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Review of Systems

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125441. Systemic effects of chronic obstructive pulmonary disease. (Abstract)

and can help in the classification and management of the disease. The present review discusses the following systemic effects of chronic obstructive pulmonary disease: 1) systemic inflammation; 2) nutritional abnormalities and weight loss; 3) skeletal muscle dysfunction; and 4) other potential systemic effects. For each of these, the potential mechanisms and clinical implications are discussed and areas requiring further research are highlighted. (...) Systemic effects of chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) is characterised by an inappropriate/excessive inflammatory response of the lungs to respiratory pollutants, mainly tobacco smoking. Recently, besides the typical pulmonary pathology of COPD (i.e. chronic bronchitis and emphysema), several effects occurring outside the lungs have been described, the so-called systemic effects of COPD. These effects are clinically relevant because they modify

2003 European Respiratory Journal

125442. A rapid staging system for predicting mortality from HIV-associated community-acquired pneumonia. (Abstract)

previously. The study objective was to develop a staging system for categorizing mortality risk of patients with HIV-associated CAP using information available prior to hospital admission.Retrospective medical records review of 1,415 patients hospitalized with HIV-associated CAP from 1995 to 1997 at 86 hospitals in seven metropolitan areas.In-patient mortality rate.Hierarchically optimal classification tree analysis was used to develop a preadmission staging system for predicting inpatient mortality (...) A rapid staging system for predicting mortality from HIV-associated community-acquired pneumonia. Community-acquired pneumonia (CAP) accounts for an increasing proportion of the pulmonary infections in individuals with HIV infection. During the mid-1990s, hospital mortality rates for HIV-associated CAP ranged from 0 to 28%. While hospital differences in case mix may account for mortality rate variation, few methods to evaluate illness severity for HIV-associated CAP have been reported

2003 Chest

125443. Treatment of systemic hypertension in patients with pulmonary disease: COPD and asthma. (Abstract)

Treatment of systemic hypertension in patients with pulmonary disease: COPD and asthma. We present a two-part review of the English-language literature pertaining to drug therapy for systemic high BP in patients with pulmonary diseases. Part I examines the literature pertaining to the use of antihypertensive drugs in patients with systemic hypertension and coexisting pulmonary conditions, especially COPD and asthma. Part II of the series reviews studies assessing the relationship between sleep (...) -disordered breathing (including the role of the sympathetic nervous system) and systemic hypertension, and presents an approach to the management of these patients. It is the aim of both parts of this review to make qualified conclusions and recommendations applying a methodologic critique to assess the current literature. In the first part of this series, we review the demographics of hypertension in patients with COPD. This is followed by an extensive review of the use of specific classes

2003 Chest

125444. Prolonged airway and systemic inflammatory reactions after smoke inhalation. (Abstract)

, airway inflammation, and systemic effects.Cross-sectional study.We assessed victims (n = 9) of smoke inhalation 6 months after they were exposed.We studied the clinical symptoms, laboratory data, and pulmonary functions of the patients. We also performed the nonspecific bronchial challenge test with methacholine on these patients. In some patients, we reviewed pathologic specimens of bronchi and measured cytokines (tumor necrosis factor [TNF]-alpha, interferon [INF]-gamma, and interleukin [IL]-2 (...) Prolonged airway and systemic inflammatory reactions after smoke inhalation. Smoke inhalation has a prolonged, negative effect on pulmonary function. The immediate change in the airway after smoke inhalation is an intense inflammatory reaction. Obstructive airway disease commonly occurs several years after smoke inhalation, but few studies have focused on long-term reactions in the airway. This study investigated the long-term effects of smoke inhalation, by examining airway responsiveness

2003 Chest

125445. Current status of outcome measure development for clinical trials in systemic sclerosis. Report from OMERACT 6. (Abstract)

