scholarly journals Patient Perceptions of Osteoporosis Treatment Thresholds

2014 ◽  
Vol 41 (3) ◽  
pp. 516-522 ◽  
Author(s):  
Joan M. Neuner ◽  
Marilyn M. Schapira
Keyword(s):  
Perceived Risk ◽  
Treatment Guidelines ◽  
Osteoporosis Treatment ◽  
Treatment Side Effects ◽  
Risk Patients ◽  
History Of ◽  
Risk Thresholds ◽  
Current Guidelines ◽  
Treatment Risks ◽  
Fracture Risks

Objective.Many older patients express concerns about medication risks, and have higher risk thresholds than physicians for cardiovascular preventive medications. We hypothesized that patients have relatively high risk thresholds for fracture preventive medications.Methods.Women ≥ 60 years old were recruited from 3 primary care internal medicine clinics in Wisconsin. Participants were provided information regarding fracture risks and treatment risks and benefits, followed by a series of vignettes depicting a 70-year-old woman at baseline fracture risks between 5–50%. Fracture risks were shown graphically and treatment side effects were provided for each vignette, and participants were asked to respond regarding whether they would accept treatment. The association of vignette treatment acceptance with participant beliefs regarding medication risks was examined in analyses adjusted for perceived risk of medications, patient numeracy, and prior respondent experience with osteoporosis.Results.The mean age of women in the cohort was 69.4 years (SD 7.29). Ninety-one percent were non-Hispanic whites, 34% reported a history of fracture, and 20.3% a history of osteoporosis. Subjects varied substantially in their responses to vignettes, but only 51% reported they would accept prescription osteoporosis treatment at the threshold currently recommended by national physician treatment guidelines, and fewer would accept treatment at lower risks. Belief that medications are generally not worth their risks was associated with lower acceptance of treatment at all levels of fracture risk.Conclusion.There is substantial variability in preferences for postmenopausal osteoporosis treatment. Presentation of individualized fracture risks as recommended by current guidelines has potential to allow better targeting to higher-risk patients, but further work is needed regarding how to present this information and counsel patients.

scholarly journals Anti-inflammatory Treatment of Kawasaki Disease: Comparison of Current Guidelines and Perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Piotr Buda ◽  
Joanna Friedman-Gruszczyńska ◽  
Janusz Książyk
Keyword(s):  
Heart Disease ◽  
Kawasaki Disease ◽  
Treatment Guidelines ◽  
Intravenous Immunoglobulins ◽  
Scientific Data ◽  
Increased Risk ◽  
Risk Patients ◽  
Acquired Heart Disease ◽  
Anti Inflammatory ◽  
Current Guidelines

Kawasaki disease (KD), an acute, generalized vasculitis, is associated with an increased risk of coronary heart disease and is the most common cause of acquired heart disease in childhood. The incidence of KD is increasing worldwide. There are numerous international treatment guidelines. Our study aims to perform the first one so far comparison of them. While the gold standard therapy remains still the same (intravenous immunoglobulins and aspirin), there is currently a lack of evidence for choosing optimal treatment for high-risk patients and refractory KD. In this review, we also discuss the treatment of complications of KD and Kawasaki-like phenotypes, present an anti-inflammatory treatment in the light of new scientific data, and present novel potential therapeutic targets for KD.

Which patients attending genitourinary medicine clinics have HIV tests?

2002 ◽  
Vol 13 (12) ◽  
pp. 843-846 ◽  
Author(s):  
T K Wickramasinghe ◽  
K E Rogstad
Keyword(s):  
Hiv Testing ◽  
Perceived Risk ◽  
Past History ◽  
Hiv Positive ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Hiv Test ◽  
Risk Patients ◽  
History Of ◽  
Genitourinary Medicine

To identify factors associated with uptake of HIV testing a questionnaire was given to patients attending a GUM clinic over a three-week period. One hundred and twenty (69.4%) of 189 patients accepted and 53 (30.6%) refused testing. Variables associated with having a HIV test were: being tested previously ( P = 0.045), given a leaflet about testing ( P = 0.001), told about the window period ( P = 0.006), told about availability of counselling ( P = 0.030), given insurance advice ( P = 0.014), and a past history of sexually transmitted infections ( P = 0.044). Most patients perceived a low risk of being HIV positive ( n = 143, 75.7%) with no difference between those accepting or declining testing. The principal reason for testing was a check-up, and for refusal was a lack of perceived risk. Patients who are well informed about HIV testing are more likely to accept a test.

scholarly journals A Novel Contact-Free Atrial Fibrillation Monitor- A Pilot Study

