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integrated medical treatment

Václav Ranc, Radovan Žižka, Zuzana Chaloupková, Juraj Ševčík, Radek Zbořil
Endodontic treatment of immature permanent teeth with necrotic pulp poses several clinical challenges and is one of the most demanding interventions in endodontics. Recently, with new discoveries in the field of tissue engineering, novel treatment protocols have been established. The most promising treatment modality is revascularization, whose integral part is the exposure of collagen matrix and embedded growth factors. However, optimization of the treatment protocol requires a development of analytical procedures able to analyze growth factors directly on the sample surface...
August 15, 2018: Analytical and Bioanalytical Chemistry
N C Stefanis, V Mavreas, Ι Νimatoudis, F Gourzis, Μ Sarakouri, A Vgontzas, A Douzenis
The disorders of the psychosis spectrum, with the most severe being schizophrenia, are prevalent and have a great impact on the patients' quality of life. The purpose of this article is to highlight the need for a novel national strategic approach to the management of psychotic disorders in accordance with the international principles of early intervention. Even though outpatient treatment is considered adequate, there is an urgent need to adopt an early and more comprehensive and effective intervention strategy for young patients with psychosis and their families whose clinical and personal needs are clearly not met by the existing infrastructure of our mental health services...
April 2018: Psychiatrikē, Psychiatriki
Katherine R Bellesheim, Lynn Cole, Daniel L Coury, Larry Yin, Susan E Levy, Meghan A Guinnee, Kirsten Klatka, Beth A Malow, Terry Katz, Jane Taylor, Kristin Sohl
OBJECTIVES: Constipation and insomnia are not consistently identified and treated in children with autism spectrum disorder (ASD) despite their high prevalence and deleterious impact in this population. To standardize care, a constipation practice pathway and an insomnia practice pathway were previously developed by Autism Treatment Network clinicians. Our objective was to implement and refine these practice pathways in clinical settings. METHODS: Eleven Autism Treatment Network sites participated in a Learning Collaborative (ie, multidisciplinary quality improvement team) and chose to implement either the constipation or insomnia practice pathway in the clinical setting...
August 14, 2018: Pediatrics
Amerigo Giudice, Selene Barone, Carmen Giudice, Francesco Bennardo, Leonzio Fortunato
OBJECTIVE: The aim of this study was to evaluate the efficacy of platelet-rich fibrin (PRF) after bone surgery compared to surgery alone in the treatment of medication-related osteonecrosis of the jaw (MRONJ). STUDY DESIGN: A total of 47 patients with diagnosis of stage II or III of MRONJ were recruited at the Academic Hospital of Magna Graecia University of Catanzaro and allocated to 2 groups: In the first, patients were treated with PRF in addition to surgery (PRF group), in the other, only bone surgery was performed (non-PRF group)...
June 30, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Joanna Goldthorpe, Caroline Sanders, Lesley Gough, Jean Rogers, Colette Bridgman, Martin Tickle, Iain Pretty
BACKGROUND: A primary care oral surgery service was commissioned alongside an electronic referral management system in England, in response to rising demand for Oral Surgery services in secondary care. It is important to ensure that standards of quality and safety are similar to those in existing secondary care services, and that the new service is acceptable to stakeholders. The aim of this study is therefore to conduct an in depth case study to explore safety, quality, acceptability and implementation of the new service...
August 14, 2018: BMC Health Services Research
Chantal Plomb-Holmes, Philippe Clavert, Frank Kolo, Eileen Tay, Alexandre Lädermann, French Society Of Arthroscopy
Ultrasound (US) imaging is an efficient, easy to use and inexpensive tool allowing for facilitated diagnosis and management of the painful shoulder. It remains primarily used by radiologists and rheumatologists, despite having shown excellent diagnostic accuracy when used by different medical specialities in their office-based consultation. It also has advantages over other imaging modalities in the evaluation of the post-operative shoulder for rotator cuff integrity and correct anchor and suture placement, as well as rotator cuff analysis following arthroplasty...
August 11, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Henrik Svedsater, Helen A Doll, Jake Macey, Gail Miles, Lisa Bradshaw, Magdalena Vanya
INTRODUCTION: This study evaluated patients' experiences with fluticasone furoate/vilanterol (FF/VI) combination therapy in UK patients with asthma or chronic obstructive pulmonary disease (COPD). METHODS: Participants aged ≥ 18 years, with self-reported, physician-diagnosed asthma or COPD (≥ 1 year) who had been receiving FF/VI (≥ 3 months) were recruited from UK primary care. This two-phase, mixed-methods study consisted of a semi-structured, telephone-interview phase (qualitative) and a self-completed online/paper-survey phase (quantitative)...
