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200 records – page 1 of 20.

A 2011 updated systematic review and clinical practice guideline for the management of malignant extradural spinal cord compression.

https://arctichealth.org/en/permalink/ahliterature126132
Source
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):312-7
Publication Type
Article
Date
Oct-1-2012
Author
D Andrew Loblaw
Gunita Mitera
Michael Ford
Normand J Laperriere
Author Affiliation
Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, Toronto, Canada. andrew.loblaw@sunnybrook.ca
Source
Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):312-7
Date
Oct-1-2012
Language
English
Publication Type
Article
Keywords
Adult
Decompression, Surgical - methods
Dose Fractionation
Humans
Meta-Analysis as Topic
Multicenter Studies as Topic
Neoplasm Recurrence, Local - radiotherapy
Ontario
Randomized Controlled Trials as Topic
Retrospective Studies
Spinal Cord Compression - diagnosis - therapy
Spinal Cord Neoplasms - secondary - therapy
Steroids - therapeutic use
Walking
Abstract
To update the 2005 Cancer Care Ontario practice guidelines for the diagnosis and treatment of adult patients with a suspected or confirmed diagnosis of extradural malignant spinal cord compression (MESCC).
A review and analysis of data published from January 2004 to May 2011. The systematic literature review included published randomized control trials (RCTs), systematic reviews, meta-analyses, and prospective/retrospective studies.
An RCT of radiation therapy (RT) with or without decompressive surgery showed improvements in pain, ambulatory ability, urinary continence, duration of continence, functional status, and overall survival. Two RCTs of RT (30 Gy in eight fractions vs. 16 Gy in two fractions; 16 Gy in two fractions vs. 8 Gy in one fraction) in patients with a poor prognosis showed no difference in ambulation, duration of ambulation, bladder function, pain response, in-field failure, and overall survival. Retrospective multicenter studies reported that protracted RT schedules in nonsurgical patients with a good prognosis improved local control but had no effect on functional or survival outcomes.
If not medically contraindicated, steroids are recommended for any patient with neurologic deficits suspected or confirmed to have MESCC. Surgery should be considered for patients with a good prognosis who are medically and surgically operable. RT should be given to nonsurgical patients. For those with a poor prognosis, a single fraction of 8 Gy should be given; for those with a good prognosis, 30 Gy in 10 fractions could be considered. Patients should be followed up clinically and/or radiographically to determine whether a local relapse develops. Salvage therapies should be introduced before significant neurologic deficits occur.
PubMed ID
22420969 View in PubMed
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Age at first birth, parity and risk of breast cancer: a meta-analysis of 8 studies from the Nordic countries.

https://arctichealth.org/en/permalink/ahliterature25102
Source
Int J Cancer. 1990 Oct 15;46(4):597-603
Publication Type
Article
Date
Oct-15-1990
Author
M. Ewertz
S W Duffy
H O Adami
G. Kvåle
E. Lund
O. Meirik
A. Mellemgaard
I. Soini
H. Tulinius
Author Affiliation
Danish Cancer Registry, Institute of Cancer Epidemiology, Danish Cancer Society, Copehagen.
Source
Int J Cancer. 1990 Oct 15;46(4):597-603
Date
Oct-15-1990
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - epidemiology
Denmark
Female
Finland
Humans
Iceland
Maternal Age
Meta-Analysis
Norway
Parity
Research Support, Non-U.S. Gov't
Risk factors
Sweden
Abstract
Several large epidemiological studies in the Nordic countries have failed to confirm an association between age at first birth and breast cancer independent of parity. To assess whether lack of power or heterogeneity between the countries could explain this, a meta-analysis was performed of 8 population-based studies (3 cohort and 5 case-control) of breast cancer and reproductive variables in the Nordic countries, including a total of 5,568 cases. It confirmed that low parity and late age at first birth are significant and independent determinants of breast-cancer risk. Nulliparity was associated with a 30% increase in risk compared with parous women, and for every 2 births, the risk was reduced by about 16%. There was a significant trend of increasing risk with increasing age at first birth, women giving first birth after the age of 35 years having a 40% increased risk compared to those with a first birth before the age of 20 years. Tests for heterogeneity between studies were not significant for any of the examined variables. In the absence of bias, this suggests that several individual Nordic studies may have had too little power to detect the weak effect of age at first birth observed in the meta-analysis.
PubMed ID
2145231 View in PubMed
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[Age related macular degeneration. A widespread disease]