. The OMERACT 6 Workshop on Systemic Sclerosis was conceived as a starting point for the process of assessing the current state of the science in outcome assessment in SSc and then setting a realistic research agenda and priorities for future work in this area This article reviews the current status of assessment tools for research in SSc within the main fundamental domains of illness in SSc, including problems related to skin, pulmonary, cardiac, peripheral vascular (Raynaud's phenomenon and digital (...) Current status of outcome measure development for clinical trials in systemic sclerosis. Report from OMERACT 6. Systemic sclerosis (SSc), also known as scleroderma, is a complex, multisystem disease that results in severe morbidity, disability, and life-threatening complications. The wide range of biological systems clinically involved, and the large spectrum of disease activity and damage that occurs in this disease have limited clinical investigation of SSc, especially therapeutic trials

2003 Journal of Rheumatology

125446. Preterm deliveries in women with systemic lupus erythematosus. (Abstract)

Preterm deliveries in women with systemic lupus erythematosus. To compare the clinical, laboratory, and demographic variables of women in our clinic with systemic lupus erythematosus (SLE) who have had a pregnancy resulting in a live birth and identify any correlations with either term or preterm delivery.Pregnancies in women with SLE from 1999 to 2001 were retrospectively reviewed. We recorded demographic data, disease activity (SLE Disease Activity Index, SLEDAI), obstetric history

2003 Journal of Rheumatology

125447. The frequency of thrombotic thrombocytopenic purpura in patients with systemic lupus erythematosus undergoing kidney biopsy. (Abstract)

The frequency of thrombotic thrombocytopenic purpura in patients with systemic lupus erythematosus undergoing kidney biopsy. To characterize the frequency of thrombotic thrombocytopenic purpura (TTP) among patients with systemic lupus erythematosus (SLE) undergoing kidney biopsy.A retrospective review of all renal biopsies of patients with SLE at Rush-Presbyterian-St. Luke's Medical Center was performed for the years 1989 to 2001.Four cases of clinical and histopathological TTP were identified

2003 Journal of Rheumatology

125448. Digital necrosis related to carboplatin and gemcitabine therapy in systemic sclerosis. (Abstract)

Digital necrosis related to carboplatin and gemcitabine therapy in systemic sclerosis. We present a woman with scleroderma who developed multiple ischemic digits after chemotherapy for lung cancer. The ischemia started during treatment with carboplatin and gemcitabine and required amputation of the affected digits. A review of the literature shows that thrombotic episodes coinciding with chemotherapy are not uncommon, though venous thrombosis occurs more frequently than arterial. Scleroderma

2003 Journal of Rheumatology

125449. Tolerability of mycophenolate mofetil in patients with systemic lupus erythematosus. (Abstract)

Tolerability of mycophenolate mofetil in patients with systemic lupus erythematosus. To quantify the adverse events (AE) associated with mycophenolate mofetil (MMF) in patients with systemic lupus erythematosus (SLE), to examine the relationship between AE and dosage of MMF, and to assess the overall tolerability of MMF in SLE patients.A consecutive cohort of adults with SLE who received MMF between October 1996 and June 1999 was identified. Charts were reviewed for baseline data, AE, MMF

2003 Journal of Rheumatology

125450. Suicide attempts in patients with systemic lupus erythematosus. Full Text available with Trip Pro

Suicide attempts in patients with systemic lupus erythematosus. Suicide and suicide attempts, although well recognised in patients with systemic lupus erythematosus (SLE), have been commented on relatively little.To obtain a better understanding of the reasons for suicidal behaviour in patients with SLE.The records of 300 patients with SLE were reviewed to identify completed or attempted suicides.Five patients made seven attempts at suicide over a 20 year follow up period; one of them was fatal

2003 Annals of the Rheumatic Diseases

125451. Antiphospholipid antibodies and incidence of venous thrombosis in a cohort of patients with systemic lupus erythematosus. (Abstract)

