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Multidisciplinary approach

Julia Wälscher, Benjamin Groß, Ralf Eberhardt, Claus Peter Heussel, Monika Eichinger, Arne Warth, Felix Lasitschka, Felix J F Herth, Michael Kreuter
BACKGROUND: Transbronchial cryobiopsy (cTBB) may offer an alternative to surgical lung biopsy (SLB) for histopathological diagnosis of interstitial lung diseases (ILDs). However, real-life experience is limited, although case series are increasingly reported. OBJECTIVES: We aimed to evaluate the value of cTBB performed under real-life conditions in a tertiary care center for ILDs. METHODS: Data on all patients undergoing a cTBB for evaluation of suspected ILD between October 2015 and January 2017 were included in this retrospective case series...
December 14, 2018: Respiration; International Review of Thoracic Diseases
Javier Martín Broto
Multidisciplinary teams (MDTs) are necessary to deliver the best sarcoma care. Planning the optimal therapeutic strategy per patient requires input and expertise from several disciplines. Case/cohort studies have reported improved patient outcomes associated with treatment by MDTs and/or treatment in sarcoma centres. Many countries have established national networks of sarcoma reference centres and most have developed evidence-based clinical practice guidelines agreed using multidisciplinary expertise. In many countries, sarcoma networks are organised as cooperative groups...
2018: Oncology
Andrew J Bishop, Maria A Zarzour, Ravin Ratan, Keila E Torres, Barry W Feig, Wei-Lien Wang, Alexander J Lazar, Bryan S Moon, Christina L Roland, B Ashleigh Guadagnolo
OBJECTIVE: To update our experience with long-term outcomes in patients with desmoid fibromatosis treated with radiation therapy (RT) and to characterize factors associated with increased risk of local recurrence. METHODS: We reviewed the records of 209 consecutive patients with desmoid fibromatosis treated with RT, either alone or as combined modality therapy (CMT) with surgery, at our institution from 1965 to 2015. RESULTS: Median follow-up time was 98 months (range, 1-509 months)...
December 12, 2018: International Journal of Radiation Oncology, Biology, Physics
Melissa Simon, Emmanuel Cordova, June M McKoy
Funded by the 21st Century Cures Act, The Beau Biden Cancer Moonshot Initiative is broad, deep, integrative, and intended to expediently address cancer's most vexing problems. Launched in 2015, it is an effort to accelerate the pace of cancer research with a focus on breaking down silos through cross-pollination of research, recruitment of multidisciplinary clinical and basic science research teams, sharing of complex scientific databases, and the creation of public-private research partnerships. This audacious approach to cancer treatment is intended to alleviate the current burden of cancer within countries and across borders...
2019: Cancer Treatment and Research
B French, K Sayal, D Daley
Attention deficit hyperactivity disorder (ADHD) is a developmental disorder affecting up to 5% of children and adults and is underdiagnosed in many European countries. The process of access to care for this disorder is complex and variable across countries. In general, those affected, or their caregiver, will seek help through their primary care practitioners who are then often responsible for referral to other professionals for diagnosis and provision of treatment. Previous studies have highlighted that many barriers to recognition exist in primary care settings (such as misconceptions, lack of education or lack of resources), preventing access to care for this population and potentially affecting diagnosis rate...
December 14, 2018: European Child & Adolescent Psychiatry
J W van den Berg, J D Luketich, E Cheong
Historically, open oesophagectomy was the gold standard for oesophageal cancer surgery. This was associated with a relatively higher morbidity. In the last two decades, we have seen significant improvements in short and long term outcomes due to centralisation of oesophagectomy, multidisciplinary approach, enhanced recovery after surgery programmes, neoadjuvant treatments and advances in minimally invasive oesophagectomy (MIO) techniques. MIO has significantly reduced postoperative morbidity and improved functional recovery, while maintaining comparable long-term oncological outcomes...
October 2018: Best Practice & Research. Clinical Gastroenterology
Erika Gucciardo, Sirpa Loukovaara, Petri Salven, Kaisa Lehti
Diabetic retinopathy (DR) is the most common diabetic microvascular complication and major cause of blindness in working-age adults. According to the level of microvascular degeneration and ischemic damage, DR is classified into non-proliferative DR (NPDR), and end-stage, proliferative DR (PDR). Despite advances in the disease etiology and pathogenesis, molecular understanding of end-stage PDR, characterized by ischemia- and inflammation-associated neovascularization and fibrosis, remains incomplete due to the limited availability of ideal clinical samples and experimental research models...
