Trends and Clinical Outcomes of Registered TB Cases 1999 - 2011 : Is There a Significant Change in Extrapulmonary Pattern ?

2018 ◽  
Vol 40 (2) ◽  
pp. 90-92
Author(s):  
Badr Rashed Al-Ghamdi
Keyword(s):  
Clinical Outcomes ◽  
Significant Change

scholarly journals OP0091 A TWO-SCORE INTERFERON SIGNATURE AND MUSCULOSKELETAL IMAGING EXPLAIN THE ASSOCIATION BETWEEN INTERFERON AND ARTHRITIS IN SLE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 60.2-60
Author(s):  
Z. Wigston ◽  
A. Burska ◽  
A. Alase ◽  
K. Mahmoud ◽  
E. Vital
Keyword(s):  
Clinical Outcomes ◽  
Objective Measure ◽  
Mean Difference ◽  
The Body ◽  
Becton Dickinson ◽  
Interferon Signature ◽  
Specific Subset ◽  
Expectation Maximisation ◽  
Significant Difference ◽  
Significant Change

Background:Interferon (IFN) signature is associated with disease activity and flare in SLE. We previously described two independent IFN gene expression scores; IFN Score A (the most commonly measured ISGs) and IFN Score B (less commonly measured ISGs which may also respond to IFN-II or other immune mediators)[1]. Many more clinical outcomes are associated with IFN Score B than with a “classic” interferon signature. These include progression of At-Risk individuals to SLE, response to rituximab, and differentiation of IFN signature in RA and SLE.In previous work, the relationship of IFN Signatures with arthritis was less clear than for other SLE features. This may be related to the local regulatory effects of IFN-beta in the synovium, contrasting with the pro-inflammatory effects of other interferons. Another reason may be the proven imprecision of clinical examination as a measure of MSK inflammation in SLE.USEFUL was a multicentre longitudinal study including serial ultrasound assessment of SLE patients with inflammatory MSK pain receiving treatment with glucocorticoids (GC).Objectives:To determine whether IFN scores A and B are associated with imaging-proven synovitis in SLE and measure the responsiveness of IFN scores to GC treatment.Methods:133 SLE patients were recruited into the USEFUL study if the referring physician deemed they had inflammatory pain warranting treatment. Participants received depomedrone 120mg IM then were assessed at 0, 2 and 6 weeks using clinical instruments and ultrasound (US). OMERACT US criteria were used to categorise patients as active (GS2 or PD1 in at least one joint or tendon), active in both joints and tendons, or non-active (no GS1 and PD0 or better in all joints).Expression of 26 interferon stimulated genes, normalised to PP1A was measured in whole blood collected in TEMPUS tubes using a custom Taqman array. IFN scores A and B were calculated as previously described[1]. Missing data was imputed using expectation-maximisation method. Parametric tests were applied with post hoc Tukey to compare scores between groups.Results:At baseline, there was no significant difference in IFN Score A between ultrasound groups (F = 1.045, p = 0.355). In contrast, IFN Score B differed significantly between ultrasound groups (F = 4.168, p = 0.018). The greatest difference was between active ultrasound for both joints and tendons (n=22) and non-active ultrasound (n=53) (difference = 0.75, 95% CI 0.13, 1.37, p=0.013).There was no significant change from baseline in IFN Score A at week 2 (mean difference 0.08, 95% -0.14, 0.31, p = 0.45) or week 6 (mean difference -0.03, 95% -0.25, 0.19, p = 0.79). Similarly, there was no significant change in IFN Score B at week 2 (mean difference -0.01, 95% -0.18, 0.17, p = 0.93) or week 6 (mean difference -0.07, 95% -0.21, 0.08, p = 0.36).Conclusion:Previous studies were unable to demonstrate an association between a typical interferon signature and arthritis in SLE. Our study includes a homogenous patient population and therapy, objective measure of synovitis, and a more detailed assessment of IFN Status. We found that imaging-proven synovitis is associated with increased expression of a specific subset of ISGs (IFN score B), but not a the more typical interferon signature genes (IFN Score A).This increases the body of evidence for the value of IFN score B in predicting clinical outcomes. GC treatment did not affect systemic IFN signature scores at follow up. Future analysis will explore the role of IFN Scores in predicting clinical responses to therapy in this study.References:[1]El-Sherbiny, Y.M., et al. Scientific Reports, 2018.8(1): p. 5793.Disclosure of Interests:Zoe Wigston: None declared, Agata Burska: None declared, Adewonuola Alase: None declared, Khaled Mahmoud: None declared, Edward Vital Grant/research support from: AstraZeneca, Roche/Genentech, and Sandoz, Consultant of: AstraZeneca, GSK, Roche/Genentech, and Sandoz, Speakers bureau: Becton Dickinson and GSK

