PO-1546 Quality of adaptive treatment plan on a 0.35 T MR-Linac

2021 ◽  
Vol 161 ◽  
pp. S1271
Author(s):  
I. Bessieres ◽  
A. Petitfils ◽  
L. Aubignac ◽  
O. Lorenzo ◽  
J. Boudet
Keyword(s):  
Treatment Plan ◽  
Adaptive Treatment

An Ayurvedic Visual Rehabilitation In Lebers Congenital Amaurosis - Prospective Case Study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Vidhyasri M ◽  
Dr. S. M. Pasha
Keyword(s):  
Marked Improvement ◽  
Clinical Case ◽  
Treatment Plan ◽  
Visual Disability ◽  
Visual Rehabilitation ◽  
Potential Risks ◽  
The Subject ◽  
Slow Frequency

Introduction: This is the case report of child who was diagnosed with LCA reported with complaints of large-amplitude, slow-frequency, roving nystagmus, frequent tendency to press on his eyes, enopthalmos, with completely normal ophthalmoscopic examination with normal appearing optic nerve and retina and has a non recordable ERG; considering this condition under the lines of Vataja Nanatmaja Vyadhi treatment was structured to render effective visual rehabilitation which showed marked results. Methods: 4 years old male child who was diagnosed with lebers congenital amaurosis was brought by his parents to Eye OPD, GAMC, Bengaluru. The presentation of this case includes bibliographic review of the subject, presentation of a clinical case and description of the importance of Ayurvedic prespective of handling of these patients. Results: The child showed improvement in fixing for light and also nystagmus showed marked improvement and there were considerable behavioural changes observed. Discussion: It is important to deepen the environment of the disease to know the possible implications in Ayurvedic management, recognize the magnitude of visual disability that our patient presents for the establishment of the treatment plan and provide an integral care of excellence in an interdisciplinary way in favor of visual rehabilitation of our patients and also help to restore quality of life with no potential risks of side effects.

scholarly journals Outcomes of Peer Review for Radiotherapy Treatment Plans With Palliative Intent

2018 ◽  
Vol 14 (12) ◽  
pp. e794-e800
Author(s):  
Dina Thompson ◽  
Kimberly Cox ◽  
James Loudon ◽  
Ivan Yeung ◽  
Woodrow Wells
Keyword(s):  
Peer Review ◽  
Treatment Plan ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Palliative Intent ◽  
Treatment Plans ◽  
Important Quality ◽  
Radiation Medicine ◽  
Radiotherapy Treatment

Purpose: Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy. Methods and Materials: Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017. Recommended and implemented changes were recorded. The content of detailed discussions was recorded to gain insight into the complexities of palliative treatment plans considered during peer review. Results: Peer review outcomes were reviewed for 1,413 treatment plans with palliative intent. The proportions of detailed discussions and changes recommended were found to be 139 (9.8%) and 29 (2.1%), respectively. The content of detailed discussions and changes recommended was categorized. Major changes represented 75.9% of recommended changes, of which 84.2% were implemented clinically. Conclusion: Many complexities exist that are specific to palliative radiotherapy. Interprofessional peer review provides a forum for these complexities to be openly discussed and is an important activity to optimize the quality of care for patients with treatment plans that have palliative intent.

OC-0181 Implementation of direct quality of life guided treatment plan optimisation

2021 ◽  
Vol 161 ◽  
pp. S112-S114
Author(s):  
A. van der Schaaf ◽  
H.P. van der Laan ◽  
L. Van den Bosch ◽  
E. Korevaar ◽  
S. Both ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Plan

Caring for Gravely Ill Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Ethics Committees ◽  
Well Being ◽  
Pediatric Health Care ◽  
Spiritual Well Being ◽  
Primary Focus

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

scholarly journals How the Future of Sonography May Change the Outlook for Patients With Osteosarcoma

2018 ◽  
Vol 34 (5) ◽  
pp. 368-373
Author(s):  
Stacey Hoya ◽  
Linda Wogeman ◽  
Sara Allstadt ◽  
Glen King
Keyword(s):  
Quality Of Life ◽  
Focused Ultrasound ◽  
Treatment Plan ◽  
Treatment Options ◽  
Therapeutic Ultrasound ◽  
Bone Lesions ◽  
Pulsed Ultrasound ◽  
Low Intensity Pulsed Ultrasound ◽  
Ultrasound Applications

