A new clinical method for prediction of postoperative complication after pancreas resection

Pancreatology ◽  
2021 ◽  
Vol 21 ◽  
pp. S101
Author(s):  
E. Drozdov ◽  
A. Baranov
Keyword(s):  
Postoperative Complication ◽  
Clinical Method ◽  
Pancreas Resection

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

Modern approaches to the treatment of mastitis in women of reproductive age

2016 ◽  
pp. 191-108
Author(s):  
A.A. Sukhanova ◽  
◽  
Yu.M. Melnik ◽  
O.O. Karlova ◽  
◽  
...  
Keyword(s):  
Ultrasound Examination ◽  
Clinical Signs ◽  
Reproductive Age ◽  
Herbal Remedies ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Clinical Method ◽  
Gynecological Examination ◽  
Study Results ◽  
Observation Period

The aim of the study: to study the efficacy and safety of use Mastofemin in the treatment of various forms of mastitis in women of reproductive age. Materials and methods. The study included 62 women of reproductive age (mean age of 33.5±2.3 years) who were screened in the Kiev city center reproductive and perinatal medicine. Women were divided into 2 groups. The first (main) group consisted of 32 patients who received the proposed treatment using herbal remedies Mastofemin 1 capsule 2 times per day for 3 months; 30 patients of the second (control) group were under observation and received no treatment. These groups were representative and homogeneous on age, clinical symptoms and sonographic characteristics. The clinical method included evaluation of complaints of patients, anamnesis, presence of concomitant gynecologic pathology, inspection, palpation of the lymph nodes and the breast and obtaining a discharge from the nipples to conduct cytological examination, which allowed excluding from the study women with suspected malignancy of the process. All the patients were performed ultrasound examination of the breast. The review was supplemented with vaginal gynecological examination and ultrasound examination of small pelvis organs to assess the condition of the uterus and its appendages, the diagnosis of gynecological diseases. Results. Summarizing obtained in this study results one should stress the positive long-term effect of applying Mastofemin for the treatment of proliferative changes of the breast in women of reproductive age. This is manifested by a decrease in the intensity of clinical signs of mastitis, consistent with the results of sonographic control. Established positive dynamics in the treatment of cystic mastitis, dectective and when combined cystic mastopathy with dectective. In the control group of patients for a given observation period (6 months) no significant changes in clinical signs of mastitis and sonographic characteristics. Regression of disease has not occurred in any of the patients, in 2 patients increased sensitivity of the breast after 6 months moved to the soreness. Sonographic characteristics of mastitis during the observation period did not change. Thus, the use of Mastofemin aimed at pathogenetic treatment of mastitis and prevention of breast cancer. Conclusion. Application of Mastofemin during the treatment of mastitis in women of reproductive age significantly improves the clinical condition of patients; reduce the subjective and objective symptoms of the disease. The positive effect of the treatment with Mastofemin proved in the case of the treatment of sonographic following forms of mastitis: cystic mastopathy, cystic mastopathy with dectectasy. Mastofemin may be the drug of choice for complex conservative monotherapy in women of reproductive age with proliferative changes in the breast, and can also be used as part of complex treatment in patients with diffuse changes of the breast when combined with hyperplastic processes of the myometrium and endometrium. Keywords: mastopathy, breast gland, herbal medicine, herbal remedies, Mastofemin.

Comparison of categorical and dimensional approaches to the diagnosis of personality disorders

2020 ◽  
pp. 15-25
Author(s):  
T. G. Gadisov ◽  
A. A. Tkachenko
Keyword(s):  
Comparative Study ◽  
Personality Disorders ◽  
Big Five ◽  
Factor Model ◽  
Five Factor Model ◽  
Personality Structure ◽  
Categorical Approach ◽  
Personal Traits ◽  
Clinical Method ◽  
Neo Five Factor Inventory

Summary. Objective: A comparative study of the personality structure from the perspective the Five-factor personality model (“Big Five”) in mentally healthy and in people with personality disorders depending on the leading radical determined by the clinical method.Materials and methods: a comparative study of personality structures in the mentally healthy (13 people) and in individuals with personality disorders (47 people) was carried out. To assess the personality structure, the NEO-Five Factor Inventory questionnaire was used. Persons with personality disorders were divided into groups in accordance with the leading radical: 24 — with emotionally unstable; 13 — with a histrionic; 6 — with schizoid; 4 — with paranoid radicals.Results: There were no differences in the values of the domains of the Five-Factor personality model between a group of individuals with personality disorders and the norm. The features of domain indicators of the Five-factor personality model were revealed in individuals with personality disorder depending on theradical.Conclusion: The NEO-Five Factor Inventory questionnaire, like most other tools from the perspective of the Five-Factor Model, is not suitable for assessing a person in terms of assigning it to variants of a mental disorder. When comparing the categorical and dimensional approaches to assessing the structure of personality disorders, it was found that the obligate personality traits identified using the categorical approach are fully reflected in the «Big Five» in individuals with a leading schizoid radical. The relations of obligate personal traits with the domains of the Five-factor model of personality in individuals with other (paranoid, histrionic,and emotionally unstable) radicals are less clear.