https://arctichealth.org/en/permalink/ahliterature50789
Source
Ugeskr Laeger. 2001 Nov 12;163(46):6396-400
Publication Type
Article
Date
Nov-12-2001
Author
M. la Cour
N V Nielsen
M. Larsen
P H Haamann
T. Vinding
Author Affiliation
H:S Rigshospitalet, øjenklinikken.
Source
Ugeskr Laeger. 2001 Nov 12;163(46):6396-400
Date
Nov-12-2001
Language
Danish
Publication Type
Article
Keywords
Age Factors
Denmark - epidemiology
Diagnosis, Differential
English Abstract
Evidence-Based Medicine
Fluorescein Angiography
Humans
Laser Coagulation
Macular Degeneration - diagnosis - epidemiology - therapy
Meta-Analysis
Photochemotherapy - methods
Abstract
Age-related macular degeneration, AMD, is the commonest cause of legal blindness in the industrialised world. Epidemiological data suggest that in Denmark more than 80,000 persons suffer impaired vision in at least one eye, because of AMD. More than 4000 are legally blind owing to this disease. AMD has two major phenotypes: wet and dry. Most severe visual losses are caused by wet AMD, where new blood vessels form under the macula. A new treatment of this condition is now available. Photodynamic therapy with verteporfin has been investigated in a double-blind, randomised clinical trial with more than 600 patients. This study has been scrutinised by a Cochrane review, which has recommended criteria for the treatment. For eyes meeting these inclusion criteria, photodynamic therapy can reduce the occurrence of moderate and severe visual loss over a two-year period by more than 60%. It is estimated that around 1000 eyes in Denmark will meet the inclusion criteria for photodynamic therapy.
PubMed ID
11816915 View in PubMed
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[Alcohol, breast cancer and causal inference in epidemiology]

https://arctichealth.org/en/permalink/ahliterature10956
Source
Tidsskr Nor Laegeforen. 1997 Oct 30;117(26):3771-6
Publication Type
Article
Date
Oct-30-1997
Author
K. Kjaerheim
Author Affiliation
Institutt for epidemiologisk kreftforskning, Oslo.
Source
Tidsskr Nor Laegeforen. 1997 Oct 30;117(26):3771-6
Date
Oct-30-1997
Language
Norwegian
Publication Type
Article
Keywords
Alcohol Drinking - adverse effects
Breast Neoplasms - epidemiology - etiology
Canada - epidemiology
Causality
Clinical Trials
English Abstract
Europe - epidemiology
Female
Humans
Meta-Analysis
United States - epidemiology
Abstract
In order to demonstrate how possible causal relationships are critically evaluated in epidemiologic research, literature on the association between alcohol and breast cancer is reviewed and discussed. A cause can be defined as a factor which, in combination with other factors, known and unknown, is sufficient to produce an effect. Since the hypothesis-generating study was published in 1977, a total of 34 positive and 16 negative studies have been published. Methodological problems, such as chance, bias and confounding, cannot be considered as plausible explanations for the above majority of positive findings. The question of causality was then evaluated using the guidelines developed by Bradford Hill in 1965. Among these, the strength of the association, consistency, temporality, biological gradient and biological plausibility, are the most important. In spite of the relatively weak association and somewhat inconsistent results, it is concluded that alcohol consumption should be considered as a cause of breast cancer. It is estimated that in Norway, between 24 and 180 cases of breast cancer may be attributed to alcohol consumption. Future research should focus on the question of effect-modification and on the possible implications of different patterns of alcohol consumption.
PubMed ID
9417679 View in PubMed
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An aggregate accident model based on pooled, regional time-series data.

https://arctichealth.org/en/permalink/ahliterature11981
Source
Accid Anal Prev. 1991 Oct;23(5):363-78
Publication Type
Article
Date
Oct-1991
Author
L. Fridstrøm
S. Ingebrigtsen
Author Affiliation
Institute of Transport Economics, Oslo, Norway.
Source
Accid Anal Prev. 1991 Oct;23(5):363-78
Date
Oct-1991
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - mortality - statistics & numerical data - trends
Bias (epidemiology)
Humans
Insurance Claim Reporting
Likelihood Functions
Logistic Models
Meta-Analysis
Norway - epidemiology
Poisson Distribution
Regression Analysis
Research Support, Non-U.S. Gov't
Risk factors
Severity of Illness Index
Time Factors
Abstract
The determinants of personal injury road accidents and their severity are studied by means of generalized Poisson regression models estimated on the basis of combined cross-section/time-series data. Monthly data have been assembled for 18 Norwegian counties (every county but one), covering the period from January 1974 until December 1986. A rather wide range of potential explanatory factors are taken into account, including road use (exposure), weather, daylight, traffic density, road investment and maintenance expenditure, accident reporting routines, vehicle inspection, law enforcement, seat belt usage, proportion of inexperienced drivers, and alcohol sales. Separate probability models are estimated for the number of personal injury accidents, fatal accidents, injury victims, death victims, car occupants injured, and bicyclists and pedestrians injured. The fraction of personal injury accidents that are fatal is interpreted as an average severity measure and studied by means of a binomial logit model.
PubMed ID
1741893 View in PubMed
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[An analysis of a selected Danish meta-analysis].

