scholarly journals Intravenous Irons: From Basic Science to Clinical Practice

2018 ◽  
Vol 11 (3) ◽  
pp. 82 ◽  
Author(s):  
Sunil Bhandari ◽  
Dora Pereira ◽  
Helen Chappell ◽  
Hal Drakesmith
Keyword(s):  
Clinical Practice ◽  
Colloidal Suspensions ◽  
Evidence Base ◽  
Third Generation ◽  
Iron Release ◽  
Complete Replacement ◽  
Future Clinical Practice ◽  
Gastrointestinal Side Effects ◽  
Iv Iron ◽  
Carbohydrate Ligand

Iron is an essential trace mineral necessary for life, and iron deficiency anaemia (IDA) is one of the most common haematological problems worldwide, affecting a sixth of the global population. Principally linked to poverty, malnutrition and infection in developing countries, in Western countries the pathophysiology of IDA is primarily linked to blood loss, malabsorption and chronic disease. Oral iron replacement therapy is a simple, inexpensive treatment, but is limited by gastrointestinal side effects that are not inconsequential to some patients and are of minimal efficacy in others. Third generation intravenous (IV) iron therapies allow rapid and complete replacement dosing without the toxicity issues inherent with older iron preparations. Their characteristic, strongly-bound iron-carbohydrate complexes exist as colloidal suspensions of iron oxide nanoparticles with a polynuclear Fe(III)-oxyhydroxide/oxide core surrounded by a carbohydrate ligand. The physicochemical differences between the IV irons include mineral composition, crystalline structure, conformation, size and molecular weight, but the most important difference is the carbohydrate ligand, which influences complex stability, iron release and immunogenicity, and which is a unique feature of each drug. Recent studies have highlighted different adverse event profiles associated with third-generation IV irons that reflect their different structures. The increasing clinical evidence base has allayed safety concerns linked to older IV irons and widened their clinical use. This review considers the properties of the different IV irons, and how differences might impact current and future clinical practice.

Hybrid Telecoaching for Corporate Speech Training and Potential Applications to Clinical Practice

2019 ◽  
Vol 4 (2) ◽  
pp. 322-324
Author(s):  
Thomas F. Burke
Keyword(s):  
Clinical Practice ◽  
Engineering Teams ◽  
Corporate Strategies ◽  
Corporate Speech ◽  
Phone Calls ◽  
Future Clinical Practice ◽  
Fortune 100 ◽  
Potential Applications ◽  
Language Pathology ◽  
Development Engineering

Purpose The purpose of this article was to describe a model for “hybrid speech telecoaching” developed for a Fortune 100 organization and offer a “thought starter” on how clinicians might think of applying these corporate strategies within future clinical practice. Conclusion The author contends in this article that corporate telecommunications and best practices gleaned from software development engineering teams can lend credibility to e-mail, messaging apps, phone calls, or other emerging technology as viable means of hybrid telepractice delivery models and offer ideas about the future of more scalable speech-language pathology services.

Genetic and epigenetic variation in vulvar cancer: Current research and future clinical practice

2014 ◽  
Vol 54 (5) ◽  
pp. 406-411 ◽  
Author(s):  
Rebekah E. McWhirter ◽  
James R. Marthick ◽  
Jacqueline A. Boyle ◽  
Joanne L. Dickinson
Keyword(s):  
Clinical Practice ◽  
Vulvar Cancer ◽  
Epigenetic Variation ◽  
Future Clinical Practice

scholarly journals Hypoxia-Inducible Factor Stabilizers in End Stage Kidney Disease: “Can the Promise Be Kept?”

