Science.gov

Sample records for a-abo dysport clinical

  1. Does Reduction of Number of Intradetrusor Injection Sites of aboBoNTA (Dysport®) Impact Efficacy and Safety in a Rat Model of Neurogenic Detrusor Overactivity?

    PubMed Central

    Huynh Le Maux, Amélie; Pignol, Bernadette; Behr-Roussel, Delphine; Blachon, Jean-Luc; Chabrier, Pierre-Etienne; Compagnie, Sandrine; Picaut, Philippe; Bernabé, Jacques; Giuliano, François; Denys, Pierre

    2015-01-01

    Intradetrusor injections of Botulinum toxin A—currently onabotulinumtoxinA—is registered as a second-line treatment to treat neurogenic detrusor overactivity (NDO). The common clinical practice is 30 × 1 mL injections in the detrusor; however, protocols remain variable and standardization is warranted. The effect of reducing the number of injection sites of Dysport® abobotulinumtoxinA (aboBoNTA) was assessed in the spinal cord-injured rat (SCI). Nineteen days post-spinalization, female rats received intradetrusor injections of saline or aboBoNTA 22.5 U distributed among four or eight sites. Two days after injection, continuous cystometry was performed in conscious rats. Efficacy of aboBoNTA 22.5 U was assessed versus aggregated saline groups on clinically-relevant parameters: maximal pressure, bladder capacity, compliance, voiding efficiency, as well as amplitude, frequency, and volume threshold for nonvoiding contractions (NVC). AboBoNTA 22.5 U significantly decreased maximal pressure, without affecting voiding efficiency. Injected in four sites, aboBoNTA significantly increased bladder capacity and compliance while only the latter when in eight sites. AboBoNTA significantly reduced NVC frequency and amplitude. This preclinical investigation showed similar inhibiting effects of aboBoNTA despite the number of sites reduction. Further studies are warranted to optimize dosing schemes to improve the risk-benefit ratio of BoNTA-based treatment modalities for NDO and further idiopathic overactive bladder. PMID:26694464

  2. Does Reduction of Number of Intradetrusor Injection Sites of aboBoNTA (Dysport(®)) Impact Efficacy and Safety in a Rat Model of Neurogenic Detrusor Overactivity?

    PubMed

    Huynh Le Maux, Amélie; Pignol, Bernadette; Behr-Roussel, Delphine; Blachon, Jean-Luc; Chabrier, Pierre-Etienne; Compagnie, Sandrine; Picaut, Philippe; Bernabé, Jacques; Giuliano, François; Denys, Pierre

    2015-01-01

    Intradetrusor injections of Botulinum toxin A-currently onabotulinumtoxinA-is registered as a second-line treatment to treat neurogenic detrusor overactivity (NDO). The common clinical practice is 30 × 1 mL injections in the detrusor; however, protocols remain variable and standardization is warranted. The effect of reducing the number of injection sites of Dysport(®) abobotulinumtoxinA (aboBoNTA) was assessed in the spinal cord-injured rat (SCI). Nineteen days post-spinalization, female rats received intradetrusor injections of saline or aboBoNTA 22.5 U distributed among four or eight sites. Two days after injection, continuous cystometry was performed in conscious rats. Efficacy of aboBoNTA 22.5 U was assessed versus aggregated saline groups on clinically-relevant parameters: maximal pressure, bladder capacity, compliance, voiding efficiency, as well as amplitude, frequency, and volume threshold for nonvoiding contractions (NVC). AboBoNTA 22.5 U significantly decreased maximal pressure, without affecting voiding efficiency. Injected in four sites, aboBoNTA significantly increased bladder capacity and compliance while only the latter when in eight sites. AboBoNTA significantly reduced NVC frequency and amplitude. This preclinical investigation showed similar inhibiting effects of aboBoNTA despite the number of sites reduction. Further studies are warranted to optimize dosing schemes to improve the risk-benefit ratio of BoNTA-based treatment modalities for NDO and further idiopathic overactive bladder. PMID:26694464

  3. Blepharospasm: long-term treatment with either Botox®, Xeomin® or Dysport®.

    PubMed

    Kollewe, Katja; Mohammadi, Bahram; Köhler, Steffen; Pickenbrock, Heidrun; Dengler, Reinhard; Dressler, Dirk

    2015-03-01

    Botulinum toxin (BT) therapy is the treatment of choice for blepharospasm (BPS). Currently available BT type A drugs include Botox(®), Dysport(®) and Xeomin(®). Until now, there are few long-term studies on BT therapy for BPS. This is the first long-term study comparing all three major BT drugs. We collected treatment, efficacy and adverse effect data on BPS patients treated with either Botox(®), Dysport(®) or Xeomin(®) for at least eight consecutive treatments. Two hundred and eighty-eight patients (208 females, 80 males, age 62 ± 12 years) were included in this study. The treatment time was 11.2 ± 4.1 years covering 10,701 injection series. Doses were 47 ± 10 MU for Botox(®), 120 ± 35 MU for Dysport(®) and 62 ± 11 MU for Xeomin(®) (Botox(®) dose vs Xeomin(®) dose: p < 0.001, unpaired t test). 85 % of all patients had stable doses. The onset of the therapeutic effect was after 6.1 ± 3.3 days and its duration lasted 10.2 ± 3.5 weeks. The Global Clinical Improvement (GCI, 0 = no, 1 = slight, 2 = moderate, 3 = marked improvement in severity and function) as estimated by the patient was 2.5 ± 0.6. It was stable in 90% of the patients. Adverse effect frequency was 3.0% (ptosis 2.3%, dry eye 0.5%, diplopia 0.2%). None of these findings was significantly different between Botox(®), Dysport(®) and Xeomin(®). Our study, one of the largest studies on BT therapy of BPS and the study with the longest follow-up, confirms that BT therapy produces robust clinical improvement which is stable throughout the treatment time. Therapeutic effects start after 6.1 days and last for about 10 weeks before they start to vanish. With this, they are approximately 2 weeks shorter than the recommended inter-injection interval. Adverse effects were rare, mild and always transient. BT therapy is a safe and effective treatment for BSP. Shorter inter-injection intervals may improve therapeutic results. PMID:25059456

  4. AbobotulinumtoxinA (Dysport) dosing in cervical dystonia: an exploratory analysis of two large open-label extension studies.

    PubMed

    Hauser, Robert A; Truong, Daniel; Hubble, Jean; Coleman, Chandra; Beffy, Jean-Luc; Chang, Stephen; Picaut, Philippe

    2013-02-01

    Treatment with botulinum toxin-A is recommended as first-line treatment for cervical dystonia (CD). In clinical practice many factors appear to influence dose adjustment and the retreatment regimen; however, there is little information available in the literature regarding the evolution of dosing over treatment cycles. We report on two similarly designed, long-term, multicenter, open-label extension studies of Dysport for the treatment of CD, which followed 500 U fixed-dose placebo-controlled trials. Both studies specified a fixed 500 U dose for the first open-label treatment cycle, with dose adjustment in subsequent treatment cycles according to the clinical response. These analyses include 218 patients who entered the two studies; doses in the subsequent treatment cycles ranged between 250 and 1,000 U. During open-label treatment, all treatment cycles resulted in improvements in mean Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) total scores. However, increasing the dose of Dysport above the initial 500 U dose was not observed to result in an incremental improvement in response as measured by the TWSTRS. No individual patient characteristic was found to reliably predict the use of higher doses at each treatment cycle. Dysport was generally well tolerated with no major differences in the incidence of adverse events (AEs) observed with different doses. Dysphagia was considered an AE of special interest and dysphagia data from the open-label studies were combined with two Phase II studies. Analysis of this enhanced database indicates that unilateral injections of >150 U into the sternocleidomastoid muscle is associated with a higher dysphagia risk. Thus, limiting the dose in the sternocleidomastoid may help reduce the incidence of dysphagia. PMID:22878514

  5. Clinical differences between botulinum neurotoxin type A and B.

    PubMed

    Bentivoglio, Anna Rita; Del Grande, Alessandra; Petracca, Martina; Ialongo, Tamara; Ricciardi, Lucia

    2015-12-01

    In humans, the therapeutic use of botulinum neurotoxin A (BoNT/A) is well recognized and continuously expanding. Four BoNTs are widely available for clinical practice: three are serotype A and one is serotype B: onabotulinumtoxinA (A/Ona), abobotulinumtoxinA (A/Abo) and incobotulinumtoxinA (A/Inco), rimabotulinumtoxinB (B/Rima). A/Abo, A/Inco, A/Ona and B/Rima are all licensed worldwide for cervical dystonia. In addition, the three BoNT/A products are approved for blepharospasm and focal dystonias, spasticity, hemifacial spasm, hyperhidrosis and facial lines, with remarkable regional differences. These toxin brands differ for specific activity, packaging, constituents, excipient, and storage. Comparative literature assessing the relative safety and efficacy of different BoNT products is limited, most data come from reports on small samples, and only a few studies meet criteria of evidence-based medicine. One study compared the effects of BoNT/A and BoNT/B on muscle activity of healthy volunteers, showing similar neurophysiological effects with a dose ratio of 1:100. In cervical dystonia, when comparing the effects of BoNT/A and BoNT/B, results are more variable, some studies reporting roughly similar peak effect and overall duration (at a ratio of 1:66, others reporting substantially shorter duration of BoNT/B than BoNT/A (at a ratio 1/24). Although the results of clinical studies are difficult to compare for methodological differences (dose ratio, study design, outcome measures), it is widely accepted that: BoNT/B is clinically effective using appropriate doses as BoNT/A (1:40-50), injections are generally more painful, in most of the studies on muscular conditions, efficacy is shorter, and immunogenicity higher. Since the earliest clinical trials, it has been reported that autonomic side effects are more frequent after BoNT/B injections, and this observation encouraged the use of BoNT/B for sialorrhea, hyperhidrosis and other non-motor symptoms. In these indications the efficacy of toxins A and B are comparable and dose ratio is 1:25-30. PMID:26260691

  6. Clinical Trials

    MedlinePLUS

    ... Disease Information Treatment Types of Treatment Clinical Trials Clinical Trials Clinical Trials SHARE: Print Glossary Taking part in a ... are based on previous clinical trials. Find personalized clinical trial searches or for more information, contact an ...

  7. Systematic Literature Review of AbobotulinumtoxinA in Clinical Trials for Blepharospasm and Hemifacial Spasm

    PubMed Central

    Dashtipour, Khashayar; Chen, Jack J.; Frei, Karen; Nahab, Fatta; Tagliati, Michele

    2015-01-01

    Background The aim was to elucidate clinical trial efficacy, safety, and dosing practices of abobotulinumtoxinA (ABO) treatment in adult patients with blepharospasm and hemifacial spasm. To date, most literature reviews for blepharospasm and hemifacial spasm have examined the effectiveness of all botulinum neurotoxin type A products as a class. However, differences in dosing units and recommended schemes provide a clear rationale for reviewing each product separately. Methods A systematic literature review was performed to identify randomized controlled trials and other comparative clinical studies of ABO in the treatment of blepharospasm and hemifacial spasm published in English between January 1991 and March 2015. Medical literature databases (PubMed, Cochrane library, EMBASE) were searched. A total of five primary publications that evaluated ABO for the management of blepharospasm and hemifacial spasm were identified and summarized. Results Data included 374 subjects with blepharospasm and 172 subjects with hemifacial spasm treated with ABO. Total ABO doses ranged between 80 and 340 U for blepharospasm and 25 and 85 U for hemifacial spasm, depending on the severity of the clinical condition. All studies showed statistically significant benefits for the treatment of blepharospasm and hemifacial spasm. ABO was generally well tolerated across the individual studies. Adverse events considered to be associated with ABO treatment included: ptosis, tearing, blurred vision, double vision, dry eyes, and facial weakness. Discussion These data from 5 randomized clinical studies represents the available evidence base of ABO in blepharospasm and hemifacial spasm. Future studies in this area will add to this evidence base. PMID:26566457

  8. Clinical Research and Clinical Trials

    MedlinePLUS

    ... Publications Scientific Research Planning Scientific Resources Research Clinical Trials & Clinical Research Skip sharing on social media links ... behavior or samples of their tissue. A clinical trial is one type of clinical research that follows ...

  9. Clinical Trials

    MedlinePLUS

    Clinical Trials Check out We Search Together , a searchable database that connects qualified study participants to researchers ... Brochure (PDF) Learn more about participating in reseach Clinical Trials A clinical trial is a study to ...

  10. CLINICAL BIOCHEMISTRY

    EPA Science Inventory

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  11. Clinical Trials

    MedlinePLUS

    Clinical Trials What is a clinical trial? A clinical trial is a study carried out in human volunteers to help doctors learn more about the human body ... medicines and treatments. The information gained from a clinical study is added to the results from lab ...

  12. Clinical Trials

    MedlinePLUS

    Clinical trials are research studies that test how well new medical approaches work in people. Each study ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to ...

  13. Clinical Trials

    Cancer.gov

    ACRIN is funded to improve the quality and utility of imaging in cancer research and cancer care through expert, multi-institutional clinical evaluation of discoveries and technological innovations relevant to imaging science as applied in clinical oncology.

  14. Clinical hubs.

    PubMed

    2015-11-25

    NHS England's ongoing urgent and emergency care review is bringing together NHS 111, GP out-of-hours services and clinical advice to improve patient access to round-the-clock urgent clinical assessment, information and treatment. As part of this new service, commissioners are encouraged to establish 'urgent care clinical hubs' that will provide clinical advice and support to patients and to professionals working in out-of-hospital settings. To support this, the commissioning standards for integrated urgent care will bring call handling and assessment, clinical advice and treatment under a single commissioning framework. To read the standards, go to www.tinyurl.com/q97yyuv. PMID:26602482

  15. Clinical Trials

    MedlinePLUS

    ... at http://www.nhlbi.nih.gov/childrenandclinicalstudies/index.php Children and Clinical Studies 06/27/2011 Children ... at http://www.nhlbi.nih.gov/childrenandclinicalstudies/index.php This video was made possible by grants from ...

  16. Clinical Research Operations

    Cancer.gov

    Clinical Research Operations  The Office of the Clinical Director serves as the interface between CCR clinical investigators and the NIH Clinical Center where CCR clinical trials take place. The Clinical Director, Dr. William L. Dahut, oversees and assure

  17. Clinical Research Operations

    Cancer.gov

    Clinical Trials - Research Resources CCR Clinical Trials at NIH - CCR conducts more than 150 cancer clinical trials at the NIH Clinical Center in Bethesda, Maryland. NCI Clinical Trials - Search NCI's list of 10,000+ clinical trials now accepting particip

  18. Clinical governance.

    PubMed

    Wilson, J

    Clinical governance has marked a significant shift towards involving clinicians in the assurances of both quality and accountability in healthcare delivery. The White Paper (Department of Health (DoH), 1997) stated that: 'The Government will require every NHS trust to embrace the concept of clinical governance, so that quality is at the core, both of their responsibilities as organizations, and of each of their staff as individual professionals.' In order to achieve this the Government will bring forward legislation to give NHS trusts a new duty for maintaining quality care. Under these arrangements, chief executives will carry ultimate responsibility for assuring the quality of the services provided by their NHS trust, just as they are already accountable for the proper use of resources. In 'A First Class Service Quality in the NHS' (DoH, 1998), clinical governance is defined as 'a framework through which NHS organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish'. The principles of clinical governance apply to all those who provide or manage patient care services in the NHS. It requires staff to work in partnerships, breaking down boundaries by providing integrated care within health and social care teams (Wilson, 1996), and between practitioners and managers and between the NHS, patients and the public. PMID:9830912

  19. CLINICAL PEARL

    PubMed Central

    Mazefsky, Carla A.; Minshew, Nancy J.

    2013-01-01

    Autism spectrum disorders are defined behaviorally by the Diagnostic and Statistical Manual (DSM) IV-TR based on abnormal development in social interaction and communication and restricted, repetitive, and stereotyped patterns of behaviors and interests that are evident before the age of 3. After decades of debate, research has demonstrated that the distinctions among autism, Asperger disorder, and pervasive developmental disorder not otherwise specified are neither clinically reliable nor based on valid neurobiological or genetic differences. The fifth edition of the DSM therefore proposes to collapse all of the clinical syndromes under the single diagnosis of autism spectrum disorder (ASD). PMID:23186793

  20. CLINICAL PERSPECTIVE

    PubMed Central

    Aller, Thomas; Wildsoet, Christine

    2013-01-01

    This article presents a clinical perspective on recent myopia research related to the development and testing of optical treatments for controlling myopia progression. The perspective is from that of a clinician in private practice and a clinician researcher, both with long term involvement in myopia management and research. PMID:23528448

  1. Clinical biochemistry

    NASA Technical Reports Server (NTRS)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  2. Learn about Clinical Studies

    MedlinePLUS

    ... Studies Glossary of Common Site Terms Learn About Clinical Studies Contents What Is a Clinical Study? Clinical ... for Participation Questions to Ask What Is a Clinical Study? A clinical study involves research using human ...

  3. Clinical Trial Basics

    MedlinePLUS

    ... of clinical research make a difference? What are clinical trials and why do people participate? Clinical trials ... treatments for others in the future. What is clinical research? Clinical research is medical research that involves ...

  4. Clinical neuroimaging

    SciTech Connect

    Gilman, S.; Mazziotta, J.C.

    1989-01-01

    Designed for practicing neurologists and neurosurgeons, this reference focuses on the newest techniques in computed assisted tomography. Text material covers basic principles of computed tomography, as well as the clinical advantages and disadvantages of each modality. The anatomical and/or physiological processes measured by XCT, PET, SPECT and MRI are first discussed in terms of the normal patient, and then applied to the diagnosis and treatment of patients with neurological disease (primarily of the brain). Emphasis is placed on areas of difficult diagnosis, such as differentiating recurrent tumor from radiation necrosis, early diagnosis of dementia, selection of patients for extracranial-intracranial bypass procedures, and localization of epileptic foci.

  5. Clinical arthrography

    SciTech Connect

    Arndt, R.; Horns, J.W.; Gold, R.H.; Blaschke, D.D.

    1985-01-01

    This book deals with the method and interpretation of arthrography of the shoulder, knee, ankle, elbow, hip, wrist, and metacarpophalangeal, interphalangeal, and temporomandibular joints. The emphasis is on orthopaedic disorders, usually of traumatic origin, which is in keeping with the application of arthrography in clinical practice. Other conditions, such as inflammatory and degenerative diseases, congenital disorders and, in the case of the hip, arthrography of reconstructive joint surgery, are included. Each chapter is devoted to one joint and provides a comprehensive discussion on the method of arthrography, including single and double contrast techniques where applicable, normal radiographic anatomy, and finally, the interpretation of the normal and the abnormal arthrogram.

  6. [Clinical diagnosis].

    PubMed

    Furukawa, Katsutoshi; Kamada, Maki; Ishiki, Aiko; Tomita, Naoki; Arai, Hiroyuki

    2014-04-01

    The commonly followed definition of dementia is the one described by the International Statistical Classification of Diseases, 10th Revision (ICD-10, World Health Organization) or the Diagnostic and Statistical Manual of Mental Disorders (DSM-V, American Psychiatric Association). The most important aspect in the diagnosis of dementia is the assessment of overall mental and functions, including living environment, activities of daily living, cognition, mental status, and behavior. Physicians should diagnose dementia on the basis of not only cognitive test results or radiological findings but also other available information, including that obtained from the families or caregivers. Tests for the quantitative evaluation of cognitive function and dementia include the Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale Revised (HDS-R), Clinical Dementia Rating (CDR), and Wechsler Memory Scale-Revised (WMS-R). PMID:24796095

  7. Chiropractic Clinical Lab Sciences

    E-print Network

    Deng, Bo

    Chiropractic Clinical Lab Sciences Clinical Perfusion Science Cytotechnology Dentistry Dental Hygiene Medicine Mortuary Science Nursing Occupational Therapy Optometry Pharmacy Physical and be Pre-Clinical Laboratory Science at NEBRASKA! Pre-Clinical Laboratory Science is one of sixteen

  8. CLINICAL CONNECTIONS RVC Clinical Services Newsletter

    E-print Network

    Daley, Monica A.

    CLINICAL CONNECTIONS AUTU M N 2014 RVC Clinical Services Newsletter In this issue: `Trans, dermatology, dentistry, internal medicine, neurology and neurosurgery, nutrition, oncology, orthopaedics, sports medicine, and rehabilitation and soft tissue surgery... `Trans-disciplinary' patient care

  9. Clinical Research Operations

    Cancer.gov

    Resources Resources are organized alphabetically by topic: Cancer Therapy Evaluation Program (CTEP) Center for Cancer Research (CCR) Clinical Center Clinical Trials - Eligibility and Enrollment Clinical Trials - Research Resources Data Reporting and Monit

  10. Find a Free Clinic

    MedlinePLUS

    ... Membership Benefits Members Only Area Login Find a Free or Charitable Clinic Search for clinics near ... Within ... 7 8 9 … next › last » National Association of Free & Charitable Clinics Address 1800 Diagonal Road, Suite 600 ...

  11. Clinical Psychology UNIVERSITYOFTASMANIA

    E-print Network

    Wapstra, Erik

    Clinical Psychology UNIVERSITYOFTASMANIA Postgraduate courses in Psychology: pathwayto opportunity. #12;Professional Training in Clinical Psychology Postgraduate training in clinical psychology of Psychology ­ MPsych(Clin) · Doctor of Psychology ­ DPsych(Clin) · Doctor of Philosophy ­ PhD(Clin) Students

  12. Clinical Trials Reporting Program

    Cancer.gov

    The Clinical Trial Reporting Program is a comprehensive database of all NCI-supported clinical trials. The database exists to identify gaps in clinical research andduplicative studies, prioritization and enhance patient accrual to trials by making physicians aware of relevant opportunities for participation in clinical trials.

  13. Being a Clinical Educator

    ERIC Educational Resources Information Center

    Higgs, Joy; Mcallister, Lindy

    2007-01-01

    What is it like to be a clinical educator? How do clinical educators experience and describe their continuing journey of becoming a clinical educator? Within the model developed in this research, dimensions of being a clinical educator were identified. These dimensions include (a) having a sense of self (and the impact of bringing self into the…

  14. Vesalius Clinical Training Centre

    E-print Network

    Bristol, University of

    Vesalius Clinical Training Centre Vesalius Clinical Training Centre #12;Vesalius Clinical Training-surgical clinical training in a safe environment through our expertise, care and facilities as a world leader Continuing Professional Development and postgraduate training. ·To develop partnerships with other external

  15. Study design and methods of the BoTULS trial: a randomised controlled trial to evaluate the clinical effect and cost effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

    PubMed Central

    Rodgers, Helen; Shaw, Lisa; Price, Christopher; van Wijck, Frederike; Barnes, Michael; Graham, Laura; Ford, Gary; Shackley, Phil; Steen, Nick

    2008-01-01

    Background Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and cost effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post stroke upper limb spasticity. Methods Trial design : A multi-centre open label parallel group randomised controlled trial and economic evaluation. Participants : Adults with upper limb spasticity at the shoulder, elbow, wrist or hand and reduced upper limb function due to stroke more than 1 month previously. Interventions : Botulinum toxin type A plus upper limb therapy (intervention group) or upper limb therapy alone (control group). Outcomes : Outcome assessments are undertaken at 1, 3 and 12 months. The primary outcome is upper limb function one month after study entry measured by the Action Research Arm Test (ARAT). Secondary outcomes include: spasticity (Modified Ashworth Scale); grip strength; dexterity (Nine Hole Peg Test); disability (Barthel Activities of Daily Living Index); quality of life (Stroke Impact Scale, Euroqol EQ-5D) and attainment of patient-selected goals (Canadian Occupational Performance Measure). Health and social services resource use, adverse events, use of other antispasticity treatments and patient views on the treatment will be compared. Participants are clinically reassessed at 3, 6 and 9 months to determine the need for repeat botulinum toxin type A and/or therapy. Randomisation : A web based central independent randomisation service. Blinding : Outcome assessments are undertaken by an assessor who is blinded to the randomisation group. Sample size : 332 participants provide 80% power to detect a 15% difference in treatment successes between intervention and control groups. Treatment success is defined as improvement of 3 points for those with a baseline ARAT of 0–3 and 6 points for those with ARAT of 4–56. Trial registration ISRCTN78533119 EudraCT 2004-002427-40 CTA 17136/0230/001 Funding National Institute for Health Research, Health Technology Assessment Programme. Ipsen Ltd provide botulinum toxin type A (Dysport®). PMID:18947418

  16. Clinical Trials and Older People

    MedlinePLUS

    ... Clinical Trials and Older People Heath and Aging Clinical Trials and Older People What is a clinical ... trial is right for you. What is a clinical trial? A clinical trial is a particular type ...

  17. American Association for Clinical Chemistry

    MedlinePLUS

    ... Career Guidance Clin Lab Job Center Publications Clinical Chemistry Clinical Laboratory News Clinical Laboratory Strategies Clinical and Forensic Toxicology News Clinical Laboratory Marketplace Books and Multimedia Health & Science Policy AACC Policy Reports ...

  18. Clinical Research Operations

    Cancer.gov

    Clinical Trial Seminar series 2015-2016 Schedule Monday, September 21, 2015: Sponsor and Investigator Responsibilities in FDA-regulated Medical Device Trialsannouncement Archieved Clinical Trials Seminar Series

  19. Clinical Research Operations

    Cancer.gov

    CCR Standard Operating Procedures This page contains links to the following categories of SOPs: Administrative - Clinical Research (ADCR) Administrative - Human Resources (ADHR) Clinical Data Management System (CDMS) Multi-Institutional Studies (MI) Proto

  20. Clinical Research Operations

    Cancer.gov

    Biostatistics and Data Management Section The Biostatistics and Data Management Section (BDMS), Office of the Clinical Director, provides statistical leadership and data management consultation for CCR's clinical activities and is involved in the design,

  1. Research Areas: Clinical Trials

    Cancer.gov

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  2. What Are Clinical Trials?

    Cancer.gov

    Information covering the basics of cancer clinical trials, including what they are, where they take place, and the types of clinical trials. Also, explains phases, randomization, placebo, and members of the research team.

  3. Informed Consent (Clinical Trials)

    MedlinePLUS

    ... Research Cancer Treatment Types of Treatment Side Effects Clinical Trials Information for Patients and Caregivers A to ... Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings ...

  4. Clinical Research Operations

    Cancer.gov

    Investigator Responsibilities The Clinical Center Medical Staff By-laws delineate who may serve as a principal investigator (PI) on a clinical research protocol. There may be only one PI on a clinical research protocol. The PI must be a health professiona

  5. UCD CLINICAL RESEARCH CENTRE

    E-print Network

    , multi-site, patient-focused resource supporting clinical and translational research. It operates under clinical and translational research. The centre is also responsible for delivering high quality education supports across the region, to deliver the benefits of participation in clinical and translation research

  6. Misty Beaudine Assoc. Clinical

    E-print Network

    Stephens, Jacqueline

    Veronica Bihm Pharmacy Tech Pharmacy Shay Bordelon Assoc. Clinical Specialist Oncology Dr. Sonya Boss Manager Pharmacy Tina Bowden Lab. Tech. Asst. Ophthalmology Catherine Christensen Med. Lab. Tech. Clinical Shared Services Nalani Sambo Pharmacy Tech. Pharmacy Karen Schamburg Assoc. Clinical Specialist Surgery

  7. NIH Pediatric Rheumatology Clinic

    MedlinePLUS

    ... NIH doctors are among the best in the country. All patients at the NIH Pediatric Rheumatology Clinic will receive top-quality medical care as part of their participation in a clinical trial or natural history study. What is available at the clinic? Medical ...

  8. Good clinical practice in clinical interventional studies

    PubMed Central

    Pieterse, Herman; Diamant, Zuzana

    2014-01-01

    Good clinical practice (GCP) guidelines should always be implemented and obeyed in clinical interventional studies. In this mini-review, we will address several burning questions relating to GCP in a concise ‘frequently asked questions’ format. While compliance to current rules and regulations is our mission, we also wish to play devil's advocate attempting to translate the rules into sizeable chunks using a high dose of common sense. PMID:26557234

  9. Clinical Trials for Dry AMD

    MedlinePLUS

    ... Degeneration? / Dry AMD / Clinical Trials For Dry AMD Clinical Trials For Dry AMD Listen Clinical trials are the final research phase before a ... is testing in humans through a succession of clinical trials. Research on treatments starts in the laboratory ...

  10. Clinical Trials for Wet AMD

    MedlinePLUS

    ... Browse: Home / Research / Clinical Trials For Wet AMD Clinical Trials For Wet AMD Listen Clinical trials are the final research phase before a ... is testing in humans through a succession of clinical trials. Research on treatments starts in the laboratory ...

  11. Imaging Clinical Trials Basics

    Cancer.gov

    Like other types of clinical trials an imaging clinical trial is a research study conducted with people who volunteer to take part. Each study answers specific scientific questions that will determine the value of imaging procedures for detecting, diagnosing, guiding, or monitoring the treatment of disease. Volunteers who take part in cancer-related imaging clinical trials have an opportunity to contribute to knowledge of, and progress against, cancer.

  12. Clinical Research Operations

    Cancer.gov

    Professional Associations ACRP (Association of Clinical Research Professionals) AHIMA (American Health Information Management Association) AMIA (American Medical Informatics Association) ASBH (American Society for Bioethics and Humanities) ASCO (American

  13. Clinical Research Operations

    Cancer.gov

    NIH and Clinical Center Orientation Requirements Below is a summary of the NIH and Clinical Center required orientation courses. All certificates of completion are to be sent to Liz Ness (Room 10/3-2571, Fax: 301.496.9020). All Web-based programs are to b

  14. Clinical Laboratory Helper.

    ERIC Educational Resources Information Center

    Szucs, Susan C.; And Others

    This curriculum guide provides competencies and tasks for the position of clinical laboratory helper; it serves as both a career exploration experience and/or entry-level employment training. A list of 25 validated competencies and tasks covers careers from entry level to those that must be mastered to earn an associate degree in clinical

  15. The NASA Clinic System

    NASA Technical Reports Server (NTRS)

    Scarpa, Philip J.; Williams, Richard

    2009-01-01

    NASA maintains on site occupational health clinics at all Centers and major facilities NASA maintains an on-site clinic that offers comprehensive health care to astronauts at the Johnson Space Center NASA deploys limited health care capability to space and extreme environments Focus is always on preventive health care

  16. Clinical management of hypophosphatasia

    PubMed Central

    Bishop, Nick

    2015-01-01

    Summary HPP is a rare disease that manifests in different ways across the life course. Accurate diagnosis depends upon the use of appropriate age-related normative data. A new therapy is undergoing clinical trials; the preliminary published data is encouraging, but the scope of clinical application remains to be determined. PMID:26604944

  17. OPTIMIZATION PRE-CLINICAL

    E-print Network

    Prostate Glycosides for Cancer Treatment PeptideVaccine Against Lupus Medical Food For GI Diseases AntiLEAD OPTIMIZATION PRE-CLINICAL DEVELOPMENT THERAPEUTICS CLINICAL TRIALSHIT TO LEADNEW DRUGS Drugs b Lactamase Inhibitors: Antibiotics II Small Molecules for Parkinson's Disease Triggered Release

  18. After the Clinic What?

    ERIC Educational Resources Information Center

    Walker, Laurens; Goldstein, Burton

    1976-01-01

    Noting the limitations of clinical legal education when it focuses only on the learning of practical skills outside the classroom, the authors describe an experimental course in civil procedure designed to adapt clinical methods to the classroom by placing each student in the role of the lawyer in a specific case with class presentations and…

  19. Building clinical pathways.

    PubMed

    Leininger, S M

    1998-01-01

    TQM principles change the work environment so that point-of-service personnel can improve health care delivery to patients. The clinical pathway process starts with the principles of TQM. In the era of managed care, health care resources can be managed effectively using a clinical pathway. The multidisciplinary team has the opportunity to improve the health care services provided to patients. PMID:9847822

  20. The new clinical leader.

    PubMed

    Oates, Kim

    2012-06-01

    The complexity and cost of health care, along with a greater need for accountability calls for a new style of clinical leadership. The new clinical leader will lead reform by putting the needs of the patient first and foremost, looking at current and planned services from the patient's point of view as well as the clinician's. Excellent clinical skills will remain essential but will be supplemented by a focus on team work and mentoring, patient safety, clear communication and reduction in waste and inefficiency, leading to better financial outcomes. The new clinical leaders will understand the importance of consulting widely and engaging colleagues in creating change to improve patient care. They will develop trusting and mutually respectful relationships with health service management and be able to negotiate the delicate balance between clinical judgement, resource constraints and personal loyalties by keeping the best outcome for the patient at the forefront of their thinking. PMID:22690934

  1. Clinical Microbiology Informatics

    PubMed Central

    Sintchenko, Vitali; Rauch, Carol A.; Pantanowitz, Liron

    2014-01-01

    SUMMARY The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future. PMID:25278581

  2. Automation in Clinical Microbiology

    PubMed Central

    Ledeboer, Nathan A.

    2013-01-01

    Historically, the trend toward automation in clinical pathology laboratories has largely bypassed the clinical microbiology laboratory. In this article, we review the historical impediments to automation in the microbiology laboratory and offer insight into the reasons why we believe that we are on the cusp of a dramatic change that will sweep a wave of automation into clinical microbiology laboratories. We review the currently available specimen-processing instruments as well as the total laboratory automation solutions. Lastly, we outline the types of studies that will need to be performed to fully assess the benefits of automation in microbiology laboratories. PMID:23515547

  3. Clinical Research Operations

    Cancer.gov

    Education and Training Continuing Education (Continuing Education Calendar) Brown Bag Lunch Clinical Trials Seminar Series In-service Sessions Journal Club M2P2: Monday Morning Practice Pearls Nursing Grand Rounds Professional Development: Education Serie

  4. Clinical specular microscopy

    SciTech Connect

    Hirst, L.W.; Laing, R.A.

    1987-01-01

    This book provides the general ophthalmologist with a guide to the clinical applications of specular microscopy. Important material is included on laser injury, cataract surgery, corneal transplants, glaucoma, uveitis, and trauma.

  5. CCR Clinical Informatics

    Cancer.gov

    Contents Purpose Record details of prior surgery related to the disease being studies by the protocol or when the details would be clinically significant for the evaluation of this study. Prior Surgery Supplement eCRF Field Name Description / Instructions

  6. CCR Clinical Informatics

    Cancer.gov

    Contents Purpose Record details of prior radiation therapy related to the disease being studies by the protocol or when the details would be clinically significant for the evaluation of this study. Prior Radiation Supplement eCRF Field Name Description /

  7. What Are Clinical Trials?

    Cancer.gov

    Whether you are a cancer survivor, someone who is touched by cancer, or someone who works with people with cancer, this presentation will help answer some of the most important questions you may have about clinical trials.

  8. ClinicalTrials.gov

    MedlinePLUS

    ... Feeds Trends, Charts, and Maps Downloading Content for Analysis About This Site ClinicalTrials.gov Background About the ... Researchers How to submit studies Download content for analysis About the results database Learn more For Study ...

  9. Clinical Research Operations

    Cancer.gov

    Online Self Learning Modules These online modules will provide a basic overview of clinical research. These modules have been developed with input from senior research nursing staff and revised based on program evaluations. All modules and the associated

  10. Types of Clinical Trials

    Cancer.gov

    Information about the several types of cancer clinical trials, including treatment trials, prevention trials, screening trials, supportive and palliative care trials. Each type of trial is designed to answer different research questions.

  11. CCR Clinical Informatics

    Cancer.gov

    DCTD (Division of Cancer Treatment and Diagnosis) sponsored studies with monitoring done via CTMS (Clinical Trials Monitoring Service), electronically report data to Theradex every two weeks according to the following calendar: CTMS 2011 Submission Calend

  12. CIB — Clinical Alerts

    Cancer.gov

    Skip to Content Home | Investigator Resources | Protocol Development | Initiatives/Programs/Collaborations | Links to More Resources | Funding Opportunities | About CTEP Home | Sitemap | Contact CTEP Search this site Clinical Investigations Branch

  13. Clinical careers film.

    PubMed

    2015-09-01

    Those interested in developing clinical academic careers might be interested in a short animated film by Health Education England (HEE) and the National Institute for Health Research. The three-minute film, a frame from which is shown below, describes the sort of opportunities that are on offer to all professionals as part of the HEE's clinical academic careers framework. You can view the film on YouTube at tinyurl.com/pelb95c. PMID:26309005

  14. Gene electrotransfer clinical trials.

    PubMed

    Heller, Richard; Heller, Loree C

    2015-01-01

    Plasmid or non-viral gene therapy offers an alternative to classic viral gene delivery that negates the need for a biological vector. In this case, delivery is enhanced by a variety of approaches including lipid or polymer conjugation, particle-mediated delivery, hydrodynamic delivery, ultrasound or electroporation. Electroporation was originally used as a laboratory tool to deliver DNA to bacterial and mammalian cells in culture. Electrode development allowed this technique to be modified for in vivo use. After preclinical therapeutic studies, clinical delivery of cell impermeant chemotherapeutic agents progressed to clinical delivery of plasmid DNA. One huge benefit of this delivery technique is its malleability. The pulse protocol used for plasmid delivery can be fine-tuned to control the levels and duration of subsequent transgene expression. This fine-tuning allows transgene expression to be tailored to each therapeutic application. Effective and appropriate expression induces the desired clinical response that is a critical component for any gene therapy. This chapter focuses on clinical trials using in vivo electroporation or electrotransfer as a plasmid delivery method. The first clinical trial was initiated in 2004, and now more than fifty trials use electric fields for gene delivery. Safety and tolerability has been demonstrated by several groups, and early clinical efficacy results are promising in both cancer therapeutic and infectious disease vaccine applications. PMID:25620013

  15. How Do Clinical Trials Work?

    MedlinePLUS

    ... Trials Clinical Trial Websites How Do Clinical Trials Work? If you take part in a clinical trial, ... kol). This plan explains how the trial will work. The trial is led by a principal investigator ( ...

  16. HIV/AIDS Clinical Trials

    MedlinePLUS

    ... APIs Widgets Order Publications Skip Nav HIV/AIDS Clinical Trials Home > Clinical Trials Español Text Size Use ... Vaccine Research HIV Preventive Vaccines HIV Therapeutic Vaccines Clinical Trial News Wednesday, December 23, 2015 HIV Antibody ...

  17. Insurance Coverage and Clinical Trials

    MedlinePLUS

    ... Ask about Your Treatment Research Insurance Coverage and Clinical Trials Federal law requires most health insurance plans ... part or limit your benefits. What are approved clinical trials? Approved clinical trials are research studies that: ...

  18. American Society of Clinical Oncology

    MedlinePLUS

    ... Special Awards Fellow of the American Society of Clinical Oncology (FASCO) Recognition for ASCO Social Media Current ... Practice Management PracticeNET Top Five List For Researchers Clinical Trial Resources Clinically Meaningful Outcomes Community Research Forum ...

  19. REFERRAL FORM PHONOLOGICAL AWARENESS CLINIC

    E-print Network

    Hickman, Mark

    REFERRAL FORM PHONOLOGICAL AWARENESS CLINIC Concerns regarding communication Please return this form to: Clinical Administrator Email: clinic@cmds.canterbury.ac.nz Department of Communication Ethnicity: Referred by: Relationship: Address: Postal code: GP name: Practice: Parents/Caregivers name

  20. Clinical Simulation Laboratory Course Catalog

    E-print Network

    Hayden, Nancy J.

    to improve clinical, collaborative, and communication skills. Simulations are further enhanced Delivery ................................................................. 5 Clinical Communication Skills and Professionalism...... 6 Effective Teamwork in Healthcare.................................... 7 Emergency

  1. Neonatal clinical pharmacology

    PubMed Central

    Allegaert, Karel; van de Velde, Marc; van den Anker, John

    2013-01-01

    Effective and safe drug administration in neonates should be based on integrated knowledge on the evolving physiological characteristics of the infant who will receive the drug, and the pharmacokinetics (PK) and pharmacodynamics (PD) of a given drug. Consequently, clinical pharmacology in neonates is as dynamic and diverse as the neonates we admit to our units while covariates explaining the variability are at least as relevant as median estimates. The unique setting of neonatal clinical pharmacology will be highlighted based on the hazards of simple extrapolation of maturational drug clearance when only based on ‘adult’ metabolism (propofol, paracetamol). Secondly, maturational trends are not at the same pace for all maturational processes. This will be illustrated based on the differences between hepatic and renal maturation (tramadol, morphine, midazolam). Finally, pharmacogenetics should be tailored to neonates, not just mirror adult concepts. Because of this diversity, clinical research in the field of neonatal clinical pharmacology is urgently needed, and facilitated through PK/PD modeling. In addition, irrespective of already available data to guide pharmacotherapy, pharmacovigilance is needed to recognize specific side effects. Consequently, paediatric anesthesiologists should consider to contribute to improved pharmacotherapy through clinical trial design and collaboration, as well as reporting on adverse effects of specific drugs. PMID:23617305

  2. Clinical Pharmacogenetics Implementation

    PubMed Central

    WEITZEL, KRISTIN W.; ELSEY, AMANDA R.; LANGAEE, TAIMOUR Y.; BURKLEY, BENJAMIN; NESSL, DAVID R.; OBENG, ANIWAA OWUSU; STALEY, BENJAMIN J.; DONG, HUI-JIA; ALLAN, ROBERT W.; LIU, J. FELIX; COOPER-DEHOFF, RHONDA M.; ANDERSON, R. DAVID; CONLON, MICHAEL; CLARE-SALZLER, MICHAEL J.; NELSON, DAVID R.; JOHNSON, JULIE A.

    2014-01-01

    Current challenges exist to widespread clinical implementation of genomic medicine and pharmacogenetics. The University of Florida (UF) Health Personalized Medicine Program (PMP) is a pharmacist-led, multidisciplinary initiative created in 2011 within the UF Clinical Translational Science Institute. Initial efforts focused on pharmacogenetics, with long-term goals to include expansion to disease-risk prediction and disease stratification. Herein we describe the processes for development of the program, the challenges that were encountered and the clinical acceptance by clinicians of the genomic medicine implementation. The initial clinical implementation of the UF PMP began in June 2012 and targeted clopidogrel use and the CYP2C19 genotype in patients undergoing left heart catheterization and percutaneous-coronary intervention (PCI). After 1 year, 1,097 patients undergoing left heart catheterization were genotyped preemptively, and 291 of those underwent subsequent PCI. Genotype results were reported to the medical record for 100% of genotyped patients. Eighty patients who underwent PCI had an actionable genotype, with drug therapy changes implemented in 56 individuals. Average turnaround time from blood draw to genotype result entry in the medical record was 3.5 business days. Seven different third party payors, including Medicare, reimbursed for the test during the first month of billing, with an 85% reimbursement rate for outpatient claims that were submitted in the first month. These data highlight multiple levels of success in clinical implementation of genomic medicine. PMID:24616371

  3. [Endocrine tumors: clinical overview].

