Practical Guidelines for Managing Patients With Psoriasis on Biologics: An Update

2019 ◽  
Vol 23 (1_suppl) ◽  
pp. 3S-12S ◽  
Author(s):  
Susan M. Poelman ◽  
Christopher P. Keeling ◽  
Andrei I. Metelitsa
Keyword(s):  
Health Care Providers ◽  
Primary Care Physicians ◽  
Inflammatory Diseases ◽  
Biologic Agents ◽  
Targeted Therapeutics ◽  
Care Providers ◽  
The Past ◽  
Practical Guidelines ◽  
Inflammatory Bowel ◽  
Systemic Therapies

The paradigm for treating inflammatory diseases has shifted dramatically in the past 10 to 20 years with the discovery of targeted therapeutics or “biologic” agents. Patients with rheumatoid arthritis, inflammatory bowel disease, psoriatic arthritis, and psoriasis, among others, are reaping the benefits of decades of bench to bedside research, allowing them to live more productive lives with less side effects than traditional systemic therapies. Despite these advances, many physicians unfamiliar with biologics are left to care for the basic needs of these patients and may be unaware of the multisystem comorbidities associated with psoriasis and the screening, monitoring, and other special considerations required of biologics patients. This can be overwhelming to primary care physicians and inadvertently expose patients to undue risks. The aim of this review is to provide a practical approach for all health care providers caring for patients with psoriasis being treated with biologics to facilitate communication with their treating dermatologist and ultimately provide patients with more comprehensive care.

scholarly journals Congenital Adrenal Hyperplasia

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 601 ◽  
Author(s):  
Phyllis W. Speiser
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Health Care Providers ◽  
Current Knowledge ◽  
Adult Health ◽  
Age Group ◽  
Care Providers ◽  
Adrenal Hyperplasia ◽  
The Past ◽  
Pediatric Age Group ◽  
Practical Guidelines

Congenital adrenal hyperplasia associated with deficiency of steroid 21-hydroxylase is the most common inborn error in adrenal function and the most common cause of adrenal insufficiency in the pediatric age group. As patients now survive into adulthood, adult health-care providers must also be familiar with this condition. Over the past several years, F1000 has published numerous commentaries updating research and practical guidelines for this condition. The purposes of this review are to summarize basic information defining congenital adrenal hyperplasia and to highlight current knowledge and controversies in management.

Biosimilars of Adalimumab in Inflammatory Bowel Disease: Are we Ready for that?

2019 ◽  
Vol 25 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Marjorie Argollo ◽  
Gionata Fiorino ◽  
Daniela Gilardi ◽  
Federica Furfaro ◽  
Giulia Roda ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Health Care Providers ◽  
Bowel Disease ◽  
Biological Treatment ◽  
Reference Product ◽  
European Medicines Agency ◽  
Care Providers ◽  
Inflammatory Bowel ◽  
To Receive ◽  
The Ideal

Introduction: Biosimilars present a considerable potential to reduce costs related to clinical management allowing health-care providers to reinvest this money, leading to a wider access to an effective biological treatment with monoclonal antibodies (mAb). Infliximab biosimilars have already been incorporated in daily clinical practice and are currently used in all indications for which the reference product (RP) was approved. Areas covered: In the next few years, also adalimumab biosimilars will become available for the treatment of inflammatory bowel disease (IBD). In fact, several of them (ABP501, BI 695501, GP2017, and SB5) have been approved by the European Medicines Agency (EMA) with the same indications of the reference product (Humira ®). Initial preclinical data proved a strong similarity between all biosimilars and the RP. Moreover, phase 3 studies in rheumatoid arthritis and psoriasis showed no differences in terms of efficacy, safety, and immunogenicity. Data on IBD patients are urgently needed. Expert opinion: Biosimilars of adalimumab showed equivalent clinical efficacy to the RP in other immunemediated diseases. However, defining the ideal patient’s profile to receive or to be switched to a biosimilar, choosing one biosimilar vs. another, or cross-switching among biosimilars, will become the next challenge in IBD.

scholarly journals A practical guide about biosimilar data for health care providers treating inflammatory diseases

