scholarly journals How Frequently Is Asthma Objectively Demonstrated before Starting a Biologic? Quality Assessment of a Group Practice of Allergists and Immunologists

2020 ◽  
Vol 17 (24) ◽  
pp. 9482
Author(s):  
Iwona Dziewa ◽  
Timothy Craig ◽  
Taha Al-Shaikhly
Keyword(s):  
Quality Assessment ◽  
Severe Asthma ◽  
Diagnostic Methods ◽  
Group Practice ◽  
Asthma Diagnosis ◽  
Systemic Corticosteroids ◽  
Quality Assessment Study ◽  
Proper Diagnosis ◽  
And Control ◽  
Current Guidelines

Worldwide, asthma-related healthcare cost remains a major burden. Individuals with severe asthma account for 50% of that cost. Although they are expensive, biologics such as anti-IL5 and anti-IgE agents promise cost-effectiveness when judiciously used to decrease asthma-related hospitalization and the debilitating side effects of systemic corticosteroids. Before considering biologics to treat patients with asthma, current guidelines recommend confirmation of asthma and control of comorbid diseases. Diagnostic confirmation of asthma can be challenging among individuals with severe asthma. In this quality assessment study, we determined the frequency of objective asthma confirmation and addressing of comorbidities prior to starting biologics at a group practice of allergists and immunologists. We surveyed our specialty providers to understand habit(s) leading to the observed results. We identified 40 adult patients who started on biologic modifiers for asthma over the past 5 years. Only 58% of these patients had a proper diagnosis of asthma. Providers underutilized several diagnostic methods that may prove useful in confirming asthma diagnosis in this patient population. The factors contributing to poor asthma control were rarely addressed. A sense of urgency to initiate biologics was the primary reason for the observed results. Further interventions are needed to improve asthma diagnosis and management prior to the initiation of biologic therapeutics.

The Prospects and Risks Connected with Increasing the Level of Self-Organisation in Students

2020 ◽  
pp. 75-81
Author(s):  
Svetlana Alexandrovna Kosareva ◽  
Keyword(s):  
Higher Education ◽  
Professional Competence ◽  
Initial Level ◽  
Education Institution ◽  
Diagnostic Methods ◽  
Study Guide ◽  
Learning Approaches ◽  
Control Groups ◽  
Self Organisation ◽  
And Control

The paper describes the method for increasing the level of self-organisation in students which has been developed by the author. It also contains the method testing results and presents the prospects and risks teachers could face while applying the method in a higher education institution. The purpose of this study is to find out the prospects and risks of applying the method for increasing the level of self-organisation in students and to determine the ways of reducing the risks. Methodology. The author points out the learning approaches which were the basis of developing the method and describes diagnostic methods for determining students’ self-organisation levels. The work focused on increasing each student’s initial level consists of a theoretical and a practical part and includes project activities on creating a study guide. The results of the study. The method developed proved to be effective. It was established by diagnosing the final level of self-organisation in students in the experimental and control groups. The paper considers the advantages of the method among which there is universal character, flexibility, improvements to teacher’s and students’ professional competence, etc. At the same time it is necessary to be aware of the risks due to the increased amount of teacher’s work and the fact that students’ work within the project tends to be monotonous. In conclusion, the prospects of the method for increasing the level of self-organisation in students are related to its advantages and the final results of the work. The risks of its use can be reduced with the help of the measures proposed in the paper.

scholarly journals Quality assessment of brands of erythromycin stearate tablets marketed in Abuja, Nigeria

2020 ◽  
Vol 17 (1) ◽  
pp. 29-33
Author(s):  
Kudirat B. Mustapha ◽  
Marlene D. Ekpo ◽  
Isa H. Galadima ◽  
Rukaiyatu A. Kirim ◽  
Olubukola A. Odeniran ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Quality Evaluation ◽  
Hardness Test ◽  
Spectrophotometric Analysis ◽  
Assessment Study ◽  
Uniformity Test ◽  
Quality Assessment Study ◽  
Percentage Weight ◽  
Pharmaceutical Industries ◽  
Erythromycin Stearate

