scholarly journals Acute period of polytrauma in children in the light of discriminant analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 145-156
Author(s):  
Vladislav B. Bakovsky ◽  
Sergey I. Golovkin ◽  
Tatyana V. Kukharova ◽  
Vladimir A. Utkin ◽  
Elena N. Chalaya ◽  
...  
Keyword(s):  
Discriminant Analysis ◽  
Injury Severity ◽  
Successful Outcome ◽  
White Blood Count ◽  
Patient Response ◽  
Acute Period ◽  
Internal Bleeding ◽  
Patient Withdrawal ◽  
Vector Orientation ◽  
Individual Patient Response

Introduction. The treatment of polytrauma in children requires identifying the signs that characterize the severity of the acute period and quantifying the priorities of the parameters. Collectively, these reflect the direction of drift of the leading pathophysiological manifestations at each stage of the patient withdrawal program from a state of severe shock. Purpose. This study uses discriminant analysis to clarify the tactics of children with polytrauma in the first days of overcoming its consequences. It is based on the pathogenetically sound idea that each of the observed parameters role, together in the form of a vector, reflects injury severity and the childs prognosis. Materials and methods. This analysis included 45 children (34 boys and 11 girls) with polytrauma aged from 2.5 to 17 years and hospitalized in Kemerovos intensive care unit. Two groups were analyzed: the survivors and those who were deceased. Both were dominated by severe traumatic brain injury (PMT). The injury severity score (ISS) scale was used for clinical assessment of injury severity. Results. Combined with objectively obtained data on the structure of polytrauma in the direction of drift, a successful outcome is defined as a whole. It borders on the day to day priorities, potassium, PH, white blood count, and hematocrit. Also, the vector orientation pattern was observed to increase organ failure. This progressive decline occurred despite timely surgical intervention to stop internal bleeding, very active efforts to compensate for hypovolemia, acidosis, and the use of adequate means of detoxification. The deterioration in the child's condition manifests itself by increased potassium losses against the background of almost no reaction from leukocytes. Conclusions. The application of discriminant analysis enables the better revelation of the peculiarities of a polytraumas multidimensional dynamics in children in the first few days of resuscitation. It also permits the numerical expression of the priorities of individual parameters that describe their state, and by the severity and individual patient response in real-time to optimize treatment.

Role of Topical Oxymetazoline for Management of Erythematotelangiectatic Rosacea

2017 ◽  
Vol 52 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Rebecca M. Hoover ◽  
John Erramouspe
Keyword(s):  
English Language ◽  
Human Subjects ◽  
Data Extraction ◽  
Drug Approval ◽  
Current Data ◽  
Patient Response ◽  
Study Selection ◽  
Cochrane Database ◽  
Drug Approval Process ◽  
Individual Patient Response

Objective: To review and summarize topical oxymetazoline’s pharmacology, pharmacokinetics, efficacy, safety, cost, and place in therapy for persistent redness associated with erythematotelangiectatic rosacea. Data Sources: Literature searches of MEDLINE (1975 to September 2017), International Pharmaceutical Abstracts (1975 to September 2017), and Cochrane Database (publications through September 2017) using the terms rosacea, persistent redness, α -agonist, and oxymetazoline. Study Selection and Data Extraction: Results were limited to studies of human subjects, English-language publications, and topical use of oxymetazoline. Relevant materials from government sources, industry, and reviews were also included. Data Synthesis: Data support the efficacy of oxymetazoline for persistent facial redness. Little study beyond clinical trials cited in the drug approval process has been conducted. Current data suggest that oxymetazoline is similar in safety and efficacy to brimonidine. Head-to-head comparisons of topical α-agonists for erythema caused by rosacea are needed. Conclusion: The topical α-agonist, oxymetazoline, is safe and effective for reducing persistent facial redness associated with erythematotelangiectatic subtype of rosacea. Health care practitioners selecting among treatments should consider not only the subtype of rosacea but also individual patient response, preference, and cost.

