International Journal of Clinical Practice 

About: International Journal of Clinical Practice is an academic journal published by Wiley-Blackwell. The journal publishes majorly in the area(s): Population & Medicine. It has an ISSN identifier of 1368-5031. Over the lifetime, 6872 publications have been published receiving 127158 citations. The journal is also known as: Int. J. Clin. Pract. & Medical Bookman and Historian.

Prognostic significance of morphologic parameters in renal cell carcinoma.

Abstract: Many morphologic parameters have been used in prognostic studies in renal cell carcinoma. In this study, the relationship between these parameters and prognosis was investigated. This study includes 75 patients who were treated with radical nephrectomy between 1985 and 2001. Pathological stage (TNM), grade (Fuhrman nuclear grade) cell type (UICC and AJCC), histologic pattern, tumour size, vascular invasion and multifocality were used as prognostic parameters. There were 34 female and 41 male patients with mean age of 54.5 +/- 12.5. The mean size of the tumour was 76.9 +/- 37.2 (30-200) mm. Of the patients, 40 had pT1, 21 pT2, nine pT3 and two pT4 diseases. Twenty-eight patients had Grade 1, 29 Grade 2, 15 Grade 3 and three Grade 4 tumour. According to cell type, 63 had clear cell, six papillary and six undifferentiated types. Five had multifocal and seven had vascular invasion. In conclusion, nuclear grade and tumour stage were found as the most important prognostic indicators.

Prevalence of hypogonadism in males aged at least 45 years: the HIM study

Abstract: The Hypogonadism in Males study estimated the prevalence of hypogonadism [total testosterone (TT) <300 ng/dl] in men aged ≥45 years visiting primary care practices in the United States. A blood sample was obtained between 8 am and noon and assayed for TT, free testosterone (FT) and bioavailable testosterone (BAT). Common symptoms of hypogonadism, comorbid conditions, demographics and reason for visit were recorded. Of 2162 patients, 836 were hypogonadal, with 80 receiving testosterone. Crude prevalence rate of hypogonadism was 38.7%. Similar trends were observed for FT and BAT. Among men not receiving testosterone, 756 (36.3%) were hypogonadal; odds ratios for having hypogonadism were significantly higher in men with hypertension (1.84), hyperlipidaemia (1.47), diabetes (2.09), obesity (2.38), prostate disease (1.29) and asthma or chronic obstructive pulmonary disease (1.40) than in men without these conditions. The prevalence of hypogonadism was 38.7% in men aged ≥45 years presenting to primary care offices.

Characterising the castration-resistant prostate cancer population: a systematic review

Abstract: SUMMARY Background: Castration-resistant prostate cancer (CRPC) is an advanced form of prostate cancer associated with poor survival rates. However, characterisation of the disease epidemiology is hampered by use of varying terminology, definition and disease management. The aim of this review was to conduct a systematic review to provide greater clarity on the sum of the available epidemiologic evidence and to guide future research into the disease prevalence, progression, characteristics and outcome. Methods: Systematic searches of PubMed and Embase were performed in March 2010 to identify relevant observational studies relating to the epidemiology, progression and outcomes of CRPC. Further studies were identified for inclusion in our review through manual searches of the authors’ bibliographical databases and the reference lists of the included articles. Results: We identified 12 articles (10 full papers and 2 abstracts) reporting studies that included a total of 71,179 patients observed for up to 12 years for evaluation in our review. Five studies looked at the prevalence of CRPC in patients with prostate cancer. Together, the data indicate that 10‐20% of prostate cancer patients develop CRPC within approximately 5 years of follow-up. Two studies reported the prevalence of bone metastases present at diagnosis of CRPC. Together, ‡ 84% were shown to have metastases at diagnosis. Of those patients with no metastases present at diagnosis of CRPC, 33% could expect to develop them within 2 years. The median survival of patients with CRPC was reported in five studies, with values varying from 9 to 30 months. A pooled, sample-weighted survival estimate calculated from the survival data included in this review is 14 months. Very few studies that met our inclusion criteria evaluated treatment patterns in CRPC. One study reported that only 37% of patients with CRPC received chemotherapy, with the remainder receiving only steroids and supportive care. The most common palliative therapies administered to patients with skeletal symptoms were radiotherapy, radionuclide therapy, bisphosphonates and opioids. Conclusions: This review highlights the poor prognosis of patients with CRPC, and demonstrates a survival of 9‐13 months in those patients with metastatic CRPC. Furthermore, progression to CRPC is associated with deterioration in quality of life, and few therapeutic options are currently available to patients with CRPC. However, epidemiologic study of these patients is hampered by differing terminology, definitions and treatment paradigms. Our review highlights the need for further well-designed, epidemiological studies of CRPC, using standardised definitions and methods. Review Criteria Observational studies reporting epidemiological data on CRPC were identified through systematic searches of literature on PubMed, Embase and authors own databases. Articles were selected using predefined inclusion ⁄exclusion criteria, and data were abstracted in a structured manner. Where possible and appropriate, meta-analysis of data was performed to provide pooled weighted means.

Oxidative stress in type 2 diabetes: the role of fasting and postprandial glycaemia.

Abstract: Oxidative stress, through the production of reactive oxygen species (ROS), has been proposed as the root cause underlying the development of insulin resistance, β-cell dysfunction, impaired glucose tolerance and type 2 diabetes mellitus (T2DM). It has also been implicated in the progression of long-term diabetes complications, including microvascular and macrovascular dysfunction. Excess nourishment and a sedentary lifestyle leads to glucose and fatty acid overload, resulting in production of ROS. Additionally, reaction of glucose with plasma proteins forms advanced glycation end products, triggering production of ROS. These ROS initiate a chain reaction leading to reduced nitric oxide availability, increased markers of inflammation and chemical modification of lipoproteins, all of which may increase the risk of atherogenesis. With the postulation that hyperglycaemia and fluctuations in blood glucose lead to generation of ROS, it follows that aggressive treatment of fasting and postprandial hyperglycaemia is important for prevention of micro and macrovascular complications in T2DM.

Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update

Abstract: SUMMARY Objectives: To update previous systematic reviews of 12-month prevalence of complementary and alternative medicine (CAM) use by general populations; to explore trends in CAM use by national populations; to develop and apply a brief tool for assessing methodological quality of published CAM-use prevalence surveys. Design: Nine databases were searched for published studies from 1998 onwards. Studies prior to 1998 were identified from two previous systematic reviews. A sixitem literature-based tool was devised to assess robustness and interpretability of CAM-use estimates. Results: Fifty-one reports from 49 surveys conducted in 15 countries met the inclusion criteria. We extracted 32 estimates of 12-month prevalence of use of any CAM (range 9.8‐76%) and 33 estimates of 12-month prevalence of visits to CAM practitioners (range 1.8‐48.7%). Quality of methodological reporting was variable; 30 ⁄51 survey reports (59%) met four or more of six quality criteria. Estimates of 12-month prevalence of any CAM use (excluding prayer) from surveys using consistent measurement methods showed remarkable stability in Australia (49%, 52%, 52%; 1993, 2000, 2004) and USA (36%, 38%; 2002, 2007). Conclusions: There was evidence of substantial CAM use in the 15 countries surveyed. Where national trends were discernable because of consistent measurement, there was no evidence to suggest a change in 12-month prevalence of CAM use since the previous systematic reviews were published in 2000. Periodic surveys are important to monitor population-level CAM use. Use of governmentsponsored health surveys may enhance robustness of population-based prevalence estimates. Comparisons across countries could be improved by standardising approaches to data collection.