Care, Part 1 By A. Marie !FULL!
Methods: The data concerning private or public hospital stays were collected from the national PMSI database. All surgical/medical institutions performing anaesthesia in France and French Overseas Departments and Territories were queried concerning the number of anaesthesias, patient age, sex ratios, institution characteristics, hospitalization types, the duration of hospital stays, and the surgical procedures performed.
Care, Part 1 by A. Marie
Meursault narrates the events of his life as they occur without interpreting them as a coherent narrative. He does not relate the events of earlier chapters to the events that take place in these chapters. It becomes clear that Meursault concentrates largely on the moment in which he finds himself, with little reference to past occurrences or future consequences. This outlook perhaps explains his ambivalent attitude toward marriage with Marie. Because he does not think about what married life would be like, Meursault does not particularly care whether or not he and Marie marry. Characteristically, the emotional and sentimental aspects of marriage never enter into his mind.
This type of holistic care, which looks after every part of you, is called palliative care. Palliative care aims to make sure you feel supported and comfortable, rather than cure the illness.
Yes. You do not have to stop seeing other health and social professionals who support you. You can have palliative care alongside care from the specialists who have been treating your particular illness.
We hope the information on this page has helped you to understand more about palliative care, including the differences between it and end of life care. If you have other questions about your care, it is best to speak with your doctor, nurse or healthcare team looking after you.
A nerve cell communicates information to distant targets by sending electrical signals down a long, thin part of the cell called the axon. The axon is surrounded by myelin, a covering that acts like the insulation on an electrical wire and aids the high-speed transmission of electrical signals. Without an intact axon and myelin sheath, signals that run along the nerve and axon are either slow or have a weak signal, meaning that the peripheral nerve cells become unable to activate muscles or relay sensory information from the limbs back to the spinal cord and the brain.
An NIH longitudinal collaborative study hopes to determine the natural history of CMT and how the presence of a certain gene mutation may result in disease types and symptoms. Also, a two-part study is looking for new genes that cause the disease as well as genes that do not cause the disease but may modify a person's symptoms. Other NIH-funded scientists are using next-generation sequencing (which can quickly identify the structure of millions of small fragments of DNA at the same time) to identify novel CMT genes.
Consider participating in a clinical trial so clinicians and scientists can learn more about CMT and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.
Layout table for study information Study Type : Interventional (Clinical Trial) ActualEnrollment : 63 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: A Phase 2 Randomized, Double-Blind, Placebo-Controlled Study of ACE-083 in Patients With Charcot-Marie-Tooth Disease Types 1 and X Actual Study Start Date : July 31, 2017 Actual Primary Completion Date : March 11, 2020 Actual Study Completion Date : March 11, 2020 Resource links provided by the National Library of Medicine MedlinePlus Genetics related topics: Hereditary neuropathy with liability to pressure palsies Charcot-Marie-Tooth disease MedlinePlus related topics: Charcot-Marie-Tooth Disease Tooth Disorders Genetic and Rare Diseases Information Center resources: Charcot-Marie-Tooth Disease Hereditary Neuropathy With Liability to Pressure Palsies Roussy Levy Syndrome Charcot-Marie-Tooth Disease Type 1 U.S. FDA Resources Arms and Interventions Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Arm Intervention/treatment Experimental: Part 1 Cohort 1ACE-083 150 mg intramuscular (IM) (tibialis anterior muscle), once every 3 weeks for up to 5 doses. Drug: ACE-083Part 1 - Recombinant fusion protein. Part 2 - Recombinant fusion protein or buffer solution. Experimental: Part 1 Cohort 2ACE-083 200 mg IM (tibialis anterior muscle), once every 3 weeks for up to 5 doses. Drug: ACE-083Part 1 - Recombinant fusion protein. Part 2 - Recombinant fusion protein or buffer solution. Experimental: Part 1 Cohort 3ACE-083 up to 250 mg IM (tibialis anterior muscle), once every 3 weeks for up to 5 doses. Drug: ACE-083Part 1 - Recombinant fusion protein. Part 2 - Recombinant fusion protein or buffer solution. Experimental: Part 2 (double-blind placebo controlled)ACE-083 up to 250 mg IM (tibialis anterior muscle) or placebo, once every 3 weeks for up to 9 doses Drug: ACE-083Part 1 - Recombinant fusion protein. Part 2 - Recombinant fusion protein or buffer solution. Drug: PlaceboRecombinant fusion protein or buffer solution Experimental: Part 2 (open label)ACE-083 up to 250 mg IM (tibialis anterior muscle), once every 3 weeks for up to 8 doses Drug: ACE-083Part 1 - Recombinant fusion protein. Part 2 - Recombinant fusion protein or buffer solution. Outcome Measures Go to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Primary Outcome Measures : Part 1: Frequency of Adverse Events [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period for Part 1 (Study Day 141). ]Number of subjects with at least one adverse event related to treatment intervention from Part 1 of this study. Since this outcome measure was only pre-specified for Part 1, only data from the Part 1 participants is reported. Part 2: Percent Change in Muscle Volume to the End of the Double-blind Placebo-controlled Portion of the Study. [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]The percent change from baseline in volume of injected muscle, by MRI compared to the Day 190 Assessment is reported. The pre-specified