2021 ◽  
Author(s):  
Ben Sadeh ◽  
Ilan Merdler ◽  
Sapir Sadon ◽  
Lior Lupu ◽  
Ariel Borohovitz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Optical Device ◽  
Machine Learning Approach ◽  
Risk Patients ◽  
History Of ◽  
Regular Rhythm ◽  
Study Participants ◽  
Contact Free ◽  
First Time ◽  
Current Guidelines

Abstract Aims Atrial fibrillation (AF) is a major cause of morbidity and mortality. Current guidelines support performing ECG screenings to spot atrial fibrillation in high-risk patients. The purpose of this study was to validate a new algorithm aimed to identify AF in patients measured with a recent FDA-cleared contact-free optical device. Methods and results Study participants were measured simultaneously using two devices: a contact-free optical system that measures chest motion-vibrations (investigational device, “Gili”) and a standard reference bed-side ECG monitor (Mindray®). Each reference ECG was evaluated by two board certified cardiologists that defined each trace as: regular rhythm, atrial fibrillation, other irregular rhythm or indecipherable/missing. A total of 3582, 30-sec intervals, pertaining to 444 patients (41.9% with a history of AF) were made available for analysis. Distribution of patients with active AF, other irregular rhythm and regular rhythm was 16.9%, 29.5% and 53.6% respectively. Following application of cross-validated machine learning approach, the observed sensitivity and specificity were 0.92 (95% CI: 0.91-0.93) and 0.96 (95% CI: 0.95-0.96) respectively. Conclusions This study demonstrates for the first time the efficacy of a contact-free optical device for detecting atrial fibrillation.

Telmisartan in High Cardiovascular Risk Patients

2012 ◽  
Vol 8 (1) ◽  
pp. 10 ◽  
Author(s):  
Roland Asmar ◽  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Ace Inhibitors ◽  
Angiotensin Receptor Blockers ◽  
High Cardiovascular Risk ◽  
Raas Blockade ◽  
Risk Patients ◽  
Receptor Blockers ◽  
Current Guidelines

The worldwide morbidity and mortality burden of cardiovascular disease (CVD) is overwhelming and caused by increasing life expectancy and an epidemic of risk factors, including hypertension. Therapeutic options targeting different areas of the renin–angiotensin–aldosterone system (RAAS) to disrupt pathophysiological processes along the cardiovascular continuum are available. Angiotensin-converting enzyme (ACE) inhibitors are first-line treatments for CVD and angiotensin receptor blockers (ARBs) are suitable alternatives. Both ACE inhibitors and ARBs prevent CVD by lowering blood pressure (BP). Additionally, several studies have demonstrated that RAAS blockade can reduce cardiovascular risk beyond what might be expected from BP lowering alone. However, the ARBs are not all equally effective. Telmisartan is a long-lasting ARB that effectively controls BP over the full 24-hour period. Recently, the Ongoing telmisartan alone and in combination with ramipril global endpoint trial (ONTARGET) study showed that telmisartan reduces cardiovascular events in high cardiovascular risk patients similarly to the gold standard ACE inhibitor ramipril beyond BP lowering alone, but with a better tolerability. Based on the results of the ONTARGET and Telmisartan randomized assessment study in ACE intolerant subjects with cardiovascular disease (TRANSCEND) studies, telmisartan is indicated for the reduction of cardiovascular morbidity. This article aims to review current guidelines for the management of CVD and consider key data from clinical trials and clinical practice evaluating the role of telmisartan in CVD.

scholarly journals Stroke prediction in patients presenting with isolated dizziness in the emergency department

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
June-sung Kim ◽  
Hong Jun Bae ◽  
Muyeol Kim ◽  
Shin Ahn ◽  
Chang Hwan Sohn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Multivariate Analysis ◽  
Acute Stroke ◽  
Neurological Deficits ◽  
Cerebrovascular Injury ◽  
Risk Patients ◽  
History Of ◽  
Independent Risk Factors ◽  
Record Review

AbstractDiagnosing stroke in patients experiencing dizziness without neurological deficits is challenging for physicians. The aim of this study was to evaluate the prevalence of acute stroke in patients who presented with isolated dizziness without neurological deficits at the emergency department (ED), and determine the relevant stroke predictors in this population. This was an observational, retrospective record review of consecutive 2215 adult patients presenting with dizziness at the ED between August 2019 and February 2020. Multivariate analysis was performed to identify risk factors for acute stroke. 1239 patients were enrolled and analyzed. Acute stroke was identified in 55 of 1239 patients (4.5%); most cases (96.3%) presented as ischemic stroke with frequent involvement (29.1%) of the cerebellum. In the multivariate analysis, the history of cerebrovascular injury (odds ratio [OR] 3.08 [95% confidence interval {CI} 1.24 to 7.67]) and an age of > 65 years (OR 3.01 [95% CI 1.33 to 6.83]) were the independent risk factors for predicting acute stroke. The combination of these two risks showed a higher specificity (94.26%) than that of each factor alone. High-risk patients, such as those aged over 65 years or with a history of cerebrovascular injury, may require further neuroimaging workup in the ED to rule out stroke.

