Search results for " Clinical practice."

showing 10 items of 51 documents

Factors associated with first- versus second-generation long-acting antipsychotics prescribed under ordinary clinical practice in Italy

2018

Background For many years, long-acting intramuscular (LAI) antipsychotics have been prescribed predominantly to chronic and severe patients, as a last resort when other treatments failed. Recently, a broader and earlier use of LAIs, particularly second-generation LAIs, has been emphasized. To date, few studies attempted to frame how this change in prescribing took place in real-world practice. Therefore, this study aimed to describe the clinical features of patients prescribed with LAIs, and to explore possible prescribing differences between first- and second-generations LAIs under ordinary clinical practice in Italy. Methods The STAR Network "Depot" Study is an observational, longitudinal…

Genetics and Molecular Biology (all)MalePediatricsEuropean PeopleBipolar DisorderCross-sectional studyEconomicsEpidemiologymedicine.medical_treatmentassessmentviruseslcsh:MedicineSocial SciencesLongitudinal StudieBiochemistryPrescriptionGeographical locations0302 clinical medicineMathematical and Statistical TechniquesBiochemistry Genetics and Molecular Biology (all); Agricultural and Biological Sciences (all)immune system diseasesEpidemiologyMedicine and Health Scienceslong-acting intramuscular (LAI) antipsychotics; clinical practice; assessment; second-generation antipsychotic (SGA) LAIsAntipsychoticsEthnicitiesLongitudinal Studieslcsh:ScienceMultidisciplinaryvirus diseasesDrugsMiddle Agedclinical practiceItalian PeopleEuropePrescriptionsItalyPhysical SciencesAripiprazoleFemaleBivariate AnalysisStatistics (Mathematics)medicine.drugHumanResearch ArticleAntipsychotic AgentsEmploymentAdultmedicine.medical_specialtyAdolescentResearch and Analysis Methods03 medical and health sciencesMental Health and PsychiatrymedicineHumansPaliperidoneBipolar disorderEuropean UnionStatistical MethodsAntipsychoticCross-Sectional StudiePharmacologyRisperidoneBiochemistry Genetics and Molecular Biology (all)business.industryMood Disorderslcsh:Rmedicine.disease030227 psychiatryAntipsychotic AgentCross-Sectional StudiesAgricultural and Biological Sciences (all)Labor EconomicsMultivariate AnalysisSchizophreniaObservational studylcsh:QPopulation Groupingslong-acting intramuscular (LAI) antipsychoticsPeople and placesbusiness030217 neurology & neurosurgerysecond-generation antipsychotic (SGA) LAIsMathematicsPLoS ONE
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MASked-unconTrolled hypERtension management based on office BP or on ambulatory blood pressure measurement (MASTER) Study: a randomised controlled tr…

2018

Introduction Masked uncontrolled hypertension (MUCH) carries an increased risk of cardiovascular (CV) complications and can be identified through combined use of office (O) and ambulatory (A) blood pressure (BP) monitoring (M) in treated patients. However, it is still debated whether the information carried by ABPM should be considered for MUCH management. Aim of the MASked-unconTrolled hypERtension management based on OBP or on ambulatory blood pressure measurement (MASTER) Study is to assess the impact on outcome of MUCH management based on OBPM or ABPM. Methods and analysis MASTER is a 4-year prospective, randomised, open-label, blinded-endpoint investigation. A total of 1240 treated hyp…

