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Knowledge based treatment planning

Mareike Kroll, Revati Phalkey, Sayani Dutta, Sharvari Shukla, Carsten Butsch, Erach Bharucha, Frauke Kraas
BACKGROUND: Despite the rising impact of non-communicable diseases (NCDs) on public health in India, lack of quality data and routine surveillance hampers the planning process for NCD prevention and control. Current surveillance programs focus largely on communicable diseases and do not adequately include the private healthcare sector as a major source of care in cities. OBJECTIVE: The objective of the study was to conceptualize, implement, and evaluate a prototype for an urban NCD sentinel surveillance system among private healthcare practitioners providing primary care in Pune, India...
2016: Global Health Action
Zhangjing Yang, Piaopiao Feng, Tian Wen, Minghua Wan, Xunning Hong
Differentiation of glioblastoma multiformes (GBMs) and lymphomas using multi-sequence magnetic resonance imaging (MRI) is an important task that is valuable for treatment planning. However, this task is a challenge because GBMs and lymphomas may have a similar appearance in MRI images. This similarity may lead to misclassification and could affect the treatment results. In this paper, we propose a semi-automatic method based on multi-sequence MRI to differentiate these two types of brain tumors. Our method consists of three steps: 1) the key slice is selected from 3D MRIs and region of interests (ROIs) are drawn around the tumor region; 2) different features are extracted based on prior clinical knowledge and validated using a t-test; and 3) features that are helpful for classification are used to build an original feature vector and a support vector machine is applied to perform classification...
October 18, 2016: CNS & Neurological Disorders Drug Targets
Deepak Dimri, Venkatashiva Reddy B, Amit Kumar Singh
Background. The pattern of skin morbidity in an area depends on climate, geography, socioeconomic status, nutrition, genetics, and habits of the community. Objective. The objective of the present study was to describe the morbidity profile of patients attending dermatology outpatient department in a tertiary care centre of Garhwal hills, North India. Methodology. This is a record based study carried out using the morbidity registers. Patient details, diagnosis, and treatment provided by physicians were documented in the morbidity register...
2016: Dermatology Research and Practice
Amy O'Donnell, Catherine McParlin, Stephen C Robson, Fiona Beyer, Eoin Moloney, Andrew Bryant, Jennifer Bradley, Colin Muirhead, Catherine Nelson-Piercy, Dorothy Newbury-Birch, Justine Norman, Emma Simpson, Brian Swallow, Laura Yates, Luke Vale
BACKGROUND: Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG...
October 2016: Health Technology Assessment: HTA
David O Akeju, Marianne Vidler, J O Sotunsa, M O Osiberu, E O Orenuga, Olufemi T Oladapo, A A Adepoju, Rahat Qureshi, Diane Sawchuck, Olalekan O Adetoro, Peter von Dadelszen, Olukayode A Dada
BACKGROUND: The dearth of health personnel in low income countries has attracted global attention. Ways as to how health care services can be delivered in a more efficient and effective way using available health personnel are being explored. Task-sharing expands the responsibilities of low-cadre health workers and allows them to share these responsibilities with highly qualified health care providers in an effort to best utilize available human resources. This is appropriate in a country like Nigeria where there is a shortage of qualified health professionals and a huge burden of maternal mortality resulting from obstetric complications like pre-eclampsia...
September 30, 2016: Reproductive Health
Umesh Ramadurg, Marianne Vidler, Umesh Charanthimath, Geetanjali Katageri, Mrutyunjaya Bellad, Ashalata Mallapur, Shivaprasad Goudar, Shashidhar Bannale, Chandrashekhar Karadiguddi, Diane Sawchuck, Rahat Qureshi, Peter von Dadelszen, Richard Derman
BACKGROUND: In India, the hypertensive disorders of pregnancy and postpartum haemorrhage are responsible for nearly 40 % of all maternal deaths. Most of these deaths occur in primary health settings which frequently lack essential equipment and medication, are understaffed, and have limited or no access to specialist care. Community health care workers are regarded as essential providers of basic maternity care; and the quality of care they provide is dependent on the level of knowledge and skills they possess...