Sonography currently provides a variety of tools to support the diagnosis and treatment of osteosarcoma and, with the development of therapeutic ultrasound practices, could play an increasingly important role in the treatment of future patients with osteosarcoma. Currently, computed tomography, magnetic resonance imaging, and radiography are the preferred imaging modalities for bone lesions; treatment options for osteosarcoma primarily include highly toxic chemotherapies and surgeries that often result in limb loss. Unfortunately, osteosarcoma is rarely eliminated, and despite this, patients lose their lives after having a significant reduction in quality of life. Evolving therapies such as high-frequency focused ultrasound, ultrasound-enhanced delivery of photodynamic therapy, and low-intensity pulsed ultrasound may offer these patients an improved quality of life while also increasing efficacy of treatment. This canine case study illustrates the various ways in which sonography might contribute to the treatment plan for patients with osteosarcoma. It may provide a comparable model for the reimagining of treatment for future patients with osteosarcoma using a suite of therapeutic ultrasound applications.

scholarly journals A Postal Survey of Hereditary Hemorrhagic Telangectasia in the Northeast of England

2015 ◽  
Vol 6 (1) ◽  
pp. ar.2015.6.0114 ◽  
Author(s):  
Yujay Ramakrishnan ◽  
Isma Z. Iqbal ◽  
Mark Puvanendran ◽  
Mohamed Reda ElBadawey ◽  
Sean Carrie
Keyword(s):  
Family History ◽  
Treatment Plan ◽  
Positive Family History ◽  
Tertiary Hospital ◽  
Postal Survey ◽  
History Of ◽  
Unknown Gene ◽  
Specific Education ◽  
Nose And Throat

The aim of this study is to identify the demographics and epistaxis burden of hereditary hemorrhagic telangiectasia (HHT). A questionnaire was sent to participants with HHT who were recruited from a prospectively maintained respiratory clinic data base in a tertiary hospital. Details on demographics, HHT symptoms, family history, epistaxis severity, and treatment received were recorded. There were 34 of 60 responses (57%). Two responses were from families of the deceased. Of the 32 evaluable patients (men, 14; women 18), the average age was 51 years (range, 23–78 years). The average age of HHT diagnosis was 31 years (range, 3–61 years). The diagnosis of HHT was made by the respiratory team in 13 patients; neurologist (2); ear, nose, and throat (ENT) specialist (4); general practitioner (5); hematologist (4); gastroenterologist (1); and not mentioned in two patients. Twenty-seven of 32 patients (84%) had a positive family history of HHT. Only 13 patients had formal genetic testing (4 endoglin, 1 activin receptor–like kinase, 8 unknown gene). All patients who presented to the respiratory clinic had a background of epistaxis, which was noted on presentation. The average age at initial epistaxis was 14 years (range, 2–50 years). The frequency of epistaxis was daily 63% (n = 20), weekly 9% (3), monthly 16% (5), and a few times a year 10% (3), and unstated in one patient. Nine of 32 patients (28%) required a transfusion. Six patients thought that they were unable to perform daily activities due to epistaxis. Only 15 of 32 patients (47%) were under the care of an ENT specialist. The treatment plan for epistaxis management was deemed good by 7 patients, adequate in 8, poor in 6, and not stated by 11 patients. In conclusion, this survey is the first to quantify the epistaxis burden within the northeast of England. The management of epistaxis needs specific education and treatment to optimize the quality of life among these patients.

scholarly journals Importance of Diagnostic Waxing in Oral Rehabilitation: Case Report

2020 ◽  
Vol 22 (2) ◽  
pp. 146-150
Author(s):  
Mariana Lima da Costa Valente ◽  
Marcela Silva Costa ◽  
Paulo Marcos Bérgamo ◽  
Denise Tornavoi de Castro
Keyword(s):  
Quality Of Life ◽  
Treatment Plan ◽  
Dental Restoration ◽  
Oral Rehabilitation ◽  
Correct Treatment ◽  
Life Planning ◽  
End Of Treatment ◽  
Patient Reported ◽  
And Function

