Updates and Advances: Pediatric Musculoskeletal Infection Imaging Made Easier for Radiologists and Clinicians

2021 ◽  
Vol 25 (01) ◽  
pp. 167-175
Author(s):  
Michael S. Furman ◽  
Ricardo Restrepo ◽  
Supika Kritsaneepaiboon ◽  
Bernard F. Laya ◽  
Domen Plut ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Imaging Techniques ◽  
Daily Clinical Practice ◽  
Infants And Children ◽  
Imaging Evaluation ◽  
Musculoskeletal Infection ◽  
Wide Range ◽  
Life Threatening ◽  
Optimal Patient Management

AbstractInfants and children often present with a wide range of musculoskeletal (MSK) infections in daily clinical practice. This can vary from relatively benign superficial infections such as cellulitis to destructive osseous and articular infections and life-threatening deep soft tissue processes such as necrotizing fasciitis. Imaging evaluation plays an essential role for initial detection and follow-up evaluation of pediatric MSK infections. Therefore, a clear and up-to-date knowledge of imaging manifestations in MSK infections in infants and children is imperative for timely and accurate diagnosis that, in turn, can result in optimal patient management. This article reviews an up-to-date practical imaging techniques, the differences between pediatric and adult MSK infections, the spectrum of pediatric MSK infections, and mimics of pediatric MSK infections encountered in daily clinical practice by radiologists and clinicians.

Selective Prescribing of Spasmolytics

2000 ◽  
Vol 34 (6) ◽  
pp. 716-720 ◽  
Author(s):  
Kris LL Movig ◽  
Antoine CG Egberts ◽  
Albert W Lenderink ◽  
Hubert GM Leufkens
Keyword(s):  
Clinical Practice ◽  
Initial Therapy ◽  
Daily Clinical Practice ◽  
New Drugs ◽  
Therapeutic Effects ◽  
Policy Makers ◽  
Pharmacy And Therapeutics Committees ◽  
Third Line ◽  
Trial Setting

BACKGROUND: Daily clinical practice often differs largely from the clinical trial setting, so extrapolation of outcomes from trial data, such as safety, effectiveness, and economic outcomes, can be deceptive. Prescribers may intend to treat a selected group of patients with new drugs; this practice could result in significant bias in assessing outcomes of these agents during their use in daily clinical practice. OBJECTIVE: To evaluate what type of patient received tolterodine compared with the spasmolytic drugs previously marketed (oxybutynin, flavoxate, emepronium). DESIGN: An observational, follow-up study. SETTING: Eighteen collaborating community pharmacies. PATIENTS: Aged ≥18 years, noninstitutionalized; initial therapy with tolterodine, oxybutynin, flavoxate, or emepronium. RESULTS: Tolterodine was often used as a second-line and even as a third-line treatment, and was prescribed to a “polluted” population in terms of concomitant psychotropic medication. Tolterodine users were 7.5 times more likely to have received another spasmolytic drug (RR 7.5, 95% CI 4.8 to 11.9). In addition, these patients more frequently used antiparkinsonian drugs (RR 4.1, 95% CI 1.6 to 10.4) as well as antipsychotic drugs (RR 2.9, 95% CI 1.4 to 6.2). There was a small difference in concomitant use of antidepressants and benzodiazepines between patients receiving tolterodine versus those taking other spasmolytic drugs. CONCLUSIONS: Tolterodine is prescribed for a population differing from that receiving previously marketed spasmolytic drugs. Selective prescribing should be recognized when evaluating new drugs in daily clinical practice. Policy makers, such as pharmacy and therapeutics committees, should consider this aspect in their formulary decisions since selective prescribing can lead to unjustified conclusions about a drug's therapeutic effects (e.g., efficacy, safety, cost-effectiveness).

Biological Dose Tapering in Daily Clinical Practice: A 10 Year Follow-up Study

2020 ◽  
Vol 16 (5) ◽  
pp. 319-323 ◽  
Author(s):  
Mercedes Alperi-López ◽  
Sara Alonso-Castro ◽  
Isla Morante-Bolado ◽  
Rubén Queiro-Silva ◽  
José Luis Riestra-Noriega ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Daily Clinical Practice ◽  
Follow Up Study ◽  
Biological Dose

Pazopanib in metastatic renal carcinoma (mRC): Experience of 31 centers in Spain in first, second, third, or subsequent lines in daily clinical practice.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15609-e15609 ◽  
Author(s):  
Angel Rodriguez Sanchez ◽  
Rocio García Domínguez ◽  
Guillermo De Velasco ◽  
Alvaro Pinto ◽  
Javier Puente ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Renal Carcinoma ◽  
Soft Tissues ◽  
Clear Cell ◽  
Daily Clinical Practice ◽  
Limited Information ◽  
Time To Treatment Failure ◽  
Metastatic Sites ◽  
Practice Methods

