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Results: 41 to 60 of 117

Immune treatments for peripheral neuropathy caused by an IgM paraprotein antibody, which may bind to MAG, a protein on the myelin sheath of nerves

IgM anti‐myelin‐associated glycoprotein paraprotein‐associated peripheral neuropathy is a condition affecting more men than women, most commonly over the age of 60 years. An IgM paraprotein (a cloned antibody of one type) in the blood may be an antibody that reacts against myelin‐associated glycoprotein (MAG), a molecule on the insulating myelin sheath of nerves. The antibody probably results in damage to the nerve fibres to which it is bound and thus causes a specific type of peripheral neuropathy. Treatments that act on the immune system such as plasma exchange (which removes circulating antibodies and replaces blood plasma with a clean plasma substitute), intravenous immunoglobulin (antibodies that have been purified from donated blood), rituximab (which kills some of the cells that produce the antibody), corticosteroids or chemotherapeutic drugs might be expected to reduce levels of these antibodies and slow or prevent progression of the disease. Many of these therapies have been tried in non‐randomised studies but we found only seven small randomised controlled trials, involving 182 participants, that were of adequate quality to be included in this review. Two trials with 33 participants (20 with antibodies against myelin‐associated glycoprotein) suggest that intravenous immunoglobulin may sometimes produce short‐term benefit and is relatively safe. No severe adverse effects related to intravenous immunoglobulin were reported in these trials. A trial of cyclophosphamide and steroids showed some mild benefit. A trial of rituximab was of very low quality with a high risk of bias and a further, larger study is awaited. The other trials did not allow conclusions to be drawn about the efficacy of other agents. Large, well designed randomised trials are needed to assess the efficacy of the existing and novel therapies, and better ways are needed for doctors and researchers to detect changes that patients report in response to treatments.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Omalizumab for the treatment of inadequately controlled allergic rhinitis: a systematic review and meta-analysis of randomized clinical trials

BACKGROUND: Patients with moderate-to-severe allergic rhinitis who are inadequately controlled despite treatment according to current rhinitis management guidelines have a significant unmet medical need. Such patients have a negative impact on daily functioning and are at risk of developing serious comorbidities, such as asthma and chronic rhinosinusitis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Nonmyeloablative allogeneic stem cell transplantation (NST) after truly nonmyeloablative and reduced intensity conditioning regimens

Nonmyeloablative allogeneic stem cell transplantation (NST) has been explored to overcome transplant-related mortality (TRM). From the review of 39 published reports, 50% of the 1484 treated patients had NSTs with truly nonmyeloablative conditioning (NMC) and 417 patients (29%) received an unrelated donor transplant (UDT). Median age was 49 years (range 17-59). A median dose of 4.74 x 10(6) CD34+ per kg (range 1.7-7.5) was administered. Hematological recovery was rapid with all the regimens used. Sustained engraftment was obtained in 1267/1355 assessable patients (94%, range 67-100%). Complete donor chimerism was observed in 707/948 assessable patients (75%, range 22-100%). Both were higher after reduced intensity conditioning (RIC) than after NMC regimens. Reject was more frequent after UDT and NMC regimens. Grades II-IV and III-IV acute graft versus host disease (GVHD) occurred in 580/1400 (41%; range 7-72%) and 188/1093 (17%; range 0-29%) assessable patients, respectively; grades II-IV and III-IV acute GVHD were more frequent after UDT and RIC regimens, respectively. Chronic GVHD occurred in 407/1046 assessable patients (39%; range 0-79%) and extensive chronic GVHD in 166/835 patients (20%; range 0-69%); they were more frequent after RIC regimens and less frequent after UDT. Transplant-related mortality (TRM) rate of 20.6%, without differences between RIC and NMC regimens, was observed; TRM was higher with UDTs. The most frequent causes of TRM were acute or chronic GVHD after RIC regimens and infections after NMC regimens and UDTs. Indolent lymphoid malignancies and some solid tumors appear sensitive to the graft versus malignancy (GVM) effect. NSTs could guarantee relatively low TRM and toxicity in patients not eligible for conventional allogeneic transplantation and could represent a platform for successive specific immunotherapy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Diagnosing and managing common food allergies: a systematic review

