Update on vertebral fractures in pituitary diseases: from research to clinical practice

HORMONES ◽  
2021 ◽  
Author(s):  
Flaminia Carrone ◽  
Salvatore Ariano ◽  
Sara Piccini ◽  
Davide Milani ◽  
Marco Mirani ◽  
...  
2018 ◽  
Vol 47 (suppl_5) ◽  
pp. v13-v60
Author(s):  
Mohd Ikhwan Marion ◽  
Kate Johnson ◽  
Silvana Vulpie ◽  
Rachael Doyle

Bone Reports ◽  
2020 ◽  
Vol 13 ◽  
pp. 100555
Author(s):  
Michael Kriegbaum Skjødt ◽  
Joeri Nicolaes ◽  
Christopher Dyer Smith ◽  
Jonas Banefelt ◽  
Florence Lebon ◽  
...  

2011 ◽  
Vol 20 (03) ◽  
pp. 239-247
Author(s):  
R. Andresen ◽  
D. Banzer ◽  
G. Möller

SummaryThe accurate and clear reporting of vertebral fractures in routine clinical practice is essential to ensure that patients with osteoporosis receive appropriate treatment to prevent the occurrence of further fractures. A statistical shape model-based vision system for semi-automated morphometry called MorphoXpress® has been developed and needs to be tested in routine clinical practice.This multi-centre medical practice evaluation pilot study compared the degree of agreement between two methods to detect vertebral body deformities in routine clinical practice: qualitative visual evaluation of conventional lateral thoracic and lumbar spine radiographs as a “gold standard” and the MorphoXpress® semi-automatic software system for vertebral morphometry.This pilot study was performed in seven participating osteo-centers in Germany. The analysis included 223 ambulatory patients with 446 conventional lateral thoracic (n = 223) and lumbar (n = 223) spine radiographs showing 2676 vertebrae from T5 to L4. Qualitative visual radiograph evaluation was performed by clinician experts, who classified vertebral shape as fractured or not fractured. MorphoXpress® was used for quantitative assessment of vertebral height in digitized radiographs by localising all morphometric points within the set range of vertebrae based on a statistical model-based vision system. Using the interactive tools in Morpho Xpress→, clinicians could refine the positions of morphometric points to their satisfaction. Agreement between the two methods was analyzed.Using qualitative visual radiograph evaluation, clinicians recognised fractures in 92 (41.3 %) patients while quantitative evaluation with MorphoXpress®with interactive manual corrections detected fractures in 85 (38.1 %) patients. Distribution of fractures was comparable using the two methods. The Morpho Xpress→ system alone identified 76 % of the fractured vertebrae correctly. This result was improved to 98 % using additional manual corrections by the clinician once. The overall mean time needed for MorphoXpress® fracture morphometric assessment of vertebral fractures in clinical practice took 13 minutes and 36 seconds.Quantitative measurement using the current version of the MorphoXpress® software system for vertebral morphometry in combination with qualitative interactive corrections by clinicians seems to be a valuable tool for assessment and follow-up documentation of osteoporotic vertebral deformities in patients without severe scoliosis in epidemiological studies and clinical drug trials only. Currently the technique is too timeconsuming and only after significant improvement of the procedure time and following appropriate training for physicians, MorphoXpress® vertebral morphometry could be a valuable tool in daily routine clinical use for osteoporotic patients.


2020 ◽  
Vol 48 (5) ◽  
pp. 2295-2305
Author(s):  
Jiawei Zhang ◽  
Dandan Li ◽  
Rui Zhang ◽  
Peng Gao ◽  
Rongxue Peng ◽  
...  

The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.


2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.


2019 ◽  
Vol 4 (2) ◽  
pp. 322-324
Author(s):  
Thomas F. Burke

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.


2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.


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