scholarly journals Characterization of T2-Low and T2-High Asthma Phenotypes in Real-Life

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1684
Author(s):  
Fabio Luigi Massimo Ricciardolo ◽  
Andrea Elio Sprio ◽  
Andrea Baroso ◽  
Fabio Gallo ◽  
Elisa Riccardi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Real Life ◽  
Asthma Severity ◽  
University Hospital ◽  
Cross Sectional ◽  
Asthma Phenotypes ◽  
Asthmatic Patients ◽  
Non Invasive ◽  
Grade 5

Asthma is a heterogeneous and complex condition characterized by chronic airway inflammation, which may be clinically stratified into three main phenotypes: type 2 (T2) low, T2-high allergic, and T2-high non-allergic asthma. This real-world study investigated whether phenotyping patients with asthma using non-invasive parameters could be feasible to characterize the T2-low and T2-high asthma phenotypes in clinical practice. This cross-sectional observational study involved asthmatic outpatients (n = 503) referring to the Severe Asthma Centre of the San Luigi Gonzaga University Hospital. Participants were stratified according to the patterns of T2 inflammation and atopic sensitization. Among outpatients, 98 (19.5%) patients had T2-low asthma, 127 (25.2%) T2-high non-allergic, and 278 (55.3%) had T2-high allergic phenotype. In comparison to T2-low, allergic patients were younger (OR 0.945, p < 0.001) and thinner (OR 0.913, p < 0.001), had lower smoke exposure (OR 0.975, p < 0.001) and RV/TLC% (OR 0.950, p < 0.001), higher prevalence of asthma severity grade 5 (OR 2.236, p < 0.05), more frequent rhinitis (OR 3.491, p < 0.001) and chronic rhinosinusitis with (OR 2.650, p < 0.001) or without (OR 1.919, p < 0.05) nasal polyps, but less common arterial hypertension (OR 0.331, p < 0.001). T2-high non-allergic patients had intermediate characteristics. Non-invasive phenotyping of asthmatic patients is possible in clinical practice. Identifying characteristics in the three main asthma phenotypes could pave the way for further investigations on useful biomarkers for precision medicine.

Placebo use in clinical practice by nurses in an Iranian teaching hospital

2011 ◽  
Vol 18 (3) ◽  
pp. 364-373 ◽  
Author(s):  
Nayereh Baghcheghi ◽  
Hamid Reza Koohestani
Keyword(s):  
Clinical Practice ◽  
Teaching Hospital ◽  
Descriptive Study ◽  
Placebo Treatment ◽  
Self Report ◽  
University Hospital ◽  
Cross Sectional ◽  
The Past ◽  
Knowledge And Attitude

The present study was carried out to explore Iranian nurses’ use of placebos in clinical practice and their knowledge and attitude towards its use. A cross-sectional, descriptive study was conducted using self-report questionnaires. All nurses working in a university hospital in Arak (n = 342) were invited to participate in the study. Among 295 respondents, 221 (75%) reported that they had used at least one placebo within the past year and 179 (81%) told patients they were receiving actual medication. The most common reason and symptom for placebo use were after unjustified demand for medication and pain, respectively. Only 60 (20.33%) of the nurses believed that placebos should never be used. Results showed that most nurses in our study had used placebos and probably will continue to use them. Placebo use is viewed as ethically permissible among nurses. Some patients benefit from the placebos, but their use raises ethical questions. The role of placebo treatment, its mechanisms, and its ethics issues should be taught to nurses.

scholarly journals Nursing Interventions in the Clinical Practice of an Intensive Care Unit

2010 ◽  
Vol 18 (5) ◽  
pp. 873-880 ◽  
Author(s):  
Amália de Fátima Lucena ◽  
Maria Gaby Rivero de Gutiérrez ◽  
Isabel Cristina Echer ◽  
Alba Lucia Bottura Leite de Barros
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Nursing Care ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Nursing Interventions ◽  
Sectional Study ◽  
Cross Sectional ◽  
Respiratory Management

