scholarly journals Long-term noninvasive ventilation in COPD: current evidence and future directions

2021 ◽  
pp. 1-13
Author(s):  
Daniel S Majorski ◽  
Marieke L Duiverman ◽  
Wolfram Windisch ◽  
Sarah B Schwarz
Keyword(s):  
Noninvasive Ventilation ◽  
Current Evidence ◽  
Future Directions

scholarly journals Predicting Long-term Disability in Multiple Sclerosis: A Narrative Review of Current Evidence and Future Directions

2021 ◽  
Author(s):  
Bianca Weinstock-Guttman ◽  
Maria Pia Sormani ◽  
Pavle Repovic
Keyword(s):  
Multiple Sclerosis ◽  
Disease Progression ◽  
Panel Discussion ◽  
Current Evidence ◽  
Future Directions ◽  
Current State ◽  
Published Evidence ◽  
Disability Status ◽  
Insight Into

Abstract The ability to reliably monitor disease progression in patients with multiple sclerosis (MS) is integral to patient care. The Expanded Disability Status Scale (EDSS) is a commonly used tool to assess the disability status of patients with MS; however, it has limited sensitivity in detecting subtle changes in disability levels and, as a result, does not consistently provide clinicians with accurate insight into disease progression. At the 2019 European Committee for Treatment and Research in Multiple Sclerosis meeting in Stockholm, Sweden, a panel of neurologists met to discuss the limitations of the EDSS as a short-term predictor of MS progression. Prior to this panel discussion, a targeted literature review was conducted to evaluate published evidence on prognostic measures such as fatigue, physical assessments, and measures that are more taxing for patients, all of which may be useful to clinicians at different stages of the course of MS. This article summarizes currently available evidence in support of these measures. In addition, this article highlights the current state of expert clinical consensus regarding the current approaches used to predict and monitor disease progression and offers insight for future studies to assist clinicians in accurately monitoring disease progression in patients with MS.

Telehealth for rehabilitation and recovery after stroke: State of the evidence and future directions

2022 ◽  
pp. 174749302110624
Author(s):  
Coralie English ◽  
Maria Gabriella Ceravolo ◽  
Simone Dorsch ◽  
Avril Drummond ◽  
Dorcas BC Gandhi ◽  
...  
Keyword(s):  
Stroke Rehabilitation ◽  
Rapid Review ◽  
Current Evidence ◽  
Future Directions ◽  
Virtual Care ◽  
Clinical Community ◽  
Type 2 Error ◽  
Key Terms

Aims: The aim of this rapid review and opinion paper is to present the state of the current evidence and present future directions for telehealth research and clinical service delivery for stroke rehabilitation. Methods: We conducted a rapid review of published trials in the field. We searched Medline using key terms related to stroke rehabilitation and telehealth or virtual care. We also searched clinical trial registers to identify key ongoing trials. Results: The evidence for telehealth to deliver stroke rehabilitation interventions is not strong and is predominantly based on small trials prone to Type 2 error. To move the field forward, we need to progress to trials of implementation that include measures of adoption and reach, as well as effectiveness. We also need to understand which outcome measures can be reliably measured remotely, and/or develop new ones. We present tools to assist with the deployment of telehealth for rehabilitation after stroke. Conclusion: The current, and likely long-term, pandemic means that we cannot wait for stronger evidence before implementing telehealth. As a research and clinical community, we owe it to people living with stroke internationally to investigate the best possible telehealth solutions for providing the highest quality rehabilitation.