Antiphospholipid antibodies and incidence of venous thrombosis in a cohort of patients with systemic lupus erythematosus. To study the relationship between antiphospholipid antibodies (aPL) and the incidence of venous thrombosis (VT) among patients with systemic lupus erythematosus (SLE).The study population consisted of 678 patients with SLE enrolled in the Hopkins Lupus Cohort. Medical records were reviewed to identify the occurrence of VT prior to cohort entry. During cohort participation

2002 Journal of Rheumatology

125452. Defining lupus cases for clinical studies: the Boston weighted criteria for the classification of systemic lupus erythematosus. (Abstract)

developed and evaluated the ability of a weighted classification system to identify a broader spectrum of patients with lupus.We constructed the Boston Weighted Criteria system for the classification of SLE, updating that developed in 1984. Using a hospital billing database, we identified 27l patients seen in our rheumatology clinic for possible SLE and reviewed medical records for all ACR criteria and the treating rheumatologist's diagnosis. We compared both the Boston Criteria and the treating (...) Defining lupus cases for clinical studies: the Boston weighted criteria for the classification of systemic lupus erythematosus. The 1982 American College of Rheumatology (ACR) revised criteria for the classification of systemic lupus erythematosus (SLE), updated in 1997, have become the standard for establishing eligibility of subjects for epidemiologic and clinical lupus studies. These criteria may exclude patients with limited disease, restricting the generalizability of research findings. We

2002 Journal of Rheumatology

125453. Neuropsychiatric manifestations in systemic lupus erythematosus: prevalence and association with antiphospholipid antibodies. (Abstract)

Neuropsychiatric manifestations in systemic lupus erythematosus: prevalence and association with antiphospholipid antibodies. To apply the new American College of Rheumatology nomenclature for neuropsychiatric systemic lupus erythematosus (NPSLE), determine the prevalence of the different neuropsychiatric (NP) syndromes, and evaluate which of these manifestations correlates with the presence of antiphospholipid antibodies (aPL). Methods. Clinical, serological, and imaging data of 323 (...) consecutive patients with SLE were retrospectively reviewed. Neuropsychometric testing was applied by a neuropsychologist. Univariate and multivariate statistical analyses were applied to evaluate the association bewteen NP manifestations, magnetic resonance imaging (MRI) abnormalities, and aPL.In total, 185 patients (57.3%) had NP manifestations at any time during followup. Headache was the most frequent manifestation, present in 78 patients (24%). Cerebrovascular disease (CVD) was diagnosed in 47/323

2003 Journal of Rheumatology

125454. Systemic sclerosis: the susceptible host (genetics and environment). (Abstract)

Systemic sclerosis: the susceptible host (genetics and environment). It is becoming evident that several genetic factors participate in modulating susceptibility to SSc and its clinical manifestations. Some genes that specifically affect ECM metabolism and vascular function may be unique to SSc and scleroderma-related disorders; others, such as those genes involved in regulating immune tolerance, are likely shared with other autoimmune diseases. The effect of genetic variations (...) association studies, but conventional case-controls designs may be subject to selection bias and will require large sample sizes if the genes that are under investigation confer only modest (OR = 1.5-2.0) disease risk (Fig. 2). The simultaneous examination of several genes that are biologically relevant to a specific disease process to attain higher aggregate ORs, is one approach that was used in several reports that were cited in this review. The use of family-based controls, such as in the transmission

2003 Rheumatic Diseases Clinics of North America

125455. A systems neuroscience approach to autism: biological, cognitive, and clinical perspectives. (Abstract)

A systems neuroscience approach to autism: biological, cognitive, and clinical perspectives. Autism is a behaviorally defined disorder characterized by a broad constellation of symptoms. Numerous studies directed to the biological substrate demonstrate clear effects of neurodevelopmental differences that will likely point to the etiology, course, and long-term outcomes of the disorder. Consistently replicated research on the neural underpinnings of autism is reviewed. In general, results

