Clinical effectiveness of single lumbar transforaminal epidural steroid injections

One last curious conclusion about the evidence is worth addressing. Namely, some proponents of person-centred theory suggest that it is unsurprising that different therapeutic orientations do not differ in terms of aggregate effectiveness. They suggest that only individual therapists who manifest the ‘core conditions’ of person-centred theory will be effective, and that anyone from any orientation could do a good job of offering the core conditions. The evidence does not support this conclusion: these conditions have been researched along with many others, and there is no evidence to suggest that success can be picked out just by looking at the core conditions. (It is entirely possible that the view is true , but for now it remains an item of faith, not a conclusion correctly derived from reliable empirical evidence.) Moreover, if it were true, it would imply an interesting conclusion which person-centred proponents would presumably find unpalatable: namely, that counsellors who successfully manifest the core conditions are no more likely to be found in the ranks of the person-centred tradition than within any other therapeutic tradition. In other words, it would imply than person-centred counsellors are no more likely to be person-centred than any other type of counsellor.

Our work includes:
•   Supporting the development of medicine management in GP practices and improving outcomes with the use of medicines (optimisation)
•   Working  with colleagues in primary care (GPs, community pharmacists and nurses) and hospital staff to facilitate transition of patients between hospital and primary care
•   Assisting patients in getting the best outcome from their medicines so they lead healthy lives and avoid hospital admissions (optimisation).
•   Supporting the NHS to achieve value for money in the use of medicine, which costs around £35 million in Wandsworth
•   Providing professional advice on clinical pharmacy matters to patients and healthcare staff
•   Ensuring governance around medicines is maintained and the organisation complies with current, national and local prescribing best practice within limited financial resources ​​​​​

A Phase III , randomised, 12 month clinical trial (CS21) in prostate cancer [4] compared androgen deprivation with one of two doses of degarelix or the GnRH agonist, leuprolide . Both degarelix doses were at least as effective as leuprolide at suppressing testosterone to castration levels (≤ ng/mL) from Day 28 to study end (Day 364). Testosterone levels were suppressed significantly faster with degarelix than with leuprolide, with degarelix uniformly achieving castration levels by Day 3 of treatment which was not seen in the leuprolide group. There were no testosterone surges with degarelix compared with surges in 81% of those who received leuprolide. Degarelix resulted in a faster reduction in PSA levels compared with leuprolide indicating faster control of the prostate cancer. Recent results also suggest that degarelix therapy may result in longer control of prostate cancer compared with leuprolide. [5]

Clinical effectiveness of single lumbar transforaminal epidural steroid injections

clinical effectiveness of single lumbar transforaminal epidural steroid injections

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