HYPERTENSION MANAGEMENTHipertensión.1302masked uncontrolled hypertensionEnfermedades cardiovasculares - Pacientes - Factores de riesgo.office blood pressureMASKED UNCONTROLLED HYPERTENSIONMedicina ClínicaCardiovascular Medicine030204 cardiovascular system & hematologyAMBULATORY BLOOD PRESSURE MONITORINGlaw.invention0302 clinical medicineClinical trialsRandomized controlled triallawBlood Pressure MonitoringMasked Hypertension//purl.org/becyt/ford/3.2 [https]ProtocolMulticenter Studies as Topic1506030212 general & internal medicineCardiovascular system - Diseases - Patients - Risk factors.Blood pressure.OFFICE BLOOD PRESSURERandomized Controlled Trials as TopicSistemas Cardíaco y CardiovascularGeneral MedicineBlood Pressure Monitoring Ambulatory3. Good healthCor MalaltiesEchocardiographyAmbulatoryHypertensionBlood pressure//purl.org/becyt/ford/3 [https]Hipertensióambulatory blood pressure monitoring; hypertension; hypertension management; masked uncontrolled hypertension; office blood pressure; treated hypertensive patientsTREATED HYPERTENSIVE PATIENTS1683medicine.medical_specialtyAmbulatory blood pressureCIENCIAS MÉDICAS Y DE LA SALUDhypertensionHeart Ventriclestreated hypertensive patientPressió sanguínia03 medical and health sciencesAmbulatoryHypertension.medicineAlbuminuriaHumansAntihypertensive AgentsProtocol (science)business.industryConsolidated Standards of Reporting Trialsambulatory blood pressure monitoring; hypertension; hypertension management; masked uncontrolled hypertension; office blood pressure; treated hypertensive patients; Albuminuria; Antihypertensive Agents; Echocardiography; Heart Ventricles; Humans; Masked Hypertension; Multicenter Studies as Topic; Randomized Controlled Trials as Topic; Blood Pressure Monitoring Ambulatorytreated hypertensive patientsambulatory blood pressure monitoringBlood pressurePresión sanguínea.Good clinical practiceEmergency medicinebusinessDeclaration of Helsinkihypertension managementAssaigs clínicsBMJ Open
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How bilastine is used to treat allergic rhinitis and urticaria in children

2021

Management guidelines for allergic rhinitis and urticaria recommend oral second-generation antihistamines as first-line treatment. The efficacy and safety of bilastine, the newest nonsedating second-generation antihistamine, are well established in adolescents/adults with these allergic conditions. The bilastine development program for pediatric use (2–<12 years) followed EMA-authorized processes. Pharmacokinetic/pharmacodynamic simulation and modeling and a pharmacokinetic study were conducted to identify and confirm the pediatric dose (10 mg/day). A Phase III, multicenter, double-blind, randomized, placebo-controlled, parallel-group study was performed to confirm the safety of bilasti…

Histamine H1 Antagonists Non-Sedatingmedicine.medical_specialtyAdolescentUrticariaSecond Generation Antihistaminesmedicine.medical_treatmentImmunologychemistry.chemical_compoundDouble-Blind MethodPiperidinesPharmacokineticsHumansImmunology and AllergyMedicineRoutine clinical practiceChildBilastinebusiness.industryRhinitis AllergicDermatologyTreatment OutcomeOncologychemistryPharmacodynamicsBenzimidazolesAntihistaminebusinessImmunotherapy
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Good clinical practice for the use of vasopressor and inotropic drugs in critically ill patients: state-of-the-science and expert consensus

2021

Vasopressors and inotropic agents are widely used in critical care. However, strong evidence supporting their use in critically ill patients is lacking in many clinical scenarios. Thus, the Italian Society of Anesthesia and Intensive Care (SIAARTI) promoted a project aimed to provide indications for good clinical practice on the use of vasopressors and inotropes, and on the management of critically ill patients with shock. A panel of 16 experts in the field of intensive care medicine and hemodynamics has been established. Systematic review of the available literature was performed based on PICO questions. Basing on available evidence, the panel prepared a summary of evidences and then wrote…

Inotropemedicine.medical_specialtyConsensusCritical CareCritical IllnessMEDLINEshockCardiotonic AgentsCardiotonic agentsVasoconstrictor agentsCardiogenic shock; Cardiotonic agents; Septic shock; Vasoconstrictor agents03 medical and health sciences0302 clinical medicineVasoconstrictor agents030202 anesthesiologySeptic shockIntensive caremedicineHumansVasoconstrictor AgentsIntensive care medicineCardiogenic shockbusiness.industrySeptic shockCardiogenic shock030208 emergency & critical care medicinemedicine.diseaseAnesthesiology and Pain MedicinePharmaceutical PreparationsShock (circulatory)Good clinical practicemedicine.symptombusinessCardiotonic agents
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Practice guidelines for the treatment of hepatitis C: recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting.

2010

It is increasingly clear that a tailored therapeutic approach to patients with hepatitis C virus infection is needed. Success rates in difficult to treat and low-responsive hepatitis C virus patients are not completely satisfactory, and there is the need to optimise treatment duration and intensity in patients with the highest likelihood of response. In addition, the management of special patient categories originally excluded from phase III registration trials needs to be critically re-evaluated. This article reports the recommendations for the treatment of hepatitis C virus infection on an individual basis, drafted by experts of three scientific societies.