August 13, 2018: Advances in Therapy
Nikhil Sharma, Frederick L Hitti, Grant Liu, M Sean Grady
Background: Pseudotumor cerebri (PTC), which has a prevalence in the general population of 1 to 2 out of 100,000, presents with raised intracranial pressure (ICP) but generally lacks a space occupying lesion. Case Description: Patient 1 is a 32-year-old woman with a history of multiple meningiomas. Upon presentation to our institution, her clinical exam was notable for a right sixth nerve palsy. An integrated diagnosis of PTC was made and shunting for the cerebrospinal fluid (CSF) diversion was recommended...
2018: Surgical Neurology International
Amy E Mitchell
Dermatological conditions are common among children. They are a frequent cause of presentation to health care services and a leading contributor to burden of disease. Evidence supports the notion that bidirectional relationships exist between children's physical and psychological health, whereby the child's dermatological condition can impact their psychological health and well-being, while, in the reverse direction, psychological factors (eg, stress) can impact the severity and course of the child's skin disease...
2018: Psychology Research and Behavior Management
Antoine Guillon, Delphine Fouquenet, Eric Morello, Clémence Henry, Sonia Georgeault, Mustapha Si-Tahar, Virginie Hervé
The endotracheal tube (ETT) is an essential interface between the patient and ventilator in mechanically-ventilated patients. However, a microbial biofilm is formed gradually on this tube and is associated with the development of ventilator-associated pneumonia. Bacteria present in the biofilm are more resistant to antibiotics and current medical practices do not make it possible to eliminate. P. aeruginosa is one of the leading pathogens that cause biofilm infections and ventilator-associated pneumonia. Poly-L-lysine (pLK) is a cationic polypeptide possessing antibacterial properties and mucolytic activity by compacting DNA...
August 13, 2018: Antimicrobial Agents and Chemotherapy
Runtong Zhang, Yuping Xing, Jun Wang, Xiaopu Shang, Xiaomin Zhu
The hierarchical medical treatment system is an efficient way to solve the problem of insufficient and unbalanced medical resources in China. Essentially, classifying the different degrees of diseases according to the doctor's diagnosis is a key step in pushing forward the hierarchical medical treatment system. This paper proposes a framework to solve the problem where diagnosis values are given as picture fuzzy numbers (PFNs). Point operators can reduce the uncertainty of doctor's diagnosis and get intensive information in the process of decision making, and the Choquet integral operator can consider correlations among symptoms...
August 10, 2018: International Journal of Environmental Research and Public Health
Carsten Gutt, Christian Jenssen, Ana-Paula Barreiros, Thorsten O Götze, Caroline S Stokes, Petra Lynen Jansen, Michael Neubrand, Frank Lammert
This guideline provides evidence-based key recommendations for the prevention, diagnosis and therapy of gallstones and upgrades the 2007 version. The guideline was developed by an interdisciplinary team of gastroenterologists and surgeons, and patient support groups under the auspice of the German Society for Gastroenterology and Metabolic Diseases and the German Society for General Surgery and Surgery of the Alimentary Tract. The guideline used structural S3 consensus-based methodology and includes statements on clinical practice, medical education, prevention, quality assurance, outcome analysis, and integration of outpatient and inpatient care for patients with gallstone diseases...
August 2018: Zeitschrift Für Gastroenterologie
Ian Kodish
Youth admitted to pediatric hospitals face a variety of emotional challenges throughout their stay. In addition to feeling compromised by their acute medical condition, managing the requirements imposed by hospital care can intensify the potential for behavioral dysregulation. Even meeting basic behavioral expectations often requires children to be highly vulnerable, uncomfortable, and in pain, having to trust a parade of people routinely delivering aversive interventions, all in the context of overwhelmed caregivers...