e15609 Background: In clinical trials pazopanib (P) was superior to placebo, noninferior to sunitinib, and very well tolerated as 1st-line for mRC, but there is limited information in daily clinical practice. Methods: We retrospectively reviewed 159 patients (p) who received P in in 31 centers in Spain during the first 18 month after P approval, to evaluate the timing of use and its efficacy. Results: Mean age was 66 y, 64.8% were males, 81.1% clear-cell, 12% non-clear cell, and 6.9% unspecified. At diagnosis of mRC 73.6% had nephrectomy, 78.6% and 71.7% of p were of good-intermediate risk (MSKCC and Heng criteria respectively). Metastatic sites were lung (59.7%), lymph nodes (26.4%), bone (22.6%), skin/soft-tissues (17.6%), liver (11.9%), CNS (2.5%), and 31.4% others (adrenal, pancreas, etc.). Median follow-up since diagnosis of mRC was 16 months (m). P was given as 1st systemic treatment in 81 p, (50.9%), as 2nd line in 32 p (20.1%, most after sunitinib, 17 due to intolerance), or as ≥3r line (46 p, 29%). Median follow-up after P was 7 m in 1st line, and 10 m in 2nd or ≥ 3rd line. Toxicity was as expected. No toxic deaths were registered. At the time of analysis, 85 p have discontinued P (progression: 73 p, toxicity: 10 p, other causes: 2 p), and 35 p have died. The table shows time to treatment failure due to progression or toxicity (TTF), and overall survival (OS) since the 1st dose of P. There were statistically significant differences in 1st line TTF and OS between MSKCC subgroups. Conclusions: In p with mRC and good-intermediate prognosis, P appears to be as effective in daily clinical practice as it was in 1st line trials. P also showed efficacy in p with poor risk, in 2nd-line (particularly progression or intolerance to sunitinib), and after 2 or more TKIs. Updated analysis will be available in June 2013. [Table: see text]

scholarly journals TCT-647 Predictors of Stent Thrombosis up to 12 Years Follow-up After Drug-Eluting Stent Implantation in Daily Clinical Practice

2014 ◽  
Vol 64 (11) ◽  
pp. B188-B189
Author(s):  
RICARDO A. COSTA ◽  
Amanda Sousa ◽  
Adriana Moreira ◽  
Jose d Costa ◽  
Galo Maldonado ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Stent Thrombosis ◽  
Stent Implantation ◽  
Daily Clinical Practice ◽  
Drug Eluting Stent ◽  
Drug Eluting

Four-Year Follow-Up of Absorb BVS Compared to Xience EES in Daily Clinical Practice Shows Continued Accrual of Events

2020 ◽  
Author(s):  
Laura Kerkmeijer ◽  
RubenY.G. Tijssen ◽  
Sjoerd H. Hofma ◽  
Rene J. van der Schaaf ◽  
E. Karin Arkenbout ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Daily Clinical Practice ◽  
Absorb Bvs

Emerging Strategies for Sensing of Blood-Stream Bacterial Diseases

2021 ◽  
pp. 16-32
Author(s):  
A. K. Mishra ◽  
Ankur Kaul ◽  
Dimple Sethi Chopra ◽  
Abhishek Thakur ◽  
Pranav Shah
Keyword(s):  
Clinical Practice ◽  
Molecular Imaging ◽  
Bacterial Infections ◽  
Imaging Techniques ◽  
Blood Stream ◽  
Blood Samples ◽  
Bacterial Diseases ◽  
Detection Of Biomarkers ◽  
Systemic Infections

Early prognosis of infection has been a major concern for clinicians worldwide. The diagnostic investigation in clinical practice focuses on resolving the complex mysteries of the deep-seated systemic infections, which are often difficult to decipher. Amongst the infectious diseases, the bacterial infections are the most ubiquitously found infections. The clinics have moved to application of molecular imaging techniques for early detection of systemic bacterial infections which even allow the follow-up during antimicrobial therapy to assess the efficacy of a particular course. Further, new age diagnostic methodology has seen a paradigm shift to the detection of biomarkers in the blood samples of patients.

scholarly journals Gingival Bleeding of a High-Flow Mandibular Arteriovenous Malformation in a Child with 8-Year Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Elvira Ferrés-Amat ◽  
Jordi Prats-Armengol ◽  
Isabel Maura-Solivellas ◽  
Eduard Ferrés-Amat ◽  
Javier Mareque-Bueno ◽  
...  
Keyword(s):  
Imaging Study ◽  
Neck Region ◽  
Arterial Embolization ◽  
High Flow ◽  
Gingival Bleeding ◽  
Clinical Presentations ◽  
Wide Range ◽  
Life Threatening ◽  
Flow Through

Intraosseous arteriovenous malformations (AVMs) in the head and neck region are uncommon. There are several types and they can have a wide range of clinical presentations. Depending on the blood flow through the AVM, the treatment may be challenging for the attending team and may lead to life-threatening hemorrhages. A clinical case report is presented. A 9-year-old girl, seen for gingival bleeding during oral hygiene, was found to have a high-flow AVM located within and around the mandible. Two-stage treatment consisted of intra-arterial embolization followed by intraoral injection of a sclerosing agent 8 weeks later. At the 8-year follow-up, imaging study showed no evidence of recurrent lesion inside or outside the bone. The final outcome is a correct occlusion with a symmetric facial result. This case shows that conservative treatment may be the first treatment option mostly in children. Arteriography and transcortical injection were enough to control the AVM.

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