timepoint for this outcome was only for data collected from participants to the end of the double-blind placebo controlled portion of the study, therefore data for the open-label arm of the study is not reported. Secondary Outcome Measures : Part 2: Absolute Change in Amount of Intramuscular Fat Tissue to the End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]The absolute change from baseline in intramuscular fat fraction of the injected muscle, by MRI compared to Day 190 Assessment is reported. The pre-specified timepoint for this outcome was only for data collected from participants to the end of the double-blind placebo controlled portion of the study, therefore data for the open-label arm of the study is not reported. Part 2: Percent Change in Muscle Strength to the End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]Percent change from baseline in strength of the injected muscle, by Quantitative Muscle Testing (QMT) compared to Day 190 Assessment is reported. The pre-specified timepoint for this outcome was only for data collected from participants to the end of the double-blind placebo controlled portion of the study, therefore data for the open-label arm of the study is not reported. Part 2: Percent Change in Muscle Function - Walk/Run Time to the End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]The percent change from baseline in functional assessments, as measured by 10-meter walk/run time when compared to Day 190 Assessment is reported. The pre-specified timepoint for this outcome was only for data collected from participants to the end of the double-blind placebo controlled portion of the study, therefore data for the open-label arm of the study is not reported. Part 2: Percent Change in Muscle Function - Walk Distance Assessed at the End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period for the double-blind placebo-controlled portion of the study (Study Day 190). ]Percent change from baseline in functional assessments, as measured by 6-minute walk distance when compared to Day 190 Assessment, is reported. The pre-specified timepoint for this outcome was only for data collected from participants to the end of the double-blind placebo controlled portion of the study, therefore data for the open-label arm of the study is not reported. Part 2: Change in Balance and Fall Risk at the End of the Double-blind Placebo-controlled Portion of the Study. [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]Change from baseline in static and dynamic balance, as measured by the Berg Balance Scale, a 14-item scoring system to assess balance and fall risk in adults. The Berg balance scale is used to objectively determine a patient's ability (or inability) to safely balance during a series of predetermined tasks. It is a 14 item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function. Total scores are used for reporting, with a range of 0-56, with higher scores mean a better demonstration of function. A score of 56 indicates functional balance. A score of Part 2: Percent Change in Balance and Fall Risk From Baseline to the End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]Percent change was calculated for the difference from baseline and Day 190 Assessment scores on the Berg Balance Scale. The Berg Balance Scale, is a 14-item scoring system to assess balance and fall risk in adults. The Berg balance scale is used to objectively determine a patient's ability (or inability) to safely balance during a series of predetermined tasks. It is a 14 item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function. Total scores are used for reporting, with a range of 0-56, with higher scores mean a better demonstration of function. A score of 56 indicates functional balance. A score of Part 2: Change in Clinical Examination Score From Baseline to End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]Change from baseline in the Charcot-Marie-Tooth (CMT) Examination Score, version 2 (CMTES2), a composite scoring system to assess sensory and motor impairment in subjects with CMT. The total score is a subset of the following items from the CMT neuropathy score instrument: Sensory symptoms, Motor symptoms (legs), Motor symptoms (arms), Pinprick Sensibility, Vibration, Strength (legs), and Strength (arms). Each individual item is assessed using a rating from 0 to 4 inclusive. The range of CMTES2 scores is from 0 to 28 inclusive. A higher score means a greater degree of symptom severity. The Baseline score and score on the Day 190 Assessment are reported. The pre-specified timepoints for reporting are baseline Berg scale score and Day 190 score, therefore data for the open-label arm of the study is not reported. Part 2: Percent Change in Clinical Examination Score in Baseline to End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]Percent change was calculated for the difference in the Charcot-Marie-Tooth (CMT) Examination Score (CMTES2) from baseline and Day 190 Assessment scores. The pre-specified timepoints for reporting are baseline Berg scale score and Day 190 score, therefore data for the open-label arm of the study is not reported. Part 2: Change in Patient-reported Quality of Life From Baseline to the End of the Double-blind Placebo-controlled Portion of the Study [ Time Frame: From initiation of treatment (Study Day 1) to end of follow-up period of the double-blind placebo-controlled portion of the study (Study Day 190). ]The absolute change from baseline in Charcot-Marie-Tooth Health Index (CMT-HI), a disease-specific, patient-reported health index score from baseline and Day 190 Assessment scores. The pre-specified timepoints for reporting are baseline Berg scale score and Day 190 score, therefore data for the open-label arm of the study is not reported. Eligibility CriteriaGo to Top of Page Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. Layout table for eligibility information Ages Eligible for Study: 18 Years and older (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Key Inclusion Criteria 041b061a72