This review concluded that best practices for management and prevention of food allergies were greatly hindered by a lack of uniformity of criteria for making a diagnosis. Given the limited quality of the studies and heterogeneity among studies, the authors? conclusions seem appropriate, but interpretation should take into account potential for review bias.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Bevacizumab, sorafenib tosylate, sunitinib and temsirolimus for renal cell carcinoma: a systematic review and economic evaluation

Renal cell carcinoma (RCC) is a highly vascular type of kidney cancer arising in the epithelial elements of the nephrons. The most common histological subtype of RCC is clear cell carcinoma (approximately 75% of cases). RCC is often asymptomatic until it reaches a late stage. In England and Wales, kidney cancer is the eighth most common cancer in men and the fourteenth most common in women. Of those diagnosed with RCC in England and Wales, about 44% live for at least 5 years after initial diagnosis and about 40% for at least 10 years. However, prognosis following diagnosis of metastatic disease is poor, and only about 10% of people diagnosed with stage IV RCC live for at least 5 years after diagnosis.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2010

Allergies: What are the advantages and disadvantages of various antihistamines?

Of out of several antihistamines for allergy symptoms, loratadine might have some advantages for people with allergic rhinitis and urticaria. Cetirizine might cause more sleepiness than some of the other drugs, but this is not certain.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 11, 2008

Bendamustine for patients with slow‐growing lymphoma

Lymphoma is a cancer that originates from cells of the immune system in the lymph nodes, called lymphocytes. Slow‐growing (indolent) lymphoma is a group of lymphomas characterised by slow and continuous growth, a high initial response rate to treatment that target lymphoma cells (chemotherapy or rituximab), but a relapsing and progressive disease course. It includes follicular lymphoma, small lymphocytic lymphoma and chronic lymphocytic leukaemia, mantle cell lymphoma, lymphoplasmacytic lymphoma and marginal zone lymphoma. With current therapy people with advanced‐stage indolent lymphoma will experience relapse of their disease. Bendamustine is a type of chemotherapy that can be given to people with indolent lymphoma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Fact sheet: Asthma in pregnancy

Many women who have asthma find that it actually improves in early pregnancy, or at least stays the same. But for about 1 in 3 women, the changes of pregnancy will make their asthma worse. Towards the end of pregnancy it often becomes increasingly difficult to stay physically active. Carrying the extra weight around can even make women who do not have asthma get out of breath. Many are unable to sleep properly, feel tired and exhausted. This does not make pregnancy any easier.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 31, 2012

Scientific evaluation of therapeutic interventions in children aged from 2 to under 5 years with bronchial obstruction: Executive Summary of final report V06-02B, Version 1.0

The aim of this research was to obtain findings on the benefit and harm of therapeutic interventions in children aged from 2 to under 5 years presenting symptoms of bronchial obstruction (sub-goal 1). The definitive diagnosis of bronchial asthma cannot yet be made consistently in this age group, so a broad, symptom-oriented disease definition was used. By school age, many of these children no longer have symptoms and do not develop bronchial asthma, so that the weighing of benefit and, especially, harm of interventions for these children was to be studied as sub-goal 2.

Institute for Quality and Efficiency in Health Care: Executive Summaries [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 9, 2009

A systematic review of the clinical effectiveness and cost-effectiveness of Pharmalgen® for the treatment of bee and wasp venom allergy.

