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Medical self-help

Magaly Rodriguez de Bittner, Viktor V Chirikov, Ian M Breunig, Roxanne W Zaghab, Fadia Tohme Shaya
OBJECTIVE: To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. SETTING: The Patients, Pharmacists Partnerships (P(3) Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. PRACTICE DESCRIPTION: Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2...
October 18, 2016: Journal of the American Pharmacists Association: JAPhA
Gisella Orsini
This article aims to shed light on the self-perceptions of people with eating disorders in Malta and Italy through a deep understanding of their narratives. In contrast to the biomedical perception of the phenomenon and in opposition with the prevalent feminist theories on the subject, I consider eating disorders as the result of self-transformative processes. I suggest that anorexics, bulimics and binge eaters are actively and deliberately engaged in a project of moral self-transformation that is culturally defined...
October 19, 2016: Culture, Medicine and Psychiatry
Işıl Bavunoğlu, Musa Balta, Zeynep Türkmen
BACKGROUND: There is an increasing interest in herbal products as a self-medication method in recent years. Some plant extracts either turn into drugs over time or are consumed directly without treatment. One of these plants is Nerium oleander L., which is a potentially lethal plant, since it has cardiac glycosides. However, numerous researches of its extracts have been performed against cancer cell lines in recent literature. This contradiction leads to misinterpretation and induces the prevalence of intoxication or fatal cases...
September 2016: Balkan Medical Journal
Hans Lehrach
Every human is unique. We differ in our genomes, environment, behavior, disease history, and past and current medical treatment-a complex catalog of differences that often leads to variations in the way each of us responds to a particular therapy. We argue here that true personalization of drug therapies will rely on "virtual patient" models based on a detailed characterization of the individual patient by molecular, imaging, and sensor techniques. The models will be based, wherever possible, on the molecular mechanisms of disease processes and drug action but can also expand to hybrid models including statistics/machine learning/artificial intelligence-based elements trained on available data to address therapeutic areas or therapies for which insufficient information on mechanisms is available...
September 2016: Dialogues in Clinical Neuroscience
Rajeev Kumar, Rajendra G Sonkawade, Anil K Pandey, Madhavi Tripathi, Nishikant A Damle, Praveen Kumar, Chandra S Bal
OBJECTIVE: The aim of this article was to share 10 years of operational experience of medical cyclotron and to provide working knowledge on the same. This experience has helped us gain working knowledge on cyclotron operation with practical points, which may help in improving F yield, minimizing the breakdown time, and help in the prevention of the occurrence of unusual events. MATERIALS AND METHODS: Our facility has a self-shielded radioisotope delivery system eclipse 111 medical cyclotron with an 11 MeV proton beam in use for the past 10 years to produce positron emitters - namely, F, N, and F-2 gas - for PET imaging...
October 13, 2016: Nuclear Medicine Communications
Abib Agbetoba, Amber Luong, Jin Keat Siow, Brent Senior, Claudio Callejas, Kornel Szczygielski, Martin J Citardi
BACKGROUND: Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. METHODS: Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups...
October 18, 2016: International Forum of Allergy & Rhinology
Eeva Juhanoja, Jouni Johansson, Lutgarde Thijs, Kei Asayama, Atsushi Hozawa, Takayoshi Ohkubo, George Stergiou, Ichiro Tsuji, Yutaka Imai, Antti Jula, Teemu Niiranen, Jan Staessen
OBJECTIVE: Increased home blood pressure (BP) variability seems to be associated with cardiovascular disease, but the lack of operational thresholds limits its clinical application. Our aim was to define outcome-driven thresholds for day-to-day home BP variability in the general population. DESIGN AND METHOD: The study population consisted of 6312 community-dwelling participants from Ohasama, Japan; Tsurugaya, Japan; Didima, Greece; and Finland. The participants were divided into ten groups by deciles of home BP variability, defined as the coefficient of variation (CV) of the first measurements of each day between 5:00 and 12:00 AM to account for between-cohort differences in measurement protocols...