Liver CirrhosisANTIVIRAL TREATMENTHuman immunodeficiency virus (HIV)HIV InfectionsHepacivirusANTIVIRAL THERAPY; PEGYLATED INTERFERON-ALPHA-2B; LIVER-TRANSPLANTATION; PEGINTERFERON ALPHA-2A; HIV-INFECTED PATIENTS; VIRUS-COINFECTED PATIENTS; RAPID VIROLOGICAL RESPONSEAntiviral therapymedicine.disease_causeGastroenterologyPolyethylene GlycolsHBVguidelinesAcute hepatitisChronic hepatitisSettore MED/12 - Gastroenterologialiver transplantationGastroenterologyAntiviral therapyHepatitis CVIRUS-COINFECTED PATIENTSLIVER-TRANSPLANTATIONHepatitis CRecombinant Proteinsacute hepatitis; antiviral therapy; chronic hepatitis; cirrhosis; elderly patients; hbv; hcv; hdv; hiv; liver transplantationCLINICAL PRACTICE GUIDELINESCirrhosisHCVDrug Therapy CombinationAntiviral therapy Acute hepatitis Chronic hepatitisCirrhosis Elderly patients HBV HCV HDV HIV Liver transplantationElderly patientAcute hepatitiAcute hepatitismedicine.medical_specialtyGenotypePEGINTERFERON ALPHA-2AAlpha interferonHIV-INFECTED PATIENTSInterferon alpha-2CHRONIC HEPATITIS CAntiviral AgentsHepatitis B ChronicChronic hepatitisInternal medicineHDVDrug Resistance ViralRibavirinmedicineHumansPEGYLATED INTERFERON-ALPHA-2BCirrhosiHepatologybusiness.industrySettore MED/09 - MEDICINA INTERNAInterferon-alphaHIVHepatitis C Chronicmedicine.diseaseElderly patientsFamily medicineExpert opinionAntiviral therapy; Acute hepatitis; Chronic hepatitis; Cirrhosis; Elderly patients; HBV; HCV; HDV; HIV; liver transplantationChronic hepatitiRAPID VIROLOGICAL RESPONSEbusinessCHRONIC HEPATITIS C; ANTIVIRAL TREATMENT; CLINICAL PRACTICE GUIDELINES
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Health-related quality of life in patients with compensated and decompensated liver cirrhosis.

2019

Compensated (Child-Pugh [CP] A) and decompensated (CP B/C) liver cirrhosis significantly differs in terms of impairment of health-related quality of life (HRQoL). However, sufficient data on potentially treatable factors associated with HRQoL in both stages of the disease are still lacking. Consequently, aims of this study were to determine differences in HRQoL between patients with compensated and decompensated liver cirrhosis and to identify potentially treatable factors associated with HRQoL.218 patients with liver cirrhosis were enrolled into this study. Chronic Liver Disease Questionnaire (CLDQ) was used to assess HRQoL. Covert hepatic encephalopathy (CHE) was diagnosed according to a …

Liver CirrhosisMalemedicine.medical_specialtyCirrhosisPsychometricsDisease030204 cardiovascular system & hematologyChronic liver diseaseGastroenterologySeverity of Illness Index03 medical and health sciences0302 clinical medicineQuality of lifeRisk FactorsInternal medicineGermanySurveys and QuestionnairesInternal MedicinemedicineHumansRoutine clinical practiceIn patient030212 general & internal medicineProspective StudiesHepatic encephalopathyAgedHealth related quality of lifebusiness.industryMiddle Agedmedicine.diseasehumanitiesHepatic EncephalopathyMultivariate AnalysisLinear ModelsQuality of LifeFemalebusinessEuropean journal of internal medicine
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“Better explanations” in multiple sclerosis diagnostic workup

2019

BackgroundThe exclusion of other diseases that can mimic multiple sclerosis (MS) is the cornerstone of current diagnostic criteria. However, data on the frequency of MS mimics in real life are incomplete.MethodsA total of 695 patients presenting with symptoms suggestive of MS in any of the 22 RIREMS centers underwent a detailed diagnostic workup, including a brain and spinal cord MRI scan, CSF and blood examinations, and a 3-year clinical and radiologic follow-up.FindingsA total of 667 patients completed the study. Alternative diagnoses were formulated in 163 (24.4%) cases, the most frequent being nonspecific neurologic symptoms in association with atypical MRI lesions of suspected vascular…