    PubMed

    Leidig-Bruckner, G

    2014-10-01

    The term endocrine tumor incorporates all neoplasms which originate from the various endocrine organs. Endocrine tumors can be characterized by different criteria: localization, endocrine function, dignity (i.e. tumorigenesis, sporadic or hereditary). These characteristics also determine the clinical outcome. The clinical history, symptoms and physical examination findings (e.g. amenorrhea, skin alterations, striae, virilization, increased blood pressure and flush) direct the diagnostic process of functioning endocrine tumors. Laboratory findings (endocrine parameters) are needed to establish a diagnosis supplemented by imaging for localization and special investigations (ophthalmological examination). In hereditary tumor syndromes, the familial history and molecular genetic testing and screening of family members are essential for establishing the diagnosis and achieve optimal and early treatment. Ideally, affected family members can be treated before clinical symptoms or metastatic disease occurs, improving outcome and prognosis. Incidentalomas are increasingly found due to widespread use of imaging techniques, especially in the thyroid, adrenal glands, pancreas and pituitary gland. In incidentalomas the functional status and risk of malignancy has to be evaluated as both parameters determine therapy decisions. The aim of this introductory article is to give an overview about particular features of endocrine tumors, clinical and related aspects for the diagnostic and therapeutic approach. The clinical features of tumors of the pituitary, parathyroid and adrenal glands and the gastroenteropancreatic system are summarized according to localization. PMID:25269723

  4. Advanced clinical medicine requires advanced clinical ethics.

    PubMed

    Hansen, Thor Willy Ruud

    2012-01-01

    Many advances have occurred in clinical medicine in the last decades. Solid organ transplants, corrective surgery for congenital malformations, improved cytostatic regimes for children with cancer, and respiratory care for premature infants are but a few examples of the changing face of medical practice. Such changes have added years to life. But along the way many patients have paid a price, both in terms of loss of life and of added suffering. Even today, some survivors are faced with a life of impairment and suffering. Follow-up studies of extremely low-birth-weight infants show that the smallest infants have a high rate of severe sequelae. Some argue that such suffering should be sufficient reason to make us desist from further attempts to advance the frontiers of therapy. This paper seeks to reflect on the character of advanced medicine and on how we relate to patients and their kin in our quest for further improvements in therapy. The price for continued advances will inevitably be paid by some patients who will not profit from them. Therefore, patients who are asked to participate in such a quest must receive honest and transparent information, including a discussion about where and how they would draw the limits. Clinical competency is a core concept in advanced medicine, but a caring comportment also demands that our relationship to the patient be characterized by honesty, integrity, and decency. In dialogue with parents, finding the right balance between parental exercise of autonomy and safe-guarding the best interest of the child remains a challenge. PMID:21791934

  5. Psoriatic Disease: Clinical Staging.

    PubMed

    Scarpa, Raffaele; Caso, Francesco; Costa, Luisa; Peluso, Rosario; Spanò, Angelo; Lubrano, Ennio; Del Puente, Antonio; Moll, John M H

    2015-11-01

    In 2006, the introduction of the concept "psoriatic disease" (PsD) extended the traditional idea of a condition confined to skin and joints. Now we consider PsD a systemic condition, in which the increased activity of tumor necrosis factor acts as the most potent engine for a series of molecular interactions. These lead not only to the genesis of skin and joint symptoms, but also to other clinical aspects such as inflammatory bowel disease, eye involvement, and metabolic syndrome. The blocking of a precise molecular target has dramatically modified therapeutic strategies, making possible adequate control of all the clinical aspects of the condition. Therefore, an expanded clinical staging of patients could now be considered in order to ensure the best therapeutic approach and prognosis. PMID:26523050

  6. [Terminology in clinical bioethics].

    PubMed

    Herreros, Benjamín; Moreno-Milán, Beatriz; Pacho-Jiménez, Eloy; Real de Asua, Diego; Roa-Castellanos, Ricardo Andrés; Valentia, Emanuele

    2015-01-01

    In this article some of the most relevant terms in clinical bioethics are defined. The terms were chosen based on three criteria: impact on the most important problems in clinical bioethics, difficulty in understanding, and need to clarify their meaning. For a better understanding, the terms were grouped into 5 areas: general concepts (conflict of values, deliberation, conflict of interest, conscientious objection); justice (justice, distributive justice, models of justice, triage); clinical matters (information, competency, capability, informed consent, mature minor, coercion, secrecy, privacy, confidentiality, professional secrecy); end of life (prior instructions, limitation of therapeutic efforts, professional obstinacy, futility, palliative care, palliative sedation, principle of double effect, euthanasia, assisted suicide, persistent vegetative state, minimally conscious state, locked-in syndrome, brain death), and beginning of life (assisted reproduction, genetic counseling, preimplantation genetic diagnosis). PMID:26506495

  7. Pediatric Anthrax Clinical Management

    PubMed Central

    Bradley, John S.; Peacock, Georgina; Krug, Steven E.; Bower, William A.; Cohn, Amanda C.; Meaney-Delman, Dana; Pavia, Andrew T.

    2015-01-01

    Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as “children”) in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults. PMID:24777226

  8. Gateways to Clinical Trials.

    PubMed

    Tomillero, A; Moral, M A

    2008-11-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: Albinterferon alfa-2b, ARRY-142886, Asenapine maleate; Bazedoxifene acetate, Bevacizumab; Caspofungin acetate, Certolizumab pegol, Custirsen sodium; Darifenacin hydrobromide; Ecogramostim, EndoTAG-1, Enzastaurin hydrochloride; HER2Bi; Lapatinib ditosylate, L-BLP-25; Micafungin sodium; O6-Benzylguanine, Odanacatib; Pazopanib hydrochloride, Pegfilgrastim, Peginterferon alfa-2a, Posaconazole; Sagopilone, Satraplatin; Tanespimycin, Tremelimumab; Vatalanib succinate, Voriconazole; Zoledronic acid monohydrate, ZP-10A. PMID:19229381

  9. Sense and clinical sensibility.

    PubMed

    Billow, Richard M

    2013-10-01

    I call attention to the metapsychology of sense, and the role sense plays-phenomenologically and symbolically-in the life of the clinician and the group. Each group member asserts influence in taking a role as the perceiver and the perceived, the senser and the sensed. We reach for sense, for without sense reference, we cannot grasp or even talk about psychic reality. It serves as sign and symbol, as metaphor, analogy, illustration, and model. Sense fixes experience yet may fixate experience and interfere with developing abstract thoughts. Clinical vignettes illustrate how the leader may utilize his or her particular clinical sensibility to reach the group and focus attention, to link sense to psychic qualities: to the personality of the members, the group culture and process, and the live clinical interaction. PMID:24004010

  10. Marking out the clinical expert/clinical leader/clinical scholar: perspectives from nurses in the clinical arena

    PubMed Central

    2013-01-01

    Background Clinical scholarship has been conceptualised and theorised in the nursing literature for over 30 years but no research has captured nurses’ clinicians’ views on how it differs or is the same as clinical expertise and clinical leadership. The aim of this study was to determine clinical nurses’ understanding of the differences and similarities between the clinical expert, clinical leader and clinical scholar. Methods A descriptive interpretative qualitative approach using semi-structured interviews with 18 practising nurses from Australia, Canada and England. The audio-taped interviews were transcribed and the text coded for emerging themes. The themes were sorted into categories of clinical expert, clinical leader and clinical scholarship as described by the participants. These themes were then compared and contrasted and the essential elements that characterise the nursing roles of the clinical expert, clinical leader and clinical scholar were identified. Results Clinical experts were seen as linking knowledge to practice with some displaying clinical leadership and scholarship. Clinical leadership is seen as a positional construct with a management emphasis. For the clinical scholar they linked theory and practice and encouraged research and dissemination of knowledge. Conclusion There are distinct markers for the roles of clinical expert, clinical leader and clinical scholar. Nurses working in one or more of these roles need to work together to improve patient care. An ‘ideal nurse’ may be a blending of all three constructs. As nursing is a practice discipline its scholarship should be predominantly based on clinical scholarship. Nurses need to be encouraged to go beyond their roles as clinical leaders and experts to use their position to challenge and change through the propagation of knowledge to their community. PMID:23587282

  11. Memory clinics in context

    PubMed Central

    Jolley, David; Moniz-Cook, Esme

    2009-01-01

    The growing number of older people in all parts of the world raises the question of how best to respond to their health needs, including those associated with memory impairment. Specialist Memory Clinics have a role to play, complementing community services which reach out to older people with mental health problems and encompassing younger people who become forgetful. Dementia is the most common syndrome seen, but there are other important treatable conditions which present with subjective or objective dysmnesia. Memory Clinics provide a high quality, devoted focus for early intervention, treatment, support and research. PMID:21416022

  12. Pharmacogenomics in the clinic.

    PubMed

    Relling, Mary V; Evans, William E

    2015-10-15

    After decades of discovery, inherited variations have been identified in approximately 20 genes that affect about 80 medications and are actionable in the clinic. And some somatically acquired genetic variants direct the choice of 'targeted' anticancer drugs for individual patients. Current efforts that focus on the processes required to appropriately act on pharmacogenomic variability in the clinic are moving away from discovery and towards implementation of an evidenced-based strategy for improving the use of medications, thereby providing a cornerstone for precision medicine. PMID:26469045

  13. Professional Doctorate in Clinical Psychology

    E-print Network

    Burton, Geoffrey R.

    Professional Doctorate in Clinical Psychology Programme information #12;Professional Doctorate in Clinical Psychology www.bath.ac.uk/psychology/clinical As the most recently established Doctorate in Clinical Psychology the Bath team has combined well established best practice in teaching and research

  14. The Clinical Schools Project.

    ERIC Educational Resources Information Center

    San Francisco State Univ., CA. Dept. of Elementary Education.

    This description of the Clinical Schools Project (a partnership which includes San Francisco State University, San Francisco Unified School District, and United Educators of San Francisco, California) contains a project description, three papers, and a proposal for establishing the project. The project description outlines the project, defines a…

  15. Clinical definitions of melioidosis.

    PubMed

    Cheng, Allen C; Currie, Bart J; Dance, David A B; Funnell, Simon G P; Limmathurotsakul, Direk; Simpson, Andrew J H; Peacock, Sharon J

    2013-03-01

    Clinical definitions of melioidosis and inhalation-acquired melioidosis (Burkholderia pseudomallei infection) are described together with the evidence used to develop these definitions. Such definitions support accurate public health reporting, preparedness planning for deliberate B. pseudomallei release, design of experimental models, and categorization of naturally acquired melioidosis. PMID:23468355

  16. Clinical Intuition at Play

    ERIC Educational Resources Information Center

    Marks-Tarlow, Terry

    2014-01-01

    A clinical psychologist and consulting psychotherapist discusses how elements of play, inherent in the intuition required in analysis, can provide a cornerstone for serious therapeutic work. She argues that many aspects of play--its key roles in human development, individual growth, and personal creativity, among others--can help therapists and…

  17. Clinical Research Operations

    Cancer.gov

    Brown Bag Lunch (BBL) The Brown Bag Lunch is a series of educational presentations developed to provide an open forum to discuss clinically focused topics in an informal, relaxed atmosphere. It is open to all oncology nurses at the NIH. The goal of the BB

  18. CCR Clinical Informatics

    Cancer.gov

    Contents Purpose Record details of prior therapies related to the disease being studies by the protocol or when the details would be clinically significant for the evaluation of this study as indicated on the Prior Treatment Summary case report form. Prio

  19. Clinical Research Operations

    Cancer.gov

    Clinical Informatics Protocol Development and Management iRIS (Integrated Research Information System (iRIS) helps create, manage and process CCR research protocols. iRIS can be accessed from any computer that has a connection to the NIH internal network.

  20. Clinical Research Operations

    Cancer.gov

    2013 Protocol Submission Deadlines and Meeting Dates National Cancer Institute Institutional Review Board (IRB) Time:  1:00 p.m. - 5:30 p.m. Location:  Clinical Research Center (CRC), Room 3-1608 IRB Deadline IRB Meeting Date IRB Deadline IRB Meeting Date

  1. CCR Clinical Informatics

    Cancer.gov

    Contents Purpose Record the patient's lab results. Patients on NCI/CCR's intramural studies who have their labs drawn at the Clinical Center will use the Lab Load Interface (LLI) tool to select which labs results to electronically transfer into C3D. The s

  2. Clinical Research Operations

    Cancer.gov

    2012 Protocol Submission Deadlines and Meeting Dates National Cancer Institute Institutional Review Board (IRB) Time:  1:00 p.m. - 5:30 p.m. Location:  Clinical Research Center (CRC), Room 3-1608 IRB Deadline IRB Meeting Date IRB Deadline IRB Meeting Date

  3. Pharmacology and Clinical Pharmacology

    E-print Network

    Auckland, University of

    Pharmacology and Clinical Pharmacology Handbook 2014 #12;Pharmacology involves the study. The study of pharmacology requires understanding normal body functions (biochemistry and physiology) and the disturbances that occur (pathology). Pharmacology is the basis of much of the research and development of new

  4. Teaching Clinical Reasoning.

    ERIC Educational Resources Information Center

    Kurtz, Daniel

    1990-01-01

    Research on the cognitive processes used by physicians during patient care (template matching, deductive logic starting with multiple hypotheses, and algorithmic logic) is examined for its applicability to optometrists and the problem-solving strategies used by optometric students in the classroom or clinic. (Author/MSE)

  5. Computerized Clinical Simulations.

    ERIC Educational Resources Information Center

    Reinecker, Lynn

    1985-01-01

    Describes technique involved in designing a clinical simulation problem for the allied health field of respiratory therapy; discusses the structure, content, and scoring categories of the simulation; and provides a sample program which illustrates a programming technique in BASIC, including a program listing and a sample flowchart. (MBR)

  6. Designing Clinical Remediation Programs.

    ERIC Educational Resources Information Center

    Oleszewski, Susan C.

    1989-01-01

    Elements and considerations in the provision of effective remediation for optometry students not achieving in clinical competence are discussed. Remediation of technical, cognitive, and noncognitive skills are included. A course in professional communication offered by the Pennsylvania College of Optometry is described. (MSE)

  7. Hearing Clinic Communication Disorders

    E-print Network

    Hickman, Mark

    Hearing Clinic Communication Disorders Hearing. ScienceSPTH4093 Hearing Aid Fittings Hearing aid fitting and counselling involves matching hearing aids according to the type of hearing loss and the wants and needs of the person with the hearing loss. Counselling includes discussing how to successfully use

  8. Clinical Trials Helpful information

    E-print Network

    Ferrara, Katherine W.

    're old enough to face the possibility of cancer, there will be a cure." Toni Carter SACRAMENTO, CA: BREAST CANCER #12;Answering questions, offering hope A cancer clinical trial offers today's newest drugs and treatments in an effort to answer scientific questions and find better ways to treat cancer. UC Davis

  9. Clinical Trials Guidelines

    Cancer.gov

    Consensus Recommendations for the Use of 18F-FDG PET as an Indicator of Therapeutic Response in Patients in National Cancer Institute Trials, Shankar LK, Hoffman JM, Bacharach S, Graham MM, et al. J Nucl Med (2006) 47:1059-1066. Print This Page Clinical

  10. Clinical Nuclear Pharmacy Clerkship

    ERIC Educational Resources Information Center

    Dunson, George L.; Christopherson, William J., Jr.

    1977-01-01

    The School of Pharmacy, University of the Pacific, and the Pharmacy Service, Letterman Army Medical Center, initiated a 15-week clinical nuclear pharmacy clerkship in 1975. It includes basic nuclear medical science, technical competency, professional competency, and special interest emphasis. (LBH)

  11. Clinical Research Operations

    Cancer.gov

    ICH and OHRP Guidance ICH (International Conference on Harminization of Technical Requirements for Registration of Pharmaceuticals for Human Use) E6_ICH Good Clinical Practice E15 FDA Guidance Document AAHRPP Tip Sheet 11: Following the Guideline of the I

  12. Clinical Research Operations

    Cancer.gov

    Fellowship Cinical Trial Education Series for 2013-2014 Series Syllabus Clinical Trial Design (6 slides per page) U.S. Drug Development and the Role of the Sponsor (6 slides per page) Protocol Development, Review and Approval Process (6 slides per page) S

  13. Clinical Research Operations

    Cancer.gov

    NIH/CC/CCR Orientation Requirements All new hires to the CCR, both government and contractor, are required to participate in orientation. This orientation program has been developed and coordinated by the CCR Office of the Clinical Director to be complian

  14. Clinical Research Operations

    Cancer.gov

    The learning modules below will provide you with general information about clinical trials. Each module will have a syllabus, a series of audio slides, links to YouTube videos if applicable, and resources/references.  Module content is consistent with U.

  15. Clinical Mastery of Hypnosis.

    ERIC Educational Resources Information Center

    Horevitz, Richard P.

    Hypnosis is an increasingly popular clinical intervention. The number of training courses in hypnosis is growing each year. Research on hypnosis training appears to show that limited exposure to training, as is typical in the common 3 to 5 day format of mass training, produces limited results. Only when training is extended over time do the…

  16. The Unstructured Clinical Interview

    ERIC Educational Resources Information Center

    Jones, Karyn Dayle

    2010-01-01

    In mental health, family, and community counseling settings, master's-level counselors engage in unstructured clinical interviewing to develop diagnoses based on the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association, 2000). Although counselors receive education about…

  17. Clinical Investigations Branch (CIB)

    Cancer.gov

    Meg Mooney, MD, MBA is the Chief of the Clinical Investigations Branch (CIB) of the Cancer Therapy Evaluation Program (CTEP), Division of Cancer Treatment and Diagnosis, at the NCI and oversees adult sarcoma cancer therapeutics. She was formerly the Interim Director of the Office of Evidence-Based Surgery at the American College of Surgeons in Chicago, Illinois.

  18. Clinical Paper Orthognathic Surgery

    E-print Network

    Frey, Pascal

    . Stoelinga4,5 1 Department of Oral and Maxillofacial Surgery/Pathology, Academic Centre for Dentistry of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, Netherlands; 5 DepartmentClinical Paper Orthognathic Surgery Do the changes in muscle mass, muscle direction, and rotations

  19. [Unusual nasal clinical entities].

    PubMed

    Guerrero-Palma, Miguel A; Avila-Espín, Luis; González-Pérez, José M; Moreno-León, Javier A; Fernández-Pérez, Antonio; Prieto Sánchez, Elisa

    2007-12-01

    Three cases of rare entities in nasal pathology are reported. Two of them are high-grade lymphomas (T/NK type), with nasal blockage as the first symptom. Clinical course and treatment response are described. The third case refers to an infrequent benign nasal entity called angiocentric eosinophilic fibrosis. Its aetiology and management remains rather uncertain nowadays. PMID:18082079

  20. Survivorship Clinic Osteoradionecrosis

    E-print Network

    Brent, Roger

    of the mouth) Oropharyngeal (mouth and throat) Neck or spine ("cervical" portion) Supraclavicular (area to determine the location and dose of radiation that was given. Fred Hutchinson Cancer Research Center Survivorship Program #12;Survivorship Clinic Fred Hutchinson Cancer Research Center Survivorship Program How

  1. [Controlled randomized clinical trials].

    PubMed

    Jaillon, Patrice

    2007-01-01

    It is generally agreed that the first comparative clinical trial in history was done by James Lind in 1747, in the treatment of scurvy. The general bases of modern experimental medicine were published by Claude Bernard in 1865. However, it is the development of new drugs and the evolution of methodological concepts that led to the first randomized controlled clinical trial, in 1948, which showed that the effects of streptomycin on pulmonary tuberculosis were significantly different from those of a placebo. Today, "evidence-based" medicine aims to rationalize the medical decision-making process by taking into account, first and foremost, the results of controlled randomized clinical trials, which provide the highest level of evidence. In the second half of the 20th century it became clear that different kinds of clinical trials might not provide the same level of evidence. Practitioners' intimate convictions must be challenged by the results of controlled clinical trials. Take the CAST trial for example, which, in 1989, tested antiarrhythmic drugs versus placebo in patients with myocardial infarction. It was well known that ventricular arrhythmias were a factor of poor prognosis in coronary heart disease, and it was therefore considered self-evident that drug suppression of these ventricular arrhythmias would reduce the mortality rate. In the event, the CAST trial showed the exact opposite, with an almost 3-fold increase in total mortality among patients with coronary heart disease who were treated with antiarrhythmic drugs. These results had a profound impact on the use of antiarrythmic drugs, which became contraindicated after myocardial infarction. A clinical trial has to fulfill certain methodological standards to be accepted as evidence-based medicine. First, a working hypothesis has to be formulated, and then the primary outcome measure must be chosen before beginning the study. An appropriate major endpoint for efficacy must be selected, in keeping with the primary outcome. One may choose either a single endpoint (for instance all-cause mortality; or a composite criterion taking into account various manifestations of the same health disorder (for instance cardiovascular mortality plus non lethal myocardial infarction plus non lethal ischemic stroke). The trial must be controlled, i.e. must compare the intervention with a standard or dummy treatment. A randomization process is used to ensure that the groups are comparable. The patients must be monitored and the results analyzed in double-blind manner The required number of patients is calculated based on the working hypothesis ("superiority" trial or "equivalence" trial), as well as the spontaneous variability of the main endpoint, and the alpha and beta statistical risks. The experimental design (cross-over or parallel groups) is chosen according to the primary outcome measure and the disease characteristics. Finally, the results must be analyzed in an intention-to-treat manner, taking into account all the patients who were initially randomized. The results of these methodologically sound trials form the basis for official therapeutic guidelines, which help physicians to choose the best treatments for their patients. However, extrapolating the results of randomized controlled clinical trials to the general patient population is not always straightforward. For instance, it is well known that patients who participate in clinical trials are highly selected and therefore somewhat unrepresentative. In addition, their numbers are limited and the treatment period is often much shorter than in routine management of a chronic disease. Finally, patients in clinical trials are monitored more closely than in routine practice. This is why we need post-marketing pharmacoepidemiological studies, in which cohorts of patients exposed to the treatment in question are monitored sufficiently long to determine the precise risk-benefit ratio. Controlled clinical trials are lacking in various fields of biomedical research, either because drug companies consi

  2. Clinical vaccine development

    PubMed Central

    2015-01-01

    Vaccination is regarded as one of the biggest triumphs in the history of medicine. We are living in the most successful period of vaccine development. The accumulation of multidisciplinary knowledge and the investment of massive funding have enabled the development of vaccines against many infectious diseases as well as other diseases including malignant tumors. The paradigm of clinical vaccine evaluation and licensure has also been modernized based on scientific improvements and historical experience. However, there remain a number of hurdles to overcome. Continuous efforts are focused on increasing the efficacy and reducing the risks related to vaccine use. Cutting-edge knowledge about immunology and microbiology is being rapidly translated to vaccine development. Thus, physicians and others involved in the clinical development of vaccines should have sufficient understanding of the recent developmental trends in vaccination and the diseases of interest. PMID:25648742

  3. Clinical applications for estetrol.

    PubMed

    Visser, Monique; Coelingh Bennink, Herjan J T

    2009-03-01

    In this paper the potential clinical applications for the human fetal estrogen estetrol (E(4)) are presented based on recently obtained data in preclinical and clinical studies. In the past E(4) has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E(4) is an effective orally bioavailable estrogen agonist with estrogen antagonistic effects on the breast in the presence of estradiol. Based on the pharmacokinetic properties, the pharmacological profile and the safety and efficacy results in human studies, E(4) seems potentially suitable as a drug for human use in applications such as hormone replacement therapy (vaginal atrophy and vasomotor symptoms), contraception, osteoporosis and breast cancer. PMID:19167495

  4. [Reporting on psychoanalytic clinic].

    PubMed

    Levín, Raúl E

    2006-01-01

    As mediation between absolute reserve (which is inherent in the psychoanalytic session) and communication of this experience to third parties (as supervisors, colleagues, public), psychoanalytic clinical accounts require and acquire a narrative procedure with its own specificity. So much so, that it can be said that this token consecrates a particular testimony as valid for scientific discussion. The present work makes reference to the moment in history since when Psychoanalysis departs from traditional psychiatry and progressively conquers an autonomy that dwells upon such procedure. The transmission in words, be it oral o written, of what went on during the sessions shares many common grounds with Literature. Regarding these, some points are raised as to the style that may be more germane to this purpose, and queries come up whether or not clinical accounts can ever enter the realm of letters as a literary subclass on its own. PMID:16645680

  5. Clinical confocal microscopy.

    PubMed

    Petroll, W M; Cavanagh, H D; Jester, J V

    1998-08-01

    Because it provides much higher magnification and better optical sectioning than a slit-lamp biomicroscope, confocal microscopy is ideally suited for clinical imaging of the cornea. One important clinical application of confocal microscopy has been the early detection and diagnosis of a number of infectious conditions, including infection with Acanthamoeba and microsporidium species, fungal keratitis, and contact lens-associated bacterial keratitis. Confocal microscopy has also been used for temporal evaluation of corneal wound healing following refractive surgery and penetrating keratoplasty. With the development of the new technique of quantitative confocal microscopy through-focusing, confocal microscopy can be used to measure epithelial, stromal, and corneal thickness accurately and reproducibly in human patients. Furthermore, conofocal microscopy through-focusing can be used to determine the initial photoablation depth, changes in epithelial, stromal, and corneal thickness, and subepithelial haze following photorefractive keratectomy. PMID:10387471

  6. Capability and Clinical Success

    PubMed Central

    Ferrer, Robert L.; Carrasco, Alejandra Varela

    2010-01-01

    Better outcomes for chronic diseases remain elusive because success depends on events outside the control of the health care system: patients’ ability to mange their health behaviors and chronic diseases. Among the most powerful influences on self-management are the social and environmental constraints on healthy living, yet the clinical response to these environmental determinants is poorly developed. A potential approach for addressing social determinants in practice, as well as planning and evaluating community responses, is the capability framework. Defined as the real opportunity to achieve a desired lifestyle, capability focuses attention on the material conditions that constrain real opportunity and how opportunity emerges from the interaction between personal resources and the social environment. Using examples relevant to chronic disease and behavior change, we discuss the clinical application of the capability framework. PMID:20843888

  7. Radiotherapy in clinical practice

    SciTech Connect

    Hope-Stone, H.F.

    1986-01-01

    Radiotherapy is one of the cornerstones of the treatment of malignant disease, and modern techniques used in conjunction with chemotherapy and surgery have radically improved the prognosis for patients. Although the practice of radiotherapy still may be considered by some to be more of an art than a science, the empirical era has passed and basic radiobiological research coupled with extensive clinical investigation has led to a more rational and scientifically founded approach. Radiotherapy in Clinical Practice, is a major new work for those in training or practice, and reflects the maturity of the discipline. The editor, an experienced radiotherapist of many years' standing, has assembled a team of experts from the United Kingdom to write authoritative accounts of their particular subjects. Every aspect of radiotherapeutic management of tumours is covered in detail.

  8. Rural health clinics infrastructure

    SciTech Connect

    Olson, K.

    1997-12-01

    The author discusses programs which were directed at the installation of photovoltaic power systems in rural health clinics. The objectives included: vaccine refrigeration; ice pack freezing; lighting; communications; medical appliances; sterilization; water purification; and income generation. The paper discusses two case histories, one in the Dominican Republic and one in Colombia. The author summarizes the results of the programs, both successes and failures, and offers an array of conclusions with regard to the implementation of future programs of this general nature.

  9. Clinical multiphoton FLIM tomography

    NASA Astrophysics Data System (ADS)

    König, Karsten

    2012-03-01

    This paper gives an overview on current clinical high resolution multiphoton fluorescence lifetime imaging in volunteers and patients. Fluorescence lifetime imaging (FLIM) in Life Sciences was introduced in Jena/Germany in 1988/89 based on a ZEISS confocal picosecond dye laser scanning microscope equipped with a single photon counting unit. The porphyrin distribution in living cells and living tumor-bearing mice was studied with high spatial, temporal, and spectral resolution. Ten years later, time-gated cameras were employed to detect dental caries in volunteers based on one-photon excitation of autofluorescent bacteria with long fluorescence lifetimes. Nowadays, one-photon FLIM based on picosecond VIS laser diodes are used to study ocular diseases in humans. Already one decade ago, first clinical twophoton FLIM images in humans were taken with the certified clinical multiphoton femtosecond laser tomograph DermaInspectTM. Multiphoton tomographs with FLIM modules are now operating in hospitals at Brisbane, Tokyo, Berlin, Paris, London, Modena and other European cities. Multiple FLIM detectors allow spectral FLIM with a temporal resolution down to 20 ps (MCP) / 250 ps (PMT) and a spectral resolution of 10 nm. Major FLIM applications include the detection of intradermal sunscreen and tattoo nanoparticles, the detection of different melanin types, the early diagnosis of dermatitis and malignant melanoma, as well as the measurement of therapeutic effects in pateints suffering from dermatitis. So far, more than 1,000 patients and volunteers have been investigated with the clinical multiphoton FLIM tomographs DermaInspectTM and MPTflexTM.

  10. [Clinical variations of keratoacanthomas].

    PubMed

    Hundeiker, M

    1978-08-15

    Clinical variants of Keratoacanthomas are, besides the very frequent crateriform types, and the plate-shaped ones, Keratoacanthoma marginatum centrifugum, aggregated Keratoacanthomas, successive multiple Keratoacanthomas, and rare special forms like multiple eruptive Keratoakanthomas and Keratoacanthomas combined with Hyperplasia of sebaceous glands and epitheliomas. A detailed description of the different types is derived from their growth and their origin from supraseboglandular epithelium of hair follicles. PMID:685362

  11. Innovative Clinical Trial Designs

    PubMed Central

    Lavori, Philip W.

    2015-01-01

    Whereas the 20th-century health care system sometimes seemed to be inhospitable to and unmoved by experimental research, its inefficiency and unaffordability have led to reforms that foreshadow a new health care system. We point out certain opportunities and transformational needs for innovations in study design offered by the 21st-century health care system, and describe some innovative clinical trial designs and novel design methods to address these needs and challenges. PMID:26140056

  12. [Hyponatremia in clinical practice].

    PubMed

    Regolisti, Giuseppe; Cabassi, Aderville; Antonucci, Elio; Brusasco, Irene; Cademartiri, Carola; Pistolesi, Valentina; Morabito, Santo; Fiaccadori, Enrico

    2015-01-01

    Hyponatremia is the most frequent electrolyte disorder in hospitalized patients and it is associated with unfavorable clinical outcomes as well as increased hospital costs. Its clinical presentation may be highly variable, ranging from asymptomaticity to neurologic emergencies with seizures or coma as signs of rapidly worsening cerebral edema. In these cases, prompt treatment is mandatory to avoid the patients death. On the other hand, in the case of gradual development of hyponatremia, it is imperative that its correction be also appropriately slow in order to avoid another neurological catastrophe, namely the osmotic demyelination syndrome. Whilst recent international guidelines and expert consensus agree on the approach to the treatment of acute severe and symptomatic hyponatremia, the recommendations on pharmacological therapy in chronic hyponatremia diverge, particularly as to the potential use of vasopressin antagonists. This review is aimed at summarizing essential aspects of epidemiology, pathophysiology and the diagnostic process of hyponatremia, to set the ground for a practical as well as evidence-based approach to treatment. As a guide through the discussion of the available evidence, a clinical case is presented in which the patients history and laboratory data are crucial for identifying the etiology of hyponatremia. The severe neurological signs at presentation justify an emergency treatment with hypertonic saline, as indicated. Subsequently, as the neurological emergency subsides, we discuss the need to revert the trend towards hypercorrection by an apparently counterintuitive approach, based in fact on sound pathophysiological grounds, with continuous infusion of hypotonic solutions and administration of desmopressin. PMID:25774584

  13. Basic and clinical immunology

    NASA Technical Reports Server (NTRS)

    Chinen, Javier; Shearer, William T.

    2003-01-01

    Progress in immunology continues to grow exponentially every year. New applications of this knowledge are being developed for a broad range of clinical conditions. Conversely, the study of primary and secondary immunodeficiencies is helping to elucidate the intricate mechanisms of the immune system. We have selected a few of the most significant contributions to the fields of basic and clinical immunology published between October 2001 and October 2002. Our choice of topics in basic immunology included the description of T-bet as a determinant factor for T(H)1 differentiation, the role of the activation-induced cytosine deaminase gene in B-cell development, the characterization of CD4(+)CD25(+) regulatory T cells, and the use of dynamic imaging to study MHC class II transport and T-cell and dendritic cell membrane interactions. Articles related to clinical immunology that were selected for review include the description of immunodeficiency caused by caspase 8 deficiency; a case series report on X-linked agammaglobulinemia; the mechanism of action, efficacy, and complications of intravenous immunoglobulin; mechanisms of autoimmunity diseases; and advances in HIV pathogenesis and vaccine development. We also reviewed two articles that explore the possible alterations of the immune system caused by spaceflights, a new field with increasing importance as human space expeditions become a reality in the 21st century.

  14. Gateways to Clinical Trials.

    PubMed

    Bayés, M; Rabasseda, X; Prous, J R

    2002-09-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Studies knowledge area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: Adalimumab, aeroDose insulin inhaler, agomelatine, alendronic acid sodium salt, aliskiren fumarate, alteplase, amlodipine, aspirin, atazanavir; Bacillus Calmette-Guérin, basiliximab, BQ-788, bupropion hydrochloride; Cabergoline, caffeine citrate, carbamazepine, carvedilol, celecoxib, cyclosporine, clopidogrel hydrogensulfate, colestyramine; Dexamethasone, diclofenac sodium, digoxin, dipyridamole, docetaxel, dutasteride; Eletriptan, enfuvirtidie, eplerenone, ergotamine tartrate, esomeprazole magnesium, estramustine phosphate sodium; Finasteride, fluticasone propionate, fosinopril sodium; Ganciclovir, GBE-761-ONC, glatiramer acetate, gliclazide, granulocyte-CSF; Heparin sodium, human isophane insulin (pyr), Hydrochlorothiazide; Ibuprofen, inhaled insulin, interferon alfa, interferon beta-1a; Laminvudine, lansoprazole, lisinopril, lonafarnib, losartan potassium, lumiracoxib; MAb G250, meloxicam methotrexate, methylprednisolone aceponate, mitomycin, mycophenolate mofetil; Naproxen sodium, natalizumab, nelfinavir mesilate, nemifitide ditriflutate, nimesulide; Omalizumab, omapatrilat, omeprazole, oxybutynin chloride; Pantoprazole sodium, paracetamol, paroxetine, pentoxifylline, pergolide mesylate, permixon, phVEGF-A165, pramipexole hydrochloride, prasterone, prednisone, probucol, propiverine hydrochloride; Rabeprazole sodium, resiniferatoxin, risedronate sodium, risperidone, rofecoxib rosiglitazone maleate, ruboxistaurin mesilate hydrate; Selegiline transdermal system, sertraline, sildenafil citrate, streptokinase; Tadalafil, tamsulosin hydrochloride, technosphere/Insulin, tegaserod maleate, tenofovir disoproxil fumarate, testosterone heptanoate, testosterone undecanoate, tipifarnib, tolterodine tartrate, topiramate, troglitazone; Ursodeoxycholic acid; Valdecoxib, valsartan, vardenafil, venlafaxine hydrochloride, VX-745. PMID:12428432

  15. Clinical Assay Development Support - Office of Cancer Clinical Proteomics Research

    Cancer.gov

    The NCI’s Division of Cancer Treatment and Diagnosis and the Cancer Diagnosis Program announce a request for applications for the Clinical Assay Development Program (CADP) for investigators seeking clinical assay development and validation resources.

  16. 75 FR 57472 - Clinical Investigator Training Course

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... SERVICES Food and Drug Administration Clinical Investigator Training Course AGENCY: Food and Drug... Programs, in cosponsorship with the Clinical Trials Transformation Initiative (CTTI), is announcing a 3-day... clinical trials (clinical investigators). This course is intended to assist clinical investigators...

  17. Development and Clinical Outcomes of a Dialectical Behavior Therapy Clinic

    ERIC Educational Resources Information Center

    Lajoie, Travis; Sonkiss, Joshua; Rich, Anne

    2011-01-01

    Objective: The authors describe the first 6 months of a dialectical behavior therapy (DBT) clinic operated by trainees in a general adult psychiatry residency program. The purpose of this report is to provide a model for the creation and maintenance of a formalized resident DBT clinic. Methods: Residents participated in the DBT clinic, attended a…

  18. "Clinical Reasoning Theater": A New Approach to Clinical Reasoning Education.

    ERIC Educational Resources Information Center

    Borleffs, Jan C. C.; Custers, Eugene J. F. M.; van Gijn, Jan; ten Gate, Olle Th. J.

    2003-01-01

    Describes a new approach to clinical reasoning education called clinical reasoning theater (CRT). With students as the audience, the doctor's clinical reasoning skills are modeled in CRT when he or she thinks aloud during conversations with the patient. Preliminary results of students' evaluations of the relevance of CRT reveal that they…

  19. Terminal Behavioral Objectives for Teaching Clinical Toxicology to Clinical Pharmacists

    ERIC Educational Resources Information Center

    Veltri, Joseph C.; And Others

    1976-01-01

    As a first step in the development of a competency-based clinical toxicology clerkship, a set of terminal behavioral objectives were developed that reflect the anticipated role that clinical pharmacists should play as part of the clinical toxicology team. The evaluation approaches used at the University of Utah are presented. (LBH)

  20. Pathology (Gregg) Clinical Organizational Structure

    E-print Network

    Leistikow, Bruce N.

    Molecular Pathology (Gregg) Clinical Organizational Structure Department Chair (Howell) Vice Chair, Strategic Technology (Levenson) Vice Chair, Research (Wan) Senior Director, Anatomic Pathology (Bishop) Vice (Jin) Surgical Pathology (Bishop) Directors of: Senior Director, Clinical Pathology (Gregg) Progenitor

  1. Rare Diseases Clinical Research Network

    MedlinePLUS

    ... is the RDCRN? Aims of the Rare Diseases Clinical Research Network Contact Us RDCRN Members Login Accessibility Disclaimer The Rare Diseases Clinical Research Network is an initiative of the Office ...

  2. AIDS Clinical Trials Group Network

    MedlinePLUS

    ... Center Statistical and Data Management Center Glossaries Sites Clinical Trials About the Trial Process Trials Open to Enrollment Layman’s Study Summaries Access to Published Data Clinical Trials Resources Committees Executive Scientific Resource Community General ...

  3. Are Clinical Studies for You?

    MedlinePLUS

    ... Contact Us | Site Map | Search The "About the Clinical Center" navigation menu has been enchanced by javascript. ... reach the non-javascript version . The "Participate in Clinical Studies" navigation menu has been enchanced by javascript. ...

  4. Clinical Trials in Vision Research

    MedlinePLUS

    ... nih.gov Clinical trials in vision research have led to new medications, surgeries, and methods for disease ... your questions. Clinical trials in vision research have led to new medications, surgeries, and methods for disease ...

  5. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Clinical psychologist and clinical social worker services. 405.2450 Section... Clinical psychologist and clinical social worker services. (a) For clinical psychologist or clinical social worker professional services to be...

  6. PERFORMANCE Clinical Education video series

    E-print Network

    Peak, Derek

    Clinical education documents posted http://www.medicine.usask.ca/pt Clin Ed video series Orientation1 PERFORMANCE EVALUATION Clinical Education video series School of Physical Therapy Master Clinical Education Program Evaluation Evaluation of the MPT Curriculum #12;5 Who evaluates What? Student

  7. Finding an imaging clinical trial

    Cancer.gov

    Information about imaging clinical trials and clinical trials in general is available from the Cancer Information Service (CIS). Information specialists at the CIS use PDQ, the NCI's cancer information database, to identify and provide detailed information about specific ongoing clinical trials.

  8. Biomedical Knowledge and Clinical Expertise.

    ERIC Educational Resources Information Center

    Boshuizen, Henny P. A.; Schmidt, Henk G.

    A study examined the application and availability of clinical and biomedical knowledge in the clinical reasoning of physicians as well as possible mechanisms responsible for changes in the organization of clinical and biomedical knowledge in the development from novice to expert. Subjects were 28 students (10 second year, 8 fourth year, and 10…

  9. Standardized National Dental Clinical Examinations.

    ERIC Educational Resources Information Center

    Allen, Don L.

