Absolute PASI as a valuable marker to determine initial treatment response in psoriasis patients treated with guselkumab in routine clinical care

Management of Parkinson’s disease traditionally relies solely on clinical assessment. The PKG objectively measures affected persons’ movements in daily life. The present study evaluated how often PKG data changed treatment decisions in routine clinical care and to what extent the clinical assessment and the PKG interpretation differed. PKG recordings were performed before routine visits. The neurologist first made a clinical assessment without reviewing the PKG. Signs and symptoms were recorded, and a treatment plan was documented. Afterward, the PKG was evaluated. Then, the neurologist decided whether to change the initial treatment plan or not. PKG review resulted in a change in the initial treatment plan in 21 of 66 participants (31.8%). The clinical assessment and the PKG review differed frequently, mainly regarding individual overall presence of motor problems (67%), profile of bradykinesia/wearing off (79%), dyskinesia (35%) and sleep (55%). PKG improved the dialogue with the participant in 88% of cases. PKG and clinical variables were stable when they were repeated after 3–6 months. In conclusion, PKG information changes treatment decisions in nearly a third of people with Parkinson’s disease in routine care. Standard clinical assessment and PKG evaluation are often non-identical. Objective measurements in people living with Parkinson’s disease can add therapeutically relevant information.

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Pharmacological treatment for borderline personality disorder: comparing data from routine clinical care with recommended guidelines

10.26226/morressier.59d4913bd462b8029238a351 ◽

2017 ◽

Author(s):

Friedrich Riffer

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Pharmacological Treatment ◽

Clinical Care ◽

Borderline Personality ◽

Routine Clinical Care ◽

Recommended Guidelines

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Treatment of painful bone metastases in prostate and breast cancer patients with the therapeutic radiopharmaceutical rhenium-188-HEDP

Nuklearmedizin ◽

10.3413/nukmed-0828-16-05 ◽

2016 ◽

Vol 55 (05) ◽

pp. 188-195 ◽

Cited By ~ 16

Author(s):

Floor Overbeek ◽

John de Klerk ◽

Pieternel Pasker-de Jong ◽

Alexandra van den Berk ◽

Rob ter Heine ◽

...

Keyword(s):

Bone Metastases ◽

Clinical Benefit ◽

Response Rate ◽

Clinical Care ◽

Pain Response ◽

Pain Palliation ◽

Breast Cancer Patients ◽

Routine Clinical Care ◽

Painful Bone Metastases

Summary Aim: Rhenium-188-HEDP (188Re-HEDP) is an effective radiopharmaceutical for the palliative treatment of osteoblastic bone metastases. However, only limited data on its routine use are available and its effect on quality of life (QoL) has not been studied. Therefore, we evaluated the clinical benefit of 188Re-HEDP in routine clinical care. Patients and methods: Prostate or breast cancer patients with painful bone metastases receiving 188Re-HEDP as a routine clinical procedure were eligible for evaluation. Clinical benefit was assessed in terms of efficacy and toxicity. Pain palliation and QoL were monitored using the visual analogue scale (VAS), corrected for opioid intake, and the EORTC QLQ-C30 Global health status/QoL-scale. Thrombocyte and leukocyte nadirs were used to assess haematological toxicity. Results: 45 and 47 patients were evaluable for pain palliation and QoL, respectively. After a single injection of 188Re-HEDP, the overall pain response rate was 69% and mean VAS-scores decreased relevantly and significantly (p < 0.05). Repeated treatment resulted in similar pain response. The overall QoL response rate was 68% and mean Global health status/QoL-scores increased relevantly and significantly. Haematological side effects were mild and transient. Conclusion: The clinically relevant response on pain and quality of life and the limited adverse events prove clinical benefit of treatment with 188Re-HEDP and support its use in routine clinical care. Its effectiveness appears comparable to that of external beam radiotherapy.

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Interpersonal Psychotherapy for the Treatment of Eating Disorders

The Oxford Handbook of Eating Disorders ◽

10.1093/oxfordhb/9780195373622.013.0020 ◽

2010 ◽

pp. 347-372 ◽

Cited By ~ 1

Author(s):

Marian Tanofsky-Kraff ◽

Denise E. Wilfley

Keyword(s):

Anorexia Nervosa ◽

Clinical Care ◽

Interpersonal Psychotherapy ◽

Future Research ◽

Cognitive Behavior ◽

Research Directions ◽

Routine Clinical Care ◽

Interpersonal Factors ◽

Future Research Directions

Interpersonal psychotherapy (IPT) is a focused, time-limited treatment that targets interpersonal problem(s) associated with the onset and/or maintenance of EDs. IPT is supported by substantial empirical evidence documenting the role of interpersonal factors in the onset and maintenance of EDs. IPT is a viable alternative to cognitive behavior therapy for the treatment of bulimia nervosa and binge eating disorder. The effectiveness of IPT for the treatment of anorexia nervosa requires further investigation. The utility of IPT for the prevention of obesity is currently being explored. Future research directions include enhancing the delivery of IPT for EDs, increasing the availability of IPT in routine clinical care settings, exploring IPT adolescent and parent–child adaptations, and developing IPT for the prevention of eating and weight-related problems that may promote full-syndrome EDs or obesity.

