British medical bulletin
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British medical bulletin · Jun 2015
ReviewAutoimmune hepatitis: an approach to disease understanding and management.
Autoimmune hepatitis is a chronic immune-mediated liver injury, frequently associated with progression to end-stage liver disease if untreated. Patients commonly present with hepatitis, positive immune serology, elevated immunoglobulins and compatible liver histology, in the absence of an alternative aetiology. ⋯ Increased understanding of the immunoregulatory mechanisms behind autoimmune hepatitis has led to opportunities for new therapies. These are developed including a discussion of timely research studies relevant to future therapies for patients.
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British medical bulletin · Jun 2015
Review Meta AnalysisNo difference between unicompartmental versus total knee arthroplasty for the management of medial osteoarthtritis of the knee in the same patient: a systematic review and pooling data analysis.
One-third of patients with knee osteoarthritis (OA) has involvement of only one compartment, especially the medial one. ⋯ Large, multicentre, powered, randomized trials comparing UKA and TKA are needed to identify the best management for medial OA of the knee. Moreover, new score systems for satisfaction of the patient should be formulated.
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British medical bulletin · Jun 2015
ReviewPhenoxy herbicides, soft-tissue sarcoma and non-Hodgkin lymphoma: a systematic review of evidence from cohort and case-control studies.
Phenoxy herbicides have been used widely in agriculture, forestry, parks and domestic gardens. Early studies linked them with soft-tissue sarcoma (STS) and non-Hodgkin lymphoma (NHL), but when last reviewed by the International Agency for Research on Cancer in 1986, the evidence for human carcinogenicity was limited. ⋯ Extended follow-up of previously assembled cohorts may be the most efficient way of further reducing uncertainties.
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Antipsychotic medications are mainstays in the treatment of schizophrenia and a range of other psychotic disorders. ⋯ A focus on the different symptom domains of schizophrenia may lead to endophenotypic markers being identified, e.g. for negative symptoms and cognitive deficits (as well as for positive symptoms) that can promote the development of novel therapeutics, which will rationally target cellular and molecular targets, rather than just the dopamine 2 receptor. Future developments will target additional processes, including glutamatergic, cholinergic and cannabinoid receptor targets and will utilize personalized medicine techniques, such as pharmacogenetic variants and biomarkers allowing for a tailored and safer use of antipsychotics.
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British medical bulletin · Jun 2015
ReviewReinventing clinical trials: a review of innovative biomarker trial designs in cancer therapies.
Recently, new clinical trial designs involving biomarkers have been studied and proposed in cancer clinical research, in the hope of incorporating the rapid growing basic research into clinical practices. ⋯ Biomarker-related trial designs that can resolve the statistical issues and satisfy the regulatory requirement.