Systematic-Review-Drug-Efficiency-Dissertation-Sample-Work-Tutors-India

More documents

Recommendations

Info

Physical findings: The exhibited IPF related physical examination observations with prognosis are digital clubbing and BMI. A remarkable related decrease in survival was exhibited by digital clubbing after assimilation of age and smoking status with an HR of 2.5 that was extremely notable (King et al., 2001b). This relation although has not been distinctively studied in other cohorts. An inverse relation is exhibited by BMI with survival, with a median survival of 3.6 years for BMI less than 25, 3.8 years for BMI 25 to 30, and 5.8 years for BMI greater than 30 (Alakhras et al., 2007). Per 1-unit rise in BMI there was an HR of 0.93. The protective consequence of enhanced BMI cause in IPF is uncertain, but as hypothesized with other chronic lung diseases, it may be that reduced BMI is a marker of malnutrition and/or increased activity and basal energy dissipation (Alakhras et al., 2007). Impact of comorbidities: Pulmonary hypertension is frequent in IPF and related with lower diffusing capacity of carbon monoxide (DlCO), desaturation during exercise, shorter walk distances and enhanced risk of death in patients with IPF (Lettieri et al., 2006a; Hamada et al., 2007; Fell & Martinez, 2007; Nathan et al., 2007; Nadrous et al., 2005). In an IPF recorded study of patients for lung transplantation, 32% of patients had pulmonary hypertension by right-sided heart catheterization (Lettieri et al., 2006a). Pulmonary hypertension persistent patients had much greater mortality (1-yr mortality of 28% in contrast to 5.5% for patients without pulmonary hypertension), and the risk of mortality risk linearly associated with mean pulmonary artery pressure. According to another study on continuous right-sided heart catheterization in patients with IPF anticipating transplantation approximately all patients exhibited evolution of pulmonary hypertension subsequent in their path (38.6% at baseline and 86.4% at transplantation) (Nathan et al., 2008a). Since there are restricted data substantiating successful particular therapies for pulmonary hypertension in patients with IPF and right-sided heart catheterization is invasive, its regular utilization for prognostic evaluation alone is inappropriate, and non-invasive procedures for screening would be advantageous. Transthoracic echocardiography as a noninvasive procedure of capturing pulmonary hypertension have been evaluated by various © 2017-2018 All Rights Reserved, No part of this document should be modified/used without prior consent Tutors India - Your trusted mentor since 2001 www.tutorindia.com I UK # +44-1143520021, info@tutorsindia.com Page 44 of 172
studies and have exhibited that increased approximate pulmonary artery systolic pressure is related with decreased survival employing thresholds of 40 to 50 mm Hg (Song et al., 2009; Nadrous et al., 2005). Its test features are poor though, with an accuracy of only 40% in contrast to the right-sided heart catheterization (Nathan et al., 2008b). B-type natriuretic peptide extent may be more anticipating of mortality than pulmonary artery systolic pressure by transthoracic echocardiography since it is associated with pulmonary hypertension (Song et al., 2009). As measured by HRCT the main pulmonary artery diameter may be a questionable indicator of pulmonary hypertension in IPF (Zisman et al., 2007). In choosing patients with higher pretest probability for having pulmonary hypertension in IPF other clinical variables may be helpful, comprising reduced DlCO, poor performance on 6MWT and use of supplemental oxygen (Lettieri et al., 2006a). A prediction formula employing room air saturation, DlCO, and FVC indeed exhibited adequate accuracy and high sensitivity for drecognizing pulmonary hypertension in IPF, indicating the role in screening for pulmonary hypertension (Zisman et al., 2008). The patients with IPF and emphysema are generally heavy cigarette-smoking men who exhibit comparatively reserved lung volumes related with irregular deterioration of gas exchange and encounter serious dyspnea on exertion (Grubstein et al., 2005; Mura et al., 2006; Jankowich et al., 2008; Casas et al., 2008; Silva et al., 2008; Akagi et al., 2009). The baseline pulmonary function tests are affected by emphysema by enhancing lung volumes and declining DlCO and FEV1/FVC, as well as modifying the conversion of these values over a period and hence modifying or concealing the evaluation of disease seriousness at baseline and advancement over a period (Cottin et al., 2005; Akagi et al., 2009). In these patients the early and severe pulmonary arterial hypertension originates and they have a critical survival in contrast to the patients with IPF without emphysema (Mejía et al., 2009; Cottin et al., 2010). It is observed by few professionals that the relation of IPF with emphysema is a discrete clinical structure (Millar & Denison, 1990; Wiggins et al., 1990; Hiwatari et al., 1993; Doherty et al., 1997; Silva et al., 2008; Cottin et al., 2005; Mejía et al., 2009; Cottin et al., 2010). Subsequent research is necessary to ascertain that other comorbidities may also impact the outcome in IPF. Gastroesophageal reflux and IPF have a strong relation © 2017-2018 All Rights Reserved, No part of this document should be modified/used without prior consent Tutors India - Your trusted mentor since 2001 www.tutorindia.com I UK # +44-1143520021, info@tutorsindia.com Page 45 of 172
