BACKGROUND:
Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR).
METHODS:
Using previously described methodology, specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus.
RESULTS:
The ICAR:AR document addresses over 100 individual topics related to AR, including diagnosis, pathophysiology, epidemiology, disease burden, risk factors for the development of AR, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR.
CONCLUSION:
This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding.

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International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis.

Maintaining or improving quality of life (QoL) is a key outcome of clinical interventions in older people. Fear of falling (FoF) is associated with activity restriction as well as with poorer physical and cognitive functions and may be an important contributor to a diminished QoL. The objectives of this systematic review were to determine i) the effect of FoF on QoL in older people, ii) whether the association between these two constructs depends on the use of specific conceptualizations and measurement instruments, and iii) the role of fall events as mediating factor in this relationship. Four electronic databases (PubMed, EMBASE, CINAHL, and Cochrane Library) were searched from their inceptions to February 2018. Thirty mostly cross-sectional studies in nearly 30.000 people (weighted mean age 75.6 years (SD =6.1); 73% women) were included. FoF was associated with QoL in most studies, and this association appeared to be independent of the conceptualization of FoF. Moreover, this relationship was independent of falls people experienced which seemed to have a lower impact. FoF should be considered not only as by-product of falls and targeted interventions in parts different from those to reduce falls are likely required. Studies are needed showing that reducing FoF will lead to increased QoL.

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A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls?

In 2006, PAIN published a systematic review of the measurement properties of self-report pain intensity measures in children and adolescents (Stinson JN, Kavanagh T, Yamada J, Gill N, Stevens B. Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. PAIN 2006;125:143-57). Key developments in pediatric pain necessitate an update of this work, most notably growing use of the 11-point numeric rating scale (NRS-11). Our aim was to review the measurement properties of single-item self-report pain intensity measures in children 3 to 18 years old. A secondary aim was to develop evidence-based recommendations for measurement of child and adolescent self-report of acute, postoperative, and chronic pain. Methodological quality and sufficiency of measurement properties for reliability, validity, responsiveness, and interpretability was assessed by at least 2 investigators using COnsensus based Standards for the selection of health Measurement INstruments (COSMIN). Searches identified 60 unique self-report measures, of which 8 (reported in 80 papers) met inclusion criteria. Well-established measures included the NRS-11, Color Analogue Scale (CAS), Faces Pain Scale-Revised (FPS-R; and original FPS), Pieces of Hurt, Oucher-Photographic and Numeric scales, Visual Analogue Scale, and Wong-Baker FACES Pain Rating Scale (FACES). Quality of studies ranged from poor to excellent and generally reported sufficient criterion and construct validity, and responsiveness, with variable reliability. Content and cross-cultural validity were minimally assessed. Based on available evidence, the NRS-11, FPS-R, and CAS were strongly recommended for self-report of acute pain. Only weak recommendations could be made for self-report measures for postoperative and chronic pain. No measures were recommended for children younger than 6 years, identifying a need for further measurement refinement in this age range. Clinical practice and future research implications are discussed.

Recommendations for selection of self-report pain intensity measures in children and adolescents: a systematic review and quality assessment of measurement properties.

Importance Though anecdotally linked, few studies have investigated the impact of facial paralysis on depression and quality of life (QOL). Objective To measure the association between depression, ...

/pdf/association-among-facial-paralysis-depression-and-quality-of-4r40s7e486.pdf

Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients

https://pure.rug.nl/ws/files/17596084/Title_and_contents_.pdf

Medication beliefs, treatment complexity, and non-adherence to different drug classes in patients with type 2 diabetes

Now-a-days there is significant discussion about patient-reported outcomes (PRO) in medical world. The following article covers almost all the areas of PRO including-their importance, important concepts for understanding of PRO, significance, ideal properties, types, development and evaluation of PRO instruments. It is useful for physicians, pharmacists and patients for the assessment and improvement of the therapy.

Patient-reported outcomes: A new era in clinical research

Bioanalytical chiral chromatographic technique and docking studies for enantioselective separation of meclizine hydrochloride: Application to pharmacokinetic study in rabbits.

Psoriasis results in expenses to patients from many cost sources. Psoriasis treatment may result in considerable time and travelling costs, yet many studies fail to account for these costs. The objective of this study was to evaluate the economic burden of psoriasis in patients.Methods: The study was based on 200 patients with psoriasis visiting a tertiary level dermatological clinic. The data was based on a patient questionnaire and clinical data from the medical records. Item costs were based on true costs charged from the patients and all time cost estimates were done.Results: 200 patients with psoriasis were included in the study. Total costs were higher for patients receiving phototherapy than those receiving systemic treatment. The majority of the visit costs arose from hospitalization and only a small proportion were attributed to outpatient visits.Conclusion: Visit charges and other patient investigations were estimated to play a minor role in the total cost of psoriasis incurred by patients, while travel costs and loss of pay comprised the majority of the costs, which should not be omitted in future studies regarding costs of treatments.

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Cost of illness in Psoriasis Patients on Bath PUVA therapy Versus Methotrexate

Aim: Ultra-fast LC was used to establish a new bioanalytical method for enantiomeric separation of oxomemazine. Methods: The proposed study was carried out using the ultra-fast LC technique with an amylose chiral column. The bioanalytical approach was used in rabbit plasma following US FDA regulations and then extended to oxomemazine enantiomeric separation using metronidazole as the internal standard. Results: The retention times of (R)-oxomemazine, (S)-oxomemazine and the internal standard were found to be 9.511, 10.712 and 6.503 min, respectively. Within-run and between-run precision (percent relative standard deviation) was found to be in the range of 0.018-0.102% for (R)-oxomemazine and 0.028-0.675% for (S)-oxomemazine, whereas accuracy (%) was found to be in the range of 95.971-99.720% for (R)-oxomemazine and 97.199-103.921% for (S)-oxomemazine. Conclusion: The findings revealed that stereospecific distribution of oxomemazine enantiomers does not change significantly.

Surulivel Rajan

Papers

Patient-reported outcomes: A new era in clinical research

Bioanalytical chiral chromatographic technique and docking studies for enantioselective separation of meclizine hydrochloride: Application to pharmacokinetic study in rabbits.

Cost of illness in Psoriasis Patients on Bath PUVA therapy Versus Methotrexate

Enantiomeric separation of oxomemazine in rabbit plasma by ultra-fast LC and application in a stereoselective pharmacokinetic study.