Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Clinical application”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2001

Magnetic resonance imaging of rheumatoid arthritis: the evolution of clinical applications through clinical trials.

Powerful techniques are being developed for evaluating rheumatoid arthritis with magnetic resonance imaging (MRI). Much of this development is being driven by the pharmaceutical and biotechnology industries searching for novel therapies for this disease. Accordingly, the imaging tools that ultimately will be used to direct patients to specific therapies and then to monitor treatment effectiveness and safety are currently being refined and validated in rigorous multicenter and multinational clinical trials aimed at gaining regulatory approval of these new therapies. As these trials approach completion, rheumatologists can anticipate an increased demand for expertise and experience in evaluating disease progression and treatment response with these techniques and the emergence of MRI systems specifically designed for this market. The following discussion reviews this novel pathway for evolving imaging techniques for clinical use through clinical drug trials, lists the most promising MRI markers available today for evaluating joint destruction in rheumatoid arthritis, and speculates on how these techniques will find their way into clinical practice.

Arthritis, Rheumatoid↗
PubMed1991

[Clinical application of clinical laboratory tests].

Recent advances in clinical laboratory tests have made it possible to study and clarify the pathogenesis of various diseases from various aspects. Such major advances can be very useful for the treatment and prophylaxis of diseases. Better tests can clarify the mutual relationships among diseases. Unfortunately, however, many clinical tests are not used effectively because they are not adequately understood. On this occasion, we are being given the opportunity to learn about the most recent clinical tests related to blood coagulation and fibrinolysis. These tests offer us the means of elucidating the pathogenesis of diseases. By applying the knowledge gained at this workshop in our clinical practice, we will be able to repay, in a small way, Dr. Matsuo, the chairman, for his efforts in the planning of this workshop.

Blood Coagulation↗
PubMed1987

Who still prefers aggressive surgery for breast cancer? Implications for the clinical applications of clinical trials.

Conservative breast surgery and modified radical mastectomy may, according to recent reports, yield equivalent survival. Analysis of a 1985 Canada-wide study (N = 228) compared surgeons and oncologists still recommending modified radical mastectomy (30%) with those recommending less aggressive surgery (69%) for a hypothetical stage I patient. The groups did not differ significantly in most physician characteristics, estimated survival and cure probabilities, importance of most treatment goals, uncertainty about treatment choice, or most attitudinal responses. Although equally involved with and cognizant of the value of clinical trials, the modified radical group expressed more skepticism about the ability of trial results to be transferred to practice and to take sufficient account of patient uniqueness, indicating greater focus on variation than mean results. Trial results might be more readily adopted if they are reported in accessible data-bases, incorporating patient characteristics potentially relevant to treatment choice. This would allow clinicians to individualize treatment by analyzing patient subsets of their own choosing.

Attitude of Health Personnel↗
PubMed2002

A review of physical phenomena associated with ultrasonic contrast agents and illustrative clinical applications.

Successful clinical applications of contrast agents involve an understanding of the physical interaction of ultrasound (US) with contrast agents. This paper reviews the physical phenomena involved in these interactions and discusses the relevant theoretical background for modeling US-contrast agent interactions. Measurement techniques using US to obtain information regarding contrast agents are summarized. Illustrative clinical applications are given in the second part of the paper. Recent developments in nonlinear imaging techniques and transient techniques are reviewed. New methods, such as depletion perfusion measurement, and high-frequency applications are included.

Contrast Media↗
PubMed1997

Antifungal susceptibility testing: technical advances and potential clinical applications.

The clinical application of in vitro antifungal susceptibility testing has been limited by a lack of reproducibility and uncertain clinical relevance. As a result of several collaborative studies, the National Committee for Clinical Laboratory Standards (NCCLS) has proposed a standardized antifungal susceptibility test method, NCCLS M27-T. More convenient, user-friendly methods (microdilution broth and stable gradient technology) have been evaluated, and the potential for a similar process with a disk diffusion method is apparent. Adaptation of the standard method for susceptibility testing of filamentous fungi appears promising. The existence of a standardized method facilitates meaningful analysis of studies addressing the issue of clinical relevance of antifungal susceptibility testing. Correlation of MICs with clinical response to therapy is beginning to emerge, most notably in relation to fluconazole and itraconazole therapy for oropharyngeal candidiasis associated with infection with the human immunodeficiency virus. This accumulated experience with antifungal susceptibility testing allows us to provide several specific recommendations for antifungal susceptibility testing in the clinical laboratory. Application of this developing technology to new antifungal agents and other disease states will enhance our ability to effectively deal with the emerging problem of fungal infection.

