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integrated medical treatment

Oana A Tatucu-Babet, Emma J Ridley
Outpatients who receive hyperbaric oxygen treatment (HBOT) may represent a group at significant risk of malnutrition owing to the underlying conditions that are often treated with HBOT (e.g., non-healing diabetic wounds and radiation-induced skin injury). In this issue, See and colleagues provide new, preliminary evidence of the prevalence of malnutrition in a small group of HBOT outpatients treated in an Australian hospital, reporting that approximately one-third of patients receiving HBOT were at risk of malnutrition...
December 24, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Yu Lysanets, O Bieliaieva, I Znamenska, N Nikolaieva, S Efendiieva, M Hutsol
The paper examines the narrative arrangement of the problem-oriented medical record (POMR) as an effective method of registering and assessing clinical data. The aim of the research is to examine the types of narrators and focalization, as well as the hierarchy and interaction of narrative levels in the analyzed discourse. The research has demonstrated the presence of several types of narrators within the analyzed discourse: (1) the omniscient hetero-extradiegetic narrator with transient internal focalization (the third-person narration, represented by the physician) and (2) homo-intradiegetic narration (patient's first-person narration) in the "Subjective Observation" section; (3) the "estranged" heterodiegetic narrator with external focalization (the "Objective Observation" part); (4) the "uncertain" type of narrator (the "Assessment" part); (5) and the imperative mode of narration (the "Plan" section)...
October 2018: Georgian Medical News
Zacariah K Shannon, Stacie A Salsbury, Donna Gosselin, Robert D Vining
BACKGROUND: Few studies have investigated patient and provider expectations of chiropractic care, particularly in multidisciplinary settings. This qualitative study explored stakeholder expectations of adding a chiropractor to the healthcare team at a rehabilitation specialty hospital. METHODS: The research methodology was an organizational case study with an inpatient facility for persons recovering from complex neurological conditions serving as the setting. Sixty stakeholders, including patients, families, hospital staff, and administrators, were interviewed or participated in focus groups in June 2015...
December 4, 2018: BMC Complementary and Alternative Medicine
Bianca Senf, Jens Fettel, Christina Demmerle, Paula Maiwurm
OBJECTIVE: Clinical experience reveals a gap between recommended psychosocial care and actual support for psycho-oncology. Physicians' are essential for managing psychosocial distress and for the successful implementation of psycho-oncology. The aim was to explore physician's attitudes towards psycho-oncology, their self-perceived barriers towards referral to psycho-oncology, and their personal psychosocial competencies in a maximum-care hospital. METHOD: Semi-structured interviews informed the development of a questionnaire administered to a monocentric sample of 120 physicians at the University Hospital Frankfurt...
December 4, 2018: Psycho-oncology
Ezra E W Cohen, Denis Soulières, Christophe Le Tourneau, José Dinis, Lisa Licitra, Myung-Ju Ahn, Ainara Soria, Jean-Pascal Machiels, Nicolas Mach, Ranee Mehra, Barbara Burtness, Pingye Zhang, Jonathan Cheng, Ramona F Swaby, Kevin J Harrington
BACKGROUND: There are few effective treatment options for patients with recurrent or metastatic head-and-neck squamous cell carcinoma. Pembrolizumab showed antitumour activity and manageable toxicity in early-phase trials. We aimed to compare the efficacy and safety of pembrolizumab versus standard-of-care therapy for the treatment of head-and-neck squamous cell carcinoma. METHODS: We did a randomised, open-label, phase 3 study at 97 medical centres in 20 countries...
November 30, 2018: Lancet
David A Provenzano, Khalid M Kamal, Vincent Giannetti
BACKGROUND: The management of chronic pain is complex and often involves the integration of multiple clinical, humanistic, and economic factors. Primary care physicians (PCPs) are often at the forefront of managing chronic pain and often initiate pharmacological pain management therapy. To date little is known surrounding the pain management practices of PCPs. OBJECTIVE: The purpose of this study is to assess the knowledge and practice of PCPs in management of chronic pain...
November 2018: Pain Physician
Devon K Check, Marilyn L Kwan, Neetu Chawla, Stacie B Dusetzina, Emily Valice, Isaac J Ergas, Janise M Roh, Tatjana Kolevska, Donald L Rosenstein, Lawrence H Kushi
CONTEXT: Patients with cancer commonly experience depression. If not addressed, depression can lead to reduced quality of life and survival. OBJECTIVE: Given the introduction of national initiatives to improve management of psychiatric symptoms among patients with cancer, we examined patterns of depression detection and treatment over time, and with respect to patient characteristics. METHODS: This cross-sectional study linked data from the Pathways Study, a prospective cohort study of women diagnosed with breast cancer at Kaiser Permanente Northern California (KPNC) between 2005-2013, with data from KPNC's electronic medical record...
