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| Clinical Trials |
Clinical trials mainly deals with biomedical, biochemical and behavioral
tests on subjects but in some special cases commentary of care giver or parent
plays crucial role in determining the actual scenario. The most crucial aspect
of clinical results is its reproducibility and authenticity, which sometimes
guide the fellow physician to postulate the therapeutic paradigm for a
challenging issue. Pharmaceutical industries are the most dependent sector on
clinical trial because, success in clinical trial only bring forward the
'Approved Drug'. Not only drug or medicine, various medical devices are also
subjected to clinical trial and only successful device can be allowed to do
business without any restrictions. Present ‘Journal of Clinical Trials’
accumulates all the relevant information on clinical research and provides a
scope for communication of the articles related to clinical trials. Read more>>>>>
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| Thymoma |
A chest X-ray was performed and the patient was hospitalized because of
a mediastinal mass. After CT-scan and a biopsy the diagnosis of a Thymoma Type
AB Masaoka Stadium II was established. The surgical in toto thymectomy was
performed without complications. A few days postinterventionally the patient
presented with serious alteration of his general condition, constipation,
vomiting after food intake and weight loss to now 35 kg, representing a BMI of
13.7 kg/m2. Symptomatic therapy was initiated and the patient was discharged.
The patient was seen again by the thoracic surgeons for a follow up and removal
of the surgical sutures. Because of a further alteration of his general
condition and persistent gastrointestinal symptoms the patient was admitted to
our clinic. To know more>>>>>>
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| Diabetes Mellitus |
Pulse wave velocity (PWV) which was reflecting arterial stiffness, was
used for last 30 years, but was inherently changed at the blood pressure at
measuring time. The cardio-ankle vascular index (CAVI) was recently developed
marker reflecting arterial stiffness of the arterial tree from the origin of
the aorta to the ankle. The conspicuous feature of CAVI is independency from
the blood pressure at measuring time. CAVI increased with aging both in males
than in females. So, CAVI could be a good marker reflecting arterial aging.
Furthermore, CAVI showed high value in most of those with various risks of
coronary artery disease, and especially high in those with diabetes mellitus
and even with prediabetes condition. Diabetes mellitus is kwon to be a strong
factor for arterial aging. Read more>>>>>>
Though
the United States is one of the wealthiest nations in the world, the
disparities in income are only surpassed by the inequalities in access to health
care. Because of the close tie between the health care crisis and the fiscalhealth of the country as a whole, proposals have been made to introduce
universal health care, to adapt existing systems and to support efforts,
including what has been deemed “ObamaCare” to move towards greater
accountability in obtaining and maintaining health insurance for the millions
of uninsured and underinsured. Though most countries in the developed world
perceive health care as a basic human right, the United States has yet to
determine a way of creating and funding a single-payer universal health care
system that will address the inequalities that exist and provide a better
option for preventative medicine, interventive medicine, and long-term care.
One
of the central problems for this country is that our political process is
divided ideologically and health care paradigms do not appear to address issues
on both sides. While there is support for a national health program that would
ensure access to the working poor, fiscal conservatives view this as a system
that cannot be afforded and that would expand debt in an uncontrollable manner.
In fact, there is a clear division between the patriarchal perspectives of the
democrats and the growing Tea Party call for personal responsibility.(Read More)
Endocarditis
incurred by Streptococcus
agalactiae in adults (nonpregnant females and men) has increased in
recent years, even though the source of infection due to this bacterium and the
portal of entry are unclear and not often well documented.Concerning the possible sexual
port of entry in the cause of endocarditis, this mode of transmission should be
suspected in a search of clinical history, especially in recurrent
endocarditis.(Read more)
Administration of Inhaled
Corticosteroids (ICS) in Chronic Obstructive Pulmonary Disease (COPD) has
always remained controversial because of its questionable benefit in this
disease. Although several clinicians believe that corticosteroids have little
or no role in controlling inflammation in COPD, its use in stable to heavilyexacerbated COPD has been in practice especially in the developing countrieswhere COPD is often over diagnosed/ underdiagnosed or misdiagnosed. Neutrophils
being the crucial players in inflammation in COPD, steroids are considered to
have a less functional effect on this type of inflammation as steroids
especially glucocorticoids has been shown to enhance the survival of
neutrophils and increase their functional responsiveness. Therefore, such
treatment might lead to incurring detrimental effects on the patients by
enhancing the exacerbation.
Although some evidence have
suggested that some drugs such as β2-agonists, methylxanthines (theophylline)
or antibiotics (macrolides) may somewhat facilitate corticosteroid sensitivity
in COPD, their functional aspects and clinical relevance are not quite clear.
Moreover, since the effect of ICS may be modulated by these other add-on drugs,
the effect of ICS alone in COPD has remained questionable. Most of the studies
showed that ICS alone does not effectively reverse the progressive decline of
FEV1 or mortality in patients with COPD. The TOwards a Revolution in COPD
Health (TORCH) trial showed higher mortality among COPD patients treated with
ICS alone than those who received ICS (Inhaled Corticosteroids) +LABA (Long
acting β2-agonists).(Read more)
Long-term
oxygen treatment (LTOT) has shown to increase survival in patients with COPD
having chronic respiratory failure. It also appears to improve the health-relatedquality of life, increase exercise capacity, and reduce the number of hospitalizationsin patients with COPD. To obtain the maximum benefits of LTOT, patients with
COPD are required to use their ambulatory oxygen systems at all times, even
when outside. Therefore, ambulatory oxygen therapy is a common component of
LTOT to maximize the number of hours per day of receiving oxygen as well as to
maintain physical activity. Currently, LTOT users may choose among several
portable oxygen devices (e.g., portable oxygen cylinders, portable oxygen
concentrators, and liquid oxygen) and/or different transport carriers (e.g.,
cylinder cart, backpack, and shoulder bag). However, little is known about how
to select a suitable ambulatory oxygen carrier for each patient with COPD
having chronic respiratory failure.
Previous
studies have suggested that differences among cylinder transport carriers
affect the patient’s functional performance Pohle- Krauza et al. showed that
the distance walked with a backpack was longer than that walked with a cylinder
cart or shoulder bag in patients with COPD. In other studies on LTOT for COPD, Crisafulli et al. showed that patients with
severe COPD could walk longer with a cylinder cart than those with a shoulder
bag, while healthy controls could walk longer with a shoulder bag than with a
cart. These results indicate that differences among ambulatory oxygen carriers
can affect that patient’s performance in daily life. In addition, a proper
carrier may depend on the pulmonary function of LTOT user.(Read More)