This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping. A total of 57 different NIC interventions frequently used in the unit were identified; most of them in the complex (42%) and basic physiological (37%) domains, in the classes ‘respiratory management’ and ‘self-care facilitation’. Similarity between the nursing care prescribed and nursing interventions/NIC was found in 97.2% of the cases. The conclusion is that the interventions/NIC used in the clinical practice of this intensive care unit reflects the level of complexity of nursing care, which is mainly directed at the regulation of the body’s physical and homeostatic functioning.

scholarly journals Asthma Control According to the Community Pharmacists: Evidence and Potential Implications from an Italian Cross-Sectional Study

2020 ◽  
Author(s):  
Marco Caminati ◽  
Luca Cegolon ◽  
Marco Bacchini ◽  
Nadia Segala ◽  
Annarita Dama ◽  
...  
Keyword(s):  
Asthma Control ◽  
Multinomial Logistic Regression ◽  
Treatment Compliance ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Community Pharmacies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Severity Level ◽  
Asthmatic Patients

Abstract Background. Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay with primary care as an effective strategy, the community pharmacies’are rarely involved in asthma management.The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control according to the community pharmacies’ perspective of the health district of Verona (North-Eastern Italy).Methods. A call for participation was launched through the Pharmacists’ Association of Verona.Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to completethe Asthma Control Testand a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined the severity level of asthma.A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI).Results.57 community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were recruited. According to the ACT score 50.5% patients hada controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion patients with uncontrolled asthma was observed at every level of severity, although more frequently in mild persistent form of disease. Most patients (92%) reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR=0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT<16 compared to those not taking medications regularly.Conclusions.Overall, our findings highlighted an unsatisfactory asthma control from the pharmacists’ perspective, independently of the asthma severity level. The relevance of community pharmacies as a first line interface suggest their involvement inan effective asthma management plan, from disease control and treatment compliance assessment to referral of asthmatic patients to medical consultancies.

Characterization of inflammatory bowel disease management by vedolizumab and concomitant treatments in real-life clinical practice

Biologicals ◽  
2019 ◽  
Vol 58 ◽  
pp. 50-56
Author(s):  
Tero Ylisaukko-oja ◽  
Saku Torvinen ◽  
Jaakko Aaltonen ◽  
Heikki Nuutinen ◽  
Timo Blomster ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Disease Management ◽  
Bowel Disease ◽  
Real Life ◽  
Inflammatory Bowel

Physicians' perception toward non-invasive prenatal testing through the eye of the Rogers' diffusion of innovation theory in China

2020 ◽  
Vol 36 (3) ◽  
pp. 239-244
Author(s):  
Yan Wei ◽  
Lizheng Shi ◽  
Jian Ming ◽  
Luyang He ◽  
Yan Xu ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Diffusion Of Innovation ◽  
Prenatal Screening ◽  
Prenatal Testing ◽  
Self Report ◽  
Patient Acceptance ◽  
Screening Methods ◽  
Hospital Competition ◽  
Cross Sectional ◽  
Non Invasive

ObjectivePhysicians' attitudes and adoption behavior toward the delivery of prenatal tests take vital significance for its influence on their professional practice and patient acceptance. This study aimed to identify how physicians have perceived the diffusion of non-invasive prenatal testing (NIPT) in China.MethodsA cross-sectional study was conducted from July 2016 to October 2016 in Shanghai, and Fujian and Sichuan Provinces in China. Physicians working on prenatal screening completed a self-report questionnaire. Following Roger's diffusion of innovation model, multivariable logistic regressions were performed separately for the following key elements of the theory which influence diffusion: physician-perceived attributes of NIPT, communication channels, the nature of the social system, the extent of change agent (who introduces innovations into a society), promotion efforts, and physicians' benefits from adopting NIPT.ResultsMost specialists had a positive attitude (53.2 percent) toward NIPT, whereas 58.9 percent of physicians had already adopted NIPT in their clinical practice. Physician adoption of NIPT was positively associated with the strength of HTA evidence (p = .03), perceived communication frequency with colleagues (p = .04), adoption by other physicians (p = .07), hospital competition (p = .06), hospital teaching status (p = .02), perceived for-profit genetic testing company's promotion (p < .001), and perceived clinical practice skill improvement (p = .02). However, the adoption behavior toward NIPT may be negatively associated with physician-perceived ethical concerns of NIPT (p = .06).ConclusionObstetricians and gynecologists’ positive perceptions facilitate the adoption of NIPT. Combined with cost-effectiveness analysis of prenatal screening methods, health policy makers can promote the adoption of appropriate, cost-effective prenatal screening in pregnant women.

