Matching Items (4)

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Orphan drugs in development for primary biliary cirrhosis: challenges and progress

Description

Primary biliary cirrhosis (PBC) is a chronic progressive liver disease that often leads to fibrosis, cirrhosis, and end-stage liver disease. The diagnosis is made when there is evidence of cholestasis

Primary biliary cirrhosis (PBC) is a chronic progressive liver disease that often leads to fibrosis, cirrhosis, and end-stage liver disease. The diagnosis is made when there is evidence of cholestasis and reactivity to the antimitochondrial antibody. The etiology of PBC is poorly understood; however, several lines of evidence suggest an environmental factor that triggers a series of immune-mediated inflammatory reactions in the bile ducts in a genetically susceptible individual. Fatigue and pruritus are the most common symptoms of PBC; however, many patients are diagnosed with PBC only based on laboratory abnormalities. The only pharmacological treatment approved for PBC is ursodeoxycholic acid (UDCA). Several controlled studies have shown that UDCA improves liver biochemistries and prolongs transplant-free survival in PBC patients. Nearly 40% of PBC patients do not respond to UDCA, and those patients are at high risk of serious adverse events, such as the development of liver failure. Therefore, newer alternative therapeutic options for PBC are needed. Obeticholic acid is a first-in-class farnesoid X receptor agonist that has been recently evaluated in PBC patients with inadequate response to UDCA, and demonstrated beneficial results in improving liver biochemistries. Several other agents (fibrates and glucocorticoids) have been previously examined in PBC patients with inadequate response to UDCA, and preliminary results showed biochemical improvement. However, large-scale controlled clinical trials are needed to determine the long-term effects of fibrates and glucocorticoids on the clinical outcomes of PBC. Clinical trials of NGM282 (a fibroblast growth factor-19 analog) and Abatacept (a fusion protein composed of the Fc portion of immunoglobulin G1 fused to CTLA4) are currently underway.

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Date Created
  • 2015-09-10

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My journey to initiate a study for determining the prevalence/incidence of Primary Sclerosing Cholangitis (""PSC"") in different race/ethnic groups through a retrospective study in Arizona

Description

This paper will chronicle my personal experience in trying to design and initiate a retrospective patient data study to determine the prevalence of Primary Sclerosing Cholangitis (“PSC”) in certain races/ethnic

This paper will chronicle my personal experience in trying to design and initiate a retrospective patient data study to determine the prevalence of Primary Sclerosing Cholangitis (“PSC”) in certain races/ethnic groups in Arizona. This experience will also be the basis for my proposed roadmap for a more successful future study.

My nearly 10 month thesis project of trying to complete a study yielded considerable ‘learning opportunities’ in large part due to my inexperience. I made numerous errors in sequencing tasks, grossly under-scoping elapsed time and hours for other tasks, completely overlooking other critical tasks, and being insensitive to how irrelevant I and my project were to the many professionals whose help I needed to complete the study. Based upon the knowledge I gained through this process, I will describe the design of a future study of retrospective patient data that will assess whether PSC patients in Phoenix, Arizona follow racial/ethnic trends. I chose Phoenix as an ideal location to perform this proposed study because of the diverse racial/ethnic population in the greater Phoenix area. The goal will be to obtain and review 20 years of retrospective patient data from three large hospital groups in Phoenix, identify the races/ethnicities of PSC patients, and quantify the prevalence and incidence of PSC in such races/ethnicities. The lack of IRB uniformity among the subject hospitals/clinics will pose a challenge, but a detailed outline of how to approach the IRB approval process and obtain PSC patient data from each institution is provided.

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Created

Date Created
  • 2016-12

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Voces Oídas: Yuma Regional Cancer Center Hispanic Breast Cancer Patient Experiences Told Through Video Documentary

Description

The goal of this pilot study is to capture the lived experiences of racial/ethnic Hispanic breast cancer patients at Yuma Regional Cancer Center in Yuma, Arizona, through video documentary. This

The goal of this pilot study is to capture the lived experiences of racial/ethnic Hispanic breast cancer patients at Yuma Regional Cancer Center in Yuma, Arizona, through video documentary. This unique media gives a "voice" to patients who may otherwise feel underrepresented in healthcare and in social support resources. An analysis of ten interviews with Hispanic/Latina breast cancer patients reveals the intersectional nature of social support and emotional adjustment during the breast cancer experience from diagnosis to treatment. The resulting interviews are analyzed for reoccurring themes that may resonate with a large proportion of the Hispanic breast cancer population. The final result of the pilot study is a video documentary reflecting the unique social support needs of Hispanic breast cancer patients as well as provider education needs. This video will then be broadly promoted throughout Yuma Regional Medical Center and Mayo Clinic.

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Date Created
  • 2016-12

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The Evolution of Medicine: Predictions for the Future of Emergency Medicine

Description

Medicine is evolving at an accelerating rate. The needs of the future in medicine are different than the needs of today. With many possible outcomes for the future of medicine,

Medicine is evolving at an accelerating rate. The needs of the future in medicine are different than the needs of today. With many possible outcomes for the future of medicine, researchers and physicians have tried to predict the future for particular fields. As new healthcare workers enter the medical field, their training must be tailored to provide the best education to prepare healthcare workers for their careers. Therefore, it is imperative to take a closer look into the future in order to better decide how to train doctors, nurses, PA’s, etc. effectively to provide the best care possible.

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Date Created
  • 2020-05