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integrated medical treatment

Anja W Dynesen, Charlotte A Gehrt, Sabine E Klinker, Lisa B Christensen
It is well known that early signs of eating disorders (EDs), such as dental erosion and enlarged salivary glands, may be recognized in the dental clinic. Dentists acknowledge that approaching a patient to discuss the suspicion of an ED is difficult. However, little is known about how persons with EDs experience and manage dental visits. Therefore, this study aimed to uncover knowledge, experience, and attitude of oral health and oral health behavior among persons with EDs. The study design was cross-sectional and 260 persons with EDs completed an electronic questionnaire...
October 19, 2018: European Journal of Oral Sciences
Nina C Silander, David J Chesire, Kamela S Scott
The primary medical goals of acute care are restoration of physical health and return to physical function. However, in response to traumatic events and injuries, psychological factors are critical to one's overall recovery. Both pre-morbid psychiatric comorbidities and post-injury psychological compromise affect physical and psychological recovery in inpatient trauma populations. The Psychological Services Program (PSP), a model trauma/acute care program, addresses these critical factors in a Level 1 Trauma Center...
October 19, 2018: Journal of Clinical Psychology in Medical Settings
Jun Wang, Yin Wang, Hui Zhang, Ming Lu, Weilu Gao, Li Yin, Zongsheng Yin
INTRODUCTION: Osteoarthritis is a common degenerative joint disease that eventually leads to disability and poor quality of life. The main symptoms are joint pain and mobility disorders. If the patient has severe pain or other analgesics are contraindicated, opioids may be a viable treatment option. To evaluate and compare the efficacy and safety of opioids in the treatment of knee or hip osteoarthritis, we will integrate direct and indirect evidence using a Bayesian network meta-analysis to establish hierarchies of these drugs...
October 18, 2018: BMJ Open
Arthur Yin Fan, Sarah F Alemi, Yingping H Zhu, Sudaba Rahimi, Hui Wei, Haihe Tian, Deguang He, Changzhen Gong, Guanhu Yang, Chong He, Hui Ouyang
BACKGROUND: Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evaluate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with intercourse...
October 10, 2018: Journal of Integrative Medicine
Celine-Marie Pascale, Catherine M Schaeff
OBJECTIVES: This pilot case study sought to examine the efficacy of subtle energy treatments as conducted by Buddhist healing master Segyu Rinpoche at his Juniper Integrative Clinic in Northern California. DESIGN: Over the course of a year, this study followed two patients with terminal diagnoses, their treating physicians, and Segyu Rinpoche as the patients underwent treatment at the Juniper Clinic. The patients entering the study had exhausted all known medical options...
August 21, 2018: Explore: the Journal of Science and Healing
Liam G Heaney, John Busby, Peter Bradding, Rekha Chaudhuri, Adel H Mansur, Robert Niven, Ian D Pavord, John T Lindsay, Richard W Costello
Rationale Poor adherence is common in difficult-to-control asthma. Distinguishing patients with difficult-to-control asthma who respond to inhaled corticosteroids (ICS) from refractory asthma is an important clinical challenge. Objectives Suppression of fractional exhaled nitric oxide (FeNO) with directly observed ICS therapy over 7 days can identify non-adherence to ICS treatment in difficult-to-control asthma. We examined the feasibility and utility of FeNO suppression testing in routine clinical care within UK severe asthma centres using remote monitoring technologies...
October 19, 2018: American Journal of Respiratory and Critical Care Medicine
Benjamin Marent, Flis Henwood, Mary Darking
BACKGROUND: Despite advances in testing and treatment, HIV incidence rates within European countries are at best stable or else increasing. mHealth technology has been advocated to increase quality and cost-effectiveness of health services while dealing with growing patient numbers. However, studies suggested that mHealth apps are rarely adopted and often considered to be of low quality by users. Only a few studies (conducted in the United States) have involved people living with HIV (PLWH) in the design of mHealth...
October 19, 2018: JMIR MHealth and UHealth
Bijan Zomorodbakhsch, Christian Keinki, Eckart Seilacher, Jutta Huebner
Numeracy is highly relevant for therapy safety and effective self-management. Worse numeracy leads to poor health outcome. Most medical information is expressed in numbers. Considering the complexity of decisions, more information on the patient's ability to understand information is needed. We used a standardized questionnaire. Content was self-perception of numeracy, preferences regarding decision-making with respect to medical issues, and preferred content of information from four possible answers on side effect of cancer therapies (insomnia) within two scenarios...