September 30, 2016: Reproductive Health
Gustavo C Oliveira, Alexandre M Valença, Talvane M de Moraes, Mauro V Mendlowicz, Miles C Forrest, Fred F Batista, Gabriella A Mendes, Tiago N Lima, Vinicius R Gonçalves, Kátia Mecler
Objectives: To evaluate factors related to dangerousness cessation at the end of involuntary commitment based on an analysis of expert reports. In light of the current legal requirement of dangerousness cessation as a pre-requisite for prison or internment release of individuals subjected to the safety measure, we sought elements to reflect on the practice of expert examiners in charge of making this decision. Methods: The authors revised 224 expert psychiatric dangerousness cessation reports released 2011 through 2014 and collected data for a statistical analysis...
September 29, 2016: Revista Brasileira de Psiquiatria
F J Erbguth, L Erbguth
End-of-life decisions in neurology have repeatedly given occasion for controversies. Often these are based on lack of knowledge of the juridical and ethical framework conditions. This review describes the juridical-ethical basis for the implementation and continuation, and for withholding and withdrawal of life-sustaining measures, in particular, the significance of medical indication and patient's will. The different forms of assisted dying ("Sterbehilfe"), namely homicide by request, assisted suicide, palliative symptom relief and treatment withdrawal are characterized...
September 2016: Deutsche Medizinische Wochenschrift
Eric J Wright, Rohit K Khosla, Lori Howell, Gordon K Lee
BACKGROUND: Comprehensive aesthetic surgery training continues to be a challenge for residency programs. Our residency program developed a rhinoplasty-based objective structured clinical examination (OSCE) based upon validated methods as part of the residency education curriculum. We report our experience with the rhinoplasty-based OSCE and offer guidance to its incorporation within residency programs. METHODS: The encounter involved resident evaluation and operative planning for a standardized patient desiring a rhinoplasty procedure...
September 2016: Archives of Plastic Surgery
Jyoti Savla, Zhe Wang, Karen A Roberto, Rosemary Blieszner
Introduction: An emerging perspective of dyadic coping with chronic illness argues that concordance in the appraisal of illness is crucial for collaborative attempts at seeking information, making treatment decisions, and planning for long-term management of the illness and psychological and physical adjustments of both the care provider and care recipient. The present study examined whether persons with mild cognitive impairment (PwMCIs) and their family care partners (CPs) exhibited concordance in their awareness of deficits in the PwMCIs...
September 29, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
T Giaddui, D Bollinger, A Glick, H Zhong, H Phillips, F Nunez, R Infante, S Hames, N Linnemann, R Lee, A Tak-Cheung Chan, S S Yom, W Hara, S S Baxi, A Chakravarti, N Lee, P Xia, Y Xiao
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
J H Lefevre, S Benoist
GOAL: To report the current clinical practice of French physicians for rectal cancer in various complex settings. METHODS: Nineteen clinical situations and four surveillance modalities were proposed to a panel of experts via 11 learned societies. The answers of 48 experts and the impact of colorectal specialists on therapeutic options were compared to those of other participants. RESULTS: A total of 722 physicians [surgeons=319 (44%), gastro-intestinal oncologists=305 (42%), radiotherapists=98 (14%)] participated in this study...
September 20, 2016: Journal of Visceral Surgery
Black Hawk Hancock, Daniel R Morrison
Drawing on and extending the Foucaultian philosophical framework that Jeffrey Bishop develops in his masterful book, The Anticipatory Corpse: Medicine, Power, and the Care of the Dying, we undertake a sociological analysis of the neurological procedure-deep brain stimulation (DBS)-which implants electrodes in the brain, powered by a pacemaker-like device, for the treatment of movement disorders. Following Bishop's work, we carry out this analysis through a two-fold strategy. First, we examine how a multidisciplinary team evaluates candidates for this implant at a major medical center...
September 22, 2016: Journal of Medicine and Philosophy
Stefanie Puszka, Kylie M Dingwall, Michelle Sweet, Tricia Nagel
BACKGROUND: Electronic mental health (e-mental health) interventions offer effective, easily accessible, and cost effective treatment and support for mental illness and well-being concerns. However, e-mental health approaches have not been well utilized by health services to date and little is known about their implementation in practice, particularly in diverse contexts and communities. OBJECTIVE: This study aims to understand stakeholder perspectives on the requirements for implementing e-mental health approaches in regional and remote health services for Indigenous Australians...