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Disease monitoring of biologic treatment in IBD: early impact and future implications of COVID-19 pandemic

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101563 ◽

2020 ◽

pp. flgastro-2020-101563

Author(s):

Stephanie Shields ◽

Allan Dunlop ◽

John Paul Seenan ◽

Jonathan Macdonald

Keyword(s):

Clinical Care ◽

Chronic Illnesses ◽

Therapeutic Drug ◽

Disease Monitoring ◽

Biologic Treatment ◽

Faecal Calprotectin ◽

Routine Clinical Care ◽

Risk Of Disease ◽

Inflammatory Bowel ◽

The Impact

COVID-19 has dominated life in 2020 with, at the time of writing, over 4.9M global cases and >320 000 deaths. The impact has been most intensely felt in acute and critical care environments. However, with most UK elective work postponed, laboratory testing of faecal calprotectin halted due to potential risk of viral transmission and non-emergency endoscopies and surgeries cancelled, the secondary impact on chronic illnesses such as inflammatory bowel disease (IBD) is becoming apparent. Data from the Scottish Biologic Therapeutic Drug Monitoring (TDM) service shows a dramatic drop in TDM testing since the pandemic onset. April 2020 saw a 75.6% reduction in adalimumab testing and a 36.2% reduction in infliximab testing when compared with February 2020 data, a reduction coinciding with the widespread cancellation of outpatient and elective activity. It is feared that disruption to normal patterns of care and disease monitoring of biologic patients could increase the risk of disease flare and adverse clinical outcomes. Urgent changes in clinical practice have been instigated to mitigate the effects of the pandemic on routine clinical care. Further transformations are needed to maintain safe, effective, patient-centred IBD care in the future.

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Quality of Life for Children with Persistent Sinonasal Symptoms

Otolaryngology ◽

10.1067/mhn.2003.41 ◽

2003 ◽

Vol 128 (1) ◽

pp. 17-26 ◽

Cited By ~ 97

Author(s):

David J. Kay ◽

Richard M. Rosenfeld

Keyword(s):

Quality Of Life ◽

Clinical Care ◽

Longitudinal Change ◽

Good Test ◽

Routine Clinical Care ◽

Before And After ◽

The Mean ◽

The Individual ◽

Sinonasal Symptoms

OBJECTIVE: The goal was to validate the SN-5 survey as a measure of longitudinal change in health-related quality of life (HRQoL) for children with persistent sinonasal symptoms. DESIGN AND SETTING: We conducted a before and after study of 85 children aged 2 to 12 years in a metropolitan pediatric otolaryngology practice. Caregivers completed the SN-5 survey at entry and at least 4 weeks later. The survey included 5 symptom-cluster items covering the domains of sinus infection, nasal obstruction, allergy symptoms, emotional distress, and activity limitations. RESULTS: Good test-retest reliability ( R = 0.70) was obtained for the overall SN-5 score and the individual survey items ( R ≥ 0.58). The mean baseline SN-5 score was 3.8 (SD, 1.0) of a maximum of 7.0, with higher scores indicating poorer HRQoL. All SN-5 items had adequate correlation ( R ≥ 0.36) with external constructs. The mean change in SN-5 score after routine clinical care was 0.88 (SD, 1.19) with an effect size of 0.74 indicating good responsiveness to longitudinal change. The change scores correlated appropriately with changes in related external constructs ( R ≥ 0.42). CONCLUSIONS: The SN-5 is a valid, reliable, and responsive measure of HRQoL for children with persistent sinonasal symptoms, suitable for use in outcomes studies and routine clinical care.

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Incorporation of Medicare Annual Wellness Visits into the Routine Clinical Care of Nursing Home Residents

Journal of the American Geriatrics Society ◽

10.1111/jgs.16984 ◽

2020 ◽

Author(s):

Milta O. Little ◽

Angela M. Sanford ◽

Theodore K. Malmstrom ◽

Christina Traber ◽

John E. Morley

Keyword(s):

Nursing Home ◽

Clinical Care ◽

Nursing Home Residents ◽

Routine Clinical Care

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Recommendations of the AGG (Task Force for Obstetrics, Section Maternal Diseases) on the Management of Maternal Hepatitis B, C and D Infection in Pregnancy

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-1330-7514 ◽

2021 ◽

Vol 81 (04) ◽

pp. 390-397

Author(s):

Maritta Kühnert ◽

Sven Kehl ◽

Ulrich Pecks ◽

Ute Margaretha Schäfer-Graf ◽

Tanja Groten ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis B ◽

Task Force ◽

Clinical Care ◽

Diagnostic Procedures ◽

Routine Clinical Care ◽

Prenatal Counselling ◽

Hepatitis Infection ◽

Birth Planning ◽

In Pregnancy

AbstractThese statements and recommendations should provide appropriate information about maternal and fetal routes of infection, screening, detection of risk factors, diagnostic procedures, treatment, birth planning and peripartum and postpartum management of maternal hepatitis infection and offer pointers for prenatal counselling and routine clinical care on delivery wards.

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