scholarly journals The role of PhD-prepared, hospital-based nurses: an inter-Nordic study

2019 ◽  
Vol 24 (7) ◽  
pp. 470-485
Author(s):  
Erik Elgaard Sørensen ◽  
Kathrine Hoffmann Kusk ◽  
Asa Muntlin Athlin ◽  
Kirsten Lode ◽  
Tone Rustøen ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Close Contact ◽  
Cross Sectional Study ◽  
Nordic Countries ◽  
University Hospital ◽  
University Hospitals ◽  
Cross Sectional ◽  
Research Activities ◽  
Evidence Based Care

Background Little is known about PhD-prepared nurses employed at Nordic university hospitals, how they are organised, what their practices look like or what career pathway they have chosen. Aims The purpose was to investigate and compare the prevalence of PhD-prepared nurses employed at university hospitals in the Nordic countries, to investigate what functions they fulfil and what research activities they undertake and to document how they describe their ideal work life. Methods A descriptive cross-sectional study. An electronic questionnaire was sent to 245 PhD-prepared nurses working at a university hospital in one of six Nordic countries and 166 responses were achieved (response rate 67%). Descriptive analyses were performed using SPSS Statistics. Results The study found notable differences among PhD-prepared nurses employed at university hospitals with respect to work function; organisational structure; satisfaction about time split between research and practice; and the mean scores of time spend on research, clinical practice and teaching, supervision and administration. Conclusions In order to succeed with capacity building among the nursing workforce, collaboration and networking with other researchers and close contact to clinical practice is important. The role of the hospital-based, PhD-prepared nurse needs to be better described and defined to ensure that evidence-based care is provided.

scholarly journals Phenotypic Characterization of Circulating Lung Cancer Cells for Clinically Actionable Targets

Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 380 ◽  
Author(s):  
Arutha Kulasinghe ◽  
Joanna Kapeleris ◽  
Carolina Cooper ◽  
Majid Ebrahimi Warkiani ◽  
Kenneth O’Byrne ◽  
...  
Keyword(s):  
Growth Factor Receptor ◽  
Stage Iv ◽  
Invasive Procedure ◽  
Cross Sectional Study ◽  
Phenotypic Characterization ◽  
Cross Sectional ◽  
Lung Cancers ◽  
Anaplastic Lymphoma ◽  
Non Invasive

Objectives: In non-small cell lung cancers (NSCLC), tumour biopsy can often be an invasive procedure. The development of a non-invasive methodology to study genetic changes via circulating tumour cells (CTCs) is an appealing concept. Whilst CTCs typically remain as rare cells, improvements in epitope-independent CTC isolation techniques has given rise to a greater capture of CTCs. In this cross sectional study, we demonstrate the capture and characterization of NSCLC CTCs for the clinically actionable markers epidermal growth factor receptor (EGFR) alterations, anaplastic lymphoma kinase (ALK) rearrangements and programmed death ligand-1 (PD-L1) expression. The study identified CTCs/CTC clusters in 26/35 Stage IV NSCLC patients, and subsequently characterized the CTCs for EGFR mutation, ALK status and PD-L1 status. This pilot study demonstrates the potential of a non-invasive fluid biopsy to determine clinically relevant biomarkers in NSCLC.