Antifungal Agents↗
PubMed2000

Surgical navigation based on fluoroscopy--clinical application for computer-assisted distal locking of intramedullary implants.

OBJECTIVE: Fluoroscopy is used to guide surgical instruments during orthopedic procedures. Radiation exposure and lack of spatial information are drawbacks of this method. Improvements are expected when fluoroscopy-based surgical navigation is used for intraoperative guidance, e.g., in computer-assisted distal locking of intramedullary implants. PATIENTS AND METHODS: The method was applied to 42 interlocking procedures during implantation of the short proximal femoral nail in 27 patients with pertrochanteric femoral fractures. Precision of interlocking, exposure time, operating time, and number of personnel required for computer-assisted distal locking were recorded. RESULTS: One misplaced interlocking screw was observed (2.3%), and contact between the drill bit and the nail during drilling was noticed in 8 cases (19%). The average exposure time was 16 seconds (range 4-42 seconds), and the procedure took an average of 43 min (range 20-70 min). The number of persons required for computer-assisted distal locking was reduced from three to one within the course of the study. CONCLUSIONS: Fluoroscopy-based surgical navigation provided precise intraoperative guidance for computer-assisted distal locking with minimal use of fluoroscopy. The complex system and related procedure times may be drawbacks in this application. Clinical studies are underway to define implants and surgical procedures where intraoperative guidance by fluoroscopy-based surgical navigation is beneficial for the patient and/or surgeon.

Computer Simulation↗
PubMed1990

Home urinary luteinizing hormone immunoassays: clinical applications.

Home ovulation prediction kits represent a valuable advance in monoclonal antibody technology and offer patients a quick, reliable, and relatively inexpensive means to predict the day of ovulation. These kits are used widely by patients trying to conceive and are commonly recommended by physicians involved in the care of infertile couples. They provide a more accurate and practical means to prospectively predict the time of ovulation than do BBT graphs or cervical mucus exams, and can be used as presumptive evidence of ovulation. Whereas ovulation prediction kits appear to be most useful for couples in timing sexual intercourse, other possible uses exist, including timing of AI, the PCT, and the endometrial biopsy for luteal phase evaluation. Despite multiple potential applications, clinical studies which support the use of urinary LH immunoassays in the evaluation and treatment of the infertile couple are quite limited. More well-designed studies to define the clinical value of ovulation prediction kits need to be undertaken.

Female↗
PubMed1980

[Studies of pacing the canine stomach with electric stimulation for its possible clinical application (author's transl)].

In dogs anesthetized by pentobarbital sodium, bipolar stimulating and recording electrodes were implanted on the gastric serosal surface and pacing effect of stimuli of rectangular current on the basic electric rhythm (BER) was examined. For judgement of pacing, the appearance of a compensatory pause after off-stimulation was a useful criterion. When BER was recorded at the oral side of stimulation, antiperistaltic one was added. Maximum driven frequency (MDF) was 6.0 +/- 0.6 (SD) cycles/min. The relation between stimulus interval (x) and BER interval (y) was represented by y = x in the stimuli below MDF. In the stimulus frequency until 2 times of MDF above MDF, it was replaced by y = 2x. Phase lag between BERs of two separated points was increased as the stimulus frequency was increased up to MDF. This tendency was observed similarly within 2 times of MDF above MDF. Using a gastrointestinal fiberscope, electric stimulation was delivered from the gastric mucosal side, while BER was recorded from the serosal side in 5 dogs and was recorded with electrodes through the endoscope in 2 dogs. Pacing was possible, too. These results may indicate that pacing and recording of the BER using gastrointestinal fiberscope are applicable clinically.

Animals↗
PubMed1986

Single photon emission computed tomography (SPECT). Part II: Clinical applications.