Erythromycin is one of the most frequently prescribed antibiotics. With the increasing number of pharmaceutical industries, the possibility of  purchasing a substandard product is on the high side. This makes it necessary to subject various commercially produced brands of erythromycin to quality evaluation in order to ascertain the quality. In this quality assessment study, six (6) brands of erythromycin tablets were subjected to physicochemical assay using standard physical methods and UV/VIS spectrophotometric analysis at 480 nm. The calibration curve for reference erythromycin was linear over a concentration range of 10-100 μg/ml with a correlation coefficient (R2) of 0.999. All the brands had standard deviation of weight greater than ±5 for the weight uniformity test. 66.67% of the brands passed the test for content of active ingredient. 83.33% of the brands examined passed the hardness test. All the brands failed the friability test because the percentage weight loss are greater than 1% as specified in the official book. Keywords: Erythromycin stearate; Tablets; Brands; Pharmaceutical Industries

scholarly journals The problems of increasing transparency on uncertainty

2017 ◽  
Vol 27 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Magda Osman ◽  
Amanda J. Heath ◽  
Ragnar Löfstedt
Keyword(s):  
Decision Making ◽  
Disease Prevention ◽  
Prevention And Control ◽  
Scientific Evidence ◽  
European Medicines Agency ◽  
Scientific Process ◽  
The Public ◽  
And Control ◽  
Current Guidelines ◽  
Practical Implications

Public regulators (such as European Food Safety Authority, European Medicines Agency, and European Centre for Disease Prevention and Control) are placing increasing demands on scientists to make uncertainties about their evidence transparent to the public. The stated goal is utilitarian, to inform and empower the public and ensure the accountability of policy and decision-making around the use of scientific evidence. However, it is questionable what constitutes uncertainty around the evidence on any given topic, and, while the goal is laudable, we argue the drive to increase transparency on uncertainty of the scientific process specifically does more harm than good, and may not serve the interests of those intended. While highlighting some of the practical implications of making uncertainties transparent using current guidelines, the aim is to discuss what could be done to make it worthwhile for both public and scientists.

The role of systemic corticosteroids in severe asthma and new evidence in their management and tapering

2021 ◽  
Author(s):  
Francesco Menzella ◽  
Giulia Ghidoni ◽  
Matteo Fontana ◽  
Silvia Capobelli ◽  
Francesco Livrieri ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Systemic Corticosteroids ◽  
New Evidence

The relationship between BMI, leptin, leptin receptors (LepR) and Foxp3+ Tregs cells in women with asthma

2016 ◽  
Vol 51 (4) ◽  
pp. 277-284
Author(s):  
Łukasz Kraszula ◽  
Makandjou-Ola Eusebio ◽  
Anna Jasińska ◽  
Maciej Kupczyk ◽  
Piotr Kuna ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Leptin Receptor ◽  
Control Group ◽  
Soluble Receptor ◽  
Leptin Receptors ◽  
Global Initiative For Asthma ◽  
Moderate Disease ◽  
Global Initiative ◽  
And Control ◽  
The Relationship

The aim of this study was evaluation whether there is an association between BMI, leptin and its soluble receptor, the expression of FoxP3 in CD4+ pTreg in women with severe asthma. Materials and methods. The study included thirty women with asthma: 17 patients with severe and 13 with mild-moderate disease. The control group comprised of 25 healthy women. Asthma was diagnosed in accordance with the Global Initiative For Asthma guidelines (GINA 2014). The phenotype of CD4+CD25highCD127lowFoxp3+CD152+ cells was evaluated by multicolor flow cytometry. The concentration of leptin and its soluble receptor were determined using an immunoenzymatic method (ELISA). Results. It has been shown significantly increased leptin concentration in the group of women with severe asthma compared with mild-moderate asthma and control group (p <0.05). The concentration of the leptin receptor significantly increased (p <0.05) in women with severe asthma compared with control group. There were no differences in percentage of CD4+FoxP3+ and CD4+CD25highCD127low- FoxP3+CD152+ subsets after leptin stimulation in all tested groups. Conclusions. Our results don’t confirm the direct effect of leptin on the CD4+ pTreg cells and the expression of FoxP3 in these cells, in tested groups.