2021 ◽  
Vol 22 (22) ◽  
pp. 12590
Author(s):  
Giuseppina Crugliano ◽  
Raffaele Serra ◽  
Nicola Ielapi ◽  
Yuri Battaglia ◽  
Giuseppe Coppolino ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Cardiovascular Events ◽  
Iron Supplementation ◽  
Hypoxia Inducible Factor ◽  
Current Treatment ◽  
Prolyl Hydroxylase ◽  
Individual Risk ◽  
Increased Risk ◽  
Gastrointestinal Side Effects ◽  
Iv Iron

Anemia is a common complication of chronic kidney disease (CKD). The prevalence of anemia in CKD strongly increases as the estimated Glomerular Filtration Rate (eGFR) decreases. The pathophysiology of anemia in CKD is complex. The main causes are erythropoietin (EPO) deficiency and functional iron deficiency (FID). The administration of injectable preparations of recombinant erythropoiesis-stimulating agents (ESAs), especially epoetin and darbepoetin, coupled with oral or intravenous(iv) iron supplementation, is the current treatment for anemia in CKD for both dialysis and non-dialysis patients. This approach reduces patients’ dependence on transfusion, ensuring the achievement of optimal hemoglobin target levels. However, there is still no evidence that treating anemia with ESAs can significantly reduce the risk of cardiovascular events. Meanwhile, iv iron supplementation causes an increased risk of allergic reactions, gastrointestinal side effects, infection, and cardiovascular events. Currently, there are no studies defining the best strategy for using ESAs to minimize possible risks. One class of agents under evaluation, known as prolyl hydroxylase inhibitors (PHIs), acts to stabilize hypoxia-inducible factor (HIF) by inhibiting prolyl hydroxylase (PH) enzymes. Several randomized controlled trials showed that HIF-PHIs are almost comparable to ESAs. In the era of personalized medicine, it is possible to envisage and investigate specific contexts of the application of HIF stabilizers based on the individual risk profile and mechanism of action.

scholarly journals The Evolving Role of Catheter Ablation in Patients With Heart Failure and AF

2019 ◽  
Vol 8 (1) ◽  
pp. 47-53
Author(s):  
Sandeep Prabhu ◽  
Wei H Lim ◽  
Richard J Schilling
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Catheter Ablation ◽  
Patient Group ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Evidence Base ◽  
Patients With Heart Failure ◽  
Recent Developments

AF and heart failure are emerging epidemics worldwide. Several recent trials have provided a growing evidence base for the benefits of catheter ablation in this patient group, which are yet to be universally adopted in clinical practice guidelines. This paper provides a summary of recent developments in this field and provides pragmatic advice to the treating physician regarding the appropriate role of catheter ablation in the overall management of patients with comorbid AF and heart failure.

scholarly journals Implementation—The Missing Link in the Research Translation Pipeline: Is It Any Wonder No One Ever Implements Evidence-Based Practice?

2018 ◽  
Vol 32 (9) ◽  
pp. 751-761 ◽  
Author(s):  
Elizabeth A. Lynch ◽  
Brigit M. Chesworth ◽  
Louise A. Connell
Keyword(s):  
Clinical Practice ◽  
Stroke Rehabilitation ◽  
Evaluation Research ◽  
Well Being ◽  
Professional Associations ◽  
Evidence Base ◽  
Care Practice ◽  
Research Translation ◽  
Evidence Based ◽  
Rehabilitation Research

Despite the exponential growth in the evidence base for stroke rehabilitation, there is still a paucity of knowledge about how to consistently and sustainably deliver evidence-based stroke rehabilitation therapies in clinical practice. This means that people with stroke will not consistently benefit from research breakthroughs, simply because clinicians do not always have the skills, authority, knowledge or resources to be able to translate the findings from a research trial and apply these in clinical practice. This “point of view” article by an interdisciplinary, international team illustrates the lack of available evidence to guide the translation of evidence to practice in rehabilitation, by presenting a comprehensive and systematic content analysis of articles that were published in 2016 in leading clinical stroke rehabilitation journals commonly read by clinicians. Our review confirms that only a small fraction (2.5%) of published stroke rehabilitation research in these journals evaluate the implementation of evidence-based interventions into health care practice. We argue that in order for stroke rehabilitation research to contribute to enhanced health and well-being of people with stroke, journals, funders, policy makers, researchers, clinicians, and professional associations alike need to actively support and promote (through funding, conducting, or disseminating) implementation and evaluation research.

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