Teaching a Clinical Method Adapted to Contemporary Medicine

2018 ◽  
Author(s):  
J. Donald Boudreau ◽  
Eric J. Cassell ◽  
Abraham Fuks
Keyword(s):  
Clinical Observation ◽  
Skills Training ◽  
Spoken Language ◽  
Communication Skills Training ◽  
Clinical Method ◽  
Medical Interviewing ◽  
The Status ◽  
Clinical Thinking ◽  
Contemporary Medicine ◽  
Person Centered Approach

A truly person-centered curriculum requires important changes to how the clinical method is taught. Medical interviewing demands explicit instruction in how the spoken language works and specific strategies that elevate the status of attentive listening so that this aspect is seen as important as the more mechanical aspects of traditional communication skills training. The term chief complaint is declared outdated and suggestions for its replacement are offered. The medical record is considered an important educational instrument, and recommendations are made so that it is in service of functional assessment and better aligned to a person-centered approach. Modifications to the physical examination, particularly a renewed emphasis on clinical observation, are outlined. The chapter concludes with a discussion of clinical thinking and judgment. A plea is made for inculcating a receptiveness toward a narrative competence within medicine.

The Clinical Method and Subjectivity in Medicine

2018 ◽  
Author(s):  
J. Donald Boudreau ◽  
Eric J. Cassell ◽  
Abraham Fuks
Keyword(s):  
Physical Examination ◽  
Medical History ◽  
Medical Record ◽  
Chronic Conditions ◽  
Process Of Care ◽  
Clinical Method ◽  
Functional Assessments ◽  
Contemporary Medicine

The clinical method is defined as the means by which doctors gather information about their patients, think about and evaluate these medical facts, and enter the facts into their process of care. Its key components are the medical history, including the process by which it is acquired from patients and its subsequent documentation in the medical record, as well as the physical examination. Characteristics, such as the reproducibility and accuracy of various components, are discussed with a reference to prevailing opinions of subjectivity and objectivity in medicine. It is argued that as a consequence of a shift in the prevalence of illness, from acute to chronic conditions, a misalignment exists between the clinical method currently taught and contemporary medicine. It is suggested that a renewed and repurposed clinical method must incorporate enhanced strategies for functional assessments.

Implant Complications in 20 Triple Pelvic Osteotomies

1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Cindy Fries ◽  
Audrey Remedios
Keyword(s):  
Postoperative Complication ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Implant Failure ◽  
Screw Loosening ◽  
Common Complication ◽  
Implant Complications ◽  
Gait Abnormalities

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.

scholarly journals Clinical application of thioredoxin reductase as a novel biomarker in liver cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xuping Wu ◽  
Qi Wang ◽  
Yousheng Lu ◽  
Jinye Zhang ◽  
Hanwei Yin ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Tumor Markers ◽  
Clinical Application ◽  
Thioredoxin Reductase ◽  
Superior Performance ◽  
Percutaneous Ablation ◽  
Hepatic Cancer ◽  
Diagnostic Efficiency ◽  
Malignant Diseases ◽  
Clinical Method

AbstractHepatic cancer is often amenable to surgery, including percutaneous ablation, trans-arterial chemoembolization. However, in metastatic cases, surgery is often not an effective option. Chemotherapy as a conventional clinical method for treatment of malignant diseases may be useful in such cases, but it is likewise not always able to slow or halt progression, therefore novel approaches for treatment of hepatic cancer are needed. Current research suggests that molecular tumor markers (TM) can play a crucial role for diagnosis and prognostic evaluation of malignancies, and TM such as AFP, CEA, CA19-9 have been reported in many malignant diseases. Thioredoxin reductase (TrxR), a type of anti-oxidant biomarker, has become a TM of significant interest. However, little is known about the above TM and TrxR activity in liver cancer. Therefore, this paper aimed to assess these TM with regards to diagnosis and and monitoring treatment efficacy in both primary and metastatic liver cancer. Our results showed TrxR had superior performance for discriminating between liver cancer patients and healthy controls than AFP, CEA, and CA19-9. TrxR also exhibited superior performance for assessing benefits of chemotherapy regardless if patients had PLC or MLC. Meanwhile, due to diagnostic efficiency of unresponsive chemotherapy patients, TrxR also showed a higher activity levels than other general markers in liver metastasis patients. Our results suggest that application of TrxR in combination with other tumor markers may maximize the efficiency of diagnosis and assessment of therapeutic efficiency, and provide new insights for the clinical application of TrxR as a candidate biomarker for liver cancer.

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