December 13, 2018: International Journal of Molecular Sciences
Brandon Bosse, Samir Damle, Abraham Akinin, Yi Jing, Dirk-Uwe Bartsch, Lingyun Cheng, Nicholas Oesch, Yu-Hwa Lo, Gert Cauwenberghs, William R Freeman
Purpose: For more than 20 years, there has been an international, multidisciplinary effort to develop retinal prostheses to restore functional vision to patients blinded by retinal degeneration. We developed a novel subretinal prosthesis with 1512 optically addressed silicon nanowire photodiodes, which transduce incident light into an electrical stimulation of the remaining retinal circuitry. This study was conducted to evaluate the efficacy of optically driving the subretinal prosthesis to produce visual cortex activation via electrical stimulation of the retina...
December 3, 2018: Investigative Ophthalmology & Visual Science
Jessica Saunders, Shahram Ahmadzadeh, Margaret Bush, Robin Wright, Bradi Granger
BACKGROUND: The commonly employed medication reconciliation process leaves room for mismanagement of medications in the complex end-stage renal disease patient population. PURPOSE: The purpose of this quality improvement project was to implement and evaluate a multidisciplinary education and feedback intervention designed to improve self-management for adults with end-stage renal disease. METHODS: A pre-post, same subject repeated measures design was used to evaluate the intervention...
December 12, 2018: Journal of Nursing Care Quality
J Daniel Muehlschlegel, Peter S Burrage, Jennie Yee Ngai, Jordan M Prutkin, Chuan-Chin Huang, Xinling Xu, Sanders H Chae, Bruce A Bollen, Jonathan P Piccini, Nanette M Schwann, Aman Mahajan, Marc Ruel, Simon C Body, Frank W Sellke, Joseph Mathew, Ben O'Brien
Postoperative atrial fibrillation (poAF) is the most common adverse event after cardiac surgery and is associated with increased morbidity, mortality, and hospital and intensive care unit length of stay. Despite progressive improvements in overall cardiac surgical operative mortality and postoperative morbidity, the incidence of poAF has remained unchanged at 30%-50%. A number of evidence-based recommendations regarding the perioperative management of atrial fibrillation (AF) have been released from leading cardiovascular societies in recent years; however, it is unknown how closely these guidelines are being followed by medical practitioners...
January 2019: Anesthesia and Analgesia
Sarah L Miller, Robyn M Hodges, Lindsey L Wilner
Concepts of gender, gender roles, and gender norms have continuously adapted with the increased acceptance of diversity throughout the United States in recent decades. Although guidelines exist regarding competent assessment and treatment of transgender individuals, correctional environments place substantial restrictions and complications on this process. Recent legal cases have increased public awareness of such cases, including challenges to the status quo of which responsibilities fall under the purview of correctional systems...
December 13, 2018: Psychological Services
Elvira Brignoli, Paolo Frassanito, Elisabetta Vercesi, Chiara Ferretti, Guido Felicetti, Roberto Maestri, Maja Barak
OBJECTIVES: Systemic sclerosis is a multisystem autoimmune disease that causes chronic widespread obliterative vasculopathy of the small arteries associated with various degrees of tissue fibrosis. The prognosis of the disease depends largely on the visceral involvement; however musculoskeletal involvement is an important factor to functional disability. Suffering from a chronic auto-immune disease, such as Systemic Sclerosis, compromises the quality of life and the work ability. The rehabilitative treatment may be a viable option for improving the quality of life, but there are few studies to support this hypothesis in adequate population...
December 2018: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
Lisa Younge
Inflammatory bowel disease (IBD) is a term that refers to two main conditions: Crohn's disease and ulcerative colitis. It is a lifelong inflammatory disorder that affects the gastrointestinal tract. Managing IBD requires a multidisciplinary team approach, and specialist IBD nurses have an important role in this, providing education, support and advocacy to patients with IBD. This article provides an overview of the symptoms of Crohn's disease and ulcerative colitis, as well as the medical, nutritional and surgical management strategies that can be used...
