scholarly journals How can neurophysiological studies help with movement disorders characterization in clinical practice? A review

2020 ◽  
Vol 78 (8) ◽  
pp. 512-522
Author(s):  
Talyta GRIPPE ◽  
Natalia Spinola Costa da CUNHA ◽  
Pedro Renato de Paula BRANDÃO ◽  
Rubens Nelson Morato FERNANDEZ ◽  
Francisco Eduardo Costa CARDOSO
Keyword(s):  
Clinical Practice ◽  
Movement Disorders ◽  
Atypical Parkinsonism ◽  
Review Of The Literature ◽  
Indirect Measures ◽  
Neurophysiological Studies ◽  
Probable Site ◽  
Practice Methods ◽  
System Objective ◽  
Brainstem Excitability

ABSTRACT Background: Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phenomenology, help distinguish functional from organic origin and assess the most probable site of the movement generator in the nervous system. Objective: We intend to provide an update for clinicians on helpful neurophysiological tools to assess movement disorders in clinical practice. Methods: Non-systematic review of the literature published up to June 2019. Results: A diversity of protocols was found and described. These include EMG analyses to define dystonia, myoclonus, myokymia, myorhythmia, and painful legs moving toes pattern; EMG in combination with accelerometer to study tremor; and EEG-EMG to study myoclonus. Also, indirect measures of cortical and brainstem excitability help to describe and diagnose abnormal physiology in Parkinson's disease, atypical parkinsonism, dystonia, and myoclonus. Conclusion: These studies can be helpful for the diagnosis and are usually underutilized in neurological practice.

Development of Harmonized Outcome Measures for Use in Patient Registries and Clinical Practice: Methods and Lessons Learned

2019 ◽  
Author(s):  
Michelle B. Leavy ◽  
Claudia Schur ◽  
Ferhat Q. Kassamali ◽  
Margaret Edder Johnson ◽  
Raj Sabharwal ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Outcome Measures ◽  
Lessons Learned ◽  
Patient Registries ◽  
Practice Methods

scholarly journals Botulinum Toxin in Movement Disorders: An Update

Toxins ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 42
Author(s):  
Charenya Anandan ◽  
Joseph Jankovic
Keyword(s):  
Botulinum Toxin ◽  
Movement Disorders ◽  
Neurological Disorders ◽  
Active Drug ◽  
Therapeutic Agents ◽  
Therapeutic Modality ◽  
Review Of The Literature ◽  
Pilot Studies ◽  
The Us ◽  
Novel Applications

Since its initial approval in 1989 by the US Food and Drug Administration for the treatment of blepharospasm and other facial spasms, botulinum toxin (BoNT) has evolved into a therapeutic modality for a variety of neurological and non-neurological disorders. With respect to neurologic movement disorders, BoNT has been reported to be effective for the treatment of dystonia, bruxism, tremors, tics, myoclonus, restless legs syndrome, tardive dyskinesia, and a variety of symptoms associated with Parkinson’s disease. More recently, research with BoNT has expanded beyond its use as a powerful muscle relaxant and a peripherally active drug to its potential central nervous system applications in the treatment of neurodegenerative disorders. Although BoNT is the most potent biologic toxin, when it is administered by knowledgeable and experienced clinicians, it is one of the safest therapeutic agents in clinical use. The primary aim of this article is to provide an update on recent advances in BoNT research with a focus on novel applications in the treatment of movement disorders. This comprehensive review of the literature provides a critical review of evidence-based clinical trials and highlights recent innovative pilot studies.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

scholarly journals New Potential Biomarkers for Chronic Kidney Disease Management—A Review of the Literature

2020 ◽  
Vol 22 (1) ◽  
pp. 43
Author(s):  
Irina Lousa ◽  
Flávio Reis ◽  
Idalina Beirão ◽  
Rui Alves ◽  
Luís Belo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Renal Damage ◽  
Recent Literature ◽  
Therapeutic Interventions ◽  
Review Of The Literature ◽  
Medical Need ◽  
Early Use ◽  
Reasonable Approach

The prevalence of chronic kidney disease (CKD) is increasing worldwide, and the mortality rate continues to be unacceptably high. The biomarkers currently used in clinical practice are considered relevant when there is already significant renal impairment compromising the early use of potentially successful therapeutic interventions. More sensitive and specific biomarkers to detect CKD earlier on and improve patients’ prognoses are an important unmet medical need. The aim of this review is to summarize the recent literature on new promising early CKD biomarkers of renal function, tubular lesions, endothelial dysfunction and inflammation, and on the auspicious findings from metabolomic studies in this field. Most of the studied biomarkers require further validation in large studies and in a broad range of populations in order to be implemented into routine CKD management. A panel of biomarkers, including earlier biomarkers of renal damage, seems to be a reasonable approach to be applied in clinical practice to allow earlier diagnosis and better disease characterization based on the underlying etiologic process.

scholarly journals The Role of Research in Guiding Treatment for Women’s Health: A Qualitative Study of Traditional Chinese Medicine Acupuncturists

2021 ◽  
Vol 18 (2) ◽  
pp. 834
Author(s):  
Mike Armour ◽  
Debra Betts ◽  
Kate Roberts ◽  
Susanne Armour ◽  
Caroline A. Smith
Keyword(s):  
Clinical Practice ◽  
Women’S Health ◽  
Women's Health ◽  
Clinical Decision ◽  
Health Conditions ◽  
Case Histories ◽  
Research Literacy ◽  
The Right ◽  
Practice Methods

