scholarly journals Investigation of Patient Satisfaction with Education in a Biosimilar Multiswitch Scenario - A Comparison Between Rheumatologists and Nurse Specialists

2021 ◽  
Author(s):  
Sabina Gall ◽  
Uta Kiltz ◽  
Tanja Kobylinski ◽  
Ioana Andreica ◽  
Kristina Vaupel ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Negative Impact ◽  
Satisfaction With Care ◽  
Nurse Specialist ◽  
Clinical Trial Evidence ◽  
Standardized Parameters ◽  
And Function ◽  
Satisfaction With Education ◽  
Trial Evidence ◽  
Structured Questionnaire

Abstract The aim of this project was to understand patients’ knowledge and opinion about biosimilars and to evaluate patient satisfaction with care after education on multiswitching of biosimilars (bsDMARDs) by rheumatologists in comparison to nurse specialists. Adult patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis who underwent a non-medical switch to the adalimumab biosimilar MSB 11022 were randomized into a group in which information about multiswitching of bsDMARDs was provided by a nurse specialist or a rheumatologist. Validated outcome tools and standardized parameters for assessment of disease activity and function were used at baseline and 12 weeks after switching. Patients’ satisfaction with care was assessed by the Leeds Satisfaction Questionnaire. A structured questionnaire was used to assess patient’s knowledge. A total of 102 patients was randomized, 40 were seen by the rheumatologist (39.2%) and 62 by the nurse (60.8%). Fifty patients (49%) had already undergone one and 52 multiple switches (51%). Less than one third of patients was able to correctly answer questions on manufacturing, effectiveness, clinical trial evidence and cost of bsDMARDs. Patients were generally satisfied with care irrespective of whether the information had been given by the nurse or the rheumatologist. No difference in outcomes was seen.Patient satisfaction and outcomes after education about bsDMARDs and switching by nurses and rheumatologists were similarly good. The number of switches did not have a negative impact on patient satisfaction.

scholarly journals Negative impact of disuse and unloading on tendon enthesis structure and function

2021 ◽  
Vol 29 ◽  
pp. 46-52
Author(s):  
S. Roffino ◽  
C. Camy ◽  
A. Foucault-Bertaud ◽  
E. Lamy ◽  
M. Pithioux ◽  
...  
Keyword(s):  
Negative Impact ◽  
Structure And Function ◽  
And Function

scholarly journals Updated Review and Meta-Analysis of Probiotics for the Treatment of Clinical Depression: Adjunctive vs. Stand-Alone Treatment

2021 ◽  
Vol 10 (4) ◽  
pp. 647
Author(s):  
Viktoriya L. Nikolova ◽  
Anthony J. Cleare ◽  
Allan H. Young ◽  
James M. Stone
Keyword(s):  
Meta Analysis ◽  
Clinical Depression ◽  
Controlled Clinical Trial ◽  
Reactive Protein ◽  
Treatment Type ◽  
Antidepressant Effects ◽  
Clinical Trial Evidence ◽  
Randomised Controlled ◽  
Trial Evidence ◽  
Insight Into

Recent years have seen a rapid increase in the use of gut microbiota-targeting interventions, such as probiotics, for the treatment of psychiatric disorders. The objective of this update review was to evaluate all randomised controlled clinical trial evidence on the efficacy of probiotics for clinical depression. Cochrane guidelines for updated reviews were followed. By searching PubMed and Web of Science databases, we identified 546 new records since our previous review. A total of seven studies met selection criteria, capturing 404 people with depression. A random effects meta-analysis using treatment type (stand-alone vs. adjunctive) as subgroup was performed. The results demonstrated that probiotics are effective in reducing depressive symptoms when administered in addition to antidepressants (SMD = 0.83, 95%CI 0.49–1.17), however, they do not seem to offer significant benefits when used as stand-alone treatment (SMD = −0.02, 95%CI −0.34–0.30). Potential mechanisms of action may be via increases in brain-derived neurotrophic factor (BDNF) and decreases in C-reactive protein (CRP), although limited evidence is available at present. This review offers stronger evidence to support the clinical use of probiotics in depressed populations and provides an insight into the mode of administration more likely to yield antidepressant effects.

