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Your search keyword '"McMaster University, McMaster Institute of Urology"' showing total 4 results
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4 results on '"McMaster University, McMaster Institute of Urology"'

1. Differences between the real and the desired worlds in the results of clinical trials

Author

El Dib, Regina [UNESP], Dib, Regina El, Jorge, Eliane Chaves [UNESP], Kamegasawa, Amélia [UNESP], Daher, Solange Ramires [UNESP], Spagnuolo, Regina Stella [UNESP], da Silva, Marise Pereira [UNESP], Braga, Gabriel Pereira [UNESP], Volpato, Enilze [UNESP], Módolo, Norma Sueli Pinheiro [UNESP], Betini, Marluci [UNESP], Do Valle, Adriana [UNESP], Corrêa, Ione [UNESP], Bazan, Rodrigo [UNESP], Almeida, Ricardo Augusto M. B. [UNESP], Weber, Silke Anna Theresa [UNESP], Molina, Silvana [UNESP], Yoo, Hugo [UNESP], Boas, Paulo Villas [UNESP], Corrente, José Eduardo [UNESP], Mathew, Joseph, Kapoor, Anil, Carvalho, Raíssa Pierri [UNESP], Vital, Roberto Bezerra [UNESP], Braz, Leandro Gobbo [UNESP], Do Nascimento Junior, Paulo [UNESP], Universidade Estadual Paulista (Unesp), McMaster University, McMaster Institute of Urology, and Pediatric Pulmonology, PGIMER

Subjects
Research design, medicine.medical_specialty, Efficacy, Systematic survey, Psychological intervention, MEDLINE, Effectiveness, law.invention, Randomized controlled trial, law, medicine, Humans, Clinical Trials, Randomized Controlled Trials as Topic, Clinical Trials as Topic, lcsh:R5-920, Evidence-Based Medicine, business.industry, Research, General Medicine, Evidence-based medicine, Clinical Science, Clinical trial, Clinical Practice, Treatment Outcome, Bibliometrics, Research Design, Physical therapy, Clinical Medicine, business, lcsh:Medicine (General)
Abstract

Made available in DSpace on 2018-12-11T17:25:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-01-01. Added 1 bitstream(s) on 2019-10-09T18:32:09Z : No. of bitstreams: 1 S1807-59322015000900618.pdf: 243111 bytes, checksum: 6fbbe57cd02f4260c36d6a9a23cd10c0 (MD5) OBJECTIVE: We refer to the effectiveness (known as pragmatic or real world) and efficacy (known as explanatory or desired or ideal world) of interventions. However, these terms seem to be randomly chosen by investigators who design clinical trials and do not always reflect the true purpose of the study. A pragmaticexplanatory continuum indicator summary tool was thus developed with the aim of identifying the characteristics of clinical trials that distinguish between effectiveness and efficacy issues. We verified whether clinical trials used the criteria proposed by the indicator summary tool, and we categorized these clinical trials according to a new classification. METHOD: A systematic survey of randomized clinical trials was performed. We added a score ranging from 0 (more efficacious) to 10 (more effective) to each domain of the indicator summary tool and proposed the following classifications: high efficacy (

Published
2015

2. An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

Author

Paulo do Nascimento Junior, Anil Kapoor, Regina El Dib, Universidade Estadual Paulista (Unesp), and McMaster University McMaster Institute of Urology

Subjects
Male, medicine.medical_specialty, RD1-811, MEDLINE, Review, Cryosurgery, law.invention, Randomized controlled trial, Meta-Analysis as Topic, law, Health care, medicine, Humans, Intensive care medicine, Carcinoma, Renal Cell, Clinical Trials as Topic, business.industry, Methodology, Reproducibility of Results, Evidence-based medicine, Time Series Studies, Kidney Neoplasms, Surgery, Clinical trial, Meta-analysis, Systematic review, Clinical research, Treatment Outcome, Catheter Ablation, Female, business
Abstract

