Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Conference Proceedings”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 901 records · Page 50Linked to original sources
PubMed2003

Excitatory amino acid antagonists for acute stroke.

BACKGROUND: Focal cerebral ischaemia causes release of excitatory amino acid (EAA) neurotransmitters, principally glutamate, with resultant over-stimulation of EAA receptors and downstream pathways. Excess glutamate release is a pivotal event in the evolution of irreversible ischaemic damage in animal models of ischaemia, and drugs that modulate glutamate action either by inhibiting its release, or blocking post-synaptic receptors, are potent neuroprotective agents. Many clinical trials with EAA modulating drugs have been conducted, none individually demonstrating efficacy. OBJECTIVES: To synthesise all the available data on all different classes of EAA modulators and to evaluate evidence of effects on outcome systematically. SEARCH STRATEGY: Relevant trials were identified in the Specialised Register of Controlled Trials (last searched May 2001). In addition, MEDLINE and EMBASE online searches for the terms "neuroprotection" (and its variants), "neuroprotective agent", for all individual drugs and drug classes included in the review, hand searches of conference proceedings from European, International, American Heart Association and Princeton conferences on Stroke, American Neurological Association and American Academy of Neurology meetings from 1992-2001, and direct contact with individual investigators and pharmaceutical companies. SELECTION CRITERIA: Trials were included if they were randomised, controlled studies giving agents with pharmacological properties that included modification of release of EAAs, or blockade of EAA receptors, in stroke within 24h of onset. Efficacy analysis was restricted to trials with a parallel group design: dose escalation studies were excluded. Intention-to-treat analyses were performed on all data. Outcome had to be reported in terms of death or dependence 1-12 months after the acute event. DATA COLLECTION AND ANALYSIS: Data were available for 36 of 41 relevant trials identified, involving 11,209 subjects. Data were unavailable for 632 participants (517 in trials fulfilling criteria for efficacy analysis). Seven trials did not report disability data, which were available for 29 trials involving 10,802 subjects. Twenty one of these trials, involving 10,342 subjects, were parallel group studies included in the primary efficacy analysis. Efficacy analysis included data derived from 9 trials not primarily designed to assess efficacy (1022 subjects). The primary (efficacy) end-point was the proportion of patients dead or disabled at final follow-up (defined by Barthel Index<60 at 3 months by preference). Mortality was a secondary end-point. Drugs were considered as individual agents, and also grouped principally into categories of ion channel modulators (glutamate release inhibition) and NMDA antagonists. MAIN RESULTS: There was no significant heterogeneity of outcome amongst individual drugs, or of drug classes either for the primary efficacy analysis (death or dependence) or for mortality at final follow-up. For the primary efficacy analysis, odds of death or dependence were 1.03 [95% confidence interval 0.96-1.12], and for mortality 1.02 [0.92-1.12]. Neither ion channel modulators (death or dependence 1.02 [0.90-1.16]) nor NMDA antagonists (death or dependence 1.05 [0.95-1.16]) differed from the principal analysis including all compounds. Trends for increased mortality with three NMDA antagonists were seen - selfotel (OR 1.19 [0.81-1.74]), aptiganel (OR 1.32 [0.91-1.93]) and gavestinel (OR 1.12 [0.95-1.32]) - but this did not achieve significance for the NMDA antagonists considered as a class (1.09 [0.96-1.23]). Aptiganel was also associated with a trend towards worse functional outcome (OR 1.20 [0.88-1.65]) although this was not the case for either of the other two compounds. No statistically significant detriment of psychotomimetic NMDA antagonists was found, although a trend towards higher mortality in this sub-group was seen (OR 1.25 [0.96-1.64]). REVIEWER'S CONCLUSIONS: There was no evidence of significant benefit or harm from drugs modulating excitatory amino acid action. Reductio]). REVIEWER'S CONCLUSIONS: There was no evidence of significant benefit or harm from drugs modulating excitatory amino acid action. Reduction of death or dependence by 8% or more has been excluded for gavestinel and lubeluzole, which contribute most of the data for this review. However, mechanistic understanding of neuroprotection is too poor to extrapolate from these two failed development plans to all glutamate modulators. Further clinical trials of neuroprotective agents remain justified, since confidence limits around estimates of effect remain wide for most agents, and cannot reliably exclude benefit. Although numbers of patients are too small to confirm or refute a trend towards increased mortality with some NMDA antagonists, further commercial development of these agents is exceedingly unlikely.