Negative impact of tissue inhibitor of metalloproteinase-3 null mutation on lung structure and function in response to sepsis

2003 ◽  
Vol 285 (6) ◽  
pp. L1222-L1232 ◽  
Author(s):  
Erica L. Martin ◽  
Brent Z. Moyer ◽  
M. Cynthia Pape ◽  
Barry Starcher ◽  
Kevin J. Leco ◽  
...  
Keyword(s):  
Negative Impact ◽  
Cecal Ligation ◽  
Lung Compliance ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Tissue Inhibitors Of Metalloproteinases ◽  
Wild Type ◽  
Gelatinase Activity ◽  
Lung Structure ◽  
And Function ◽  
Knockout Animals

Matrix metalloproteinases (MMPs) are degradative enzymes, which act to remodel tissue. Their activity is regulated by the tissue inhibitors of metalloproteinases (TIMPs). An imbalance in the degradation/inhibition activities has been associated with many diseases, including sepsis. We have previously shown that TIMP-3 knockout animals develop spontaneous, progressive air space enlargement. The objectives of this study were to determine the effects of a septic lung stress induced by cecal ligation and perforation (CLP) on lung function, structure, pulmonary surfactant, and inflammation in TIMP-3 null mice. Knockout and wild-type animals were randomized to either sham or CLP surgery, allowed to recover for 6 h, and then euthanized. TIMP-3 null animals exposed to sham surgery had a significant increase in lung compliance when compared with sham wild-type mice. Additionally, the TIMP-3 knockout mice showed a significant increase in compliance following CLP. Rapid compliance changes were accompanied by significantly decreased collagen and fibronectin levels and increased gelatinase (MMP-2 and -9) abundance and activation. Additionally, in situ zymography showed increased airway-associated gelatinase activity in the knockout animals enhanced following CLP. In conclusion, exposing TIMP-3 null animals to sepsis rapidly enhances the phenotypic abnormalities of these mice, due to increased MMP activity induced by CLP.

scholarly journals Enteral resorbable diet versus standard diet in primary sphincter reconstruction: a prospective randomised trial

2021 ◽  
Author(s):  
Andreas Joos ◽  
Dieter Bussen ◽  
Christian Galata ◽  
Christoph Reißfelder ◽  
Alexander Herold ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Healing Rate ◽  
Negative Impact ◽  
Randomised Trial ◽  
Sample Size Calculation ◽  
Standard Diet ◽  
Complication Rates ◽  
Significance Level ◽  
Sphincter Reconstruction ◽  
Prospective Randomised Trial

Abstract Aim Bowel movements after reconstructive anorectal surgery may negatively affect surgical outcome. This study was aimed to assess any differences between a standard diet (SD) and the enteral resorbable diet (ED) in terms of operative outcomes and patient tolerance after fistulectomy with primary sphincter reconstruction. Method Adult patients undergoing elective fistulectomy with primary sphincter reconstruction for anorectal and rectovaginal fistulas were eligible for inclusion. Patients were intraoperatively randomised to receive either the ED and peristalsis-inhibiting medication (ED) or a SD. The primary endpoint was the healing rate. Secondary endpoints included continence scores, complications and quality of life. Sample size calculation resulted in the analysis of 60 patients to detect a difference in fistula recurrence of 30% with 70% power and a 5% significance level. Results Sixty-six patients (24 women) were prospectively and randomly assigned to the ED (n = 34: 51%) or a SD (n = 32; 48%); mean age was 47 (18-74) years. The primary healing rate was 64 out of 66 patients (96%). No statistical difference in healing rate was seen between the groups. However, patient satisfaction was significantly higher in the SD group (P < 0.0001). Conclusions Fistulectomy with primary sphincter reconstruction is a safe method with low complication rates. Postoperative stool behaviour has no significant influence on the healing rate but has a significant negative impact on patient satisfaction. Therefore, maintaining a standard diet seems to be preferable following reconstructive anal surgery. Trial registration The trial was registered with the German Clinical Trials Register (DRKS00020524).

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