How much do we know about the long-term effectiveness of parenting programmes? Advances, shortcomings, and future directions

2015 ◽  
Vol 10 (2) ◽  
pp. 120-132 ◽  
Author(s):  
Metin Özdemir
Keyword(s):  
Cost Effective ◽  
Well Being ◽  
Conclusive Evidence ◽  
Current Evidence ◽  
Causal Inferences ◽  
Future Directions ◽  
Content Type ◽  
Problem Behaviours ◽  
Parent Outcomes

Purpose – Parenting programmes are seen as feasible and cost-effective in preventing early behavioural problems in children and adolescents. A number of studies have concluded that such programmes are effective in reducing child problem behaviours and improving the skills and well-being of parents. Nevertheless, less is known about long-term programme effects. The paper aims to discuss these issues. Design/methodology/approach – A non-meta-analytic discussion. Findings – Long-term evaluations of parenting programmes suffer from a number of methodological weaknesses resulting in an inability to make robust causal inferences about child and parent outcomes in the longer term. The current evidence is favourable but is likely to be biased by methodological weaknesses. There is a need for more studies of greater methodological strength to obtain conclusive evidence that would guide empirical research, practice and policy. Originality/value – The paper discusses weaknesses in long-term evaluations of parenting programmes and highlights concrete future directions towards improving the quality of study design, evaluation and data analysis.

Levosimendan to facilitate weaning from cardiorespiratory support in critically ill patients: current evidence and future directions

2020 ◽  
Vol 86 (6) ◽  
Author(s):  
Fabio Sangalli ◽  
Giacomo Bellani ◽  
Alessandro Affronti ◽  
Francesca Volpi ◽  
Marco Feri ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Current Evidence ◽  
Future Directions

Integrated Biomarkers for Depression in Alzheimer’s Disease: A Critical Review

2017 ◽  
Vol 14 (4) ◽  
pp. 441-452 ◽  
Author(s):  
Sofia Wenzler ◽  
Christian Knochel ◽  
Ceylan Balaban ◽  
Dominik Kraft ◽  
Juliane Kopf ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Affect Regulation ◽  
Current Evidence ◽  
Diagnostic Process ◽  
Neuropsychiatric Manifestation ◽  
The Brain ◽  
Control Functional

Depression is a common neuropsychiatric manifestation among Alzheimer’s disease (AD) patients. It may compromise everyday activities and lead to a faster cognitive decline as well as worse quality of life. The identification of promising biomarkers may therefore help to timely initiate and improve the treatment of preclinical and clinical states of AD, and to improve the long-term functional outcome. In this narrative review, we report studies that investigated biomarkers for AD-related depression. Genetic findings state AD-related depression as a rather complex, multifactorial trait with relevant environmental and inherited contributors. However, one specific set of genes, the brain derived neurotrophic factor (BDNF), specifically the Val66Met polymorphism, may play a crucial role in AD-related depression. Regarding neuroimaging markers, the most promising findings reveal structural impairments in the cortico-subcortical networks that are related to affect regulation and reward / aversion control. Functional imaging studies reveal abnormalities in predominantly frontal and temporal regions. Furthermore, CSF based biomarkers are seen as potentially promising for the diagnostic process showing abnormalities in metabolic pathways that contribute to AD-related depression. However, there is a need for standardization of methodological issues and for replication of current evidence with larger cohorts and prospective studies.

Cognitive Treatment for OCD

2012 ◽  
Author(s):  
Maureen L. Whittal ◽  
Melisa Robichaud
Keyword(s):  
Term Treatment ◽  
Future Directions ◽  
Cognitive Treatment ◽  
Long Term Treatment ◽  
Inflated Responsibility ◽  
And Control ◽  
The Relationship ◽  
Control Of Thoughts

The cornerstone of cognitive treatment (CT) for OCD is based upon the knowledge that unwanted intrusions are essentially a universal experience. As such, it is not the presence of the intrusion that is problematic but rather the associated meaning or interpretation. Treatment is flexible, depending upon the nature of the appraisals and beliefs, but can include strategies focused on inflated responsibility and overestimation of threat, importance and control of thoughts, and the need for perfectionism and certainty. The role of concealment and the relationship to personal values are important maintaining and etiological factors. The short-term and long-term treatment outcome is reviewed, along with predictors of treatment response and mechanisms of action, and the chapter concludes with future directions regarding CT for OCD.

scholarly journals Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2084
Author(s):  
Kostas Nizamis ◽  
Alkinoos Athanasiou ◽  
Sofia Almpani ◽  
Christos Dimitrousis ◽  
Alexander Astaras
Keyword(s):  
Point Of Care ◽  
Brain Activity ◽  
Technological Evolution ◽  
Future Directions ◽  
Specific Patient ◽  
Cord Injury ◽  
Hybrid Solutions ◽  
New Research ◽  
Rehabilitation Robotic

Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human–machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals—namely, family members and professional carers—to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.

scholarly journals Adhesive Small Bowel Obstruction and the six w’s: Who, How, Why, When, What, and Where to diagnose and operate?