October 18, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Lata Rani, Ajay Gogia, Vishwajeet Singh, Lalit Kumar, Atul Sharma, Gurvinder Kaur, Ritu Gupta
Prognostic indices combining several clinical and laboratory parameters have been proposed for prognostication in chronic lymphocytic leukemia (CLL). Recently, international consortium on CLL proposed an international prognostic index (CLL-IPI) integrating clinical, molecular, and genetic parameters. The present study was designed to evaluate the reproducibility of CLL-IPI in Indian CLL cohort. The prognostic ability of CLL-IPI in terms of overall survival (OS) and time to first treatment (TTFT) was investigated in treatment-naive CLL patients and also compared with other existing prognostic scores...
October 18, 2018: Annals of Hematology
Krzysztof Ślosarek, Iwona Brąclik, Wojciech Leszczyński, Joanna Kopczyńska, Wojciech Osewski, Jacek Wendykier
Aim: The aim of this study is to answer the question whether the calculated dose distributions for HD and Millennium collimators (Varian Medical Systems) are equivalent for large treatment volumes. Background: Modern biomedical linacs are equipped with multileaf collimators where leaves can be of different widths. Thinner leaves allow better fit to desired (tumor) shape. At the same time, however, the maximum size of the field that can be obtained with the collimator is also reduced...
January 2019: Reports of Practical Oncology and Radiotherapy
Carol S Camlin, Janet Seeley
INTRODUCTION: Very few pragmatic and community-level effectiveness trials integrate the use of qualitative research over all stages of the trial, to inform trial design, implementation optimization, results interpretation and post-trial policy recommendations. This is despite the growing demand for mixed methods research from funding agencies and awareness of the vital importance of qualitative and mixed methods research for understanding trial successes and challenges. DISCUSSION: We offer examples from work we have been involved in to illustrate how qualitative research conducted within trials can reveal vital contextual factors that influence implementation and outcomes, can enable an informed adaptation of trials as they are being conducted and can lead to the formulation of theory regarding the social and behavioural pathways of intervention, while also enabling community engagement in trial design and implementation...
October 2018: Journal of the International AIDS Society
Alberto Carli, Francesca Moretti, Giulia Giovanazzi, Valentina Niero, Valeria Perilli, Giovanna Ghirlanda, Chiara Bovo, Stefano Tardivo
BACKGROUND AND AIM: Patients could leave ED not receiving the desired care either Without Being Seen by a doctor (LWBS) or Against Medical Advice (DAMA). In term of care quality, LWBS may be related to inappropriate access and process of care, while DAMA may lead to increased risk of mortality and re-admissions. This study aims to identify frequency of patients who leave ED, determine their characteristics and identify associated factor. METHODS: This was a retrospective observational study of patients that attended EDs of University Hospital Trust of Verona in 2017...
October 8, 2018: Acta Bio-medica: Atenei Parmensis
Richard Crevenna, Franz Kainberger, Christoph Wiltschke, Christine Marosi, Michael Wolzt, Fadime Cenik, Mohammad Keilani
BACKGROUND: Cancer rehabilitation has the goal to improve functional status, quality of life, participation, and can improve quality of patient-centered programs and health care efficiencies. In Austria, inpatient cancer rehabilitation is well established but outpatient rehabilitation has not yet established well. METHODS: The present article is describing current rehabilitation in practice and focuses on cancer rehabilitation in Austria, namely bringing together a descriptive account of current trends and practices within an Austrian University Hospital Center (General Hospital of Vienna linked to the Medical University of Vienna) and the Comprehensive Cancer Centre (CCC) Vienna, Austria...
