the Marshall Islands. The nuclear tests resulted in radioactive contamination of a number of atolls and resulted in exposure of Marshallese to undefined levels before our study. Little information has been paid to health consequences among residents of the nearly twenty inhibited atolls except for some information about nodular thyroid disease which was reported on by an US group. In a cooperative agreement with the Government of the Marshall Islands, between 1993 and 1997 we studied the prevalence of both thyroid nodules and thyroid cancer among 4766 Marshallese potentially exposed to radioiodines from bomb test fallout. That group represents more than 65% of the population at risk. We diagnosed 45 thyroid cancers and 1398 benign thyroid nodules. In addition, 23 study participants had been operated on prior to our study for thyroid cancer. Presently, we are developing a database of information to estimate radiation doses and planning a statistical analysis to determine if a dose-response relationship exists. These data will be important for the health promotion of exposed people all over the world including Hiroshima, Nagasaki, Semipalatinsk, Chernobyl and other locations. A timely completion is important for purpose of assisting Marshallese as well as to add the global understanding of radiation induced thyroid cancer.

Databases, Factual↗