International journal of clinical practice
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Int. J. Clin. Pract. · Nov 2021
ReviewParadigm shift in the management of metastatic Non-small Cell Lung Cancer.
Lung cancer is one of the leading causes of cancer mortality in the United States. The use of precision medicine in the past 10 years has significantly changed the therapeutic landscape of lung cancer. Management of advanced nonsmall cell lung cancer (NSCLC) has transitioned from a chemotherapeutic approach to targeted treatments and immunotherapeutic agents. Several tyrosine kinase inhibitors (TKIs) have been approved for patients with targeted mutations and patients who do not have driver mutations; immunotherapy has been recently approved as frontline therapy, which has resulted in marked improvement in overall survival and added a new tool in our armamentarium. ⋯ The use of next-generation sequencing has significantly changed our understanding of molecular oncogenic mechanisms of lung cancer. These advancements have created a paradigm shift in the treatment strategies of metastatic lung cancer from primarily chemotherapeutic approach to increasing use of targeted therapies and immune checkpoint inhibitors (ICI) leading to better survival rates and lesser toxicity.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisEffect of Artemisia extract on glycemic control: A systematic review and meta-analysis of randomized controlled trial.
Animal and human studies have indicated anti-diabetic effect of Asteraceae. The present study aimed to systematically review and analyse randomized controlled trials assessing the effect of Artemisia extract on glycemic status in patients with impaired glycemic control. ⋯ Supplementation with Artemisia extract may reduce HOMA-IR, but beneficial effects on other markers such as FBG requires further investigations.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisThe association between apolipoprotein A-1 plasma level and premature coronary artery disease; a systematic review and meta-analysis.
Apolipoprotein A-1 (Apo A-1) is a constituent of high-density lipoprotein (HDL) and emerging evidences put forward a potential association between Apo A-1 plasma levels and premature coronary artery disease (pCAD). The aim of the present study is to gather relative literature and perform a systematic review and meta-analysis regarding the association between serum ApoA-1 levels and pCAD. ⋯ In conclusion, there seems to be a significant association between the serum levels of ApoA-1 and pCAD. However, all of the included studies had a case-control design and since there is no good quality and prospective cohort studies included, reliability of the current evidence is debatable. Therefore, further well-designed cohort studies are required to assess the impact of serum ApoA-1 reduction on pCAD onset.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisComparison of efficacy and safety of gabapentin and duloxetine in painful diabetic peripheral neuropathy: A systematic review and meta-analysis of randomized controlled trials.
In patients with diabetes mellitus, painful diabetic peripheral neuropathy (PDPN) is a frequent complication and can cause poor quality of life. We compared the efficacy and safety of duloxetine with those of gabapentin in patients with PDPN through a systematic review and meta-analysis of randomised controlled trials. ⋯ No significant differences were observed in the efficacy of duloxetine and gabapentin when treating patients with PDPN.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisThe association between psoriasis and psoriatic arthritis with the risk of osteoporosis, osteopenia, and bone fractures: a systematic review and meta-analysis.
The possible association between psoriatic/psoriatic arthritis (PsA) and bone loss has been observed; however, studies have yielded inconclusive results. This meta-analysis aimed to assess whether there is an increase in the risk of osteoporosis, osteopenia and fractures in patients with psoriasis/PsA, compared with healthy individuals. ⋯ Patients with psoriasis/PsA have an increased risk of fractures. There is little evidence supporting the relation of psoriasis to osteoporosis/osteopenia.