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Bulletin of the World Health... Apr 2021
Topics: Hearing; Hearing Aids; Hearing Tests; Humans
PubMed: 33953438
DOI: 10.2471/BLT.21.285643 -
European Journal of Cancer (Oxford,... Mar 2021Nuclear medicine plays an increasingly important role in the management neuroendocrine neoplasms (NEN). Somatostatin analogue (SSA)-based positron emission... (Review)
Review
Nuclear medicine plays an increasingly important role in the management neuroendocrine neoplasms (NEN). Somatostatin analogue (SSA)-based positron emission tomography/computed tomography (PET/CT) and peptide receptor radionuclide therapy (PRRT) have been used in clinical trials and approved by the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). European Association of Nuclear Medicine (EANM) Focus 3 performed a multidisciplinary Delphi process to deliver a balanced perspective on molecular imaging and radionuclide therapy in well-differentiated neuroendocrine tumours (NETs). NETs form in cells that interact with the nervous system or in glands that produce hormones. These cells, called neuroendocrine cells, can be found throughout the body, but NETs are most often found in the abdomen, especially in the gastrointestinal tract. These tumours may also be found in the lungs, pancreas and adrenal glands. In addition to being rare, NETs are also complex and may be difficult to diagnose. Most NETs are non-functioning; however, a minority present with symptoms related to hypersecretion of bioactive compounds. NETs often do not cause symptoms early in the disease process. When diagnosed, substantial number of patients are already found to have metastatic disease. Several societies' guidelines address Neuroendocrine neoplasms (NENs) management; however, many issues are still debated, due to both the difficulty in acquiring strong clinical evidence in a rare and heterogeneous disease and the different availability of diagnostic and therapeutic options across countries. EANM Focus 3 reached consensus on employing gallium-labelled somatostatin analogue ([Ga]Ga-DOTA-SSA)-based PET/CT with diagnostic CT or magnetic resonance imaging (MRI) for unknown primary NET detection, metastatic NET, NET staging/restaging, suspected extra-adrenal pheochromocytoma/paraganglioma and suspected paraganglioma. Consensus was reached on employing fluorine-fluoro-2-deoxyglucose ([F]FDG) PET/CT in neuroendocrine carcinoma, G3 NET and in G1-2 NET with mismatched lesions (CT-positive/[Ga]Ga-DOTA-SSA-negative). Peptide receptor radionuclide therapy (PRRT) was recommended for second line treatment for gastrointestinal NET with [Ga]Ga-DOTA-SSA uptake in all lesions, in G1/G2 NET at disease progression, and in a subset of G3 NET provided all lesions are positive at [F]FDG and [Ga]Ga-DOTA-SSA. PRRT rechallenge may be used for in patients with stable disease for at least 1 year after therapy completion. An international consensus is not only a prelude to a more standardised management across countries but also serves as a guide for the direction to follow when designing new research studies.
Topics: Animals; Consensus; Humans; Molecular Imaging; Neuroendocrine Tumors; Radiopharmaceuticals
PubMed: 33588146
DOI: 10.1016/j.ejca.2021.01.008 -
Journal of Exercise Rehabilitation Oct 2022This study aimed to analyze nursing diagnoses determined by the nursing students for patients in rehabilitation unit. Data were collected from 190 case reports submitted...
This study aimed to analyze nursing diagnoses determined by the nursing students for patients in rehabilitation unit. Data were collected from 190 case reports submitted by the nursing students who practiced in the rehabilitation unit, and analyzed on the basis of North American Nursing Diagnosis Association (NANDA) International, Inc. nursing diagnoses. Thirty different diagnoses were documented in rehabilitation unit. The most frequent nursing diagnosis was impaired physical mobility (n=68, 14.6%). The 30 diagnoses were grouped into 10 domains and 20 classes of the NANDA International, Inc. human response patterns. The average quality of nursing statements corresponded to a score of 8.63, indicating relatively good quality. The results of this study will help to improve the quality of nursing process education and provide guidelines to improve the quality of nursing care for the rehabilitation nursing situation in Korea.
PubMed: 36420472
DOI: 10.12965/jer.2244336.168 -
Gut Apr 2015
Topics: Acute Kidney Injury; Algorithms; Ascites; Consensus; Humans; Liver Cirrhosis
PubMed: 25631669
DOI: 10.1136/gutjnl-2014-308874 -
Epilepsia Nov 2020We aimed to delineate the phenotypic spectrum and long-term outcome of individuals with KCNB1 encephalopathy.
OBJECTIVE
We aimed to delineate the phenotypic spectrum and long-term outcome of individuals with KCNB1 encephalopathy.
METHODS
We collected genetic, clinical, electroencephalographic, and imaging data of individuals with KCNB1 pathogenic variants recruited through an international collaboration, with the support of the family association "KCNB1 France." Patients were classified as having developmental and epileptic encephalopathy (DEE) or developmental encephalopathy (DE). In addition, we reviewed published cases and provided the long-term outcome in patients older than 12 years from our series and from literature.