2016: JMIR Mental Health
Pravinkumar G Patil, Takayuki Ueda, Kaoru Sakurai
OBJECTIVE: The objective of this study is to identify the influence of early clinical exposure for undergraduate students on self-perception of different aspects of geriatric dental care. MATERIALS AND METHODS: We have selected two different colleges from Japan and India, namely, Tokyo Dental College (TDC), Tokyo, and Government Dental College (GDC), Nagpur, respectively. The GDC students exposed to patients in a 3(rd) year and TDC in the 5(th) year of course. Survey of 74 undergraduate students GDC and 95 of TDC was conducted...
July 2016: Journal of Indian Prosthodontic Society
Jee Young Kim, Soo Ah Im, Ju Hyun Lee, Jae Wook Lee, Nak Gyun Chung, Bin Cho
BACKGROUND: Extramedullary relapse (EMR) is a recurrence of leukemia in sites other than the bone marrow, and it exhibits a relatively rare presentation of relapse of acute leukemia. However, EMR is an important cause of treatment failure among patients with acute leukemia. Therefore, early detection of these relapses may improve the prognosis. OBJECTIVES: To describe the disease-related demographic and clinical features and radiologic findings for children diagnosed with EMR in acute leukemia...
June 2016: Iranian Journal of Pediatrics
Lisa M Puchalski Ritchie, Monique van Lettow, Austine Makwakwa, Adrienne K Chan, Jemila S Hamid, Harry Kawonga, Alexandra L C Martiniuk, Michael J Schull, Vanessa van Schoor, Merrick Zwarenstein, Jan Barnsley, Sharon E Straus
BACKGROUND: Despite availability of effective treatment, tuberculosis (TB) remains an important cause of morbidity and mortality globally, with low- and middle-income countries most affected. In many such settings, including Malawi, the high burden of disease and severe shortage of skilled healthcare workers has led to task-shifting of outpatient TB care to lay health workers (LHWs). LHWs improve access to healthcare and some outcomes, including TB completion rates, but lack of training and supervision limit their impact...
2016: Trials
Mashudat Bello-Mojeed, Cornelius Ani, Ike Lagunju, Olayinka Omigbodun
BACKGROUND: Autism Spectrum Disorders (ASD) is a disabling and lifelong neuro-developmental disorder. Challenging behaviours such as aggression and self injury are common maladaptive behaviours in ASD which adversely affect the mental health of both the affected children and their caregivers. Although there is evidence-base for parent-delivered behavioural intervention for children with ASD and challenging behaviours, there is no published research on the feasibility of such an intervention in sub-Saharan Africa...
2016: Child and Adolescent Psychiatry and Mental Health
Sunghwan Suh, Kyoungjune Pak, Ju Won Seok, In Joo Kim
PURPOSE: Thyroid cancer is the most common endocrine cancer and its incidence has continuously increased in the last three decades all over the world. We aimed to evaluate the prognostic value of extranodal extension (ENE) of thyroid cancer. MATERIALS AND METHODS: We performed a systematic search of MEDLINE (from inception to June 2014) and EMBASE (from inception to June 2014) for English-language publication. The inclusion criteria were studies of thyroid cancer that reported the prognostic value of ENE in thyroid cancer...
November 2016: Yonsei Medical Journal
Uwe Weber, Mihai A Constantinescu, Ulrich Woermann, Felix Schmitz, Kai Schnabel
INTRODUCTION: Various different learning methods are available for planning tuition regarding the introduction to surgical hand disinfection. These learning methods should help to organise and deal with this topic. The use of a video film is an alternative to conventional tuition due to the real presentation possibilities of practical demonstration. OBJECTIVE: This study examines by way of comparison which form of communication is more effective for learning and applying surgical hand disinfection for medical students in their first year of studies: video-based instruction or conventional tuition...
2016: GMS Journal for Medical Education
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