scholarly journals Individualized Drugs’ Selection by Evaluation of Drug Properties, Pharmacogenomics and Clinical Parameters: Performance of a Bioinformatic Tool Compared to a Clinically Established Counselling Process

2021 ◽  
Vol Volume 14 ◽  
pp. 955-962
Author(s):  
Marina Borro ◽  
Giovanna Gentile ◽  
Sally H Preissner ◽  
Leda Marina Pomes ◽  
Björn-Oliver Gohlke ◽  
...  
Keyword(s):  
Clinical Parameters ◽  
Bioinformatic Tool ◽  
Counselling Process

Healing venous ulcers with different modalities of leg compression

Phlebologie ◽  
2006 ◽  
Vol 35 (05) ◽  
pp. 349-355 ◽  
Author(s):  
E. O. Brizzio ◽  
G. Rossi ◽  
A. Chirinos ◽  
I. Cantero ◽  
G. Idiazabal ◽  
...  
Keyword(s):  
Wound Care ◽  
Univariate Analysis ◽  
Compression Therapy ◽  
Healing Time ◽  
Clinical Parameters ◽  
Compression Stockings ◽  
Local Pressure ◽  
Ulcer Size ◽  
Venous Ulcers ◽  
Unexpected Findings

Summary Background: Compression therapy (CT) is the stronghold of treatment of venous leg ulcers. We evaluated 5 modalities of CT in a prospective open pilot study using a unique trial design. Patients and methods: A group of experienced phlebologists assigned 31 consecutive patients with 35 venous ulcers (present for 2 to 24 months with no prior CT) to 5 different modalities of leg compression, 7 ulcers to each group. The challenge was to match the modality of CT with the features of the ulcer in order to achieve as many healings as possible. Wound care used standard techniques and specifically tailored foam pads to increase local pressure. CT modalities were either stockings Sigvaris® 15-20, 20-30, 30-40 mmHg, multi-layer bandages, or CircAid® bandaging. Compression was maintained day and night in all groups and changed at weekly visits. Study endpoints were time to healing and the clinical parameters predicting the outcome. Results: The cumulative healing rates were 71%, 77%, and 83% after 3, 6, and 9 months, respectively. Univariate analysis of variables associated with nonhealing were: previous surgery, presence of insufficient perforating and/or deep veins, older age, recurrence, amount of oedema, time of presence of CVI and the actual ulcer, and ulcer size (p <0.05-<0.001). The initial ulcer size was the best predictor of the healing-time (Pearson r=0.55, p=0.002). The modality of CT played an important role also, as 19 of 21 ulcers (90%) healed with stockings but only 8 of 14 with bandages (57%; p=0.021). Regression analysis allowed to calculate a model to predict the healing time. It compensated for the fact that patients treated with low or moderate compression stockings were at lower risk of non-healing. and revealed that healing with stockings was about twice as rapid as healing with bandages. Conclusion: Three fourths of venous ulcers can be brought to healing within 3 to 6 months. Healing time can be predicted using easy to assess clinical parameters. Irrespective of the initial presentation ulcer healing appeared more rapid with the application of stockings than with bandaging. These unexpected findings contradict current believes and require confirmation in randomised trials.

Sophistry and Circumstance at the End of Life

2008 ◽  
Vol 5 (1) ◽  
pp. 81-88
Author(s):  
Philip Berry
Keyword(s):  
Liver Failure ◽  
Medical Personnel ◽  
Medical Decision ◽  
Loss Of Consciousness ◽  
Supportive Treatment ◽  
Medical Decisions ◽  
Life Threatening Illness ◽  
Two Factors ◽  
Life Threatening ◽  
Counselling Process

When life-threatening illness robs a patient of the ability to express their desires, medical personnel must work through the issues of management and prognosis with relatives. Management decisions are guided by medical judgement and the relatives’ account of the patient’s wishes, but difficulties occur when distance grows between these two factors. In these circumstances the counselling process may turn into a doctor-led justification of the medical decision. This article presents two strands of dialogue, in which a doctor, counselling for and against continuation of supportive treatment in two patients with liver failure, demonstrates selectivity and inconsistency in constructing an argument. The specific issues of loss of consciousness (with obscuration of personal identity), statistical ‘futility’ and removal of autonomy are explored and used to bolster diametrically opposed medical decisions. By examining the doctor’s ability to interpret these issues according to circumstance, the author demonstrates how it is possible to shade medical facts depending on the desired outcome.

Assessment of healing of dental implant surgical site following Low-Level Laser Therapy using Bio-Clinical parameters: An Exploratory Study

2020 ◽  
Author(s):  
VARSHA PALLED ◽  
DR. JITENDRA RAO ◽  
DR. RAGHUWAR DAYAL SINGH ◽  
DR. SHUCHI TRIPATHI ◽  
DR. KALPANA SINGH ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Test Group ◽  
Low Level Laser Therapy ◽  
Control Group ◽  
Clinical Parameters ◽  
Implant Stability ◽  
Low Level ◽  
Implant Stability Quotient ◽  
Low Level Laser ◽  
Level Laser

The purpose of this study was to evaluate whether Low-Level Laser Therapy (LLLT) improves the healing of the implant surgical site with clinical and biochemical parameters.Thirty patients with an edentulous space spanning a single tooth were selected. The patients were randomly allocated to two groups - the control group and the test group. The test group received laser energy at a power of 2J/cm 2 with a total of 4-6J energy over each implant. Clinical parameters (Implant Stability Quotient, probing index, modified sulcus bleeding index)and osteoprotegerin (OPG) were assessed at baseline and follow-up intervals (2 weeks, 6 weeks, and 3 months).The test group showed significantly higher implant stability quotient compared to thecontrol group at 2 weeks(57.93±3.95 and 35.67±3.08; p&lt;0.01) and 3months(58.86±3.75 and 67.06±3.78; p&lt;0.01). A significant rise in OPG levels of the test group(686.30±125.36pg/ml at baseline and 784.25±108.30pg/ml at 3months;p&lt;0.01) was seen contrary to significant decline in the control group (839.50±249.08pg/ml at baseline,415.30±78.39pg/ml at 3months;p&lt;0.01). Within the limitations of the study, the study suggests that the healing of peri-implant hard and soft tissues may be enhanced with the use of LLLT as an explicit modality during the post-operative period.

Discovering Associations Comparing Directly Clinical Parameters with Different Dimensional Units

2014 ◽  
Vol 2014 (2) ◽  
pp. 139-151
Author(s):  
Miguel Murguía-Romero ◽  
◽  
Rafael Jiménez-Flores ◽  
René Méndez-Cruz ◽  
Rafael Villalobos-Molina ◽  
...  
Keyword(s):  
Clinical Parameters

733-P: Postprandial Glucose Variability in People with Type 1 Diabetes Is Individual and Impacted by Physiological and Clinical Parameters

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 733-P
Author(s):  
CASSY F.B. DINGENA ◽  
AILSA MARSH ◽  
RAMZI AJJAN ◽  
MATTHEW CAMPBELL
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Variability ◽  
Postprandial Glucose ◽  
Clinical Parameters
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