    1992-01-01

    Because most states incorporate similar clinical tests in their dental licensing examinations and most dentists surveyed would like greater mobility between states without taking another clinical examination, development of a national clinical examination is desirable. Demonstration of continued competency should also be required. (MSE)

  10. Clinical Nutrition SHRP Department of

    E-print Network

    Delgado, Mauricio

    Doctorate of Clinical Nutrition SHRP Department of Nutritional Sciences about it's all Choi: Graduate Programs in Clinical Nutrition Office 973-972-8525 · 973-972-9048 How to Apply Applications, Doctorate of Clinical Nutrition Riva Touger-Decker, PhD, RD, CDN, FADA Chair and Professor Laura D. Byham

  11. Master of Science Clinical Nutrition

    E-print Network

    Delgado, Mauricio

    SHRP Master of Science in Clinical Nutrition Department of Nutritional Sciences about it's all Choi.rutgers.edu/dept/nutr/programs/m_clinutr Email: ms-cn@shrp.rutgers.edu Call: Graduate Programs in Clinical Nutrition Office 973-972-8525 · 973? Laura D. Byham-Gray, PhD, RD Associate Professor Director, Master of Science in Clinical Nutrition Jane

  12. Gateways to clinical trials.

    PubMed

    Bayés, M; Rabasseda, X; Prous, J R

    2004-03-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Studies Knowledge Area of Prous Science Integrity(R), the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: Activated protein C concentrate, Ad-CD154, Adeno-Interferon gamma, alemtuzumab, APC-8024, 9-aminocamptothecin, aprepitant, l-arginine hydrochloride, aripiprazole, arsenic trioxide, asimadoline; O6-Benzylguanine, bevacizumab, Bi-20, binodenoson, biphasic insulin aspart, bivatuzumab, 186Re-bivatuzumab, BMS-181176, bosentan, botulinum toxin type B, BQ-123, bryostatin 1; Carboxy- amidotriazole, caspofungin acetate, CB-1954, CC-4047, CDP-860, cerivastatin sodium, clevidipine, CTL-102; 3,4-DAP, darbepoetin alfa, decitabine, desloratadine, DHA-paclitaxel, duloxetine hydrochloride; Efalizumab, EGF vaccine, eletriptan, eniluracil, ENMD-0997, eplerenone, eplivanserin, erlosamide, ertapenem sodium, escitalopram oxalate, esomeprazole magnesium, eszopiclone, everolimus, exatecan mesilate, exenatide, ezetimibe; Fondaparinux sodium, FR-901228, FTY-720; Gefitinib, gemtuzumab ozogamicin, gepirone hydrochloride; Hexyl insulin M2, human insulin; Imatinib mesylate, insulin detemir, insulin glargine, iodine (I131) tositumomab, ISV-205, ivabradine hydrochloride, ixabepilone; Levetiracetam, levocetirizine, linezolid, liposomal NDDP, lonafarnib, lopinavir, LY-156735; Mafosfamide cyclohexylamine salt, magnesium sulfate, maxacalcitol, meclinertant, melagatran, melatonin, MENT, mepolizumab, micafungin sodium, midostaurin, motexafin gadolinium; Nesiritide, NS-1209, NSC-601316, NSC-683864; Osanetant; Palonosetron hydrochloride, parecoxib sodium, pegaptanib sodium, peginterferon alfa-2a, peginterferon alfa-2b, pegylated OB protein, pemetrexed disodium, perillyl alcohol, picoplatin, pimecrolimus, pixantrone maleate, plevitrexed, polyglutamate paclitaxel, posurdex, pramlintide acetate, prasterone, pregabalin; Rasburicase, rimonabant hydrochloride, rostaporfin, rosuvastatin calcium; SDZ-SID-791, sibrotuzumab, sorafenib, SU-11248; Tadalafil, targinine, tegaserod maleate, telithromycin, TheraCIM, tigecycline, tiotropium bromide, tipifarnib, tirapazamine, treprostinil sodium; Valdecoxib, Valganciclovir hydrochloride, Vardenafil hydrochloride hydrate; Ximelagatran; Zofenopril calcium, Zoledronic acid monohydrate. PMID:15071612

  13. Gateways to clinical trials.

    PubMed

    Bayés, M; Rabasseda, X

    2008-01-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prouse Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: 101M, 3F8; Abatacept, ABT-263, Adalimumab, AG-7352, Agatolimod sodium, Alfimeprase, Aliskiren fumarate, Alvimopan hydrate, Aminolevulinic acid hexyl ester, Ammonium tetrathiomolybdate, Anakinra, Aripiprazole, AS-1404, AT-9283, Atomoxetine hydrochloride, AVE-1642, AVE-9633, Axitinib, AZD-0530; Becocalcidiol, Belotecan hydrochloride, Bevacizumab, BG-9928, BIBF-1120, BMS-275183, Bortezomib, Bosentan; Catumaxomab, Cetuximab, CHR-2797, Ciclesonide, Clevidipine, Cypher, Cytarabine/daunorubicin; Darifenacin hydrobromide, Darunavir, Denosumab, Desvenlafaxine succinate, Disufenton sodium, Duloxetine hydrochloride, Dutasteride; Eculizumab, Efalizumab, Eicosapentaenoic acid/docosahexaenoic acid, Eplerenone, Epratuzumab, Erlotinib hydrochloride, Escitalopram oxalate, Ethynylcytidine, Etravirine, Everolimus, Ezetimibe; Fulvestrant; Garenoxacin mesilate, Gefitinib, Gestodene; HI-164, Hydralazine hydrochloride/isosorbide dinitrate; Icatibant acetate, ICX-RHY, Idraparinux sodium, Indacaterol, Ispronicline, Ivabradine hydrochloride, Ixabepilone; KB-2115, KW-2449; L-791515, Lapatinib ditosylate, LGD-4665, Licofelone, Liposomal doxorubicin, Lisdexamfetamine mesilate, Lumiracoxib; Methoxy polyethylene glycol-epoetin-beta, Miglustat, Mipomersen sodium, Mitumprotimut-T, MK-0822A, MK-0974; Nelarabine; Obatoclax mesylate, Olmesartan medoxomil, Olmesartan medoxomil/hydrochlorothiazide; Paliperidone, Palonosetron hydrochloride, Panitumumab, Pegfilgrastim, Peginterferon alfa-2a, Pemetrexed disodium, Perospirone hydrochloride, Pertuzumab, Pimecrolimus, Pitrakinra, Pixantrone maleate, Posaconazole, Pregabalin; Quercetin; RALGA, Raltegravir potassium, Ranelic acid distrontium salt, rhHistone 1.3, Rimonabant, Rivaroxaban, Rosuvastatin calcium, RTS,S/SBAS2; Satraplatin, SNDX-275, Sodium butyrate, Solifenacin succinate, Sorafenib, SU-14813, Sunitinib malate; Tadalafil, Tafenoquine succinate, Tamatinib fosdium, Taxus, Telbivudine, Telmisartan/hydrochlorothiazide, Temsirolimus, Tiotropium bromide, Tipranavir, Tocilizumab, Trabectedin, Tramadol hydrochloride/acetaminophen; Ulipristal acetate, Uracil, Ursodeoxycholyltaurine; Valdecoxib, Vardenafil hydrochloride hydrate, Varenicline tartrate, Vildagliptin, Vinflunine, Vitespen, Vorinostat; ZK-EPO, Zoledronic acid monohydrate. PMID:18389098

  14. Gateways to clinical trials.

    PubMed

    Tomillero, A; Moral, M A

    2010-11-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Thomson Reuters Integrity(SM), the drug discovery and development portal, http://www.thomsonreutersintegrity.com. This issue focuses on the following selection of drugs: Abatacept, Adalimumab, AdCD40L, Adefovir, Aleglitazar, Aliskiren fumarate, AM-103, Aminolevulinic acid methyl ester, Amlodipine, Anakinra, Aprepitant, Aripiprazole, Atazanavir sulfate, Axitinib; Belimumab, Bevacizumab, Bimatoprost, Bortezomib, Bupropion/naltrexone; Calcipotriol/betamethasone dipropionate, Certolizumab pegol, Ciclesonide, CYT-997; Darbepoetin alfa, Darunavir, Dasatinib, Desvenlafaxine succinate, Dexmethylphenidate hydrochloride cogramostim; Eltrombopag olamine, Emtricitabine, Escitalopram oxalate, Eslicarbazepine acetate, Eszopiclone, Etravirine, Everolimus-eluting coronary stent, Exenatide, Ezetimibe; Fenretinide, Filibuvir, Fludarabine; Golimumab; Hepatitis B hyperimmunoglobulin, HEV-239, HP-802-247, HPV-16/18 AS04, HPV-6/11/16/18, Human albumin, Human gammaglobulin; Imatinib mesylate, Inotuzumab ozogamicin, Invaplex 50 vaccine; Lapatinib ditosylate, Lenalidomide, Liposomal doxorubicin, Lopinavir, Lumiliximab, LY-686017; Maraviroc, Mecasermin rinfabate; Narlaprevir; Ocrelizumab, Oral insulin, Oritavancin, Oxycodone hydrochloride/naloxone; Paclitaxel-eluting stent, Palonosetron hydrochloride, PAN-811, Paroxetine, Pazopanib hydrochloride, Peginterferon alfa-2a, Peginterferon alfa-2b, Pemetrexed disodium, Pertuzumab, Pitavastatin calcium, Posaconazole, Pregabalin, Prucalopride succinate; Raltegravir potassium, Ranibizumab, RHAMM R3 peptide, Rosuvastatin calcium; Salclobuzic acid sodium salt, SCY-635, Selenate sodium, Semapimod hydrochloride, Silodosin, Siltuximab, Silybin, Sirolimus-eluting stent, SIR-Spheres, Sunitinib malate; Tapentadol hydrochloride, Tenofovir disoproxil fumarate, Tocilizumab, Tositumomab/iodine (I131) tositumomab, Trabectedin, TransVax™ hepatitis C vaccine; Ustekinumab; V-260, Valspodar, Varenicline tartrate, VCL-IPT1, Vildagliptin, VRC-HIVADV014-00-VP, VRC-HIVDNA009-00-VP, VRC-HIVDNA016-00-VP; Yttrium 90 (90Y) ibritumomab tiuxetan, Yttrium Y90 Epratuzumab; Zibotentan, Zotarolimus-eluting stent. PMID:21225019

  15. Gateways to clinical trials.

    PubMed

    Bayés, M; Rabasseda, X; Prous, J R

    2004-11-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity(R), the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: (PE)HRG214, 1E10, 21-Aminoepothilone B; Ad.Egr.TNF.11D, Ad100-B7.1/HLA, adalimumab, adefovir dipivoxil, alefacept, alemtuzumab, AMD-070, anhydrovinblastine, aripiprazole, asimadoline, atrasentan, AVE-5883; Bimatoprost, BNP-7787, bosentan, botulinum toxin type B, BR-1; Canfosfamide hydrochloride, ciclesonide, curcumin, cypher; D0401, darbepoetin alfa, darifenacin hydrobromide, D-D4FC, dendritic cell-based vaccine, desloratadine, dextrin sulfate, dolastatin 10, drospirenone drospirenone/estradiol, DS-992, duloxetine hydrochloride, dutasteride; E-7010, efalizumab, eletriptan, EM-1421, enfuvirtide, entecavir, etoricoxib, everolimus, exenatide, ezetimibe; Favid, fidarestat, fingolimod hydrochloride, FK-352; Gefitinib, gemifloxacin mesilate, gepirone hydrochloride, gimatecan; HE-2000; Imatinib mesylate, indisulam, insulin detemir, irofulven, ISIS-5132; Lapatinib, levocetirizine, liraglutide, lumiracoxib; Metformin/Glyburide, methionine enkephalin, MK-0431, morphine hydrochloride, motexafin gadolinium, mycobacterium cell wall complex; Naturasone, neridronic acid, nesiritide; Oblimersen sodium, olanzapine/fluoxetine hydrochloride, omalizumab, oral insulin; Paclitaxel poliglumex, PC-515, PEG-filgrastim, peginterferon alfa-2a, peginterferon alfa-2b, peginterferon alfa-2b/ ribavirin, pegvisomant, pexelizumab, picoplatin, pramlintide acetate, prasterone, pregabalin; Quercetin; Ramelteon, ranirestat, RG228, rhGAD65, roflumilast, rubitecan; Sitaxsentan sodium, solifenacin succinate; Tadalafil, taxus, tipifarnib, tolevamer sodium, topixantrone hydrochloride; Valganciclovir hydrochloride, vardenafil hydrochloride hydrate, vildagliptin, voriconazole; XTL-001; Zoledronic acid monohydrate. PMID:15632957

  16. Gateways to clinical trials.

    PubMed

    Tomillero, A; Moral, M A

    2010-12-01

    Gateways to Clinical Trials is a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Thomson Reuters Integrity(SM), the drug discovery and development portal, http://www.thomsonreutersintegrity.com. This issue focuses on the following selection of drugs: 17-Hydroxyprogesterone caproate; Abacavir sulfate/lamivudine, Aclidinium bromide, Adalimumab, Adefovir, Alemtuzumab, Alkaline phosphatase, Amlodipine, Apilimod mesylate, Aripiprazole, Axitinib, Azacitidine; Belotecan hydrochloride, Berberine iodide, Bevacizumab, Bortezomib, Bosentan, Bryostatin 1; Calcipotriol/hydrocortisone, Carglumic acid, Certolizumab pegol, Cetuximab, Cinacalcet hydrochloride, Cixutumumab, Coumarin, Custirsen sodium; Darbepoetin alfa, Darifenacin hydrobromide, Darunavir, Dasatinib, Denibulin hydrochloride, Denosumab, Diacetylmorphine, Dulanermin, Duloxetine hydrochloride; Ecogramostim, Enfuvirtide, Entecavir, Enzastaurin hydrochloride, Eplerenone, Escitalopram oxalate, Esomeprazole sodium, Etravirine, Everolimus, Ezetimibe; Fenofibrate/pravastatin sodium, Ferric carboxymaltose, Flavangenol, Fondaparinux sodium; Glutamine, GSK-1024850A; Hepatitis B hyperimmunoglobulin, Hib-MenC, HIV-LIPO-5; Immunoglobulin intravenous (human), Indacaterol maleate, Indibulin, Indium 111 (¹¹¹In) ibritumomab tiuxetan, Influenza A (H1N1) 2009 Monovalent vaccine, Inhalable human insulin, Insulin glulisine; Lapatinib ditosylate, Leucovorin/UFT; Maraviroc, Mecasermin, MMR-V, Morphine hydrochloride, Morphine sulfate/naltrexone hydrochloride, Mycophenolic acid sodium salt; Naproxen/esomeprazole magnesium, Natalizumab; Oncolytic HSV; Paliperidone, PAN-811, Paroxetine, Pegfilgrastim, Peginterferon alfa-2a, Peginterferon alfa-2b/ribavirin, Pegvisomant, Pemetrexed disodium, Pimecrolimus, Posaconazole, Pregabalin; Raltegravir potassium, Ranelic acid distrontium salt, Rasburicase, Rilpivirine hydrochloride; Sertindole, Sivelestat sodium hydrate, Sorafenib, Sumatriptan succinate/naproxen sodium, Sunitinib malate; Tafluprost, Telithromycin, Temsirolimus, Tenofovir disoproxil fumavate, Tenofovir disoproxil fumarate/emtricitabine, Teriparatide, Ticagrelor, Tigecycline, Tipranavir, Tirapazamine, Trimetrexate; Ulipristal acetate; Valganciclovir hydrochloride, Vicriviroc, Vorinostat; Yttrium 90 (90Y) ibritumomab tiuxetan. PMID:21225012

  17. Comfrey: A Clinical Overview

    PubMed Central

    Staiger, Christiane

    2012-01-01

    Comfrey has a centuries-old tradition as a medicinal plant. Today, multiple randomized controlled trials have demonstrated the efficacy and safety of comfrey preparations for the topical treatment of pain, inflammation and swelling of muscles and joints in degenerative arthritis, acute myalgia in the back, sprains, contusions and strains after sports injuries and accidents, also in children aged 3 or 4 and over. This paper provides information on clinical trials and non-interventional studies published on comfrey to date and further literature, substantiating the fact that topical comfrey preparations are a valuable therapy option for the treatment of painful muscle and joint complaints. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22359388

  18. Likelihood and clinical trials.

    PubMed

    Hill, G; Forbes, W; Kozak, J; MacNeill, I

    2000-03-01

    The history of the application of statistical theory to the analysis of clinical trials is reviewed. The current orthodoxy is a somewhat illogical hybrid of the original theory of significance tests of Edgeworth, Karl Pearson, and Fisher, and the subsequent decision theory approach of Neyman, Egon Pearson, and Wald. This hegemony is under threat from Bayesian statisticians. A third approach is that of likelihood, stemming from the work of Fisher and Barnard. This approach is illustrated using hypothetical data from the Lancet articles by Bradford Hill, which introduced clinicians to statistical theory. PMID:10760630

  19. Clinical applications of angiocardiography

    NASA Technical Reports Server (NTRS)

    Dodge, H. T.; Sandler, H.

    1974-01-01

    Several tables are presented giving left ventricular (LV) data for normal patients and patients with heart disease of varied etiologies, pointing out the salient features. Graphs showing LV pressure-volume relationships (compliance) are presented and discussed. The method developed by Rackley et al. (1964) for determining left ventricular mass in man is described, and limitations to the method are discussed. Some clinical methods for determining LV oxygen consumption are briefly described, and the relation of various abnormalities of ventricular performance to coronary artery disease and ischemic heart disease is characterized.

  20. Constructing clinical science.

    PubMed

    Gaspare de Santo, Natale; Bisaccia, Carmela; Cirillo, Massimo; Salvatore de Santo, Luca; Richet, Gabriel

    2005-01-01

    Clinical practice became clinical science in the years 1720-1820. There were many reasons for this transformation. The discoveries by Santorio Santorio, William Harvey, Marcello Malpighi, Giovanni Alfonso Borelli, Lorenzo Bellini, Thomas Sydenham, Giovanni Maria Lancisi, were perceived by students who asked for changes in the medical curriculum. In 1761 Morgagni centered the study of diseases on morbid anatomy, a way to control at autopsy the validity of diagnosis. J.P. Frank who worked on public health and John Locke who supported a method of scientific reasoning based on asking questions were also instrumental for changes. Hospitals, formerly hospices for the poor, became places for curing and healing. Military hospitals represented models to be followed. In Vienna Marie Therese inaugurated the Allegemein Krankenhaus in 1785. In revolutionary France Fourcroy with the law Frimaire An III, 1794 gave a new rationale. Medicine and surgery were unified in the curriculum. Basic sciences were introduced. Dissection became compulsory, practical teaching became the rule. But it was with John Hunter, Domenico Cotugno and P. Joseph Desault that the great advancement was achieved. They were anatomists and therefore they made the knowledge of human body the core of medical curriculum. However experimentation on animals, as well as practical bedside teaching at the hospital also became important. Through their work hospitals and universities were associated in a common goal. PMID:16285082

  1. Debating Clinical Utility

    PubMed Central

    Burke, W.; Laberge, A.-M.; Press, N.

    2010-01-01

    The clinical utility of genetic tests is determined by the outcomes following test use. Like other measures of value, it is often contested. Stakeholders may have different views about benefits and risks and about the importance of social versus health outcomes. They also commonly disagree about the evidence needed to determine whether a test is effective in achieving a specific outcome. Questions may be presented as factual disagreements, when they are actually debates about what information matters or how facts should be interpreted and used in clinical decision-making. Defining the different issues at stake is therefore an important element of policy-making. Key issues include evidence standards for test use, and in particular, the circumstances under which prospective controlled data should be required, as well as evidence on feasibility, cost and equitable delivery of testing; the goals of population-based screening programs, and in particular, the role of social outcomes in evaluating test value; and the appropriate uses and funding of tests that inform non-medical actions. Addressing each of these issues requires attention to stakeholder values and methods for effective deliberation that incorporate consumer as well as health professional perspectives. PMID:20395690

  2. Clinical studies with curcumin.

    PubMed

    Hsu, Chih-Hung; Cheng, Ann-Lii

    2007-01-01

    Curcumin has long been expected to be a therapeutic or preventive agent for several major human diseases because of its antioxidative, anti-inflammatory, and anticancerous effects. In phase I clinical studies, curcumin with doses up to 3600-8000 mg daily for 4 months did not result in discernible toxicities except mild nausea and diarrhea. The pharmacokinetic studies of curcumin indicated in general a low bioavailability of curcumin following oral application. Nevertheless, the pharmacologically active concentration of curcumin could be achieved in colorectal tissue in patients taking curcumin orally and might also be achievable in tissues such as skin and oral mucosa, which are directly exposed to the drugs applied locally or topically. The effect of curcumin was studied in patients with rheumatoid arthritis, inflammatory eye diseases, inflammatory bowel disease, chronic pancreatitis, psoriasis, hyperlipidemia, and cancers. Although the preliminary results did support the efficacy of curcumin in these diseases, the data to date are all preliminary and not conclusive. It is imperative that well-designed clinical trials, supported by better formulations of curcumin or novel routes of administration, be conducted in the near future. PMID:17569225

  3. Clinical pharmacology of Cilomilast.

    PubMed

    Down, Geoff; Siederer, Sarah; Lim, Sam; Daley-Yates, Peter

    2006-01-01

    Chronic obstructive pulmonary disease (COPD) is a multicomponent, chronic inflammatory disease of the lungs with systemic complications. The majority of the inflammation occurs in the peripheral airways and lung parenchyma. It is a progressive disease, leading to disability and eventual death, despite conventional therapy. Inflammatory activity can be reduced by increasing intracellular cyclic adenosine-3',5'-monophosphate (cAMP) through inhibition of phosphodiesterase (PDE) IV, the principal PDE isoenzyme within pro-inflammatory cells, including eosinophils, mast cells, macrophages, lymphocytes, neutrophils and epithelial cells. PDE IV inhibition also has other effects, including relaxation of airway smooth muscle, suppression of smooth muscle mitogenesis and modulation of excitatory activity in pulmonary nerves. Cilomilast is a systemically available, second-generation, selective PDE IV inhibitor. It retains the therapeutic activity of the first-generation PDE IV inhibitors but lacks their profound emetic effect. Cilomilast is the first drug to demonstrate a reduction of tissue cells considered central to the ongoing inflammatory process (macrophages and CD8+ lymphocytes) in patients with stable COPD. Cilomilast is completely absorbed following oral administration and has negligible first-pass metabolism. It exhibits linear pharmacokinetics, with low between-subject variability. Cilomilast is highly protein bound (99.4%), but this binding is concentration-independent at clinically relevant doses, and it has a small volume of distribution at steady state (17L). Plasma clearance (approximately 2 L/h) is almost entirely metabolic, through multiple parallel pathways. Its terminal elimination half-life is approximately 6.5 hours and steady state is rapidly achieved with twice-daily administration. The most abundant metabolite, formed by the action of cytochrome P450 2C8, has <10% of the activity of the parent molecule. Cilomilast pharmacokinetics in COPD patients were consistent with those in healthy subjects. Smoking, age and ethnicity had no clinically relevant effects. Total plasma cilomilast pharmacokinetic parameters did not change significantly with renal or hepatic impairment, but concentrations of unbound cilomilast increased with declining renal or hepatic function. Cilomilast had no clinically relevant interactions with a range of drugs likely to be coadministered to patients with COPD, with the exception of erythromycin where concurrent administration with cilomilast was associated with an increased incidence of gastrointestinal adverse events, a pharmacodynamic interaction predicted by their secondary pharmacology. Nausea was the principal adverse reaction seen in healthy subjects taking cilomilast, but this was reduced by administration with food or by use of simple dose-escalation regimens. Cilomilast has not shown a propensity for any of the serious cardiac or neurological adverse effects associated with theophylline. Cilomilast exhibits favourable and predictable pharmacokinetics, has few clinically relevant drug-drug interactions and has demonstrated effects on measures of inflammation of potential benefit in the treatment of COPD. It is generally well tolerated and has not generated safety concerns in any clinical study. PMID:16509757

  4. Opioid metabolism and clinical aspects.

    PubMed

    Mercadante, Sebastiano

    2015-12-15

    Opioids are are commonly used for the management of acute and chronic pain. Opioids have different physicochemical and pharmacokinetic characteristics, which explain the profound changes in the clinical effect in several clinical conditions. Pharmacokinetics influences the opioid response affecting bioavailability, production of metabolites with residual clinical activity, and elimination. Generality of opioid metabolism and clinical implications for specific opioids in different clinical conditions were reviewed to bridge the gap between pharmacokinetics and clinical response. The knowledge of opioid metabolism is essential, particularly for older and complicated patients who receive multiple medications and may have impaired of renal and hepatic function. The recognition of possible metabolic problems and the consideration of adverse drug-drug interactions are fundamental to optimize the use of opioids in clinical practice. PMID:26522929

  5. Gateways to clinical trials.

    PubMed

    Bayes, M; Rabasseda, X; Prous, J R

    2005-01-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables have been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: (-)-Epigallocatechin gallate; ACP-103, Ad.Egr.TNF.11 D, adalimumab, AF-IL 12, AIDSVAX gp120 B/B, alefacept, alemtuzumab, a-Galactosylceramide, ALVAC vCP 1452, alvimopan hydrate, alvocidib hydrochloride, aminolevulinic acid hydrochloride, aminolevulinic acid methyl ester, anakinra, anidulafungin, antarelix, aprepitant, aripiprazole, arsenic sulfide, asoprisnil, atazanavir sulfate, atomoxetine hydrochloride; Bevacizumab, bimatoprost, BMS-184476, bortezomib, bosentan, botulinum toxin type B, BrachySil, brivudine; Caffeine, calcipotriol/betamethasone dipropionate, cannabidiol, capsaicin for injection, caspofungin acetate, CC-4047, cetuximab, CGP-36742, clofazimine, CpG-7909, Cypher; Darbepoetin alfa, dextromethorphan/quinidine sulfate, dimethylfumarate, dronabinol/cannabidiol, drotrecogin alfa (activated), duloxetine hydrochloride, dutasteride; Ecogramostim, efalizumab, eletriptan, emtricitabine, enfuvirtide, eplerenone, esomeprazole magnesium, estradiol acetate, eszopiclone, etoricoxib, exenatide, ezetimibe, ezetimibe/simvastatin; Fampridine, fondaparinux sodium, fosamprenavir calcium; Gefitinib, GPI-0100; hA 20, HTU-PA, human insulin, HuOKT 3 gamma 1(Ala 234-Ala 235), hyaluronic acid; Icatibant, imatinib mesylate, Indiplon, INKP-100, INKP-102, iodine (I131) tositumomab, istradefylline, IV gamma-globulin, ivabradine hydrochloride, ixabepilone; Lacosamide, landiolol, lanthanum carbonate, lasofoxifene tartrate, LB-80380, lenalidomide, lidocaine/tetracaine, linezolid, liposomal doxorubicin, liposomal vincristine sulfate, lopinavir, lopinavir/ritonavir, lumiracoxib, lurtotecan; Maribavir, morphine glucuronide, MVA-5 T 4; NBI-56418, NCX-4016, nesiritide, nicotine conjugate vaccine, NSC-330507; Oglufanide, omalizumab, oxipurinol; Palifermin, palonosetron hydrochloride, parecoxib sodium, PEG-filgrastim, peginterferon alfa-2a, peginterferon alfa-2b, peginterferon alfa-2b/ribavirin, PEGylated interferon alfacon-1, perospirone hydrochloride, pimecrolimus, pixantrone maleate, plerixafor hydrochloride, PowderJect lidocaine, pradefovir mesylate, prasterone, pregabalin, Prostvac VF, PT-141, PTC-124, pyridoxamine; QS-21, quercetin; R-126638, R-411, ralfinamide, rasagiline mesilate, rF-PSA, RG-2077, rhThrombin, rimonabant hydrochloride, rofecoxib, rosuvastatin calcium, rotigotine hydrochloride, rV-PSA; S-18886, S-303, seocalcitol, SGN-40, sitaxsentan sodium, SPP-301, St. John's Wort extract; Tadalafil, taxus, telithromycin, tenatoprazole, tenofovir disoproxil fumarate, testosterone MDTS, testosterone transdermal patch, tgAAC-09, TH-9507, thioacetazone, tipifarnib, TQ-1011, trabectedin, travoprost, trimethoprim; Valdecoxib, valganciclovir hydrochloride, valopicitabine, voriconazole; Xcellerated T cells. PMID:16179960

  6. Polyamines in Clinical Disorders

    PubMed Central

    Tierney, Donald F.; Marton, Laurence J.; Hacker, Allen D.; Lowe, Nicholas

    1985-01-01

    An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine, Los Angeles. The Director of Conferences is William M. Pardridge, MD, Associate Professor of Medicine. Polyamines, necessary for cell growth, influence many cell functions. As small polyvalent cations they can change the configuration of large polyvalent anions, such as DNA, and alter their sensitivity to other molecules including chemotherapeutic agents. By altering polyamine content in a cell, we can change its growth, its susceptibility to drugs and change other cellular functions. Malignant conditions, other proliferative diseases and infections are the most apparent clinical conditions likely to improve by depleting polyamines and suppressing cell growth. Proliferative disorders of the skin respond to many agents that suppress polyamine metabolism. Hyperoxia may suppress cell growth in the lung by suppressing polyamine metabolism. PMID:3976221

  7. [Clinical profile of roflumilast].

    PubMed

    Izquierdo Alonso, José Luis

    2010-12-01

    Patients with chronic obstructive pulmonary disease (COPD) and associated bronchitis are at higher risk of exacerbations, which are a major cause of morbidity and impaired quality of life. Moreover, exacerbations are associated with more rapid disease progression and higher mortality. The typical symptoms of chronic bronchitis (chronic cough and sputum production) are correlated with inflammatory markers in COPD. Roflumilast is an anti-inflammatory drug belonging to the novel therapeutic class of phosphodiesterase-4 inhibitors and is the first drug to be developed for the treatment of a specific COPD phenotype (COPD associated with chronic bronchitis). The results of clinical trials indicate that, in patients with COPD associated with chronic bronchitis and a history of exacerbations, roflumilast improves pulmonary function and reduces the symptoms and frequency of exacerbations requiring medical intervention. This effect is maintained when regular treatment with a long-acting bronchodilator or an inhaled corticosteroid is added. PMID:21316553

  8. Neurogenic neuroprotection: clinical perspectives

    PubMed Central

    Mandel, Mauricio; Fonoff, Erich Talamoni; Bor-Seng-Shu, Edson; Teixeira, Manoel Jacobsen; Chadi, Gerson

    2012-01-01

    Summary Neurogenic neuroprotection is a promising approach for treating patients with ischemic brain lesions. In rats, stimulation of the deep brain nuclei has been shown to reduce the volume of focal infarction. In this context, protection of neural tissue can be a rapid intervention that has a relatively long-lasting effect, making fastigial nucleus stimulation (FNS) a potentially valuable method for clinical application. Although the mechanisms of neuroprotection induced by FNS remain partially unclear, important data have been presented in the last two decades. A 1-h electrical FNS reduced, by 59%, infarctions triggered by permanent occlusion of the middle cerebral artery in Fisher rats. The acute effect of electrical FNS is likely mediated by a prolonged opening of potassium channels, and the sustained effect appears to be linked to inhibition of the apoptotic cascade. A better understanding of the neuronal circuitry underlying neurogenic neuroprotection may contribute to improving neurological outcomes in ischemic brain insults. PMID:23597434

  9. [Anamnesis and clinical examination].

    PubMed

    Grüne, Stefan

    2016-01-01

    Anamnesis and clinical examination are the key functions of medical doctors to reveal the health problems of their patients. The correct assessment and handoff of these informations are the preconditions for a specific and cost saving diagnostic and therapy. The handoff can be made orally, in written form analogue or digital. The examination and documentation should be conducted in the order specified for every patient to avoid mistakes. New digital programs help to reach this aim but absorb the time of the medical doctor and depart him from the patients. Nurses and medical doctors should perform the rounds together for a mutually acquisition of information. This conduces towards a single-minded and cost-effectively diagnostic and therapy. PMID:26710199

  10. Clinical radiation nephropathy

    SciTech Connect

    Cassady, J.R.

    1995-03-30

    An analysis of the normal tissue effects of irradiation of the kidney is presented. Various clinical syndromes resulting from treatment are described as well as the potential cellular basis for these findings. Effects of concurrent and/or sequential treatment with irradiation and various chemotherapeutic agents are discussed and the impact of these agents on toxicity presented. Adverse consequences of renal treatment in the child is described and possible radiation effects on so-called compensatory hypertrophy following nephrectomy presented. Renal consequences described to date of bone marrow transplantation programs utilizing irradiation are also presented. The necessity of a dose-volume histogram analysis approach to analyzing renal toxic effects in patients followed for long (>10 year) periods is essential in developing accurate guidelines of renal tolerance. 53 refs., 6 figs., 5 tabs.

  11. Possession: a clinical enigma

    PubMed Central

    Gadit, Amin

    2011-01-01

    This is a case of a 21-year-old lady who presented with history of episodes where she would display extraordinary strength while becoming aggressive towards her family members, speak in foreign language and display bizarre behaviour. The episode would last for 15–20 min and would resolve spontaneously. She would always claim amnesia for the event. This would remain irritable in the intervening period. The frequency of such episodes is at least three times a week. The family members took her to several faith healers with no improvement in her condition. On the suggestion of a family friend, the patient was brought in for consultation in the psychiatric clinic. The patient remained a diagnostic dilemma though there has been some reduction in intensity of such episodes on psychotropic medication. Unfortunately, there is no remission in episodes. PMID:22701065

  12. Possession: a clinical enigma.

    PubMed

    Gadit, Amin

    2011-01-01

    This is a case of a 21-year-old lady who presented with history of episodes where she would display extraordinary strength while becoming aggressive towards her family members, speak in foreign language and display bizarre behaviour. The episode would last for 15-20 min and would resolve spontaneously. She would always claim amnesia for the event. This would remain irritable in the intervening period. The frequency of such episodes is at least three times a week. The family members took her to several faith healers with no improvement in her condition. On the suggestion of a family friend, the patient was brought in for consultation in the psychiatric clinic. The patient remained a diagnostic dilemma though there has been some reduction in intensity of such episodes on psychotropic medication. Unfortunately, there is no remission in episodes. PMID:22701065

  13. Venomous animals: clinical toxinology.

    PubMed

    White, Julian

    2010-01-01

    Venomous animals occur in numerous phyla and present a great diversity of taxa, toxins, targets, clinical effects and outcomes. Venomous snakes are the most medically significant group globally and may injure >1.25 million humans annually, with up to 100 000 deaths and many more cases with long-term disability. Scorpion sting is the next most important cause of envenoming, but significant morbidity and even deaths occur following envenoming with a wide range of other venomous animals, including spiders, ticks, jellyfish, marine snails, octopuses and fish. Clinical effects vary with species and venom type, including local effects (pain, swelling, sweating, blistering, bleeding, necrosis), general effects (headache, vomiting, abdominal pain, hypertension, hypotension, cardiac arrhythmias and arrest, convulsions, collapse, shock) and specific systemic effects (paralytic neurotoxicity, neuroexcitatory neurotoxicity, myotoxicity, interference with coagulation, haemorrhagic activity, renal toxicity, cardiac toxicity). First aid varies with organism and envenoming type, but few effective first aid methods are recommended, while many inappropriate or frankly dangerous methods are in widespread use. For snakebite, immobilisation of the bitten limb, then the whole patient is the universal method, although pressure immobilisation bandaging is recommended for bites by non-necrotic or haemorrhagic species. Hot water immersion is the most universal method for painful marine stings. Medical treatment includes both general and specific measures, with antivenom being the principal tool in the latter category. However, antivenom is available only for a limited range of species, not for all dangerous species, is in short supply in some areas of highest need, and in many cases, is supported by historical precedent rather than modern controlled trials. PMID:20358686

  14. 75 FR 57472 - Clinical Investigator Training Course

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ...Docket No. FDA-2010-N-0456] Clinical Investigator Training Course AGENCY...Programs, in cosponsorship with the Clinical Trials Transformation Initiative (CTTI...involved in, the conduct and/or design of clinical trials (clinical investigators)....

  15. OBJECTIVES OF TRAINING CLINICAL MICROBIOLOGY TRAINING

    E-print Network

    MacMillan, Andrew

    OBJECTIVES OF TRAINING CLINICAL MICROBIOLOGY TRAINING PROGRAM DEPARTMENT OF LABORATORY MEDICINE AND PATHOLOGY FACULTY OF MEDICINE AND DENTISTRY #12;University of Alberta, Clinical Microbiology Training Program 2014 Clinical Microbiology Training Program Objectives: 2014 Property of: Clinical Microbiology

  16. 76 FR 45577 - Clinical Investigator Training Course

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

    ... SERVICES Food and Drug Administration Clinical Investigator Training Course AGENCY: Food and Drug... Programs and the Clinical Trials Transformation Initiative (CTTI) are cosponsoring a 3-day training course for clinical investigators on scientific, ethical, and regulatory aspects of clinical trials....

  17. The National Institutes of Health Clinical Center

    MedlinePLUS

    ... Issue Past Issues The National Institutes of Health Clinical Center Past Issues / Spring 2007 Table of Contents ... Communications, NIH Clinical Center Welcome to the nation's clinical research hospital. The NIH Clinical Center: For more ...

  18. Complementary and Alternative Medicine Cancer Clinical Trials

    MedlinePLUS

    ... Introduction Cancer CAM Clinical Trials Introduction What are clinical trials? A clinical trial is one of the ... and effective. What are the different types of clinical trials? Treatment trials test new treatments (like a ...

  19. A Knowledge Management Framework to Morph Clinical Cases with Clinical

    E-print Network

    Abidi, Syed Sibte Raza

    originate from different sources and be represented in diverse modalities. Our tacit-explicit knowledge morphing framework supports the extraction of tacit knowledge from past cases stored in a case Management, Clinical Practice Guidelines, Clinical Cases, Tacit Knowledge 1. Introduction Medical knowledge

  20. Evaluation of Clinical Electives: Factors Differentiating between Clinical Training Sites.

    ERIC Educational Resources Information Center

    Biddle, W. Barry; Smith, Douglas U.

    A questionnaire used in the assessment of medical school learning environments is described. Thirty-one statements drawn from the Medical School Environment Inventory, which reflected qualities desired in the clinical training environment, made up the questionnaire. The instrument was administered to fourth-year medical students at three clinical

  1. Integrating Academic and Clinical Learning Using a Clinical Swallowing Assessment

    ERIC Educational Resources Information Center

    Phillips, Daniel E.

    2013-01-01

    This article describes an experiential learning activity designed to integrate classroom knowledge and a clinical swallowing assessment. Twenty master's-level graduate students in a dysphagia course conducted a clinical swallowing assessment with a resident of an independent retirement community. The exercise was designed to allow students an…

  2. The clinical encounter revisited.

    PubMed

    Schattner, Ami

    2014-04-01

    The patient-physician encounter is the pivotal starting point of any healthcare delivery, but it is subject to multiple process breakdowns and prevalent suboptimal performance. An overview of the techniques and components of a successful encounter valid for every setting and readily applicable is presented, stressing 7 rules: (1) ensuring optimal environment, tools, and teamwork; (2) viewing each encounter not only as a cognitive/biomedical challenge, but also as a personal one, and a learning opportunity; (3) adopting an attitude of curiosity, concentration, compassion, and commitment, and maintaining a systematic, orderly approach; (4) "simple is beautiful"-making the most of the basic clinical data and their many unique advantages; (5) minding "the silent dimension"-being attentive to the patient's identity and emotions; (6) following the "Holy Trinity" of gathering all information, consulting databases/colleagues, and tailoring gained knowledge to the individual patient; and (7) using the encounter as a "window of opportunity" to further the patient's health-not just the major problem, by addressing screening and prevention; promoting health literacy and shared decision-making; and establishing proper follow-up. Barriers to implementation identified can be overcome by continuous educational interventions. A high-quality encounter sets a virtuous cycle of patient-provider interaction and results in increasing satisfaction, adherence, and improved health outcomes. PMID:24333201

  3. Advances in clinical cardiology.

    PubMed

    McNeice, Andrew H; McAleavey, Neil M; Menown, Ian B A

    2014-08-01

    Multiple, potentially practice-changing cardiology trials have been presented or published over the past year. In this paper, we summarize and place in clinical context, new data regarding management of acute coronary syndrome and ST-elevation myocardial infarction (copeptin assessment, otamixaban, cangrelor, prasugrel, sodium nitrite, inclacumab, ranolazine, preventive coronary intervention of non-culprit lesions, immediate thrombolytic therapy versus transfer for primary intervention), new coronary intervention data (thrombectomy, radial access, pressure wire fractional flow reserve, antiplatelet therapy duration and gene-guidance, permanent and biodegradable polymers, coronary bifurcation and strategies), and coronary artery bypass data (off pump vs. on pump). Latest trials in trans-aortic valve implantation, heart failure (eplerenone, aliskiren, spironolactone, sildenafil, dopamine, nesiritide, omecamtiv mecarbil, the algisyl left ventricular augmentation device, and echo-guided cardiac resynchronization), atrial fibrillation (edoxaban, dabigatran, and ablation), cardiac arrest (hypothermia, LUCAS™ mechanical chest compression), and cardiovascular prevention (vitamins, renal denervation for resistant hypertension, renal artery stenting, saxagliptin, alogliptin, and gastric banding) are also discussed. PMID:25074280

  4. Clinical biochemistry of aluminum

    SciTech Connect

    King, S.W.; Savory, J.; Wills, M.R.

    1981-05-01

    Aluminum toxicity has been implicated in the pathogenesis of a number of clinical disorders in patients with chronic renal failure on long-term intermittent hemodialysis treatment. The predominant disorders have been those involving either bone (osteomalacic dialysis osteodystrophy) or brain (dialysis encephalopathy). In nonuremic patients, an increased brain aluminum concentration has been implicated as a neurotoxic agent in the pathogenesis of Alzheimer's disease and was associated with experimental neurofibrillary degeneration in animals. The brain aluminum concentrations of patients dying with the syndrome of dialysis encephalopathy (dialysis dementia) are significantly higher than in dialyzed patients without the syndrome and in nondialyzed patients. Two potential sources for the increased tissue content of aluminum in patients on hemodialysis have been proposed: (1) intestinal absorption from aluminum containing phosphate-binding gels, and (2) transfer across the dialysis membrane from aluminum in the water used to prepare the dialysate. These findings, coupled with our everyday exposure to the ubiquitous occurrence of aluminum in nature, have created concerns over the potential toxicity of this metal.

  5. Quality improvement in clinical documentation: does clinical governance work?

    PubMed Central

    Dehghan, Mahlegha; Dehghan, Dorsa; Sheikhrabori, Akbar; Sadeghi, Masoume; Jalalian, Mehrdad

    2013-01-01

    Introduction The quality of nursing documentation is still a challenge in the nursing profession and, thus, in the health care industry. One major quality improvement program is clinical governance, whose mission is to continuously improve the quality of patient care and overcome service quality problems. The aim of this study was to identify whether clinical governance improves the quality of nursing documentation. Methods A quasi-experimental method was used to show nursing documentation quality improvement after a 2-year clinical governance implementation. Two hundred twenty random nursing documents were assessed structurally and by content using a valid and reliable researcher made checklist. Results There were no differences between a nurse’s demographic data before and after 2 years (P>0.05) and the nursing documentation score did not improve after a 2-year clinical governance program. Conclusion Although some efforts were made to improve nursing documentation through clinical governance, these were not sufficient and more attempts are needed. PMID:24324339

  6. Clinical mastitis in ewes; bacteriology, epidemiology and clinical features

    PubMed Central

    Mørk, Tormod; Waage, Steinar; Tollersrud, Tore; Kvitle, Bjørg; Sviland, Ståle

    2007-01-01

    Background Clinical mastitis is an important disease in sheep. The objective of this work was to identify causal bacteria and study certain epidemiological and clinical features of clinical mastitis in ewes kept for meat and wool production. Methods The study included 509 ewes with clinical mastitis from 353 flocks located in 14 of the 19 counties in Norway. Clinical examination and collection of udder secretions were carried out by veterinarians. Pulsed-field gel electrophoresis (PFGE) was performed on 92 Staphylococcus aureus isolates from 64 ewes. Results and conclusion S. aureus was recovered from 65.3% of 547 clinically affected mammary glands, coagulase-negative staphylococci from 2.9%, enterobacteria, mainly Escherichia coli, from 7.3%, Streptococcus spp. from 4.6%, Mannheimia haemolytica from 1.8% and various other bacteria from 4.9%, while no bacteria were cultured from 13.2% of the samples. Forty percent of the ewes with unilateral clinical S. aureus mastitis also had a subclinical S. aureus infection in the other mammary gland. Twenty-four of 28 (86%) pairs of S. aureus isolates obtained from clinically and subclinically affected mammary glands of the same ewe were indistinguishable by PFGE. The number of identical pairs was significantly greater than expected, based on the distribution of different S. aureus types within the flocks. One-third of the cases occurred during the first week after lambing, while a second peak was observed in the third week of lactation. Gangrene was present in 8.8% of the clinically affected glands; S. aureus was recovered from 72.9%, Clostridium perfringens from 6.3% and E. coli from 6.3% of the secretions from such glands. This study shows that S. aureus predominates as a cause of clinical ovine mastitis in Norway, also in very severe cases. Results also indicate that S. aureus is frequently spread between udder halves of infected ewes. PMID:17892567

  7. Stimulability: A Useful Clinical Tool.

    ERIC Educational Resources Information Center

    Powell, Thomas W.; Miccio, Adele W.