Currently, aesthetics, and especially the smile, adds considerable social value. In this way, patients suffering from dental loss wish that their rehabilitation be performed quickly and safely. The aim of oral rehabilitation is to restore masticatory, phonetic, aesthetic and quality of life to the patient. The diagnostic step is one of the most important and relevant steps in establishing a correct treatment plan and, in this way, it is possible to obtain excellent results. The present study aimed to demonstrate the importance of diagnostic waxing in oral rehabilitation. Patient sought treatment at the Dental Prosthesis Specialization Course at Odonto School, due to complaints associated with aesthetics and function. To improve their quality of life, planning of case was carried out through diagnostic waxing and a prosthetic solution was proposed. At the end of treatment and during the follow-up of the case, the patient reported satisfaction and significant improvement in quality of life. It can be concluded that the diagnostic waxing presents customized solutions offering, through a previous study, an effective clinical resolution to the patient. Keywords: Mouth Rehabilitation. Dental Restoration, Temporary. Dental Restoration, Temporary. Resumo Atualmente, a estética, e em especial o sorriso, agregam um valor social considerável. Dessa forma, ao sofrerem a perda dental, os pacientes desejam que sua reabilitação seja realizada de forma rápida e segura. A reabilitação oral tem como objetivo devolver ao paciente a eficiência mastigatória, fonética, estética e a qualidade de vida. A etapa diagnóstica constitui um dos passos mais importantes e relevantes no estabelecimento de um correto planejamento do tratamento e, desta forma, torna-se possível obter resultados de excelência. O presente estudo teve como objetivo demonstrar a importância do enceramento diagnóstico na reabilitação oral. Paciente procurou tratamento no Curso de Especialização em Prótese Dentária da Odonto School, devido a queixas associadas a estética e função. Para melhorar sua qualidade de vida, foi realizado o planejamento do caso por meio do enceramento diagnóstico e uma solução protética foi proposta. Ao final do tratamento e durante o acompanhamento do caso, a paciente relatou satisfação e melhora significativa na qualidade de vida. Pode-se concluir que o enceramento diagnóstico apresenta soluções personalizadas oferecendo, por meio de estudo prévio, uma resolução clínica efetiva ao paciente. Palavras-chave: Reabilitação Bucal. Restauração Dentária Temporária. Prótese Dentária Temporária.

An Android-Enabled PHR-based System for the Provision of Homecare Services

2013 ◽  
Vol 3 (2) ◽  
pp. 1-18 ◽  
Author(s):  
Vassiliki Koufi ◽  
Flora Malamateniou ◽  
George Vassilacopoulos
Keyword(s):  
Healthcare Professionals ◽  
Point Of Care ◽  
Treatment Plan ◽  
Personal Health Record ◽  
Healthcare Delivery ◽  
Quality Of Healthcare ◽  
Appropriate Treatment ◽  
Treatment Plans ◽  
The Continuum

Homecare is an important component of the continuum of care as it provides the potential to improve quality of life and quality of healthcare delivery while containing costs. Personal Health Record (PHR) systems are intended to reach patients outside of care settings and influence their behaviors thus allowing for more effective homecare services. To this end, these systems need to evolve well beyond providing a consolidated patient record, in ways that make it more widely applicable and valuable to health systems. The development of applications on top of PHR systems can allow them to function as a platform for both patients and healthcare professionals to exchange information and interact with the health system. This paper presents a prototype PHR-based system that aims at supporting chronic disease management at any point of care or decision making through familiar environments such as Google’s Android. In particular, it assists healthcare professionals in assessing an individual’s condition and in forming the appropriate treatment plan for him/her while it provides individuals with step-to-step guidance to their treatment plans.

scholarly journals Near-simultaneous bilateral reverse total shoulder arthroplasty for the treatment of bilateral fracture dislocations of the shoulder

2019 ◽  
Vol 12 (10) ◽  
pp. e230212 ◽  
Author(s):  
Alexander Wendling ◽  
Matthew L Vopat ◽  
Shang-You Yang ◽  
Bradley Saunders
Keyword(s):  
Shoulder Arthroplasty ◽  
Treatment Plan ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Left Shoulder ◽  
Fracture Dislocations ◽  
Bilateral Fracture ◽  
Reverse Total Shoulder

A man in his mid-80s presented with bilateral posterior fracture dislocations of the humerus after suffering a seizure. He had Parskinson’s disease and lived with his wife at home. His left shoulder was not felt to be reconstructable. The initial treatment plan was to perform reverse total shoulder arthroplasty (rTSA) on the left and non-operatively reduce his right shoulder. A left rTSA was performed, but his right shoulder was unstable due to a glenoid fracture and soft tissue instability. In order to preserve the patient’s quality of life, a right rTSA was performed 4 days later. In the follow-up period, the patient was able to regain enough pain-free range of motion on activities of daily living. The patient died from complications of Parkinson’s disease 10 months postoperatively.

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