October 17, 2018: Disability and Rehabilitation
Andrew H Talal, Anthony McLeod, Phyllis Andrews, Heidi Nieves-McGrath, Yang Chen, Andrew Reynolds, Clewert Sylvester, Suzanne S Dickerson, Marianthi Markatou, Lawrence S Brown
Background and Introduction: Virtual integration of hepatitis C virus (HCV) infection management within the opioid treatment program (OTP) through telemedicine may overcome limited treatment uptake encountered when patients are referred offsite. To evaluate the diffusion of telemedicine within the OTP, we conducted a pilot study to assess acceptance of and satisfaction with telemedicine among 45 HCV-infected opioid use disorder (OUD) patients on methadone. MATERIALS AND METHODS: We administered a modified 11-item telemedicine satisfaction questionnaire after the initial HCV telemedicine evaluation, when initiating HCV treatment, and 3 months post-HCV treatment completion...
October 16, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Nitika Pant Pai, Jana Daher, H R Prashanth, Achal Shetty, Rani Diana Sahni, Rajesh Kannangai, Priya Abraham, Rita Isaac
OBJECTIVES: In rural pregnant Indian women, multiple missed antenatal screening opportunities due to inadequate public health facility-based screening result in undiagnosed HIV and sexually transmitted bloodborne infections (STBBIs) and conditions (anaemia). Untreated infections complicate pregnancy management, precipitate adverse outcomes and risk mother-to-child transmission. Additionally, a shortage of trained doctors, rural women's preference for home delivery and health illiteracy affect health service delivery...
October 15, 2018: Sexually Transmitted Infections
Rachel Tillery, Meghan E McGrady
PURPOSE: Complementary and integrative medicine (CIM) is frequently used by oncology teams for reducing physical and emotional side-effects related to cancer treatment. In light of the changing healthcare system, evidence is needed regarding the economic implications of these interventions. The purpose of this study was to: (1) systematically examine the literature for links between CIM interventions and healthcare utilization (2) provide recommendations for growing this area of research...
October 2018: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Marc Auriacombe, Sarah Moriceau, Fuschia Serre, Cécile Denis, Jean-Arthur Micoulaud-Franchi, Etienne de Sevin, Emilien Bonhomme, Stéphanie Bioulac, Mélina Fatseas, Pierre Philip
BACKGROUND: Substance use disorders are under-detected and not systematically diagnosed or screened for by primary care. In this study, we present the acceptability and validity of an Embodied Conversational Agent (ECA) designed to screen tobacco and alcohol use disorder, in individuals who did not seek medical help for these disorders. METHODS: Individuals were included from June 2016 to May 2017 in the Outpatient Sleep Clinic of the University Hospital of Bordeaux...
October 6, 2018: Drug and Alcohol Dependence
Levon Khachatryan, Grigor Khachatryan, Gagik Hakobyan
This study is based on an analysis of the results of treatment of 21 patients with mandibular defects of different localization and etiology who underwent reconstruction with fibula free flap. Postoperative clinical and radiographic controls were made regularly, the criteria for implant success were assessed.The postoperative evolution of the patients was favorable, with the integration of the fibula vascularized grafts. Complete engraftment of bone autografts and wound healing was obtained in all observations...
October 12, 2018: Journal of Craniofacial Surgery
Takayuki Nakai, Akira Matsuo, Yoshifumi Takata, Yasuhiro Usui, Koichi Kitamura, Daichi Chikazu
OBJECTIVE: Obstructive sleep apnea (OSA) is a significant social and health issue. An integrated multidisciplinary approach to OSA management may be the most effective owing to its multifactorial etiology. In this study, we evaluated the frequency and efficacy of various treatment modalities for OSA administered via an integrated care delivery model, and assessed the role of dental sleep medicine as part of a multidisciplinary team. MATERIALS AND METHODS: We retrospectively evaluated 1115 patients with OSA treated at the Tokyo Medical University Hospital's Outpatient Clinic for OSA by a multidisciplinary team under one roof...
November 2018: Acta Odontologica Scandinavica
Katerina Karaivazoglou, Maria Kalogeropoulou, Stelios Assimakopoulos, Christos Triantos
BACKGROUND: In recent years, the adoption of unhealthy dietary habits and a sedentary lifestyle has led to an alarming increase in the prevalence of non-alcoholic fatty liver disease (NAFLD) in pediatric populations. Hepatic steatosis is now considered the most common cause of chronic liver disease in children and adolescents and may progress to liver fibrosis and even cirrhosis, increasing long-term mortality rates. Apart from its severe medical co-morbidities, pediatric NAFLD is associated with a variety of psychosocial factors which act either as precipitants or consequences of the disease...
September 8, 2018: Psychosomatics
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