    1996-01-01

    This article for clinicians treating children with phonological disorders reviews changing trends in the definition of stimulability, standardized and nonstandardized approaches to its measurement, and clinical implications of stimulability for prognosis and treatment plan development as they have evolved over a 40-year period. Clinical

  8. SPEECH-LANGUAGE-HEARING CLINIC

    E-print Network

    SPEECH-LANGUAGE- HEARING CLINIC AT OSU-TULSA The OSU-Tulsa Speech-Language-Hearing Clinic provides's faculty, offer assessment and therapy services for a variety of speech, language and hearing disorders and phonology · Voice · Hearing loss · Receptive and expressive language · Resonance · Aphasia · Reading

  9. Glossary of Clinical Trials Terms

    MedlinePLUS

    ... the study results in a scientific or academic journal after the trial is completed. (This does not apply if the PI is an employee of the sponsor.) (See also Certain Agreements results data element on ClinicalTrials.gov.) CLINICAL STUDY A research study using human subjects to evaluate biomedical or ...

  10. Clinical Teacher Preparation: A Retrospective

    ERIC Educational Resources Information Center

    Whitford, Betty Lou; Villaume, Susan Kidd

    2014-01-01

    In this article, we explore how teacher preparation programs have developed from the mid-1800s to present day, emphasizing changes in the clinical component. Drawing from the history of teacher education from the normal schools of the 19th century to present-day interest in clinically based preparation, we first review the migration of teacher…

  11. Cell Stem Cell Clinical Progress

    E-print Network

    Zandstra, Peter W.

    Cell Stem Cell Clinical Progress Rapid Expansion of Human Hematopoietic Stem Cells by Automated *Correspondence: peter.zandstra@utoronto.ca DOI 10.1016/j.stem.2012.01.003 SUMMARY Clinical hematopoietic implementations of hematopoietic stem cells (HSCs) and their deriva- tives further increase interest in strategies

  12. Clinical Guidelines. Dental Hygiene Program.

    ERIC Educational Resources Information Center

    Branson, Bonnie

    This manual contains information concerning the policies and procedures of the Southern Illinois University-Carbondale Dental Hygiene Clinic. The manual is presented in a question/answer format for the information and convenience of dental hygiene students in the program, and is intended to answer their questions concerning clinical policies and…

  13. Clinical Grading in Psychiatric Clerkships

    ERIC Educational Resources Information Center

    Briscoe, Gregory W.; Carlson, David L.; Fore Arcand, Lisa; Levine, Ruth E.; Cohen, Mitchell J.

    2006-01-01

    Objective: The clinical grade assessment is the most frequently used and heavily weighted component in the overall assessment of U.S. psychiatry clerkship students, yet the topic is understudied. The authors aimed to learn more about the nature, perceived virtues, and deficiencies of the clinical grade evaluation. Methods: A 26-item questionnaire…

  14. Clinical trials of homoeopathy.

    PubMed Central

    Kleijnen, J; Knipschild, P; ter Riet, G

    1991-01-01

    OBJECTIVE--To establish whether there is evidence of the efficacy of homoeopathy from controlled trials in humans. DESIGN--Criteria based meta-analysis. Assessment of the methodological quality of 107 controlled trials in 96 published reports found after an extensive search. Trials were scored using a list of predefined criteria of good methodology, and the outcome of the trials was interpreted in relation to their quality. SETTING--Controlled trials published world wide. MAIN OUTCOME MEASURES--Results of the trials with the best methodological quality. Trials of classical homoeopathy and several modern varieties were considered separately. RESULTS--In 14 trials some form of classical homoeopathy was tested and in 58 trials the same single homoeopathic treatment was given to patients with comparable conventional diagnosis. Combinations of several homoeopathic treatments were tested in 26 trials; isopathy was tested in nine trials. Most trials seemed to be of very low quality, but there were many exceptions. The results showed a positive trend regardless of the quality of the trial or the variety of homeopathy used. Overall, of the 105 trials with interpretable results, 81 trials indicated positive results whereas in 24 trials no positive effects of homoeopathy were found. The results of the review may be complicated by publication bias, especially in such a controversial subject as homoeopathy. CONCLUSIONS--At the moment the evidence of clinical trials is positive but not sufficient to draw definitive conclusions because most trials are of low methodological quality and because of the unknown role of publication bias. This indicates that there is a legitimate case for further evaluation of homoeopathy, but only by means of well performed trials. PMID:1825800

  15. History of Clinical Transplantation

    PubMed Central

    Starzl, Thomas E.

    2010-01-01

    The emergence of transplantation has seen the development of increasingly potent immunosuppressive agents, progressively better methods of tissue and organ preservation, refinements in histocompatibility matching, and numerous innovations in surgical techniques. Such efforts in combination ultimately made it possible to successfully engraft all of the organs and bone marrow cells in humans. At a more fundamental level, however, the transplantation enterprise hinged on two seminal turning points. The first was the recognition by Billingham, Brent, and Medawar in 1953 that it was possible to induce chimerism-associated neonatal tolerance deliberately. This discovery escalated over the next 15 years to the first successful bone marrow transplantations in humans in 1968. The second turning point was the demonstration during the early 1960s that canine and human organ allografts could self-induce tolerance with the aid of immunosuppression. By the end of 1962, however, it had been incorrectly concluded that turning points one and two involved different immune mechanisms. The error was not corrected until well into the 1990s. In this historical account, the vast literature that sprang up during the intervening 30 years has been summarized. Although admirably documenting empiric progress in clinical transplantation, its failure to explain organ allograft acceptance predestined organ recipients to lifetime immunosuppression and precluded fundamental changes in the treatment policies. After it was discovered in 1992 that long-surviving organ transplant recipients had persistent microchimerism, it was possible to see the mechanistic commonality of organ and bone marrow transplantation. A clarifying central principle of immunology could then be synthesized with which to guide efforts to induce tolerance systematically to human tissues and perhaps ultimately to xenografts. PMID:10833242

  16. Lasers in clinical ophthalmology

    NASA Astrophysics Data System (ADS)

    Ribeiro, Paulo A.

    1992-03-01

    The clinical application of lasers in ophthalmology is schematized, showing for each anatomic eye structure, pathologies that may be treated through this procedure. In the cornea, the unusual laser practice for suture removals and the promising possibility of the excimer laser in refractive surgery are discussed. In the iris, the camerular angle, and the ciliary body, the laser application is essentially used to treat the glaucoma and other situations that are not so frequent. The capsulotomy with YAG LASER is used in the treatment of structures related with crystalline and, at least, the treatment of the retina and choroid pathology is expanded. A. A. explained the primordial interest and important of laser in the diabetic retinopathy treatment and some results in patients with more than 5 years of evolution are: 55 of the patients with proliferative diabetic retinopathy (RDP) treated for more than 5 years noticed their vision improved or stabilized; 5 years after treating patients with PDR, 49.3 had their vision stabilized or even improved, provided the diabetics had declared itself more than 20 years ago, versus 61.7 provided the diabetics had declared itself less than 20 years before; finally, 53.8 of the patients under 40-years-old when the diabetics was diagnosed, had their vision improved or at least stabilized 5 years after the beginning of the treatment. On the other side, when patients were over 40 years old when the diabetics was diagnosed percentage increased to 55.9. This study was established in the follow-up of 149 cases over 10 years.

  17. Clinical aspects of telemedicine

    NASA Technical Reports Server (NTRS)

    Merrell, Ronald C.

    1991-01-01

    Communication among physicians is an essential in order to combine our experiences for the elucidation and application of new knowledge and for the accurate and uniform application of established medical practice. This communication requires an adequate understanding of the culture of the patient and the social context of disease and indeed the culture of the physician. Malnutrition in Bangladesh means caloric insufficiency, and a program to lower cholesterol would be impertinent, while a program to enhance the nutrition of patients in Texas by an international effort to import more grain would be ludicrous. In the same vein a public health effort to combat alcoholic cirrhosis in Mecca would be as silly as a program to increase fiber in the diet of the Bantu. Clinical communication must acknowledge the culture of the issue at hand and the differences in the experiential base of the physicians. Not only do geography and culture affect the potential differences in the experiential bases, but the world utilizes very different traditions of education and science in training physicians. We are influenced by the diseases we treat, and learn to look for the expected at least as much as we are attentive to the unexpected. A physician in Siberia would be much more likely to recognize frostbite than one from Buenos Aires, and the Argentine doctor would much more likely consider Chaga's Disease to explain abdominal pain than a colleague in Zurich. Beyond these obvious issues in communication among physicians we must deal with the many languages and idioms used in the world. An overview of using Telemedicine SpaceBridge after the earthquake in the Republic of Armenia in 1988 is presented.

  18. Towards clinical bioethics (or a return to clinical ethics?).

    PubMed

    Petrini, C

    2013-01-01

    Medical ethics has traditionally been oriented towards the clinical setting. Since the middle of the last century, however, various circumstances (associated mainly, though not exclusively, with rapid advances in technology and knowledge) have considerably broadened both the field of enquiry and the scope of this discipline. This is due partly to the overlap between medical ethics and bioethics, which in recent decades has acquired its own identity and concerns a multitude of ethical aspects in the biomedical field. Clinical ethics taps into the vast wealth of deontology, so that it has no need for additional criteria or principles, or for the definition of new values: rather, it recognizes the need to apply existing criteria, principles and values to contingent circumstances and contexts. A special role is reserved for ethics committees and, above all, for clinical ethics consultants, although in some countries the former are concerned mainly with authorisations for clinical trials. Clinical ethics consultants, however, may have a more incisive influence in clinical decisions: the special requisites and skills they need have been defined and discussed in various documents which are mentioned briefly in the present article. The presence of these consultants does not exonerate clinical physicians from their responsibilities or from liability for their decisions, in the formation of which they must refer constantly to codes of professional ethics. PMID:24424236

  19. Clinical intervention research in nursing.

    PubMed

    Forbes, Angus

    2009-04-01

    As a healthcare profession nursing has a duty to develop practices that contribute to the health and well being of patients. The aim of this paper is to discuss current issues in clinical research within nursing. The paper defines clinical interventions research as a theoretically based, integrated and sequential approach to clinical knowledge generation. The paper provides specific criteria for defining a clinical intervention together with an overview of the stages involved in clinical research from problem identification to implementing knowledge in practice. The paper also explored the extent to which nursing research was focussed on clinical issues, through a snapshot review of all the original research papers in Europe's three leading nursing research journals. In total of 517 different papers were included and classified in the review. Of these 88% (n=455) were classified as non-clinical intervention and 12% (n=62) as clinical intervention studies. The paper examined the intervention studies in detail examining: the underpinning theory; linkage to previous (pre-clinical) work; evidence of granularity; protocol clarity (generalisable and parsimonious); the phase of knowledge development; and evidence of safety (adverse event reporting). The paper discusses some of the shortcomings of interventions research in nursing and suggests a number of ideas to help address these problems, including: a consensus statement on interventions research in nursing; a register of nursing intervention studies; the need for nursing to develop clinical research areas in which to develop potential interventions (nursing laboratories); and a call for nursing researchers to publish more research in nursing specific journals. PMID:18930228

  20. Implications of Look AHEAD for Clinical Trials and Clinical Practice

    PubMed Central

    Wing, Rena R.

    2014-01-01

    Look AHEAD was a randomized clinical trial designed to examine the long-term health effects of weight loss in overweight and obese individuals with type 2 diabetes. The primary result was that the incidence of cardiovascular events over a median follow up of 9.6 years was not reduced in the intensive lifestyle group relative to the control group. This finding is discussed, with emphasis on its implications for design of clinical trials and clinical treatment of obese people with type 2 diabetes. PMID:24853636

  1. Clinical pharmacokinetics of mizolastine.

    PubMed

    Lebrun-Vignes, B; Diquet, B; Chosidow, O

    2001-01-01

    Mizolastine is a new histamine H1 receptor antagonist. Mizolastine 10 mg/day is effective in allergic rhinitis and chronic idiopathic urticaria. In young healthy volunteers, absorption of mizolastine is rapid with time (tmax) to peak concentration (Cmax) of about 1 hour. The absolute bioavailability of mizolastine 10mg tablets is about 65%. Distribution is rapid with a mean distribution half-life of 1.5 to 1.9 hours. Mizolastine is >98% bound to serum albumin and the apparent volume of distribution is between I and 1.4 L/kg. Mizolastine is extensively metabolised by hepatic glucuronidation and sulphation, with no major active metabolite, and excreted in faeces. The terminal elimination half-life (t1/2beta) is 7.3 to 17.1 hours. The apparent oral clearance after a repeated oral dose of 10mg is 6.02 L/h, with steady state reached from day 3 and no accumulation between days 1 and 7. Cmax and area under the concentration-time curve (AUC) are linearly related to dose. Mizolastine appears in vivo to be a relatively weak inhibitor of cytochrome P450 2E1, 2C9, 2D6 and 3A4. In vivo, no interactions were observed between mizolastine and lorazepam or ethanol. A significant increase in Cmax and trough plasma concentration (Cmin) of digoxin occurred after coadministration with mizolastine, without change in AUC, tmax or clinical parameters. Significant increases in theophylline Cmin and AUC were observed after coadministration with mizolastine. Mizolastine Cmax and AUC were increased when coadministered with erythromycin, with no change in t1/2beta. Concomitant administration of mizolastine and ketoconazole increased mizolastine AUC values with no change in t1/2beta. In a population analysis of the pharmacokinetics of mizolastine in patients with allergies, parameter values were close to those in healthy volunteers, except for duration of absorption, which was almost doubled in the patients. Bodyweight and creatinine clearance were found to have little influence on oral clearance, and no influence of liver transaminases was found on clearance and distribution. Pharmacokinetic parameters of mizolastine in elderly individuals were similar to those observed in healthy young volunteers. In patients with chronic renal insufficiency, t1/2beta was prolonged by 47% compared with young healthy volunteers. In patients with cirrhosis, tmax was longer, Cmax was lower, distribution half-life was prolonged and AUC was 50% higher than in healthy volunteers. In pharmacodynamic-pharmacokinetic trials, the percentage of wheal and flare inhibition was found to correlate with mizolastine Cmin values. No direct relationship was found between drug concentrations in skin blister fluid and antihistamine activity. PMID:11510627

  2. Social media in clinical trials.

    PubMed

    Thompson, Michael A

    2014-01-01

    Social media has potential in clinical trials for pointing out trial issues, addressing barriers, educating, and engaging multiple groups involved in cancer clinical research. Social media is being used in clinical trials to highlight issues such as poor accrual and barriers; educate potential participants and physicians about clinical trial options; and is a potential indirect or direct method to improve accrual. We are moving from a passive "push" of information to patients to a "pull" of patients requesting information. Patients and advocates are often driving an otherwise reluctant health care system into communication. Online patient communities are creating new information repositories. Potential clinical trial participants are using the Twittersphere and other sources to learn about potential clinical trial options. We are seeing more organized patient-centric and patient-engaged forums with the potential to crowd source to improve clinical trial accrual and design. This is an evolving process that will meet many individual, institutional, and regulatory obstacles as we move forward in a changed research landscape. PMID:24857086

  3. Children and Clinical Studies: Why Clinical Studies Are Important

    MedlinePLUS Videos and Cool Tools

    ... several ways: it uncovers the best dose of medicines to prevent harmful effects or under-treatment; it ... clinical research in children help us understand how medicines affect children's brains and bodies as they grow ...

  4. CMA Infobase: clinical practice guidelines.

    PubMed

    Fitzpatrick, Roberta Bronson

    2008-01-01

    The CMA Infobase is a free Web-based resource that contains evidence-based clinical practice guidelines. The database is maintained by the Canadian Medical Association (CMA) and is available on its Web site. The CMA Infobase currently contains 1,200-plus clinical practice guidelines either developed or endorsed by an authoritative health care organization located in Canada. It is an alternative source of free clinical practice guidelines to the National Guideline Clearinghouse. This column will cover the basics of CMA Infobase, including searching, special features, and available resources which complement the database. PMID:19042721

  5. Data fraud in clinical trials

    PubMed Central

    George, Stephen L; Buyse, Marc

    2015-01-01

    Highly publicized cases of fabrication or falsification of data in clinical trials have occurred in recent years and it is likely that there are additional undetected or unreported cases. We review the available evidence on the incidence of data fraud in clinical trials, describe several prominent cases, present information on motivation and contributing factors and discuss cost-effective ways of early detection of data fraud as part of routine central statistical monitoring of data quality. Adoption of these clinical trial monitoring procedures can identify potential data fraud not detected by conventional on-site monitoring and can improve overall data quality. PMID:25729561

  6. Clinical trials 101. | accrualnet.cancer.gov

    Cancer.gov

    A basic understanding of the process, ethics, and requirements of clinical trials enables nurses to support patients' awareness, understanding of and decision making about clinical trial participation. Nurses new to clinical trials will benefit from this overview of the history of clinical trials, the types of trials, the clinical research enterprise, and the roles of both the research team members and the research participant.

  7. Checklist for clinical readiness published

    Cancer.gov

    Scientists from NCI, together with collaborators from outside academic centers, have developed a checklist of criteria to evaluate the readiness of complex molecular tests that will guide decisions made during clinical trials. The checklist focuses on tes

  8. Feedback in clinical medical education.

    PubMed

    Ende, J

    1983-08-12

    In the setting of clinical medical education, feedback refers to information describing students' or house officers' performance in a given activity that is intended to guide their future performance in that same or in a related activity. It is a key step in the acquisition of clinical skills, yet feedback is often omitted or handled improperly in clinical training. This can result in important untoward consequences, some of which may extend beyond the training period. Once the nature of the feedback process is appreciated, however, especially the distinction between feedback and evaluation and the importance of focusing on the trainees' observable behaviors rather than on the trainees themselves, the educational benefit of feedback can be realized. This article presents guidelines for offering feedback that have been set forth in the literature of business administration, psychology, and education, adapted here for use by teachers and students of clinical medicine. PMID:6876333

  9. PREASDFASFS Clinical Prevention and Population

    E-print Network

    Finley Jr., Russell L.

    · Cardiovascular: Cardiovascular disease prevention- Lecture · Connective Tissue: Metabolic bone disease- Lecture · Connective Tissue: NSAIDs, gout & osteoporosis drugs- Lecture · Endocrine/Reproductive: Diabetes Medications: Ethic and Racial Disparities- Lecture · Public health- Lecture Clinical Nutrition · Diabetes

  10. Clinical aspects of crew health

    NASA Technical Reports Server (NTRS)

    Hawkins, W. R.; Zieglschmid, J. F.

    1975-01-01

    Medical procedures and findings for Apollo astronauts in the preflight, inflight, and postflight phases of the Apollo missions are described in detail. Preflight medical examinations, inflight monitoring and medications, crew illnesses, and clinical findings are summarized.

  11. Clinical Proteomic Tumor Analysis Consortium

    Cancer.gov

    The Clinical Proteomic Tumor Analysis Consortium (CPTAC) is a comprehensive and coordinated effort to accelerate the understanding of the molecular basis of cancer through the application of robust, quantitative, proteomic technologies and workflows.

  12. Who sponsors imaging clinical trials?

    Cancer.gov

    American College of Radiology Imaging Network (ACRIN)ACRIN is an international cooperative group sponsored by NCI's Cancer Imaging Program (CIP) as well as philanthropies. Through clinical trials of diagnostic imaging and image-guided therapeutic technologies, ACRIN's goal is to generate information that will lengthen and improve the quality of the lives of cancer patients. ACRIN's clinical trials address both existing and emerging technologies as they apply to cancer screening, diagnosis, staging, imaging as a biomarker, and image-guided treatment.

  13. Cleveland Clinic Next Generation Neuroimaging

    SciTech Connect

    Lowe, Mark

    2009-09-30

    This was an award to purchase equipment for state-of-the-art MRI radiofrequency coils. There was no personnel effort or construction as a part of this project. This report details the final status of the approved budget items for this project. All approved budget items were successfully delivered and installed. The equipment provided to Cleveland Clinic under this project will allow Cleveland Clinic researchers to build imaging equipment with improved capability to investigate brain disorders.

  14. Clinical Data Interchange Standards - CDISC

    Cancer.gov

    Other Vendors Biotech Regulatory Patients CROs CDISC Proprietary May 2002 6 Benefits of Standardization in our Industry z Reduce time and cost associated with clinical trials for drug development z Facilitate business processes among biopharmaceutical companies, CROs, EDC vendors, clinical laboratories z Facilitate reviews of regulatory submissions z Increase familiarity with common data elements, reducing training requirements z Improve data quality CDISC Proprietary May 2002 7 What is CDISC, and what is the history?

  15. Clinical implications of Bion's thought.

    PubMed

    Ferro, Antonino

    2006-08-01

    The author focuses on some clinical implications of Bion's thought. He takes into particular consideration the great technical importance of Bion's concept of 'waking dream thought'. He also proposes some developments of Bion's thought. Psychoanalytic exercises like those suggested by Bion are presented along with clinical material in order to render the author's theoretical-technical ideas as clear as possible. Furthermore, he deals with the fertile connection between Bion's theories and the field concept in psychoanalysis. PMID:16877248

  16. Immunologic derangement preceding clinical autoimmunity.

    PubMed

    Dellavance, A; Coelho Andrade, L E

    2014-10-01

    Autoantibodies are valuable markers for the recognition of autoimmune diseases. Over the last 25 years, several investigators have consistently shown that autoantibodies precede the clinical onset of cognate diseases by years or decades. This phenomenon, regularly observed in the natural history of autoimmune diseases, indicates that autoimmunity develops through successive stages across a variable period of time until the characteristic manifestations of disease are clinically apparent. Recent evidence indicates that the pre-clinical stages of autoimmune diseases involve a series of immunologic derangements and that this process is dynamic and progressive. During the years preceding clinical disease onset, there is progressive intensification in the humoral autoimmune response, characterized by increases in autoantibody titer, avidity, number of immunoglobulin isotypes, and spread of epitopes and of autoantigens targeted. This scenario is reminiscent of cancer processes that develop slowly by means of progressive stages, and may be interrupted by early detection and therapeutic intervention. Therefore, it might be reasoned that early intervention may be more effective in reverting the less firmly established autoimmune abnormalities at the pre-clinical stage of autoimmunity. With the continuous progress in novel immunologic therapeutic strategies, one can envision the possibility that early intervention at pre-clinical stages may lead to prevention of overt disease development and even cure of the autoimmune disorder. PMID:25228734

  17. Detailed Clinical Models: A Review

    PubMed Central

    Goossen-Baremans, Anneke; van der Zel, Michael

    2010-01-01

    Objectives Due to the increasing use of electronic patient records and other health care information technology, we see an increase in requests to utilize these data. A highly level of standardization is required during the gathering of these data in the clinical context in order to use it for analyses. Detailed Clinical Models (DCM) have been created toward this purpose and several initiatives have been implemented in various parts of the world to create standardized models. This paper presents a review of DCM. Methods Two types of analyses are presented; one comparing DCM against health care information architectures and a second bottom up approach from concept analysis to representation. In addition core parts of the draft ISO standard 13972 on DCM are used such as clinician involvement, data element specification, modeling, meta information, and repository and governance. Results Six initiatives were selected: Intermountain Healthcare, 13606/OpenEHR Archetypes, Clinical Templates, Clinical Contents Models, Health Level 7 templates, and Dutch Detailed Clinical Models. Each model selected was reviewed for their overall development, involvement of clinicians, use of data types, code bindings, expressing semantics, modeling, meta information, use of repository and governance. Conclusions Using both a top down and bottom up approach to comparison reveals many commonalties and differences between initiatives. Important differences include the use of or lack of a reference model and expressiveness of models. Applying clinical data element standards facilitates the use of conceptual DCM models in different technical representations. PMID:21818440

  18. Transitioning biomarkers into the clinic.

    PubMed

    Waldman, Scott A

    2009-01-01

    Scott Waldman is currently the Chairman of the Department of Pharmacology and Experimental Therapeutics and the Director of the Division of Clinical Pharmacology. He is the Samuel MV Professor, Department of Medicine and Biochemistry and Molecular Pharmacology. Waldman's research interests focus on molecular pathways underlying early intestinal tumorigenesis and their utility as novel targeted agents for managing patients with colorectal cancer. Waldman obtained his BSc degree in Biology from the University at Albany, his PhD degree in Anatomy from Thomas Jefferson University and his MD degree from Stanford University. He was a postdoctoral fellow at the University of Virginia and Stanford University in the Division of Clinical Pharmacology. He has received numerous honors and awards. He currently has 20 awarded patents and 30 patents pending related to novel diagnostic, therapeutic and immunological targets for gastrointestinal malignancies. He is a member of several editorial boards and scientific peer-review committees. Waldman has over 200 publications in various journals, including Proceedings of the National Academy of Science, Gastroenterology, Journal of Biological Chemistry and Journal of Clinical Investigation. Waldman has served on many councils and chaired NIH study sections. He is currently a member of the Osler Society and the College of Reviewers for the Canada Research Chairs Program. He is a past member of the American Board of Clinical Pharmacology, a past Regent of the American College of Clinical Pharmacology and a past President of the American Society for Clinical Pharmacology and Therapeutics. PMID:24422768

  19. Methodology Rigor in Clinical Research

    PubMed Central

    Yang, Lynda J-S.; Chang, Kate W-C.; Chung, Kevin C.

    2012-01-01

    Background Methodology rigor increases the quality of clinical research by encouraging freedom from the biases inherent in clinical studies. As randomized controlled studies (clinical trial design) are rarely applicable to surgical research, we address the commonly used observational study designs and methodologies by presenting guidelines for rigor. Methods Review of study designs including cohort, case-control, and cross-sectional studies and case series/reports, as well as biases and confounders of study design. Results Details about biases and confounders at each study stage, study characteristics, rigor checklists, and published literature examples for each study design are summarized and presented in this report. Conclusions For those surgeons interested in pursuing clinical research, mastery of the principles of methodology rigor is imperative in of the context of evidence-based medicine and widespread publication of clinical studies. Knowledge of the study designs, their appropriate application, and strictly adhering to study design methods can provide high-quality evidence to serve as the basis for rational clinical decision-making. PMID:22634695

  20. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 2 2010-10-01 2010-10-01 false Clinical psychologist and clinical social worker services. 405.2450 Section...Qualified Health Center Services § 405.2450 Clinical psychologist and clinical social worker...

  1. 77 FR 35407 - Proposed Collection; Comment Request: Clinical Mythteries: A Video Game About Clinical Trials

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ...Health Proposed Collection; Comment Request: Clinical Mythteries: A Video Game About Clinical Trials SUMMARY: In compliance with the requirement...and approval. Proposed Collection: Title: Clinical Mythteries: A Video Game About Clinical...

  2. Where do imaging clinical trials take place?

    Cancer.gov

    Imaging clinical trials take place in doctor's offices, cancer centers, other medical centers, community hospitals and clinics, and veterans' and military hospitals in cities and towns across the United States and in other countries. Imaging clinical

  3. 77 FR 60440 - Clinical Investigator Training Course

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ...Docket No. FDA-2012-N-0001] Clinical Investigator Training Course AGENCY...cosponsoring a 3- day training course for clinical investigators on scientific, ethical, and regulatory aspects of clinical trials. This training course is...

  4. 76 FR 45577 - Clinical Investigator Training Course

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-29

    ...Docket No. FDA-2011-N-0523] Clinical Investigator Training Course AGENCY...Office of Critical Path Programs and the Clinical Trials Transformation Initiative (CTTI...cosponsoring a 3-day training course for clinical investigators on scientific,...

  5. Clinical and Translational Research Fellowship Program (CTRFP)

    E-print Network

    Mullins, Dyche

    Clinical and Translational Research Fellowship Program (CTRFP) Program Guidelines 2014, San Francisco Updated: June, 2014 #12;Clinical and Translational Research Fellowship Program (CTRFP-2015 A program sponsored by the Clinical & Translational Science Institute (CTSI) at the University of California

  6. Cancer Clinical Investigator Team Leadership Award (CCITLA)

    Cancer.gov

    NCI’s Cancer Clinical Investigator Team Leadership Awards (CCITLAs) recognize mid-career clinical investigators at NCI-designated Cancer Centers working to improve the lives of people with cancer through clinical trials.

  7. Dr. Beverly Adams ZCDH (Zone Clinical Department

    E-print Network

    Calgary, University of

    Health Community Clinic Dr. J. Taggart ACH Psychiatry Ambulatory Clinic Dr. K. Tomm Family Therapy Vacant Rural Mental Health Clinics Vacant SMCHC Urgent Mental Health Special Services Division Dr. D and Adolescent Psychiatry #12;

  8. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Clinical psychologist and clinical social worker... Health Clinic and Federally Qualified Health Center Services Federally Qualified Health Center Services § 405.2450 Clinical psychologist and clinical social worker services. (a) For clinical psychologist...

  9. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Clinical psychologist and clinical social worker... § 405.2450 Clinical psychologist and clinical social worker services. (a) For clinical psychologist or clinical social worker professional services to be payable under this subpart, the services must be—...

  10. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Clinical psychologist and clinical social worker... § 405.2450 Clinical psychologist and clinical social worker services. (a) For clinical psychologist or clinical social worker professional services to be payable under this subpart, the services must be—...

  11. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Clinical psychologist and clinical social worker... § 405.2450 Clinical psychologist and clinical social worker services. (a) For clinical psychologist or clinical social worker professional services to be payable under this subpart, the services must be—...

  12. 42 CFR 405.2450 - Clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Clinical psychologist and clinical social worker... § 405.2450 Clinical psychologist and clinical social worker services. (a) For clinical psychologist or clinical social worker professional services to be payable under this subpart, the services must be—...

  13. Clinical Utility of Quantitative Imaging

    PubMed Central

    Rosenkrantz, Andrew B; Mendiratta-Lala, Mishal; Bartholmai, Brian J.; Ganeshan, Dhakshinamoorthy; Abramson, Richard G.; Burton, Kirsteen R.; Yu, John-Paul J.; Scalzetti, Ernest M.; Yankeelov, Thomas E.; Subramaniam, Rathan M.; Lenchik, Leon

    2014-01-01

    Quantitative imaging (QI) is increasingly applied in modern radiology practice, assisting in the clinical assessment of many patients and providing a source of biomarkers for a spectrum of diseases. QI is commonly used to inform patient diagnosis or prognosis, determine the choice of therapy, or monitor therapy response. Because most radiologists will likely implement some QI tools to meet the patient care needs of their referring clinicians, it is important for all radiologists to become familiar with the strengths and limitations of QI. The Association of University Radiologists Radiology Research Alliance Quantitative Imaging Task Force has explored the clinical application of QI and summarizes its work in this review. We provide an overview of the clinical use of QI by discussing QI tools that are currently employed in clinical practice, clinical applications of these tools, approaches to reporting of QI, and challenges to implementing QI. It is hoped that these insights will help radiologists recognize the tangible benefits of QI to their patients, their referring clinicians, and their own radiology practice. PMID:25442800

  14. Clinical Pearls in pediatric infections.

    PubMed

    Singhi, Sunit; Mathew, Joseph; Jindal, Atul; Verma, Sanjay

    2011-12-01

    This series of Clinical Pearls presents four cases presenting with infection. Each of these cases had clinical clues to the correct diagnosis, which could be picked up on meticulous history, clinical examination, or basic laboratory investigations. The authors highlight the important lessons to be learnt from each case. The first is a 7 year old boy with recurrent respiratory tract infections since early life. Clinical examination revealed the presence of dextrocardia and situs inversus and bronchiectasis leading to a diagnosis of Primary Ciliary Dyskinesia. The second case is a 1.5-month-old infant who presented with meningitis and increasing head size since birth. CSF examination and CT scanning led to the correct diagnosis of congenital Toxoplasmosis. The next case is an infant with high grade fever and neck swelling. He had the rare Lemierre's syndrome comprising of oro-pharyngeal infection, suppurative thrompbophlebitis of the internal jugular vein and systemic dissemination of septic emboli. The fourth case is a 2-year-old infant with recurrent respiratory tract infections and discharging neck swellings from early life. Repeated testing for tuberculosis was negative. The diagnosis was Chronic granulomatous disease. The authors describe the clinical approach and investigations in these cases; along with an outline of the management. PMID:21625832

  15. Malaria Diagnostics in Clinical Trials

    PubMed Central

    Murphy, Sean C.; Shott, Joseph P.; Parikh, Sunil; Etter, Paige; Prescott, William R.; Stewart, V. Ann

    2013-01-01

    Malaria diagnostics are widely used in epidemiologic studies to investigate natural history of disease and in drug and vaccine clinical trials to exclude participants or evaluate efficacy. The Malaria Laboratory Network (MLN), managed by the Office of HIV/AIDS Network Coordination, is an international working group with mutual interests in malaria disease and diagnosis and in human immunodeficiency virus/acquired immunodeficiency syndrome clinical trials. The MLN considered and studied the wide array of available malaria diagnostic tests for their suitability for screening trial participants and/or obtaining study endpoints for malaria clinical trials, including studies of HIV/malaria co-infection and other malaria natural history studies. The MLN provides recommendations on microscopy, rapid diagnostic tests, serologic tests, and molecular assays to guide selection of the most appropriate test(s) for specific research objectives. In addition, this report provides recommendations regarding quality management to ensure reproducibility across sites in clinical trials. Performance evaluation, quality control, and external quality assessment are critical processes that must be implemented in all clinical trials using malaria tests. PMID:24062484

  16. Clinical microbiology of coryneform bacteria.

    PubMed Central

    Funke, G; von Graevenitz, A; Clarridge, J E; Bernard, K A

    1997-01-01

    Coryneform bacteria are aerobically growing, asporogenous, non-partially-acid-fast, gram-positive rods of irregular morphology. Within the last few years, there has been a massive increase in the number of publications related to all aspects of their clinical microbiology. Clinical microbiologists are often confronted with making identifications within this heterogeneous group as well as with considerations of the clinical significance of such isolates. This review provides comprehensive information on the identification of coryneform bacteria and outlines recent changes in taxonomy. The following genera are covered: Corynebacterium, Turicella, Arthrobacter, Brevibacterium, Dermabacter. Propionibacterium, Rothia, Exiguobacterium, Oerskovia, Cellulomonas, Sanguibacter, Microbacterium, Aureobacterium, "Corynebacterium aquaticum," Arcanobacterium, and Actinomyces. Case reports claiming disease associations of coryneform bacteria are critically reviewed. Minimal microbiological requirements for publications on disease associations of coryneform bacteria are proposed. PMID:8993861

  17. Clinical development of Ebola vaccines

    PubMed Central

    Sridhar, Saranya

    2015-01-01

    The ongoing outbreak of Ebola virus disease in West Africa highlighted the lack of a licensed drug or vaccine to combat the disease and has renewed the urgency to develop a pipeline of Ebola vaccines. A number of different vaccine platforms are being developed by assessing preclinical efficacy in animal models and expediting clinical development. Over 15 different vaccines are in preclinical development and 8 vaccines are now in different stages of clinical evaluation. These vaccines include DNA vaccines, virus-like particles and viral vectors such as live replicating vesicular stomatitis virus (rVSV), human and chimpanzee adenovirus, and vaccinia virus. Recently, in preliminary results reported from the first phase III trial of an Ebola vaccine, the rVSV-vectored vaccine showed promising efficacy. This review charts this rapidly advancing area of research focusing on vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola vaccines.

  18. Clinical imaging of the pancreas

    SciTech Connect

    May, G.; Gardiner, R.

    1987-01-01

    Featuring more than 300 high-quality radiographs and scan images, clinical imaging of the pancreas systematically reviews all appropriate imaging modalities for diagnosing and evaluating a variety of commonly encountered pancreatic disorders. After presenting a succinct overview of pancreatic embryology, anatomy, and physiology, the authors establish the clinical indications-including postoperative patient evaluation-for radiologic examination of the pancreas. The diagnostic capabilities and limitations of currently available imaging techniques for the pancreas are thoroughly assessed, with carefully selected illustrations depicting the types of images and data obtained using these different techniques. The review of acute and chronic pancreatitis considers the clinical features and possible complications of their variant forms and offers guidance in selecting appropriate imaging studies.

  19. Clinical utility of curcumin extract.

    PubMed

    Asher, Gary N; Spelman, Kevin

    2013-01-01

    Turmeric root has been used medicinally in China and India for thousands of years. The active components are thought to be the curcuminoids, primarily curcumin, which is commonly available worldwide as a standardized extract. This article reviews the pharmacology of curcuminoids, their use and efficacy, potential adverse effects, and dosage and standardization. Preclinical studies point to mechanisms of action that are predominantly anti-inflammatory and antineoplastic, while early human clinical trials suggest beneficial effects for dyspepsia, peptic ulcer, inflammatory bowel disease, rheumatoid arthritis, osteoarthritis, uveitis, orbital pseudotumor, and pancreatic cancer. Curcumin is well-tolerated; the most common side effects are nausea and diarrhea. Theoretical interactions exist due to purported effects on metabolic enzymes and transport proteins, but clinical reports do not support any meaningful interactions. Nonetheless, caution, especially with chemotherapy agents, is advised. Late-phase clinical trials are still needed to confirm most beneficial effects. PMID:23594449

  20. [Scientific concepts in clinical medicine].

    PubMed

    Rogler, G

    2003-11-28

    The understanding of the scientific basis and the theory of knowledge are surprisingly heterogeneous in practical and clinical medicine. It is frequently influenced or based on the philosophical theory of critical rationalism founded by Sir Karl Popper. Because the theory of knowledge and the understanding of scientific truth is the central basis for cautious and good clinical practise it is necessary to discuss both points to avoid unscientific auto-immunisation against critique in a type of medicine that regards herself as science-based. Evidence-based medicine would not be possible without interpretation and explanation of existing data into the individual treatment context. Besides an inductive or deductive logic the historical and situative side-conditions of the gathering of knowledge and of experiments are of central importance for their interpretation and their relevance in clinical practice. This historical and situative context warrants reflection but must also be paid attention to in the reflections on medical ethics. PMID:14648440

  1. Clinical development of Ebola vaccines.

    PubMed

    Sridhar, Saranya

    2015-09-01

    The ongoing outbreak of Ebola virus disease in West Africa highlighted the lack of a licensed drug or vaccine to combat the disease and has renewed the urgency to develop a pipeline of Ebola vaccines. A number of different vaccine platforms are being developed by assessing preclinical efficacy in animal models and expediting clinical development. Over 15 different vaccines are in preclinical development and 8 vaccines are now in different stages of clinical evaluation. These vaccines include DNA vaccines, virus-like particles and viral vectors such as live replicating vesicular stomatitis virus (rVSV), human and chimpanzee adenovirus, and vaccinia virus. Recently, in preliminary results reported from the first phase III trial of an Ebola vaccine, the rVSV-vectored vaccine showed promising efficacy. This review charts this rapidly advancing area of research focusing on vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola vaccines. PMID:26668751

  2. Gatekeepers for pragmatic clinical trials.

    PubMed

    Whicher, Danielle M; Miller, Jennifer E; Dunham, Kelly M; Joffe, Steven

    2015-10-01

    To successfully implement a pragmatic clinical trial, investigators need access to numerous resources, including financial support, institutional infrastructure (e.g. clinics, facilities, staff), eligible patients, and patient data. Gatekeepers are people or entities who have the ability to allow or deny access to the resources required to support the conduct of clinical research. Based on this definition, gatekeepers relevant to the US clinical research enterprise include research sponsors, regulatory agencies, payers, health system and other organizational leadership, research team leadership, human research protections programs, advocacy and community groups, and clinicians. This article provides a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. Relevant ethical considerations for gatekeepers include (1) concern for the interests of individuals, groups, and communities affected by the gatekeepers' decisions, including protection from harm and maximization of benefits; (2) advancement of organizational mission and values; and (3) stewardship of financial, human, and other organizational resources. Separate from these ethical considerations, gatekeepers' actions will be guided by relevant federal, state, and local regulations. This framework also suggests that to further enhance the legitimacy of their decision-making, gatekeepers should adopt transparent processes that engage relevant stakeholders when feasible and appropriate. We apply this framework to the set of gatekeepers responsible for making decisions about resources necessary for pragmatic clinical trials in the United States, describing the relevance of the criteria in different situations and pointing out where conflicts among the criteria and relevant regulations may affect decision-making. Recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding the use of limited and valuable resources. PMID:26374683

  3. 42 CFR 405.2452 - Services and supplies incident to clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...incident to clinical psychologist and clinical social worker services. 405.2452 Section...incident to clinical psychologist and clinical social worker services. (a) Services and...a clinical psychologist's or clinical social worker's services are reimbursable...

  4. Physicians Reentering Clinical Practice: Characteristics and Clinical Abilities

    ERIC Educational Resources Information Center

    Grace, Elizabeth S.; Korinek, Elizabeth J.; Weitzel, Lindsay B.; Wentz, Dennis K.

    2010-01-01

    Introduction: Limited information exists to describe physicians who return to practice after absences from patient care. The Center for Personalized Education for Physicians (CPEP) is an independent, not-for-profit organization that provides clinical competency assessment and educational programs for physicians, including those reentering…

  5. Physicians Reentering Clinical Practice: Characteristics and Clinical Abilities

    ERIC Educational Resources Information Center

    Grace, Elizabeth S.; Korinek, Elizabeth J.; Weitzel, Lindsay B.; Wentz, Dennis K.

    2011-01-01

    Introduction: Limited information exists to describe physicians who return to practice after absences from patient care. The Center for Personalized Education for Physicians (CPEP) is an independent, not-for-profit organization that provides clinical competency assessment and educational programs for physicians, including those reentering…

  6. Death Anxiety in Clinical and Non-Clinical Groups

    ERIC Educational Resources Information Center

    Abdel-Khalek, Ahmed M.