Acute Disease↗
PubMed2001

Bisphosphonates for osteoporosis in people with cystic fibrosis.

BACKGROUND: Osteoporosis is a disorder of bone mineralization that can lead to reduced bone mineral density and an increased risk for fractures. It is found in about one third of adults with cystic fibrosis. Bisphosphonates have been shown to increase bone mineral density and decrease the risk of new fractures in post-menopausal women and in patients receiving long-term oral corticosteroids. OBJECTIVES: To assess the effects of bisphosphonates on the frequency of fractures, bone mineral density, quality of life, adverse events, study withdrawals, and survival in people with cystic fibrosis. SEARCH STRATEGY: Relevant trials were identified in the Cochrane Cystic Fibrosis and Genetic Disorders Review Group specialised register of controlled trials by the centre co-ordinator. This register comprises references identified from comprehensive electronic database searches, handsearching of relevant journals and of conference proceedings. Additional sources such as abstract books for osteoporosis conferences were hand-searched by the authors. The most recent search(es) were conducted in February 2001. SELECTION CRITERIA: Randomised controlled trials of at least six months duration that studied the use of bisphosphonates in adults with cystic fibrosis were considered for inclusion. Outcomes included one of the following: fractures, bone mineral density, quality of life, adverse events, study withdrawals, or survival. DATA COLLECTION AND ANALYSIS: Information on study design, participants, interventions, and outcomes was abstracted from included studies. Two independent reviewers abstracted the information. Authors were contacted to obtain missing data. MAIN RESULTS: Two trials were identified in the trials search. Both trials with a total of 65 participants were included in this review. One study examined patients without lung transplants while the other study included only patients who had received a lung transplant. The intervention in both trials was pamidronate administered intravenously every three months. In patients who had not received a lung transplant, bone mineral density at axial sites was increased after six months of treatment in the treatment group compared to the control group (lumbar spine WMD [for % change BMD] = 5.8 [95% CI 4.63 to 6.97], hip WMD = 3.00 [95% CI 1.99 to 4.01]). There was a small decrease in forearm bone mineral density in patients treated with pamidronate versus controls (distal forearm WMD = -1.70 [95% CI -2.46 to -0.94]). Bone pain was the most common adverse event occurring in 11/15 participants not using corticosteroids (RR = 24.40, 95% CI 1.57 to 381.48). There was no difference in survival (RR = 1.00, 95% CI 0.83 to 1.20), although this may be due to short follow-up and small sample size. In patients who had received a lung transplant, the number of new fractures did not change with the use of pamidronate (non-vertebral RR = 3.38 [95% CI 0.39 to 29.29], vertebral RR = 0.56 [95% CI 0.17 to 1.89]). Bone mineral density at axial sites was increased after two years of treatment in the treatment group compared to the control group (lumbar spine WMD [for % change in BMD] = 6.20 [95% CI 4.28 to 8.12], femur WMD = 7.90 [95% CI 5.78 to 10.03]). REVIEWER'S CONCLUSIONS: Intravenous pamidronate increases bone mineral density at axial sites in people with cystic fibrosis, although it can cause severe bone pain in patients not receiving corticosteroids. Additional studies in larger populations are needed to determine the effect on fracture rate and survival.

Bone Density↗
PubMed2004

Patches of different types for carotid patch angioplasty.

