61 research outputs found

    Effectiveness of photodynamic therapy for mammary and extra-mammary Paget's disease: a state of the science review

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    <p>Abstract</p> <p>Background</p> <p>Paget's disease is a rare skin disorder occurring in the breast (mammary) or in the groin, genital, peri-anal and axillary regions (extra-mammary). Typical treatment involves surgical excision, which in the case of extra-mammary Paget's disease, can lead to significant morbidity. Photodynamic therapy (PDT) which uses a topical or intravenous photosensitizing agent that is activated by a light source to ablate abnormal tissue, offers a minimally invasive alternative. The purpose of this study was to assess the effectiveness of photodynamic therapy in the treatment of Paget's disease.</p> <p>Methods</p> <p>Following Cochrane guidelines, a comprehensive systematic review of all clinical studies and reports examining the use of PDT for mammary and extra-mammary Paget's disease was conducted. Study quality was assessed using the Oxford Levels of Evidence Scale.</p> <p>Results</p> <p>21 retrospective and 2 prospective non-comparative studies were identified and included in the review: 9 case reports with 1-2 patients and 14 case series with 1-16 patients. These reports totalled 99 patients with 133 extra-mammary Paget's lesions and 3 patients (with 3 lesions) with mammary Paget's disease. Follow-up periods were typically one year or less, with 77/133 extra-mammary lesions exhibiting complete response to PDT. One recurrent mammary skin lesion and two mammary lesions treated concomitantly with surgery also exhibited complete responses.</p> <p>Conclusions</p> <p>Evidence of the effectiveness of PDT for Paget's disease is promising, but limited. This may, in part, be explained by the rarity of the condition, making controlled comparative clinical trials challenging.</p

    Anglo-Dutch translations of medical and scientific texts

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    In the seventeenth century the use of vernacular languages became more and more accepted in scientific publications and communications, and began to supplement the traditional language in this field, namely: Latin. The increase in the number of languages used in science and medicine was accompanied by a heightened need for translators. The close relationship between England and the Low Countries in the seventeenth century has led to a focus in the existing research on political and religious issues, and this has been reflected in the study of translations between English and Dutch. Yet one also finds in the fields of medicine and science an exchange of ideas through translation. The language skills of both Dutch and English men and women were often not sufficient to understand each other's language, which means that translations were vital. By considering the examples of how Thomas Browne's Religio medici was translated into Dutch, and how letters by Antoni van Leeuwenhoek and a publication by Jan Baptista van Helmont were translated into English, this essay examines the exchange of scientific and medical ideas across the Channel.Part of this article was written during a visiting fellowship in the Summer of 2016 at the Max Planck Institute for the History of Science in Berlin, and I would like to thank the MPIWG and the Global Knowledge Society Project for hosting me, as well as the Making Visible Project (Arts and Humanities Research Council, grant number AH/M001928/1) for providing me with support and the time to write

    A global core outcome measurement set for snakebite clinical trials.

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    Snakebite clinical trials have often used heterogeneous outcome measures and there is an urgent need for standardisation. A globally representative group of key stakeholders came together to reach consensus on a globally relevant set of core outcome measurements. Outcome domains and outcome measurement instruments were identified through searching the literature and a systematic review of snakebite clinical trials. Outcome domains were shortlisted by use of a questionnaire and consensus was reached among stakeholders and the patient group through facilitated discussions and voting. Five universal core outcome measures should be included in all future snakebite clinical trials-mortality, WHO disability assessment scale, patient-specific functional scale, acute allergic reaction by Brown criteria, and serum sickness by formal criteria. Additional syndrome-specific core outcome measures should be used depending on the biting species. This core outcome measurement set provides global standardisation, supports the priorities of patients and clinicians, enables meta-analysis, and is appropriate for use in low-income and middle-income settings

    Définition d’un jeu universel de critères de décision de base pour les essais cliniques sur les morsures de serpent: traduction par Jean-Philippe Chippaux de l’article de Abouyannis M, et al. A global core outcome measurement set for snakebite clinical trials

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    A global core outcome measurement set for snakebite clinical trials Background. Snakebite clinical trials have often used heterogeneous outcome measures and there is an urgent need for standardisation. Method. A globally representative group of key stakeholders came together to reach consensus on a globally relevant set of core outcome measurements. Outcome domains and outcome measurement instruments were identified through searching the literature and a systematic review of snakebite clinical trials. Outcome domains were shortlisted by use of a questionnaire and consensus was reached among stakeholders and the patient group through facilitated discussions and voting. Results. Five universal core outcome measures should be included in all future snakebite clinical trials: mortality, WHO disability assessment scale, patient-specific functional scale, acute allergic reaction by Brown criteria, and serum sickness by formal criteria. Additional syndrome-specific core outcome measures should be used depending on the biting species. Conclusion. This core outcome measurement set provides global standardisation, supports the priorities of patients and clinicians, enables meta-analysis, and is appropriate for use in low-income and middle-income settings. Définition d’un jeu universel de critères de décision de base pour les essais cliniques sur les morsures de serpent Contexte. Les essais cliniques sur les morsures de serpent ont souvent utilisé des critères de décision hétérogènes qui demandent à être standardisés. Méthode. Un groupe d’acteurs clés mondialement représentatifs s’est réuni pour parvenir à un consensus sur un jeu universel de critères de décision de base. Les domaines d’intérêt et les instruments d’évaluation des critères de décision ont été identifiés à partir d’une recherche documentaire et d’un examen systématique des essais cliniques concernant les envenimations par morsure de serpent. Les domaines d’intérêt ont été présélectionnés à l’aide d’un questionnaire et un consensus a été obtenu entre le groupe d’acteurs et un groupe représentatif de patients à la suite de discussions orientées et d’un vote. Résultats. Cinq critères de décision de base universels devraient être inclus dans tous les futurs essais cliniques sur les morsures de serpent : la mortalité, l’échelle d’évaluation du handicap de l’OMS, l’échelle fonctionnelle propre à chaque patient, la réaction allergique immédiate selon les critères de Brown et la maladie sérique en fonction de critères formels. D’autres critères de décision spécifiques aux différents syndromes observés lors des envenimations par morsure de serpent doivent être utilisés en fonction de l’espèce responsable de la morsure. Conclusion. Ce jeu universel de critères de décision de base permet une standardisation mondiale, répond aux priorités des patients et des cliniciens, favorise des méta-analyses et est compatible avec une utilisation dans les pays à revenu faible ou intermédiaire

    Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

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    It is well documented that the majority of adults, children and families in need of evidence-based behavioral health interventionsi do not receive them [1, 2] and that few robust empirically supported methods for implementing evidence-based practices (EBPs) exist. The Society for Implementation Research Collaboration (SIRC) represents a burgeoning effort to advance the innovation and rigor of implementation research and is uniquely focused on bringing together researchers and stakeholders committed to evaluating the implementation of complex evidence-based behavioral health interventions. Through its diverse activities and membership, SIRC aims to foster the promise of implementation research to better serve the behavioral health needs of the population by identifying rigorous, relevant, and efficient strategies that successfully transfer scientific evidence to clinical knowledge for use in real world settings [3]. SIRC began as a National Institute of Mental Health (NIMH)-funded conference series in 2010 (previously titled the “Seattle Implementation Research Conference”; $150,000 USD for 3 conferences in 2011, 2013, and 2015) with the recognition that there were multiple researchers and stakeholdersi working in parallel on innovative implementation science projects in behavioral health, but that formal channels for communicating and collaborating with one another were relatively unavailable. There was a significant need for a forum within which implementation researchers and stakeholders could learn from one another, refine approaches to science and practice, and develop an implementation research agenda using common measures, methods, and research principles to improve both the frequency and quality with which behavioral health treatment implementation is evaluated. SIRC’s membership growth is a testament to this identified need with more than 1000 members from 2011 to the present.ii SIRC’s primary objectives are to: (1) foster communication and collaboration across diverse groups, including implementation researchers, intermediariesi, as well as community stakeholders (SIRC uses the term “EBP champions” for these groups) – and to do so across multiple career levels (e.g., students, early career faculty, established investigators); and (2) enhance and disseminate rigorous measures and methodologies for implementing EBPs and evaluating EBP implementation efforts. These objectives are well aligned with Glasgow and colleagues’ [4] five core tenets deemed critical for advancing implementation science: collaboration, efficiency and speed, rigor and relevance, improved capacity, and cumulative knowledge. SIRC advances these objectives and tenets through in-person conferences, which bring together multidisciplinary implementation researchers and those implementing evidence-based behavioral health interventions in the community to share their work and create professional connections and collaborations

    Intermittent preventive treatment for malaria among children in a refugee camp in Northern Uganda: lessons learned

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    Northern Uganda hosts a large population of refugees from South Sudan, and malaria is one of the major health problems in the area. In 2015, intermittent preventive treatment for malaria (IPTc) was implemented in two refugee camps among children aged 6 months to 14 years. Three distributions of dihydroartemisinin-piperaquine (DP) were conducted at 8-week intervals. The first dose was directly administered at IPTc distribution sites and the second and third doses were given to caregivers to administer at home. A multi-faceted evaluation was implemented, including coverage surveys, malaria prevalence surveys, reinforced surveillance, and pharmacovigilance. Programme coverage exceeded 90% during all three distributions with a total of 40,611 participants. Compared to same period during the previous year (only available data), the incidence of malaria in the target populations was reduced (IRR 0.73, 95% CI 0.69-0.77 among children under 5 years old; IRR 0.70, 95% CI 0.67-0.72 among children aged 5-14 years). Among those not targeted for intervention, the incidence between the 2 years increased (IRR 1.49, 95% CI 1.42-1.56). Cross-sectional surveys showed a prevalence of parasitaemia (microscopy or PCR) of 12.9-16.4% (95% CI 12.6-19.3) during the intervention, with the highest prevalence among children aged 5-14 years, but with a large increase 8 weeks after the final distribution. A total of 57 adverse events were reported during the intervention period, including one severe adverse event (death from varicella). Adverse events were of mild to moderate severity, and were mainly dermatologic and gastrointestinal. This is the first documentation of an IPTc programme in a refugee camp. The positive impact of DP on the incidence of malaria, together with its favourable safety profile, should lead to further use of IPTc in similar settings. Expanding coverage groups and decreasing intervals between distributions might provide more benefit, but would need to be balanced with the operational implications of a broader, more frequent distribution schedule

    Supporting the transition of incarcerated youth back to the community: A Multi-systemic wraparound approach

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    Meeting the often-complex needs of young people transitioning from juvenile justice centers back into the community can be a daunting proposition, but well-planned transitions that include all stakeholders via a multi-systemic wraparound approach result in significantly improved outcomes. In this chapter, a multi-systemic approach is described and offered as best practice. It is well aligned with the last two areas of the Taxonomy for Transition Programming 2.0: interagency collaboration and program structures. The approach is also supported by the other taxonomy areas, and current research literature. The historical background of the wraparound approach is provided, as are the theoretical and conceptual frameworks that underpin wraparound. This chapter also provides an overview of successful collaborative models and program structures that have supported incarcerated youth in achieving positive outcomes post-release
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