scholarly journals A New Classification for Hemorrhoidal Disease: The Creation of the “BPRST” Staging and Its Application in Clinical Practice

2020 ◽  
Vol 36 (4) ◽  
pp. 249-255 ◽  
Author(s):  
Carlos Walter Sobrado Júnior ◽  
Carlos de Almeida Obregon ◽  
Afonso Henrique da Silva e Sousa Júnior ◽  
Lucas Faraco Sobrado ◽  
Sérgio Carlos Nahas ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Strong Association ◽  
Management Strategies ◽  
Hemorrhoidal Disease ◽  
New Classification ◽  
The Past ◽  
Internal Hemorrhoids ◽  
New Treatment ◽  
Treatment Alternatives

Purpose: Present an updated classification for symptomatic hemorrhoids, which not only guides the treatment of internal hemorrhoids but also the treatment of external components. In addition, this new classification includes new treatment alternatives created over the last few years.Methods: Throughout the past 7 years, the authors developed a method to classify patients with symptomatic hemorrhoids. This study, besides presenting this classification proposal, also retrospectively analyzed 149 consecutive patients treated between March 2011 and November 2013 and aimed to evaluate the association between the management adopted with Goligher classification and our proposed BPRST classification.Results: Both classifications had a statistically significant association with the adopted management strategies. However, the BPRST classification tended to have fewer management discrepancies when each stage of disease was individually analyzed.Conclusion: Although there is much disagreement about how the classification of hemorrhoidal disease should be updated, it is accepted that some kind of revision is needed. The BPRST method showed a strong association with the management that should be adopted for each stage of the disease. Further studies are needed for its validation, but the current results are encouraging.

scholarly journals Emergency management of the paediatric patient with convulsive status epilepticus

2021 ◽  
Vol 26 (1) ◽  
pp. 50-57
Author(s):  
Kyle C McKenzie ◽  
Cecil D Hahn ◽  
Jeremy N Friedman
Keyword(s):  
Clinical Practice ◽  
Status Epilepticus ◽  
Emergency Management ◽  
Treatment Algorithm ◽  
Position Statement ◽  
Convulsive Status Epilepticus ◽  
Pharmacological Management ◽  
The Past ◽  
New Treatment ◽  
New Evidence

Abstract This guideline addresses the emergency management of convulsive status epilepticus (CSE) in children and infants older than 1 month of age. It replaces a previous position statement from 2011, and includes a new treatment algorithm and table of recommended medications based on new evidence and reflecting the evolution of clinical practice over the past several years. This statement emphasizes the importance of timely pharmacological management of CSE, and includes some guidance for diagnostic approach and supportive care.

Dimensions of evaluation

2009 ◽  
Vol 17 (1) ◽  
pp. 146-175 ◽  
Author(s):  
Monika Bednarek
Keyword(s):  
Psychological Research ◽  
New Classification ◽  
Basic Emotions ◽  
The Past ◽  
Cognitive Studies ◽  
Linguistic Research ◽  
Evaluative Meaning ◽  
Diachronic Development ◽  
Appraisal Processes

In the past two decades or so, a number of researchers from various fields within linguistics have turned their attention to interpersonal phenomena, such as the linguistic expression of speaker opinion or evaluation (also called stance or appraisal), or the encoding of subjectivity in language and its diachronic development (subjectification/subjectivization). Many linguists have offered categorizations of evaluative meaning, based on authentic discourse data, but no connection has been made with cognitive approaches to appraisal processes. This paper offers a first meta-theoretical exploration of such issues. It compares dimensions of evaluation that have been identified in linguistic and cognitive studies, and also examines how psychological research into basic emotions can be related to linguistic research on affect. On the basis of these comparisons a proposal for a new classification of evaluative meanings is made. The focus of this paper is on only one aspect of the highly complex phenomenon of evaluation, namely potential evaluative dimensions, although other relevant issues will also be touched upon, including the pragmatics of evaluation (evaluation and context).

