Cysteamine as a topical management option for melasma

Misophonia: An Evidence-Based Case Report

American Journal of Audiology ◽

10.1044/2020_aja-19-00111 ◽

2020 ◽

Vol 29 (4) ◽

pp. 685-690

Author(s):

C. S. Vanaja ◽

Miriam Soni Abigail

Keyword(s):

Quality Of Life ◽

Case Report ◽

Case History ◽

Pure Tone ◽

Physiological Responses ◽

Evidence Based ◽

Management Option ◽

Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

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Hydrogels: A Promising Vehicle for the Topical Management of Atopic Dermatitis

Advanced Therapeutics ◽

10.1002/adtp.202100028 ◽

2021 ◽

pp. 2100028

Author(s):

Ana Isabel Barbosa ◽

Tiago Torres ◽

Sofia A. Costa Lima ◽

Salette Reis

Keyword(s):

Atopic Dermatitis ◽

Topical Management

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Referral patterns for catheter-directed thrombolysis for iliofemoral deep venous thrombosis

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520977281 ◽

2021 ◽

pp. 026835552097728

Author(s):

Kirtan D Patel ◽

Alison YY Tang ◽

Ashik DJ Zala ◽

Rakesh Patel ◽

Kishan R Parmar ◽

...

Keyword(s):

Lower Limb ◽

Management Option ◽

Venous Anatomy ◽

Nice Guidelines ◽

Patient Demographics ◽

Radiology Reports ◽

Catheter Directed Thrombolysis ◽

Nice Guidance ◽

Icd 10 ◽

Venous Thromboses

Objectives Post thrombotic syndrome (PTS) is a serious complication of deep venous thromboses (DVTs). PTS occurs more frequently and severely following iliofemoral DVT compared to distal DVTs. Catheter directed thrombolysis (CDT) of iliofemoral DVTs may reduce PTS incidence and severity. We aimed to determine the rate of iliofemoral DVT within our institution, their subsequent management, and compliance with NICE guidelines. Methods Retrospective review of all DVTs diagnosed over a 3-year period was conducted. Cases of iliofemoral DVT were identified using ICD-10 codes from patient notes, and radiology reports of Duplex scans. Further details were retrieved, such as patient demographics and referrals to vascular services. NICE guidance was applied to determine if patients would have been suitable for CDT. A survey was sent to clinicians within medicine to identify awareness of CDT and local guidelines for iliofemoral DVT management. Results 225 patients with lower limb DVTs were identified. Of these, 96 were radiographically confirmed as iliofemoral DVTs. The median age was 77. 67.7% of iliofemoral DVTs affected the left leg. Right leg DVTs made up 30.2% and 2.1% were bilateral DVTs. Of the 96 iliofemoral DVTs, 21 were deemed eligible for CDT. Only 3 patients (14.3%) were referred to vascular services, and 3 received thrombolysis. From our survey, 95.5% of respondents suggested anticoagulation alone as management for iliofemoral DVT. Only one respondent recommended referral to vascular services. There was a knowledge deficiency regarding venous anatomy, including superficial versus deep veins. Conclusions CDT and other mechanochemical procedures have been shown to improve outcomes of patients post-iliofemoral DVT, however a lack of awareness regarding CDT as a management option results in under-referral to vascular services. We suggest closer relations between vascular services and their “tributary” DVT clinics, development of guidelines and robust care pathways in the management of iliofemoral DVT.

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6 Animal performance in grass monoculture or silvopasture systems using tree legumes

Journal of Animal Science ◽

10.1093/jas/skz397.041 ◽

2020 ◽

Vol 98 (Supplement_2) ◽

pp. 18-19

Author(s):

Izabela Aline Gomes da Silva ◽

Jose Carlos Batista Dubeux ◽

Alexandre C Leão de Mello ◽

Márcio Vieira da Cunha ◽

Mércia Ferreira dos Santos ◽

...