    2005-01-01

    The Arabic Scale of Death Anxiety (ASDA) was administered, individually, to 7 groups (N=765) of Egyptian normal participants (non-clinical), anxiety disorder patients, and patients suffering from schizophrenia (males and females), and addicts (males only). They were generally matched as groups according to age, occupation, and education. The…

  7. Clinical description of toxic neuropathies.

    PubMed

    Little, Ann A; Albers, James W

    2015-01-01

    Toxic neuropathy, although rare, is an important consideration in the setting of a known or suspected toxic exposure in the workplace or other environment. This chapter discusses the clinical and electrodiagnostic evaluation of peripheral neuropathies, highlighting findings that direct further workup and may point to specific toxins as etiology. The difficulty of establishing causality of a toxin in relation to peripheral neuropathy is discussed; guidelines for establishing causality are presented. Examples of common industrial toxins are listed, including their typical industrial uses and their mechanisms of action in producing neuropathy. Characteristic clinical presentations of specific toxic neuropathies are highlighted with selected case studies. PMID:26563794

  8. Handbook of clinical nursing practice

    SciTech Connect

    Asheervath, J.; Blevins, D.R.

    1986-01-01

    Written in outline format, this reference will help nurses further their understanding of advanced nursing procedures. Information is provided on the physiological, psychological, environmental, and safety considerations of nursing activities associated with diagnostic and therapeutic procedures. Special consideration is given to the areas of pediatric nursing, nursing assessment, and selected radiologic and nuclear medicine procedures for each system. Contents: Clinical Introduction. Clinical Nursing Practice: Focus on Basics. Focus on Cardiovascular Function. Focus on Respiratory Function. Focus on Gastrointestinal Function. Focus on Renal and Genito-Urological Function. Focus on Neuro-Skeletal and Muscular Function. Appendices.

  9. Osteitis pubis: a clinical challenge *

    PubMed Central

    DeFinney, John; Clements, David; Staines, Marilyn; Mior, Silvano

    1990-01-01

    Mechanical pain in the region of the groin poses an interesting and at times confusing clinical dilemma. This is especially true for osteitis pubis, an inflammatory condition affecting the symphysis pubis. Recently it has been recognized as a potential source of pain in athletes. In this report, we will review the typical presentation of osteitis pubis, including the clinical, examination and radiographic features of this condition. A proposed plan of management, based on previous work on avulsion injuries is presented. A case report has been included to illustrate the salient features. ImagesFigure 1Figure 2Figure 4

  10. Clinical Subtypes of Frontotemporal Dementia.

    PubMed

    Ghosh, Sayantani; Lippa, Carol F

    2015-11-01

    Frontotemporal dementia (FTD) was one of the lesser known dementias until the recent advancements revealing its genetic and pathological foundation. This common neurodegenerative disorder has three clinical subtypes- behavioral, semantic and progressive non fluent aphasia. The behavioral variant mostly exhibits personality changes, while the other two encompass various language deficits. This review discusses the basic pathology, genetics, clinical and histological presentation and the diagnosis of the 3 subtypes. It also deliberates the different therapeutic modalities currently available for frontotemporal dementia and the challenges faced by the caregivers. Lastly it explores the scope of further research into the diagnosis and management of FTD. PMID:23813692

  11. Electrochemical Sensors for Clinic Analysis

    PubMed Central

    Wang, You; Xu, Hui; Zhang, Jianming; Li, Guang

    2008-01-01

    Demanded by modern medical diagnosis, advances in microfabrication technology have led to the development of fast, sensitive and selective electrochemical sensors for clinic analysis. This review addresses the principles behind electrochemical sensor design and fabrication, and introduces recent progress in the application of electrochemical sensors to analysis of clinical chemicals such as blood gases, electrolytes, metabolites, DNA and antibodies, including basic and applied research. Miniaturized commercial electrochemical biosensors will form the basis of inexpensive and easy to use devices for acquiring chemical information to bring sophisticated analytical capabilities to the non-specialist and general public alike in the future.

  12. Monoamine Oxidase Inhibitors: Clinical Review

    PubMed Central

    Remick, Ronald A.; Froese, Colleen

    1990-01-01

    Monoamine oxidase inhibitors (MAOIs) are effective antidepressant agents. They are increasingly and effectively used in a number of other psychiatric and non-psychiatric medical syndromes. Their potential for serious toxicity (i.e., hypertensive reaction) is far less than original reports suggest, and newer reversible substrate-specific MAOIs may offer even less toxicity. The author reviews the pharmacology, mechanism of action, clinical indications, and dosing strategies of MAOIs. The common MAOI side-effects (hypotension, weight gain, sexual dysfunction, insomnia, daytime sedation, myoclonus, and hypertensive episodes) are described and management techniques suggested. Recent clinical developments involving MAOIs are outlined. PMID:21233984

  13. Clinical privileges for laparoscopic surgery.

    PubMed

    Albrink, M H; Rosemurgy, A S

    1993-06-01

    Laparoscopic cholecystectomy has undergone an explosive growth. Its benefits to patients--shortened recovery time and less pain--became immediately obvious. The procedure's development and adaptation have largely been devised and implemented by ingenious and creative private practitioners, not the typical mode of introduction. Most or many new procedures in the past evolved from academic institutions after laboratory and then clinical trials. With rapid development and acceptance has come an additional new burden among medical practitioners: credentialing and granting clinical privileges. PMID:8340775

  14. New developments in clinical CARS

    NASA Astrophysics Data System (ADS)

    Weinigel, Martin; Breunig, Hans Georg; Kellner-Höfer, Marcel; Bückle, Rainer; Darvin, Maxim; Lademann, Juergen; König, Karsten

    2013-02-01

    We combined two-photon fluorescence and coherent anti-Stokes Raman scattering (CARS) imaging in a clinical hybrid multiphoton tomograph for in vivo imaging of human skin. The clinically approved TPEF/CARS system provides simultaneous imaging of endogenous fluorophores and non-fluorescent lipids. The Stokes laser for the two-beam configuration of CARS is based on spectral broadening of femtosecond laser pulses in a photonic crystal fiber (PCF). We report on the highly flexible medical TPEF/CARS tomograph MPTflex®-CARS with an articulated arm and first in vivo measurements on human skin.

  15. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory... clinical use is a device intended to identify inorganic or organic compounds (e.g., lead, mercury,...

  16. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory... clinical use is a device intended to identify inorganic or organic compounds (e.g., lead, mercury,...

  17. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory... clinical use is a device intended to identify inorganic or organic compounds (e.g., lead, mercury,...

  18. 21 CFR 862.2700 - Nephelometer for clinical use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2700 Nephelometer for clinical use. (a)...

  19. SOUTH SANTA CLARA COUNTY MIGRANT TREATMENT CLINIC.

    ERIC Educational Resources Information Center

    SKILLICORN, STANLEY A.

    IN THE SUMMER OF 1965, A MIGRANT HEALTH CLINIC WAS STARTED IN THE SOUTHERN PART OF SANTA CLARA COUNTY, CALIFORNIA. THE CLINIC DIFFERS FROM THE PUBLIC HEALTH DEPARTMENT'S CLINICS BY OFFERING TREATMENT AND MEDICATION, INSTEAD OF ONLY PREVENTIVE SERVICES. THE ENTIRE STAFF, FROM DOCTORS TO BABY-SITTERS, VOLUNTEERS ITS TIME, AND THE CLINIC IS NOW OPEN…

  20. 78 FR 63988 - Clinical Investigator Training Course

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... HUMAN SERVICES Food and Drug Administration Clinical Investigator Training Course AGENCY: Food and Drug... cosponsoring a 3- day training course for clinical investigators on scientific, ethical, and regulatory aspects of clinical trials. This training course is intended to provide clinical investigators with...

  1. HIV/AIDS Clinical Trials Fact Sheet

    MedlinePLUS

    HIV Prevention HIV/AIDS Clinical Trials (Last updated 9/15/2015; last reviewed 9/15/2015) Key Points HIV/AIDS clinical trials are research studies ... aren’t infected with HIV. What is a clinical trial? A clinical trial is a research study ...

  2. 77 FR 60440 - Clinical Investigator Training Course

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... HUMAN SERVICES Food and Drug Administration Clinical Investigator Training Course AGENCY: Food and Drug... are cosponsoring a 3- day training course for clinical investigators on scientific, ethical, and regulatory aspects of clinical trials. This training course is intended to provide clinical...

  3. 42 CFR 440.90 - Clinic services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Clinic services. 440.90 Section 440.90 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.90 Clinic services. Clinic... furnished at the clinic by or under the direction of a physician or dentist. (b) Services furnished...

  4. Situational Supervision for Athletic Training Clinical Education

    ERIC Educational Resources Information Center

    Levy, Linda S.; Gardner, Greg; Barnum, Mary G.; Willeford, K. Sean; Sexton, Patrick; Guyer, M. Susan; Fincher, A. Louise

    2009-01-01

    Introduction: The medical education model provides the basis for athletic training students to learn theoretical and practical skills. Clinical rotations are completed where they apply what they have learned under the direct supervision of a clinical instructor (CI) or approved clinical instructor (ACI). Approved clinical instructors are taught…

  5. Occupational and Environmental Clinical Medicine II

    E-print Network

    Finley Jr., Russell L.

    Occupational and Environmental Medicine Years I-IV 2014-2015 Year II Clinical Medicine II · Toxicology- 4 lecture unit · Clinical Correlations: Poisoned Patient- 2 lecture unit Year I Clinical MedicineDetroit · Earthworks · Greening of Detroit Street Medicine · Detroit Clean Up Clinical Education Year III Family

  6. The Future of Clinical Dentistry.

    ERIC Educational Resources Information Center

    Slavkin, Harold C.

    1998-01-01

    Discussion of the future of clinical dentistry looks at a variety of influences, including historical development factors; demographic trends; the role of the Human Genome Project in the development of scientific knowledge; a paradigm shift in approaches to oral infection and systemic disease; advancing technology; and reforms resulting from these…

  7. Clinical Experiences in Athletic Training.

    ERIC Educational Resources Information Center

    Knight, Kenneth L.

    This book offers a systematic approach to teaching athletic training. Modules are separated into 10 content areas: direct clinical experience; policies and procedures; emergency procedures; modality operation; advanced modality operation; taping, wrapping, bracing, and padding; management of specific injuries; examination; supervision; and…

  8. Clinical Bioinformatics: challenges and opportunities

    PubMed Central

    2012-01-01

    Background Network Tools and Applications in Biology (NETTAB) Workshops are a series of meetings focused on the most promising and innovative ICT tools and to their usefulness in Bioinformatics. The NETTAB 2011 workshop, held in Pavia, Italy, in October 2011 was aimed at presenting some of the most relevant methods, tools and infrastructures that are nowadays available for Clinical Bioinformatics (CBI), the research field that deals with clinical applications of bioinformatics. Methods In this editorial, the viewpoints and opinions of three world CBI leaders, who have been invited to participate in a panel discussion of the NETTAB workshop on the next challenges and future opportunities of this field, are reported. These include the development of data warehouses and ICT infrastructures for data sharing, the definition of standards for sharing phenotypic data and the implementation of novel tools to implement efficient search computing solutions. Results Some of the most important design features of a CBI-ICT infrastructure are presented, including data warehousing, modularity and flexibility, open-source development, semantic interoperability, integrated search and retrieval of -omics information. Conclusions Clinical Bioinformatics goals are ambitious. Many factors, including the availability of high-throughput "-omics" technologies and equipment, the widespread availability of clinical data warehouses and the noteworthy increase in data storage and computational power of the most recent ICT systems, justify research and efforts in this domain, which promises to be a crucial leveraging factor for biomedical research. PMID:23095472

  9. How clinical decisions are made

    PubMed Central

    Bate, Louise; Hutchinson, Andrew; Underhill, Jonathan; Maskrey, Neal

    2012-01-01

    There is much variation in the implementation of the best available evidence into clinical practice. These gaps between evidence and practice are often a result of multiple individual decisions. When making a decision, there is so much potentially relevant information available, it is impossible to know or process it all (so called ‘bounded rationality’). Usually, a limited amount of information is selected to reach a sufficiently satisfactory decision, a process known as satisficing. There are two key processes used in decision making: System 1 and System 2. System 1 involves fast, intuitive decisions; System 2 is a deliberate analytical approach, used to locate information which is not instantly recalled. Human beings unconsciously use System 1 processing whenever possible because it is quicker and requires less effort than System 2. In clinical practice, gaps between evidence and practice can occur when a clinician develops a pattern of knowledge, which is then relied on for decisions using System 1 processing, without the activation of a System 2 check against the best available evidence from high quality research. The processing of information and decision making may be influenced by a number of cognitive biases, of which the decision maker may be unaware. Interventions to encourage appropriate use of System 1 and System 2 processing have been shown to improve clinical decision making. Increased understanding of decision making processes and common sources of error should help clinical decision makers to minimize avoidable mistakes and increase the proportion of decisions that are better. PMID:22738381

  10. Clinical use of diagnostic tests.

    PubMed

    McClure, E A

    1987-01-01

    Case histories are presented to illustrate a cross-section of work undertaken by optometrists in the Visual Assessment Department at the Tennent Institute of Ophthalmology. The clinical value of ocular diagnostic tests is emphasized, with particular reference to the differential diagnosis in cases of optic atrophy. PMID:3502656

  11. Survivorship Clinic Female Health Issues

    E-print Network

    Brent, Roger

    , the pituitary gland in the brain signals the ovaries by releasing two hormones (FSH and LH). The ovaries secrete Cancer Research Center Survivorship Program #12;Survivorship Clinic teenagers or young adults at the time to the brain. The pituitary gland, located in the center of the brain, regulates the production of two hormones

  12. Autism: Clinical and Research Issues.

    ERIC Educational Resources Information Center

    Accardo, Pasquale J., Ed.; Magnusen, Christy, Ed.; Capute, Arnold J., Ed.

    This text examines the characteristics that define autism: impairments in communication; abnormal social development; and clinically significant odd behaviors. Specific chapters include: (1) Neural Mechanisms in Autism (Andrew W. Zimmerman and Barry Gordon); (2) Epidemiology of Autism and Other Pervasive Developmental Disorders: Current…

  13. Clinical competence in pain assessment.

    PubMed

    Sjöström, B; Jakobsson, E; Haljamäe, H

    2000-10-01

    Our knowledge about the content of the clinical knowledge used by nurses in a surgical recovery unit for assessment of postoperative pain is fairly limited. The aim of the present study was to analyse and describe the variations of nurses' conceptions of the impact of clinical experience on competence in post-operative pain assessment. The informants consist of critical care nurses. A phenomenographical approach has been applied to tape-recorded interview data. The results reveal that clinical competence in pain assessment was described in three categories: (a) to be able to see; (b) to be able to differentiate; (c) to be able to give. The observations articulate what nurses perceive that they have learnt from experience in performing many clinical pain assessments and point to some difficulties in using a single-data source for the development of valid and truthful professional knowledge. In the development of professional experience, it is of the utmost importance to be able to change perspective from what is most frequent and general to what is special and unique, to base one's standpoint on the individual patient's experience and integrate this with previous professional experience. PMID:11000601

  14. Patient Safety in Clinical Trials

    Cancer.gov

    Information for patients, their families and friends, and the general public about how the rights and safety of people who take part in clinical trials are protected. Learn about informed consent, institutional review boards (IRB's), and how trials are closely monitored for safety.

  15. Clinical Judgment in Science: Reply

    ERIC Educational Resources Information Center

    Westen, Drew; Weinberger, Joel

    2005-01-01

    This paper presents replies to comments published by M. S. Schulz and R. J. Waldinger, J. M. Wood and M. T. Nezworski, and H. N. Garb and W. M. Grove on the original article by D. Westen and J. Weinberger. Schulz and Waldinger (2005) make the important point that just as researchers can capitalize on the knowledge of experienced clinical observers…

  16. Effect Size in Clinical Phonology

    ERIC Educational Resources Information Center

    Gierut, Judith A.; Morrisette, Michele L.

    2011-01-01

    The purpose of this article is to motivate the use of effect size (ES) for single-subject research in clinical phonology, with an eye towards meta-analyses of treatment effects for children with phonological disorders. Standard mean difference (SMD) is introduced and illustrated as one ES well suited to the multiple baseline (MBL) design and…

  17. Teaching Techniques in Clinical Chemistry.

    ERIC Educational Resources Information Center

    Wilson, Diane

    This master's thesis presents several instructional methods and techniques developed for each of eleven topics or subject areas in clinical chemistry: carbohydrate metabolism, lipid metabolism, diagnostic enzymology, endocrinology, toxicology, quality control, electrolytes, acid base balance, hepatic function, nonprotein nitrogenous compounds, and…

  18. Gentamicin in the Clinical Setting

    ERIC Educational Resources Information Center

    Pillers, De-Ann M.; Schleiss, Mark R.

    2005-01-01

    Gentamicin is an aminoglycoside antibiotic that has been a mainstay in pediatric care for decades. Although new antibiotics are constantly under development, gentamicin continues to play an important role in clinical medicine. Although this may be surprising in the context of evidence of an association with hearing loss, both on a toxicity and a…

  19. Bone scanning in clinical practice

    SciTech Connect

    Fogelman, I. )

    1987-01-01

    The topics covered in this book include the history of bone scanning, mechanisms of uptake of diphosphonate in bone, the normal bone scan, and the role of bone scanning in clinical practice. The aim of this book is to provide a source of reference relating to bone scan imaging for all those who are interested in the skeleton.

  20. Clinical Perspective Genes Associated with

    E-print Network

    Oliver, Douglas L.

    Clinical Perspective Genes Associated with Alcohol Dependence There is good evidence from studies, hundreds of genes likely are involved in this complex disorder, with each variant contributing only a very small effect. Therefore, identifying individual risk genes is difficult. Using a new approach

  1. SouthCampus Clinic Parking

    E-print Network

    Krovi, Venkat

    SouthCampus To Dow ntow n Cam pus Clinic Parking Zipcar space EOC M.W. Kapoor Hall Child Care-645-3943 · 106 Spaulding Quad Allen Hall Sherman Annex Allen Lot Foster Lot Squire Loop NFTA Park & Ride Lot) 6. Roswell Park Cancer Institute 5. Buffalo General 4. Parker Lot 3. Main Circle 2. Goodyear 1. Main

  2. Purposive Sampling in Clinical Research.

    ERIC Educational Resources Information Center

    Royeen, Charlotte Brasic; Fortune, Jim Carlton

    This paper identifies typical sampling problems, including improper application of the Central Limit Theorem, that are associated with the probability-based sampling procedures currently used in clinical psychology research. It then presents two alternative research designs, the theory validation model and the extended case study model, which…

  3. FAU Clinical Practice Organization, Inc.

    E-print Network

    Fernandez, Eduardo

    . In making those risk assessments, the auditor considers internal control relevant to the entity on the effectiveness of the entity's internal control. Accordingly, we express no such opinion. An audit also includes on the Financial Statements We have audited the accompanying financial statements of FAU Clinical Practice

  4. School and Clinic Work Together.

    ERIC Educational Resources Information Center

    Callias, Maria; Rickett, Julia

    1986-01-01

    Teachers at a south London secondary school met regularly in group sessions with staff from a hospital-based children's clinic to find new approaches to working with students with behavior difficulties. The evolving structure, purpose, procedures, and outcomes of this interdisciplinary collaborative effort over a seven-year period are described.…

  5. Survivorship Clinic Nutrition after Cancer

    E-print Network

    Brent, Roger

    Survivorship Clinic Nutrition after Cancer Surviving cancer has a way of changing the way you look of practical, everyday questions that accompany life as a cancer survivor: Now what? How should I live successful treatment and are now leading vital, cancer- free lives. Maybe your doctor or dietitian has

  6. Using Disguised Clinical Case Material

    ERIC Educational Resources Information Center

    Kantrowitz, Judy L.

    2010-01-01

    When, why, and how clinicians decide to write about clients are ethical concerns. There are risks and potential clinical ramifications as well as responsibilities for how these decisions are made. On the basis of 141 interviews with psychoanalysts who have published in 3 major national and international psychoanalytic journals, the author explores…

  7. Improving the surgical hot clinic

    PubMed Central

    Hubbard, Thomas; Thomas, Rhys

    2014-01-01

    Ambulatory care is an underdeveloped concept in the setting of emergency surgery, however it is recognised that many institutions will need to develop this service to cope with increased time and financial pressures.[1] There is increased emphasis on ambulatory care pathways for a variety of medical conditions.[2] Risk management is important in managing patients with acute abdominal pain in an outpatient setting and senior doctor support is essential. While the patient remains in the community, effective communication with the patient's primary care provider improves patient safety and satisfaction.[3] This quality improvement project identified current service provision of ambulatory care for surgical patients in the hot clinic at Croydon University Hospital with subsequent consultation with the surgical department to identify problems arising from the throughput of patients. Guidelines were then updated incorporating solutions to the identified issues which were then validated by the department of general surgery. Post intervention measurement identified a decrease in patients whose principal assessment and management was made by a senior house officer level doctor through the hot clinic patient journey from 26% to 9% (64% decrease), indicating an increase in registrar and/or consultant involvement in managing the hot clinic. The number of patients attending hot clinic that had effective discharge liaison (in the form of a formal letter) to the GP increased from 18% to 68% (250% increase). In conclusion, the introduction of updated guidelines effected a safer and more effective ambulatory hot clinic to perform closer to full capacity, providing improved patient care for the local population.

  8. Clinical multiphoton tomography and clinical two-photon microendoscopy

    NASA Astrophysics Data System (ADS)

    König, Karsten; Bückle, Rainer; Weinigel, Martin; Elsner, Peter; Kaatz, Martin

    2009-02-01

    We report on applications of high-resolution clinical multiphoton tomography based on the femtosecond laser system DermaInspectTM with its flexible mirror arm in Australia, Asia, and Europe. Applications include early detection of melanoma, in situ tracing of pharmacological and cosmetical compounds including ZnO nanoparticles in the epidermis and upper dermis, the determination of the skin aging index SAAID as well as the study of the effects of anti-aging products. In addition, first clinical studies with novel rigid high-NA two-photon 1.6 mm GRIN microendoscopes have been conducted to study the effect of wound healing in chronic wounds (ulcus ulcera) as well as to perform intrabody imaging with subcellular resolution in small animals.

  9. Future Clinical Trials in DIPG: Bringing Epigenetics to the Clinic

    PubMed Central

    Morales La Madrid, Andres; Hashizume, Rintaro; Kieran, Mark W.

    2015-01-01

    In spite of major recent advances in diffuse intrinsic pontine glioma (DIPG) molecular characterization, this body of knowledge has not yet translated into better treatments. To date, more than 250 clinical trials evaluating radiotherapy along with conventional cytotoxic chemotherapy as well as newer biologic agents have failed to improve the dismal outcome when compared to palliative radiation alone. The biology of DIPG remained unknown until recently when the neurosurgical expertise along with the recognition by the scientific and clinical community of the importance of tissue sampling at diagnosis; ideally, in the context of a clinical trial and by trained neurosurgical teams to maximize patient safety. These pre-treatment tumor samples, and others coming from tissue obtained post-mortem, have yielded new insights into DIPG molecular pathogenesis. We now know that DIPG comprises a heterogeneous disease with variable molecular phenotypes, different from adult high-grade glioma, other non-pontine pediatric high-grade gliomas, and even between pontine gliomas. The discovery of histone H3.3 or H3.1 mutations has been an important step forward in understanding tumor formation, maintenance, and progression. Pharmacologic reversal of DIPG histone demethylation therefore offers an important potential intervention strategy for the treatment of DIPG. To date, clinical trials of newly diagnosed or progressive DIPG with epigenetic (histone) modifiers have been unsuccessful. Whether this failure represents limited activity of the agents used, their CNS penetration, redundant pathways within the tumor, or the possibility that histone mutations are necessary only to initiate DIPGs but not maintain their growth, suggest that a great deal still needs to be elucidated in both the underlying biology of these pathways and the drugs designed to target them. In this review, we will discuss the role of both epigenetic and genetic mutations within DIPG and the development of treatment strategies directed against the unique abnormalities present in this disease. PMID:26191506

  10. [Clinical pharmacology and pharmacoepidemiology for medication safety in clinical settings].

    PubMed

    Kawakami, Junichi

    2015-01-01

    In this review, optimization of individualized analgesic therapy in cancer-pain patients (1), pharmacoepidemiological studies using a hospital database (DB) (2), and other clinical and practical research studies (3) were summarized. (1) The aim of the analgesic study was to evaluate individual factors in the effects of pain-relief, and ADR of analgesics from the viewpoints of clinical pharmacokinetics and pharmacodynamics. Oxycodone, fentanyl, and gabapentin were used. For the dose escalation and ADR of oxycodone, the plasma disposition of noroxycodone regulated by CYP3A5 polymorphisms and cancer cachexia were found to be individual factors. The ADR and clinical response of fentanyl were affected by polymorphisms of CYP3A5 and ABCB1. In the pharmacokinetics of gabapentin, concomitant magnesium oxide reduced the intestinal absorption of gabapentin. (2) The aim of the DB study was to demonstrate a pharmacoepidemiological advantage using a hospital DB of a million-scale for post-marketing safety management. We tried to detect fluoroquinolone (FQ)-induced tendon disorders, because its risk ratio in Japan has not been clarified. The risk of a tendon disorder in FQ-prescribed patients was 0.082% (95%CI: 0.049-0.137%), and significantly higher than that in cephalosporin-prescribed patients. The risk ratio in FQ-prescribed patients in relation to cephalosporin-prescribed patients was 6.29 (95%CI: 2.27-17.46). (3) Individual variation of plasma exposure of free linezolid and its ratio to minimum inhibitory concentration in critically ill patients, as well as three other studies, were described. In conclusion, our achievement in accurately assessing these would contribute to medication safety and the appropriate use of medicines in clinical settings. PMID:25832841

  11. Variability in Clinical Integration Achieved by Athletic Training Students across Different Clinical Sport Assignments

    ERIC Educational Resources Information Center

    Dodge, Thomas M.; Mazerolle, Stephanie M.; Bowman, Thomas G.

    2015-01-01

    Context: Clinical integration impacts athletic training students' (ATSs) motivation and persistence. Research has yet to elucidate the manner in which different clinical placements can influence clinical integration. Objective: To examine differences in the levels of clinical integration achieved by ATSs across various clinical sport assignments.…

  12. Introduction to clinical radiation oncology

    SciTech Connect

    Coia, L.R. . Dept. of Radiation Oncology); Moylan, D.J. III . Dept. of Medicine)

    1991-01-01

    This book discusses the management of cancer by radiation therapy both for cure and palliation. A wide range of clinical topics are introduced. In the introductory chapters on radiation physics and radiobiology, important terms and concepts used in clinical radiation oncology are covered. The subsequent chapters, which form the core of the book, group tumors predominantly according to major physiologic systems or anatomic site. Acute and chronic complications of treatment are listed along with pertinent information regarding their pathogenesis and management. There are also chapters dealing with radiation oncology emergencies, palliative treatment, combined-modality therapy and quality assurance. The radiation safety chapter presents guidelines for radiation protection. Current areas of promising investigation are presented in the final chapter. Individual chapters have been processed separately for inclusion in the appropriate data bases.

  13. Proton therapy in clinical practice

    PubMed Central

    Liu, Hui; Chang, Joe Y.

    2011-01-01

    Radiation dose escalation and acceleration improves local control but also increases toxicity. Proton radiation is an emerging therapy for localized cancers that is being sought with increasing frequency by patients. Compared with photon therapy, proton therapy spares more critical structures due to its unique physics. The physical properties of a proton beam make it ideal for clinical applications. By modulating the Bragg peak of protons in energy and time, a conformal radiation dose with or without intensity modulation can be delivered to the target while sparing the surrounding normal tissues. Thus, proton therapy is ideal when organ preservation is a priority. However, protons are more sensitive to organ motion and anatomy changes compared with photons. In this article, we review practical issues of proton therapy, describe its image-guided treatment planning and delivery, discuss clinical outcome for cancer patients, and suggest challenges and the future development of proton therapy. PMID:21527064

  14. Clinical science and human behavior.

    PubMed

    Plaud, J J

    2001-09-01

    The debate between mentalism/cognitivism and behaviorism is analyzed, and it is concluded that behaviorism is the philosophy more closely associated with psychology as a behavioral science, the cognitive approach being more closely aligned with biological science. Specific objections to mentalistic interpretations of behavioral phenomena are detailed, and examples from clinical psychology are used to show the importance of behavioral approaches in applied domains. It is argued that the relation between behavior theory and clinical psychology is critical to the continued advancement of applied psychology. Behavior analysis is offered as a direct, applied extension of behavior theory as well as a highly practical and effective approach for understanding, explaining, and modifying the factors that contribute to and maintain maladaptive behaviors. PMID:11494239

  15. Loop Diuretics in Clinical Practice

    PubMed Central

    Oh, Se Won

    2015-01-01

    Diuretics are commonly used to control edema across various clinical fields. Diuretics inhibit sodium reabsorption in specific renal tubules, resulting in increased urinary sodium and water excretion. Loop diuretics are the most potent diuretics. In this article, we review five important aspects of loop diuretics, in particular furosemide, which must be considered when prescribing this medicine: (1) oral versus intravenous treatment, (2) dosage, (3) continuous versus bolus infusion, (4) application in chronic kidney disease patients, and (5) side effects. The bioavailability of furosemide differs between oral and intravenous therapy. Additionally, the threshold and ceiling doses of furosemide differ according to the particular clinical condition of the patient, for example in patients with severe edema or chronic kidney disease. To maximize the efficiency of furosemide, a clear understanding of how the mode of delivery will impact bioavailability and the required dosage is necessary. PMID:26240596

  16. Clinical biomarkers of angiogenesis inhibition

    PubMed Central

    Brown, Aaron P.; Citrin, Deborah E.; Camphausen, Kevin A.

    2009-01-01

    Introduction An expanding understanding of the importance of angiogenesis in oncology and the development of numerous angiogenesis inhibitors are driving the search for biomarkers of angiogenesis. We review currently available candidate biomarkers and surrogate markers of anti-angiogenic agent effect. Discussion A number of invasive, minimally invasive, and non-invasive tools are described with their potential benefits and limitations. Diverse markers can evaluate tumor tissue or biological fluids, or specialized imaging modalities. Conclusions The inclusion of these markers into clinical trials may provide insight into appropriate dosing for desired biological effects, appropriate timing of additional therapy, prediction of individual response to an agent, insight into the interaction of chemotherapy and radiation following exposure to these agents, and perhaps most importantly, a better understanding of the complex nature of angiogenesis in human tumors. While many markers have potential for clinical use, it is not yet clear which marker or combination of markers will prove most useful. PMID:18414993

  17. Clinical research in anthroposophic medicine.

    PubMed

    Hamre, Harald Johan; Kiene, Helmut; Kienle, Gunver Sophia

    2009-01-01

    Anthroposophic medicine includes special medications and special artistic and physical therapies. More than 200 clinical studies of varying design and quality have been conducted on anthroposophic treatment. Half of these studies concern anthroposophic mistletoe therapy for cancer. Clinical effects of mistletoe products include improvement of quality of life, reduction of side effects from chemotherapy and radiation, and possibly increased survival. Apart from cancer therapy, the largest studies of anthroposophic treatment have been 2 naturalistic system evaluations: In German outpatients with mental, musculoskeletal, respiratory, and other chronic conditions, anthroposophic treatment was followed by sustained improvements of symptoms and quality of life. In primary care patients from 4 European countries and the United States treated for acute respiratory and ear infections by anthroposophic or conventional physicians, anthroposophic treatment was associated with reduced use of antibiotics and antipyretics, quicker recovery, and fewer adverse reactions; these differences remained after adjustment for relevant baseline differences. PMID:19943577

  18. Clinical integration and the CFO.

    PubMed

    Gosfield, Alice G

    2013-12-01

    Healthcare CFOs should consider five strategies for promoting clinical integration: Seize the opportunity to work with physicians in demanding credible payment models from payers. Collaborate with physicians in redesigning compensation models and processes of care. Establish financial relationships with physicians who are not employed by the hospital or health system. Develop data-sharing relationships with referral sources. Become actively involved in creating an articulated, transparent approach to capacity control. PMID:24380249

  19. Human clinical trials in antiepileptogenesis

    PubMed Central

    Mani, Ram; Pollard, John; Dichter, Marc A.

    2011-01-01

    Blocking the development of epilepsy (epileptogenesis) is a fundamental research area with the potential to provide large benefits to patients by avoiding the medical and social consequences that occur with epilepsy and lifelong therapy. Human clinical trials attempting to prevent epilepsy (antiepileptogenesis) have been few and universally unsuccessful to date. In this article, we review data about possible pathophysiological mechanisms underlying epileptogenesis, discuss potential interventions, and summarize prior antiepileptogenesis trials. Elements of ideal trials designs for successful antiepileptogenic intervention are suggested. PMID:21439351

  20. Clinical Genetic Testing in Epilepsy

    PubMed Central

    2015-01-01

    New technologies for mutation detection in the human genome have greatly increased our understanding of epilepsy genetics. Application of genomic technologies in the clinical setting allows for more efficient genetic diagnosis in some patients; therefore, it is important to understand the types of tests available and the types of mutations that can be detected. Making a genetic diagnosis improves overall patient care by enhancing prognosis and recurrence risk counseling and informing treatment decisions. PMID:26316867

  1. [Clinical activity in nursing education].

    PubMed

    Brignon, Béatrice

    2009-12-01

    The purpose of this research is to enlight the actual nursing act of the student in order to search for what makes sense in his (her) self nursing becoming and to reinterpret what is said regarding what is done. Up till, researchs were focused on declarative intentions; instead here, we go beyond using an innovative approach based on the clinical activity research method applied to the nursing education field. PMID:20180339

  2. Clinical Status of Duplex RNA

    PubMed Central

    Watts, Jonathan K.; Corey, David R.

    2010-01-01

    Double stranded RNA has become a ubiquitous tool for inhibition of gene expression in the laboratory. If similar success could be achieved in vivo, duplex RNA might provide a new class of therapeutics capable of treating a broad spectrum of disease. Chemists and biologists developing duplex RNA as a drug have made progress but continue to face challenges. This review presents the current status of duplex RNA in the clinic and comments on future prospects for the approach. PMID:20399650

  3. Clinical features of gastroenteropancreatic tumours

    PubMed Central

    Czarnywojtek, Agata; B?czyk, Maciej; Ziemnicka, Katarzyna; Fischbach, Jakub; Wrotkowska, El?bieta; Rucha?a, Marek

    2015-01-01

    Gastroenteropancreatic (GEP) endocrine tumours (carcinoids and pancreatic islet cell tumours) are composed of multipotent neuroendocrine cells that exhibit a unique ability to produce, store, and secrete biologically active substances and cause distinct clinical syndromes. The classification of GEP tumours as functioning or non-functioning is based on the presence of symptoms that accompany these syndromes secondary to the secretion of hormones, neuropeptides and/or neurotransmitters (functioning tumours). Non-functioning tumours are considered to be neoplasms of neuroendocrine differentiation that are not associated with obvious symptoms attributed to the hypersecretion of metabolically active substances. However, a number of these tumours are either capable of producing low levels of such substances, which can be detected by immunohistochemistry but are insufficient to cause symptoms related to a clinical syndrome, or alternatively, they may secrete substances that are either metabolically inactive or inappropriately processed. In some cases, GEP tumours are not associated with the production of any hormone or neurotransmitter. Both functioning and non-functioning tumours can also produce symptoms due to mass effects compressing vital surrounding structures. Gastroenteropancreatic tumours are usually classified further according to the anatomic site of origin: foregut (including respiratory tract, thymus, stomach, duodenum, and pancreas), midgut (including small intestine, appendix, and right colon), and hindgut (including transverse colon, sigmoid, and rectum). Within these subgroups the biological and clinical characteristics of the tumours vary considerably, but this classification is still in use because a significant number of previous studies, mainly observational, have used it extensively. PMID:26516377

  4. The renaissance of clinical leadership.

    PubMed

    Cook, M J

    2001-03-01

    The purpose of this work was to explore clinical nursing leadership. The research was based on a critical examination of the leadership themes derived from the nursing literature of the United Kingdom, the United States of America and Australia, between 1992 and 1997. The work was also influenced by the findings from semistructured interviews undertaken with five clinical leaders in nursing from the United Kingdom, and study tours to both the United States of America and Australia. The findings support a proposed leadership model as a basis for further exploration and as a framework for contemplating clinical leadership and leadership preparation. A model is presented that identifies factors which influence leadership styles, such as external environment, internal environment, experience and understanding. Four leadership styles are outlined: transactional, transformational, connective and renaissance. These leadership styles are linked to nursing care approaches. A second model provides a basis for considering power and its impact in the workplace. Based on these findings, the contents of a leadership preparation course are outlined. PMID:11316275

  5. Clinical Trials in Head Injury

    PubMed Central

    NARAYAN, RAJ K.; MICHEL, MARY ELLEN; Ansell, Beth; Baethmann, Alex; Biegon, Anat; Bracken, Michael B.; Bullock, M. Ross; Choi, Sung C.; Clifton, Guy L.; Contant, Charles F.; Coplin, William M.; Dietrich, W. Dalton; Ghajar, Jamshid; Grady, Sean M.; Grossman, Robert G.; Hall, Edward D.; Heetderks, William; Hovda, David A.; Jallo, Jack; Katz, Russell L.; Knoller, Nachshon; Kochanek, Patrick M.; Maas, Andrew I.; Majde, Jeannine; Marion, Donald W.; Marmarou, Anthony; Marshall, Lawrence F.; McIntosh, Tracy K.; Miller, Emmy; Mohberg, Noel; Muizelaar, J. Paul; Pitts, Lawrence H.; Quinn, Peter; Riesenfeld, Gad; Robertson, Claudia S.; Strauss, Kenneth I.; Teasdale, Graham; Temkin, Nancy; Tuma, Ronald; Wade, Charles; Walker, Michael D.; Weinrich, Michael; Whyte, John; Wilberger, Jack; Young, A. Byron; Yurkewicz, Lorraine

    2006-01-01

    Traumatic brain injury (TBI) remains a major public health problem globally. In the United States the incidence of closed head injuries admitted to hospitals is conservatively estimated to be 200 per 100,000 population, and the incidence of penetrating head injury is estimated to be 12 per 100,000, the highest of any developed country in the world. This yields an approximate number of 500,000 new cases each year, a sizeable proportion of which demonstrate signficant long-term disabilities. Unfortunately, there is a paucity of proven therapies for this disease. For a variety of reasons, clinical trials for this condition have been difficult to design and perform. Despite promising pre-clinical data, most of the trials that have been performed in recent years have failed to demonstrate any significant improvement in outcomes. The reasons for these failures have not always been apparent and any insights gained were not always shared. It was therefore feared that we were running the risk of repeating our mistakes. Recognizing the importance of TBI, the National Institute of Neurological Disorders and Stroke (NINDS) sponsored a workshop that brought together experts from clinical, research, and pharmaceutical backgrounds. This workshop proved to be very informative and yielded many insights into previous and future TBI trials. This paper is an attempt to summarize the key points made at the workshop. It is hoped that these lessons will enhance the planning and design of future efforts in this important field of research. PMID:12042091

  6. Planning an Academic Clinical Trial.

    PubMed

    Champion, Kim M; Jones, Gemma R

    2015-01-01

    Clinical trials are performed to discover or verify the efficacy and safety of one or more investigational medicinal product (IMP). Biological medicinal products, including gene therapies, offer groundbreaking new opportunities for the treatment of disease and injury, but they are also highly regulated and trials with these products can be logistically challenging to set up and execute. To ensure a compliant and successful trial, it is important to know and understand the regulatory framework, and to be aware of available guidance documents published to advise the different stakeholders on how to develop, manufacture, handle, administer, or destroy these products safely and legally. This chapter summarizes the standard requirements and considerations applicable for clinical trials with IMPs and also describes additional requirements for trials with gene therapies or genetically modified microorganisms (GMM).This chapter has been written from the perspective of a UK noncommercial (academic) sponsor. As such, the discussion and guidance has its basis in gene therapy research as governed by UK law. Nevertheless, European legislation and guidance documents are also referenced; most of the following recommendations will be applicable to clinical trials with a gene therapy medicinal product in any European Member State, and the overriding principles would be applicable to any trial. PMID:26072413

  7. 78 FR 5816 - Guidance for Industry on Clinical Pharmacogenomics: Premarket Evaluation in Early-Phase Clinical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ...FDA-2011-D-0082] Guidance for Industry on Clinical Pharmacogenomics: Premarket Evaluation in Early-Phase Clinical Studies and Recommendations for Labeling...a guidance for industry entitled ``Clinical Pharmacogenomics: Premarket...

  8. 77 FR 13513 - Modernizing the Regulation of Clinical Trials and Approaches to Good Clinical Practice; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ...FDA-2012-N-0170] Modernizing the Regulation of Clinical Trials and Approaches to Good Clinical Practice; Public Hearing; Request for Comments...and practices that apply to the conduct of clinical trials of FDA-regulated products....

  9. Clinical Trials: Information and Options for People with Mood Disorders

    MedlinePLUS

    Clinical Trials: Information and Options for People with Mood Disorders What are clinical trials? Clinical trials are research studies involving people, ... before the trial begins. What happens during a clinical trial? In some clinical trials, participants are given ...

  10. 21 CFR 862.3200 - Clinical toxicology calibrator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 2011-04-01 false Clinical toxicology calibrator. 862.3200 Section 862.3200...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3200 Clinical...

  11. 21 CFR 862.3200 - Clinical toxicology calibrator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 2013-04-01 false Clinical toxicology calibrator. 862.3200 Section 862.3200...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3200 Clinical...

  12. 21 CFR 862.3280 - Clinical toxicology control material.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 2011-04-01 false Clinical toxicology control material. 862.3280 Section 862...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3280 Clinical...

  13. 21 CFR 862.3280 - Clinical toxicology control material.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...2014-04-01 2014-04-01 false Clinical toxicology control material. 862.3280 Section 862...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3280 Clinical...

  14. 21 CFR 862.3200 - Clinical toxicology calibrator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 2012-04-01 false Clinical toxicology calibrator. 862.3200 Section 862.3200...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3200 Clinical...

  15. 21 CFR 862.3280 - Clinical toxicology control material.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 2012-04-01 false Clinical toxicology control material. 862.3280 Section 862...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3280 Clinical...

  16. 21 CFR 862.3280 - Clinical toxicology control material.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 2013-04-01 false Clinical toxicology control material. 862.3280 Section 862...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3280 Clinical...