scholarly journals Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria

2018 ◽  
Vol 10 (5-6) ◽  
pp. 129-139 ◽  
Author(s):  
Fabian Proft ◽  
Denis Poddubnyy
Keyword(s):  
Clinical Practice ◽  
Ankylosing Spondylitis ◽  
Early Diagnosis ◽  
Axial Spondyloarthritis ◽  
Early Stage ◽  
Classification Criteria ◽  
New Classification ◽  
The Past ◽  
Asas Classification Criteria ◽  
Recent Developments

Development of the Assessment in Spondyloarthritis International Society (ASAS) classification criteria for axial spondyloarthritis (SpA) was one of the major breakthroughs in the field over the past decade. Despite some concerns related to the specificity of the criteria, they stimulated research into the early stage of the disease. This resulted in major advances in the understanding of the course of the disease, revealing predictors of progression, improvement in early diagnosis and treatment in axial SpA. In this review, we summarize the recent developments resulting from the introduction of the ASAS classification criteria for axial SpA and the implications for research and clinical practice.

Assessment and management of endo-periodontal lesions

Dental Update ◽  
2019 ◽  
Vol 46 (10) ◽  
pp. 930-941
Author(s):  
Philippa Hoyle ◽  
Manoj Tank ◽  
Somayeh Modarres-Simmons ◽  
Claire Annabel Storey
Keyword(s):  
American Academy ◽  
Treatment Strategy ◽  
Clinical Relevance ◽  
Periodontal Diseases ◽  
Management Strategies ◽  
Accurate Diagnosis ◽  
European Federation ◽  
New Classification ◽  
Systematic Methodology

Endo-periodontal lesions present a number of challenges for clinicians. These include understanding their underlying aetiology, forming an accurate diagnosis and suitable prognosis and subsequently formulating an effective treatment strategy. This article aims to provide a summary of the literature available in the areas highlighted above, with particular reference to the recent joint American Academy of Periodontology and European Federation of Periodontology (AAP/EFP) world workshop for classification of periodontal and peri-implant diseases. CPD/Clinical Relevance: This paper outlines important aspects a clinician must consider, including anatomy, a systematic methodology for assessment and introduction of the new classification of periodontal diseases in diagnosis. Prognosis and formulation of appropriate management strategies are explored.

Histoclinical basis for a new classification of hemorrhoidal disease

1988 ◽  
Vol 31 (6) ◽  
pp. 474-480 ◽  
Author(s):  
Pedro J. Morgado ◽  
José A. Suárez ◽  
Luis G. Gómez ◽  
Pedro J. Morgado
Keyword(s):  
Hemorrhoidal Disease ◽  
New Classification

New Treatment Options for Lymphangioma in Infants and Children

2002 ◽  
Vol 111 (12) ◽  
pp. 1066-1075 ◽  
Author(s):  
Chantal M. Giguère ◽  
Nancy M. Bauman ◽  
Richard J. H. Smith
Keyword(s):  
Lymphatic System ◽  
Clinical Presentation ◽  
Treatment Options ◽  
Therapeutic Interventions ◽  
Lymphatic Malformations ◽  
Diagnostic Measures ◽  
The Past ◽  
New Treatment ◽  
In Infants And Children

Lymphangiomas are congenital malformations of the lymphatic system. These lesions occur most often in the head and neck area, and their treatment continues to be a challenge. Fortunately, a number of advances have occurred in the diagnosis and management of lymphatic malformations in the past decade. The purpose of this article is to clarify the embryology, pathogenesis, histopathology, and classification of these lesions, as well as to describe their various forms of clinical presentation. We provide a complete review of the diagnostic measures available and thoroughly discuss new therapeutic interventions proposed to treat lymphangiomas.

scholarly journals Classifications of endometriosis

2017 ◽  
Vol 66 (2) ◽  
pp. 77-92 ◽  
Author(s):  
Edvard K Aylamazyan ◽  
Mariya I Yarmolinskaya ◽  
Arseniy S Molotkov ◽  
Dmitry Z Tsitskarava
Keyword(s):  
Clinical Practice ◽  
Empirical Evidence ◽  
Hormonal Therapy ◽  
Clinical Course ◽  
Pain Syndrome ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
New Classification ◽  
New Guidelines

