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  • Arendt, Josephine, et al. (författare)
  • Clinical update : melatonin and sleep disorders.
  • 2008
  • Ingår i: Clin Med. - 1470-2118. ; 8:4, s. 381-3
  • Tidskriftsartikel (refereegranskat)abstract
    • Clinical update: melatonin and sleep disorders.Arendt J, Van Someren EJ, Appleton R, Skene DJ, Akerstedt T.Centre for Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford. j.arendt@surrey.ac.ukThe hormone melatonin is increasingly used for the treatment of certain sleep disorders, particularly those related to disturbed biological rhythms. This article summarises current knowledge of its mechanism of action and identifies situations where there is good evidence for its efficacy. The authors provide advice, based on their own experience and consistent published data, concerning the dose range of melatonin to be used and the critically important question of the timing of treatment. Anecdotal evidence for the use of melatonin needs to be replaced by data from well-controlled, preferably multi-centre, randomised clinical trials.
  • Donoghoe, MC, et al. (författare)
  • HIV/AIDS in the transitional countries of eastern Europe and central Asia
  • 2005
  • Ingår i: Clinical Medicine. - : Royal College of Physicians of London. - 1470-2118. ; 5:5, s. 487-490
  • Tidskriftsartikel (refereegranskat)abstract
    • In the 1990s, HIV/AIDS became a major threat to health, economic stability and human development in countries in eastern Europe and central Asia. Social, political and economic transition exacerbated the structural conditions that allowed HIV/AIDS to flourish as dramatic changes led to increasing drug injection, economic decline and failing health and healthcare systems. There is a need to address the professional and ideological opposition - even in countries considered to be fully functioning democracies - to evidence-based public health interventions like harm reduction, coupled with treating HIV/AIDS for all those in need, if countries are to provide a more effective response.
  • Norén, G. Niklas, et al. (författare)
  • Modern methods of pharmacovigilance : detecting adverse effects of drugs
  • 2009
  • Ingår i: Clinical medicine (London). - 1470-2118 .- 1473-4893. ; 9:5, s. 486-489
  • Tidskriftsartikel (refereegranskat)abstract
    • Medicines improve health and the chances of survival in a wide variety of conditions. At the same time, no substance with pharmacological effects is without hazard. Adverse drug reactions (ADRs) can be associated with the intended pharmacological effect of the medicine (eg bleeding from warfarin), mediated by other mechanisms (eg anticholinergic effects of tricyclic antidepressants) or can be altogether unexpected (eg hypersensitivity reactions to abacavir). Some ADRs can be identified early in the development of a medicine, but knowledge of the adverse effects profile is provisional when the medicine is first marketed and usually changes over time. Premarketing clinical trials include too few patients and are too short to detect every outcome that will affect public health and individual patient safety. In addition, clinical trials are carried out in controlled settings that differ from real-world practice. This reduces their power to detect ADRs, for example those that are due to drug-drug interactions or that affect only susceptible subgroups (eg phocomelia due to thalidomide). Safety needs to be evaluated continuously throughout the life-cycle of a medicinal product.1,2 A key challenge is to identify emerging problems as early as possible, without generating false alarms.
  • Spångfors, Martin, et al. (författare)
  • In-hospital cardiac arrest and preceding National Early Warning Score (NEWS) : A retrospective case-control study
  • Ingår i: Clinical Medicine. - : Royal College of Physicians of London. - 1470-2118. ; 20:1, s. 55-60
  • Tidskriftsartikel (refereegranskat)abstract
    • We aimed to describe and evaluate the National Early Warning Score (NEWS) in the 24 hours preceding an in-hospital cardiac arrest among general somatic ward patients.The 24 hours preceding the in-hospital cardiac arrest were divided into four timespans and analysed by a medical record review of 127:254 matched case-control patients. The median NEWS ranged from 3 (2-6) to 6 (3-9) points for cases vs 1 (0-3) to 1 (0-3) point for controls. The proportion of cases ranged from 23-45% at high risk vs 3-6% for controls. The NEWS high-risk category was associated with an increase of 3.17 (95% confidence interval (CI) 1.66-6.04) to 4.43 (95% CI 2.56-7.67) in odds of in-hospital cardiac arrest compared to the low-risk category.NEWS, with its intuitive and for healthcare staff easy to interpret risk classification, is suitable for discriminating deteriorating patients with major deviating vital signs scoring high risk on NEWS.
  • Wingfield, T, et al. (författare)
  • Autoimmune limbic encephalitis
  • 2012
  • Ingår i: Clinical medicine (London, England). - 1470-2118. ; 12:1, s. 96-96
  • Tidskriftsartikel (övrigt vetenskapligt)
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