2017 ◽  
Vol Volume 11 ◽  
pp. 13-21 ◽  
Author(s):  
Joseph Markenson ◽  
Daniel Alvarez ◽  
Ira Jacobs ◽  
Carol Kirchhoff
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Inflammatory Diseases ◽  
Care Providers ◽  
Practical Guide

scholarly journals Engaging Athletic Trainers in Concussion Detection: Overview of the National Football League ATC Spotter Program, 2011–2017

2019 ◽  
Vol 54 (8) ◽  
pp. 852-857 ◽  
Author(s):  
Christina Mack ◽  
Emily Myers ◽  
Ronnie Barnes ◽  
Gary Solomon ◽  
Allen Sills
Keyword(s):  
Health Care Providers ◽  
National Football League ◽  
Athletic Trainers ◽  
Care Providers ◽  
The Past ◽  
Future Improvement ◽  
Certified Athletic Trainer ◽  
And Training ◽  
Program Data ◽  
Concussive Injuries

Objective To assist sideline medical staff and to augment detection of concussion in National Football League (NFL) players during preseason and regular season games via the use of certified athletic trainer (ATC) spotters. Background Detecting concussive injuries in contact-sport athletes can be a challenging task for health care providers on the sideline. Over the past 8 years, professional sport leagues have begun to use additional sets of eyes (medical spotters along with video review) to help identify athletes with possible concussive injuries. Description The NFL first began a program using spotters in 2011, and the ATC Spotter Program has undergone systematic enhancements each year. This article describes the evolution of the ATC Spotter Program, the requirements and training of its participants, and the program data available to date. Directions for future improvement and research are addressed. Clinical Advantages The use of ATC spotters stationed in the broadcast booth has enhanced the real-time detection of concussed players in the NFL.

scholarly journals Queering whole person care in a pandemic

2022 ◽  
Vol 9 (1) ◽  
pp. 56-57
Author(s):  
Jane Shulman ◽  
David Kenneth Wright
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
The Past ◽  
Health Care Experiences ◽  
The People ◽  
Whole Person ◽  
Care Approach ◽  
The Face ◽  
Nursing Educator

How can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to? In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat. The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic. A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat. The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices.

scholarly journals Residential transience among US adolescents: association with depression and mental health treatment

2019 ◽  
Vol 28 (6) ◽  
pp. 682-691 ◽  
Author(s):  
C. Glasheen ◽  
V. Forman-Hoffman ◽  
S. Hedden ◽  
T. Ridenour ◽  
J. Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Mental Health Treatment ◽  
Representative Sample ◽  
Care Providers ◽  
Health Treatment ◽  
The Past ◽  
Significant Difference ◽  
Nationally Representative ◽  
To Receive

AbstractAimsResidential instability, including transience (i.e. unusually frequent mobility), is associated with higher risk for emotional and behavioural problems in children and young adults. However, most studies have not compared the effect of recent v. more distal moves on mental health or on mental health treatment. This study examined associations between recent (past year) and distal (past 2–4 years) residential transience and past year major depressive episode (MDE) and mental health treatment in a nationally representative sample of US adolescents aged 12–17.MethodsData are from the 2010–2014 National Surveys on Drug Use and Health (n = ~107 300 adolescents). T-tests were used to examine the prevalence of MDE by number of moves in the past 5 years among a nationally representative sample of adolescents. Additionally, multivariable logistic regression models were used to evaluate the adjusted association between recent (⩾2 moves in the past year) and distal (⩾4 moves in the past 5 years, but no recent transience) and (1) past year MDE and (2) past year mental health treatment among adolescents with MDE.ResultsMDE prevalence increased linearly with number of moves in the past 5 years (p < 0.001). The adjusted odds of MDE were greater among youths with distal transience (adjusted odds ratio (AOR) = 1.25, 95% confidence interval (CI) = 1.09–1.44) and among those with proximal transience (AOR = 1.31, 95% CI = 1.17–1.46), compared with those without transience in the past 5 years. The MDE prevalence did not differ between those with distal and proximal transience (p = 0.163). In youths with past year MDE, the prevalence of past year mental health treatment was greater among those with proximal transience compared with those without transience (AOR = 1.40, 95% CI = 1.15–1.70), but there was no significant difference in treatment among those with distal v. no transience.ConclusionsDistal and recent transience are associated with past year MDE among adolescents. Adolescents with MDE who had recent transience were more likely to receive past year mental health treatment compared with those without transience. However, those with only distal transience were not more likely to receive treatment. Parents, school officials and health care providers should be aware that residential mobility in the past 5 years may indicate increased odds of depression among adolescents even among adolescents whose housing stability has improved in the past year.