Made available in DSpace on 2014-10-01T13:08:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-12-01Bitstream added on 2014-10-01T14:03:09Z : No. of bitstreams: 1 S0102-86502013001200010.pdf: 1090436 bytes, checksum: 9e2bed42f6160b0a0011995ed48bb172 (MD5) PURPOSE: Systematic reviews are criticized for frequently offering inconsistent evidences and absence of straightforward recommendations. Their value seems to be depreciated when the conclusions are uncertain. To describe an alternative approach of evaluating case series studies in health care when there is absence of clinical trials. METHODS: We provide illustrations from recent experiences. Proportional meta-analysis was performed on surgical outcomes: (a) case series studies, (b) use of cryoablation or radiofrequency ablation, and (c) patients with small renal cell carcinoma. The statistically significant difference between both interventions studied was defined if their combined 95% confidential interval (CI) did not overlap. RESULTS: As demonstrated by the example, this analysis is an alternative approach to provide some evidence of the intervention´s effects under evaluation and plotting all available case series in the absence of clinical trials for the health field. CONCLUSIONS: Although we are leading to a low level of evidence to determine efficacy, effectiveness and safety of interventions this alternative approach can help surgeons, physicians and health professionals for a provisionally decision in health care along with their clinical expertise and the patient´s wishes and circumstances in the absence of high-quality primary studies. It´s not a replacement for the gold standard randomized clinical trial, but an alternative analysis for clinical research. Sao Paulo State University Botucatu Medical School Anaesthesiology Department McMaster University McMaster Institute of Urology UNESP Botucatu Medical School Anaesthesiology Department Sao Paulo State University Botucatu Medical School Anaesthesiology Department UNESP Botucatu Medical School Anaesthesiology Department

Published
2013

3. Evolving Role of Urologists in the Management of Advanced Renal Cell Carcinoma.

Author

Kapoor A, Kim J, Goucher G, and Hoogenes J

Subjects
Antineoplastic Agents administration & dosage, Biopsy, Carcinoma, Renal Cell pathology, Combined Modality Therapy, Humans, Kidney Neoplasms pathology, Nephrectomy, Prognosis, Risk Assessment, Urologists, Antineoplastic Agents therapeutic use, Carcinoma, Renal Cell therapy, Kidney Neoplasms therapy, Physician's Role
Abstract

Advanced renal cell carcinoma is not uncommon, but necessitates a multidisciplinary approach for optimal treatment. Targeted therapy has increased the likelihood of urologists managing patients in all disease stages. Neoadjuvant therapy is currently experimental. Systemic therapy for metastatic disease demonstrates survival benefits. The role of cytoreductive nephrectomy and adjuvant therapy is dependent on patient selection. Management of advanced renal cell carcinoma involves continued optimization of available agents and biomarker development. This article reviews the role of the urologist in medical and surgical therapies, including prognostication, management of locally advanced and metastatic disease, and provides the most recent clinical trial data., Competing Interests: Disclosure The authors have no conflicts of interest to declare., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Published
2020
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4. A systematic review of new advances in the management of mucopolysaccharidosis VI (Maroteaux-Lamy syndrome): focus on galsulfase.

Author

El Dib RP and Pastores GM

Abstract

Introduction: Mucopolysaccharidosis type VI (MPS VI, Maroteaux-Lamy syndrome) is an autosomal recessive lysosomal storage disorder, characterized primarily by skeletal dysplasia and joint contracture. It is caused by a deficiency of N-acetylgalactosamine-4-sulfatase (arylsulfatase B), for which a recombinant formulation (galsulfase) is available as replacement therapy., Objective: To evaluate the effectiveness and safety of galsulfase compared to placebo or no interventions, for treating MPS VI. We also considered studies evaluating different doses of galsulfase., Methods: A systematic review of the literature was conducted. A computerized electronic search in MEDLINE, EMBASE, CENTRAL, SciELO, and LILACS was carried on to identify any randomized trials that met our inclusion criteria., Results: Two studies were included in the review. Because the number of studies was small, our analysis probably did not find any statistically significant difference. Long-term follow-up will be required to ascertain full clinical benefit, on both event-free survival and quality of life measures., Conclusions: There is some evidence to support the use of galsulfase in the treatment of MPS VI; however due to the very low quantity of included studies we could not analyze it in an appropriate way. This review highlights the need for continued research into the use of enzyme replacement therapy for MPS VI.

Published
2009
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