scholarly journals Effects of Pediatric Training for Detecting Signs of Developmental Problems

2015 ◽  
Vol 35 (2) ◽  
pp. 359-373 ◽  
Author(s):  
Ana Silvia de Morais ◽  
Edna Márcia Koizume Bronzatto ◽  
Rogério Lerner ◽  
Maria Cristina Machado Kupfer
Keyword(s):  
Clinical Practice ◽  
Child Development ◽  
Prior Knowledge ◽  
Medical Practice ◽  
Multicenter Study ◽  
Risk Indicators ◽  
Institutional Discourse ◽  
Developmental Problems ◽  
Emergency Scenario ◽  
Parental Function

A multicenter study (2004-2008) of clinical Risk Indicators for Child Development (IRDI) created and validated 31 indicators that can be observed in the initial 18 months post birth, with a statistically significant ability to predict developmental problems and psychic risk. Pediatricians were trained to collect data using the instrument. We discuss what remained for the pediatricians by interviewing a pediatrician who attended the course. The interview was analyzed from an institutional discourse perspective, revealing an objective/subjective duality and a split between prior and acquired knowledge. The ward emergency scenario does not provide enough time for a guided look at the indicators; indicators associated with parental function had a greater impact. The course increased his pleasure in his clinical practice, although his prior knowledge was limited. We suggest investigating the extent and limits of the effects of IRDI-oriented training for medical practice.

scholarly journals Predictive value of clinical risk indicators in child development: final results of a study based on psychoanalytic theory

2010 ◽  
Vol 13 (1) ◽  
pp. 31-52 ◽  
Author(s):  
Maria Cristina Machado Kupfer ◽  
Alfredo Nestor Jerusalinsky ◽  
Leda Mariza Fischer Bernardino ◽  
Daniele Wanderley ◽  
Paulina Schmidtbauer Barbosa Rocha ◽  
...  
Keyword(s):  
Child Development ◽  
Predictive Value ◽  
Psychoanalytic Theory ◽  
Risk Indicators ◽  
Predictive Capacity ◽  
Developmental Problems ◽  
Clinical Risk ◽  
Psychoanalytic Approach ◽  
The Subject

We present the final results of a study using the IRDI (Clinical Risk Indicators in Child Development). Based on a psychoanalytic approach, 31 risk signs for child development were constructed and applied to 726 children between the ages of 0 and 18 months. One sub-sample was evaluated at the age of three. The results showed a predictive capacity of IRDIs to indicate developmental problems; 15 indicators for the IRDI were also highlighted that predict psychic risk for the constitution of the subject.

scholarly journals Adjunctive Perampanel in Older Patients With Epilepsy: A Multicenter Study of Clinical Practice

Drugs & Aging ◽  
2021 ◽  
Author(s):  
Simona Lattanzi ◽  
Claudia Cagnetti ◽  
Nicoletta Foschi ◽  
Roberta Ciuffini ◽  
Elisa Osanni ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Multicenter Study ◽  
Older Patients ◽  
Patients With Epilepsy

Integral Metatheory in the Time of COVID: Implications for Medical and Nursing Teaching and Practice

2021 ◽  
pp. HumanCaring-D-20-00027
Author(s):  
Stephen J. Darcy
Keyword(s):  
Nursing Education ◽  
Clinical Practice ◽  
Patient Care ◽  
Medical Practice ◽  
Potential Application ◽  
Illness Experience ◽  
Comprehensive View ◽  
Practice Of Medicine ◽  
Basic Concepts ◽  
Interpretive Framework

Ken Wilber's integral metatheory is an interpretive framework that can that be applied to the clinical practice of medicine and medical and nursing education. It offers a comprehensive view of the patient illness experience superior to current models of patient care and may provide a valuable guide for nursing and medical practice and teaching. This article seeks to explain some of the basic concepts of integral metatheory and show their potential application to practice and teaching using the current COVID-19 pandemic as an illustrative model.

scholarly journals THU0439 Tocilizumab in giant cell arteritis. national multicenter study of 134 patients of clinical practice

2018 ◽  
Author(s):  
D. Prieto-Peña ◽  
J. Loricera ◽  
J. Martín-V ◽  
M. Calderón-G ◽  
V. Aldasoro ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study

scholarly journals Testing the Short-Term Efficacy of a Lipid-Lowering Nutraceutical in the Setting of Clinical Practice: A Multicenter Study

2015 ◽  
Vol 18 (11) ◽  
pp. 1270-1273 ◽  
Author(s):  
Arrigo F.G. Cicero ◽  
Giuseppe Derosa ◽  
Livia Pisciotta ◽  
Carlo Barbagallo ◽  
Keyword(s):  
Clinical Practice ◽  
Multicenter Study ◽  
Lipid Lowering ◽  
Short Term ◽  
Term Efficacy

Treatment with tofacitinib in refractory psoriatic arthritis. National multicenter study of the first 87 patients of clinical practice

2021 ◽  
pp. jrheum.201204
Author(s):  
Eva Galíndez-Agirregoikoa ◽  
Diana Prieto-Peña ◽  
José Luis Martín-Varillas ◽  
Beatriz Joven ◽  
Olga Rusinovich ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Multicenter Study ◽  
Randomized Clinical Trials ◽  
Retention Rate ◽  
Gastrointestinal Symptoms ◽  
Janus Kinase ◽  
Dose Effect ◽  
Open Label ◽  
Reactive Protein