Male404241Longitudinal StudieDisease0302 clinical medicineMultiple SclerosiDiagnosisMedicine030212 general & internal medicineProspective StudiesLongitudinal StudiesProspective cohort studymedicine.diagnostic_testMagnetic Resonance Imagingclinical practiceatypical MRI lesionsMS mimicsDisease ProgressionFemaleSettore MED/26 - NeurologiaRadiologyHumanAdultmultiple sclerosis; diagnostic criteria; atypical MRI lesions; MS mimics; clinical practicemedicine.medical_specialtyMultiple Sclerosis2omarkers / metabolism Diagnosis Differential Female Follow-Up Studies Humans Longitudinal Studies Magnetic Resonance Imaging Male Multiple Sclerosis / diagnosis* Prospective StudiesArticleFollow-Up StudieDiagnosis Differential03 medical and health sciencesHumansNeuromyelitis opticabusiness.industryMultiple sclerosisAdult; Biomarkers; Diagnosis Differential; Female; Follow-Up Studies; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Prospective StudiesMagnetic resonance imagingOdds ratioBiomarkermedicine.disease101MigraineDifferentialdiagnostic criteriaNeurology (clinical)Differential diagnosisbusiness030217 neurology & neurosurgeryBiomarkersFollow-Up StudiesNeurology
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Can the TLR-4-mediated signaling pathway be "a key inflammatory promoter for sporadic TAA"?

2014

Thoracic aorta shows with advancing age various changes and a progressive deterioration in structure and function. As a result, vascular remodeling (VR) and medial degeneration (MD) occur as pathological entities responsible principally for the sporadic TAA onset. Little is known about their genetic, molecular, and cellular mechanisms. Recent evidence is proposing the strong role of a chronic immune/inflammatory process in their evocation and progression. Thus, we evaluated the potential role of Toll like receptor- (TLR-) 4-mediated signaling pathway and its polymorphisms in sporadic TAA. Genetic, immunohistochemical, and biochemical analyses were assessed. Interestingly, the rs4986790 TLR4…

MaleArticle SubjectGenotypeImmunologyAortic DiseasesSettore MED/41 - AnestesiologiaSingle-nucleotide polymorphismAorta ThoracicSettore MED/08 - Anatomia PatologicaBiologyPolymorphism Single NucleotideImmune systemPolymorphism (computer science)Genotypelcsh:PathologySettore MED/05 - Patologia ClinicaHumansGenetic Predisposition to DiseaseAgedToll-like receptorPolymorphism GeneticSettore MED/23 - Chirurgia CardiacaCell BiologyMiddle AgedPhenotypeImmunohistochemistryToll-Like Receptor 4medial degeneration sporadic thoracic aortic aneurysm TLR-4 mediated signaling pathway rs4986790 TLR4 polymorphism translation of genetic immunohistochemical and biochemical data clinical practiceImmunologyTLR4Matrix Metalloproteinase 2FemaleSignal transductionlcsh:RB1-214Research ArticleSignal Transduction
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Effectiveness of anti-vascular endothelial growth factors in neovascular age-related macular degeneration and variables associated with visual acuity…

2021

Objective To assess the overall effectiveness of anti-vascular endothelial growth factor (VEGF) therapy in treatment-naïve patients with neovascular age-related macular degeneration (nAMD) in a clinical practice setting. Study design EAGLE was a retrospective, 2-year, cohort observational, multicenter study conducted in Italy that analyzed secondary data of treatment-naïve patients with nAMD. The primary endpoint evaluated the mean annualized number of anti-VEGF injections at Years 1 and 2. The main secondary endpoints analyzed the mean change in visual acuity (VA) from baseline and variables associated with visual outcomes at Years 1 and 2. Results Of the 752 patients enrolled, 745 (99.07…