RESULTS
Our series included 36 patients (21 males, median age = 10 years, range = 1.6 months-34 years). Twenty patients (56%) had DEE with infantile onset seizures (seizure onset = 10 months, range = 10 days-3.5 years), whereas 16 (33%) had DE with late onset epilepsy in 10 (seizure onset = 5 years, range = 18 months-25 years) and without epilepsy in six. Cognitive impairment was more severe in individuals with DEE compared to those with DE. Analysis of 73 individuals with KCNB1 pathogenic variants (36 from our series and 37 published individuals in nine reports) showed developmental delay in all with severe to profound intellectual disability in 67% (n = 41/61) and autistic features in 56% (n = 32/57). Long-term outcome in 22 individuals older than 12 years (14 in our series and eight published individuals) showed poor cognitive, psychiatric, and behavioral outcome. Epilepsy course was variable. Missense variants were associated with more frequent and more severe epilepsy compared to truncating variants.
SIGNIFICANCE
Our study describes the phenotypic spectrum of KCNB1 encephalopathy, which varies from severe DEE to DE with or without epilepsy. Although cognitive impairment is worse in patients with DEE, long-term outcome is poor for most and missense variants are associated with more severe epilepsy outcome. Further understanding of disease mechanisms should facilitate the development of targeted therapies, much needed to improve the neurodevelopmental prognosis.
Topics: Adolescent; Adult; Brain Diseases; Child; Child, Preschool; Cohort Studies; Electroencephalography; Epilepsy; Female; Genetic Variation; Humans; Infant; Male; Retrospective Studies; Shab Potassium Channels; Time Factors; Treatment Outcome; Young Adult
PubMed: 32954514
DOI: 10.1111/epi.16679 -
Neurosurgery Clinics of North America Apr 2018Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific... (Review)
Review
Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit.
Topics: Communication; Decision Making; Humans; Intensive Care Units; Patient Selection; Research
PubMed: 29502720
DOI: 10.1016/j.nec.2017.11.009 -
Neurologic Clinics Nov 2017Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific... (Review)
Review
Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit.
Topics: Critical Care; Decision Making; Decision Support Techniques; Humans; Neurology
PubMed: 28962816
DOI: 10.1016/j.ncl.2017.06.014 -
Frontiers in Medicine 2022The aim of this paper is to present the AutoInflammatory Disease Alliance (AIDA) international Registry dedicated to Vacuoles, E1 enzyme, X-linked, Autoinflammatory,...
OBJECTIVE
The aim of this paper is to present the AutoInflammatory Disease Alliance (AIDA) international Registry dedicated to Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic (VEXAS) syndrome, describing its design, construction, and modalities of dissemination.
METHODS
This Registry is a clinical, physician-driven, population- and electronic-based instrument designed for the retrospective and prospective collection of real-life data. Data gathering is based on the Research Electronic Data Capture (REDCap) tool and is intended to obtain real-world evidence for daily patients' management. The Registry may potentially communicate with other on-line tools dedicated to VEXAS syndrome, thus enhancing international collaboration and data sharing for research purposes. The Registry is practical enough to be easily modified to meet future needs regarding VEXAS syndrome.
RESULTS
To date (April 22, 2022), 113 Centers from 23 Countries in 4 continents have been involved; 324 users (114 Principal Investigators, 205 Site Investigators, 2 Lead Investigators, and 3 data managers) are currently able to access the registry for data entry (or data sharing) and collection. The Registry includes 4,952 fields organized into 18 instruments designed to fully describe patient's details about demographics, clinical manifestations, symptoms, histologic details about skin and bone marrow biopsies and aspirate, laboratory features, complications, comorbidities, therapies, and healthcare access.
CONCLUSION
This international Registry for patients with VEXAS syndrome will allow the achievement of a comprehensive knowledge about this new disease, with the final goal to obtain real-world evidence for daily clinical practice, especially in relation to the comprehension of this disease about the natural history and the possible therapeutic approaches. This Project can be found on https://clinicaltrials.gov NCT05200715.
PubMed: 35899212
DOI: 10.3389/fmed.2022.926500 -
International Journal of Environmental... Dec 2022Evidence-informed healthcare decision-making relies on high quality data inputs, including robust unit costs, which in many countries are not readily available. The... (Review)
Review
Evidence-informed healthcare decision-making relies on high quality data inputs, including robust unit costs, which in many countries are not readily available. The objective of the Department of Health Economics' Unit Cost Online Database, developed based on systematic reviews of Austrian costing studies, is to make conducting economic evaluations from healthcare and societal perspectives more feasible with publicly available unit cost information in Austria. This article aims to describe trends in unit cost data sources and reporting using this comprehensive database as a case study to encourage relevant national and international methodological discussions. Database analysis and synthesis included publication/study characteristics and costing reporting details in line with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS 2022) with the year of the database launch as the cut-off point to assess how the methods have developed over time. Forty-two full economic evaluations and 278 unit costs were analyzed (2004-2016: 34 studies/232 unit costs, 2017-2022: 8 studies/46 unit costs). Although the reporting quality of costing details including the study perspective, unit cost sources and years has improved since 2017, the unit cost estimates and sources remained heterogeneous in Austria. While methodologically standardized national-level unit costs would be the gold standard, a systematically collated list of unit costs is a first step towards supporting health economic evaluations nationally.
Topics: Austria; Health Care Costs; Delivery of Health Care; Cost-Benefit Analysis
PubMed: 36612439
DOI: 10.3390/ijerph20010117 -
Anaesthesia Dec 2020
Topics: Betacoronavirus; COVID-19; Cohort Studies; Coronavirus Infections; Elective Surgical Procedures; Humans; Infections; Pandemics; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2
PubMed: 33156535
DOI: 10.1111/anae.15296