Objective Tofacitinib (TOFA) is the first Janus kinase (JAK) inhibitor approved for Psoriatic Arthritis (PsA). It has shown efficacy in patients refractory to anti-TNFα in Randomized Clinical Trials (RCT). Our aim was to assess efficacy and safety of TOFA in clinical practice. Methods Observational, open-label multicenter study of PsA patients treated with TOFA due to inefficacy or adverse events of previous therapies. Outcome variables were efficacy, sparing corticosteroid-dose effect, retention rate and safety. Comparative study of clinical features between our cohort of patients and those from the OPAL BEYOND trial was performed. Results 87 patients (28 women/59 men), mean age of 52.8±11.4 years. All patients were refractory to b-DMARDs and/or to cs-DMARDs plus Apremilast. TOFA was started at 5mg twice daily after a mean follow-up of 12.3±9.3 years from PsA diagnosis. At first month, DAS28ESR decreased from 4.8 [4.1-5.4] to 3.7 [2.8-4.7] (p <0.01), DAPSA from 28 [18.4-34.1] to 15.5 [10.1-25.7] (p < 0.01) and C-reactive protein from 1.9 [0.3-5.0] to 0.5 [0.1-2.2] mg/dL (p < 0.01). Also, TOFA led to a significant reduction of prednisone dose. Mild adverse effects were reported in 21 patients (24.13%), mainly gastrointestinal symptoms. TOFA retention rate at month 6 was 77% (CI 95%; 65.2-86.3 %). Patients of clinical practice were older with longer disease duration and received biologic agents more commonly than those in the OPAL BEYOND trial. Conclusion Data from clinical practice confirm that TOFA seems to be effective, rapid and relatively safe in refractory PsA despite clinical differences with patients in RCT.

Ethics in Medical Practice and Research

2021 ◽  
Vol 10 (1) ◽  
pp. 54-56
Author(s):  
Pramod Kattel
Keyword(s):  
Clinical Practice ◽  
Treatment Group ◽  
Medical Practice ◽  
Human Subject ◽  
Codes Of Conduct ◽  
Basic Sciences ◽  
Medical Practitioners ◽  
Medical Curricula ◽  
Trained Personnel ◽  
Standard Of Practice

Ethics is a moral guide that helps the treatment group to be treated with due respect and care following the standard of practice. It also helps the research to be conducted without or minimal harm to the population under study. Besides ethics, clinical practice and research are guided by some nationally and internationally accepted principles or codes of conduct. The human subject under treatment or study should be respected to the utmost level and should be performed by trained personnel. The importance of ethics starts before studies so should be kept in medical curricula starting from basic sciences so that medical practitioners become acquainted from the beginning of the study.

Adrenal incidentaloma

2011 ◽  
pp. 781-788
Author(s):  
Massimo Terzolo
Keyword(s):  
Clinical Practice ◽  
Medical Practice ◽  
Adrenal Mass ◽  
Adrenal Incidentaloma ◽  
Specific Diagnosis ◽  
Incidental Discovery ◽  
Definition Of ◽  
Adrenal Disease ◽  
Ct And Mri

Adrenal incidentaloma is an adrenal mass that is discovered serendipitously with a radiological examination performed for indications unrelated to adrenal disease (1). The incidental discovery of an adrenal mass has become an increasingly common problem, because of the widespread use of ultrasonography, CT, and MRI in clinical practice (2, 3). These techniques have greatly improved their power of resolution over recent years, thereby increasing the possibility of detection of tiny adrenal lumps. Several factors hinder a clear characterization of the phenomenon ‘adrenal incidentaloma’, which may be considered as a byproduct of technology applied to medical practice. Adrenal incidentaloma is not a single pathological entity and the likelihood of any specific diagnosis depends both on the circumstances of discovery and the applied definition of incidentaloma. Unfortunately, published reports are inconsistent in applying inclusion and exclusion criteria for these various factors, making the results difficult to interpret. A further issue is the lack of specific clinical features of the patients carrying an adrenal incidentaloma.

The role of diagnosis in medical practice and society

2019 ◽  
pp. 17-33
Author(s):  
Ahmed Samei Huda
Keyword(s):  
Clinical Practice ◽  
Medical Practice ◽  
Clinical Information ◽  
Relevant Information ◽  
Access To Healthcare ◽  
Social Effects ◽  
Health Statistics ◽  
Social Functions ◽  
Teaching And Research

Organization of knowledge is needed to help doctors learn and recall information in their clinical practice. Diagnostic constructs help, providing prototypes against which doctors can diagnose patient conditions. They then seek to confirm or disprove this diagnosis by searching for relevant information. Attached to these diagnostic constructs are information such as causes, prognosis, and treatment. Diagnostic constructs are provisional and should be changed if information suggests they are incorrect. They also aid communication between professionals for teaching and research, and have important social functions such as providing access to healthcare, determining eligibility for welfare, offering administrative and payment functions, and collecting health statistics. Some social effects of diagnostic constructs can be harmful, such as stigma. Diagnostic constructs are included in broad diagnostic formulations including relevant clinical information.

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