Epilepsy: Workup and Management in Adults

2020 ◽  
Vol 40 (06) ◽  
pp. 624-637
Author(s):  
Rebecca O'Dwyer
Keyword(s):  
Quality Of Life ◽  
Chronic Condition ◽  
Chronically Ill ◽  
Psychological Effects ◽  
Family Function ◽  
Chronic Epilepsy ◽  
Patients With Epilepsy ◽  
Term Management

AbstractWhen managing epilepsy, there is a temptation to focus care with respect to the last and the next seizure. However, epilepsy is a multifaceted chronic condition and should be treated as such. Epilepsy comes with many physical risks, psychological effects, and socioeconomic ramifications, demanding a long-term commitment from the treating physician. Patients with epilepsy, compared to other chronically ill patient populations, have a worse quality of life, family function, and less social support. The majority of patients are well controlled on antiseizure drugs. However, approximately one-third will continue to have seizures despite optimized medical management. The primary aim of this article is to explore the long-term management of chronic epilepsy, and to address some of the particular needs of patients with chronic epilepsy.

scholarly journals Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

2015 ◽  
Vol 3 (1) ◽  
pp. 36-47
Author(s):  
Nazma Akter ◽  
Nazmul Kabir Qureshi
Keyword(s):  
Quality Of Life ◽  
Adrenal Insufficiency ◽  
Presenting Symptoms ◽  
Life Saving ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Term Management

Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 ?g ACTH (adrenocorticotropic hormone) stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22238 Delta Med Col J. Jan 2015; 3(1): 36-47

Levocetirizine improves quality of life and reduces costs in long-term management of persistent allergic rhinitis

2004 ◽  
Vol 114 (4) ◽  
pp. 838-844 ◽  
Author(s):  
Claus Bachert ◽  
Jean Bousquet ◽  
G. Walter Canonica ◽  
Stephen R. Durham ◽  
Ludger Klimek ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Persistent Allergic Rhinitis ◽  
Term Management

scholarly journals Effectiveness of Family Function in Quality of Life in Elderly Patients: An Evidence Based Case Report

2021 ◽  
Vol 1 (2) ◽  
pp. 52
Author(s):  
Muhammad Sobri Maulana
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Chronically Ill ◽  
The Elderly ◽  
Evidence Based ◽  
Literature Searching ◽  
Family Function ◽  
Based Medicine

Background: Geriatric care is an important part in healthcare and are sometimes neglected.  Family caregivers figures assume a key role in postponing and potentially forestalling standardization of chronically ill elderly patients. The role of family function in depression has been demonstrated from earlier studies, however, the part of family function in quality of life the elderly has not concentrated widely. Objective: To evaluate the connection between family function and quality of life. Methods: Literature searching was conducted through PubMed, Science Direct and Embase. Critical appraisal using appraisal sheet for prognosis from Oxford Center for Evidence Based Medicine in 2011. Results: One article was found with good validity showed that direct relationship between family function and quality of life is not associated. However, if depression is present it plays as a strong mediator between family function and quality of life. Conclusion: Family function mediated with depression plays an important role in quality of life in elderly patients.

scholarly journals Long term management of obstructive sleep apnea and its comorbidities

2019 ◽  
Vol 14 ◽  
Author(s):  
Marta Marin-Oto ◽  
Eugenio E. Vicente ◽  
Jose M. Marin
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Premature Death ◽  
Driving Ability ◽  
Obstructive Sleep ◽  
Long Term Treatment ◽  
Term Management

Obstructive sleep apnea (OSA) is a worldwide highly prevalent disease associated with systemic consequences, including excessive sleepiness, impairment of neurocognitive function and daytime performance, including driving ability. The long-term sequelae of OSA include and increase risk for cardiovascular, cerebrovascular and metabolic syndrome disorders that ultimately lead to premature death if untreated. To ensure optimal long-term outcomes, the assessment and management of OSA should be personalized with the involvement of the appropriate specialist. Most studies have demonstrated inmediate improvement in daytime somnolence and quality of life with CPAP and other therapies, but the effect of long-term treatment on mortality is still under debate. Currently, the long-term management of OSA should be based on a) identifying physiological or structural abnormalities that are treatable at the time of patient evaluation and b) comprehensive lifestyle interventions, especially weight-loss interventions, which are associated with improvements in OSA severity, cardiometabolic comorbidities, and quality of life. In long-term management, attention should be paid to the clinical changes related to a potential reoccurrence of OSA symptoms and it is also necessary to monitor throughout the follow up how the main associated comorbidities evolve.

scholarly journals Prader-Willi Syndrome: Clinical Aspects

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Grechi Elena ◽  
Cammarata Bruna ◽  
Mariani Benedetta ◽  
Di Candia Stefania ◽  
Chiumello Giuseppe
Keyword(s):  
Quality Of Life ◽  
Genetic Disorder ◽  
Clinical Aspects ◽  
Chromosome 15 ◽  
Prader Willi Syndrome ◽  
Initial Stage ◽  
Prolong Life Expectancy ◽  
Term Management

Prader-Willi Syndrome (PWS) is a complex multisystem genetic disorder that shows great variability, with changing clinical features during a patient’s life. The syndrome is due to the loss of expression of several genes encoded on the proximal long arm of chromosome 15 (15q11.2–q13). The complex phenotype is most probably caused by a hypothalamic dysfunction that is responsible for hormonal dysfunctions and for absence of the sense of satiety. For this reason a Prader-Willi (PW) child develops hyperphagia during the initial stage of infancy that can lead to obesity and its complications. During infancy many PW child display a range of behavioural problems that become more noticeable in adolescence and adulthood and interfere mostly with quality of life. Early diagnosis of PWS is important for effective long-term management, and a precocious multidisciplinary approach is fundamental to improve quality of life, prevent complications, and prolong life expectancy.

Dry mouth

Dental Update ◽  
2021 ◽  
Vol 48 (9) ◽  
pp. 761-768
Author(s):  
Shalini Nayee ◽  
Cameron Herbert ◽  
Pepe Shirlaw ◽  
Richard Cook
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Dental Health ◽  
Dry Mouth ◽  
Common Causes ◽  
The Common ◽  
Term Management ◽  
Dental Professionals

Dry mouth has numerous causes, including medications, radiotherapy and rheumatological conditions, such as Sjögren's syndrome. This article presents the common causes of dry mouth, and details the assessment, investigations and management required for patients with dry mouth within primary dental care, in addition to outlining secondary care investigations and management. CPD/Clinical Relevance: Dry mouth is common in the general population, with widespread implications for dental health and patients' quality of life. Dental professionals have a key role in both its identification and long-term management.

Rethinking decongestive lymphoedema treatment during the pandemic

2021 ◽  
Vol 26 (Sup4) ◽  
pp. S16-S22
Author(s):  
Jeanne Everett ◽  
Sue Lawrance ◽  
Natalie Phillips
Keyword(s):  
Quality Of Life ◽  
Resource Use ◽  
Chronic Condition ◽  
Self Management ◽  
Management Regimes ◽  
Novel Approaches

During the course of the COVID-19 pandemic, lymphoedema and community clinicians have had to modify how they implement intensive treatments for patients with lymphoedema and chronic oedema. Using novel approaches to treat and move patients towards self-management regimes has enabled patients to be in control of their condition, particularly if they are unable to attend normal clinic appointments. This article explores how using Haddenham easywrap instead of time- and resource-intensive bandaging regimes, alongside the Haddenham LymphFlow Advance, as part of self-management programmes, can benefit patients' quality of life, reduce costs and resource use and enable patients to self-manage this long-term chronic condition more effectively.

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