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Medical research during the COVID-19 pandemic

World Journal of Clinical Cases 2020年第15期8卷 3156-3163页

作者： khalid alnaamani Siham AlSinani Alan N Barkun Division of Gastroenterology Department of Internal MedicineArmed Forces HospitalMuscat 999046Oman Graduate Medical Education Department and Department of Child Health Sultan Qaboos University HospitalMuscat 999046Oman Division of Gastroenterology McGill University and the McGill University Health CentreMontreal H3G1A4Canada

The current pandemic of coronavirus disease 2019(COVID-19)which was first detected in Wuhan,China in December 2019 is caused by the novel coronavirus named severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The virus has quickly spread to a large number of countries leading to a great number of ***,till today there is no specific treatment or vaccination for *** of the suggested treatment medications are based on in vitro laboratory investigations,experimental animal models,or previous clinical experience in treating similar viruses such as SARS-CoV-1 or other retroviral *** running of any clinical trial during a pandemic is affected at multiple *** for this include patient hesitancy or inability to continue investigative treatments due to self-isolation/quarantine,or limited access to public places(including hospitals).Additional barriers relate to health care professionals being committed to other critical tasks or quarantining themselves due to contact with COVID-19 positive *** best research approaches are those that adapt to such external unplanned *** clinical trials before COVID-19 pandemic have the potential for identifying important therapies in the long-term if they can be completed as ***,these clinical trials may require modifications due a pandemic such as this one to ensure the rights,safety,and wellbeing of participants as well as medical staff involved in the conduction of clinical *** trials initiated during the pandemic must be time-efficient and flexible due to high contagiousness of severe acute respiratory syndrome coronavirus 2,the significant number of reported deaths,and time constraints needed to perform high quality clinical trials,enrolling adequate sample *** between different countries as well as implementation of innovative clinical trial designs are essential to successfully complete such initiatives during the cur

关键词： SARS-CoV-2 COVID-19 Pandemic Research Clinical trials

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Randomized trial in malignant biliary obstruction:Plastic vs partially covered metal stents

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World Journal of Gastroenterology 2013年第46期19卷 8638-8646页

作者： Peter L Moses khalid M alnaamani Alan N Barkun Stuart R Gordon Roger D Mitty M Stanley Branch Thomas E Kowalski Myriam Martel Viviane Adam Division of Gastroenterology and Hepatology University of Vermont Division of Gastroenterology McGill University Health Center McGill University Department of Epidemiology and Biostatistics and Occupational Health McGill University Health Center Division of Gastroenterology and Hepatology Dartmouth Hitchcock Medical Center Lebanon Division of Gastroenterology Tufts University School of Medicine Boston Division of Gastroenterology Duke University Medical Center Durham Division of Gastroenterology and Hepatology Thomas Jefferson University Hospital

AIM:To compare efficacy and complications of par-tially covered self-expandable metal stent(pcSEMS)to plastic stent(PS)in patients treated for malignant,infrahilar biliary ***:Multicenter prospective randomized clinical trial with treatment allocation to a pcWallstent(SEMS)or a 10 French *** patients aged≥18,for infrahilar malignant biliary obstruction and a Karnofsky performance scale index>60%from 6 participating North American university *** endpoint was time to stent failure,with secondary outcomes of death,adverse events,Karnofsky performance score and short-form-36 scale administered on a three-monthly basis for up to 2 *** analyses were performed for stent failure and death,with Cox proportional hazards regression models to determine significant predictive ***:Eighty-five patients were accrued over 37mo,42 were randomized to the SEMS group and 83patients were available for *** to stent failure was 385.3±52.5 d in the SEMS and 153.3±19.8 d in the PS group,P=*** to death did not differ between groups(192.3±23.4 d for SEMS vs211.5±28.0 d for PS,P=0.70).The only significant predictor was treatment allocation,relating to the time to stent failure(P=0.01).Amongst other measured outcomes,only cholangitis differed,being more common in the PS group(4.9%vs 24.5%,P=0.029).The small number of patients in follow-up limits longitudinal assessments of performance and quality of *** an initially planned 120 patients,only 85 patients were ***:Partially covered SEMS result in a longer duration till stent failure without increased complication rates,yet without accompanying measurable benefits in survival,performance,or quality of life.

关键词： Randomized Biliary Obstruction Stent Plastic Metal Palliative Common bile duct

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