What are the unmet needs and most relevant treatment outcomes according to patients with inflammatory bowel disease? A qualitative patient preference study

BACKGROUND AND AIMS

As more therapeutic options with their own characteristics become available for inflammatory bowel disease (IBD), drug development and individual treatment decision-making needs to be tailored towards patients' preferences and needs. This study aimed to understand patient preferences among IBD patients, and their most important treatment outcomes and unmet needs.

METHODS

This qualitative study consisted of 1) a scoping literature review, 2) two focus group discussions (FGDs) with IBD patients (n=11) using the nominal group technique, and 3) two expert panel discussions.

RESULTS

IBD patients discussed a multitude of unmet needs regarding their symptoms, side-effects, psychological and social issues for which they would welcome improved outcomes. Particularly, IBD patients elaborated on the uncertainties and fears they experienced regarding the possible need for surgery or an ostomy, the effectiveness and onset of action of their medication, and its long-term effects. Furthermore, participants extensively discussed the mental impact of IBD and their need for more psychological guidance, support, and improved information and communication with healthcare workers regarding their disease and emotional well-being. The following five characteristics were identified during the attribute grading as most important: prevent surgery, long-term clinical remission, improved quality of life (QoL), occurrence of urgency, and improved labor rate.

CONCLUSIONS

This study suggests that IBD drug development and treatment decision-making needs to improve IBD symptoms and adverse events that significantly impact IBD patients' QoL. Furthermore, this study underscores patients need for a shared decision-making process where their desired treatment outcomes and uncertainties are explicitly discussed and considered.

GOLD: a parallel real-time stereo vision system for generic obstacle and lane detection

This paper describes the generic obstacle and lane detection system (GOLD), a stereo vision-based hardware and software architecture to be used on moving vehicles to increment road safety. Based on a full-custom massively parallel hardware, it allows to detect both generic obstacles (without constraints on symmetry or shape) and the lane position in a structured environment (with painted lane markings) at a rate of 10 Hz. Thanks to a geometrical transform supported by a specific hardware module, the perspective effect is removed from both left and right stereo images; the left is used to detect lane markings with a series of morphological filters, while both remapped stereo images are used for the detection of free-space in front of the vehicle. The output of the processing is displayed on both an on-board monitor and a control-panel to give visual feedbacks to the driver. The system was tested on the mobile laboratory (MOB-LAB) experimental land vehicle, which was driven for more than 3000 km along extra-urban roads and freeways at speeds up to 80 km/h, and demonstrated its robustness with respect to shadows and changing illumination conditions, different road textures, and vehicle movement.

Vision-Based Road Detection in Automotive Systems: A Real-Time Expectation-Driven Approach

The main aim of this work is the development of a vision-based road detection system fast enough to cope with the difficult real-time constraints imposed by moving vehicle applications. The hardware platform, a special-purpose massively parallel system, has been chosen to minimize system production and operational costs. This paper presents a novel approach to expectation-driven low-level image segmentation, which can be mapped naturally onto mesh-connected massively parallel SIMD architectures capable of handling hierarchical data structures. The input image is assumed to contain a distorted version of a given template; a multiresolution stretching process is used to reshape the original template in accordance with the acquired image content, minimizing a potential function. The distorted template is the process output.

Parallel and local feature extraction: a real-time approach to road boundary detection

Presents a system for the extraction of road boundaries from an image taken in an out-of-town environment. In this application, computational speed and performance play a fundamental role in the selection of the hardware platform and the design of algorithms. The algorithm has been designed to be implemented on a special-purpose mesh-connected SIR ID architecture, PAPRICA, which will be fitted to the vehicle. This presentation focuses on the algorithms and in particular on processing speed.

Measurement of glomerular filtration rate by impulse synthesis: clinical validation and optimization

Impulse synthesis is a technique which relies upon the logic of continuous infusion but extracts the clearance value from single-injection data by shifting and adding them until an asymptotic value is attained. This study has been aimed at validating and optimizing clinically the measurement of glomerular filtration rate by impulse synthesis. A single intravenous injection of 51Cr-EDTA has been made in 32 patients and plasma activity monitored over the next 6 h. Glomerular filtration rate computed by a single-exponential fit method (GFR-SEF) has been shown to be significantly (p less than 0.001) overestimated when compared with the glomerular filtration rate obtained by the impulse synthesis technique (GFR-IS) in spite of an excellent (r = 0.989) linear correlation between the two sets of data. On the other hand, the comparison between GFR-IS and 24-h creatinine clearance has not shown any significant difference. Moreover, we have found that in patients with severe renal failure GFR-IS is overestimated when the sampling time span is shortened to 3 h. On the other hand, GFR-IS is slightly underestimated in patients with severe renal failure when the convolution time interval is increased over a few minutes.

[Portal cavernoma. Observation of a case and clinico-nosographic considerations (author's transl)]

The clinical case of a sixty-two year old woman suffering for about six years from rare episodes of cramplike pains in the right hypochondriac region, radiated to the homolateral scapula, is described. After diagnosis of biliary calculosis, the patient was admitted to hospital and her gallbladder removed. During the operation a number of venous ectasias of the portal system were evidenced at the hepatic hilus, and their biopsy led to a diagnosis of portal cavernoma. The possible part played by the cavernoma in producing the patient's clinical picture is discussed, with reference also to other cases of cavernoma of varying location. This is followed by a review of the literature, in which stress is placed on the different aetiopathogenetic interpretations of angiomas and in particular of portal cavernomas. The possible evolution of angiomas and present treatment trends are also mentioned.

[Colonic mucins in idiopathic proctocolitis and Crohn's disease]

The AA. examine 75 cases of Crohn disease for studying the secretion of mucina in the different stages of disease. The result is that the acute stage is marked by a strong depletion of mucina; the interesting part of this work is that the study of sulpherized acid mucinae is an excellent standard of diagnosis in regard to the benign evolution of this disease.