scholarly journals The value of the modern embryologist to a successful IVF system: Revisiting an age-old question

2021 ◽  
Author(s):  
Fadi Choucair ◽  
Nagham Younis ◽  
Alia Hourani
Keyword(s):  
Clinical Outcomes ◽  
Science And Technology ◽  
Intangible Asset ◽  
Significant Challenge ◽  
The Future ◽  
Overall Performance ◽  
Significant Change ◽  
Patient Retention

BackgroundThe embryology laboratory remains the major factor influencing the overall performance of the IVF clinic. Clinical embryology, however, has undergone a significant change and development over the last decade. The changes and development have been science and technology-driven, in both practice and education.Main bodyThe changes in clinical embryology practice have created a significant challenge for both the profession and the embryologist. Often under-valued in the eyes of the clinic’s leadership, IVF clinic leaders must understand that embryologists have a significant impact on clinical outcomes and patient retention. They also enable many services that are significant revenue generators and may add prestige to the clinic. This framework will serve as the flagship document to extract value from the embryologist role as an intellectual intangible asset for the clinic.ConclusionTo fully leverage a modern embryologist's skill set, significant investment is required from the IVF clinics’ leadership that is, however, associated with a substantial return on the investment. From their side, embryologists should be prepared for further developments and innovations and adapt themselves to survive practicing clinical embryology. The profession needs also to prepare itself for the future to properly train high-caliber embryologists.

scholarly journals Trends of Clinical Outcomes of Patients with Advanced Hepatocellular Carcinoma Treated with First-line Sorafenib in Randomized Controlled Trials

2021 ◽  
Author(s):  
Timothy J. Brown ◽  
Arjun Gupta ◽  
Ramy Sedhom ◽  
Muhammad S. Beg ◽  
Thomas B. Karasic ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Outcomes ◽  
Median Duration ◽  
Phase Iii ◽  
Advanced Hepatocellular Carcinoma ◽  
Advanced Hcc ◽  
Duration Of Therapy ◽  
Recist 1.1 ◽  
Significant Change ◽  
Over Time

Background: Sorafenib has consistently served as the control arm in multiple RCTs evaluating novel therapies for advanced HCC for more than a decade. Analyzing trends in clinical outcomes of patients treated with sorafenib for the same indication over time offers the opportunity for unique insight into the evolution of clinical trial conduct and potential non-drug factors impacting outcomes. Methods: We identified RCTs in patients with treatment-naïve advanced HCC where sorafenib was compared to another systemic therapy or placebo. We extracted trial-level demographic, clinicopathologic, and outcome data (OS, progression-free survival (PFS), objective response rate (ORR) and duration of therapy). Sample-weighted linear regression was used to identify temporal trends with significance set at p0.05. Results: Sixteen RCTs (9 phase III and 7 phase II) enrolling 4086 patients treated with sorafenib were included in the analysis. Included trials enrolled patients from 2005-2019. OS has significantly improved by 4.5 months from 2005-2019 (p=0.048) over time. Thirteen studies provided data on PFS using RECIST 1.1, with no significant change over time (p=0.69). ORR assessed by RECIST 1.1 has significantly improved by 6.0% over time (p=0.003). Median duration of therapy with sorafenib has decreased by 53% since the enrollment of the first clinical trial in 2005, from 23.1 weeks to 12.2 weeks (p=0.0037). There was no significant change in patient demographics were identified over time to explain the OS findings. Conclusion: The median OS of patients with advanced HCC treated with sorafenib has improved significantly over 15 years. At the same time, the median duration of therapy with sorafenib has decreased. The reason for these findings was not explained by changing demographics of patients enrolled in these trials and has implications for ongoing clinical trials.

