Assessing the clinical significance of treatment outcomes for distressing voices in routine clinical practice

2019 ◽  
Vol 27 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Johanna C. Badcock ◽  
Madeleine E. Graham ◽  
Georgie Paulik
Keyword(s):  
Clinical Practice ◽  
Treatment Outcomes ◽  
Clinical Significance ◽  
Routine Clinical Practice

scholarly journals Treatment Outcomes of Retinal Vein Occlusion in Clinical Practice in Nepal

2020 ◽  
Author(s):  
SANJEEB BHANDARI ◽  
Manish Poudel ◽  
Indira Paudyal ◽  
Pratibha Lama Joshi ◽  
Chunu Shrestha ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Treatment Outcomes ◽  
Retinal Vein Occlusion ◽  
Associated Factors ◽  
Vision Loss ◽  
Routine Clinical Practice ◽  
Future Studies ◽  
Vein Occlusion ◽  
Central Subfield Thickness ◽  
The Mean

Abstract Background: This study evaluated the treatment outcomes of retinal vein occlusion (RVO) in a routine clinical practice in Nepal. Methods: This was a retrospective analysis of observational data of patients with RVO who attended the retina clinic of the Tilganga Institute of Ophthalmology from 1 November 2017 to 31 October 2018. The main outcome was the mean change in visual acuity (VA) at 12 months from the start of treatment. Other outcomes of interest were the mean change in central subfield thickness (CST) and the number of treatments over 12 months. Results: A total of 99 eyes (of 99 patients) with RVO (60 - branch RVO [BRVO] and 39 - central RVO [CRVO] were available for the analysis. Eyes with CRVO had worse VA and CST at baseline. Eyes in both groups were similar for age, associated factors for RVO, duration of vision loss and the presence of ischemia at baseline. The mean (95% Confidence Interval [CI]) VA change at 12 months for BRVO was -0.35 (-0.46, -0.23) logMAR (p < 0.001) from a mean (SD) of 0.75 (0.42) logMAR at baseline with 63% achieving VA < 0.3 logMAR while for CRVO it was -0.35 (-0.46, -0.23) logMAR (p = 0.19) from 1.13 (0.61) logMAR at baseline and VA < 0.3 logMAR in 36%. The mean (95% CI) change in CST over 12 months was -114 (-189, -40) µm (p = 0.003) from a mean (SD) of 423 (151) µm at baseline for BRVO and -184(-276, -91) µm (p < 0.001) from 519 (213) µm for CRVO. Patients in both groups received a median of 2 bevacizumab injections over 12 months. Around 37% eyes were lost before 12 months’ observation. The mean VA and CST trajectory in these eyes at their last visit was similar to those that completed 12 months. Conclusion: The outcomes of RVO are inferior and the number of treatments over the 12 months fewer than those of clinical trials and other reports from routine clinical practice. Future studies to identify the barriers for undertreatment in our practice are warranted to improve the treatment outcomes.

scholarly journals Treatment outcomes of retinal vein occlusion in clinical practice in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanjeeb Bhandari ◽  
Manish Poudel ◽  
Indira Paudyal ◽  
Pratibha L. Joshi ◽  
Chunu Shrestha ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Treatment Outcomes ◽  
Retinal Vein Occlusion ◽  
Vision Loss ◽  
Routine Clinical Practice ◽  
Treatment Barriers ◽  
Future Studies ◽  
Vein Occlusion ◽  
Central Subfield Thickness ◽  
The Mean

Abstract Background This study evaluated the treatment outcomes of retinal vein occlusion (RVO) in a routine clinical practice in Nepal. Methods This was a retrospective analysis of observational data of patients with RVO who attended the retina clinic of the Tilganga Institute of Ophthalmology from 1 November 2017 to 31 October 2018. The main outcome was the mean change in visual acuity (VA) at 12 months from the start of treatment. Other outcomes of interest were the mean change in central subfield thickness (CST) and the number of treatments over 12 months. Results A total of 99 eyes (of 99 patients) with RVO (60 - branch RVO [BRVO] and 39 - central RVO [CRVO] were available for the analysis. Eyes with CRVO had worse VA and CST at baseline. Eyes in both groups were similar for age, associated factors for RVO, duration of vision loss and the presence of ischemia at baseline. The mean (95% Confidence Interval [CI]) VA change at 12 months for BRVO was − 0.35 (− 0.46, − 0.23) logMAR (p < 0.001) from a mean (SD) of 0.75 (0.42) logMAR at baseline with 63% achieving VA < 0.3 logMAR while for CRVO it was − 0.35 (− 0.46, − 0.23) logMAR (p = 0.19) from 1.13 (0.61) logMAR at baseline and VA < 0.3 logMAR in 36%. The mean (95% CI) change in CST over 12 months was − 114 (− 189, − 40) μm (p = 0.003) from a mean (SD) of 423 (151) μm at baseline for BRVO and − 184(− 276, − 91) μm (p < 0.001) from 519 (213) μm for CRVO. Patients in both groups received a median of 2 bevacizumab injections over 12 months. Around 37% eyes were lost before 12 months’ observation. The mean VA and CST trajectory in these eyes at their last visit was similar to those that completed 12 months. Conclusion The outcomes of RVO over the 12 months were inferior and the number of treatments fewer than those of the clinical trials and other reports from routine clinical practice. Future studies to identify the treatment barriers are warranted to improve the treatment outcomes in our patients.

Diagnosis and Management of Cardiomyopathies – A Focus on Genetics, Cardiac Magnetic Resonance and Clinical Features

2011 ◽  
Vol 7 (3) ◽  
pp. 225
Author(s):  
Gianfranco Sinagra ◽  
Michele Moretti ◽  
Giancarlo Vitrella ◽  
Marco Merlo ◽  
Rossana Bussani ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Molecular Genetic ◽  
Molecular Genetic Analysis ◽  
Routine Clinical Practice ◽  
Clinical Approach ◽  
Diagnosis And Management ◽  
Made In

In recent years, outstanding progress has been made in the diagnosis and treatment of cardiomyopathies. Genetics is emerging as a primary point in the diagnosis and management of these diseases. However, molecular genetic analyses are not yet included in routine clinical practice, mainly because of their elevated costs and execution time. A patient-based and patient-oriented clinical approach, coupled with new imaging techniques such as cardiac magnetic resonance, can be of great help in selecting patients for molecular genetic analysis and is crucial for a better characterisation of these diseases. This article will specifically address clinical, magnetic resonance and genetic aspects of the diagnosis and management of cardiomyopathies.

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