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Morton Rowe postete ein Update vor 1 Jahr
By expanding the body of knowledge about factors that impact social work care for burn patients, Social work academic programs may better understand how to prepare medical social work students for best practices in the care of burn-injured patients, survivors, and families at inpatient and community levels.
Fibrosis staging in patients with nonalcoholic fatty liver disease (NAFLD) is carried out through the application of stepwise algorithms but there is little real-world data on their use. Our aim was to calculate the number of patients with NAFLD and indeterminate or high risk for fibrosis, assessed through noninvasive scores, that consequently underwent further staging evaluation.
A cross-sectional multicenter cohort study was conducted on patients with NAFLD evaluated by hepatologists within the time frame of June 1 and July 31, 2018. The FIB-4 and NAFLD fibrosis scores were calculated in all the patients, and if at least one of the scores suggested indeterminate or high risk for fibrosis, we believed the patient should have undergone additional fibrosis staging assessment.
The study included 238 patients. The median time interval from NAFLD diagnosis and inclusion in the analysis was 12.2months (IQR 3.0-36.5). A total of 128 (54%) patients had at least one noninvasive score that suggested indeterminate or high risk for fibrosis but studies to confirm the fibrosis grade (elastography, biopsy, etc.) were performed on only 72 (56%). The main barriers encountered by the physicians for applying the staging algorithms were related to health insurance coverage and imaging study costs.
A high percentage of patients with NAFLD were at indeterminate or high risk for fibrosis, according to noninvasive scores, but additional studies were carried out on only half of them, showing low adherence to current recommendations.
A high percentage of patients with NAFLD were at indeterminate or high risk for fibrosis, according to noninvasive scores, but additional studies were carried out on only half of them, showing low adherence to current recommendations.
This research aimed to investigate the effect of Nano-Bio Fusion Gingival Gel ([NBFG] NanoCureTech, Gangdong-gu, Seoul, Korea) as an aid along with oral hygiene advice and routine scaling in patients with malocclusion to control treatment-induced gingivitis and periodontitis in patients undergoing fixed orthodontic treatment.
A split-mouth design, prospective analysis after application of NBFG in 32 subjects with fixed orthodontic treatment-induced gingivitis was conducted. Patients applied NBFG to their gingiva twice daily, after brushing, for 90 consecutive days. Outcomes measured included the plaque index (PI), papillary bleeding gingival index (PBI), probing depth (PD), and clinical attachment loss using standard assessment. PI, PBI, PD, and clinical attachment loss were measured at baseline, on the seventh day of gel application, at the next visit at the orthodontic clinic (28th day), and after 90days.
From baseline to the seventh day to the 90th day, the treatment group showed significant improvement in PI, PBI, and PD over time compared with the placebogroup.
NBFG showed positive clinical effects in patients undergoing fixed orthodontic treatment. Clinical outcomes were measured in a comparatively short period.
NBFG showed positive clinical effects in patients undergoing fixed orthodontic treatment. Clinical outcomes were measured in a comparatively short period.
[1] review all studies utilizing SDM in the treatment of chronic rhinosinusitis (CRS) [2], increase awareness of otolaryngologists to shared decision-making, and [3] provide a framework for its incorporation into research and clinical practice.
systematic search was performed in November 2019 using PubMed/MEDLINE 1947-, CINAHL Complete 1937-, the Cochrane Library, ClinicalTrials.gov, and Web of Science Core Collection (SCI-EXPANDED, SSCI, A&HCI, ESCI) 1900-. All databases were searched from their inception through the date of search. Studies were eligible if they involved a discussion of SDM in the management of CRS. Studies were excluded if they lacked original patient data or outcomes of interest. Identified studies were screened by title/abstract, followed by full-text review. PRISMA guidelines were strictly followed.
in total, 416 articles met screening criteria. Six were eligible for full text review. Only one study – an expert panel of the framework for the presurgical treatment of CRS – pertant outcomes, and provides a proposed framework for incorporating SDM in research and clinical practice.Ménière’s disease is an inner ear disease with attacks characterized by ear fullness, tinnitus, fluctuant sensorineural hearing loss and vertigo. Although pathophysiology of the disease is not fully known, endolymphatic hydrops are believed to play a role. Although there is no certain treatment procedure for Ménière’s disease, some treatments are applied to prevent attacks, to treat the symptoms that occur during the attacks, and to prevent the permanent effects of the symptoms on the hearing and balance system. Lifestyle changes, dietary modifications, diuretics, vasodilator corticosteroids, intratympanic steroids, surgical methods are some of these treatment methods. Dietary modification includes a low sodium diet, a reduction in daily alcohol and caffeine intake, a gluten-free diet, and a new dietary approach to specially processed grains, all of which are first-line treatments. The goal of this review article is to examine the relationship between MD and dietary intervention, which is frequently used in the prevention and treatment of MD attacks.
To evaluate the efficacy and safety of regenerative treatment for tympanic membrane perforation (TMP) using gelatin sponge, basic fibroblast growth factor (bFGF), and fibrin glue.