August 1, 2018: Pediatric Annals
Mark Clemons, Sasha Mazzarello, John Hilton, Anil Joy, Julie Price-Hiller, Xiaofu Zhu, Shailendra Verma, Anne Kehoe, Mohammed Fk Ibrahim, Marta Sienkiewicz, Carol Stober, Lisa Vandermeer, Brian Hutton, Ranjeeta Mallick, Dean Fergusson
PURPOSE: Optimal primary febrile neutropenia (FN) prophylaxis (i.e. ciprofloxacin or granulocyte-colony stimulating factors [G-CSF]) for patients receiving docetaxel-cyclophosphamide (TC) chemotherapy is unknown. We assessed the feasibility of using a novel pragmatic comparative effectiveness trial to compare these standard-of-care options. METHODS: Early-stage breast cancer patients receiving TC chemotherapy were randomised to either ciprofloxacin or G-CSF. Trial methodology consists of broad eligibility criteria, simply-defined endpoints, integrated consent model incorporating oral consent, and web-based randomisation in the clinic...
August 11, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Vitalii Pashkov, Petro Noha, Aleksey Soloviov
OBJECTIVE: Introduction: Public health is an important concept, which is continually being globalized and integrated into today's society. It helps to improve and prolong the quality of life of people and prevent the spread of epidemics and serious incurable diseases. The components of public health include protection, prevention, and promotion. Prevention, the measures taken to prevent disease as opposed to treatment consist of screening and periodical medical examinations. There are two types of screening- universal screening and case finding (individual screening)...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Robin Guibal, Sophie Lissalde, Yoann Brizard, Gilles Guibaud
Pharmaceutical monitoring (37 pharmaceuticals and 3 human tracers) was conducted in a headwater streams in southwest France, an area characterized by a low population density with an elderly population (30% > 60 years old) and extensive agriculture (cow cattle breeding). Polar Organic Chemical Integrative Sampler (POCIS) were exposed for 14-day consecutive periods in 2016 at three sampling points. Three human wastewater tracers and 20 pharmaceuticals commonly used for human and/or cattle were quantified in headwaters...
July 31, 2018: Journal of Hazardous Materials
Christa Boer, Hugo R Touw, Stephan A Loer
PURPOSE OF REVIEW: This narrative review summarizes recent insights into the role of remote monitoring of vital signs in the postoperative period in surgical wards. RECENT FINDINGS: Despite recent improvements in the safety of anesthesia and surgical procedures, postoperative complication rates are still unacceptably high. This is partly attributable to the intermittent provision of personal care to patients by nurses and ward physicians. Continuous remote monitoring of vital functions in the early postoperative period may reduce these complication rates...
August 7, 2018: Current Opinion in Anaesthesiology
Sese Abhulimen, Abigail Hirsch
AIM: The primary objective of this study is to estimate the economic benefits relative to return on investment (ROI) of a state-wide initiative to integrate digital behavioral health (BH) self-care into the community BH system. METHODS: The observational study reviewed claims data of 799 people who registered with the digital tool (myStrength) and 715 matched control study participants. The control group was formed via coarsened exact match with blocking variables, including presence on the claims file, volume of health care utilization, participation in a medical health home, BH diagnosis, and volume of psychotherapy claims...
August 10, 2018: Journal of Medical Economics
Muhammad Hassan Majeed, Ali Ahsan Ali, Donna M Sudak
Background Long-term use of opioids to treat chronic pain incurs serious risks for the individual-including misuse, abuse, addiction, overdose and death-as well as creating economic, social, and cultural impacts on society as a whole. Chronic pain and substance use disorders are often co-morbid with other medical problems and at the present time, primary care clinicians serve most of this population. Primary care clinicians would benefit from having alternatives to opioids to employ in treating such patients...
August 9, 2018: International Journal of Psychiatry in Medicine
Evelyn E C de Jong, Lizza E L Hendriks, Wouter van Elmpt, Hester A Gietema, Paul A M Hofman, Dirk K M De Ruysscher, Anne-Marie C Dingemans
Medical images are an integral part of oncological patient records and they are reviewed by many different specialists. Therefore, it is important that besides imaging experts, other clinicians are also aware that the diagnostic value of a scan is influenced by the applied imaging protocol. Based on two clinical lung cancer trials, we experienced that, even within a study protocol, there is a large variability in imaging parameters, which has direct impact on the interpretation of the image. These two trials were: 1) the NTR3628 in which the added value of gadolinium magnetic resonance imaging (Gd-MRI) to dedicated contrast enhanced computed tomography (CE-CT) for detecting asymptomatic brain metastases in stage III non-small cell lung cancer (NSCLC) was investigated and 2) a sub-study of the NVALT 12 trial (NCT01171170) in which repeated 18 F-fludeoxyglucose positron emission tomography (18 F-FDG-PET) imaging for early response assessment was investigated...
September 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
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