Comparative efficacy of a team-led treatment protocol for the management of renal anaemia

Nephrology ◽  
2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Sradha S Kotwal ◽  
Patrick Lan ◽  
Avril MacLeod ◽  
Meg Jardine ◽  
Paul Snelling ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
Comparative Efficacy ◽  
Renal Anaemia

Treatment Fidelity Procedures for an Aphasia Intervention Within a Randomized Controlled Trial: Design, Feasibility, and Results

2020 ◽  
Vol 29 (1S) ◽  
pp. 412-424
Author(s):  
Elissa L. Conlon ◽  
Emily J. Braun ◽  
Edna M. Babbitt ◽  
Leora R. Cherney
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Treatment Protocol ◽  
Treatment Fidelity ◽  
Protocol Adherence ◽  
Study Condition ◽  
Randomized Controlled ◽  
Aphasia Therapy ◽  
Percent Accuracy ◽  
Over Time

Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.

Maximizing Outcomes in Group Treatment of Aphasia: Lessons Learned From a Community-Based Center

2014 ◽  
Vol 24 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Darlene Williamson
Keyword(s):  
Group Treatment ◽  
Treatment Protocol ◽  
Lessons Learned ◽  
Group Program ◽  
Community Based ◽  
Multiple Treatment ◽  
Use Of Technology ◽  
Communication Impairments ◽  
Treatment Settings

Given the potential of long term intervention to positively influence speech/language and psychosocial domains, a treatment protocol was developed at the Stroke Comeback Center which addresses communication impairments arising from chronic aphasia. This article presents the details of this program including the group purposes and principles, the use of technology in groups, and the applicability of a group program across multiple treatment settings.

Identifying Patterns in Complex Field Data

2017 ◽  
Vol 225 (3) ◽  
pp. 268-284 ◽  
Author(s):  
Andrew J. White ◽  
Dieter Kleinböhl ◽  
Thomas Lang ◽  
Alfons O. Hamm ◽  
Alexander L. Gerlach ◽  
...  
Keyword(s):  
Heart Rate ◽  
Panic Disorder ◽  
Latent Class ◽  
Treatment Protocol ◽  
Situational Factors ◽  
Self Report ◽  
Complex Field ◽  
Cluster Assignment ◽  
Experimental Conditions ◽  
Conventional Analysis

Abstract. Ambulatory assessment methods are well suited to examine how patients with panic disorder and agoraphobia (PD/A) undertake situational exposure. But under complex field conditions of a complex treatment protocol, the variability of data can be so high that conventional analytic approaches based on group averages inadequately describe individual variability. To understand how fear responses change throughout exposure, we aimed to demonstrate the incremental value of sorting HR responses (an index of fear) prior to applying averaging procedures. As part of their panic treatment, 85 patients with PD/A completed a total of 233 bus exposure exercises. Heart rate (HR), global positioning system (GPS) location, and self-report data were collected. Patients were randomized to one of two active treatment conditions (standard exposure or fear-augmented exposure) and completed multiple exposures in four consecutive exposure sessions. We used latent class cluster analysis (CA) to cluster heart rate (HR) responses collected at the start of bus exposure exercises (5 min long, centered on bus boarding). Intra-individual patterns of assignment across exposure repetitions were examined to explore the relative influence of individual and situational factors on HR responses. The association between response types and panic disorder symptoms was determined by examining how clusters were related to self-reported anxiety, concordance between HR and self-report measures, and bodily symptom tolerance. These analyses were contrasted with a conventional analysis based on averages across experimental conditions. HR responses were sorted according to form and level criteria and yielded nine clusters, seven of which were interpretable. Cluster assignment was not stable across sessions or treatment condition. Clusters characterized by a low absolute HR level that slowly decayed corresponded with low self-reported anxiety and greater self-rated tolerance of bodily symptoms. Inconsistent individual factors influenced HR responses less than situational factors. Applying clustering can help to extend the conventional analysis of highly variable data collected in the field. We discuss the merits of this approach and reasons for the non-stereotypical pattern of cluster assignment across exposures.