November 30, 2018: Journal of Pain and Symptom Management
Philipp E Bartko, Henrike Arfsten, Gregor Heitzinger, Noemi Pavo, Max-Paul Winter, Aurel Toma, Guido Strunk, Christian Hengstenberg, Martin Hülsmann, Georg Goliasch
Aims: Bivalvular functional regurgitation (BVFR) defined as concomitant mitral and tricuspid insufficiency has not been described or systematically assessed before. Therefore, this study sought to define incidence, impact and natural history of BVFR in heart failure with reduced ejection fraction (HFrEF) to provide the foundation for risk assessment and directions for potential treatment strategies. Methods and results: We enrolled 1021 consecutive patients with HFrEF under guideline-directed medical therapy and performed comprehensive echocardiographic and neurohumoral profiling...
December 1, 2018: European Heart Journal Cardiovascular Imaging
Robert C Smith, Stefan Leucht, John M Davis
RATIONALE: There are many psychotropic drugs available for treatment of schizophrenia. The clinician's choice of the most effective first-line antipsychotic treatment for patients with schizophrenia should balance considerations of differential efficacy of antipsychotics against the relative risk of different side effects. METHOD: We reviewed recent studies using meta-analytic techniques and additional studies of new antipsychotics which quantitatively evaluate the efficacy of side effects of first- and second-generation antipsychotics and studies of the efficacy on add-on secondary medications...
November 30, 2018: Psychopharmacology
Singh Mathuria Kaushal-Deep, Vikas Singh, Poonam Gupta, Rudra Mani, Mehershree Lodhi
Bullhorn injury is a rare mechanism causing traumatic abdominal wall hernia (TAWH). Bullhorn injury needs to be discussed as a separate sub-entity among TAWHs as the mechanism of injury is such that the great force is generated at a relatively small area of impact for a short duration of time which may lead to muscle defect without compromising integrity of overlying skin (referred to as sheathed goring) leading to herniation of abdominal viscera. The purpose of this review was to discuss abdominal herniation's associated with bullhorn injury as a separate entity from TAWHs; recognize the common presentations, mechanism of injury, and modalities of treatment currently utilized for this rare condition...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Steven T Szabo, Michael J Thorpy, Geert Mayer, John H Peever, Thomas S Kilduff
Excessive daytime sleepiness (EDS) and cataplexy are common symptoms of narcolepsy, a sleep disorder associated with the loss of hypocretin/orexin (Hcrt) neurons. Although only a few drugs have received regulatory approval for narcolepsy to date, treatment involves diverse medications that affect multiple biochemical targets and neural circuits. Clinical trials have demonstrated efficacy for the following classes of drugs as narcolepsy treatments: alerting medications (amphetamine, methylphenidate, modafinil/armodafinil, solriamfetol [JZP-110]), antidepressants (tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors), sodium oxybate, and the H3 -receptor inverse agonist/antagonist pitolisant...
November 8, 2018: Sleep Medicine Reviews
Yonghong Zhang, Lina Ma, Xiaohui Hu, Jinlu Ji, Gil Mor, Aihua Liao
STUDY QUESTION: What is the role of the programmed cell death-1 (PD-1)/PD-1 ligand-1 (PD-L1) axis in macrophage polarization during early pregnancy? SUMMARY ANSWER: PD-1 signaling is a major regulator of macrophage differentiation and function, and it is critical for the success of a pregnancy. WHAT IS KNOWN ALREADY: The predominance of decidual macrophages (DMs) with an M2 phenotype is an important contributor to maternal-fetal tolerance during early pregnancy...
November 30, 2018: Human Reproduction
Ahmed Hosny, Chintan Parmar, Thibaud P Coroller, Patrick Grossmann, Roman Zeleznik, Avnish Kumar, Johan Bussink, Robert J Gillies, Raymond H Mak, Hugo J W L Aerts
BACKGROUND: Non-small-cell lung cancer (NSCLC) patients often demonstrate varying clinical courses and outcomes, even within the same tumor stage. This study explores deep learning applications in medical imaging allowing for the automated quantification of radiographic characteristics and potentially improving patient stratification. METHODS AND FINDINGS: We performed an integrative analysis on 7 independent datasets across 5 institutions totaling 1,194 NSCLC patients (age median = 68...