The clinical applications of SPECT are just beginning to be defined since complete systems have only recently become available. SPECT studies are more difficult to perform than planar imaging studies, and close attention to quality control is important to obtain optimal studies. SPECT has higher lesion contrast and is able to detect smaller lesions than planar imaging in Tc-99m sulfur colloid liver studies. Preliminary results of SPECT T1-201 studies are encouraging, but further work comparing SPECT and planar imaging of T1-201 is needed. SPECT does give more information than planar imaging in certain bone imaging cases such as suspected avascular necrosis of the hip. Although interesting results have been published using SPECT in brain and lung perfusion studies, the clinical utility of this work has not been determined. The development of certain radiopharmaceuticals would enhance the future of SPECT. Technetium-99m labeled brain and myocardial perfusion agents would be ideally suited for SPECT studies. The ability to quantitate lesion volume (eg, in liver metastases) has not been studied and could be useful in following patents on chemotherapy. SPECT could give additional information if monoclonal antibodies labeled with I-123 or Tc-99m can be demonstrated to have appropriate sensitivity. The advantages of SPECT over planar imaging will be greater as new agents are developed.

Bone Diseases↗
PubMed1995

Toward the production of bispecific antibody fragments for clinical applications.

The clinical potential of bispecific antibodies (BsAb) has been hindered by the difficulty of obtaining clinical grade material, together with the immunogenicity of rodent-derived BsAb in patients. The supply issue is being directly addressed by recombinant methods for BsAb fragment production reviewed here. The immunogenicity issue will likely be overcome by the use of humanized or human antibodies. Currently, three technologies appear suitable for the production of BsAb fragments for clinical applications: BsF(ab')2 assembled from Fab' fragments expressed in Escherichia coli, BsF(ab')2 assembled using leucine zippers, and diabodies.

Animals↗
PubMed1996

Quality of life as an outcome in breast cancer. Clinical application.

In clinical trials of anticancer agents, the assessment of objective effects has historically been the primary end-point. However, because of the limited impact of these agents on survival, the study of quality of life (QOL) has become increasingly important. QOL evaluation is difficult and the approaches of physicians and reimbursors of healthcare are quite different. In addition, QOL is not a simple concept and several different methods have been used to evaluate it. These methods can be divided into the following 2 groups: experimental methods [the best known is the quality-adjusted life-year (QALY), which utilise some kind of experimentation; and observational methods, which use questionnaires and are often multifactorial. Some of these questionnaires are used for patients with all types of pathologies, while others are cancer-specific; all questionnaires must be validated. We conducted 3 QOL studies in patients with breast cancer using the Functional Living Index-Cancer (FLIC) questionnaire. In the first, a French translation of the FLIC questionnaire was validated. The FLIC and Functional Living Index-Emesis (FLIE) questionnaires were used to assess QOL in a second study comparing 2 different antiemetics for the control of nausea and vomiting. Finally, QOL was evaluated in patients with breast cancer during adjuvant chemotherapy. Several other studies employing different questionnaires in patients with breast cancer have been published. Clinical applications for QOL evaluation in oncology may be the prognostic implications of QOL, evaluation of toxicity and duration of treatment, and evaluation of utility and QOL. However, although assessment of QOL is important for both physicians and funders, there is no gold standard method available, and the results of QOL studies have to be interpreted cautiously.

Breast Neoplasms↗
PubMed1993

Advanced computer applications in radiology: clinical applications.

Computers play a major role in bridging the gap between image generation and patient care by providing enhanced images that better meet the needs of referring physicians. Spiral computed tomography allows generation of three-dimensional images that are not affected by motion artifact. Volume rendering, a three-dimensional reconstruction algorithm, yields images free of computer-generated artifacts and superior in quality. Currently, technologic computer advances play an important role in three clinical areas: orthopedic applications, oncologic applications, and prosthetic design. Three-dimensional imaging is especially valuable in fracture assessment because it allows exploration of image data to define the location of fracture fragments, the integrity of the joint space, and any possible displacement. With three-dimensional imaging, the extent of tumor spread into adjacent soft tissue or involvement of blood vessels can be determined, even in difficult anatomic areas. Volume rendering and increased computer speed allow greatly improved treatment planning for radiation therapy and custom design of orthopedic prostheses. Through the mutual understanding of goals between physicians and computer scientists, the computer can reach its full potential in medicine, resulting in improved patient care.

Diagnostic Imaging↗