Page 1 and 2: Efficacy of pharmacological interve
Page 3 and 4: 2.2.7 Clinical Course of IPF.......
Page 5 and 6: CHAPTER I: INTRODUCTION Idiopathic
Page 7 and 8: Progression-Free Survival (PFS) in
Page 9 and 10: is used (Azuma et al., 2005). The p
Page 11 and 12: Source: Adopted from Myllärniemi a
Page 13 and 14: disease is increased; however, no s
Page 15 and 16: CHAPTER II: LITERATURE REVIEW 2.1 I
Page 17 and 18: The dangerous disease basically att
Page 19 and 20: made between the inflammatory and f
Page 21 and 22: (Giotopoulos et al., 2007). RT of t
Page 23 and 24: derived cytokines, IL-5 and IL-9, m
Page 25 and 26: granulomatous lung disease, hence i
Page 27 and 28: infection and IPF (Wangoo et al., 1
Page 29 and 30: 2.2.6 Pathophysiology Though the pa
Page 31 and 32: smoking (Rosas et al., 2007; Steele
Page 33 and 34: histological pattern of UIP in the
Page 35 and 36: The aim of this procedure is to rec
Page 37 and 38: procedures involving internal valid
Page 39 and 40: adiological diagnosis of HRCT (Ragh
Page 41 and 42: 2.2.11.1 Clinical Predictors Age: A
Page 43: © 2017-2018 All Rights Reserved, N
Page 47 and 48: Numerous physiologic parameters lik
Page 49 and 50: Dense fibrosis and honeycombing is
Page 51 and 52: Pharmacological treatment: Glucocor
Page 53 and 54: i. Oxygen Therapy and ventilation I
Page 55 and 56: Numerous patients with IPF acquirin
Page 57 and 58: should be undergone to reveal wheth
Page 59 and 60: CHAPTER III: RESEARCH METHODOLOGY T
Page 61 and 62: 3.2 Meta-analysis of Randomised Con
Page 63 and 64: 3.4.1 Inclusion criteria The inclus
Page 65 and 66: 3.6.1 Dichotomous Comparisons The v
Page 67 and 68: CHAPTER IV: RESULTS 4.1 Introductio
Page 69 and 70: Following are the questions of the
Page 71: Study number Table 2- CASP assessme
Page 75: primary objective is to examined wh
Page 79: to NAC inhaled inhaled NAC and oral
Page 82: S. no Author; Year 1 Behr et al 7 C
Page 86: pirfenidone combined with highdose
Page 90: or temporary cessation of pirfenido
Page 93: 4.5 Patient characteristics, interv
Page 97:
oom air 3 Sakamoto et al 15 Effecti
Page 101 and 102:
Of the studies considered for the s
Page 103:
4.6 Evaluation of Efficacy of Prife
Page 107:
change in the lowest SPO2 during th
Page 111:
PaO2, and SaO2; episodes of AE-IPF
Page 115 and 116:
The efficacy of using NAC in combin
Page 117 and 118:
group. It is revealed that at the 2
Page 119 and 120:
CHAPTER V: DISCUSSION AND CONCLUSIO
Page 121 and 122:
contradicting results 50 51 . A res
Page 123 and 124:
tolerability and safety of pirfenid
Page 125 and 126:
equired. An exploratory efficacy an
Page 127 and 128:
as to verify the results and acquir
Page 129 and 130:
© 2017-2018 All Rights Reserved, N
Page 131 and 132:
American Thoracic Society. Idiopath
Page 133 and 134:
and clinical immunology. 115 (1). p
Page 135 and 136:
Behr, J., Maier, K., Degenkolb, B.,
Page 137 and 138:
Bowling, A. (2009). Research Method
Page 139 and 140:
878-81. Available from: http://www.
Page 141 and 142:
http://www.ncbi.nlm.nih.gov/pubmed/
Page 143 and 144:
El-Chemaly, S., Ziegler, S.G., Cala
Page 145 and 146:
Flaherty, K.R., Andrei, A.-C., Murr
Page 147 and 148:
pirfenidone on the generation of re
Page 149 and 150:
Hansell, D.M., Bankier, A.A., MacMa
Page 151 and 152:
proteoglycan deposition in the airw
Page 153 and 154:
Nishimura, J. & Inoue, T. (2009). A
Page 155 and 156:
313-9. Available from: http://www.n
Page 157 and 158:
Pereira, C.A., Sahn, S.A., Sussman,
Page 159 and 160:
interstitial pneumonia: the prognos
Page 161 and 162:
Leslie, K.O., Gruden, J.F., Parish,
Page 163 and 164:
America. 25 (4). pp. 709-721. Marti
Page 165 and 166:
Meyer, A., Buhl, R. & Magnussen, H.
Page 167 and 168:
Moseley, P.L., Hemken, C. & Hunning
Page 169 and 170:
topics/topics/idiopathic-pulmonary-
Page 171 and 172:
Olson, A.L., Swigris, J.J., Lezotte
Page 173 and 174:
Piguet, P.F., Vesin, C., Grau, G.E.
Page 175 and 176:
open-label Phase II study. American
Page 177 and 178:
Rødningen, O.K., Børresen-Dale, A
Page 179 and 180:
Experimental Biology and Medicine.
Page 181 and 182:
Silva, C.I.S., Müller, N.L., Fujim
Page 183 and 184:
Sutton, A.J. (2000). Methods for me
Page 185 and 186:
(11). pp. 1085-1094. Tomioka, H., K
Page 187 and 188:
Wang, Q., Zhu, H., Zhou, W.-G., Guo
Page 189 and 190:
http://www.nature.com/doifinder/10.
Page 191 and 192:
silica-induced lung fibrosis in the
show all

Systematic-Review-Drug-Efficiency-Dissertation-Sample-Work-Tutors-India

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?