MaleEaglesAntiVEGF Drugs nAMD clinical practiceVisual AcuitySocial SciencesRetinal NeovascularizationInfographicsGeographical locationsMacular DegenerationMedical ConditionsEndocrinologyRetrospective StudieClinical endpoint80 and overPsychologyAged 80 and overEukaryotaItalyCohortMedicineHumanmedicine.medical_specialtyScienceDrug Administration ScheduleFollow-Up StudieSigns and Symptomsbiology.animalLinear regressionHumansAgedRetrospective StudiesSettore MED/30 - Malattie Apparato VisivoData VisualizationOrganismsBiology and Life Sciencesmedicine.diseaseOphthalmologyMacular DisordersLesionsEyesObservational studyClinical MedicinePeople and placesNeuroscienceVascular Endothelial Growth Factor AVisual acuityTime FactorsEye DiseasesVisionPhysiologyAngiogenesis InhibitorsMedicine and Health SciencesGeriatric OphthalmologyData ManagementMultidisciplinarybiologyQRetinal DegenerationRChartsEuropeAged; Aged 80 and over; Angiogenesis Inhibitors; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Intravitreal Injections; Italy; Macular Degeneration; Male; Retinal Neovascularization; Retrospective Studies; Time Factors; Treatment Outcome; Vascular Endothelial Growth Factor A; Visual AcuityTreatment OutcomeVertebratesIntravitreal InjectionsRetinal DisordersSensory PerceptionFemalemedicine.symptomAnatomyAngiogenesis InhibitorResearch ArticleEagleComputer and Information SciencesTime FactorBirdsOcular SystemInternal medicineSettore MED/30Growth FactorsmedicineAnimalsEuropean UnionRaptorsEndocrine Physiologybusiness.industryIntravitreal InjectionCognitive PsychologyRetrospective cohort studyMacular degenerationGeriatricsAmniotesCognitive SciencePerceptionbusinessZoologyHeadFollow-Up Studies
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Comparing Long-Acting Antipsychotic Discontinuation Rates Under Ordinary Clinical Circumstances: A Survival Analysis from an Observational, Pragmatic…

2021

Background Recent guidelines suggested a wider use of long-acting injectable antipsychotics (LAI) than previously, but naturalistic data on the consequences of LAI use in terms of discontinuation rates and associated factors are still sparse, making it hard for clinicians to be informed on plausible treatment courses. Objective Our objective was to assess, under real-world clinical circumstances, LAI discontinuation rates over a period of 12 months after a first prescription, reasons for discontinuation, and associated factors. Methods The STAR Network ‘Depot Study’ was a naturalistic, multicentre, observational prospective study that enrolled subjects initiating a LAI without restrictions …

MalePediatricsrespectively)0302 clinical medicineDelayed-Action PreparationBrief Psychiatric Rating ScalePharmacology (medical)he STAR Network ‘Depot Study’ prospectively followed 394 subjects initiating treatment with long-acting injections (LAIs) of antipsychotics under naturalistic conditions for 12 months. LAI discontinuation was frequent in everyday clinical practice in ItalyOriginal Research ArticleProspective StudiesProspective cohort studytreatmentMental DisordersHazard ratiowhereas more than half of participants initiating risperidone LAI and olanzapine LAI discontinued during the 12 months of follow-up (51.4 and 62.5%Psychiatric Status Rating ScaleMiddle Agedside efectsPsychiatry and Mental healthItalyMental DisorderFemalehe STAR Network ‘Depot Study’ prospectively followed 394 subjects initiating treatment with long-acting injections (LAIs) of antipsychotics under naturalistic conditions for 12 months. LAI discontinuation was frequent in everyday clinical practice in Italy occurring in almost 40% of the entire sample; side efects participant refusal to continue LAIs and LAIs no longer being required were the most frequently reported reasons for discontinuation. Paliperidone LAI and aripiprazole LAI were the least discontinued medications (33.9 and 35.4% respectively) whereas more than half of participants initiating risperidone LAI and olanzapine LAI discontinued during the 12 months of follow-up (51.4 and 62.5% respectively). In multivariate analysis being prescribed olanzapine LAI and poor medication adherence at baseline were signifcantly associated with higher discontinuation risk.HumanAntipsychotic Agentsmedicine.drugPsychopathologyAdultmedicine.medical_specialtyDiscontinuationFollow-Up StudieMedication Adherence03 medical and health sciencesmedicineHumansPaliperidoneAdverse effectSettore MED/25 - Psichiatriadiscontinuation ratesPsychiatric Status Rating Scalesrespectively). In multivariate analysisbusiness.industryLong-Acting Antipsychoticlong-acting injectable antipsychoticsSurvival AnalysisConfidence intervalparticipant refusal to continue LAIs and LAIs no longer being required were the most frequently reported reasons for discontinuation. Paliperidone LAI and aripiprazole LAI were the least discontinued medications (33.9 and 35.4%030227 psychiatryDiscontinuationProspective StudieAntipsychotic Agentoccurring in almost 40% of the entire sampleDelayed-Action PreparationsNeurology (clinical)business030217 neurology & neurosurgerybeing prescribed olanzapine LAI and poor medication adherence at baseline were signifcantly associated with higher discontinuation riskFollow-Up Studies
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