In the article a review of the main classifications of endometriosis is presented. Main drawbacks of existing classifications have been revealed. A need for a new classification of the disease, which has to be empirical, evidence-based, containing terms that have unambiguous definitions, applicable for various clinical situations, taking into account new clinical forms and able to predict a course of the disease (including the development of pain syndrome and infertility), it’s outcomes and a risk of recurrence is stressed. The new classification of endometriosis has to be based on resolutions of a consensuses and applicable for new guidelines for diagnosis and treatment. For the new classification it is essential to be approachable and easy-to-use in routine clinical practice. It has to allow a physician to determine a stage the disease promptly and meaningfully. A new Protocol taking into account a combination of different forms of endometriosis (superficial, deep infiltrative, adenomyosis, endometriomas, extragenital), color of endometriotic lesions, special aspects of clinical course, results of hormonal examination, reproductive plans and prior hormonal therapy is proposed.

scholarly journals Tremor Syndromes: An Updated Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Abhishek Lenka ◽  
Joseph Jankovic
Keyword(s):  
Clinical Practice ◽  
Movement Disorders ◽  
Task Force ◽  
Future Perspectives ◽  
New Classification ◽  
Predominant Symptom ◽  
Wide Range ◽  
Key Aspects ◽  
Underlying Pathophysiology

Tremor is the most commonly encountered movement disorder in clinical practice. A wide range of pathologies may manifest with tremor either as a presenting or predominant symptom. Considering the marked etiological and phenomenological heterogeneity, it would be desirable to develop a classification of tremors that reflects their underlying pathophysiology. The tremor task force of the International Parkinson Disease and Movement Disorders Society has worked toward this goal and proposed a new classification system. This system has remained a prime topic of scientific communications on tremor in recent times. The new classification is based on two axes: 1. based on the clinical features, history, and tremor characteristics and 2. based on the etiology of tremor. In this article, we discuss the key aspects of the new classification, review various tremor syndromes, highlight some of the controversies in the field of tremor, and share the potential future perspectives.

How to use antidepressive drugs more effectively

1980 ◽  
Vol 18 (19) ◽  
pp. 73-74
Keyword(s):  
Clinical Practice ◽  
Depressive Symptoms ◽  
Drug Treatment ◽  
Depressive Illness ◽  
Medical Advice ◽  
Natural Course ◽  
Double Blind ◽  
The Past ◽  
Antidepressive Drugs

Depressive symptoms are common and often lead the patient to seek medical advice. Forty proprietary antidepressive drugs are available in Britain. Although it is generally agreed that antidepressives can be helpful, it is not yet clear whom they may help, or how much. This is because of disagreement on the classification of depressive illness,1 and difficulty in predicting its natural course. Many patients get better without drug treatment. Although double-blind comparisons with placebo over the past 20 years have shown that these drugs reduce depressive symptoms in most patients, this is less convincing in clinical practice.2 3 Several factors influence the response to drug treatment and understanding them should improve the management of depression.

Interleukin-23 Blockers: Born to be First-line Biologic Agents in Inflammatory Bowel Disease?

2019 ◽  
Vol 25 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Marjorie C. Argollo ◽  
Mariangela Allocca ◽  
Federica Furfaro ◽  
Laurent Peyrin-Biroulet ◽  
Silvio Danese
Keyword(s):  
Clinical Practice ◽  
Treatment Options ◽  
Biologic Agents ◽  
First Line ◽  
Treatment Algorithms ◽  
Loss Of Response ◽  
The Past ◽  
Inflammatory Bowel ◽  
New Treatment ◽  
Interleukin 23

Over the past decades, the advent of anti-TNF agents has dramatically changed the treatment algorithms for IBD. However, primarily and more importantly, secondary loss of response to anti-TNF agents, is often observed. Thus, new treatment options have been actively explored and some have already been incorporated in the current clinical practice. Among the class of anti-cytokine agents, the anti-IL12/IL23 monoclonal antibodies (mAbs) have been first presented, in clinical practice, by the anti-p40 mAb ustekinumab in Crohn’s disease (CD). More selective anti-IL23 agents (anti-p19) have shown efficacy and are being further developed, in contrast to agents inhibiting IL-17 downstream, which have failed in IBD clinical trials despite their clear efficacy in psoriasis.

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