Search results for "Treatment decision making"
showing 10 items of 14 documents
Liquid Biopsy in Cancer Patients: The Hand Lens to Investigate Tumor Evolution
2017
In recent years the treatment of cancer patients has profoundly changed due to a better comprehension of the biological processes underlying tumor development and progression. Several tumors are defined as “oncogene addicted” and this discovery has led the way to the development of target therapies that are able to specifically kill cancer cells sparing normal cells from toxicity. Nowadays treatment decision is strictly dependent on the molecular characterization of the tumor; thus the path of cancer patients’ survival is tissue dependent but this may have several limitations. Indeed a single tissue biopsy represents only a snapshot limited in time and space but we are learning that tumor e…
Treatment decision making in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: State of the art
2014
No abstract available
Treatment of high blood pressure in elderly and octogenarians: European Society of Hypertension statement on blood pressure targets
2016
Abstract The European Society of Hypertension recommend the following main rules for treatment of hypertension in elderly and octogenarians: 1) In elderly hypertensives with SBP ≥ 160 mmHg there is solid evidence to recommend reducing SBP to between 140 mmHg and 150 mmHg. 2) In fit elderly patients less than 80 years old treatment may be considered at SBP ≥ 140 mmHg with a target SBP < 140 mmHg if treatment is well tolerated. 3) In fit individuals older than 80 years with an initial SBP ≥ 160 mmHg it is recommended to reduce SBP to between 150 mmHg and 140 mmHg. 4) In frail elderly patients, it is recommended to base treatment decisions on comorbidity and carefully monitor the effects of tr…
Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: A pros…
2015
We performed a multicenter study to validate the concept that a simple comprehensive geriatric assessment (CGA) can identify elderly, non-fit patients with diffuse large B-cell lymphoma (DLBCL) in whom curative treatment is not better then palliation, and to analyze potential benefits of treatment modulation after further subdividing the non-fit category by CGA criteria. One hundred and seventy-three patients aged > 69 treated with curative or palliative intent by clinical judgement only were grouped according to CGA into fit (46%), unfit (16%) and frail (38%) categories. Two-year overall survival (OS) was significantly better in fit than in non-fit patients (84% vs. 47%; p < 0.0001).…
The joint structure–function dynamics of glaucoma progression
2015
While the presence and rate of glaucoma progression influence treatment decisions, the methods currently available to detect and monitor progression are imprecise and do not allow clinicians to make accurate assessments of the status of their patients. Models that focus on combining structural and functional parameters may improve our ability to detect and monitor glaucoma progression. Several of these models, however, are limited by their reliance on population statistics and on the static assumptions they make about the nature of glaucoma progression. Dynamic modeling of glaucoma progression may lead to a better understanding of glaucoma progression that could eventually translate into ma…
Akute Lungenembolie – Eine kritische Übersicht über aktuelle Leitlinien und Empfehlungen
2013
Die akute Lungenembolie (LE) ist eine haufige und potenziell lebensbedrohliche Erkrankung. Dieser Artikel bietet eine kritische Ubersicht uber die aktuellen Leitlinien und Empfehlungen fur das Management der akuten LE. Die Symptome und klinischen Zeichen sind unspezifisch und umfassen Dyspnoe, Brustschmerzen, Hamoptyse, Synkope, arterielle Hypotension und Schock. Bei Patienten mit klinischem Verdacht auf akute LE sollte umgehend das Vorliegen eines hohen Risikos aufgrund hamodynamischer Instabilitat festgestellt oder ausgeschlossen werden. Dies wird ein risikoadaptiertes diagnostisches und therapeutisches Vorgehen ermoglichen. Nach Semiquantifizierung der klinischen Wahrscheinlichkeit einer…
Assessment and management of agitation in psychiatry: Expert consensus
2016
International audience; BACKGROUND:Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry. Current recommendations on agitation in psychiatry are not univocal. Actually, an improper assessment and management may result in unnecessary coercive or sedative treatments. A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions.METHODS:An expert task force iteratively developed consensus using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new, re-worded or re-rated items.RESULTS:Out of 2175 papers assessing psychomo…
Evaluation of a multicomponent grading system for obstructive sleep apnoea: the Baveno classification
2021
New findings on pathophysiology, epidemiology, and outcome have raised concerns on the relevance of the apnoea–hypopnoea index (AHI) in the classification of obstructive sleep apnoea (OSA) severity. Recently, a multicomponent grading system decision integrating symptomatology and comorbidities (Baveno classification), was proposed to characterise OSA and to guide therapeutic decisions. We evaluated whether this system reflects the OSA population, whether it translates into differences in outcomes, and whether the addition of AHI improves the scheme. A total of 14 499 OSA patients from the European Sleep Apnoea Database cohort were analysed. The groups were homogeneously distributed and were…
"Card sorting" : a tool for research in ethics on treatment decision-making at the end of life in Alzheimer patients with a life threatening complica…
2011
Abstract Background End stage dementia is a particularly difficult aspect of care for patients with Alzheimer's disease and related dementias. In care institutions, caregivers and family are concerned by treatment decision-making for an acute life threatening complication occurring in Alzheimer patients at the end of life. How should the best treatment pathway be decided: to treat or not to treat? Which arguments are used for decision-making? These are mainly ethical questions which are currently difficult to express and investigate. Methods/Design Cross sectional multicentre study of clinical cases involving 67 health centres (university hospitals, general hospitals, local hospitals and ho…
Measurement of Fractional Exhaled Nitric Oxide: Comparison of Three Different Analysers
2019
<b><i>Background:</i></b> Fractional exhaled nitric oxide (FeNO) is a surrogate marker for airway inflammation, supporting the diagnostic pathway and treatment decisions for asthma patients. <b><i>Objectives:</i></b> Aim of this study was to compare the new analyser Vivatmo pro (Bosch, BV) with NIOX VERO (Circassia, CN) and CLD (Ecomedics, EC). <b><i>Methods:</i></b> In 100 asthmatics (median 53 years [range 20–87], 62% female, 86% on inhaled corticosteroids [mean 1,300 μg beclomethasone dipropionate or equivalent], 35% treated with biologics) 2 FeNO measurements per device were performed. Additionally, the success rate…