This was a multicenter, non-randomized, single-arm study conducted at tertiary referral centers. Twenty patients with chronic TMP (age 23-78 years, 6 males, 14 females) were registered from three institutions. All treated patients were included in the safety analysis population. The edges of the TMP were disrupted mechanically by myringotomy and several pieces of gelatin sponge immersed in bFGF were placed and fixed with fibrin glue to cover the perforation. The TMP was examined 4±1 weeks later. The protocol was repeated up to four times until closure was complete. The main outcome measures were closure or a decrease in size of the TMP, hearing improvement, and air-bone gap evaluated 16 weeks after the final regenerative procedure (FRP). Adverse events (AEs) were monitored throughout the study.
Total closure of the TMP at 16 weeks was achieved in 15 out of 20 patients (75.0%, 95% confidence interval [CI] 50.9%-91.3%) and the mean decrease in size was 92.2% (95%CI 82.9%-100.0%). The ratio of hearing improvement and the air-bone gap at 16 weeks after FRP were 100% (20/20; 95%CI 83.2%-100%) and 5.3±4.2dB (p<0.0001), respectively. Thirteen out of 20 patients (65.0%) experienced at least one AE, but no serious AEs occurred.
The results indicate that the current regenerative treatment for TMP using gelatin sponge, bFGF, and fibrin glue is safe and effective.
The results indicate that the current regenerative treatment for TMP using gelatin sponge, bFGF, and fibrin glue is safe and effective.Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a dysimmune neuropathy with sensory and/or motor symptoms due to destruction of the myelin sheat secondary to an auto-immune attack. A quarter to a third of patients do not respond to immunomodulatory first line recommended therapies. No second line treatment has shown its effectiveness with a sufficient level of evidence. Autologous hematopoietic stem cell transplantation (AHSCT) is a promising therapy for autoimmune disease, especially for CIDP in recent works. We present in this article an update on the diagnosis of CIDP, its conventional treatments as well as the results of AHSCT in this indication, which was the subject of French recommendations under the aegis of the SFGMTC and neuromuscular disease french faculty (FILNEMUS) as a third line therapy after failure of two first-line and one second-line treatments.
Pyoderma gangrenosum (PG) is a rare, mainly dermatological condition, whose unusual and little-known lung involvement presents a diagnostic and therapeutic challenge.
A 66-year-old man, followed for 6 years for an IgA monoclonal gammopathy of undetermined significance and an initially cutaneous corticosteroid-dependent PG, received a pneumonectomy for a mass suspected of neoplasia, that turns out to be a PG pulmonary localisation. During successive pneumopathies, sometimes dyspneic and excavated, several hypotheses are discussed. Various infectious and immunological explorations, and various antibacterial/fungal or immunosuppressive therapies are conducted, to finally conclude to pulmonary and/or cutaneous recurrences of PG. The outcome at 14 months seems finally favourable with tofacitinib.
The recognition of cutaneous involvement of PG, which is essential for the diagnosis of its lung involvement, is probably the mirror of its evolution under treatment. Only multidisciplinary confrontation of reported cases will allow the elaboration of diagnostic and therapeutic recommendations.
The recognition of cutaneous involvement of PG, which is essential for the diagnosis of its lung involvement, is probably the mirror of its evolution under treatment. Only multidisciplinary confrontation of reported cases will allow the elaboration of diagnostic and therapeutic recommendations.Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm caused by a reciprocal translocation [t(9;22)(q34;q11.2)] that leads to the fusion of ABL1 gene sequences (9q34) downstream of BCR gene sequences (22q11) and is cytogenetically visible as Philadelphia chromosome (Ph). selleck kinase inhibitor The resulting BCR/ABL1 chimeric protein is a constitutively active tyrosine kinase that activates multiple signaling pathways, which collectively lead to malignant transformation. During the early (chronic) phase of CML (CP-CML), the myeloid cell compartment is expanded, but differentiation is maintained. Without effective therapy, CP-CML invariably progresses to blast phase (BP-CML), an acute leukemia of myeloid or lymphoid phenotype. The development of BCR-AB1 tyrosine kinase inhibitors (TKIs) revolutionized the treatment of CML and ignited the start of a new era in oncology. With three generations of BCR/ABL1 TKIs approved today, the majority of CML patients enjoy long term remissions and near normal life expectancy. However, only a minority of patients maintain remission after TKI discontinuation, a status termed treatment free remission (TFR). Unfortunately, 5-10% of patients fail TKIs due to resistance and are at risk of progression to BP-CML, which is curable only with hematopoietic stem cell transplantation. Overcoming TKI resistance, improving the prognosis of BP-CML and improving the rates of TFR are areas of active research in CML.
Pertussis is a highly contagious infectious disease caused by Bordetella pertussis and a leading cause of infant mortality in Mexico. The Tetanus-diphtheria-acellular pertussis (Tdap) vaccine was recommended in the Mexican Immunisation Programme for pregnant women in 2013. We describe pertussis morbidity and mortality trends in infants ≤2 and ≤12months of age), before and after maternal Tdap immunisation implementation in Mexico.
An ecological retrospective database study was performed in the Mexican National and Workers Social Security Institutes (IMSS; ISSSTE). Data were collected on confirmed pertussis ambulatory cases, hospitalisations, and deaths, plus vaccination coverage (Tdap; Diphtheria-tetanus-acellular pertussis [DTPa]) and population estimates. Descriptive and regression time-trend analyses were performed for pertussis morbidity and mortality in infants between pre- (2010-2012) and post- (2014-2018) maternal Tdap immunisation periods.
Around 1 million infants a year are covered in IMSS/ISSSTE databases.