2021 ◽  
pp. 145749692098276
Author(s):  
M. Podda ◽  
M. Khan ◽  
S. Di Saverio
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Conservative Management ◽  
Bowel Ischemia ◽  
Current Evidence ◽  
First Episode ◽  
Adhesive Small Bowel Obstruction ◽  
Highly Effective

Background and Aims: Approximately 75% of patients admitted with small bowel obstruction have intra-abdominal adhesions as their cause (adhesive small bowel obstruction). Up to 70% of adhesive small bowel obstruction cases, in the absence of strangulation and bowel ischemia, can be successfully treated with conservative management. However, emerging evidence shows that surgery performed early during the first episode of adhesive small bowel obstruction is highly effective. The objective of this narrative review is to summarize the current evidence on adhesive small bowel obstruction management strategies. Materials and Methods: A review of the literature published over the last 20 years was performed to assess Who, hoW, Why, When, What, and Where diagnose and operate on patients with adhesive small bowel obstruction. Results: Adequate patient selection through physical examination and computed tomography is the key factor of the entire management strategy, as failure to detect patients with strangulated adhesive small bowel obstruction and bowel ischemia is associated with significant morbidity and mortality. The indication for surgical exploration is usually defined as a failure to pass contrast into the ascending colon within 8–24 h. However, operative management with early adhesiolysis, defined as operative intervention on either the calendar day of admission or the calendar day after admission, has recently shown to be associated with an overall long-term survival benefit compared to conservative management. Regarding the surgical technique, laparoscopy should be used only in selected patients with an anticipated single obstructing band, and there should be a low threshold for conversion to an open procedure in cases of high risk of bowel injuries. Conclusion: Although most adhesive small bowel obstruction patients without suspicion of bowel strangulation or gangrene are currently managed nonoperatively, the long-term outcomes following this approach need to be analyzed in a more exhaustive way, as surgery performed early during the first episode of adhesive small bowel obstruction has shown to be highly effective, with a lower rate of recurrence.

scholarly journals A Review on the Value of Imaging in Differentiating between Large Vessel Vasculitis and Atherosclerosis

2021 ◽  
Vol 11 (3) ◽  
pp. 236
Author(s):  
Pieter H. Nienhuis ◽  
Gijs D. van Praagh ◽  
Andor W. J. M. Glaudemans ◽  
Elisabeth Brouwer ◽  
Riemer H. J. A. Slart
Keyword(s):  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Current Evidence ◽  
Future Directions ◽  
Inflammatory Conditions ◽  
Positron Emission ◽  
Magnetic Resonance Imaging Mri ◽  
Review Reports ◽  
Ct Studies

Imaging is becoming increasingly important for the diagnosis of large vessel vasculitis (LVV). Atherosclerosis may be difficult to distinguish from LVV on imaging as both are inflammatory conditions of the arterial wall. Differentiating atherosclerosis from LVV is important to enable optimal diagnosis, risk assessment, and tailored treatment at a patient level. This paper reviews the current evidence of ultrasound (US), 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET), computed tomography (CT), and magnetic resonance imaging (MRI) to distinguish LVV from atherosclerosis. In this review, we identified a total of eight studies comparing LVV patients to atherosclerosis patients using imaging—four US studies, two FDG-PET studies, and two CT studies. The included studies mostly applied different methodologies and outcome parameters to investigate vessel wall inflammation. This review reports the currently available evidence and provides recommendations on further methodological standardization methods and future directions for research.

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