Keyword(s):

Ecosystem Services ◽

Experimental Design ◽

Accumulation Rate ◽

Average Daily Gain ◽

Gliricidia Sepium ◽

Tropical Region ◽

Stocking Rate ◽

Animal Performance ◽

Management Option ◽

Daily Gain

Abstract Silvopasture systems (SPS) area management option to enhance delivery of ecosystem services and diversification of income. This study evaluated productive responses of signalgrass (UrochloadecumbensStapf.) in monoculture or in SPS in the sub-humid tropical region of Brazil during six months of the rainy season. The experimental design was randomized complete block with three replications. Treatments were signalgrass + Mimosa caesalpiniifolia Benth. (SPS-Mimosa); signalgrass + Gliricidia sepium (Jacq.) (SPS-Gliricidia); and signalgrass monoculture. Cattle were managed under continuous stocking with variable stocking rate. Response variables included herbage mass (HM), herbage accumulation (HA), stocking rate (SR), average daily gain (ADG), and gain per area (GPA). Herbage mass (HM) was greater (P < 0.0001) on signal grass monoculture (2045 kg DM/ha) than in SPS (1370 kg DM/ha, average for both SPS). Herbage accumulation rate was similar for signalgrass in monoculture and SPS-Gliricidia (avg. 61 kg DM ha-1 d-1), and both were greater than SPS-Mimosa (37 kg DM ha-1 d-1). Average daily gain was greater(P < 0.0001) for SPS-Gliricidia (1.1 kg head-1 d-1), followed by signalgrass in monoculture (0.9 kg head-1 d-1), and SPS-Mimosa (0.3 kg head-1 d-1). Stocking rate ranged from 0.6 animal units (1AU = 450-kg animal) per ha in April to 2.2 AUha-1 in June. Stocking rate and animal performance per area were similar for signalgrass in monoculture and SPS-Gliricidia, and both greater than SPS-Mimosa. Gliricidia enhanced animal performance and provided ecosystem services. Mimosa, however, reduced animal performance likely due to the competition with signalgrass. Mimosa trees, however, are an important source of income (timber used for fence posts) and that might overcome the losses in animal performance.

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709 Covid-19 Pandemic: Audit on The Management of Acute Cholecystitis

British Journal of Surgery ◽

10.1093/bjs/znab134.077 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

M Asarbakhsh ◽

N Lazarus ◽

P Lykoudis

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Readmission Rate ◽

Adverse Outcomes ◽

Management Option ◽

Management Guidelines ◽

Theatre Staff ◽

The Impact ◽

Definitive Management ◽

Upper Gastrointestinal

Abstract Background The definitive management of acute cholecystitis is laparoscopic cholecystectomy on the same admission if the patient is fit. As the Covid-19 pandemic emerged, evidence suggested adverse outcomes for asymptomatic Covid positive patients undergoing surgery, including increased mortality risk. Risks to theatre staff were also highlighted. This prompted changes in acute cholecystitis management guidelines. Method The audit aim was to assess the impact of guideline change on clinical outcomes and readmission rate for acute cholecystitis. The revised Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) guidelines were the gold standard. All inpatient admissions for acute cholecystitis during the 4-week peak of the pandemic (17/04/2020 – 14/05/2020) were included. Result 24 patients were admitted with acute cholecystitis. 10 patients (41.7%) were managed with antibiotics alone, 4 patients (16.6%) underwent cholecystostomy. 12 patients (50%) were discharged within 3 days. Lack of clinical progress/ongoing symptoms was the indication for laparoscopic cholecystectomy in 5 cases (20.8%). 5 conservatively managed patients (20.8%) were readmitted with ongoing cholecystitis or pancreatitis. Conclusions 19 patients (80%) were managed non-surgically in accordance with AUGIS guidelines. However conservative management was not always appropriate. We recommend that laparoscopic cholecystectomy should remain a management option for acute cholecystitis during the ongoing Covid-19 pandemic.

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Agricultural Land Management Options Following Large-Scale Environmental Contamination: Evaluation for Fukushima Affected Agricultural Land

Volume 2: Facility Decontamination and Decommissioning; Environmental Remediation; Environmental Management/Public Involvement/Crosscutting Issues/Global Partnering ◽

10.1115/icem2013-96231 ◽

2013 ◽

Author(s):

Hildegarde Vandenhove

Keyword(s):

Land Use ◽

Land Management ◽

Nuclear Power ◽

Large Scale ◽

Agricultural Land ◽

Agricultural Practices ◽

Management Option ◽

Management Options ◽

Fukushima Daiichi ◽

Agricultural Land Management

The accident at the Fukushima Daiichi Nuclear Power Plant has raised questions about the accumulation of radionuclides in soils, the transfer in the foodchain and the possibility of continued restricted future land use. This paper summarizes what is generally understood about the application of agricultural countermeasures as a land management option to reduce the radionuclides transfer in the food chain and to facilitate the return of potentially affected soils to agricultural practices in areas impacted by a nuclear accident.

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