Background: Surveys of acupuncture practitioners worldwide have shown an increase in the use of acupuncture to treat women’s health conditions over the last ten years. Published studies have explored the effectiveness of acupuncture for various conditions such as period pain, fertility, and labor induction. However, it is unclear what role, if any, peer-reviewed research plays in guiding practice. Methods: Acupuncturists with a significant women’s health caseload were interviewed online in three small groups to explore factors that contribute to acupuncturists’ clinical decision made around treatment approaches and research. Results: Eleven practitioners participated in the focus groups. The overarching theme that emerged was one of ‘Not mainstream but a stream.’ This captured two themes relating to acupuncture as a distinct practice: ‘working with what you’ve got’ as well as ‘finding the right lens’, illustrating practitioners’ perception of research needing to be more relevant to clinical practice. Conclusions: Acupuncture practitioners treating women’s health conditions reported a disconnect between their clinical practice and the design of clinical trials, predominantly due to what they perceived as a lack of individualization of treatment. Case histories were popular as a learning tool and could be used to support increasing research literacy.

Therapies for Onychomycosis

2015 ◽  
Vol 105 (4) ◽  
pp. 357-366 ◽  
Author(s):  
Aditya K. Gupta ◽  
Deanne Daigle ◽  
Maryse Paquet
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Treatment Efficacy ◽  
Meta Analysis ◽  
Pulse Therapy ◽  
Controlled Trials ◽  
Review Of The Literature ◽  
Mycological Cure ◽  
Randomized Controlled ◽  
Topical Treatments

New therapies for onychomycosis continue to be developed, yet treatments are seldom directly compared in randomized controlled trials. The objective of this study was to compare the rates of mycological cure for oral and topical onychomycosis treatments using network meta-analysis. A systematic review of the literature on onychomycosis treatments published before March 25, 2013, was performed, and data were analyzed using network meta-analysis. Terbinafine, 250 mg, therapy was significantly superior to all treatments except itraconazole, 400 mg, pulse therapy; itraconazole, 200 mg, therapy was significantly superior to fluconazole and the topical treatments; and fluconazole, efinaconazole, ciclopirox, terbinafine nail solution, and amorolfine treatments were significantly superior to only placebo. These results support the superiority of 12-week continuous terbinafine, 250 mg, therapy and itraconazole, 400 mg, pulse therapy (1 week per month for 3 months) while suggesting the equivalence of topical therapies. These results reflect findings from the literature and treatment efficacy observed in clinical practice.

Modern imagine methods in diagnostics of acute pancreatitis in clinical practice

2020 ◽  
pp. 14-25
Author(s):  
G. R. Ahunova ◽  
R. R. Ahunova
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Mortality Rate ◽  
High Mortality ◽  
Surgical Pathology ◽  
Diagnostic Radiology ◽  
Common Disease ◽  
Review Of The Literature ◽  
Abdominal Organs ◽  
Comprehensive Examination

Acute pancreatitis is one of the most frequent and formidable diseases, and rates as one of the most common disease in the structure of acute surgical pathology of the abdominal organs. In the last decade, there has been an increase in the proportion of necrotic forms of the disease with damage to various departments of the retroperitoneal space and a stably high mortality rate. The diagnostics problem of acute pancreatitis is still relevant due to difficulties that persist despite the possibility of a comprehensive examination of patients upon admission to the hospital and during treatment. This article presents a review of the literature, reflecting the state of the problem and aspects of diagnostic radiology of acute pancreatitis.

scholarly journals The Relation between Stress of Clinical Practice and Burnout among Nursing Students: The Mediation Effect of Spiritual Well-being

2017 ◽  
Vol 23 (3) ◽  
pp. 300-308
Author(s):  
Do Young Lee ◽  
Jin Kyoung Park ◽  
Mi Young Choi
Keyword(s):  
Clinical Practice ◽  
Nursing Students ◽  
Negative Correlation ◽  
Well Being ◽  
Self Report ◽  
Mediation Effect ◽  
Mediating Effects ◽  
Significant Difference ◽  
Spiritual Well Being ◽  
Practice Methods

Purpose: The purpose of this study is to examine the factors that influence the clinical practice of nursing students and to identify the mediating effects of spiritual well-being in the relation between stress of clinical practice and burnout caused by clinical practice. Methods: Data were collected by self-report questionnaires targeting 420 nursing students in three nursing colleges located in Gyeonggi and Chungnam province. Results: Burnout of clinical practice according to general characteristics of the study subjects showed significant difference in religion (t=1.895, p=.049). Stress of clinical practice and burnout of clinical practice showed positive correlation (r=.42, p<.001), existential spiritual well-being showed negative correlation between stress of clinical practice (r=-.17, p<.001) and burnout of clinical practice (r=-.47, p<.001). In addition, religious spiritual well-being in spiritual well-being showed no mediating effects and existential spiritual well-being showed mediating effects between burnout in clinical practice stress. Conclusion: In order to alleviate the stress of clinical practice for burnout of clinical practice prevention of nursing students, solutions to improve the existential spiritual well-being will be required in the future.

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