scholarly journals Saliva Sample as a Non-Invasive Specimen for the Diagnosis of Coronavirus Disease-2019 (COVID-19): a Cross-Sectional Study

2020 ◽  
Author(s):  
Ekawat Pasomsub ◽  
Siriorn P. Watcharananan ◽  
Kochawan Boonyawat ◽  
Pareena Janchompoo ◽  
Garanyuta Wongtabtim ◽  
...  
Keyword(s):  
Throat Swab ◽  
Saliva Sample ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Rt Pcr ◽  
Easy Method ◽  
Cross Sectional ◽  
Non Invasive ◽  
Global Pandemic ◽  
Novel Coronavirus

AbstractObjectivesAmid the increasing number of global pandemic coronavirus disease 2019 (COVID-19) cases, there is a need for a quick and easy method to obtain a non-invasive sample for the detection of this novel coronavirus 2019 (SARS-CoV-2). We aimed to investigate the potential use of saliva samples as a non-invasive tool for the diagnosis of COVID-19.MethodsFrom 27 March to 4 April, 2020, we prospectively collected saliva samples and a standard nasopharyngeal and throat swab in persons seeking care at an acute respiratory infection clinic in a university hospital during the outbreak of COVID-19. Real-time polymerase chain reaction (RT-PCR) was performed, and the results of the two specimens were compared.ResultsTwo-hundred pairs of the samples were collected. Sixty-nine (34.5%) patients were male, and the median (interquartile) age was 36 (28-48) years. Using nasopharyngeal and throat swab RT-PCR as the reference standard, the prevalence of COVID-19 diagnosed by nasopharyngeal and throat swab RT-PCR was 9.5%. The sensitivity and specificity of the saliva sample RT-PCR were 84.2% [95% confidence interval (CI) 79.2%-89.3%], and 98.9% (95% CI 97.5-100.3%), respectively. An analysis of the agreement between the two specimens demonstrated 97.5% observed agreement (kappa coefficient 0.851, 95% CI 0.723-0.979; p <0.001).ConclusionsSaliva specimens can be used for the diagnosis of COVID-19. The collection method is non-invasive, and non-aerosol generating. Using a saliva sample as a specimen for the detection of SARS-CoV-2 could facilitate the diagnosis of the disease, which is one of the strategies that helps in controlling the epidemic.

scholarly journals Funcionalidad Familiar en pacientes pediátricos portadores de Asma de un hospital público de Sonora, México.

2016 ◽  
Vol 3 (1) ◽  
pp. 46
Author(s):  
Gabriela Vázquez Armenta ◽  
Francisca Cecilia Ramírez Enríquez ◽  
Diana Gabriela Trejo Ramos ◽  
Jaime Guadalupe Valle Leal ◽  
Cruz Mónica López-Morales
Keyword(s):  
Family Functioning ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Control Area ◽  
Family Impact ◽  
Cross Sectional ◽  
Dysfunctional Family ◽  
Asthmatic Patients ◽  
Asthma Patients

Introduction: The family and psychological approaches in asthma patients are essential because a dysfunctional family can increase asthma symptoms of the sick child. Aim: To determine family functioning and classification of asthma in pediatric patients, and the condition in the areas that comprises it. Method: A cross-sectional study in asthmatic patients treated in pediatrics Regional General Hospital No. 1 between April and July 2015 was done. Asthma severity was classified in response to the GINA 2010 guide. The Dr. Emma Espejel Scale of Family Functioning was applied to the patient's family. Results: The male presented more severe asthma by 70%, especially in school age. The dysfunction of the control area of family dynamics in the Mexican family impact on the severity of asthma. Discussion and Conclusion: 50% of families with a carrier member of asthma reflect dysfunction; control area was the most affected. Family and psychological approaches in patients with asthma are basic to prevent changes in family function.

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