Each year in the UK there are between two and nine deaths from anaphylaxis caused by bee and wasp venom. Anaphylactic reactions to bee and wasp venom are a medical emergency, necessitating immediate treatment with drugs, oxygen and fluids to decrease the patient’s response to the venom and support breathing and circulation.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2012

Newcastle Disease Virus (PDQ®): Health Professional Version

Expert-reviewed information summary about the use of Newcastle disease virus (NDV) as a treatment for people with cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 23, 2014

The Use of the Electromotive Drug Administration System in Patients with Superficial Bladder Cancer: A Review of the Clinical Effectiveness, Safety, and Cost-Effectiveness [Internet]

Non-muscle (superficial) invasive bladder cancer accounted for about 6% of all cancers in Canada in 2008. To treat this condition, systemic drug delivery to the bladder is generally ineffective as the bladder’s wall prevents therapeutic substances from diffusing through. Intravesical therapy delivers drugs through a catheter directly into the bladder and is therefore more effective, but still faces limitations resulting in the need for a high frequency of instillations among other issues. Furthermore, superficial bladder cancer has a high recurrence rate. In 2006, the condition was reported to cost $65,158 per patient on average in the U.S., largely as a result of complications and surveillance of recurrence.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 17, 2014
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Effectiveness and cost-effectiveness of imatinib for first-line treatment of chronic myeloid leukaemia in chronic phase: a systematic review and economic analysis

Chronic myeloid leukaemia (CML) is a rare blood cancer with an incidence of 1.0 per 100,000 for men and 0.8 per 100,000 for women. In CML, excessive numbers of leukaemic white blood cells are produced that suppress the production of normal white blood cells. In 95% of cases a specific chromosomal abnormality, the Philadelphia chromosome, is present. This is a reciprocal translocation between part of the long arm of chromosome 22 and chromosome 9. The consequent molecular abnormality is a fusion protein, BCR-ABL, which is a tyrosine kinase. There are three identifiable phases of chronic myeloid leukaemia: chronic, accelerated and blast phase, with blast phase being fatal within 3-6 months.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2004

Updating Systematic Reviews

Systematic reviews are often advocated as the best source of evidence to guide both clinical decisions and healthcare policy, yet we know very little about the extent to which they require updating.

Technical Reviews - Agency for Healthcare Research and Quality (US).

Version: September 2007

Childhood Rhabdomyosarcoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood rhabdomyosarcoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 8, 2014

Prostate Cancer Treatment (PDQ®): Health Professional Version

Expert-reviewed information summary about the treatment of prostate cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 28, 2014

Melanoma Treatment (PDQ®): Health Professional Version

Expert-reviewed information summary about the treatment of melanoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: November 7, 2014

Chronic Myelogenous Leukemia Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of chronic myelogenous leukemia.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: November 11, 2014

Metastatic Spinal Cord Compression: Diagnosis and Management of Patients at Risk of or with Metastatic Spinal Cord Compression

It is difficult to know what the true incidence of metastatic spinal cord compression (MSCC) is in England and Wales because the cases are not systematically recorded. However, evidence from an audit carried out in Scotland between 1997 and 1999 and from a published study from Ontario, Canada, suggests that the incidence may be up to 80 cases per million population per year. This would mean around 4000 cases per year in England and Wales or more than 100 cases per cancer network per year.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: November 2008
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Renal Cell Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of renal cell cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 22, 2014

Medical Encyclopedia

  • Drug Class Review: Newer Antihistamines: Final Report Update 2 [Internet]
    Antihistamines inhibit the effects of histamine at H1 receptors. They have a number of clinical indications including allergic conditions (e.g., rhinitis, dermatoses, atopic dermatitis, contact dermatitis, allergic conjunctivitis, hypersensitivity reactions to drugs, mild transfusion reactions, and urticaria), chronic idiopathic urticaria (CIU), motion sickness, vertigo, and insomnia.
  • Prostate cancer
    Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-sized structure that makes up part of a man's reproductive system. It wraps around the urethra. This is the tube that carries urine out of the body.
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Systematic Reviews in PubMed

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