Immune mediated destruction of platelets in dogs with heat stroke: A prospective study

2009 ◽  
Vol 37 (05) ◽  
pp. 314-318 ◽  
Author(s):  
L. Keller ◽  
K. Meichner ◽  
S. Unterer ◽  
K. Hartmann ◽  
I. Zenker
Keyword(s):  
Heat Stroke ◽  
Treatment Protocol ◽  
Severe Thrombocytopenia ◽  
Prospective Evaluation ◽  
Antiplatelet Antibodies ◽  
Time Period ◽  
Immune Mediated ◽  
Standardized Treatment ◽  
A Prospective Study ◽  
Risk For Bleeding

Summary Objective: Severe thrombocytopenia is a common sequelae to heat stroke in dogs. So far it has been hypothezised that it is due to disseminated intravascular coagulation. We hypothezised that it is due to immune mediated destruction via antiplatelet antibodies. Material and methods: Prospective evaluation of dogs with heat stroke from May 2005 to August 2008. Dogs that developed severe thrombocytopenia within 5 days of admission were included in the study. All dogs were treated with a standardized treatment protocol. In addition, they received either immunoglobulins or prednisolone. Results: Six dogs were presented with heat stroke during that time period. Four developed a severe thrombocytopenia. All four dogs tested positive for antiplatelet antibodies and did not have elevated D-Dimers at that time. Platelet count in three dogs recovered fully, one dog was euthanized due to liver and renal failure. Conclusion: In those cases thrombocytopenia was due to immune mediated destruction not due to DIC. Clinical rele-vance: Due to the severity of the thrombocytopenia and the high risk for bleeding in those patients, immunosuppressive therapy in addition to DIC prophylaxis should be discussed.

HER2 Expression in Gastric Cancer and Gastroesophageal Junction Cancer

2020 ◽  
Vol 22 (2) ◽  
pp. 79-82
Author(s):  
Md Azizur Rahman ◽  
Abdullah Md Abu Ayub Ansari ◽  
Kazi Mazharul Islam ◽  
Md Aminur Rahman ◽  
ABM Abdul Matin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Social Impact ◽  
Gastroesophageal Junction ◽  
Treatment Protocol ◽  
Armed Forces ◽  
Her2 Expression ◽  
Her2 Positive ◽  
Cancer Data ◽  
Her2 Positivity

Background: Carcinoma of the stomach is a major cause of cancer mortality worldwide. Due to social impact of gastric carcinoma (GC), there is a need to stratify patients into appropriate screening, surveillance and treatment programs. Although histopathology remains the most reliable and less expensive method, numerous efforts have been made to identify and validate novel biomarkers to accomplish the goals. In recent years, several molecules have been identified and tested for their clinical relevace in GC management. Among the biomarkers with the exception of HER2, none of the biomarkers is currently used in clinical practice, and some of them were described in single studies. Materials and Methods: This prospective type of observational study was performed in the Department of Surgery, Dhaka Medical College Hospital, Dhaka, 6 months from approval of protocol. Total 45 consecutive patients aged 18 years and above without consideration of gender were selected purposefully. Every patient was evaluated by clinical examination, appropriate investigations and after a confirm diagnosis of the tissue from the cancer. All patients have undergone operative intervention and Gastrectomy specimens were subtotal (including cardiac and pylorus), subtotal (including the pylorus), total radical gastrectomy and oesophago-gastrectomy sample. All specimens obtained were immersed in 10% formalin. Samples of whom were sent to the department of pathology, DMCH for histopathology examination. Portion of representative tissue/block was sent to AFIP (Armed Forces Institute of Pathology, Dhaka) for immunohistochemistry to find out the HER2 expression in gastric cancer and gastro-oesophageal cancer. Data was collected in a pre-designed questionnaire by face to face interview. Result and observation: In this study when 45 cases were categorized according to WHO grading system it was observed that majority (30) patients were found in grade II, among them 3(10%) were HER2 positive. But with grade III tumour the HER2 positivity were found more i,e; 37.5% (3/8). Grade- I tumor show HER2 neu expression 28.57% (2/7) and according to location most of the cases with HER2 positive expression was located in the gastro-esophageal junction which is 27.27% (3/11) than gastric carcinoma which is 14.70% (5/34). Conclusion: Most of the patients of gastric and gastrooesophageal junction adenocarcinoma are diagnosed at a very late stage, so they require special attention in treatment protocol, including chemotherapy and immunotherapy for increasing their survivability. The study showed with poorly differentiated (high grade) tumour, the HER2 positivity were found more. Journal of Surgical Sciences (2018) Vol. 22 (2) : 79-82

Comparative efficacy of various thrombolytic agents in treatment of pulmonary embolism

2019 ◽  
Vol 25 (3) ◽  
pp. 23
Author(s):  
N. G. Khorev ◽  
A. V. Beller ◽  
E. V. Borovikov ◽  
V. O. Konkova ◽  
Ya. N. Shoikhet
Keyword(s):  
Pulmonary Embolism ◽  
Comparative Efficacy ◽  
Thrombolytic Agents
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