scholarly journals Recognition of Immune Response for the Early Diagnosis and Treatment of Osteoarthritis

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Adrese M. Kandahari ◽  
Xinlin Yang ◽  
Abhijit S. Dighe ◽  
Dongfeng Pan ◽  
Quanjun Cui
Keyword(s):  
Quality Of Life ◽  
Immune Response ◽  
Early Diagnosis ◽  
Imaging Techniques ◽  
Disease Process ◽  
Inflammatory Cells ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Joint Disease

Osteoarthritis is a common and debilitating joint disease that affects up to 30 million Americans, leading to significant disability, reduction in quality of life, and costing the United States tens of billions of dollars annually. Classically, osteoarthritis has been characterized as a degenerative, wear-and-tear disease, but recent research has identified it as an immunopathological disease on a spectrum between healthy condition and rheumatoid arthritis. A systematic literature review demonstrates that the disease pathogenesis is driven by an early innate immune response which progressively catalyzes degenerative changes that ultimately lead to an altered joint microenvironment. It is feasible to detect this infiltration of cells in the early, and presumably asymptomatic, phase of the disease through noninvasive imaging techniques. This screening can serve to aid clinicians in potentially identifying high-risk patients, hopefully leading to early effective management, vast improvements in quality of life, and significant reductions in disability, morbidity, and cost related to osteoarthritis. Although the diagnosis and treatment of osteoarthritis routinely utilize both invasive and non-invasive strategies, imaging techniques specific to inflammatory cells are not commonly employed for these purposes. This review discusses this paradigm and aims to shift the focus of future osteoarthritis-related research towards early diagnosis of the disease process.

scholarly journals A new paradigm of screening and early diagnosis: assessment of benefits and harms

2020 ◽  
Vol 66 (6) ◽  
pp. 589-602
Author(s):  
Давид Заридзе ◽  
Dmitry Maksimovich ◽  
Ivan Stilidi
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Prostate Cancer ◽  
Clinical Trials ◽  
Early Diagnosis ◽  
The United States ◽  
Diagnostic Methods ◽  
New Paradigm

Abstract The article presents scientific evidence that confirms the new paradigm that  “early” diagnosis is not always beneficial, and that screening and early diagnosis can do more harm than good. As a result, of screening, in a number of cases, lesions are diagnosed that, although have histological patterns of cancer, are often clinically insignificant, indolent i.e. overdiagnosis takes place. Such lesions primarily include latent cancers of the prostate and thyroid gland. An increase in the incidence of certain types of cancers in the United States and other developed countries, as a result, of the introduction of PSA screening, mammography, ultrasound examination of the neck and other highly sensitive diagnostic methods, with stable or decreasing mortality, is a sign of overdiagnosis. In Russia, there is also a marked increase in the incidence of cancer of the prostate, breast, thyroid, kidney and melanoma, while mortality from these forms of cancer is stable or decreasing. The increase in the incidence of all malignant formations in Russian, as in American men, is determined by the increase in the incidence of prostate cancer. In randomized clinical trials of the efficacy of screening for prostate and breast cancer, an excess of the detected cases of cancer in the screening group compared with the control group indicates overdiagnosis. With an increase in follow-up (10-15 years), the number of excess cases in the screening group decreases. However, in some studies even after 10-15 years of follow-up, the excess of cancer cases in the screening group persisted, i.e. overdiagnosis was confirmed. Thus, the problem of overdiagnosis is also relevant to controlled clinical trials, despite a well-verified protocol and strict adherence to it. The danger of overdiagnosis in real life, daily practice, and especially with opportunistic screening, which, by definition, is carried out without quality control, is much higher. Overdiagnosis often leads to unnecessary, sometimes excessive treatment and a deterioration in the quality of life of patients who are not cancer patients. Refusal of aggressive therapy and active follow-up should be the method of choice for the management of patients with asymptomatic neoplasms identified at the screening. Such tactics will avoid unnecessary and excessive interventions, which, in turn, will prevent a deterioration in the quality of life of patients and, in addition, will reduce the cost of treatment. Key words: overdiagnosis, screening, early diagnosis, trends in incidence and mortality, prostate cancer, breast cancer, thyroid cancer

scholarly journals Early Diagnosis and Treatment of Vesicouterine Fistula Using Low-Tech Methods in Low Resource Setting of Northern Ghana. A Case Report

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Early Diagnosis ◽  
Diagnosis And Treatment ◽  
Northern Ghana ◽  
Vesicouterine Fistula ◽  
Obstetric Practice ◽  
Resource Setting ◽  
Low Resource Setting

Vesicouterine fistula is a rare but increasing phenomenon in obstetric practice. Early diagnosis and treatment will go a long way to reduce the associated morbidity as well as improve the quality of life of its victims. Our case exemplifies how the use of simple techniques can diagnose and bring great relief to such patients.