September 2016: Journal of Hypertension
Matthias Oelke, Peter Anderson, Robert Wood, Tove Holm-Larsen
AIMS: The aim of this study was to investigate the quality and timing of the diagnosis and treatment of nocturia in real-life practice in European and US-American patients to obtain better insights into the management of nocturia in different Western healthcare systems. METHODS: Data were drawn from the "LUTS Disease Specific Programme," a real-life survey of physicians and patients in France, Germany, Spain, UK and the USA. Physicians completed a patient record form for lower urinary tract symptoms (LUTS) patients...
October 17, 2016: International Journal of Clinical Practice
Chan Joo Lee, Sungha Park
Despite improvements in hypertension awareness and treatment, the blood pressure (BP) control rate still remains at around 50%. One of the major determinants of low BP control results from therapeutic inertia of the physician and suboptimal compliance of the patients. Home BP self-measurement and monitoring improves patients' awareness and helps the management of hypertension. Recent technological advances are allowing for accurate measurement and telemonitoring of home BP, with a number of randomized clinical trials demonstrating the efficacy of telemonitoring for BP control...
September 2016: Pulse (Basel, Switzerland)
Nancy J Carballo, Cathy A Alessi, Jennifer L Martin, Michael N Mitchell, Ron D Hays, Nananda Col, Emily S Patterson, Stella Jouldjian, Karen Josephson, Constance H Fung
PURPOSE: Obstructive sleep apnea is a prevalent sleep disorder among older adults. Oral appliances are increasingly prescribed as therapy for obstructive sleep apnea. Adherence to oral appliance therapy is highly variable. Based on value-expectancy theory and other social-psychological theories, adherence to oral appliance therapy may be influenced by patients' perceived effectiveness of the therapy, self-efficacy, and availability of social support. We examined these perceptions among older adults with obstructive sleep apnea who were prescribed oral appliance therapy...
October 14, 2016: Clinical Therapeutics
Mohamed M Abd El-Mawgod, Arwa S Alshaibany, Aeshah M Al-Anazi
BACKGROUND: Dysmenorrhea is one of the most common and important health problems, especially among young girls. It results in absence from school and work. It has some negative effects on the daily activities of patients. Because of cultural problems, patients ordinarily do not seek help from others in this situation. Identification of abnormal menstrual patterns during adolescence may permit early prevention of potential health concerns in adulthood. OBJECTIVES: The aim of this study was to determine the prevalence, severity, and impact of dysmenorrhea in secondary-school students and its association with school absenteeism in Arar city...
September 2016: Journal of the Egyptian Public Health Association
Edna Pereira Gomes Morais, Rachel Riera, Gustavo Jm Porfírio, Cristiane R Macedo, Vivian Sarmento Vasconcelos, Alexsandra de Souza Pedrosa, Maria R Torloni
BACKGROUND: Caesarean sections (CS) are the most frequent major surgery in the world. A transient impairment of bowel motility is expected after CS. Although this usually resolves spontaneously within a few days, it can cause considerable discomfort, require symptomatic medication and delay hospital discharge, thus increasing costs. Chewing gum in the immediate postoperative period is a simple intervention that may be effective in enhancing recovery of bowel function in other types of abdominal surgeries...
October 17, 2016: Cochrane Database of Systematic Reviews
G Iakimova, S Dimitrova, T Burté
OBJECTIVES: Computer-delivered Cognitive Behavioral Therapies (C-CBT) are emerging as therapeutic techniques which contribute to overcome the barriers of health care access in adult populations with depression. The C-CBTs provide CBT techniques in a highly structured format comprising a number of educational lessons, homework, multimedia illustrations and supplementary materials via interactive computer interfaces. Programs are often administrated with a minimal or regular support provided by a clinician or a technician via email, telephone, online forums, or during face-to-face consultations...