Ocular emergencies presenting to an emergency department in Central Spain from 2013 to 2018

2019 ◽  
pp. 112067211989642
Author(s):  
Alicia Galindo-Ferreiro ◽  
Hortensia Sanchez-Tocino ◽  
Yago Varela-Conde ◽  
Cecilia Diez-Montero ◽  
Minal Belani-Raju ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
International Classification Of Diseases ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Care Providers ◽  
Primary Health Care Providers ◽  
Ocular Surface Diseases ◽  
Classification Of Diseases

Purpose: To determine the frequency of ocular conditions among patients presenting to an emergency department at a tertiary hospital in Spain. Methods: A retrospective, longitudinal analysis of all patients who presented to the ocular emergency department of Rio Hortega University Hospital, Valladolid, Spain, from 2013 to 2018 was performed. Data on demographics, ophthalmic examination, and diagnosis were collected. Diseases were classified according the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Results: We had 20,822 patients, of which 10,878 (52.2%) were women. The main age categories were 45–65 years (7391 patients; 35.5%) and 15–45 years (5979 patients; 28.2%). Most of the patients (17,793; 85.5%) were discharged on the same day. Conjunctival pathology was the most common cause of presentation (4110; 19.7%), followed by corneal disorders (4025; 19.3%). Acute conjunctivitis was diagnosed in 2920 (14%) and ocular trauma in 2125 (10.2%) patients. Non-emergency ophthalmic conditions were diagnosed in 1581 (7.6%) patients. Retinal detachments and peripheral holes occurred more commonly in patients aged 45–65 years ( p <0.001). Corneal or conjunctival disorders and lid inflammation ( p <0.001) were more frequent in women, whereas men had higher incidences of trauma ( p <0.001). Conclusion: Most of our patients presented ocular surface diseases. Men were more vulnerable to trauma, mainly superficial foreign body. The majority of the patients presented with uncomplicated ocular conditions that would be managed more cost-effectively by primary health care providers. We advocate greater education of primary care physicians and patients in managing simple ocular emergencies to reduce the cases presenting to an emergency department of a tertiary hospital.

P003 INFLAMMATORY BOWEL DISEASE PATIENTS’ PERSPECTIVES OF CLINICAL TRIALS

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S53-S53
Author(s):  
David Rubin ◽  
Laurent Peyrin-Biroulet ◽  
Walter Reinisch ◽  
Swati Tole ◽  
Laura Sullivan ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Health Care Providers ◽  
Online Survey ◽  
The United States ◽  
Trial Participation ◽  
Pharmaceutical Manufacturer ◽  
Care Providers ◽  
Inflammatory Bowel

Abstract Background Despite recent progress in treatment for inflammatory bowel diseases (IBD), there is a need for therapies with long-term efficacy and improved safety. Clinical trials in IBD face challenges with patient recruitment because of study designs, competitive or overlapping trials, and a limited number of eligible patients. We sought to better understand patients’ motivations, awareness of, and experience with IBD clinical trials. Methods We conducted an international survey of adult patients with IBD consisting of 2 components. The quantitative component, a 15-minute online survey, was completed by all patients. A qualitative component, a 30-minute telephone interview, was completed by a subset of patients from the United States (US). All percentages indicate results from the online survey. Results 226 patients (mean age, 41.9 y) completed the online survey. Survey respondents included patients with ulcerative colitis (52%) and Crohn’s disease (48%) from the US (n=100, 21 of whom underwent a phone interview), Brazil (n=26), Canada (n=25), France (n=25), Germany (n=25), and Spain (n=25). Ninety-six percent of respondents reported at least a basic understanding of clinical trials, and 34 (15%) were current or past clinical trial participants. Patients reported learning about trials through 1 or more sources (could select as many as applied): health care providers (42%), pharmaceutical manufacturer websites (31%), social media (30%), online support groups (28%), and foundations (18%-23%). In the survey, patients rated conversations with health care providers most helpful, but patients who were interviewed revealed that most physicians often do not initiate conversations about clinical trials, and patients typically do not ask. Primary motivators for trial participation (rated from “does not encourage me at all” to “encourages me very much”) included altruistic goals of advancing medicine (67%), potentially mitigating risks of uncontrolled IBD such as colon cancer (59%), and access to treatment options that could improve quality of life (59%) or would otherwise be unaffordable (52%). Major barriers to participation (rated from “does not discourage me at all” to “discourages me very much”) included invasive screening and monitoring (35%), concern over receiving placebo (35%), or suboptimal treatment (33%), and concerns about posttrial access to study medication (27%). The majority (68%) reported that being in a clinical trial means being a “guinea pig” for an experimental treatment. Conclusion Opportunities to improve patients’ clinical trial experience in IBD include better communication with health care providers and improved patient education about clinical trial design and ethics. Ultimately, a better understanding of the patient perspective will be important for more informed patients and potentially higher recruitment and enrollment.