2003 Mental Retardation and Developmental disabilities Research Reviews

125456. Thrombocytopenia and thromboembolism in pediatric systemic lupus erythematosus. (Abstract)

Thrombocytopenia and thromboembolism in pediatric systemic lupus erythematosus. To define in children with systemic lupus erythematosus (SLE) the incidence, outcome, and association of thrombocytopenia with other SLE manifestations, specifically thromboembolic events (TEs), we retrospectively reviewed 106 pediatric patients with SLE diagnosed between 1992 and 2001. Thrombocytopenia was found in 50%, which was of a moderate or severe degree in 34%. The thrombocytopenia was sustained in 29

2003 Journal of Pediatrics

125457. New paradigms in adjuvant systemic therapy of breast cancer. (Abstract)

New paradigms in adjuvant systemic therapy of breast cancer. Since the initial studies of adjuvant therapy in the 1970s, it has become increasingly clear that chemotherapy and hormone therapy have had a substantial effect on the survival of women with early breast cancer. It was originally assumed that only women with high-risk features would derive benefit from adjuvant therapy, but it is now apparent from numerous studies that adjuvant therapy improves survival in all subgroups of women (...) with invasive breast cancer, although the absolute benefit varies depending on tumor stage and other prognostic features. Considerable progress has been made in elucidating effective adjuvant therapy regimens, but there continue to be many unanswered questions that are being addressed in ongoing clinical trials of adjuvant hormone therapy and chemotherapy. This paper reviews the current paradigms in adjuvant therapy, the published data that have affected current practice patterns, and the current

2003 Endocrine-Related Cancer

125458. Coding of sounds in the auditory system and its relevance to signal processing and coding in cochlear implants. (Abstract)

Coding of sounds in the auditory system and its relevance to signal processing and coding in cochlear implants. To review how the properties of sounds are "coded" in the normal auditory system and to discuss the extent to which cochlear implants can and do represent these codes.Data are taken from published studies of the response of the cochlea and auditory nerve to simple and complex stimuli, in both the normal and the electrically stimulated ear. REVIEW CONTENT: The review describes: 1 (...) ) the coding in the normal auditory system of overall level (which partly determines perceived loudness), spectral shape (which partly determines perceived timbre and the identity of speech sounds), periodicity (which partly determines pitch), and sound location; 2) the role of the active mechanism in the cochlea, and particularly the fast-acting compression associated with that mechanism; 3) the neural response patterns evoked by cochlear implants; and 4) how the response patterns evoked by implants

2003 Otology and Neurotology

125459. The orexin/hypocretin system: a critical regulator of neuroendocrine and autonomic function. (Abstract)

The orexin/hypocretin system: a critical regulator of neuroendocrine and autonomic function. The hypocretins/orexins are hypothalamic peptides most recognized for their significant effects on feeding and arousal. Indeed, loss of the peptides results in a cataplexy quite similar to that observed canine models of human narcolepsy. However, neurons producing these peptides project to numerous brain sites known to be important in neuroendocrine regulation of pituitary function and autonomic centers (...) as well. Results from numerous laboratories have suggested broad physiological roles for the hypocretins/orexins in neuroendocrine and autonomic regulation as a consequence of actions in the dorsal vagal complex, paraventricular nucleus, and pituitary. This review focuses upon evidence for potential physiologic roles for the peptides in these sites.

2003 Frontiers in Neuroendocrinology

125460. Complaints against an EMS system. (Abstract)

Complaints against an EMS system. Complaints against Emergency Medical Services (EMS) agencies represent a concerning and potentially time-consuming problem for all involved in the delivery of prehospital emergency medical care. The objective of this study was to identify the source of complaints against an EMS system to help focus quality and performance improvement and customer service efforts. We conducted a retrospective review of complaints filed against a busy urban EMS agency over a 6

2003 Journal of Emergency Medicine

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