An Investigation into the Response of Palatally Displaced Canines to the Removal of Deciduous Canines and an Assessment of Factors Contributing to Favourable Eruption

1993 ◽  
Vol 20 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Susan M. Power ◽  
Mary B. E. Short
Keyword(s):  
Standard Deviation ◽  
Discriminant Analysis ◽  
Clinical Features ◽  
Prognostic Indicators ◽  
Successful Outcome ◽  
Tooth Width ◽  
Maximum Period

The effect of the removal of deciduous canines on palatally displaced maxillary canines was assessed and factors contributing to a successful outcome were analysed. Thirty-nine consecutive patients of mean age 11·2 years (standard deviation 1·43), with 47 palatalfy displaced canines were included in the study. The cases were examined clinically and radiographically for a maximum period of 2 years following deciduous canine removal. Twenty-nine (62 per cent) of the 47 ectopic canines achieved a normal eruptive position and nine (19 per cent) showed some improvement in eruptive position. The outcome of the removal of the deciduous canine depended on the position of the permanent canine. Horizontal overlap of the nearest incisor was found to be the most significant factor. If this exceeded half the tooth width, success was unlikely. The presence of crowding was found to affect adversely the favourable eruption of the canine. Discriminant analysis was carried out to try to identify clinical features which could act as prognostic indicators for the outcome of deciduous canine removal.

scholarly journals Progress in Clinical Neurosciences A Systematic Review of the Use of Triptans in Acute Migraine

2001 ◽  
Vol 28 (1) ◽  
pp. 30-41 ◽  
Author(s):  
Marek J. Gawel ◽  
Irene Worthington ◽  
Anne Maggisano
Keyword(s):  
Systematic Review ◽  
Number Needed To Treat ◽  
Acute Migraine ◽  
Patient Response ◽  
Oral Formulations ◽  
Subcutaneous Sumatriptan ◽  
Individual Patient Response ◽  
Headache Recurrence ◽  
Number Needed To Harm ◽  
Selection Of

ABSTRACT:Objective:A systematic review of the literature was undertaken, to consolidate evidence concerning the efficacy and safety of triptans currently available in Canada (sumatriptan, rizatriptan, naratriptan, zolmitriptan), and to provide guidelines for selection of a triptan.Methods:Data from published, randomized, placebo-controlled trials were pooled and a combined number needed to treat (NNT) and number needed to harm (NNH) was generated for each triptan. Direct comparative trials of triptans were also examined.Results:The lowest NNTfor headache response/pain-free at one/two hours is observed with subcutaneous sumatriptan. Among the oral formulations, the lowest NNT is observed with rizatriptan and the highest NENT with naratriptan. The lowest NNH is observed with subcutaneous sumatriptan.Conclusions:Triptans are relatively safe and effective medications for acute migraine attacks. However, differences among them are relatively small. Considerations in selecting a triptan include individual patient response/tolerance, characteristics of the attacks, relief of associated symptoms, consistency of response, headache recurrence, delivery systems and patient preference.

scholarly journals Monitored Exercise and Supplemental Oxygen Improve Exercise Tolerance, Heart Rate Response and Symptoms in Three Females with Post-COVID Syndrome: A Case Series

2021 ◽  
Author(s):  
Noah Greenspan ◽  
Marion Mackles ◽  
Greg Hullstrung ◽  
Wai Chin ◽  
Robert Kaner ◽  
...  
Keyword(s):  
Heart Rate ◽  
Exercise Tolerance ◽  
Blood Pressure Response ◽  
Significant Proportion ◽  
Case Series ◽  
Supplemental Oxygen ◽  
Treatment Protocols ◽  
Patient Response ◽  
Variable Nature ◽  
Individual Patient Response