  17. 21 CFR 862.3200 - Clinical toxicology calibrator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...2014-04-01 2014-04-01 false Clinical toxicology calibrator. 862.3200 Section 862.3200...MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3200 Clinical...

  18. Clinical Trials and Translational Research Advisory Committee

    Cancer.gov

    CCCT supports the NCI Clinical Trials and Translational Research Advisory Committee (CTAC), an external oversight committee that advises NCI leadership on ways to enhance NCI's clinical and translational research enterprises.

  19. Clinical Trials: Key to Medical Progress

    MedlinePLUS

    Skip Navigation Bar Home Current Issue Past Issues Clinical Trials: Key to Medical Progress Past Issues / Summer ... this page please turn Javascript on. Photo iStock Clinical trials are research studies that test how well ...

  20. NIH Clinical Research Trials and You

    MedlinePLUS

    ... the News “Why should I participate in a clinical trial?” It’s your involvement that helps researchers to ... Learn more about participating » The Basics Finding a Clinical Trial Personal Stories For Parents and Children Highlights ...

  1. Clinical Trials | Division of Cancer Prevention

    Cancer.gov

    Information about actively enrolling, ongoing, and completed clinical trials of cancer prevention, early detection, and supportive care, including phase I, II, and III agent and action trials and clinical trials management.

  2. National Institutes of Health, Clinical Center

    MedlinePLUS

    ... a life; become a blood donor today. More Clinical Center Grand Rounds Grand Round lectures are scheduled ... Amphitheater. See the lectures scheduled this month. More Clinical Center News View the latest issue of the ...

  3. Clinical Trials Shed Light on Minority Health

    MedlinePLUS

    ... Products For Consumers Home For Consumers Consumer Updates Clinical Trials Shed Light on Minority Health Share Tweet ... health disparities The importance of including minorities in clinical trials Research collaborations OMH Director Jonca Bull's perspective ...

  4. Clinical Pharmacy Education in a Dental Pharmacy

    ERIC Educational Resources Information Center

    Helling, Dennis K.; Walker, John A.

    1978-01-01

    A clinical pharmacy training program for undergraduate students developed at the University of Iowa provides conjoint training of pharmacy and dental students in the clinic areas and pharmacy at the College of Dentistry. (LBH)

  5. University of Canterbury Children's Auditory Processing Clinic

    E-print Network

    Hickman, Mark

    -based hearing training programs Children's Auditory Processing Clinic Communication Disorders Science How difficulties (often referred to as Auditory Processing Disorder, or APD) have normally functioning ears, and soUniversity of Canterbury Children's Auditory Processing Clinic Experienced audiologists and speech

  6. Clinical Trials Management | Division of Cancer Prevention

    Cancer.gov

    Information for researchers about developing, reporting, and managing NCI-funded cancer prevention clinical trials. Protocol Information Office The central clearinghouse for clinical trials management within the Division of Cancer Prevention.Read more about the Protocol Information Office.

  7. An ontology model for clinical documentation templates

    E-print Network

    George, Joyce, S.M. Massachusetts Institute of Technology

    2005-01-01

    There are various kinds of clinical documents used in a hospital or clinic setting. With the emergence of Electronic Medical Records, efforts are being made to computerize these documents in a structured fashion in order ...

  8. Perspectives on Clinical Informatics: Integrating Large-Scale Clinical, Genomic, and Health Information for Clinical Care

    PubMed Central

    Choi, In Young; Kim, Tae-Min; Kim, Myung Shin; Mun, Seong K.

    2013-01-01

    The advances in electronic medical records (EMRs) and bioinformatics (BI) represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO) aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population. PMID:24465229

  9. Clinical implementation of digital breast tomosynthesis.

    PubMed

    Conant, Emily F

    2014-05-01

    Digital breast tomosynthesis is rapidly being implemented in breast imaging clinics across the world as early clinical data demonstrate that this innovative technology may address some of the long-standing limitations of conventional mammography. This article reviews the recent clinical data supporting digital breast tomosynthesis implementation, the basics of digital breast tomosynthesis image interpretation using case-based illustrations, and potential issues to consider as this new technology is integrated into daily clinical use. PMID:24792652

  10. 42 CFR 70.9 - Vaccination clinics.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Vaccination clinics. 70.9 Section 70.9 Public... INTERSTATE QUARANTINE § 70.9 Vaccination clinics. (a) The Director may establish vaccination clinics, through contract or otherwise, authorized to administer vaccines and/or other prophylaxis. (b) A vaccination...

  11. 42 CFR 70.9 - Vaccination clinics.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Vaccination clinics. 70.9 Section 70.9 Public... INTERSTATE QUARANTINE § 70.9 Vaccination clinics. (a) The Director may establish vaccination clinics, through contract or otherwise, authorized to administer vaccines and/or other prophylaxis. (b) A vaccination...

  12. 42 CFR 70.9 - Vaccination clinics.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Vaccination clinics. 70.9 Section 70.9 Public... INTERSTATE QUARANTINE § 70.9 Vaccination clinics. (a) The Director may establish vaccination clinics, through contract or otherwise, authorized to administer vaccines and/or other prophylaxis. (b) A vaccination...

  13. 42 CFR 70.9 - Vaccination clinics.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Vaccination clinics. 70.9 Section 70.9 Public... INTERSTATE QUARANTINE § 70.9 Vaccination clinics. (a) The Director may establish vaccination clinics, through contract or otherwise, authorized to administer vaccines and/or other prophylaxis. (b) A vaccination...

  14. 42 CFR 70.9 - Vaccination clinics.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Vaccination clinics. 70.9 Section 70.9 Public... INTERSTATE QUARANTINE § 70.9 Vaccination clinics. (a) The Director may establish vaccination clinics, through contract or otherwise, authorized to administer vaccines and/or other prophylaxis. (b) A vaccination...

  15. Serving Inland Rural Communities through University Clinics

    ERIC Educational Resources Information Center

    Allan, Julaine; Pope, Rod; O'Meara, Peter; Higgs, Joy; Kent, Jenny

    2011-01-01

    Aim: To effectively provide clinical placements for students and increase healthcare options for rural communities, an investigation of university clinics was conducted. Method: This project adopted a consultative inquiry strategy and involved two processes: (1) a review of literature; and (2) interviews with existing health sciences clinic staff.…

  16. Studienordnung fr den weiterbildenden Masterstudiengang ,,Clinical Dental

    E-print Network

    Greifswald, Ernst-Moritz-Arndt-Universität

    Studienordnung für den weiterbildenden Masterstudiengang ,,Clinical Dental CAD/CAM" an der Ernst Masterstudiengang ,,Clinical Dental CAD/CAM" als Satzung: Inhaltsverzeichnis § 1 Geltungsbereich § 2 Studium § 3 Clinical Dental CAD/CAM vom 3. Dezember 2009. * Mittl.bl. BM M-V S. 511 Soweit für Funktionsbezeichnungen

  17. Measuring Clinical Significance in Rehabilitation Research

    ERIC Educational Resources Information Center

    Johnson, Erica K.; Dow, Christian; Lynch, Ruth T.; Hermann, Bruce P.

    2006-01-01

    Measurement of clinically significant change is critical for rehabilitation research because it can enhance the credibility of rehabilitation efforts and guide evidence-based practices. The practical appeal of clinically significant change is that it can bridge research and clinical practice by focusing on individual rather than group differences.…

  18. WESLEYAN UNIVERSITY HOCKEY GIRLS SKILLS CLINICS

    E-print Network

    Royer, Dana

    WESLEYAN UNIVERSITY HOCKEY GIRLS SKILLS CLINICS CLINIC 1: Saturday & Sunday, October 27.wesleyan.edu/athletics/wihockey/index.html TO SIGN UP QUESTIONS? CALL 860-685-2904 OR EMAIL JAMCKENNA@WESLEYAN.EDU #12;WESLEYAN HOCKEY GIRLS SKILLS ________________________ to participate in the WESLEYAN HOCKEY GIRLS SKILLS CLINIC offered by Wesleyan University beginning on or about

  19. Clinical Trials Information for Patients and Caregivers

    Cancer.gov

    Perhaps you are thinking about participating in a clinical trial. Or maybe you have a friend or family member with cancer and are wondering if a clinical trial is right for them. This section contains basic information about clinical trials, things to think about when deciding to take part and questions to ask your doctor.

  20. Motivating clinical nurses to write for publication.

    PubMed

    Sheridan, D R

    1994-01-01

    Clinical nurses know what works, what doesn't, and how to trouble shoot clinical problems. Yet, many hesitate to put their ideas into manuscript form. This nursing administrator shares successful strategies in motivating clinical nurses to write for publication. PMID:7849786

  1. DVM Curriculum Overview Vacation, elective introductory clinical

    E-print Network

    Chen, Tsuhan

    . The Animal Body (12 cr.) Veterinary Practice: Physical ExamVIIa. Physical Exam (1.5 cr.) II. Cell Biology.) IIIb. Function and Dysfunction (7 cr.) IV. Host, Agent and Defense (12 cr.)/ Vet. Parasitology (2.5 cr PBL Course VII: Veterinary Practice Clinics Group 1 Clinics Group 2 * Other Pre-clinical Foundation

  2. Clinical Psychology: A Research and Development Model.

    ERIC Educational Resources Information Center

    Broskowski, Anthony

    The purpose of this paper is to present a clinical research and development (R and D) model along with the rationale for its implementation and a sample training program for clinical psychologists. Although it may be possible to correct some problems by a clearer restatement of the scientist-professional model, a new model of clinical R and D has…

  3. Speech & Hearing Clinic College of Science

    E-print Network

    Hickman, Mark

    Speech & Hearing Clinic College of Science Department of Communication Disorders How to contact us: Please contact the Speech and Hearing Clinic during business hours to make an appointment. Clinical will tell you what we have learned about your child's speech and language and phonological awareness skills

  4. Clinical Facts, Turning Points and Complexity Theory

    ERIC Educational Resources Information Center

    Lush, Margaret

    2011-01-01

    In this paper, I explore how we might link ideas about clinical facts to current issues in child psychotherapy research. I consider what our understanding of clinical facts might contribute to our research methods and how our research methods might better represent the clinical facts. The paper introduces a selection of psychoanalytic writers'…

  5. Clinical Competence Assessments Fitness for Duty Evaluations

    E-print Network

    Gleeson, Joseph G.

    the quality of healthcare by offering clinical competence assessment and focused remedial education to medical Physician Assessment and Clinical Education (PACE) Program CME Offerings Custom Programs On-Site Education Assessment and Clinical Education (PACE) Program founded in 1996, the university of California, san Diego

  6. Promoting Collaborative Teaching in Clinical Education.

    ERIC Educational Resources Information Center

    Prystowsky, Jay B.; DaRosa, Debra A.; Thompson, Jason A.

    2001-01-01

    Surveyed clinical clerkship directors at a large medical school to determine which patient problems they regarded as critical or important to know. Found a significant overlap of the clinical curriculum between clerkships, suggesting multiple opportunities for faculty collaboration in clinical education. (EV)

  7. Writing software for the clinic.

    PubMed

    Rosen, I I

    1998-03-01

    Medical physicists often write computer programs to support scientific, educational, and clinical endeavors. Errors in scientific and educational software can waste time and effort by producing meaningless results, but errors in clinical software can contribute to patient injuries. Although the ultimate goal of error-free software is impossible to achieve except in very small programs, there are many good design, implementation, and testing practices that can be used by small development groups to significantly reduce errors, improve quality, and reduce maintenance. The software development process should include four basic steps: specifications, design, implementation, and testing. A specifications document defining what the software is intended to do is valuable for clearly delimiting the scope of the project and providing a benchmark for evaluating the final product. Keep the software design simple and straightforward. Document assumptions, and check them. Emphasize maintainability, portability, and reliability rather than speed. Use layers to isolate the application from hardware and the operating system. Plan for upgrades. Expect the software to be used in unplanned ways. Whenever possible, be generous with RAM and disk storage; hardware is cheaper than development and maintenance. During implementation, use well-known algorithms whenever possible. Use prototypes to try out ideas. Use generic modules, version numbering, unique file names, defensive programming, and operating system and language/compiler defaults. Avoid binary data files and clever tricks. Remember that real numbers are not exact in a computer. Get it right before making it faster. Document the software extensively. Test continuously during development; the later a problem is found, the more it costs to fix. Use a written procedure to test the final product exactly as a typical user would run it. Allow no changes after clinical release. Expect to spend at least an additional 50% of the initial development effort on testing, fixing errors, and getting the software into routine operation. PMID:9547497

  8. Clinical nutrition and drug interactions

    PubMed Central

    Ekincio?lu, Aygin Bayraktar; Demirkan, Kutay

    2013-01-01

    A drug’s plasma level, pharmacological effects or side effects, elimination, physicochemical properties or stability could be changed by interactions of drug-drug or drug-nutrition products in patients who receive enteral or parenteral nutritional support. As a result, patients might experience ineffective outcomes or unexpected effects of therapy (such as drug toxicity, embolism). Stability or incompatibility problems between parenteral nutrition admixtures and drugs might lead to alterations in expected therapeutic responses from drug and/or parenteral nutrition, occlusion in venous catheter or symptoms or mortality due to infusion of composed particles. Compatibilities between parenteral nutrition and drugs are not always guaranteed in clinical practice. Although the list of compatibility or incompatibilities of drugs are published for the use of clinicians in their practices, factors such as composition of parenteral nutrition admixture, drug concentration, contact time in catheter, temperature of the environment and exposure to light could change the status of compatibilities between drugs and nutrition admixtures. There could be substantial clinical changes occurring in the patient’s nutritional status and pharmacological effects of drugs due to interactions between enteral nutrition and drugs. Drug toxicity and ineffective nutritional support might occur as a result of those predictable interactions. Although administration of drugs via feeding tube is a complex and problematic route for drug usage, it is possible to minimise the risk of tube occlusion, decreased effects of drug and drug toxicity by using an appropriate technique. Therefore, it is important to consider pharmacological dosage forms of drugs while administering drugs via a feeding tube. In conclusion, since the pharmacists are well-experienced and more knowledgeable professionals in drugs and drug usage compared to other healthcare providers, it is suggested that provision of information and drug counselling by pharmacists in terms of detection and prevention of problems (such as interactions, stability, incompatibility) related with enteral/parenteral nutrition and drugs are invaluable in clinical practice. PMID:25931873

  9. Cough: an unmet clinical need

    PubMed Central

    Dicpinigaitis, Peter V

    2011-01-01

    Cough is among the most common complaints for which patients worldwide seek medical attention. Thus, the evaluation and treatment of cough result in tremendous financial expenditure and consumption of health care resources. Yet, despite the clinical significance of cough, research efforts aimed at improving diagnostic capabilities and developing more effective therapeutic agents have been, to date, disappointing in their limited scope and outcomes. Acute cough due to the common cold represents the most common type of cough. Currently, available medications for the symptomatic management of acute cough are inadequate due to lack of proven efficacy and/or their association with undesirable or intolerable side effects at anti-tussive doses. Subacute cough, often representing a prolonged post-viral response, is typically refractory to standard anti-tussive therapy. Few clinical trials have evaluated therapeutic options for subacute cough. Diagnostic challenges facing the clinician in the management of chronic cough include the determination of whether symptoms of upper airway cough syndrome (formerly, postnasal drip syndrome) or gastro-oesophageal reflux disease are indeed the underlying cause of cough. Chronic, refractory unexplained (formerly, idiopathic) cough must be distinguished from cough that has not been fully evaluated and treated according to current guideline recommendations. Eagerly awaited are new safe and effective anti-tussive agents for use when cough suppression is desired, regardless of underlying aetiology of cough, as well as practical, validated ambulatory cough counters to aid clinical assessment and future research in the field of cough. LINKED ARTICLES This article is part of a themed issue on Respiratory Pharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.163.issue-1 PMID:21198555

  10. Clinical guideline: management of gastroparesis.

    PubMed

    Camilleri, Michael; Parkman, Henry P; Shafi, Mehnaz A; Abell, Thomas L; Gerson, Lauren

    2013-01-01

    This guideline presents recommendations for the evaluation and management of patients with gastroparesis. Gastroparesis is identified in clinical practice through the recognition of the clinical symptoms and documentation of delayed gastric emptying. Symptoms from gastroparesis include nausea, vomiting, early satiety, postprandial fullness, bloating, and upper abdominal pain. Management of gastroparesis should include assessment and correction of nutritional state, relief of symptoms, improvement of gastric emptying and, in diabetics, glycemic control. Patient nutritional state should be managed by oral dietary modifications. If oral intake is not adequate, then enteral nutrition via jejunostomy tube needs to be considered. Parenteral nutrition is rarely required when hydration and nutritional state cannot be maintained. Medical treatment entails use of prokinetic and antiemetic therapies. Current approved treatment options, including metoclopramide and gastric electrical stimulation (GES, approved on a humanitarian device exemption), do not adequately address clinical need. Antiemetics have not been specifically tested in gastroparesis, but they may relieve nausea and vomiting. Other medications aimed at symptom relief include unapproved medications or off-label indications, and include domperidone, erythromycin (primarily over a short term), and centrally acting antidepressants used as symptom modulators. GES may relieve symptoms, including weekly vomiting frequency, and the need for nutritional supplementation, based on open-label studies. Second-line approaches include venting gastrostomy or feeding jejunostomy; intrapyloric botulinum toxin injection was not effective in randomized controlled trials. Most of these treatments are based on open-label treatment trials and small numbers. Partial gastrectomy and pyloroplasty should be used rarely, only in carefully selected patients. Attention should be given to the development of new effective therapies for symptomatic control. PMID:23147521

  11. Searching the Clinical Fitness Landscape

    PubMed Central

    Eppstein, Margaret J.; Horbar, Jeffrey D.; Buzas, Jeffrey S.; Kauffman, Stuart A.

    2012-01-01

    Widespread unexplained variations in clinical practices and patient outcomes suggest major opportunities for improving the quality and safety of medical care. However, there is little consensus regarding how to best identify and disseminate healthcare improvements and a dearth of theory to guide the debate. Many consider multicenter randomized controlled trials to be the gold standard of evidence-based medicine, although results are often inconclusive or may not be generally applicable due to differences in the contexts within which care is provided. Increasingly, others advocate the use “quality improvement collaboratives”, in which multi-institutional teams share information to identify potentially better practices that are subsequently evaluated in the local contexts of specific institutions, but there is concern that such collaborative learning approaches lack the statistical rigor of randomized trials. Using an agent-based model, we show how and why a collaborative learning approach almost invariably leads to greater improvements in expected patient outcomes than more traditional approaches in searching simulated clinical fitness landscapes. This is due to a combination of greater statistical power and more context-dependent evaluation of treatments, especially in complex terrains where some combinations of practices may interact in affecting outcomes. The results of our simulations are consistent with observed limitations of randomized controlled trials and provide important insights into probable reasons for effectiveness of quality improvement collaboratives in the complex socio-technical environments of healthcare institutions. Our approach illustrates how modeling the evolution of medical practice as search on a clinical fitness landscape can aid in identifying and understanding strategies for improving the quality and safety of medical care. PMID:23166791

  12. Urological diagnosis using clinical PACS

    NASA Astrophysics Data System (ADS)

    Mills, Stephen F.; Spetz, Kevin S.; Dwyer, Samuel J., III

    1995-05-01

    Urological diagnosis using fluoroscopy images has traditionally been performed using radiographic films. Images are generally acquired in conjunction with the application of a contrast agent, processed to create analog films, and inspected to ensure satisfactory image quality prior to being provided to a radiologist for reading. In the case of errors the entire process must be repeated. In addition, the radiologist must then often go to a particular reading room, possibly in a remote part of the healthcare facility, to read the images. The integration of digital fluoroscopy modalities with clinical PACS has the potential to significantly improve the urological diagnosis process by providing high-speed access to images at a variety of locations within a healthcare facility without costly film processing. The PACS additionally provides a cost-effective and reliable means of long-term storage and allows several medical users to simultaneously view the same images at different locations. The installation of a digital data interface between the existing clinically operational PACS at the University of Virginia Health Sciences Center and a digital urology fluoroscope is described. Preliminary user interviews that have been conducted to determine the clinical effectiveness of PACS workstations for urological diagnosis are discussed. The specific suitability of the workstation medium is discussed, as are overall advantages and disadvantages of the hardcopy and softcopy media in terms of efficiency, timeliness and cost. Throughput metrics and some specific parameters of gray-scale viewing stations and the expected system impacts resulting from the integration of a urology fluoroscope with PACS are also discussed.

  13. Evaluation of clinical practice guidelines.

    PubMed Central

    Basinski, A S

    1995-01-01

    Compared with the current focus on the development of clinical practice guidelines the effort devoted to their evaluation is meagre. Yet the ultimate success of guidelines depends on routine evaluation. Three types of evaluation are identified: evaluation of guidelines under development and before dissemination and implementation, evaluation of health care programs in which guidelines play a central role, and scientific evaluation, through studies that provide the scientific knowledge base for further evolution of guidelines. Identification of evaluation and program goals, evaluation design and a framework for evaluation planning are discussed. PMID:7489550

  14. Clinical associations of Dupuytren's disease

    PubMed Central

    Hart, M; Hooper, G

    2005-01-01

    Dupuytren's disease (DD) is a common progressive fibrotic condition affecting the palmar and digital fascia. Although its management is undertaken by hand surgeons, it is commonly seen by other doctors as an incidental finding. In many cases it is believed to be associated with other medical conditions, although the evidence for such associations is not always clear. This review considers the evidence behind these associations and discusses the aetiology of DD. By doing so, it is hoped that this review will permit a better understanding of the relevance of DD as a clinical sign. PMID:15998816

  15. [100 years' of clinical electrocardiography].

    PubMed

    Bergovec, Mijo

    2003-01-01

    In 1903 Willem Einthoven published in Pflügers Arch his classic article on the investigation of human electrocardiogram by his string galvanometer. Many historians of medicine, Einthoven also marked that publication as the beginning of clinical electrocardiography. Many investigators like Galvani, Manteucci, Kölliker, Müller, Lipmann, Waller, Ader, Einthoven, Lewis, Wilson and others participated in creation and development of electrocardiogram. From that time electrocardiogram quickly became, and has remained the most essential diagnostic laboratory tool in investigation of heart diseases. The aim of this article is to remind us of the beginning of this part of cardiology 100 years ago. PMID:15209030

  16. Informatics and the Clinical Laboratory

    PubMed Central

    Jones, Richard G; Johnson, Owen A; Batstone, Gifford

    2014-01-01

    The nature of pathology services is changing under the combined pressures of increasing workloads, cost constraints and technological advancement. In the face of this, laboratory systems need to meet new demands for data exchange with clinical electronic record systems for test requesting and results reporting. As these needs develop, new challenges are emerging especially with respect to the format and content of the datasets which are being exchanged. If the potential for the inclusion of intelligent systems in both these areas is to be realised, the continued dialogue between clinicians and laboratory information specialists is of paramount importance. Requirements of information technology (IT) in pathology, now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, ‘Informatics’ – the art and science of turning data into useful information – is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology – whether in implementing processes for pathology modernisation, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients – which requires critical assessment of the ever-increasing volume of information available – can also benefit greatly from appropriate use of informatics in enhancing self-management of long term conditions. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this review. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerised order entry, data security and recovery, and audit. We conclude that there is a need to rethink the architecture of pathology systems and in particular to address the changed environment in which electronic patient record systems are maturing rapidly. The opportunity for laboratory-based informaticians to work collaboratively with clinical systems developers to embed clinically intelligent decision support systems should not be missed. PMID:25336763

  17. Clinical uses of radiolabeled platelets

    SciTech Connect

    Datz, F.L.; Christian, P.E.; Baker, W.J.

    1985-12-01

    Platelets were first successfully radiolabeled in 1953. At that time, investigators were primarily interested in developing a technique to accurately measure platelet life span in both normal and thrombocytopenic patients. Studies using platelets labeled with /sup 51/Cr have shown shortened platelet survival times in a number of diseases including idiopathic thrombocytopenic purpura, coronary artery disease, and diabetes mellitus. More recently, labels such as /sup 111/In have been developed that allow in vivo imaging of platelets. Indium-111 platelets are being used to better understand the pathophysiology of atherosclerosis, thrombophlebitis, pulmonary embolism and clotting disorders, and to improve the clinical diagnosis of these diseases.

  18. Phenotypic mapping and clinical ideology

    SciTech Connect

    Lurie, I.W.; Opitz, J.M.

    1995-07-17

    Scientists have been trying to determine whether the main clinical findings in the 4p deletion syndrome are due to a deletion of one small critical segment, or whether deletions of some particular segments of 4p are responsible for different phenotypic manifestations. This is the basic issue for the whole group of autosomal deletion syndromes, as well as for our understanding of mechanisms of the origin of the abnormal phenotype. All circumstances need to be taken into consideration when trying to apply molecular methods for the mapping of phenotypic findings in the 4p deletion or in any other autosomal deletion syndrome. 8 refs.

  19. Informatics and the clinical laboratory.

    PubMed

    Jones, Richard G; Johnson, Owen A; Batstone, Gifford

    2014-08-01

    The nature of pathology services is changing under the combined pressures of increasing workloads, cost constraints and technological advancement. In the face of this, laboratory systems need to meet new demands for data exchange with clinical electronic record systems for test requesting and results reporting. As these needs develop, new challenges are emerging especially with respect to the format and content of the datasets which are being exchanged. If the potential for the inclusion of intelligent systems in both these areas is to be realised, the continued dialogue between clinicians and laboratory information specialists is of paramount importance. Requirements of information technology (IT) in pathology, now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, 'Informatics' - the art and science of turning data into useful information - is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology - whether in implementing processes for pathology modernisation, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients - which requires critical assessment of the ever-increasing volume of information available - can also benefit greatly from appropriate use of informatics in enhancing self-management of long term conditions. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this review. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerised order entry, data security and recovery, and audit. We conclude that there is a need to rethink the architecture of pathology systems and in particular to address the changed environment in which electronic patient record systems are maturing rapidly. The opportunity for laboratory-based informaticians to work collaboratively with clinical systems developers to embed clinically intelligent decision support systems should not be missed. PMID:25336763

  20. Introduction to veterinary clinical oncology

    SciTech Connect

    Weller, R.E.

    1991-10-01

    Veterinary clinical oncology involves a multidisciplinary approach to the recognition and management of spontaneously occurring neoplasms of domestic animals. This requires some knowledge of the causes, incidence, and natural course of malignant disease as it occurs in domestic species. The purpose of this course is to acquaint you with the more common neoplastic problems you will encounter in practice, so that you can offer your clients an informed opinion regarding prognosis and possible therapeutic modalities. A major thrust will be directed toward discussing and encouraging treatment/management of malignant disease. Multimodality therapy will be stressed. 10 refs., 3 tabs.

  1. Hypothermia as a clinical neuroprotectant.

    PubMed

    Sherman, Andrew L; Wang, Michael Y

    2014-08-01

    Applying therapeutic hypothermia (TH) for the purposes of neuroprotection, originally termed "hibernation," started nearly 100 years ago. Because TH cooling systems have improved to the point where it is practical and safe for general application, interest in providing such treatment in conditions such as spinal cord injury, traumatic brain injury, stroke, and cardiac arrest has increased. This article reviews the mechanisms by which TH mitigates secondary neurologic injury, the clinical scenarios where TH is being applied, and reviews selected published studies using TH for central nervous system neuroprotection. PMID:25064786

  2. New clinical pathways for keratoconus

    PubMed Central

    Gore, D M; Shortt, A J; Allan, B D

    2013-01-01

    Pre-2000, the clinical management of keratoconus centred on rigid contact lens fitting when spectacle corrected acuity was no longer adequate, and transplantation where contact lens wear failed. Over the last decade, outcome data have accumulated for new interventions including corneal collagen crosslinking, intracorneal ring implantation, topographic phototherapeutic keratectomy, and phakic intraocular lens implantation. We review the current evidence base for these interventions and their place in new management pathways for keratoconus under two key headings: corneal shape stabilisation and visual rehabilitation. PMID:23258309

  3. Sertindole: a clinical efficacy profile.

    PubMed

    Hale, A

    2002-01-01

    Sertindole is an effective atypical antipsychotic drug that is associated with significant improvements in the symptoms of schizophrenia. It is at least as efficacious as haloperidol and risperidone in treating the overall and positive symptoms of schizophrenia and has been shown to have advantages over these two drugs with respect to the treatment of the negative symptoms of schizophrenia. In clinical trials, notable improvements in patients' quality of life were observed, which suggest that patients prescribed sertindole would be more likely to adhere to treatment and continue taking the drug as part of their long-term treatment regimen. Continued treatment gives patients the best chance of avoiding relapse. Indeed, other benefits of sertindole demonstrated in clinical trials include relatively low relapse and re-admission rates. Sertindole could theoretically reduce the financial burden of schizophrenia on health- and social-care systems by reducing the need for re-hospitalization and by enabling patients to manage their illness and to live as normal a life as possible. PMID:24931885

  4. Ultrasound contrast agents: clinical applications.

    PubMed

    Jakobsen, J A

    2001-01-01

    Ultrasound contrast agents (USCA) for intravenous injections are usually gas-filled microbubbles with a mean diameter less than that of a red blood corpuscle. There are only a few products on the market at the time of this writing, but several companies have various agents under development. This paper covers both established USCA on the market, and some new agents under clinical evaluation. The potential of improving ultrasound imaging using USCA depends on several factors. These factors include the pharmacokinetic and pharmacodynamic properties of the products, which determine the effects they have on various ultrasound imaging techniques. Furthermore, the proper clinical application of the agents requires a combination of technical and medical knowledge by the examiner, dedicated equipment, a disease that can be diagnosed or characterised by ultrasound and USCA, and a cooperative patient. Taking into account these factors, USCA can be used for improving the detection, characterisation and follow-up of diseases of several vascular beds and parenchymal organs from head to foot. PMID:11519539

  5. Sixty years of clinical electroencephalography.

    PubMed

    Karbowski, K

    1990-01-01

    As a result of painstaking studies carried out over a period of almost 30 years, the German neurologist and psychiatrist Hans Berger, of Jena, published the first paper on the human electroencephalogram (Uber das Elektrenkephalogramm des Menschen') in 1929. Clinical electroencephalography, which reached a zenith in the 1950s and 1960s, increased the range of diagnostic techniques available for a series of brain diseases and revolutionized the study of epilepsy. Today, conventional electroencephalography no longer yields startling scientific discoveries. Nor can it complete with computer tomography and magnetic resonance imaging, in the diagnosis of structural disorders of the brain. In spite of this, the scope of its uses continues to increase and it remains an indispensable instrument of neurophysiological diagnosis, especially in its capacity as a 'seismograph' of the brain. The trend that is apparent throughout the world to cut back clinical electroencephalographic units in favor of other neurophysiological investigative techniques is both unjustified and dangerous. If it continues, it will inevitably lead to a decline in epileptology, which is an essential part of the work of many different medical specialists both in practice and in hospitals. PMID:2192889

  6. Clinical status of benzoporphyrin derivative

    NASA Astrophysics Data System (ADS)

    Levy, Julia G.; Chan, Agnes H.; Strong, H. Andrew

    1996-01-01

    Benzoporphyrin derivative monoacid ring A (BPD) is currently in Phase II clinical trials for the treatment of cutaneous malignancies (basal cell carcinoma and cutaneous metastases) and psoriasis. Results to date suggest that this photosensitizer has potential in both of these areas. Recently, a clinical trial with BPD was initiated for the treatment of age related macular degeneration, a neovascular condition in the eye which leads to blindness. BPD is a lipophilic photosensitizer which is rapidly taken up by activated cells and the vascular endothelium of neovasculature. The PDT effects seen with BPD appear to be a combination of vascular occlusion and direct killing of target cells. Since many diseases involve either activated cells and/or neovasculature, PDT with photosensitizer with characteristics like those of BPD, has applications far wider than oncology. A new area of interest involving photosensitizers is that of immune modulation. A number of photosensitizers have been shown to effect immune modulation in animal models of immune dysfunction including autoimmunity (rheumatoid arthritis, lupus), cutaneous hypersensitivity and allografts. BPD and PHOTOFRINR have both been shown to be effective in ameliorating arthritic symptoms in a number of animal models. The mechanisms by which immune modulation is affected in these studies still remains to be resolved.

  7. Clinical Proteomics of Breast Cancer

    PubMed Central

    Bask?n, Y.; Yi?itba??, T.

    2010-01-01

    Despite the lifetimes that increased in breast cancers due to the the early screening programs and new therapeutic strategies, many cases still are being lost due to the metastatic relapses. For this reason, new approaches such as the proteomic techniques have currently become the prime objectives of breast cancer researches. Various omic-based techniques have been applied with increasing success to the molecular characterisation of breast tumours, which have resulted in a more detailed classification scheme and have produced clinical diagnostic tests that have been applied to both the prognosis and the prediction of outcome to the treatment. Implementation of the proteomics-based techniques is also seen as crucial if we are to develop a systems biology approach in the discovery of biomarkers of the early diagnosis, prognosis and prediction of the outcome of the breast cancer therapies. In this review, we discuss the studies that have been conducted thus far, for the discovery of diagnostic, prognostic and predictive biomarkers, and evaluate the potential of the discriminating proteins identified in this research for clinical use as breast cancer biomarkers. PMID:21532837

  8. Interpreting and using clinical trials.

    PubMed

    Doig, G S

    1998-07-01

    In 1754, aboard HMS Salisbury, James Lind conducted a simple, controlled clinical trial. He took 12 patients with "pale and bloated skin, listlessness, an aversion to exercise, swollen gums, halitosis, ecchymotic mucous membranes, and limb edema" and allocated them to receive treatment with one of six different therapies. Since the patients receiving two of his six chosen interventions had such a dramatic recovery, he felt ethically obligated to end his trial and administer these treatments to all the remaining sailors. Today we fully recognize the impact that the controlled clinical trial can have on the development of new interventions. Unfortunately, very few of these interventions are likely to have as dramatic an impact on outcomes as lemons and oranges did on scurvy. Because the interventions we study tend to have relatively small treatment effects, and because the design and reporting of published RCTs has consistently been documented to be less than perfect, there is a real need for us to develop critical appraisal skills. This article is by no means the only approach to critical appraisal, but hopefully it serves as an adequate starting point for the journey. PMID:9700445

  9. Clinical use of profiled hemodialysis.

    PubMed

    Colì, L; Bonomini, M; La Manna, G; Dalmastri, V; Ursino, M; Ivanovich, P; Bonomini, V

    1998-09-01

    The new population on dialysis today consists mainly of high risk patients (the elderly, diabetics, etc.) with high cardiovascular scores, and such vascular pathology is the most important predisposing factor for the occurrence of a frequent intradialytic clinical complication, vascular instability syndrome, which covers a range of clinical problems. Recently a new dialysis technique, profiled hemodialysis (PHD), has been set up and proposed for routine use. PHD consists of the clinical use of preestablished individual dialysis profiles aimed at antagonizing the changes in intradialytic plasma osmolarity by continuous modulation of dialysate sodium concentration throughout the whole extracorporeal session. In particular, PHD aims at reducing the fall of plasma osmolarity in the first half of the session (when it is higher) by reducing the sodium removal rate through increasing its dialysate concentration while taking into account the desired individual sodium balance to be reached at the end of the session. In this work, we report clinical experience with PHD compared to standard hemodialysis with constant sodium dialysate (SHD) in terms of its efficacy to maintain a more stable intradialytic blood volume (BV) and more stable hemodynamics. The PHD used in this work has been implemented by a mathematical model for computing the individual dialysate sodium profile which we have recently validated (Ursino M, Coli L, La Manna G, Grilli Cicilioni M, Dalmastri V, Guidicissi A, Masotti P, Avanzolini G, Stefani S, Bonomini V. A simple mathematical model of intradialytic sodium kinetics: "in vivo" validation during hemodialysis with constant or variable sodium. Int J Artif Organs 1996;19:393-403.). Eleven uremic patients affected by hypotension at the beginning of dialysis treatment were studied. Each patient first underwent an SHD treatment and 1 week later a PHD treatment. The 2 extracorporeal sessions (one on SHD and the other on PHD) were performed in each individual patient under identical operative conditions including the sodium mass removal by the end of the session and the ultrafiltration rate. The crit line and Doppler echocardiography were used to determine BV, cardiac output (CO), and stroke volume (SV) throughout the sessions. The mean blood pressure (MBP) and heart rate (HR) were simultaneously monitored. PHD was associated with a more stable intradialytic BV and more stable hemodynamics compared to SHD. The higher stability of BV and cardiac function (in terms of SV and CO maintenance) which was obtained above all in the first half of the PHD session was associated with a higher stability of the MBP and the HR. This resulted in an enhancement in cardiovascular tolerance to ultrafiltration throughout the session in all tested patients. In contrast, SHD in the same patients was characterized by early significant changes in BV and cardiovascular parameters resulting in a significant decrease of the MBP and a significant increase of the HR throughout the session and also 1 h after the end of dialysis. Our results indicate that PHD may represent an efficient approach for the treatment of patients suffering from intradialytic vascular instability. If long-term clinical practice confirms the efficacy of PHD in controlling dialysis intolerance symptoms, it will have great scope as a routine procedure. PMID:9754456

  10. "Clinical" Significance: "Clinical" Significance and "Practical" Significance are NOT the Same Things

    ERIC Educational Resources Information Center

    Peterson, Lisa S.

    2008-01-01

    Clinical significance is an important concept in research, particularly in education and the social sciences. The present article first compares clinical significance to other measures of "significance" in statistics. The major methods used to determine clinical significance are explained and the strengths and weaknesses of clinical significance…

  11. How Does Gender Interact with Clinical Teachers' Perceptions of Clinical Teaching?

    ERIC Educational Resources Information Center

    Masunaga, Hiromi; Hitchcock, Maurice A.

    2011-01-01

    This study analyzed 816 medical professors' perceptions of clinical teaching, as measured with the online version of the Clinical Teaching Perception Inventory, and examined difficulties that female professors faced in becoming the ideal clinical teacher. While describing themselves as a clinical teacher, female professors rated themselves lower…

  12. 78 FR 13347 - Clinical Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... HUMAN SERVICES Food and Drug Administration Clinical Chemistry and Clinical Toxicology Devices Panel of... and Drug Administration (FDA). The meeting will be open to the public. Name of Committee: Clinical Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory Committee. General...

  13. 77 FR 35407 - Proposed Collection; Comment Request: Clinical Mythteries: A Video Game About Clinical Trials

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ... HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request: Clinical Mythteries: A Video Game About Clinical Trials SUMMARY: In compliance with the requirement of Section 3506(c)(2... Collection: Title: Clinical Mythteries: A Video Game About Clinical Trials. Type of Information...

  14. Respiratory microbiota: addressing clinical questions, informing clinical practice

    PubMed Central

    Rogers, Geraint B; Shaw, Dominick; Marsh, Robyn L; Carroll, Mary P; Serisier, David J; Bruce, Kenneth D

    2015-01-01

    Over the last decade, technological advances have revolutionised efforts to understand the role played by microbes in airways disease. With the application of ever more sophisticated techniques, the literature has become increasingly inaccessible to the non-specialist reader, potentially hampering the translation of these gains into improvements in patient care. In this article, we set out the key principles underpinning microbiota research in respiratory contexts and provide practical guidance on how best such studies can be designed, executed and interpreted. We examine how an understanding of the respiratory microbiota both challenges fundamental assumptions and provides novel clinical insights into lung disease, and we set out a number of important targets for ongoing research. PMID:25035125

  15. Respiratory microbiota: addressing clinical questions, informing clinical practice.

    PubMed

    Rogers, Geraint B; Shaw, Dominick; Marsh, Robyn L; Carroll, Mary P; Serisier, David J; Bruce, Kenneth D

    2015-01-01

    Over the last decade, technological advances have revolutionised efforts to understand the role played by microbes in airways disease. With the application of ever more sophisticated techniques, the literature has become increasingly inaccessible to the non-specialist reader, potentially hampering the translation of these gains into improvements in patient care. In this article, we set out the key principles underpinning microbiota research in respiratory contexts and provide practical guidance on how best such studies can be designed, executed and interpreted. We examine how an understanding of the respiratory microbiota both challenges fundamental assumptions and provides novel clinical insights into lung disease, and we set out a number of important targets for ongoing research. PMID:25035125

  16. Republished: Respiratory microbiota: addressing clinical questions, informing clinical practice.

    PubMed

    Rogers, Geraint B; Shaw, Dominick; Marsh, Robyn L; Carroll, Mary P; Serisier, David J; Bruce, Kenneth D

    2015-08-01

    Over the last decade, technological advances have revolutionised efforts to understand the role played by microbes in airways disease. With the application of ever more sophisticated techniques, the literature has become increasingly inaccessible to the non-specialist reader, potentially hampering the translation of these gains into improvements in patient care. In this article, we set out the key principles underpinning microbiota research in respiratory contexts and provide practical guidance on how best such studies can be designed, executed and interpreted. We examine how an understanding of the respiratory microbiota both challenges fundamental assumptions and provides novel clinical insights into lung disease, and we set out a number of important targets for ongoing research. PMID:26304986

  17. Republished: Respiratory microbiota: addressing clinical questions, informing clinical practice

    PubMed Central

    Rogers, Geraint B; Shaw, Dominick; Marsh, Robyn L; Carroll, Mary P; Serisier, David J; Bruce, Kenneth D

    2015-01-01

    Over the last decade, technological advances have revolutionised efforts to understand the role played by microbes in airways disease. With the application of ever more sophisticated techniques, the literature has become increasingly inaccessible to the non-specialist reader, potentially hampering the translation of these gains into improvements in patient care. In this article, we set out the key principles underpinning microbiota research in respiratory contexts and provide practical guidance on how best such studies can be designed, executed and interpreted. We examine how an understanding of the respiratory microbiota both challenges fundamental assumptions and provides novel clinical insights into lung disease, and we set out a number of important targets for ongoing research. PMID:26304986

  18. Credentialing for participation in clinical trials

    PubMed Central

    Followill, David S.; Urie, Marcia; Galvin, James M.; Ulin, Kenneth; Xiao, Ying; FitzGerald, Thomas J.

