scholarly journals Optic disc dose reduction in ocular brachytherapy using 125 I notched COMS plaques: A simulation study based on current clinical practice

2020 ◽  
Vol 21 (9) ◽  
pp. 57-70
Author(s):  
Yongsook C. Lee ◽  
Shih‐Chi Lin ◽  
Yongbok Kim
Keyword(s):  
Clinical Practice ◽  
Dose Reduction ◽  
Optic Disc ◽  
Simulation Study ◽  
Current Clinical Practice

Ankle Brachial Pressure Index and compression application: Review summary

2019 ◽  
Vol 27 (2) ◽  
pp. 74-77
Author(s):  
Victoria Team ◽  
Georgina Gethin ◽  
John D Ivory ◽  
Kimberley Crawford ◽  
Ayoub Bouguettaya ◽  
...  
Keyword(s):  
Content Analysis ◽  
Clinical Practice ◽  
Venous Insufficiency ◽  
Arterial Disease ◽  
Leg Ulcers ◽  
Current Clinical Practice ◽  
Ankle Brachial Pressure Index ◽  
Arterial Circulation ◽  
Pressure Index ◽  
Peripheral Arterial

Venous leg ulcers (VLUs) are a significant complication amongst persons with chronic venous insufficiency (CVI) that frequently follow a cycle of healing and recurrence. Current clinical practice guidelines (CPGs) recommend applying below knee compression to improve VLU healing. Compression could be applied if the Ankle Brachial Pressure Index (ABPI) rules out significant arterial disease, as sufficient peripheral arterial circulation is necessary to ensure safe compression use. We conducted a content analysis of 13 global CPGs on the accuracy of recommendations related to ABPI and compression application. Eight CPGs indicated that compression is recommended when the ABPI is between 0.8 and 1.2 mmHg. However, this review found there is disagreement between 13 global VLU CPGs, with a lack of clarity on whether or not compression is indicated for patients with ABPIs between 0.6 and 0.8 mmHg. Some CPGs recommend reduced compression for treatment of VLUs, while others do not recommend any type of compression at all. This has implications for when it is safe to apply compression, and the inconsistency in evidence indicates that specialist advice may be required at levels beyond the ABPI “safe” range listed above.

Role of niacin in current clinical practice

2019 ◽  
Vol 110 (1) ◽  
Author(s):  
Abhishek Sharma ◽  
Nidhi Madan
Keyword(s):  
Clinical Practice ◽  
Current Clinical Practice

Antiplatelet Therapy in TAVI: Current Clinical Practice and Recommendations

2016 ◽  
Vol 22 (13) ◽  
pp. 1888-1895 ◽  
Author(s):  
Nikolaos A. Magkoutis ◽  
Sabi Fradi ◽  
Alexandre Azmoun ◽  
Ramsi Ramadan ◽  
Sami Ben Ouanes ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Antiplatelet Therapy ◽  
Current Clinical Practice

Clinical genomics in the 21st century: The fine balance between ethics and science

2021 ◽  
pp. 147775092110366
Author(s):  
Terence YS Liew ◽  
Chun Y Khoo
Keyword(s):  
Clinical Practice ◽  
Informed Consent ◽  
21St Century ◽  
Preventive Medicine ◽  
Genomic Medicine ◽  
Traditional Practices ◽  
Current Clinical Practice ◽  
Common Goal ◽  
Clinical Genomics ◽  
Ethical Concerns

The 21st century has been revolutionary for the field of clinical genomics, with major advancements and breakthroughs over the years. It is now considered an instrumental tool in clinical and preventive medicine and has been used on a day-to-day basis to complement current clinical practice. However, with advancements in genomics comes greater bioethical concerns, which becomes increasingly complex with more cutting-edge technology. Some of the major ethical concerns include obtaining informed consent, possibility for genetic enhancements and eugenics, genomic equity and potential discrimination and cloning. It is imperative that we appreciate the benefits of genomic medicine in complementing traditional practices, identify and address the ethical concerns with relation to the practice of genomic medicine, and to ensure a common goal of improving human lives. With these in mind, the practice of genomics can have maximum impact in the collective health of the population, with greater benefit to all.