Accreditation of predoctoral dental education: clinical outcomes assessment

1991 ◽  
Vol 55 (11) ◽  
pp. 729-734
Author(s):  
MA Boyd ◽  
IC Bennett ◽  
KC Bentley
Keyword(s):  
Clinical Outcomes ◽  
Dental Education ◽  
Outcomes Assessment ◽  
Clinical Outcomes Assessment

Selecting Skills To Teach Communication Partners: Where Do I Start?

2012 ◽  
Vol 21 (4) ◽  
pp. 127-135 ◽  
Author(s):  
Cathy Binger ◽  
Jennifer Kent-Walsh
Keyword(s):  
Clinical Outcomes ◽  
Intervention Program ◽  
Communication Partners ◽  
Multiple Challenges

Abstract Clinicians and researchers long have recognized that teaching communication partners how to provide AAC supports is essential to AAC success. One way to improve clinical outcomes is to select appropriate skills to teach communication partners. Although this sometimes seems like it should be a straightforward component of any intervention program, deciding which skills to teach partners can present multiple challenges. In this article, we will troubleshoot common issues and discuss how to select skills systematically, resulting in the desired effects for both communication partners and clients.

Linguistic Interactions: A Therapeutic Consideration for Adults With Aphasia

2008 ◽  
Vol 17 (3) ◽  
pp. 93-98
Author(s):  
Lynn E. Fox
Keyword(s):  
Clinical Outcomes ◽  
Social Contexts ◽  
Interaction Models ◽  
Social Communities ◽  
Wernicke's Aphasia ◽  
Communication Challenges ◽  
Therapeutic Consideration ◽  
Patterns Of Interaction ◽  
Structural Language

Abstract Linguistic interaction models suggest that interrelationships arise between structural language components and between structural and pragmatic components when language is used in social contexts. The linguist, David Crystal (1986, 1987), has proposed that these relationships are central, not peripheral, to achieving desired clinical outcomes. For individuals with severe communication challenges, erratic or unpredictable relationships between structural and pragmatic components can result in atypical patterns of interaction between them and members of their social communities, which may create a perception of disablement. This paper presents a case study of a woman with fluent, Wernicke's aphasia that illustrates how attention to patterns of linguistic interaction may enhance AAC intervention for adults with aphasia.

The Complexity of Health Disparities: More Than Just Black–White Differences

2021 ◽  
pp. 1-10
Author(s):  
Charles Ellis ◽  
Molly Jacobs
Keyword(s):  
Health Disparities ◽  
Clinical Outcomes ◽  
The United States ◽  
Careful Examination ◽  
White Americans ◽  
Speech Language Pathology ◽  
Death Rates ◽  
The Social ◽  
Health Related ◽  
Language Pathology

Health disparities have once again moved to the forefront of America's consciousness with the recent significant observation of dramatically higher death rates among African Americans with COVID-19 when compared to White Americans. Health disparities have a long history in the United States, yet little consideration has been given to their impact on the clinical outcomes in the rehabilitative health professions such as speech-language pathology/audiology (SLP/A). Consequently, it is unclear how the absence of a careful examination of health disparities in fields like SLP/A impacts the clinical outcomes desired or achieved. The purpose of this tutorial is to examine the issue of health disparities in relationship to SLP/A. This tutorial includes operational definitions related to health disparities and a review of the social determinants of health that are the underlying cause of such disparities. The tutorial concludes with a discussion of potential directions for the study of health disparities in SLP/A to identify strategies to close the disparity gap in health-related outcomes that currently exists.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

Clinical Outcomes of the Intensive Stuttering Clinic for Adolescents and Adults

2018 ◽  
Vol 3 (4) ◽  
pp. 17-29 ◽  
Author(s):  
Lauren DeBelly ◽  
Rodney Gabel ◽  
Farzan Irani
Keyword(s):  
Clinical Outcomes ◽  
Adolescents And Adults
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