    2012-01-01

    The National Cancer Institute (NCI) clinical cooperative groups have been instrumental over the past 50 years in developing clinical trials and evidence-based clinical trial processes for improvements in patient care. The cooperative groups are undergoing a transformation process to launch, conduct, and publish clinical trials more rapidly. Institutional participation in clinical trials can be made more efficient and include the expansion of relationships with international partners. This paper reviews the current processes that are in use in radiation therapy trials and the importance of maintaining effective credentialing strategies to assure the quality of the outcomes of clinical trials. The paper offers strategies to streamline and harmonize credentialing tools and processes moving forward as the NCI undergoes transformative change in the conduct of clinical trials. PMID:23272300

  19. Clinical judgement and the medical profession

    PubMed Central

    Kienle, Gunver S; Kiene, Helmut

    2011-01-01

    Objectives Clinical judgment is a central element of the medical profession, essential for the performance of the doctor, and potentially generating information also for other clinicians and for scientists and health care managers. The recently renewed interest in clinical judgement is primarily engaged with its role in communication, diagnosis and decision making. Beyond this issue, the present article highlights the interrelations between clinical judgement, therapy assessment and medical professionalism. Methods Literature review and theory development. Results The article presents different methodological approaches to causality assessment in clinical studies and in clinical judgement, and offers criteria for clinical single case causality. The article outlines models of medical professionalism such as technical rationality and practice epistemology, and characterizes features of professional expertise such as tacit knowledge, reflection in action, and gestalt cognition. Conclusions Consequences of a methodological and logistical advancement of clinical judgment are discussed, both in regard to medical progress and to the renewel of the cognitive basis of the medical profession. PMID:20973873

  20. PEDIATRIC PROVIDERS’ ATTITUDES TOWARD RETAIL CLINICS

    PubMed Central

    Garbutt, Jane M.; Mandrell, Kathy M.; Sterkel, Randall; Epstein, Jay; Stahl, Kristin; Kreusser, Katherine; O’Neil, Jerome; Sitrin, Harold; Ariza, Adolfo; Reis, Evelyn Cohen; Siegel, Robert; Pascoe, John; Strunk, Robert C.

    2013-01-01

    Objective To describe pediatric primary care providers’ attitudes toward retail clinics and their experiences of retail clinics use by their patients. Study design A 51-item, self-administered survey from four pediatric practice-based research networks from the Midwestern United States, which gauged providers’ attitudes toward and perceptions of their patients’ interactions with retail clinics, and changes to office practice to better compete. Results A total of 226 providers participated (50% response). Providers believed that retail clinics were a business threat (80%) and disrupted continuity of chronic disease management (54%). Few (20%) agreed that retail clinics provided care within recommended clinical guidelines. Most (91%) reported that they provided additional care after a retail clinic visit (median 1–2 times per week) and 37% felt this resulted from suboptimal care at retail clinics “most or all of the time.” Few (15%) reported being notified by the retail clinic within 24 hours of a patient visit. Those reporting prompt communication were less likely to report suboptimal retail clinic care (OR 0.20, 95%CI 0.10 to 0.42) or disruption in continuity of care (OR 0.32, 95%CI 0.15 to 0.71). Thirty-six percent reported changes to office practice to compete with retail clinics (most commonly adjusting or extending office hours) and change was more likely if retail clinics were perceived as a threat (OR 3.70, 95%CI 1.56 to 8.76); 30% planned to make changes in the near future. Conclusions Based on the perceived business threat, pediatric providers are making changes to their practice to compete with retail clinics. Improved communication between the clinic and providers may improve collaboration. PMID:23810720

  1. Clinical knowledge governance: the international perspective.

    PubMed

    Garde, Sebastian

    2013-01-01

    As a basis for semantic interoperability, ideally, a Clinical Knowledge Resource for a clinical concept should be defined formally and defined once in a way that all clinical professions and all countries can agree on. Clinical Knowledge Governance is required to create high-quality, reusable Clinical Knowledge Resources and achieve this aim. Traditionally, this is a time-consuming and cumbersome process, relying heavily on face-to-face meetings and being able to get sufficient input from clinicians. However, in a national or even international space, it is required to streamline the processes involved in creating Clinical Knowledge Resources. For this, a Web 2.0 tool that supports online collaboration of clinicians during their creation and publishing of Clinical Knowledge Resources has been developed. This tool is named the Clinical Knowledge Manager (CKM) and supports the development, review and publication of Clinical Knowledge Resources. Also, post-publication activities such as adding terminology bindings, translating the Clinical Knowledge Resource into another language and republishing it are supported. The acceptance of Clinical Knowledge Resources depends on their quality and being able to determine their quality, for example it is important to know that a broad umber of reviewers from various clinical disciplines have been involved in the development of the Clinical Knowledge Resource. We are still far from realizing the vision of a global repository of a great number of reusable, high-quality Clinical Knowledge Resources, which can provide the basis for broad semantic interoperability between systems. However progress towards this aim is being made around the world. PMID:24018522

  2. Perilous periodontitis: a clinical study.

    PubMed

    Emmanuel, Roby V; Neelakantan, Shiba

    2011-12-01

    The aim of this study is to determine whether periodontitis in pregnant women could be a risk factor for pre term low birth weight. The oral hygiene status, periodontal status and periodontal treatment needs of mothers who birthed infants with normal birth weight and normal gestation period (group A) and mothers who birthed pre term low birth weight infants (group B) were assessed and compared. The clinical parameters used were Oral Hygiene Index--simplified (OHI-S), gingival bleeding index (GBI), probing pocket depth and Community Periodontal Index of Treatment Needs (CPITN). This article presents the study and its findings and draws conclusions as to the relationship between poor periodontal condition and pre term low birth weight. PMID:22216586

  3. Clinical assessment of auditory dysfunction.

    PubMed Central

    Thomas, W G

    1982-01-01

    Many drugs, chemical substances and agents are potentially toxic to the human auditory system. The extent of toxicity depends on numerous factors. With few exceptions, toxicity in the auditory system affects various organs or cells within the cochlea or vestibular system, with brain stem and other central nervous system involvement reported with some chemicals and agents. This ototoxicity usually presents as a decrease in auditory sensitivity, tinnitus and/or vertigo or loss of balance. Classical and newer audiological techniques used in clinical assessment are beneficial in specifying the site of lesion in the cochlea, although auditory test results, themselves, give little information regarding possible pathology or etiology within the cochlea. Typically,, ototoxicity results in high frequency hearing loss, progressive as a function of frequency, usually accompanied by tinnitus and occasionally by vertigo or loss of balance. Auditory testing protocols are necessary to document this loss in auditory function. PMID:7044778

  4. Chloracne. Clinical manifestations and etiology

    SciTech Connect

    Zugerman, C. )

    1990-01-01

    Chloracne is a rare but important acneiform eruption often associated with the ingestion of chlorinated phenolic agents such as dioxins with subsequent toxicity from these chemicals. Clinically, chloracne can be distinguished from acne vulgaris by the distribution and appearance of the lesions and by taking a detailed history. In some instances, it may be associated with particularly xerotic skin, pigmentation, follicular hyperkeratosis, conjunctivitis, and actinic elastosis. Histologically, the primary lesion is a follicular plug containing keratinous material. Chloracne is difficult if not impossible to treat adequately and once present, may persist for years. Consequently, good hygiene, safe manufacturing processes so that no inhalation or skin contact is possible, and the elimination of atmospheric contamination are all necessary in the prevention of this potentially debilitating disease.34 references.

  5. Tissue Microarrays in Clinical Oncology

    PubMed Central

    Voduc, David; Kenney, Challayne; Nielsen, Torsten O.

    2008-01-01

    The tissue microarray is a recently-implemented, high-throughput technology for the analysis of molecular markers in oncology. This research tool permits the rapid assessment of a biomarker in thousands of tumor samples, using commonly available laboratory assays such as immunohistochemistry and in-situ hybridization. Although introduced less than a decade ago, the TMA has proven to be invaluable in the study of tumor biology, the development of diagnostic tests, and the investigation of oncological biomarkers. This review describes the impact of TMA-based research in clinical oncology and its potential future applications. Technical aspects of TMA construction, and the advantages and disadvantages inherent to this technology are also discussed. PMID:18314063

  6. Introducing students to clinical audit.

    PubMed

    Parkes, Jacqueline; O'Dell, Cindy

    2015-11-01

    It is more than a decade since the UK Central Council for Nursing Midwifery and Health Visiting said that engaging with clinical audit is 'the business of every registered practitioner', yet there appears to be little evidence that nursing has embraced the process. To address this issue, Northampton General Hospital and the University of Northampton implemented a pilot project in which two third-year adult nursing students worked on a 'real life' audit. Supported by the hospital's audit department, and supervised by academic tutors with the relevant experience, the students worked on a pressure-ulcer care audit for their final year dissertation. This article describes the process undertaken by the hospital audit team and the university academic team to develop the pilot project and support the students. Based on the positive evaluations, the university has extended the project to a second phase, incorporating two new partner organisations. PMID:26508069

  7. Clinical encounters with internet pornography.

    PubMed

    Kalman, Thomas P

    2008-01-01

    Abstract Pornography, if understood to involve the depiction of sexual activity, organs, and experiences, is perhaps as old as human civilization itself. Historically linked to various technological innovations, pornography viewing in the Internet age has reached epic proportions, with large numbers of individuals taking advantage of ease of access, affordability, and presumed anonymity to explore sexual material online. Within the mental health professions substantial research exists on the effects of viewing general pornography; however, the distinctive effects of the marriage of pornography and cyberspace is only beginning to be examined. In addition to reviewing some historical and statistical material about pornography and the relevant psychiatric and psychoanalytic literature, four detailed clinical vignettes are presented to illustrate the types of problems related to Internet pornography use that are being presented to practicing psychotherapists. PMID:19113956

  8. Gestational diabetes: A clinical update

    PubMed Central

    Kampmann, Ulla; Madsen, Lene Ring; Skajaa, Gitte Oeskov; Iversen, Ditte Smed; Moeller, Niels; Ovesen, Per

    2015-01-01

    Gestational diabetes mellitus (GDM) is increasing in prevalence in tandem with the dramatic increase in the prevalence of overweight and obesity in women of childbearing age. Much controversy surrounds the diagnosis and management of gestational diabetes, emphasizing the importance and relevance of clarity and consensus. If newly proposed criteria are adopted universally a significantly growing number of women will be diagnosed as having GDM, implying new therapeutic challenges to avoid foetal and maternal complications related to the hyperglycemia of gestational diabetes. This review provides an overview of clinical issues related to GDM, including the challenges of screening and diagnosis, the pathophysiology behind GDM, the treatment and prevention of GDM and the long and short term consequences of gestational diabetes for both mother and offspring. PMID:26240703

  9. Clinical management of progressive myopia.

    PubMed

    Aller, T A

    2014-02-01

    Myopia has been increasing in prevalence throughout the world, reaching over 90% in some East Asian populations. There is increasing evidence that whereas genetics clearly have an important role, the type of visual environment to which one is exposed to likely influences the onset, progression, and cessation of myopia. Consequently, attempts to either modify the environment or to reduce the exposure of the eye to various environmental stimuli to eye growth through the use of various optical devices are well under way at research centers around the globe. The most promising of current treatments include low-percentage atropine, bifocal soft contact lenses, orthokeratology, and multifocal spectacles. These methods are discussed briefly and are then categorized in terms of their expected degree of myopia progression control. A clinical strategy is presented for selecting the most effective treatment for the appropriate type of patient at the optimal stage of refractive development to achieve the maximum control of myopia progression. PMID:24357844

  10. Clinical management of progressive myopia

    PubMed Central

    Aller, T A

    2014-01-01

    Myopia has been increasing in prevalence throughout the world, reaching over 90% in some East Asian populations. There is increasing evidence that whereas genetics clearly have an important role, the type of visual environment to which one is exposed to likely influences the onset, progression, and cessation of myopia. Consequently, attempts to either modify the environment or to reduce the exposure of the eye to various environmental stimuli to eye growth through the use of various optical devices are well under way at research centers around the globe. The most promising of current treatments include low-percentage atropine, bifocal soft contact lenses, orthokeratology, and multifocal spectacles. These methods are discussed briefly and are then categorized in terms of their expected degree of myopia progression control. A clinical strategy is presented for selecting the most effective treatment for the appropriate type of patient at the optimal stage of refractive development to achieve the maximum control of myopia progression. PMID:24357844

  11. Gynecomastia: Clinical evaluation and management

    PubMed Central

    Cuhaci, Neslihan; Polat, Sefika Burcak; Evranos, Berna; Ersoy, Reyhan; Cakir, Bekir

    2014-01-01

    Gynecomastia is the benign enlargement of male breast glandular tissue and is the most common breast condition in males. At least 30% of males will be affected during their life. Since it causes anxiety, psychosocial discomfort and fear of breast cancer, early diagnostic evaluation is important and patients usually seek medical attention. Gynecomastia was reported to cause an imbalance between estrogen and androgen action or an increased estrogen to androgen ratio, due to increased estrogen production, decreased androgen production or both. Evaluation of gynecomastia must include a detailed medical history, clinical examination, specific blood tests, imaging and tissue sampling. Individual treatment requirements can range from simple reassurance to medical treatment or even surgery. The main aim of any intervention is to relieve the symptoms and exclude other etiological factors. PMID:24741509

  12. Clinical anatomy of the knee.

    PubMed

    Saavedra, Miguel Ángel; Navarro-Zarza, José Eduardo; Villaseñor-Ovies, Pablo; Canoso, Juan J; Vargas, Angélica; Chiapas-Gasca, Karla; Hernández-Díaz, Cristina; Kalish, Robert A

    The clinical anatomy of several pain syndromes of the knee is herein discussed. These include the iliotibial tract syndrome, the anserine syndrome, bursitis of the medial collateral ligament, Baker's cyst, popliteus tendon tenosynovitis and bursitis of the deep infrapatellar bursa. These syndromes are reviewed in terms of the structures involved and their role in knee physiology. All of the discussed structures can be identified in their normal state and more so when they are affected by disease. The wealth of information gained by cross examination of the medial, lateral, posterior and anterior aspects of the knee brings to life knowledge acquired at the dissection table, from anatomical drawings and from virtual images. PMID:23219082

  13. Expert Systems in Clinical Microbiology

    PubMed Central

    Winstanley, Trevor; Courvalin, Patrice

    2011-01-01

    Summary: This review aims to discuss expert systems in general and how they may be used in medicine as a whole and clinical microbiology in particular (with the aid of interpretive reading). It considers rule-based systems, pattern-based systems, and data mining and introduces neural nets. A variety of noncommercial systems is described, and the central role played by the EUCAST is stressed. The need for expert rules in the environment of reset EUCAST breakpoints is also questioned. Commercial automated systems with on-board expert systems are considered, with emphasis being placed on the “big three”: Vitek 2, BD Phoenix, and MicroScan. By necessity and in places, the review becomes a general review of automated system performances for the detection of specific resistance mechanisms rather than focusing solely on expert systems. Published performance evaluations of each system are drawn together and commented on critically. PMID:21734247

  14. Clinical considerations for biosimilar antibodies

    PubMed Central

    Mellstedt, Håkan

    2013-01-01

    Biosimilar agents are approximate copies of branded biologic therapies. Since the first biosimilar was authorized in the European Union in 2006, fifteen additional agents have been approved by the European Medicines Agency, including two biosimilar monoclonal antibodies (mAbs). Biosimilar mAbs represent a distinct class given their large molecular size, complex protein structure, and post-translational modifications. While guidelines have been established for the development, approval, and use of biosimilars, further scrutiny and discussion is necessary to fully understand their potential impact on clinical outcomes. This review takes a critical look at the structural complexity of biosimilar mABs, the feasibility of indication extrapolation, the impact of product variability on immunogenicity, the importance of comprehensive pharmacovigilance, and the potential for ongoing pharmacoeconomic impact. PMID:26217160

  15. Clinical assessment of vascular calcification.

    PubMed

    Raggi, Paolo; Bellasi, Antonio

    2007-01-01

    Cardiovascular calcification poses an increased risk for cardiovascular events in advanced phases of chronic kidney disease. This evidence has brought many investigators to focus their attention on the importance of detection of calcification and avoidance of further development of it with appropriate therapeutic choices. Physicians can use a variety of noninvasive imaging tools to identify cardiovascular calcification, some with merely qualitative and others with both qualitative and quantitative capabilities. Plain x-rays and ultrasonography can be used to identify macroscopic calcification of aorta and peripheral arteries, echocardiography is helpful for assessment of valvular calcification, and computed tomography technologies constitute the gold standard for quantification of cardiovascular calcification. The latter is also useful to monitor calcification progression and to assess the effect of different therapeutic strategies directed at modifying calcification progression. In this article, we review the clinical significance of vascular calcification and some of the evidence surrounding the most commonly employed noninvasive imaging techniques. PMID:17200042

  16. Towards advanced OCT clinical applications

    NASA Astrophysics Data System (ADS)

    Kirillin, Mikhail; Panteleeva, Olga; Agrba, Pavel; Pasukhin, Mikhail; Sergeeva, Ekaterina; Plankina, Elena; Dudenkova, Varvara; Gubarkova, Ekaterina; Kiseleva, Elena; Gladkova, Natalia; Shakhova, Natalia; Vitkin, Alex

    2015-07-01

    In this paper we report on our recent achievement in application of conventional and cross-polarization OCT (CP OCT) modalities for in vivo clinical diagnostics in different medical areas including gynecology, dermatology, and stomatology. In gynecology, CP OCT was employed for diagnosing fallopian tubes and cervix; in dermatology OCT for monitoring of treatment of psoriasis, scleroderma and atopic dermatitis; and in stomatology for diagnosis of oral diseases. For all considered application, we propose and develop different image processing methods which enhance the diagnostic value of the technique. In particular, we use histogram analysis, Fourier analysis and neural networks, thus calculating different tissue characteristics as revealed by OCT's polarization evolution. These approaches enable improved OCT image quantification and increase its resultant diagnostic accuracy.

  17. Human Schistosomiasis: Clinical Perspective: Review

    PubMed Central

    Barsoum, Rashad S.; Esmat, Gamal; El-Baz, Tamer

    2013-01-01

    The clinical manifestations of schistosomiasis pass by acute, sub acute and chronic stages that mirror the immune response to infection. The later includes in succession innate, TH1 and TH2 adaptive stages, with an ultimate establishment of concomitant immunity. Some patients may also develop late complications, or suffer the sequelae of co-infection with other parasites, bacteria or viruses. Acute manifestations are species-independent; occur during the early stages of invasion and migration, where infection-naivety and the host’s racial and genetic setting play a major role. Sub acute manifestations occur after maturity of the parasite and settlement in target organs. They are related to the formation of granulomata around eggs or dead worms, primarily in the lower urinary tract with Schistosoma haematobium, and the colon and rectum with Schistosoma mansoni, Schistosoma japonicum, Schistosoma intercalatum and Schistosoma mekongi infection. Secondary manifestations during this stage may occur in the kidneys, liver, lungs or other ectopic sites. Chronic morbidity is attributed to the healing of granulomata by fibrosis and calcification at the sites of oval entrapment, deposition of schistosomal antigen-antibody complexes in the renal glomeruli or the development of secondary amyloidosis. Malignancy may complicate the chronic lesions in the urinary bladder or colon. Co-infection with salmonella or hepatitis viruses B or C may confound the clinical picture of schistosomiasis, while the latter may have a negative impact on the course of other co-infections as malaria, leishmaniasis and HIV. Prevention of schistosomiasis is basically geared around education and periodic mass treatment, an effective vaccine being still experimental. Praziquantel is the drug of choice in the treatment of active infection by any species, with a cure rate of 80%. Other antischistosomal drugs include metrifonate for S. haematobium, oxamniquine for S. mansoni and Artemether and, possibly, Mirazid for both. Surgical treatment may be needed for fibrotic lesions. PMID:25685450

  18. Clinical and Technical Phosphoproteomic Research

    PubMed Central

    2011-01-01

    An encouraging approach for the diagnosis and effective therapy of immunological pathologies, which would include cancer, is the identification of proteins and phosphorylated proteins. Disease proteomics, in particular, is a potentially useful method for this purpose. A key role is played by protein phosphorylation in the regulation of normal immunology disorders and targets for several new cancer drugs and drug candidates are cancer cells and protein kinases. Protein phosphorylation is a highly dynamic process. The functioning of new drugs is of major importance as is the selection of those patients who would respond best to a specific treatment regime. In all major aspects of cellular life signalling networks are key elements which play a major role in inter- and intracellular communications. They are involved in diverse processes such as cell-cycle progression, cellular metabolism, cell-cell communication and appropriate response to the cellular environment. A whole range of networks that are involved in the regulation of cell development, differentiation, proliferation, apoptosis, and immunologic responses is contained in the latter. It is so necessary to understand and monitor kinase signalling pathways in order to understand many immunology pathologies. Enrichment of phosphorylated proteins or peptides from tissue or bodily fluid samples is required. The application of technologies such as immunoproteomic techniques, phosphoenrichments and mass spectrometry (MS) is crucial for the identification and quantification of protein phosphorylation sites in order to advance in clinical research. Pharmacodynamic readouts of disease states and cellular drug responses in tumour samples will be provided as the field develops. We aim to detail the current and most useful techniques with research examples to isolate and carry out clinical phosphoproteomic studies which may be helpful for immunology and cancer research. Different phosphopeptide enrichment and quantitative techniques need to be combined to achieve good phosphopeptide recovery and good up- and-down phospho-regulation protein studies. PMID:21635771

  19. Human schistosomiasis: clinical perspective: review.

    PubMed

    Barsoum, Rashad S; Esmat, Gamal; El-Baz, Tamer

    2013-09-01

    The clinical manifestations of schistosomiasis pass by acute, sub acute and chronic stages that mirror the immune response to infection. The later includes in succession innate, TH1 and TH2 adaptive stages, with an ultimate establishment of concomitant immunity. Some patients may also develop late complications, or suffer the sequelae of co-infection with other parasites, bacteria or viruses. Acute manifestations are species-independent; occur during the early stages of invasion and migration, where infection-naivety and the host's racial and genetic setting play a major role. Sub acute manifestations occur after maturity of the parasite and settlement in target organs. They are related to the formation of granulomata around eggs or dead worms, primarily in the lower urinary tract with Schistosoma haematobium, and the colon and rectum with Schistosoma mansoni, Schistosoma japonicum, Schistosoma intercalatum and Schistosoma mekongi infection. Secondary manifestations during this stage may occur in the kidneys, liver, lungs or other ectopic sites. Chronic morbidity is attributed to the healing of granulomata by fibrosis and calcification at the sites of oval entrapment, deposition of schistosomal antigen-antibody complexes in the renal glomeruli or the development of secondary amyloidosis. Malignancy may complicate the chronic lesions in the urinary bladder or colon. Co-infection with salmonella or hepatitis viruses B or C may confound the clinical picture of schistosomiasis, while the latter may have a negative impact on the course of other co-infections as malaria, leishmaniasis and HIV. Prevention of schistosomiasis is basically geared around education and periodic mass treatment, an effective vaccine being still experimental. Praziquantel is the drug of choice in the treatment of active infection by any species, with a cure rate of 80%. Other antischistosomal drugs include metrifonate for S. haematobium, oxamniquine for S. mansoni and Artemether and, possibly, Mirazid for both. Surgical treatment may be needed for fibrotic lesions. PMID:25685450

  20. Clinical evaluation of contemporary oxygenators.

    PubMed

    Stanzel, Roger Dp; Henderson, Mark

    2016-01-01

    Advances in cardiopulmonary bypass equipment have played a critical role in improving outcomes for cardiac surgery patients. Recent advancements include reduced priming volumes, biocompatible coatings and gaseous microemboli handling, as well as the incorporation of an arterial filter into the oxygenator.The purpose of this study was to conduct a comprehensive clinical evaluation of adult oxygenators on the market. Oxygenators assessed included the Sorin Synthesis(®) (n = 30), the Sorin Inspire 6F(®) (n = 10) and Inspire 8F(®) (n = 30), the Terumo FX15(®) (n = 13) and FX25(®) (n = 30), the Maquet Quadrox-i(®) (n = 30) and the Medtronic Fusion(®) (n = 30). Parameters assessed included functional prime volumes, gas exchange, pressure gradients and the effects on patient hematology.The Synthesis had the largest functional prime volume (1426 ml), the FX15 the lowest (956 ml). The Inspire 6F, 8F and Fusion had the greatest O2 transfer. The Sorin oxygenators required the lowest sweep gas flows to obtain a PaCO2 of 40 mmHg. The Sorin oxygenators had the largest pressure gradients. While no differences were observed for hemoglobin and platelet levels post cross-clamp removal, the Sorin Synthesis and Inspire 8F had the largest increases in white blood cell (WBC) counts (122% and 141% of baseline, respectively) and neutrophils (162% and 185% of baseline, respectively).The data demonstrate that no single product is superior in all aspects. The choice of ideal oxygenator depends on the aspect(s) of oxygenator performance the perfusion team believes most clinically acceptable based on available data. PMID:26407816

  1. Ganetespib: research and clinical development

    PubMed Central

    Jhaveri, Komal; Modi, Shanu

    2015-01-01

    Under stressful conditions, the heat shock protein 90 (HSP90) molecular chaperone protects cellular proteins (client proteins) from degradation via the ubiquitin-proteasome pathway. HSP90 expression is upregulated in cancers, and this contributes to the malignant phenotype of increased proliferation and decreased apoptosis and maintenance of metastatic potential via conservation of its client proteins, including human epidermal growth factor receptor 2, anaplastic lymphoma kinase, androgen receptor, estrogen receptor, Akt, Raf-1, cell cycle proteins, and B-cell lymphoma 2 among others. Hence, inhibition of HSP90 leads to the simultaneous degradation of its many clients, thereby disrupting multiple oncogenic signaling cascades. This has sparked tremendous interest in the development of HSP90 inhibitors as an innovative anticancer strategy. Based on the wealth of compelling data from preclinical studies, a number of HSP90 inhibitors have entered into clinical testing. However, despite enormous promise and anticancer activity reported to date, none of the HSP90 inhibitors in development has been approved for cancer therapy, and the full potential of this class of agents is yet to be realized. This article provides a review on ganetespib, a small molecule HSP90 inhibitor that is currently under evaluation in a broad range of cancer types in combination with other therapeutic agents with the hope of further enhancing its efficacy and overcoming drug resistance. Based on our current understanding of the complex HSP90 machinery combined with the emerging data from these key clinical trials, ganetespib has the potential to be the first-in-class HSP90 inhibitor to be approved as a new anticancer therapy. PMID:26244021

  2. Pre-clinical versus clinical medical students’ attitudes towards the poor in the United States

    PubMed Central

    2015-01-01

    This study assessed the poverty-related attitudes of pre-clinical medical students (first and second years) versus clinical medical students (third and fourth years). First through fourth year medical students voluntarily completed the Attitude Towards Poverty scale. First and second year students were classified together in the preclinical group and third and fourth year students together in the clinical group. A total of 297 students participated (67% response rate). Statistically significant differences were noted between pre-clinical and clinical students for scores on the subscales personal deficiency (P<0.001), stigma (P=0.023), and for total scores (P=0.016). Scores across these subscales and for total scores were all higher in the clinical group. The only subscale which did not show statistical significance between pre-clinical and clinical students was the structural perspective. Medical students in their clinical training have a less favorable attitude towards the poor than their preclinical counterparts. PMID:26582628

  3. [Clinical research XXI. From the clinical judgment to survival analysis].

    PubMed

    Rivas-Ruiz, Rodolfo; Pérez-Rodríguez, Marcela; Palacios, Lino; Talavera, Juan O

    2014-01-01

    Decision making in health care implies knowledge of the clinical course of the disease. Knowing the course allows us to estimate the likelihood of occurrence of a phenomenon at a given time or its duration. Within the statistical models that allow us to have a summary measure to estimate the time of occurrence of a phenomenon in a given population are the linear regression (the outcome variable is continuous and normally distributed -time to the occurrence of the event-), logistic regression (outcome variable is dichotomous, and it is evaluated at one single interval), and survival curves (outcome event is dichotomous, and it can be evaluated at multiple intervals). The first reference we have of this type of analysis is the work of the astronomer Edmond Halley, an English physicist and mathematician, famous for the calculation of the appearance of the comet orbit, recognized as the first periodic comet (1P/Halley's Comet). Halley also contributed in the area of health to estimate the mortality rate for a Polish population. The survival curve allows us to estimate the probability of an event occurring at different intervals. Also, it leds us to estimate the median survival time of any phenomenon of interest (although the used term is survival, the outcome does not need to be death, it may be the occurrence of any other event). PMID:24878091

  4. Ethics of clinical trials in Nigeria

    PubMed Central

    Okonta, Patrick I.

    2014-01-01

    The conduct of clinical trials for the development and licensing of drugs is a very important aspect of healthcare. Drug research, development and promotion have grown to a multi-billion dollar global business. Like all areas of human endeavour involving generation and control of huge financial resources, it could be subject to deviant behaviour, sharp business practices and unethical practices. The main objective of this review is to highlight potential ethical challenges in the conduct of clinical trials in Nigeria and outline ways in which these can be avoided. Current international and national regulatory and ethical guidelines are reviewed to illustrate the requirements for ethical conduct of clinical trials. Past experiences of unethical conduct of clinical trials especially in developing countries along with the increasing globalisation of research makes it imperative that all players should be aware of the ethical challenges in clinical trials and the benchmarks for ethical conduct of clinical research in Nigeria. PMID:25013247

  5. Aripiprazole: from pharmacological profile to clinical use

    PubMed Central

    Di Sciascio, Guido; Riva, Marco Andrea

    2015-01-01

    Clinical experience with aripiprazole has confirmed the effectiveness and the safety of this novel antipsychotic drug in patients with schizophrenia as well as for the treatment of mania in type I bipolar disorder. However the generalization of the results from clinical trials requires further effort in order to address some issues and to overcome incorrect and partial interpretation of the clinical evidence. This article provides some straightforward guidance that may help clinical psychiatrists to translate the mechanism of action of aripiprazole into clinical setting, thus improving the appropriate use of the drug through rational application of its pharmacological profile. Examples of paradigmatic clinical situations are presented and discussed, suggesting possible intervention strategies, which may contribute to achieving the most appropriate use of the pharmacological properties of aripiprazole in real life settings. PMID:26508859

  6. Automated Knowledge Acquisition from Clinical Narrative Reports

    PubMed Central

    Wang, Xiaoyan; Chused, Amy; Elhadad, Noémie; Friedman, Carol; Markatou, Marianthi

    2008-01-01

    Knowledge of associations between biomedical entities, such as disease-symptoms, is critical for many automated biomedical applications. In this work, we develop automated methods for acquisition and discovery of medical knowledge embedded in clinical narrative reports. MedLEE, a Natural Language Processing (NLP) system, is applied to extract and encode clinical entities from narrative clinical reports obtained from New York-Presbyterian Hospital (NYPH), and associations between the clinical entities are determined based on statistical methods adjusted by volume tests. We focus on two types of entities, disease and symptom, in this study. Evaluation based on a random sample of disease-symptom associations indicates an overall recall of 90% and a precision of 92%. In conclusion, the preliminary study demonstrated that this method for knowledge acquisition of disease-symptom pairs from clinical reports is effective. The automated method is generalizable, and can be applied to detect other clinical associations, such as between diseases and medications. PMID:18999156

  7. Why are clinical trials necessary in India?

    PubMed Central

    Poongothai, Subramani; Unnikrishnan, Ranjit; Balasubramanian, Jeyakumar; Nair, Mohan Damodaran; Mohan, Viswanathan

    2014-01-01

    Clinical trials are emerging as an important activity in India as it is an essential component of the drug discovery and development program to which India is committed. The only robust way to evaluate a new medicine is by doing properly designed clinical trials. In addition to advancing science, clinical trials offer myriad benefits to the participants. The recent hue that created in India about clinical trials is probably an exaggeration of facts. However, these points to the need for ensuring proper compliance with the regulatory norms and proper training of concerned personnel in good clinical practice (GCP). This will ensure that India continues to reap the benefits of clinical trials and also become a world leader in this field. PMID:24741480

  8. 21 CFR 862.2730 - Osmometer for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 2010-04-01 false Osmometer for clinical use. 862.2730 Section 862.2730 Food...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory...

  9. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 2010-04-01 false Mass spectrometer for clinical use. 862.2860 Section 862.2860 Food...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory...

  10. 21 CFR 862.2680 - Microtitrator for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 2010-04-01 false Microtitrator for clinical use. 862.2680 Section 862.2680 Food...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory...

  11. 21 CFR 862.2310 - Clinical sample concentrator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 8 2010-04-01 2010-04-01 false Clinical sample concentrator. 862.2310 Section 862...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory...

  12. 21 CFR 862.2700 - Nephelometer for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...2010-04-01 2010-04-01 false Nephelometer for clinical use. 862.2700 Section 862.2700 Food...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory...

  13. 21 CFR 862.3200 - Clinical toxicology calibrator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 8 2010-04-01 2010-04-01 false Clinical toxicology calibrator. 862.3200 Section...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test...

  14. 21 CFR 862.3280 - Clinical toxicology control material.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 8 2010-04-01 2010-04-01 false Clinical toxicology control material. 862.3280 Section...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test...

  15. Clinical and Translational Research Institute What is Translational Medicine?

    E-print Network

    California at San Diego, University of

    Clinical and Translational Research Institute #12;What is Translational Medicine? · Divided of treatment, diagnosis, and prevention ­ T2--Translation of clinical research results into clinical practice ­ T3--Comparative effectiveness of new treatments #12;Clinical and Translational Research Institute

  16. What Are the Possible Benefits and Risks of Clinical Trials?

    MedlinePLUS

    ... What Are the Possible Benefits and Risks of Clinical Trials? Possible Benefits Taking part in a clinical ... Clinical Trials Protect Participants?" Featured Video Children and Clinical Studies: Messages for researchers 08/15/2013 In ...

  17. What Are Clinical Trials? | NIH MedlinePlus the Magazine

    MedlinePLUS

    ... of this page please turn Javascript on. Feature: Clinical Trials What Are Clinical Trials? Past Issues / Fall 2010 Table of Contents ... conducted all the time. The Different Phases of Clinical Trials Clinical trials related to drugs are classified ...

  18. 21 CFR 862.2680 - Microtitrator for clinical use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2680 Microtitrator for clinical use. (a) Identification....

  19. 21 CFR 862.2680 - Microtitrator for clinical use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2680 Microtitrator for clinical use. (a) Identification....

  20. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments...for clinical use is a device intended to identify inorganic or organic compounds (e.g., lead, mercury, and drugs) in...

  1. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments...for clinical use is a device intended to identify inorganic or organic compounds (e.g., lead, mercury, and drugs) in...

  2. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments...for clinical use is a device intended to identify inorganic or organic compounds (e.g., lead, mercury, and drugs) in...

  3. 21 CFR 862.2860 - Mass spectrometer for clinical use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments...for clinical use is a device intended to identify inorganic or organic compounds (e.g., lead, mercury, and drugs) in...

  4. Clinical Teaching Roles of Athletic Trainers

    PubMed Central

    Foster, Danny T.; Leslie, David K.

    1992-01-01

    Studies of clinical teaching roles have not appeared in the athletic training literature. The purposes of this study were to: 1) describe clinical teaching roles of Midwest ATCs, and 2) determine the effect of educational preparation on teaching activities and opinions of ATCs. A three-part questionnaire was returned by 154 ATCs (78%) in NATA District 5. The questionnaire included demographic, teaching, and opinion items. More than 50% of the ATCs were teacher-certified and the majority had a master's or higher degree. Most ATCs clinically supervised between one to eight students who received clinical instruction about 20 hours weekly. The ATCs who taught clinically either presented information or directed tasks from five to six Role Delineation Domains. They used three or more teaching methods and six or more audiovisual aids with their presentations. The ATCs saw the importance of clinical education and the responsibility to present clinical information, and expressed positive opinions about academic preparation for clinical teaching. Those with teaching degrees felt more prepared to teach (p<.05) than did nonteachers. Teachers conducted clinical teaching activities similar to nonteachers. We concluded that less experienced athletic trainers feel educationally prepared and enjoy clinical teaching as much as their more experienced peers. The ATCs with a teaching background presented a broader content through more mature teaching methods than did nonteachers. It appeared that adequate preparation for teaching and the attainment of an advanced degree may inspire confidence in clinical teaching. These attributes may become important characteristics to look for when recruiting clinical instructors. PMID:16558184

  5. Clinical Trials | Radiation Research Program (RRP)

    Cancer.gov

    This document outlines the essential elements of an adequate plan for data and safety monitoring (DSM) of clinical trials. It is intended to assist investigators and institutions in the formulation of DSM plans for all phases of cancer clinical trials, in accordance with NIH requirements. We suggest that institutions sponsoring a significant number of clinical trials formulate institutional DSM plans that can be broadly applied to the individual trials in their portfolio.

  6. Breast dosimetry in clinical mammography

    NASA Astrophysics Data System (ADS)

    Benevides, Luis Alberto Do Rego

    The objective of this study was show that a clinical dosimetry protocol that utilizes a dosimetric breast phantom series based on population anthropometric measurements can reliably predict the average glandular dose (AGD) imparted to the patient during a routine screening mammogram. In the study, AGD was calculated using entrance skin exposure and dose conversion factors based on fibroglandular content, compressed breast thickness, mammography unit parameters and modifying parameters for homogeneous phantom (phantom factor), compressed breast lateral dimensions (volume factor) and anatomical features (anatomical factor). The protocol proposes the use of a fiber-optic coupled (FOCD) or Metal Oxide Semiconductor Field Effect Transistor (MOSFET) dosimeter to measure the entrance skin exposure at the time of the mammogram without interfering with diagnostic information of the mammogram. The study showed that FOCD had sensitivity with less than 7% energy dependence, linear in all tube current-time product stations, and was reproducible within 2%. FOCD was superior to MOSFET dosimeter in sensitivity, reusability, and reproducibility. The patient fibroglandular content was evaluated using a calibrated modified breast tissue equivalent homogeneous phantom series (BRTES-MOD) designed from anthropomorphic measurements of a screening mammography population and whose elemental composition was referenced to International Commission on Radiation Units and Measurements Report 44 tissues. The patient fibroglandular content, compressed breast thickness along with unit parameters and spectrum half-value layer were used to derive the currently used dose conversion factor (DgN). The study showed that the use of a homogeneous phantom, patient compressed breast lateral dimensions and patient anatomical features can affect AGD by as much as 12%, 3% and 1%, respectively. The protocol was found to be superior to existing methodologies. In addition, the study population anthropometric measurements enabled the development of analytical equations to calculate the whole breast area, estimate for the skin layer thickness and optimal location for automatic exposure control ionization chamber. The clinical dosimetry protocol developed in this study can reliably predict the AGD imparted to an individual patient during a routine screening mammogram.

  7. The value of clinical interventional radiology.

    PubMed

    Soares, Gregory M

    2011-05-01

    Interventional radiology (IR) is a vital component of diagnostic imaging (DI). The Society of Interventional Radiology has long held that the practice of IR should be clinical in nature, with dedicated clinical time, space, and infrastructure. The ACR has recognized the necessity of the clinical practice of IR. The cost to DI groups and hospitals of providing clinical IR is substantial. A willingness to invest in the creation or maintenance of a clinical IR service should be based on the value such an investment may provide. The author presents a 2-fold assessment of the value of IR. A review of the intangible value of IR to DI groups and facilities follows the presentation of an algorithm that ascribes a tangible, financial value to the provision of clinical IR services. The author provides an example of this algorithm applied to a mature, clinical IR practice. The author's assertion is that this value is compelling justification to warrant support of clinical IR. Additionally, the author's hope is that the utilization of this algorithm may allow DI groups to determine the financial value of clinical IR in their own settings. PMID:21531307

  8. Standards for Clinical Grade Genomic Databases.

    PubMed

    Yohe, Sophia L; Carter, Alexis B; Pfeifer, John D; Crawford, James M; Cushman-Vokoun, Allison; Caughron, Samuel; Leonard, Debra G B

    2015-11-01

    Context .- Next-generation sequencing performed in a clinical environment must meet clinical standards, which requires reproducibility of all aspects of the testing. Clinical-grade genomic databases (CGGDs) are required to classify a variant and to assist in the professional interpretation of clinical next-generation sequencing. Applying quality laboratory standards to the reference databases used for sequence-variant interpretation presents a new challenge for validation and curation. Objectives .- To define CGGD and the categories of information contained in CGGDs and to frame recommendations for the structure and use of these databases in clinical patient care. Design .- Members of the College of American Pathologists Personalized Health Care Committee reviewed the literature and existing state of genomic databases and developed a framework for guiding CGGD development in the future. Results .- Clinical-grade genomic databases may provide different types of information. This work group defined 3 layers of information in CGGDs: clinical genomic variant repositories, genomic medical data repositories, and genomic medicine evidence databases. The layers are differentiated by the types of genomic and medical information contained and the utility in assisting with clinical interpretation of genomic variants. Clinical-grade genomic databases must meet specific standards regarding submission, curation, and retrieval of data, as well as the maintenance of privacy and security. Conclusion .- These organizing principles for CGGDs should serve as a foundation for future development of specific standards that support the use of such databases for patient care. PMID:26516938

  9. An Optometric Clinical Practicum Examination Model.

    ERIC Educational Resources Information Center

    Eskridge, Jess B.

    1979-01-01

    A practical clinical examination model for use by state board examiners in optometry is described including purpose, format, examination design, procedures, evaluation examples and administration. (JMF)

  10. Cardinal Baseball 2015 Fall Pitcher's Clinic

    E-print Network

    Royer, Dana

    : ____________________________________________________________________ ____________________________________________________________________________________ Home Phone: _______________________________Cell Phone: ________________________________ As parent: ________________________________________________________________________________ ________________________________________________________________________________________ Phone: ___________________________________ E-mail: ________________________________________ Questions: ____________________________________________________________ Emergency Phone Number where you can be reached during the clinic: _________________________ #12;

  11. Interventional CMR: Clinical Applications and Future Directions

    PubMed Central

    Rogers, Toby

    2015-01-01

    Interventional cardiovascular magnetic resonance (iCMR) promises to enable radiation-free catheterization procedures and to enhance contemporary image guidance for structural heart and electrophysiological interventions. However, clinical translation of exciting pre-clinical interventions has been limited by availability of devices that are safe to use in the magnetic resonance (MR) environment. We discuss challenges and solutions for clinical translation, including MR-conditional and MR-safe device design, and how to configure an interventional suite. We review the recent advances that have already enabled diagnostic MR right heart catheterization and simple electrophysiologic ablation to be performed in humans and explore future clinical applications. PMID:25894793

  12. The Cooperative Landscape of Multinational Clinical Trials

    PubMed Central

    Hsiehchen, David; Espinoza, Magdalena; Hsieh, Antony

    2015-01-01

    The scale and nature of cooperative efforts spanning geopolitical borders in clinical research have not been elucidated to date. In a cross-sectional study of 110,428 interventional trials registered in Clinicaltrials.gov, we characterized the evolution, trial demographics, and network properties of multinational clinical research. We reveal that the relative growth of international collaboratives has remained stagnant in the last two decades, although clinical trials have evolved to become much larger in scale. Multinational clinical trials are also characterized by higher patient enrollments, industry funding, and specific clinical disciplines including oncology and infectious disease. Network analyses demonstrate temporal shifts in collaboration patterns between countries and world regions, with developing nations now collaborating more within themselves, although Europe remains the dominant contributor to multinational clinical trials worldwide. Performances in network centrality measures also highlight the differential contribution of nations in the global research network. A city-level clinical trial network analysis further demonstrates how collaborative ties decline with physical distance. This study clarifies evolving themes and highlights potential growth mechanisms and barriers in multinational clinical trials, which may be useful in evaluating the role of national and local policies in organizing transborder efforts in clinical endeavors. PMID:26103155

  13. Clinical and Translational Epidemiology Branch (CTEB)

    Cancer.gov

    The Clinical and Translational Epidemiology Branch focuses on factors that influence cancer progression, recurrence, survival, and other treatment outcomes, and factors associated with cancer development.