Fecal Incontinence: Nonsurgical Management

2018 ◽  
Author(s):  
Madeleine Blank ◽  
Lilian Chen
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Nonoperative Management ◽  
Disease Process ◽  
The United States ◽  
Pelvic Floor Physical Therapy ◽  
Nonsurgical Management ◽  
Accidental Bowel Leakage

Fecal incontinence is the uncontrolled passage of feces or flatus. It is a debilitating and often unrecognized condition whose prevalence is increasing with our aging population and often carries significant stigmata associated with decreased quality of life. It is also one of the leading causes of nursing home admissions in the United States. The etiology of fecal incontinence is multifactorial, with many risk factors contributing to this disease process. Treatment may be challenging and needs to be individualized. In this review, we discuss the initial evaluation of the patient presenting with fecal incontinence, adjunctive testing modalities, and nonoperative management. This review contains 6 figures, 2 tables and 50 references Key words: accidental bowel leakage, biofeedback, bowel incontinence, fecal incontinence, pelvic floor physical therapy, pelvic floor retraining

An international collaborative design of clinical nursing practice guidelines for patients with cholangiocarcinoma.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 65-65
Author(s):  
Susan Acquisto ◽  
Renuka V. Iyer ◽  
Karen M Driskill ◽  
Natasha Pinheiro ◽  
Jacqueline Weatherly ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Practice Guidelines ◽  
Nursing Practice ◽  
Disease Process ◽  
The United States ◽  
Photon Radiation ◽  
Evidence Based ◽  
Clinical Nursing ◽  
Key Aspects

65 Background: Cholangiocarcinoma (CC) accounts for approximately 3% of all gastrointestinal cancers and have a poor incident to mortality rate. The incidence in the United States (US) is 2,000-3,000 cases annually, with this rate steadily increasing during the last twenty years; this trend is not solely observed in US but also seen in Europe, Australia and Japan. The highest incidence is seen in Southeast Asia due to parasitic infection. CC presents many challenges to healthcare professionals due to the anatomic nature of CC (Lowe et al, 2015). The worldwide increase in incidence of CC is indication for the essential development of nursing practice guidelines underpinned by expert evidence and knowledge and regarding the key aspects of care. Methods: A collaboration of nursing professionals representing major cancer research institutions from around the country and the United Kingdom worked together to identify key aspects of care, the aim being to develop Clinical Nursing Practice Guidelines. The process included an exhaustive literature review using Pubmed, Uptodate, Medline, and CINAHL databases; submission of respective institutional practices; group consensus on guideline content, evidence-based scoring assignment and approval by the Cholangiocarcinoma Medical Advisory Board. Results: The guidelines developed include the care of the patient: (1) with external biliary drains and internal bile duct stents, (2) with intractable nausea and vomiting resulting from disease process, (3) with fatigue resulting from disease process, (4) undergoing chemotherapy, (5) undergoing photon radiation, (6) undergoing radiation on a clinical trial, and (7) preparing for liver transplantation. The purpose of the guidelines are to advance the scientific knowledge of the symptoms experienced, quality of life of patients with CCA, establish standards in patient care, and improve quality of care and satisfaction for patients diagnosed with CC. Conclusions: Creation of evidence-based guidelines will provide a springboard for expanded competent knowledge and a model to test for improvement in the care and quality of life of the patient with CC.

Fecal Incontinence: Nonsurgical Management

2017 ◽  
Author(s):  
Madeleine Blank ◽  
Lilian Chen
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Nonoperative Management ◽  
Disease Process ◽  
The United States ◽  
Pelvic Floor Physical Therapy ◽  
Nonsurgical Management ◽  
Accidental Bowel Leakage

Fecal incontinence is the uncontrolled passage of feces or flatus. It is a debilitating and often unrecognized condition whose prevalence is increasing with our aging population and often carries significant stigmata associated with decreased quality of life. It is also one of the leading causes of nursing home admissions in the United States. The etiology of fecal incontinence is multifactorial, with many risk factors contributing to this disease process. Treatment may be challenging and needs to be individualized. In this review, we discuss the initial evaluation of the patient presenting with fecal incontinence, adjunctive testing modalities, and nonoperative management. This review contains 6 figures, 2 tables and 50 references Key words: accidental bowel leakage, biofeedback, bowel incontinence, fecal incontinence, pelvic floor physical therapy, pelvic floor retraining

scholarly journals Screening for comorbidities in COPD

Breathe ◽  
2020 ◽  
Vol 16 (1) ◽  
pp. 190315
Author(s):  
Delphine Natali ◽  
Georges Cloatre ◽  
Philippe Hovette ◽  
Belinda Cochrane
Keyword(s):  
Quality Of Life ◽  
Early Diagnosis ◽  
Respiratory System ◽  
Current Knowledge ◽  
Outpatient Setting ◽  
The State ◽  
Diagnosis And Treatment ◽  
Screening Protocol ◽  
The Impact

Due to growing recognition of comorbidities, COPD is no longer considered a disease affecting only the respiratory system. Its management now entails the early diagnosis and treatment of comorbidities. However, although many studies have examined the impact of comorbidities on the evolution of COPD and patients’ quality of life, very few have explored the means to systematically identify and manage them. The aims of this article are to summarise the state of current knowledge about comorbidities associated with COPD and to propose a possible screening protocol in the outpatient setting, emphasising the areas needing further research.

scholarly journals One Case of Anti-Yo Antibody Positive Subacute Cerebellar Degenera

2020 ◽  
Vol 5 (7) ◽  
Keyword(s):  
Quality Of Life ◽  
Immune Response ◽  
Early Diagnosis ◽  
Patient Survival ◽  
Cerebellar Degeneration ◽  
Paraneoplastic Cerebellar Degeneration ◽  
Improve Patient Survival ◽  
Subacute Cerebellar Degeneration ◽  
Improve Patient

Subacute cerebellar degenera also known as paraneoplastic cerebellar degeneration, is one of the typical neurological lesions caused by paraneoplastic neurological syndrom. It is caused by changes in the immune response. A case of tumor-negative anti-Yo antibody-positive subacute cerebellar degeneration is reported to strengthen clinicians’ understanding of the disease. Early diagnosis of subacute cerebellar degeneration is essential to improve patient survival and quality of life.

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