A Group Therapy Approach to Facilitate Integration of Risk Information for Women at Risk for Breast Cancer

1998 ◽  
Vol 43 (4) ◽  
pp. 375-380 ◽  
Author(s):  
Mary Jane Esplen ◽  
Brenda Toner ◽  
Jonathan Hunter ◽  
Gordon Glendon ◽  
Kate Butler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
At Risk ◽  
Family History ◽  
Group Therapy ◽  
Perceived Risk ◽  
Positive Family History ◽  
Risk Information ◽  
Degree Relative ◽  
Therapy Approach ◽  
History Of

Objective: To describe and illustrate elements of a group counselling approach designed to enhance the communication of risk information on breast cancer (BC) to women with a family history of this disease. Breast cancer is a leading cause of female cancer death. The most important risk factor for BC is a positive family history in at least 1 first-degree relative, and approximately one-third of women with BC have a family history of the disease. Recent evidence suggests that there is a significant psychological impact associated with having a family history of BC, and this may influence the psychological adjustment and response to being counselled for personal risk. New counselling approaches are required. Method: This paper describes a group therapy approach that incorporates principles of supportive-expressive therapy designed to address the emotional impact of being at risk for BC and to promote accuracy of perceived risk. The key elements of the intervention are described along with clinical illustrations from groups that are part of an ongoing study to develop and standardize the group therapy. Conclusion: Qualitative data from the groups suggest that this model of therapy is both feasible and effective.

Bilateral chorea following severe traumatic brain injury treated with risperidone

2021 ◽  
Vol 14 (5) ◽  
pp. e241929
Author(s):  
Daniel Krasna ◽  
Erica Montgomery ◽  
Jacob Koffer ◽  
Miriam Segal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Movement Disorders ◽  
Daily Living ◽  
Brain Injuries ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Burden Of Care ◽  
History Of

A functionally independent man in his 20s with a history of intellectual disability and epilepsy and family history of Huntington’s disease suffered a severe traumatic brain injury. Postinjury, bilateral chorea rendered him dependent for all activities of daily living. Risperidone provided a significant reduction of chorea, decreasing the overall burden of care. Movement disorders are a common sequela of brain injury. Currently, there are no best treatment guidelines for chorea in patients with brain injury. To the authors’ knowledge there have been no case reports describing the effects of brain injury on patients with a primary movement disorder. Risperidone was an effective treatment in this case. Further research is needed to establish guidelines for treatment of movement disorders following brain injury and to better understand the effect of brain injuries on primary movement disorders.

scholarly journals From the “ancestar” of turtles to the turtle-mouse: when Greek words are used for turtle taxon names

2015 ◽  
Author(s):  
Evangelos Vlachos
Keyword(s):  
Zoological Nomenclature ◽  
Alternative Systems ◽  
Proper Name ◽  
History Of ◽  
Greek Alphabet ◽  
Scientific Results ◽  
The Times ◽  
Animal Size ◽  
Current Guidelines ◽  
Phylogenetic Nomenclature

Background. Regardless using a rank-based or a phylogenetic nomenclature code, the use of Latinized binomens to describe the extant and extinct species has been essential. Ever since the times of Linnaeus, the use of Latinized Greek names has been a common practice both for neontologists and paleontologists. Methods. I critically analyzed the most common Greek words used as taxa names in the chelonian literature to establish their etymology and check whether the transliteration process has been done correctly. I also compared the current guidelines for the latinisation of Greek words recommended by the International Code of Zoological Nomenclature, with other alternative systems for the transformation of names formed in the Greek alphabet into Latin-based languages. Results. The preliminary results show that some Greek words (e.g. Chelone, Emys) dominate the chelonian nomenclature, but the history of the application of many of those names is intriguing. The use of Greek words is quite common in turtle taxa names when the name describes physical properties of the animal (size, shape, colour). However, several unfortunate examples exist, as some quite successful and famous names contain misspellings or poor choice of words that resulted in meanings opposite from the ones intended by the authors. Discussion. Naming species is an integral part of the research of both neontologists and palaeontologists, but the application of Greek words to life sciences is even far more extensive, applied to numerous terminologies as well. Forming a proper name for a taxon could aid significantly to the communication and interpretation of the scientific results. Publishing a new name requires a sense of responsibility as well, as the formation of a taxon name is a unique linguistic procedure. But in the end, to add a taxonomic side to the old shakespearean question, is not the name that is important, but the information it conveys. That which we call a turtle by any other name would be as unique.

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