Abstract Background: It is now recognized that a significant proportion of previously healthy young and middle-aged adults who contract COVID-19 will develop protracted post-viral symptoms including fatigue, dyspnea, cough, post-exertional malaise and autonomic dysfunction. Effective treatment approaches for this post-COVID syndrome (PCS) are crucially needed.Methods: Three previously healthy females (ages 34, 39, and 38) who contracted COVID-19 in Spring 2020 and subsequently developed PCS received monitored aerobic exercise combined with supplemental oxygen beginning seven or eight months following acute-illness. Pre- and post-treatment exercise tolerance was tested using the Bensen treadmill protocol. Treatment consisted of 22 sessions of graduated treadmill exercise during which 6 liters of continuous oxygen was delivered via nasal canula. Findings: All patients demonstrated ~54% improvement in exercise tolerance, improvement in heart rate and systolic blood pressure response during exercise, and remission or improvement of symptoms, including cough, dyspnea on exertion, laryngeal inflammation, chest discomfort, fatigue, and/or post-exertional malaise. Interpretation: We show that measured, monitored exercise combined with supplemental oxygen improved lingering symptoms in three female PCS patients. Supplemental oxygen may reduce post-exercise inflammation, therefore providing the benefits of exercise while reducing the likelihood of PCS symptom exacerbation. Due to the variable nature of PCS, it is crucial to individualize treatment protocols and to continually evaluate and modify each protocol based upon individual patient response. Funding: This work was funded by the Pulmonary Wellness Foundation.

Blunt Thoracic Aortic Injury

2008 ◽  
Vol 74 (10) ◽  
pp. 1033-1037 ◽  
Author(s):  
Elizabeth R. Benjamin ◽  
Areti Tillou ◽  
Jonathan R. Hiatt ◽  
H. Gill Cryer
Keyword(s):  
Injury Severity ◽  
Aortic Injury ◽  
Diagnosis And Treatment ◽  
Successful Outcome ◽  
Operative Repair ◽  
Blunt Thoracic Aortic Injury ◽  
Thoracic Aortic Injury ◽  
Pelvic Embolization ◽  
Life Threatening ◽  
Level I

Blunt thoracic aortic injury (BAI) is a rare but often fatal injury that occurs with severe polytrauma. Immediate diagnosis and treatment of BAI are essential for a successful outcome. We reviewed our experience with 20 patients with BAI treated at a Level I trauma center between 1995 and 2006. The mean Injury Severity Score was 38 ± 14 and 14 patients had an abnormal Glasgow Coma Score; associated injuries included abdomen in 13 patients, extremity in 12, and head in six. Chest x-ray (CXR) findings were suggestive of aortic injury in 15 patients, equivocal in three, and showed no evidence of aortic injury in two. Diagnosis was made by CT angiography (CTA) in 17 patients, transesophageal echocardiography (TEE) in two, and formal angiography in one. Sixteen patients underwent operative repair of BAI. Of these, eight also underwent laparotomy, six had operative repair of extremity fractures, and three had pelvic embolization. Five patients died, three of whom were treated nonoperatively, and length of hospitalization in survivors was 32 ± 20 days. BAI is rare and often associated with multiple life-threatening injuries complicating diagnosis and treatment. Our data support the aggressive use of CTA even when classic CXR findings are not present. When CT must be delayed for abdominal exploration, intraoperative TEE is useful.

Antipsychotics: How Strict the Formulary?

1988 ◽  
Vol 22 (4) ◽  
pp. 324-326 ◽  
Author(s):  
Bruce Alexander
Keyword(s):  
Dosage Form ◽  
Relative Efficacy ◽  
Patient Response ◽  
Antipsychotic Medications ◽  
Clinical Considerations ◽  
Individual Patient Response ◽  
Relative Differences ◽  
Level Monitoring ◽  
Formulary Inclusion ◽  
The U.S

Seventeen antipsychotic medications are available in the U.S. Antipsychotic formulary considerations include relative efficacy, individual patient response, relative differences in adverse effects, dosage form availability, blood level monitoring, and generic availability. Chlorpromazine, thioridazine, haloperidol, and fluphenazine are recommended for formulary inclusion based on research and clinical considerations. A recommendation for managing a patient receiving a nonformulary antipsychotic is presented.