BACKGROUND: Some surgeons who use carotid patching favour using a patch made from an autologous vein, whilst others prefer to use synthetic materials. OBJECTIVES: The objective of this review was to assess the safety and efficacy of different materials for carotid patch angioplasty. SEARCH STRATEGY: We searched the Cochrane Stroke Group trials register (last searched November 2002). In addition, we searched the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001), MEDLINE (1966 to December 2001), EMBASE (1980 to December 2001) and Index to Scientific and Technical Proceedings (1980 to 2001). We also handsearched eight journals and five conference proceedings. Reference lists were checked and we contacted experts in the field to identify further published and unpublished studies. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing one type of carotid patch with another for carotid endarterectomy. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed eligibility, trial quality, and extracted the data MAIN RESULTS: The previous version of this review included three trials involving 326 operations. Since then a further five trials have been reported, increasing the number of operations to 1480. Prior to 1995, all studies had compared vein closure with PTFE closure, but three of the later studies compared vein to Dacron grafts instead and one compared Dacron with PTFE. Allocation was not adequately concealed in two trials, and one only followed up patients to the time of hospital discharge. Intention to treat analysis was possible for six trials. In all but two trials a patient could be randomised twice and have each carotid artery randomised to different treatment groups. There were too few operative events to determine whether there was any difference between the vein and Dacron patches for perioperative stroke, death and arterial complications. The one study that compared Dacron and PTFE patches found a significant risk of combined stroke and transient ischaemic attack (p = 0.03) and restenosis at 30 days (p = 0.01), a borderline significant risk of perioperative stroke (p = 0.06), and a non significant increased risk of perioperative carotid thrombosis (p = 0.1) with dacron compared with PTFE. Five trials followed up patients for longer than 30 days. During follow-up for more than one year, no difference was shown between the two types of patch for the risk of stroke, death, or arterial restenosis. However, the number of events was small. Based on 15 events in 776 patients in four trials, there were significantly fewer pseudoaneurysms associated with synthetic patches than vein (odds ratio [OR] 0.09, 95% confidence interval [CI] 0.02 to 0.49) but the numbers involved were small and the clinical significance of this finding is uncertain. REVIEWERS' CONCLUSIONS: It is likely that the differences between different types of patch material are very small. Consequently, many more data than are currently available will be required to establish whether any differences do exist. Some evidence exists that PTFE patches may be superior to Colagen impregnated Dacron grafts in terms of perioperative stroke rates and restenosis. However the evidence is based upon data from a single, small trial and more studies that compare different types of synthetic graft are required to make firm conclusions. Psuedo aneurysm formation may be more common after use of a vein patch compared with a synthetic patch.

Blood Vessel Prosthesis↗
PubMed2004

Patch angioplasty versus primary closure for carotid endarterectomy.

BACKGROUND: Carotid patch angioplasty (with either a venous or a synthetic patch) may reduce the risk of carotid artery restenosis and subsequent ischaemic stroke. OBJECTIVES: The objective of this review was to assess the safety and efficacy of routine or selective carotid patch angioplasty compared to carotid endarterectomy with primary closure. SEARCH STRATEGY: We searched the Cochrane Stroke Group Trials Register (last searched November 2002). In addition, we searched the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001), MEDLINE (1966 to December 2001), EMBASE (1980 to December 2001) and Index to Scientific and Technical Proceedings (1980 to 2001). We also handsearched eight journals and five conference proceedings. Reference lists were checked and we contacted experts in the field to identify further published and unpublished studies. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing carotid patch angioplasty with primary closure in any patients undergoing carotid endarterectomy. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed eligibility, trial quality and extracted the data. MAIN RESULTS: The previous review included six trials involving 794 patients undergoing 882 operations. Since the last review only one study of adequate quality to be included has been reported. This added 399 operations randomised to either primary closure, vein patch or synthetic patch groups resulting in 1127 patients undergoing 1307 operations being available for analysis. The quality of trials was generally poor. Follow-up varied from hospital discharge to five years. Carotid patch angioplasty was associated with a reduction in the risk of stroke of any type (OR = 0.33, p = 0.004), ipsilateral stroke (OR = 0.31, p = 0.0008), and stroke or death, during the perioperative period (OR = 0.39, p = 0.007) and long term follow-up (OR = 0.59, p = 0.004). It was also associated with a reduced risk of perioperative arterial occlusion (odds ratio 0.15, 95% confidence interval 0.06 to 0.37 p = 0.00004), and decreased restenosis during long-term follow-up in five trials, (odds ratio 0.20, 95% confidence interval 0.13 to 0.29 p < 0.00001). These results are more certain than those of the previous review since the number of operations and events have increased. However, the sample sizes are still relatively small, data were not available from all trials, and there was significant loss to follow-up. Very few arterial complications, including haemorrhage, infection, cranial nerve palsies and pseudo-aneurysm formation were recorded with either patch or primary closure. No significant correlation was found between use of patch angioplasty and the risk of either perioperative or long-term all-cause death rates REVIEWERS' CONCLUSIONS: Limited evidence suggests that carotid patch angioplasty may reduce the risk of perioperative arterial occlusion and restenosis. It would appear to reduce the risk of combined death or stroke and there is a non significant trend towards a reduction in all-cause mortality.