https://arctichealth.org/en/permalink/ahliterature225660
Source
Ugeskr Laeger. 1991 Sep 30;153(40):2840-2
Publication Type
Article
Date
Sep-30-1991
Author
N C Henningsen
Source
Ugeskr Laeger. 1991 Sep 30;153(40):2840-2
Date
Sep-30-1991
Language
Danish
Publication Type
Article
Keywords
Blood Pressure - physiology
Denmark
Diet, Sodium-Restricted
Humans
Meta-Analysis as Topic
PubMed ID
1926627 View in PubMed
Less detail

An oncology perspective on the benefits and cost of combined androgen blockade in advanced prostate cancer.

https://arctichealth.org/en/permalink/ahliterature182699
Source
Can J Urol. 2003 Oct;10(5):1986-94
Publication Type
Article
Date
Oct-2003
Author
Armen G Aprikian
Neil Fleshner
Adrian Langleben
Jeffrey Hames
Author Affiliation
Department of Surgery, McGill University, MUHC - Montréal General Hospital, Montréal, Québec, Canada.
Source
Can J Urol. 2003 Oct;10(5):1986-94
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Androgen Antagonists - economics - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - economics - therapeutic use
Canada
Cost-Benefit Analysis
Humans
Male
Meta-Analysis as Topic
Neoplasms - drug therapy - economics
Prostatic Neoplasms - drug therapy - economics
Randomized Controlled Trials as Topic
Abstract
To provide context in oncology for the significance of the benefits and cost of combined androgen blockade (CAB) in the treatment of advanced prostate cancer.
Canadian drug costs for the survival benefit with CAB in advanced prostate cancer were compared with the costs of benefit with new treatments in advanced non-small-cell lung cancer (NSCLC), metastatic colorectal cancer, and metastatic breast cancer. Clinical toxicities were also compared.
The survival benefit with CAB in advanced prostate cancer appears to be approximately 3 months. The survival benefit with the addition of vinorelbine to cisplatin for the treatment of advanced NSCLC is approximately 2 months, and the survival benefit with the addition of irinotecan to fluorouracil (and leucovorin) for the treatment of metastatic colorectal cancer is approximately 2 to 3 months. The survival benefit with anastrozole or exemestane in advanced breast cancer, or with the addition of trastuzumab to standard chemotherapy in metastatic breast cancer that overexpresses human epidermal growth factor receptor 2 (HER2), is approximately 4 to 5 months. The calculated cost per month of survival benefit with bicalutamide in CAB for prostate cancer is 437 US dollars to 1107 US dollars. The cost per month of survival benefit with vinorelbine for NSCLC is 1241 US dollars and with irinotecan for colorectal cancer is 6812 to 11,214 US dollars. The calculated cost per month of survival benefit with anastrozole for breast cancer is 170 US dollars, for exemestane is 185 US dollars, and the cost per month with the addition of trastuzumab is 5230 US dollars. Vinorelbine and irinotecan are associated with severe grade 3 or 4 clinical toxicities, and an increased frequency of heart failure has been observed when trastuzumab is added to anthracyclines. Anastrozole, exemestane and nonsteroidal antiandrogens are associated with mild to moderate side effects.
The advantages offered by CAB (including the cost per month of survival benefit and minimal associated clinical toxicities) are comparable to the reported advantages of new treatments for other common cancers such as NSCLC, colorectal cancer, and breast cancer.
PubMed ID
14633326 View in PubMed
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Antiepileptic drugs in the treatment of anxiety disorders: role in therapy.