scholarly journals Prevalence and Risk Factors of Substance Use Disorder in Inflammatory Bowel Disease

2020 ◽  
Vol 27 (1) ◽  
pp. 58-64
Author(s):  
Heather Carney ◽  
Ruth Ann Marrie ◽  
James M Bolton ◽  
Scott B Patten ◽  
Lesley A Graff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Substance Use ◽  
Anxiety Disorder ◽  
Bowel Disease ◽  
Inflammatory Diseases ◽  
Primary Care Providers ◽  
Care Providers ◽  
Factors Associated ◽  
Inflammatory Bowel

Abstract Background Substance use disorders (SUDs) impose a substantial individual and societal burden; however, the prevalence and associated factors in persons with inflammatory bowel disease (IBD) are largely unknown. We evaluated the prevalence and risk factors of SUD in an IBD cohort. Methods Inflammatory bowel disease participants (n = 247) were recruited via hospital- and community-based gastroenterology clinics, a population-based IBD research registry, and primary care providers as part of a larger cohort study of psychiatric comorbidity in immune-mediated inflammatory diseases. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV was administered to participants to identify lifetime SUD, anxiety disorder, and major depressive disorder. Additional questionnaires regarding participants’ sociodemographic and clinical characteristics were also completed. We examined demographic and clinical factors associated with lifetime SUD using unadjusted and adjusted logistic regression modeling. Results Forty-one (16.6%) IBD participants met the criteria for a lifetime diagnosis of an SUD. Factors associated with elevated odds of SUD were ever smoking (adjusted odds ratio [aOR], 2.96; 95% confidence interval [CI], 1.17–7.50), male sex (aOR, 2.44; 95% CI, 1.11–5.36), lifetime anxiety disorder (aOR, 2.41; 95% CI, 1.08–5.37), and higher pain impact (aOR, 1.08; 95% CI, 1.01–1.16). Conclusions One in six persons with IBD experienced an SUD, suggesting that clinicians should maintain high index of suspicion regarding possible SUD, and inquiries about substance use should be a part of care for IBD patients, particularly for men, smokers, and patients with anxiety disorders and pain.

Advances in Supportive Care for Late Effects of Head and Neck Cancer

2015 ◽  
Vol 33 (29) ◽  
pp. 3314-3321 ◽  
Author(s):  
Barbara A. Murphy ◽  
Jie Deng
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Health Care Providers ◽  
Neck Cancer ◽  
Late Effects ◽  
Primary Care Physicians ◽  
Nutritional Deficiencies ◽  
Care Providers ◽  
Functional Deficits

As the population of head and neck cancer survivors increases, it has become increasingly important for health care providers to understand and manage late complications of therapy. Functional deficits can be categorized as general health deficits resulting in frailty or debility, head and neck–specific functional deficits such as swallowing and speech, and musculoskeletal impairment as a result of tumor and treatment. Of critical importance is the growing data indicating that swallow therapy and physical therapy may prevent or ameliorate long-term functional deficits. Oral health complications of head and neck therapy may manifest months or years after the completion of treatment. Patients with hyposalivation are at high risk for dental caries and thus require aggressive oral hygiene regimens and routine dental surveillance. Swallowing abnormalities, xerostomia, and poor dentition may result in dietary adaptations that may cause nutritional deficiencies. Identification and management of maladaptive dietary strategies are important for long-term health. Follow-up with primary care physicians for management of comorbidities such as diabetes and hyperlipidemia may help to limit late vascular complications caused by radiation therapy. Herein, we review late effects of head and neck cancer therapy, highlighting recent advances.

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