November 2018: PLoS Medicine
Carolin C Hack, Sophia Antoniadis, Matthias W Beckmann, Anna Lisa Brandl, Peter A Fasching, Janina Hackl, Hanna Langemann, Stock Katja, Natalie Weber, Anna-Katharin Theuser
Background During cancer therapy, many patients suffer from malnutrition or vitamin deficiency. Treatment for nutrition-related deficiencies should therefore include nutritional therapy and possibly oral or intravenous substitution of micronutrients. Little information exists on multinutrient infusion therapies. The aim of this study was to develop standardized infusion protocols for integrative medicine infusions with micronutrients (IMed infusions) and to report on side effects of the treatment and patients' satisfaction with it...
November 2018: Geburtshilfe und Frauenheilkunde
Nathalie Y Pauwen, Edouard Louis, Corey Siegel, Jean-Frederic Colombel, Jean Macq
Evolution in the management of Crohn's disease [CD] has been characterized by recent paradigm changes. First, new biological therapies induce intestinal healing and full disease control in a substantial number of patients, particularly when introduced early in the disease course. However, they are expensive and associated with potentially severe side effects, raising the question of optimal treatment duration. Secondly, progress in biomarkers and medical imaging performance has enabled better refinement of the definition and prediction of remission or relapse of the disease through monitoring [tight control]...
November 28, 2018: Journal of Crohn's & Colitis
Wen-Li Lin, Jia-Ling Sun, Shu-Chan Chang, Tsung-Chih Tsai, Pei-Hua Wu, Wen-Tsung Huang, Chao-Jung Tsao, Chien-Liang Lin
The multidisciplinary team (MDT) model involves multiple medical professionals providing integrated medical care. Colorectal cancer (CRC) has the highest prevalence of cancer in Taiwan. This study examines and evaluates the survival rates of CRC patients treated under the MDT model. In this retrospective and prospective study, 651 CRC patients were recruited. They were divided into 2 groups: the MDT group and the traditional care (TC) group. The MDT group comprised 326 patients who received care from a MDT...
November 2018: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Lorraine A Smith-MacDonald, Jean-Sébastien Morin, Suzette Brémault-Phillips
Moral Injury (MI) describes the profound distress experienced by military personnel as a result of a violation of personal beliefs. Impacting not only psychological, but spiritual, health, and well-being, MI is associated with spiritual/religious (S/R) suffering and a need to find hope, trust, connection, reconciliation, and wholeness. Addressing spiritual wounds can help military personnel overcome fundamental barriers that may impede them from effectively engaging in or benefitting from traditional trauma therapies and having a more complete recovery...
2018: Frontiers in Psychiatry
Amanda M Midboe, Steve Martino, Sarah L Krein, Joseph W Frank, Jacob T Painter, Michael Chandler, Allison Schroeder, Brenda T Fenton, Lara Troszak, Taryn Erhardt, Robert D Kerns, William C Becker
BACKGROUND: Dissemination of evidence-based practices that can reduce morbidity and mortality is important to combat the growing opioid overdose crisis in the USA. Research and expert consensus support reducing high-dose opioid therapy, avoiding risky opioid-benzodiazepine combination therapy, and promoting multi-modal, collaborative models of pain care. Collaborative care interventions that support primary care providers have been effective in medication tapering. We developed a patient-centered Primary Care-Integrated Pain Support (PIPS) collaborative care clinical program based on effective components of previous collaborative care interventions...
November 29, 2018: Implementation Science: IS
(no author information available yet)
OBJECTIVEThe quality of surgical treatment of intracranial aneurysms is determined by complete aneurysm occlusion while preserving blood flow in the parent, branching, and perforating arteries. For a few years, there has been a nearly noninvasive and cost-effective technique for intraoperative flow evaluation: microscope-integrated indocyanine green videoangiography (mICG-VA). This method allows for real-time information about blood flow in the aneurysm and the involved vessels, but its limitations are seen in the evaluation of structures located in the depth of the surgical field, especially through small craniotomies...
October 1, 2018: Journal of Neurosurgery
Tony Realini, Olusola Olawoye, Nkiru Kizor-Akaraiwe, Selina Manji, Arthur Sit
Glaucoma is the leading cause of irreversible blindness in Africa. The condition is treatable but not curable. There are numerous obstacles to glaucoma care in Africa, including availability, accessibility and affordability of treatments, as well as medication nonadherence among patients. Medical therapy is costly relative to the average income in Africa and it requires daily self-dosing by patients. Surgery is of limited availability in many regions in Africa, and a high proportion of patients refuse surgery because it is expensive...
November 28, 2018: Asia-Pacific Journal of Ophthalmology
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