October 10, 2016: L'Encéphale
Wei Cheng, Edmund T Rolls, Jiang Qiu, Wei Liu, Yanqing Tang, Chu-Chung Huang, XinFa Wang, Jie Zhang, Wei Lin, Lirong Zheng, JunCai Pu, Shih-Jen Tsai, Albert C Yang, Ching-Po Lin, Fei Wang, Peng Xie, Jianfeng Feng
The first brain-wide voxel-level resting state functional connectivity neuroimaging analysis of depression is reported, with 421 patients with major depressive disorder and 488 control subjects. Resting state functional connectivity between different voxels reflects correlations of activity between those voxels and is a fundamental tool in helping to understand the brain regions with altered connectivity and function in depression. One major circuit with altered functional connectivity involved the medial orbitofrontal cortex Brodmann area 13, which is implicated in reward, and which had reduced functional connectivity in depression with memory systems in the parahippocampal gyrus and medial temporal lobe, especially involving the perirhinal cortex Brodmann area 36 and entorhinal cortex Brodmann area 28...
October 14, 2016: Brain: a Journal of Neurology
Elif Can, Felicitas Richter, Ralitsa Valchanova, Marc Dewey
OBJECTIVES: To identify underlying causes for failure of medical thesis projects and the constantly high drop-out rate in Germany from the supervisors' perspective and to compare the results with the students' perspective. SETTING: Cross-sectional survey. Online questionnaire for survey of medical thesis supervisors among the staff of Charité-Universitätsmedizin Berlin, Germany. Published, earlier longitudinal survey among students for comparison. PARTICIPANTS: 1069 thesis supervisors participated...
October 14, 2016: BMJ Open
M K Ju, S Son, S Kim
BACKGROUND: The purpose of this study was to understand the adjustment process after kidney transplantation. METHODS: The research method followed grounded theory methodology of Strauss and Corbin. Twelve recipients after kidney transplantation were selected. The data were collected through in-depth, face-to-face interviews or e-mailing or phone-interviews and analyzed by means of a constant comparative method. RESULTS: Through the category analysis, "struggling for independence" was verified as the central phenomenon of recipients, and the causal conditions that influence this phenomenon were "unpredictable physical status," "the difficulty of self-care," "apathy of families and friends," and "emotional instability...
September 2016: Transplantation Proceedings
Kathleen P Conte, Michelle C Odden, Natalie M Linton, S Marie Harvey
OBJECTIVES: To evaluate the effectiveness of Walk With Ease (WWE), an evidence-based arthritis self-management program that was scaled up in Oregon in 2012 to 2014. METHODS: Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, we collected participant surveys and attendance records and conducted observations. Preprogram and postprogram, participants self-reported pain and fatigue (scale: 0-10 points; high scores indicate more pain and fatigue) and estimated episodes of physical activity per week in the last month...
October 13, 2016: American Journal of Public Health
Christina M DuBois, Rachel A Millstein, Christopher M Celano, Deborah J Wexler, Jeff C Huffman
OBJECTIVE: Positive psychological attributes (eg, optimism) have been associated with a healthier lifestyle and superior medical outcomes in patients with type 2 diabetes; however, there has been minimal study of behavioral interventions that target positive psychological constructs in this population. Accordingly, we developed a novel, telephone-based, 12-week positive psychology intervention and assessed its feasibility and short-term impact in adults with type 2 diabetes and suboptimal health behavior adherence...
2016: Primary Care Companion to CNS Disorders
Ravindra B Ghooi, Kelly Dhru, Sheela Jaywant
Many individuals at the end of life are unable to convey their wishes regarding medical treatments. Advance directives (ADs) or living wills (LWs) allow them to crystallise their wishes in a written form so that these can be carried out if the relevant situation arises. In many countries, ADs are legally valid and enforceable; they reduce the use of life-sustaining treatments, which often merely prolong life without improving or even maintaining the quality of life. Such treatment puts a financial burden on the patient's family, often leading to penury...
October 2016: Indian Journal of Medical Ethics
Olav Nyttingnes, Torleif Ruud, Jorun Rugkåsa
PURPOSE: Some patients criticize coercive mental health treatment using extremely strong words. This may be connected to poor therapeutic relationships and unfavourable treatment outcomes, so a better understanding of this criticism is warranted. METHODS: Data consisted of detailed notes from 15 all-day dialogue seminars on coercion and voluntariness in Oslo, Norway from 2006 to 2009. Very dissatisfied patients and ex-patients were a central voice through the seminars...
October 7, 2016: International Journal of Law and Psychiatry
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