Diagnosis of deep-vein thrombosis: Adherence to guidelines and outcomes in real-world health care

2009 ◽  
Vol 102 (12) ◽  
pp. 1234-1240 ◽  
Author(s):  
Horst Gerlach ◽  
Viola Hach-Wunderle ◽  
Eberhard Rabe ◽  
Hanno Riess ◽  
Heike Carnarius ◽  
...  
Keyword(s):  
Health Care ◽  
Deep Vein Thrombosis ◽  
Ambulatory Care ◽  
Real World ◽  
Diagnostic Methods ◽  
World Health ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Work Up ◽  
Current Guidelines

SummaryCurrent guidelines recommend optimised algorithms for diagnosis of suspected deep-vein thrombosis (DVT). There is little data to determine to what extent real-world health care adheres to guidelines, and which outcome in terms of diagnostic efficiency and safety is achieved. This registry involved patients with clinically suspected DVT of the leg recruited in German ambulatory care between October and December 2005. Registry items were: diagnostic methods applied; diagnostic categories at day 1; and venous thromboembolic events up to 90 days in patients without firmly established DVT. A total of 4,976 patients were recruited in 326 centres. Venous ultrasonography was performed in 4,770 patients (96%), D-dimer assay in 1,773 patients (36%) and venography in 288 patients (6%). At day 1, DVT was confirmed in 1,388 patients (28%), and ruled out in 3,389 patients (68%), and work-up was inconclusive in 199 patients (4%).The rate of venous thromboembolism at 90 days was 0.34% (95% confidence interval [CI]: 0.09 to 0.88) in patients in whom the diagnosis of DVT had been ruled out, and 2.50% (95% CI: 0.69 to 6.28) in patients with inconclusive diagnostic workup. This nationwide evaluation in German ambulatory care revealed that the diagnostic work-up for suspected DVT did not adhere to current guidelines. However, the overall diagnostic safety was excellent, although there is potential for improvement in a well defined minority of patients.The TULIPA registry was funded by GlaxoSmithKline GmbH und Co KG, Munich.

scholarly journals An objective and subjective quality assessment study of passive gaming video streaming

2018 ◽  
Vol 30 (3) ◽  
Author(s):  
Nabajeet Barman ◽  
Saman Zadtootaghaj ◽  
Steven Schmidt ◽  
Maria G. Martini ◽  
Sebastian Möller
Keyword(s):  
Quality Assessment ◽  
Video Streaming ◽  
Subjective Quality ◽  
Subjective Quality Assessment ◽  
Assessment Study ◽  
Quality Assessment Study

A point-of-care diagnostic for differentiating Ebola from endemic febrile diseases

2018 ◽  
Vol 10 (471) ◽  
pp. eaat0944 ◽  
Author(s):  
David Sebba ◽  
Alexander G. Lastovich ◽  
Melody Kuroda ◽  
Eric Fallows ◽  
Joshua Johnson ◽  
...  
Keyword(s):  
Ebola Virus ◽  
Clinical Symptoms ◽  
Point Of Care ◽  
Hemorrhagic Fever ◽  
Diagnostic Methods ◽  
Outbreak Detection ◽  
Molecular Diagnostic ◽  
Clinical Samples ◽  
Live Virus ◽  
And Control

Hemorrhagic fever outbreaks such as Ebola are difficult to detect and control because of the lack of low-cost, easily deployable diagnostics and because initial clinical symptoms mimic other endemic diseases such as malaria. Current molecular diagnostic methods such as polymerase chain reaction require trained personnel and laboratory infrastructure, hindering diagnostics at the point of need. Although rapid tests such as lateral flow can be broadly deployed, they are typically not well-suited for differentiating among multiple diseases presenting with similar symptoms. Early detection and control of Ebola outbreaks require simple, easy-to-use assays that can detect and differentiate infection with Ebola virus from other more common febrile diseases. Here, we developed and tested an immunoassay technology that uses surface-enhanced Raman scattering (SERS) tags to simultaneously detect antigens from Ebola, Lassa, and malaria within a single blood sample. Results are provided in <30 min for individual or batched samples. Using 190 clinical samples collected from the 2014 West African Ebola outbreak, along with 163 malaria positives and 233 negative controls, we demonstrated Ebola detection with 90.0% sensitivity and 97.9% specificity and malaria detection with 100.0% sensitivity and 99.6% specificity. These results, along with corresponding live virus and nonhuman primate testing of an Ebola, Lassa, and malaria 3-plex assay, indicate the potential of the SERS technology as an important tool for outbreak detection and clinical triage in low-resource settings.

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