Blood Vessel Prosthesis↗
PubMed2005

Abstracts presented at the American Society of Clinical Oncology conference: how completely are trials reported?

PURPOSE: To assess how completely trials published in conference proceedings are reported and whether this has changed over time. METHODS: Conference abstracts published at the American Society of Clinical Oncology (ASCO) conference (1992 and 2002) were read to identify reports of randomized trials. A checklist was devised (based on CONSORT) to assess the completeness of reporting. RESULTS: Four-hundred and ninety-four abstracts reporting randomized trials were identified; 209 in 1992 and 285 in 2002. More trials included "randomized" in the title in 2002 compared to 1992 (54% versus 36%). Almost no trials stated the method of allocation concealment, 12% stated the method of blinding, 95% described eligible participants and 98% described the interventions. Ninety-five per cent reported the number of participants in each trial. The median number of participants per trial increased over time; 120 in 1992 and 209 in 2002 (P < 0.01). In 1992, 67% of trials reported the number of participants analysed, compared to only 49% in 2002 (P < 0.01), 28% reported or suggested intention to treat analysis dropping to 15% in 2002. Twenty-nine abstracts in 2002 and five in 1992 reported no results, with a promise of presentation at the meeting. CONCLUSIONS: The reporting of conference abstracts for trials should be improved to further facilitate understanding of their conduct and validity.

Congresses as Topic↗
PubMed2005

Insulin and oral agents for managing cystic fibrosis-related diabetes.

BACKGROUND: Insulin therapy is recommended by the Cystic Fibrosis Foundation when cystic fibrosis-related diabetes has been diagnosed. Diagnosis is based on an elevated fasting blood glucose level greater than 6.94 mmol/liter (125 mg/deciliter) or symptomatic diabetes for random glucose levels greater than 11.11 mmol/liter (200 mg/deciliter). OBJECTIVES: To examine the evidence that, when treated with agents for managing diabetes, people with cystic fibrosis improve their sugar metabolic control resulting in beneficial impact on lung function and the ability to maintain optimal weight. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also handsearched abstracts from pulmonary and North American Cystic Fibrosis Conference symposia. Date of the most recent search of the Group's Trials Register: December 2004. SELECTION CRITERIA: Randomized controlled trials comparing all methods of diabetes therapy for one month or longer in people with cystic fibrosis. DATA COLLECTION AND ANALYSIS: No studies were found which were eligible for inclusion in this review. MAIN RESULTS: Six references to four studies were identified by the searches, but none were eligible for inclusion in the review as they were not randomized controlled trials. AUTHORS' CONCLUSIONS: While some cystic fibrosis centers use oral medications to help control diabetes, a condition which complicates the course of cystic fibrosis, insulin therapy is the recommended and most widely used treatment method. Lung function has been reported to improve with the use of insulin, but this has not been correlated to the degree in which sugar metabolism has been affected. While the Cystic Fibrosis Foundation recommends insulin therapy be used in managing diabetes, this systematic review identifies the need for a multicentre randomized controlled trial assessing both the efficacy of insulin or other insulin-releasing or insulin-sensitizing medications and their possible adverse effects in managing cystic fibrosis-related diabetes.

Administration, Oral↗