December 10, 2018: Nursing Standard
Amit Ritter, Gideon Bachar, Raphael Feinmesser, Thomas Shpitzer, Aron Popovtzer, Naomi Rabinovics
BACKGROUND: Nonmelanoma skin cancers (NMSC) are the most common malignancies in solid organ recipients. We investigated the incidence, clinical features, and outcome of solid organ recipients with NMSC of the head and neck. METHODS: A retrospective chart review was conducted for solid organ recipients who were treated from 1992 to 2015 and who developed NMSC of the head and neck. RESULTS: Of 3339 organ recipients, 259 patients developed 697 head and neck NMSC...
December 14, 2018: Head & Neck
Nino Rainusso, Heather Cleveland, J Alberto Hernandez, Norma M Quintanilla, John Hicks, Sanjeev Vasudevan, Rex A W Marco, Wendy Allen-Rhoades, Lisa L Wang, Jason T Yustein
One of the limitations of performing percutaneous biopsies in patients with bone sarcomas is the small amount of tumor that can be obtained for research purposes. Here, we describe our experience developing patient-derived tumor xenografts (PDXs) using percutaneous tumor biopsies in children with bone sarcomas. We generated 14 bone sarcoma PDXs from percutaneous tumor biopsies. We also developed eight bone sarcoma PDXs from surgical resection of primary bone tumors and pulmonary metastases. A multidisciplinary team approach was critical to establish an accurate diagnosis and to provide adequate tumor samples for PDX generation...
December 11, 2018: Pediatric Blood & Cancer
Marie Gaudefroy, Aline Osbery, Émilie Christophe
INTRODUCTION: Health inequalities is a complex issue and may appear to be unrelated to the reality of field workers. This article describes Lor'IS, a support grid for project leaders designed to enable them to review their actions based on criteria contributing to reduction of social and geographical inequalities in health. METHODS: This tool was based on a review of the literature and assessment of the needs of field workers. It was created by a multidisciplinary working party and was tested and improved by the future users...
September 6, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Johan W S Vlaeyen, Chris G Maher, Katja Wiech, Jan Van Zundert, Carolina Beraldo Meloto, Luda Diatchenko, Michele C Battié, Marielle Goossens, Bart Koes, Steven J Linton
Low back pain affects individuals of all ages and is a leading contributor to disease burden worldwide. Despite advancements in assessment and treatment methods, the management of low back pain remains a challenge for researchers and clinicians alike. One reason for the limited success in identifying effective treatments is the large variation in the manifestations, possible causes, precipitating and maintaining factors, course, prognosis and consequences in terms of activity interference and quality of life...
December 13, 2018: Nature Reviews. Disease Primers
Stefano Omboni, Mauro Tenti, Claudio Coronetti
Community pharmacists play a crucial role in hypertension management and their intervention, mainly including education, medication monitoring, and reviewing, blood pressure (BP) measurement and cardiovascular risk factors tracking, have proved to enhance BP control and adherence to antihypertensive treatment. A multidisciplinary collaborative approach with the referring physician and a patient-centered model of care have been proved to be particularly effective for improving control of hypertension and promoting patients' health...
December 13, 2018: Journal of Human Hypertension
Michael D McGoon, Pisana Ferrari, Iain Armstrong, Migdalia Denis, Luke S Howard, Gabi Lowe, Sanjay Mehta, Noriko Murakami, Brad A Wong
The assessment of objective measurement of cardiopulmonary status has helped us achieve better clinical outcomes for patients and develop new therapies through to the point of market access; however, patient surveys indicate that more can be done to improve holistic care and patient engagement. In this multidisciplinary review, we examine how clinical teams can acknowledge and embrace the individual patient's perspective, and thus improve the care for individual patients suffering from pulmonary hypertension by cultivating the importance and relevance of health-related quality of life in direct clinical care...
December 13, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Adam T Hill, Sally A Welham, Anita L Sullivan, Michael R Loebinger
The new British Thoracic Society (BTS) Guideline for Bronchiectasis in Adults has been published. This article provides a summary of key highlights of the new BTS Guideline and covers who to investigate, what investigations should be carried out and a management strategy.
January 2019: Thorax
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