  14. 42 CFR 405.2452 - Services and supplies incident to clinical psychologist and clinical social worker services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 false Services and supplies incident to clinical psychologist and clinical social worker services. 405.2452 Section...405.2452 Services and supplies incident to clinical psychologist and clinical social worker...

  15. 78 FR 13351 - Submission for OMB Review; Comment Request: Clinical Mythteries: A Video Game About Clinical Trials

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ...Submission for OMB Review; Comment Request: Clinical Mythteries: A Video Game About Clinical Trials SUMMARY: Under the provisions of Section...control number. Proposed Collection: Title: Clinical Mythteries: A Video Game About Clinical...

  16. MSc Clinical Pharmacology 1 Do you want to

    E-print Network

    Neri, Peter

    MSc Clinical Pharmacology 1 Do you want to promote the safer use of medicines in man? www.abdn.ac.uk/msc/clinical-pharmacology MSc Clinical Pharmacology #12;www.abdn.ac.uk/msc/clinical-pharmacology Our MSc in Clinical Pharmacology will develop your research skills, your knowledge of clinical drugs and their use in the real

  17. 21 CFR 862.2700 - Nephelometer for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nephelometer for clinical use. 862.2700 Section... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2700 Nephelometer for clinical use. (a) Identification. A nephelometer for clinical use is...

  18. 21 CFR 862.3280 - Clinical toxicology control material.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Clinical toxicology control material. 862.3280... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3280 Clinical toxicology control material. (a) Identification. A clinical toxicology...

  19. 21 CFR 862.3200 - Clinical toxicology calibrator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Clinical toxicology calibrator. 862.3200 Section... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Toxicology Test Systems § 862.3200 Clinical toxicology calibrator. (a) Identification. A clinical toxicology calibrator...

  20. 21 CFR 862.2310 - Clinical sample concentrator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Clinical sample concentrator. 862.2310 Section 862...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2310 Clinical sample concentrator. (a) Identification. A clinical sample concentrator is a...

  1. 21 CFR 862.2680 - Microtitrator for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Microtitrator for clinical use. 862.2680 Section... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2680 Microtitrator for clinical use. (a) Identification. A microtitrator for clinical use...

  2. 21 CFR 862.2800 - Refractometer for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Refractometer for clinical use. 862.2800 Section... (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2800 Refractometer for clinical use. (a) Identification. A refractometer for clinical use...

  3. 21 CFR 862.2730 - Osmometer for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Osmometer for clinical use. 862.2730 Section 862...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2730 Osmometer for clinical use. (a) Identification. An osmometer for clinical use is a device...

  4. 21 CFR 862.2560 - Fluorometer for clinical use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fluorometer for clinical use. 862.2560 Section 862...) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Laboratory Instruments § 862.2560 Fluorometer for clinical use. (a) Identification. A fluorometer for clinical use is a...

  5. Clinical update on scorpion envenoming.

    PubMed

    Cupo, Palmira

    2015-12-01

    Scorpion stings are currently the leading cause of venom-related injury to humans in Brazil and are a significant public health problem globally. Only scorpions of the Tityus genus are of medical importance in Brazil, and Tityus serrulatus is responsible for the most serious envenomations and deaths. The toxic effects of scorpion envenomation are due to a massive release of sympathetic and parasympathetic neurotransmitters; the severity is related to cardiac and hemodynamic changes, with cardiogenic shock and pulmonary edema contributing to the main causes of death. The pathophysiology of cardiac involvement has been discussed for decades and has been attributed to adrenergic discharge and a possible toxic effect of venom on the myocardium, while acute pulmonary edema may have a cardiogenic and/or non-cardiogenic origin. Currently, the clinical data point to catecholamine excess as the cause for reversible scorpion cardiomyopathy . These data include electrocardiographic changes, profiling of cardiac enzymes and troponin I, echocardiographic data with global or regional left ventricle dysfunction, and myocardial perfusion alterations compatible with spasm in the coronary microcirculation. Furthermore, recent data on cardiac magnetic resonance imaging findings, which are similar to those observed for stress-induced cardiomyopathy, have also been linked to catecholamine excess. The efficiency of antivenom serum treatment is controversial in the literature. Our experience in Brazil is that the management of patients with systemic manifestations of scorpion stings is based on three approaches, all of which are extremely important. These include symptomatic treatment, antivenom serum, and cardiorespiratory support. PMID:26676487

  6. Novel nanomaterials for clinical neuroscience.

    PubMed

    Gilmore, Jamie L; Yi, Xiang; Quan, Lingdong; Kabanov, Alexander V

    2008-06-01

    Neurodegenerative disorders including Alzheimer's and Parkinson's diseases, amyotrophic lateral sclerosis, and stroke are rapidly increasing as population ages. The field of nanomedicine is rapidly expanding and promises revolutionary advances to the diagnosis and treatment of devastating human diseases. This paper provides an overview of novel nanomaterials that have potential to improve diagnosis and therapy of neurodegenerative disorders. Examples include liposomes, nanoparticles, polymeric micelles, block ionomer complexes, nanogels, and dendrimers that have been tested clinically or in experimental models for delivery of drugs, genes, and imaging agents. More recently discovered nanotubes and nanofibers are evaluated as promising scaffolds for neuroregeneration. Novel experimental neuroprotective strategies also include nanomaterials, such as fullerenes, which have antioxidant properties to eliminate reactive oxygen species in the brain to mitigate oxidative stress. Novel technologies to enable these materials to cross the blood brain barrier will allow efficient systemic delivery of therapeutic and diagnostic agents to the brain. Furthermore, by combining such nanomaterials with cell-based delivery strategies, the outcomes of neurodegenerative disorders can be greatly improved. PMID:18210200

  7. [ECG mapping in clinical practice].

    PubMed

    Boudík, F; Aschermann, M; Anger, Z

    2002-12-01

    First the authors present a review of important cornerstones in the history of the electrocardiogram (ECG) and ECG mapping. The first to describe the electric cardiac field based on twenty ECGs was A.D. Waller in 1889. The decisive cornerstone for practical use was the introduction of a string galvanometer in 1901 by W. Einthoven and his triaxial lead system. Another very important cornerstone in the development of ECG were the findings of F.N. Wilson. Merits as regards the development and application of ECG mapping are due to B. Taccardi. Workers of the Second Medical Clinic in Prague enhanced after 15 years of studies and comparison of ECG maps with coronarographic findings in subjects with ischaemic heart disease (IHD) and microvascular coronary dysfunction (syndrome X--SyX) substantially the specificity of this method in impaired myocardial vascularization. Better diagnosis was achieved by introduction of diagnostic tests which influence coronary vascularization such as e.g. hyperventilation, as well as other tests. After their application progression of chronic myocardial ischaemia occurs, e.g. by the mechanism of the "steal phenomenon" or restriction of the microcirculation after hyperventilation in patients with SyX. Furthermore the authors present examples of ECG maps after PTCA, after application of diagnostic tests in IHD and SyX and also regression of myocardial ischaemia after marked reduction of total cholesterol. PMID:12744039

  8. AOSLO: from benchtop to clinic

    NASA Astrophysics Data System (ADS)

    Zhang, Yuhua; Poonja, Siddharth; Roorda, Austin

    2006-08-01

    We present a clinically deployable adaptive optics scanning laser ophthalmoscope (AOSLO) that features micro-electro-mechanical (MEMS) deformable mirror (DM) based adaptive optics (AO) and low coherent light sources. With the miniaturized optical aperture of a ?DMS-Multi TM MEMS DM (Boston Micromachines Corporation, Watertown, MA), we were able to develop a compact and robust AOSLO optical system that occupies a 50 cm X 50 cm area on a mobile optical table. We introduced low coherent light sources, which are superluminescent laser diodes (SLD) at 680 nm with 9 nm bandwidth and 840 nm with 50 nm bandwidth, in confocal scanning ophthalmoscopy to eliminate interference artifacts in the images. We selected a photo multiplier tube (PMT) for photon signal detection and designed low noise video signal conditioning circuits. We employed an acoustic-optical (AOM) spatial light modulator to modulate the light beam so that we could avoid unnecessary exposure to the retina or project a specific stimulus pattern onto the retina. The MEMS DM based AO system demonstrated robust performance. The use of low coherent light sources effectively mitigated the interference artifacts in the images and yielded high-fidelity retinal images of contiguous cone mosaic. We imaged patients with inherited retinal degenerations including cone-rod dystrophy (CRD) and retinitis pigmentosa (RP). We have produced high-fidelity, real-time, microscopic views of the living human retina for healthy and diseased eyes.

  9. The clinical challenges of akathisia.

    PubMed

    Lohr, James B; Eidt, Carolyn A; Abdulrazzaq Alfaraj, Areej; Soliman, Mounir A

    2015-12-01

    Akathisia is one of the most vexing problems in neuropsychiatry. Although it is one of the most common side effects of antipsychotic medications, it is often difficult to describe by patients, and is difficult to diagnose and treat by practitioners. Akathisia is usually grouped with extrapyramidal movement disorders (ie, movement disorders that originate outside the pyramidal or corticospinal tracts and generally involve the basal ganglia). Yet, it can present as a purely subjective clinical complaint, without overt movement abnormalities. It has been subtyped into acute, subacute, chronic, tardive, withdrawal-related, and "pseudo" forms, although the distinction between many of these is unclear. It is therefore not surprising that akathisia is generally either underdiagnosed or misdiagnosed, which is a serious problem because it can lead to such adverse outcomes as poor adherence to medications, exacerbation of psychiatric symptoms, and, in some cases, aggression, violence, and suicide. In this article, we will attempt to address some of the confusion surrounding the condition, its relationship to other disorders, and differential diagnosis, as well as treatment alternatives. PMID:26683525

  10. Clinical experience with CT colonography

    NASA Astrophysics Data System (ADS)

    Reed, Judd E.; Garry, John L.; Wilson, Lynn A.; Johnson, C. Daniel

    2000-04-01

    Since the introduction of Computed Tomographic Colonography (CTC) in 1995, many advances in computer equipment and software have become available. Despite these advances, the promise of colon cancer prevention has not been realized. A colorectal screening tool that performs at a high level, is acceptable to patients, and can be performed safely and at low cost holds promise of saving lives in the future. Our institution has performed over two hundred seventy five clinical CTC examinations. These scans, which each entail a supine and a prone acquisition, only differ from our research protocol in the necessity of an expeditious interpretation. Patients arrive for their CTC examination early in the morning following a period of fasting and bowel preparation. If a CTC examination has a positive finding, the patient is scheduled for colonoscopic polypectomy that same morning. To facilitate this, the patients are required to continue fasting until the CTC examination has been interpreted. It is therefore necessary to process the CTC examination very quickly to minimize patient discomfort. A positive CTC result occurred in fifteen percent of examinations. Among these positive results, the specificity has been in excess of ninety five percent. Additionally, life threatening extra-colonic lesions were discovered in two percent of the screened population.

  11. Clinical trials: present and future.

    PubMed

    Mitsumoto, H

    2001-03-01

    The past decade has seen a major expansion of clinical trials in amyotrophic lateral sclerosis (ALS). However, the perfectly-designed ALS trial remains elusive. Attempts to track the progression of the disease are affected by continual improvements in the care of patients. Comparing the effectiveness of different drugs is difficult because different primary endpoints are used in different studies. We also need to decide how much benefit we are aiming to achieve when studying a new treatment. The interpretation of animal models has also proved problematic, with results not being replicated in human studies. Moreover, promising phase I/II trial results have often not been confirmed by phase III studies. Our patients, meanwhile, are anxious to try any medication that may help. The ALS research community has learned a great deal from past trials and this will be greatly beneficial when evaluating the novel and combination therapies currently being developed. Effort must also be directed towards the search for objective markers for ALS. PMID:11465917

  12. Clinical Practice Update: Pediculosis Capitis.

    PubMed

    Bohl, Brittany; Evetts, Jessica; McClain, Kymberli; Rosenauer, Amanda; Stellitano, Emily

    2015-01-01

    A review of the current evidence on primary treatment modalities of head lice demonstrates increasing resistance to current regimens. New and alternative therapies are now available. A treatment algorithm was created to address safety and efficacy of treatments, as well as to guide clinicians through navigation of the regimens. Through an online journal search, 59 articles were selected for the review. Literature searches were performed through PubMed, Medline, Ebsco Host, and CINAHL, with key search words of "Pediculosis capitis" and "head lice" in the title, abstract, and index. Meta-analyses and controlled clinical trials were viewed with greater weight if they had a large sample size, were statistically significant, and did not allude to bias. When resistant infestations are well-documented in a locality, changes to the treatment regimen are indicated, and alternative treatments should be considered. Recent studies and U.S. Food and Drug Administration (FDA) approvals have changed the available treatment options for Pediculosis capitis, including benzyl alcohol, topical ivermectin, spinosad, and the LouseBuster. Further, environmental management and prevention measures should be taken to avoid reinfestation and to prevent the spread of head lice. Continued study is recommended to establish long-term safety of new and alternative agents. PMID:26665422

  13. Clinical multiphoton and CARS microscopy

    NASA Astrophysics Data System (ADS)

    Breunig, H. G.; Weinigel, M.; Darvin, M. E.; Lademann, J.; König, K.

    2012-03-01

    We report on clinical CARS imaging of human skin in vivo with the certified hybrid multiphoton tomograph CARSDermaInspect. The CARS-DermaInspect provides simultaneous imaging of non-fluorescent intradermal lipid and water as well as imaging of two-photon excited fluorescence from intrinsic molecules. Two different excitation schemes for CARS imaging have been realized: In the first setup, a combination of fs oscillator and optical parametric oscillator provided fs-CARS pump and Stokes pulses, respectively. In the second setup a fs oscillator was combined with a photonic crystal fiber which provided a broadband spectrum. A spectral range out of the broadband-spectrum was selected and used for CARS excitation in combination with the residual fs-oscillator output. In both setups, in addition to CARS, single-beam excitation was used for imaging of two-photon excited fluorescence and second harmonic generation signals. Both CARS-excitation systems were successfully used for imaging of lipids inside the skin in vivo.

  14. Clinical study on cervical phlegmons.

    PubMed

    Stan, C; Dr?gulescu, C; Bacalba?a, N

    2014-01-01

    The purpose of this paper is to develop an algorithm for the diagnosis and treatment of cervical phlegmons in order to increase the diagnostic accuracy, to reduce the intra and postoperative risks and complication rates and to increase the number of cases with restitutio ad integrum. This is a retrospective clinical study on 21 patients diagnosed with cervical phlegmon. The study group consists of patients with lateral and retropharyngeal phlegmon (18 cases, of which two pharyngeal or cervical oesophagus effractions by foreign body- chicken or fish bone - with pneumomediastinum), retropharyngeal abscess and posttraumatic mediastinal (one case),peritonsillar phlegmon fused in the parapharyngeal space complicated by parapharyngeal haemorrhage after spontaneous drainage of purulent collections (2 cases). Surgical treatment was applied in all cases, associated with intravenous antibiotic medication; the treatment was individualized according to the particularities of each case: the location and extent of the phlegmon, complications, duration of evolution, mechanisms of production, etiology, associated general conditions, age and, not least, the patient's choice. PMID:24956341

  15. Clinical review: Corticotherapy in sepsis

    PubMed Central

    Prigent, Helene; Maxime, Virginie; Annane, Djillali

    2004-01-01

    The use of glucocorticoids (corticotherapy) in severe sepsis is one of the main controversial issues in critical care medicine. These agents were commonly used to treat sepsis until the end of the 1980s, when several randomized trials casted serious doubt on any benefit from high-dose glucocorticoids. Later, important progress in our understanding of the role played by the hypothalamic–pituitary–adrenal axis in the response to sepsis, and of the mechanisms of action of glucocorticoids led us to reconsider their use in septic shock. The present review summarizes the basics of the physiological response of the hypothalamic–pituitary–adrenal axis to stress, including regulation of glucocorticoid synthesis, the cellular mechanisms of action of glucocorticoids, and how they influence metabolism, cardiovascular homeostasis and the immune system. The concepts of adrenal insufficiency and peripheral glucocorticoid resistance are developed, and the main experimental and clinical data that support the use of low-dose glucocorticoids in septic shock are discussed. Finally, we propose a decision tree for diagnosis of adrenal insufficiency and institution of cortisol replacement therapy. PMID:15025773

  16. Computed tomographic colonography: clinical value.

    PubMed

    Lefere, Philippe; Dachman, Abraham H; Gryspeerdt, Stefaan

    2007-01-01

    Computed tomographic colonography (CTC) has the potential to reliably detect polyps in the colon. Its clinical value is accepted for several indications. The main target is screening asymptomatic people for colorectal cancer (CRC). As in large multi-centre trials controversial results were obtained, acceptance of this indication on a large scale is still pending. Agreement exists that in experienced hands screening can be performed with CTC. This emphasizes the importance of adequate and intensive training. Besides this, other problems have to be solved. A low complication profile is mandatory. Perforation rate is very low. Ultra-low dose radiation should be used. When screening large patient cohorts, CTC will need a time-efficient and cost-effective management without too many false positives and additional exploration. Can therefore a cut-off size of polyp detection safely be installed? Is the flat lesion an issue? Can extra-colonic findings be treated efficiently? A positive relationship with the gastro-enterologists will improve the act of screening. Improvements of scanning technique and software with dose reduction, improved 3D visualisation methods and CAD are steps in the good direction. Finally, optimisation of laxative-free CTC could be invaluable in the development of CTC as a screening tool for CRC. PMID:17508124

  17. Laser scatter in clinical applications

    NASA Astrophysics Data System (ADS)

    Luther, Ed; Geddie, William

    2008-02-01

    Brightfield Laser Scanning Imaging (BLSI) is available on Laser Scanning Cytometers (LSCs) from CompuCyte Corporation. Briefly, digitation of photodetector outputs is coordinated with the combined motions of a small diameter (typically 2 to 10 microns) laser beam scanning a specimen in the Y direction (directed by a galvanometer-driven scanning mirror) and the microscope stage motion in the X direction. The output measurements are assembled into a two-dimensional array to provide a "non-real" digital image, where each pixel value reports the amount of laser-scattered light that is obtained when the laser beam is centered on that location. Depending on the detector positions, these images are analogous to Differential Interference Contrast or Phase Contrast microscopy. We report the incorporation of the new laser scattering capabilities into the workflow of a high-volume clinical cytology laboratory at University Health Network, Toronto, Canada. The laboratory has been employing LSC technology since 2003 for immunophenotypic fluorescence analysis of approximately 1200 cytological specimens per year, using the Clatch methodology. The new BLSI component allows visualization of cellular morphology at higher resolution levels than is possible with standard brightfield microscopic evaluation of unstained cells. BLSI is incorporated into the triage phase, where evaluation of unstained samples is combined with fluorescence evaluation to obtain specimen background levels. Technical details of the imaging methodology will be presented, as well as illustrative examples from current studies and comparisons to detailed, but obscure, historical studies of cytology specimens based on phase contrast microscopy.

  18. Patient, provider, and clinic characteristics associated with public STD clinic patient satisfaction

    PubMed Central

    Mehta, S; Zenilman, J; Erbelding, E

    2005-01-01

    Objectives: There is a lack of information describing levels of patient satisfaction among patients seeking sexually transmitted diseases (STD) care in a public clinic setting. We sought to identify patient, provider, and clinic characteristics associated with patient satisfaction within public STD clinics. Methods: A cross sectional survey with random sampling was conducted among patients attending two public STD clinics. Satisfaction was assessed using questions from validated national surveys. Outcomes for multivariate logistic regression analysis were ratings of overall health care and clinician. Results: 499/605 (82%) patients were enrolled. Patients were mean age 29 years, 51% male, 94% black. Lower rating of clinician technical skills (OR = 15.6 clinic A, OR = 7.9 clinic B) and clinic environment (OR = 3.9 clinic A, OR = 9.6 clinic B) were associated with lower healthcare rating, as was lower rating of television/video in waiting room (OR = 10.2, clinic A) and dysuria (OR = 4.2, clinic B). Higher clinician rating (OR = 0.58, clinic A) and receiving written materials (OR = 0.44, clinic B) were protective of lower healthcare rating. Risks for lower clinician rating at clinic A were greater pain, problems getting care, lower rating of clinician technical skill, and overall health care, while receiving written materials was protective. At clinic B, lower rating of clinician technical skill and clinic environment were risks for lower clinician rating. Conclusions: Patient satisfaction was associated with modifiable provider and clinic characteristics. Results from our study indicate a need to examine whether health outcomes of STD management vary by patient satisfaction. PMID:15800094

  19. Outcome Prediction in Clinical Treatment Processes.

    PubMed

    Huang, Zhengxing; Dong, Wei; Ji, Lei; Duan, Huilong

    2016-01-01

    Clinical outcome prediction, as strong implications for health service delivery of clinical treatment processes (CTPs), is important for both patients and healthcare providers. Prior studies typically use a priori knowledge, such as demographics or patient physical factors, to estimate clinical outcomes at early stages of CTPs (e.g., admission). They lack the ability to deal with temporal evolution of CTPs. In addition, most of the existing studies employ data mining or machine learning methods to generate a prediction model for a specific type of clinical outcome, however, a mathematical model that predicts multiple clinical outcomes simultaneously, has not yet been established. In this study, a hybrid approach is proposed to provide a continuous predictive monitoring service on multiple clinical outcomes. More specifically, a probabilistic topic model is applied to discover underlying treatment patterns of CTPs from electronic medical records. Then, the learned treatment patterns, as low-dimensional features of CTPs, are exploited for clinical outcome prediction across various stages of CTPs based on multi-label classification. The proposal is evaluated to predict three typical classes of clinical outcomes, i.e., length of stay, readmission time, and the type of discharge, using 3492 pieces of patients' medical records of the unstable angina CTP, extracted from a Chinese hospital. The stable model was characterized by 84.9% accuracy and 6.4% hamming-loss with 3 latent treatment patterns discovered from data, which outperforms the benchmark multi-label classification algorithms for clinical outcome prediction. Our study indicates the proposed approach can potentially improve the quality of clinical outcome prediction, and assist physicians to understand the patient conditions, treatment inventions, and clinical outcomes in an integrated view. PMID:26573645

  20. 77 FR 49449 - Food and Drug Administration Clinical Trial Requirements, Compliance, and Good Clinical Practice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-16

    ...Trial Requirements, Compliance, and Good Clinical...Society of Clinical Research Associates (SoCRA...investigators, IRBs, and research sponsors. Date...plus applicable taxes (available until...investigator initiated research. Topics for discussion...3) Part 11 Compliance--Electronic...

  1. What is Clinical Psychology? The field of Clinical Psychology integrates science, theory, and practice to un-

    E-print Network

    Liu, Taosheng

    What is Clinical Psychology? The field of Clinical Psychology integrates science, theory as to promote human adaptation, adjustment, and personal development. Clini- cal Psychology focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning across

  2. Facilitated Communication: The Clinical and Social Phenomenon.

    ERIC Educational Resources Information Center

    Shane, Howard C., Ed.

    This text explains the phenomenon of facilitated communication (FC) from an empirical, data-based, and/or clinical perspective. It is not a how-to-facilitate text, but one that explores the clinical and sociological reality of FC. A common theme running through each of the papers in the book is the question of FC's legitimacy. The papers reveal…

  3. ANNUAL REPORT 2007-2008 Clinical Council

    E-print Network

    Oliver, Douglas L.

    ANNUAL REPORT 2007-2008 Clinical Council Peter C. Albertsen, MD Chairman The Clinical Council care primarily at the John Dempsey Hospital and ambulatory care to patients at the Farmington campus and Surgery. In addition, UMG has worked closely with John Dempsey Hospital to increase the number

  4. Virginia Commonwealth University Clinical Psychology Doctoral Program

    E-print Network

    Hammack, Richard

    Virginia Commonwealth University Clinical Psychology Doctoral Program Student Admissions, Outcomes if not applicable: http://www.psychology.vcu.edu/clinical/program.shtml Program Costs Description 2014-2015 1 st internships conforming to CDSPP guidelines that were not APA/CPA-accredited (if applicable) 0 0 0 0 0 0 0 0 0

  5. Clinical Oncology Assistantship Program for Medical Students.

    ERIC Educational Resources Information Center

    Neilan, Barbara A.; And Others

    1985-01-01

    The Clinical Oncology Assistantship Program at the University of Arkansas for Medical Sciences is described, along with student reactions to the program. The summer elective program involves cancer lectures (one week) and clinical exposure (nine weeks) in medical, surgical, and pediatric oncology services, as well as self-directed learning…

  6. Clinical Utility and "DSM-V"

    ERIC Educational Resources Information Center

    Mullins-Sweatt, Stephanie N.; Widiger, Thomas A.

    2009-01-01

    The construction of the American Psychiatric Association's diagnostic manual has been guided primarily by concerns of construct validity rather than of clinical utility, despite claims by its authors that the highest priority has in fact been clinical utility. The purpose of this article was to further articulate the concept and importance of…

  7. Clinical pharmacology of old age syndromes

    PubMed Central

    Broadhurst, C; Wilson, K C M; Kinirons, M T; Wagg, A; Dhesi, J K

    2003-01-01

    Several syndromes occur in old age. They are often associated with increased mortality and in all there is a paucity of basic and clinical research. The recent developments in the clinical pharmacology of three common syndromes of old age (delirium, urinary incontinence, and falls) are discussed along with directions for future research. PMID:12919174

  8. Integrated Case Learning: Teaching Clinical Reasoning

    ERIC Educational Resources Information Center

    Radomski, Natalie; Russell, John

    2010-01-01

    Learning how to "think like doctors" can be difficult for undergraduate medical students in their early clinical years. Our model of collaborative Integrated Case Learning (ICL) and simulated clinical reasoning aims to address these issues. Taking a socio-cultural perspective, this study investigates the reflective learning interactions and…

  9. Establishing High Expectations through the LEAP Clinic.

    ERIC Educational Resources Information Center

    Conderman, Greg; Snider, Vicki E.; Crawford, Donald

    1997-01-01

    The Learning Enhancement and Progression (LEAP) clinic is an eight-week summer extension to the University of Wisconsin (Eau Claire) teacher education program. The LEAP clinic has provided remedial instruction to more than 600 school-age children over the last 15 years. Five components involved are advanced preparation; teacher training;…

  10. Enhancing Adherence in Clinical Exercise Trials.

    ERIC Educational Resources Information Center

    O'Neal, Heather A.; Blair, Steven N.

    2001-01-01

    Discusses exercise adherence from the perspective of adhering to an exercise treatment in a controlled trial, focusing on: adherence (to intervention and measurement); the development of randomized clinical trials; exemplary randomized clinical trials in exercise science (exercise training studies and physical activity interventions); and study…

  11. College of Science CLINICAL SCIENCE AREA MANUAL

    E-print Network

    1 College of Science CLINICAL SCIENCE AREA MANUAL DEPARTMENT OF PSYCHOLOGY VIRIGINIA TECH AY2015 Training 24 B. Clinical Science Area Committee 25 C. Graduate Student Representatives 25 D. Advisor 26 E for Continuation on to the Preliminary Examination 49 F. Plan of Study: Doctoral Degree 51 G. The Preliminary

  12. Speech & Hearing Clinic College of Science

    E-print Network

    Hickman, Mark

    Speech & Hearing Clinic College of Science Department of Communication Disorders How to contact us: If you feel that you or your child has hearing or listening difficulties and would like a formal assessment, please contact the Speech and Hearing Clinic during business hours to make an appointment

  13. [The clinical picture of "circumscribed granuloma diseases"].

    PubMed

    Hundeiker, M

    1979-06-01

    Characteristic findings, differential diagnosis and clinical course of the so-called "circumscript granulomas" (Granuloma anulare, necrobiosis lipoidica, Miescher's granulomatosis, disciformis, necrobiosis maculosa, granuloma multiforme, actinic granuloma, granuloma faciale and lethal midline granuloma etc.) are represented in a condensed clinical survey. PMID:463173

  14. 1 | P a g e Earth Clinic

    E-print Network

    Qian, Ning

    1 | P a g e Earth Clinic Practical Solutions Grants Call for Proposals 2015-2016 To: Columbia faculty and research staff to advance the goals and objectives of the Earth Institute's Earth Clinic to the challenge of sustainable development through academically informed problem solving. As the Earth Institute

  15. Annual Report 201314 YORK LAW SCHOOL | Clinic

    E-print Network

    Pumfrey, David

    managed to help clients who may struggle to find or otherwise afford legal advice. The Clinic has been...Very professional and compassionate." #12;YORK LAW SCHOOL | clinic Case study 1: a sign of the times? Food banks are who wanted to get unwanted food supplies to those most in need. They were understandably concerned

  16. Clinical governance, litigation and human rights.

    PubMed

    Harpwood, V

    2001-01-01

    Explores the relationship between doctors, lawyers and the government in the context of the explosion in clinical negligence litigation, clinical governance and the introduction of the Human Rights Act 1998. Examines these issues from a legal perspective. Concludes that successful risk management, careful monitoring and the implementation of authoritative guidelines hold the key to legal change. PMID:11547582

  17. The Clinical Model in Rehabilitation and Alternatives.

    ERIC Educational Resources Information Center

    Woods, Diane E., Ed.; And Others

    This book is a compilation of responses and reactions to a position paper by Dr. Joseph Stubbins entitled "The Clinical Model in Rehabilitation and Alternatives." The text of the position paper is presented along with a brief summary of the main points he made in it pertaining to the clinical model and the systems model. Also included in the…

  18. Enhancing Adult Learning in Clinical Supervision

    ERIC Educational Resources Information Center

    Goldman, Stuart

    2011-01-01

    Objective/Background: For decades, across almost every training site, clinical supervision has been considered "central to the development of skills" in psychiatry. The crucial supervisor/supervisee relationship has been described extensively in the literature, most often framed as a clinical apprenticeship of the novice to the master craftsman.…

  19. Using Clinical Cases to Teach General Chemistry

    ERIC Educational Resources Information Center

    Dewprashad, Brahmadeo; Kosky, Charles; Vaz, Geraldine S.; Martin, Charlotte L.

    2004-01-01

    A clinical study was designed and used to show the relationship of health and medicine, in a typical clinical scenario, where many chemical principles are involved and that an integrated knowledge of chemistry and biology is essential to the understanding, diagnosing and treating of illnesses. A case study would be a positive learning experience…

  20. CLINICAL PSYCHOLOGY DOCTORAL PROGRAM GRADUATE STUDENT HANDBOOK

    E-print Network

    Gelfond, Michael

    2014-2015 CLINICAL PSYCHOLOGY DOCTORAL PROGRAM GRADUATE STUDENT HANDBOOK The Texas Tech Univeristy Clinical Psychology doctoral program is accredited by the American PsychologicalAssociation (APA: Office of Program Consultation and Accreditation American Psychology Association 750 First Street, N. E

  1. [Type text] Instructions for Clinical Rotation Abroad

    E-print Network

    Reidenbach, Matthew A.

    [Type text] 1 Instructions for Clinical Rotation Abroad While travelling abroad you may have with you at all times during your clinical rotation. Before you travel: 1. Obtain Medical Evacuation to take with you. Bring your prescriptions to the Student Health Pharmacy on the same day

  2. Vulvar Ulcers and Erosions: A Clinical Approach.

    PubMed

    Bohl, Tanja G

    2015-09-01

    Vulvar ulcers have a plethora of potential causes and variable clinical presentations that can prove to be a challenge to any clinician. The terminology of these causes can further add to the difficulty of diagnosis. A clinical approach to diagnosis and management is presented with classification tables and a discussion of the terminology of aphthosis, a common cause of vulvar ulceration. PMID:26176786

  3. EFFICIENT DESIGNS OF MULTIPLE SCLEROSIS CLINICAL TRIALS

    E-print Network

    Brennand, Tracy

    EFFICIENT DESIGNS OF MULTIPLE SCLEROSIS CLINICAL TRIALS by Dean Emile Vrecko B.Sc., University of Science Title of project: Efficient Designs of Multiple Sclerosis Clinical Trials Examining Committee: Dr Multiple sclerosis (MS) is a debilitating disease that attacks the central nervous system. Much research

  4. Diagnostic Medical Sonography Clinical Technical Standards

    E-print Network

    Barrash, Warren

    Diagnostic Medical Sonography Clinical Technical Standards Listed below are the technical standards identified for students in the Diagnostic Medical Sonography (DMS) clinical program. Review each standard and communicate effectively. Smell Be able to detect electrical hazards inherent in medical equipment Speech

  5. Health Clinic Environments in Georgia Elementary Schools

    ERIC Educational Resources Information Center

    Simpson, Susan Rogers

    2005-01-01

    Schools seem to be the logical place to serve the health needs of students, since children spend a majority of their time there. Design standards were not available for health clinics in Georgia elementary schools; therefore, this study examined key characteristics of an elementary school clinic in order to determine the importance of each design…

  6. The Pursuit of Understanding in Clinical Reasoning.

    ERIC Educational Resources Information Center

    Feltovich, Paul J.; Patel, Vimla L.

    Trends in emphases in the study of clinical reasoning are examined, with attention to three major branches of research: problem-solving, knowledge engineering, and propositional analysis. There has been a general progression from a focus on the generic form of clinical reasoning to an emphasis on medical content that supports the reasoning…

  7. Clinical Considerations of Biological Correlates of Suicide.

    ERIC Educational Resources Information Center

    Motto, Jerome A.

    1986-01-01

    Reviews possible biochemical markers for suicide risk but notes that none has clear application for clinical work in suicide prevention. Comments on other biological aspects of suicide including genetics, plasma drug levels, electroconvulsive therapy (ECT) and psychoimmunology. Encourages ECT use. Cautions against hasty clinical use of other…

  8. Medical Schools, Clinical Research, and Ethical Leadership

    ERIC Educational Resources Information Center

    Makarushka, Julia L.; Lally, John J.

    1974-01-01

    Recent discussion of the ethical problems of biomedical human experimentation has drawn attention to the responsibility of the medical schools for training new clinical investigators and for safeguarding the rights and welfare of the subjects of clinical research conducted in the medical schools and their affiliated hospitals. (Author)

  9. Prisons: Logical, Innovative Clinical Nursing Laboratories.

    ERIC Educational Resources Information Center

    Fontes, Honore Culleton

    1991-01-01

    The nursing faculty at Mercy College (New York) affiliated with several prison facilities to provide clinical experiences for senior nursing students. An ideal setting for the clinical group leadership course, the prison affiliations also helped students develop social awareness and advocacy strategies for this at-risk population. (SK)

  10. Lesbian Families: Cultural and Clinical Issues

    ERIC Educational Resources Information Center

    Hall, Marny

    1978-01-01

    To counteract society's hostility toward homosexuality, effective social work with lesbian couples and families must include cultural as well as clinical work. This article suggests a multilevel approach, including self-exploration on the part of the worker, acquisition of specific clinical tools, and assumption of an advocacy stance with lesbian…

  11. Clinical Assessment in Mathematics: Learning the Craft.

    ERIC Educational Resources Information Center

    Hunting, Robert P.; Doig, Brian A.

    1997-01-01

    Discusses a professional development program called Clinical Approaches to Mathematics Assessment. Argues for the advanced training of mathematics teachers who understand knowledge construction processes of students; can use clinical tools for evaluating a student's unique mathematical "fingerprint"; and can create or adapt problems, tasks, or…

  12. Basic and Clinical Pharmacology of Glucocorticosteroids

    PubMed Central

    Becker, Daniel E.

    2013-01-01

    Glucocorticosteroids are a product of the adrenal cortex and perform a staggering number of physiological effects essential for life. Their clinical use is largely predicated on their anti-inflammatory and immunosuppressive properties, but they also have notable efficacy in the prophylaxis of postoperative nausea and vomiting. This article reviews the basic functions of glucocorticoids and their clinical use in dental practice. PMID:23506281

  13. NIH Clinical Center Strategic and Annual

    E-print Network

    , the Clinical Center begins 2015 at the forefront of addressing the Ebola crisis. Housing a unique isolation state-of-the-art care for patients with Ebola who are participating in research protocols to mitigate vaccines such as its recent first-in-human clinical trials of two promising Ebola vaccines. In the new year

  14. Assessment of Clinical Skills in Medical Practice

    ERIC Educational Resources Information Center

    Scoles, Peter V.; Hawkins, Richard E.; LaDuca, Anthony

    2003-01-01

    The introduction of a clinical skills examination (CSE) to Step 2 of the U.S. Medical Licensing Examination (USMLE) has focused attention on the design and delivery of large-scale standardized tests of clinical skills and raised the question of the appropriateness of evaluation of these competencies across the span of a physician's career. This…

  15. The Rural Clinical Nurse Placement Center.

    ERIC Educational Resources Information Center

    Stuart-Siddall, Sandra; And Others

    The Rural Clinical Nurse Placement Center (RCNP) was begun in Chico, California, in 1975 to develop, implement, evaluate, and disseminate a model of a rural internship program in an effort to attract nurses to rural communities. Run by a director, clinical coordinator, full-time secretary, and half-time typist, the program places BS/RN degree…

  16. Ethics and Professionalism Clinical Medicine II

    E-print Network

    Finley Jr., Russell L.

    Ethics and Professionalism Years I-IV 2014-2015 Year II Clinical Medicine II · Advance Care Planning; End-of-Life Issues; Ethics- Small Group Session · Ethical Principles- Lecture · HIV/ Ethics- Panel · HIV/ Ethics- Small groups · HIV/ Ethics- Lecture · Ethical Principles- Lecture · Clinical Ethics

  17. Graduate Program Organization in Clinical Veterinary Medicine.

    ERIC Educational Resources Information Center

    Horne, R. D.

    1979-01-01

    Graduate training in clinical veterinary medicine is discussed. The options available to the student and problems that must be dealt with are presented, along with the requirements to accomplish a finely structured program that satisfies the needs of both the trainee and clinical veterinary medicine. (Author/MLW)

  18. Clinical Concepts on Thyroid Emergencies

    PubMed Central

    Papi, Giampaolo; Corsello, Salvatore Maria; Pontecorvi, Alfredo

    2014-01-01

    Objective: Thyroid-related emergencies are caused by overt dysfunction of the gland which are so severe that require admission to intensive care units (ICU) frequently. Nonetheless, in the ICU setting, it is crucial to differentiate patients with non-thyroidal illness and alterations in thyroid function tests from those with intrinsic thyroid disease. This review presents and discusses the main etiopathogenetical and clinical aspects of hypothyroid coma (HC) and thyrotoxic storm (TS), including therapeutic strategy flow-charts. Furthermore, a special chapter is dedicated to the approach to massive goiter, which represents a surgical thyroid emergency. Data Source: We searched the electronic MEDLINE database on September 2013. Data Selection and Data Extraction: Reviews, original articles, and case reports on “myxedematous coma,” “HC,” “thyroid storm,” “TS,” “massive goiter,” “huge goiter,” “prevalence,” “etiology,” “diagnosis,” “therapy,” and “prognosis” were selected. Data Synthesis and Conclusion: Severe excess or defect of thyroid hormone is rare conditions, which jeopardize the life of patients in most cases. Both HC and TS are triggered by precipitating factors, which occur in patients with severe hypothyroidism or thyrotoxicosis, respectively. The pillars of HC therapy are high-dose l-thyroxine and/or tri-iodothyroinine; i.v. glucocorticoids; treatment of hydro-electrolyte imbalance (mainly, hyponatraemia); treatment of hypothermia; often, endotracheal intubation and assisted mechanic ventilation are needed. Therapy of TS is based on beta-blockers, thyrostatics, and i.v. glucocorticoids; eventually, high-dose of iodide compounds or lithium carbonate may be of benefit. Surgery represents the gold standard treatment in patients with euthyroid massive nodular goiter, although new techniques – e.g., percutaneous laser ablation – are helpful in subjects at high surgical risk or refusing operation. PMID:25071718

  19. Clinical Outcome of Hypertensive Uveitis

    PubMed Central

    Lewkowicz, Deborah; Willermain, François; Relvas, Lia Judice; Makhoul, Dorine; Janssens, Sarah; Janssens, Xavier; Caspers, Laure

    2015-01-01

    Purpose. To review the clinical outcome of patients with hypertensive uveitis. Methods. Retrospective review of uveitis patients with elevated intraocular pressure (IOP) > 25?mmHg and >1-year follow-up. Data are uveitis type, etiology, viral (VU) and nonviral uveitis (NVU), IOP, and medical and/or surgical treatment. Results. In 61 patients, IOP values are first 32.9?mmHg (SD: 9.0), highest 36.6?mmHg (SD: 9.9), 3 months after the first episode 19.54?mmHg (SD: 9.16), and end of follow-up 15.5?mmHg (SD: 6.24). Patients with VU (n = 25) were older (50.6?y/35.7?y, p = 0.014) and had more unilateral disease (100%/72.22%??p = 0.004) than those with NVU (n = 36). Thirty patients (49.2%) had an elevated IOP before topical corticosteroid treatment. Patients with viral uveitis might have higher first elevated IOP (36.0/27.5?mmHg, p = 0,008) and maximal IOP (40.28/34.06?mmHg, p = 0.0148) but this was not significant when limited to the measurements before the use of topical corticosteroids (p = 0.260 and 0.160). Glaucoma occurred in 15 patients (24.59%) and was suspected in 11 (18.03%) without difference in viral and nonviral groups (p = 0.774). Conclusion. Patients with VU were older and had more unilateral hypertensive uveitis. Glaucoma frequently complicates hypertensive uveitis. Half of the patients had an elevated IOP before topical corticosteroid treatment. PMID:26504598

  20. 78 FR 13347 - Clinical Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... From the Federal Register Online via the Government Printing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Clinical Chemistry and Clinical Toxicology Devices Panel of... Chemistry and Clinical Toxicology Devices Panel of the Medical Devices Advisory Committee. General...