scholarly journals AB1176 UTILITY OF REDOSER TOOL IN DOSE OPTIMIZATION OF BIOLOGICAL THERAPY IN PATIENTS WITH RHEUMATOID ARTHRITIS IN CLINICAL PRACTICE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1879.2-1879
Author(s):  
A. M. Cabezas-Lucena ◽  
M. Morales-Águila ◽  
S. Manrique Arija ◽  
C. Fuego-Varela ◽  
L. Cano Garcia ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Dose Reduction ◽  
Biological Therapy ◽  
Activity Index ◽  
Standard Dose ◽  
Disease Evolution ◽  
Independent Variables ◽  
Outpatient Unit ◽  
Baseline Activity

Background:Objectives:To describe the characteristics of patients with rheumatoid arthritis (RA) in dose reduction of biological therapy (BT) in clinical practice and identify possible factors associated with the time in dose reduction and verify the utility of REDOSER tool.Methods:Design:A retrospective, observational longitudinal study under conditions of clinical practice.Patients:RA in BT dose reduction between 2007- 2019 were selected. Inclusion criteria: RA according to ACR 2010 criteria which have been initiated BT dose reduction. Patients with BT are followed prospectively every 3-4 months in a specialized outpatient unit of BT dose reduction with a pre-established protocol for data collection and registered in a database.Variables: Primary:Time in reduction: was defined as the time in which patients maintained the BT optimization andRelapse at 12 and 24 months: percentage of patients who, after starting BT optimization, return to the previous or standard dose.Secondary variables:REDOSER:Appropriate, Doubtful and Inappropriate (If dose reduction was adequate according to the REDOSER tool applied retrospectively were evaluated). Other variables: Demographic, clinical-analytical: time of disease evolution, RF, anti CCP antibodies, Number of Tender Joints, Number of swollen joints, erosions, activity index (DAS28, SDAI, CDAI) and physical function (HAQ). Previous treatments.Statistical Analysis:descriptive, bivariate using x2 and T-Student among patients with and without relapse at 24 months and multivariate linear regression to identify independent variables associated with the time in BT dose reduction (DV: time in reduction).Results:59 patients with RA were included. Table 1 shows the main characteristics of the subjects. The average (SD) of optimization in months was 17.9 (17.7). Ten patients (16.9%) relapsed at 12 months and 16 (27.1%) at 24 months. The mean (SD) of DAS28 and SDAI of patients who relapsed at 24 months was higher compared to baseline DAS28 (2.3 [0.9] vs. 1.5 [0.8]; p = 0.015) and SDAI (7.8 [6.3] versus 3.3 [1.6]; p 0.05). These patients who relapsed at 24 months compared to patients who did not have more erosions at the start of BT (p = 0.004), longer duration of disease (p = 0.072) and greater baseline activity of DAS28 (p = 0.017), of SDAI (p = 0.030) and CDAI (p = 0.036). After simulating the REDOSER tool to all patients at the beginning of the OBT, 28 patients (56%) were “Appropriate”, 20 (40%) “Doubtful” and 2 (4%) “Inappropriate” of which they continue in OBT at the conclusion of study 22, 10 and 0, respectively (p = 0.020). In the multivariant analysis, the independent variables that are associated with time in dose reduction of BT were baseline DAS28 (β = -0.660, 95% CI[2.7-14.0]; p=0.014) and age (β=-0.800, 95% CI [0.8-0.0]; p=0.038).Conclusion:The majority of the patients with RA who initiate BT dose reduction maintain the optimization after 24 months. REDOSER can be useful in clinical practice to assess the BT optimization in patients with RA. A longer time in BT dose reduction was associated with lower values of DAS28 at the beginning and younger age of the patients.Figure 1:Disclosure of Interests:None declared

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