Current Concepts of Tumor Immunology II. Tumor Immunodetection

1977 ◽  
Vol 86 (6) ◽  
pp. 871-874 ◽  
Author(s):  
Charles J. Krause ◽  
John O. Nysather
Keyword(s):  
Tumor Immunology ◽  
Response To Treatment ◽  
Skin Tests ◽  
Treatment Modalities ◽  
Patient Response ◽  
The Status ◽  
Individual Patient Response ◽  
Humoral Responses ◽  
Fetal Antigens

A great deal of investigation is presently underway to develop methods of effectively assessing the status of an individual patient's immune system. Such methods might provide a means of early detection of tumor or of indicating prognosis so that treatment modalities may be tailored to individual patient needs. The cell-mediated response may be monitored using intradermal skin tests and in vitro lymphocyte stimulation and cytotoxicity tests. Humoral responses have been monitored using assays for antibodies against tumor specific as well as tumor associated antigens. Assays have been developed which are capable of detecting circulating fetal antigens in very small concentrations. Thus far no one assay technique has proven to be sufficiently sensitive nor specific to be clinically useful. However, by utilizing a battery of tests before, during and after treatment, it is possible to determine a great deal about individual patient response to treatment and prognosis. With so many investigators focusing upon this problem, it seems likely that more effective methods of immunodetection will soon be developed.

Opipramol and Chlorthalidone in the Treatment of Premenstrual Tension

1973 ◽  
Vol 1 (3) ◽  
pp. 172-179
Author(s):  
G Kagan ◽  
G Beaumont
Keyword(s):  
Clinical Trial ◽  
Response To Therapy ◽  
Emotional Lability ◽  
Patient Response ◽  
Favourable Response ◽  
Premenstrual Tension ◽  
The Third ◽  
Valid Comparison ◽  
Individual Patient Response ◽  
Effect Of Age

Thirty-three patients under the age of 38 suffering from premenstrual tension were admitted to a clinical trial and treated for three cycles. Five received opipramol alone and twenty-eight received a combination of opipramol and chlorthalidone. Slightly better results were obtained with the combination than with opipramol alone, although the number of opipramol patients was too small for valid comparison. There was a progressive improvement over the three cycles. By the third cycle there was a 47.92% improvement in the total score for ten symptoms on opipramol and 59.2% improvement on the combination. As far as the combination was concerned, best results were obtained for the symptoms, swelling of breasts (90%) mastalgia (88.8%), swelling of ankles (83.3%), oliguria (64.2%) and emotional lability (59.2%). The effect of age, marital state and gravidity on the syndrome was examined. No major differences were found in the symptomatology as far as these three factors were concerned. Young, single nulligravid women however, showed a consistently more favourable response to therapy. In terms of individual patient response, twenty-eight patients showed moderate or much improvement by the end of the third cycle.

Desirable performance characteristics for BCR-ABL measurement on an international reporting scale to allow consistent interpretation of individual patient response and comparison of response rates between clinical trials

Blood ◽  
2008 ◽  
Vol 112 (8) ◽  
pp. 3330-3338 ◽  
Author(s):  
Susan Branford ◽  
Linda Fletcher ◽  
Nicholas C. P. Cross ◽  
Martin C. Müller ◽  
Andreas Hochhaus ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Reference Method ◽  
Response Rates ◽  
Performance Characteristics ◽  
Molecular Response ◽  
Mrna Levels ◽  
Patient Response ◽  
Accurate Comparison ◽  
Validation Procedure ◽  
Individual Patient Response

AbstractAn international basis for comparison of BCR-ABL mRNA levels is required for the common interpretation of data derived from individual laboratories. This will aid clinical decisions for individual patients with chronic myeloid leukemia (CML) and assist interpretation of results from clinical studies. We aligned BCR-ABL values generated by 38 laboratories to an international scale (IS) where a major molecular response (MMR) is 0.1% or less. Alignment was achieved by application of laboratory-specific conversion factors calculated by comparisons performed with patient samples against a reference method. A validation procedure was completed for 19 methods. We determined performance characteristics (bias and precision) for consistent interpretation of MMR after IS conversion. When methods achieved an average BCR-ABL difference of plus or minus 1.2-fold from the reference method and 95% limits of agreement within plus or minus 5-fold, the MMR concordance was 91%. These criteria were met by 58% of methods. When not met, the MMR concordance was 74% or less. However, irrespective of precision, when the bias was plus or minus 1.2-fold as achieved by 89% of methods, there was good agreement between the overall MMR rates. This indicates that the IS can deliver accurate comparison of molecular response rates between clinical trials when measured by different laboratories.

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