Institution
Medical Research Council
Government•London, United Kingdom•
About: Medical Research Council is a government organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Malaria. The organization has 16430 authors who have published 19150 publications receiving 1475494 citations.
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University of Toronto1, Mayo Clinic2, McGill University3, Dartmouth College4, Harvard University5, Partners In Health6, University of New Mexico7, Veterans Health Administration8, Taipei Medical University9, Médecins Sans Frontières10, University of California, Davis11, International Union Against Tuberculosis and Lung Disease12, World Health Organization13, Medical Research Council14, California Department of Public Health15, Yeshiva University16, University of Colorado Denver17, University of California, San Francisco18, Sungkyunkwan University19, South African Medical Research Council20, University of Groningen21, University of Washington22, Imperial College London23, Autonomous University of Madrid24, Pierre-and-Marie-Curie University25, Stellenbosch University26, University of Ulsan27, University of Sassari28, Shahid Beheshti University of Medical Sciences and Health Services29, National Institutes of Health30, Grantham Hospital31, Seoul National University32
TL;DR: Findings from a collaborative, individual patient-level meta-analysis of treatment outcomes among patients with multidrug-resistant tuberculosis are reported.
Abstract: Background
Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB.
Methods and Findings
Three recent systematic reviews were used to identify studies reporting treatment outcomes of microbiologically confirmed MDR-TB. Study authors were contacted to solicit individual patient data including clinical characteristics, treatment given, and outcomes. Random effects multivariable logistic meta-regression was used to estimate adjusted odds of treatment success. Adequate treatment and outcome data were provided for 9,153 patients with MDR-TB from 32 observational studies. Treatment success, compared to failure/relapse, was associated with use of: later generation quinolones, (adjusted odds ratio [aOR]: 2.5 [95% CI 1.1–6.0]), ofloxacin (aOR: 2.5 [1.6–3.9]), ethionamide or prothionamide (aOR: 1.7 [1.3–2.3]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.3 [1.3–3.9]), and three or more likely effective drugs in the continuation phase (aOR: 2.7 [1.7–4.1]). Similar results were seen for the association of treatment success compared to failure/relapse or death: later generation quinolones, (aOR: 2.7 [1.7–4.3]), ofloxacin (aOR: 2.3 [1.3–3.8]), ethionamide or prothionamide (aOR: 1.7 [1.4–2.1]), use of four or more likely effective drugs in the initial intensive phase (aOR: 2.7 [1.9–3.9]), and three or more likely effective drugs in the continuation phase (aOR: 4.5 [3.4–6.0]).
Conclusions
In this individual patient data meta-analysis of observational data, improved MDR-TB treatment success and survival were associated with use of certain fluoroquinolones, ethionamide, or prothionamide, and greater total number of effective drugs. However, randomized trials are urgently needed to optimize MDR-TB treatment.
Please see later in the article for the Editors' Summary.
501 citations
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TL;DR: The favourable toxicity profile of single-agent carboplatin suggests that this drug is a reasonable option as first-line chemo therapy for ovarian cancer.
500 citations
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22 Apr 1993TL;DR: In this article, a method for determining the sequence of a nucleic acid comprising the steps of: a) forming a single-stranded template comprising the nucleic acids to be sequenced; b) hybridising a primer to the template to form a template/primer complex; c) extending the primer by the addition of a single labeled nucleotide; determining the type of the labelled nucleotide added onto the primer; removing or neutralising the label; and f) repeating steps (c) to (e) sequentially and recording the order of incorporation of labelled nucleotides
Abstract: There is disclosed a method for determining the sequence of a nucleic acid comprising the steps of: a) forming a single-stranded template comprising the nucleic acid to be sequenced; b) hybridising a primer to the template to form a template/primer complex; c) extending the primer by the addition of a single labelled nucleotide; d) determining the type of the labelled nucleotide added onto the primer; e) removing or neutralising the label; and f) repeating steps (c) to (e) sequentially and recording the order of incorporation of labelled nucleotides. There is also disclosed apparatus for carrying out the method.
500 citations
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TL;DR: Mean platelet volume (MPV) is a further independent risk factor for recurrent MI and consistent trends of increasing age-adjusted relative odds of death and recurrent ischaemic events were noted for MPV.
499 citations
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TL;DR: The controversies that surround the interpretation of 25OHD, other proposed indices of vitamin D adequacy and dietary reference values for vitamin D, and the emerging evidence that a very low calcium intake may contribute to the etiology of rickets in Africa and Asia are discussed.
Abstract: The prevalence of clinical vitamin D deficiency (rickets and osteomalacia) is high in many parts of the world, and there is a resurgence of rickets among children of ethnic minority groups in Europe and Australasia. Plasma 25-hydroxyvitamin D concentration (25OHD) is a useful risk marker of clinical vitamin D deficiency. This review summarizes the factors that contribute to differences in 25OHD among populations and provides an overview of the prevalence of low vitamin D status worldwide. It discusses the controversies that surround the interpretation of 25OHD, other proposed indices of vitamin D adequacy and dietary reference values for vitamin D, and describes the emerging evidence that a very low calcium intake may contribute to the etiology of rickets in Africa and Asia. There is an urgent need for action to address the global burden of rickets and osteomalacia.
498 citations
Authors
Showing all 16441 results
Name | H-index | Papers | Citations |
---|---|---|---|
Shizuo Akira | 261 | 1308 | 320561 |
Trevor W. Robbins | 231 | 1137 | 164437 |
Richard A. Flavell | 231 | 1328 | 205119 |
George Davey Smith | 224 | 2540 | 248373 |
Nicholas J. Wareham | 212 | 1657 | 204896 |
Cyrus Cooper | 204 | 1869 | 206782 |
Martin White | 196 | 2038 | 232387 |
Frank E. Speizer | 193 | 636 | 135891 |
Michael Rutter | 188 | 676 | 151592 |
Richard Peto | 183 | 683 | 231434 |
Terrie E. Moffitt | 182 | 594 | 150609 |
Kay-Tee Khaw | 174 | 1389 | 138782 |
Chris D. Frith | 173 | 524 | 130472 |
Phillip A. Sharp | 172 | 614 | 117126 |
Avshalom Caspi | 170 | 524 | 113583 |