https://arctichealth.org/en/permalink/ahliterature178148
Source
Drugs. 2004;64(19):2199-220
Publication Type
Article
Date
2004
Author
Michael Van Ameringen
Catherine Mancini
Beth Pipe
Mark Bennett
Author Affiliation
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada. vanamer@mcmaster.ca
Source
Drugs. 2004;64(19):2199-220
Date
2004
Language
English
Publication Type
Article
Keywords
Anticonvulsants - adverse effects - therapeutic use
Anxiety Disorders - classification - drug therapy - physiopathology
Canada
Humans
Meta-Analysis as Topic
Abstract
Pharmacotherapy for anxiety disorders is an active area of research. A variety of drug groups have been shown to be effective in treating many of the anxiety disorders, with selective serotonin reuptake inhibitors (SSRIs) being considered first-line agents for virtually all anxiety disorders. There is a clinical need for alternative drug treatments, as many patients do not achieve a complete response and experience significant adverse effects. The successful use of antiepileptic drugs in mood disorders has led clinicians and researchers to investigate their potential efficacy in other psychiatric disorders, particularly in anxiety disorders. There have been a number of investigations conducted in the form of case reports, case series and open-label trials, suggesting the potential usefulness of antiepileptic drug treatment in a variety of anxiety disorders. More reliable evidence for the use of antiepileptic drugs in anxiety disorders can be gleaned from recent placebo-controlled trials. Thus far, the strongest placebo-controlled evidence has demonstrated the efficacy of pregabalin in treating social phobia and generalised anxiety disorder, while smaller or less robust controlled trials have suggested the potential efficacy of gabapentin in social phobia, lamotrigine in post-traumatic stress disorder, and valproic acid in panic disorder. Antiepileptic drugs may have a place in the treatment of anxiety disorders; however, further investigation is warranted to determine in what circumstances they should be used as monotherapy or as augmenting agents in individuals who are partially or non-responsive to conventional therapy.
PubMed ID
15456335 View in PubMed
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An update: women, hypertension and therapeutic efficacy.

https://arctichealth.org/en/permalink/ahliterature192027
Source
Can J Cardiol. 2001 Dec;17(12):1283-9
Publication Type
Article
Date
Dec-2001
Author
C A Jones
S. Nagpal
Author Affiliation
University of Calgary, 3300 Hospital Drive Northwest, Alberta T3A 2K2, Canada. jonesc@ucalgary.ca
Source
Can J Cardiol. 2001 Dec;17(12):1283-9
Date
Dec-2001
Language
English
Publication Type
Article
Keywords
Adult
African Continental Ancestry Group
Age Distribution
Aged
Antihypertensive Agents - therapeutic use
Canada - epidemiology
Cardiovascular Diseases - epidemiology - prevention & control
European Continental Ancestry Group
Female
Humans
Hypertension - drug therapy - epidemiology
Incidence
Kidney Failure, Chronic - epidemiology
Male
Meta-Analysis as Topic
Middle Aged
Prevalence
Randomized Controlled Trials as Topic
Research Design - standards
Risk factors
Sex Factors
Survival Rate
Treatment Outcome
Abstract
One in five Canadians has high blood pressure. The prevalence is as high as 58% in women between the ages of 65 and 74 years. Approximately 40% of stroke cases, 39% of myocardial infarction cases and 28% of end stage renal diseases are attributable to hypertension. Despite the burden that hypertension places on women, the effect of antihypertensive therapy on cardiovascular complications has not been well established. To address this knowledge gap, two meta-analyses with sex-specific results, including the most current randomized, controlled trials to evaluate hypertension treatment, were reviewed. The Individual Data Analysis of Antihypertensive (INDANA) intervention trials group and Quan and colleagues analyzed treatment benefits in 23,000 women and 19,975 men according to subgroup meta-analyses from 12 randomized, controlled trials that compared antihypertensive drug therapy with placebo. The meta-analyses demonstrated a statistically significant treatment benefit for all of the reported clinical outcomes in men of all ages and in black women. In women over the age of 54 years, antihypertensive treatment was associated with a significant reduction of fatal and nonfatal stroke, cardiovascular events and cardiovascular mortality. Overall, there was no significant difference in the relative treatment benefit in women and men; however, the absolute treatment benefit was lower in women than in men. Thus, the number needed to treat for the end points of fatal stroke, nonfatal stroke and cardiovascular events was one- to threefold higher for women than for men. Furthermore, white women between the ages of 30 and 54 years showed no treatment benefit or harm. Data from the 6.7-year follow-up in the Hypertension Detection and Follow-up Program (HDFP) trial suggested that this group of younger women might benefit from a longer duration of treatment. Indications for pharmacological intervention seem quite clear for all subgroups, excluding these younger women. Until further evidence is available for this low risk subgroup, the current recommendations for lifestyle modification cannot be challenged.
PubMed ID
11773939 View in PubMed
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[A slice of the same pie--the normal and the abnormal].

https://arctichealth.org/en/permalink/ahliterature225222
Source
Tidsskr Nor Laegeforen. 1991 Dec 10;111(30):3608-9
Publication Type
Article
Date
Dec-10-1991
Author
A. Bjørndal
Source
Tidsskr Nor Laegeforen. 1991 Dec 10;111(30):3608-9
Date
Dec-10-1991
Language
Norwegian
Publication Type
Article
Keywords
Epidemiology - statistics & numerical data
Humans
Meta-Analysis as Topic
Norway - epidemiology
Reference Values
Research
Risk factors
PubMed ID
1838210 View in PubMed
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200 records – page 1 of 20.