Hidradenitis Suppurativa: A Novel Model of Care and an Integrative Strategy to Adopt an Orphan Disease

2017 ◽  
Vol 22 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Wayne Gulliver ◽  
Ian D. R. Landells ◽  
David Morgan ◽  
Syed Pirzada
Keyword(s):  
Health Care Professionals ◽  
Hidradenitis Suppurativa ◽  
Management Strategies ◽  
Treatment Algorithm ◽  
Orphan Disease ◽  
Model Of Care ◽  
Integrative System ◽  
Inappropriate Treatment ◽  
The Status ◽  
New Treatment

Unnecessary investigations, inappropriate treatment, worsening disease, and frustration for both patients and health care professionals are the hallmarks of hidradenitis suppurativa (HS) management. In light of a new treatment algorithm and biologic therapies made available to patients, an HS model of care is outlined in this article. The recommendations and management strategy presented here have been developed to help address the currently unmet needs of this patient population. The patient-centred model of care and disease management strategies were developed through the guidance and recommendations of HS medical experts in Newfoundland and Labrador. This article lays the foundation for the resources and steps required to change the status of this orphan disease and firmly embed patients with HS within a coordinated and integrative system of care.

scholarly journals Emergency management of the paediatric patient with convulsive status epilepticus

2021 ◽  
Vol 26 (1) ◽  
pp. 50-57
Author(s):  
Kyle C McKenzie ◽  
Cecil D Hahn ◽  
Jeremy N Friedman
Keyword(s):  
Clinical Practice ◽  
Status Epilepticus ◽  
Emergency Management ◽  
Treatment Algorithm ◽  
Position Statement ◽  
Convulsive Status Epilepticus ◽  
Pharmacological Management ◽  
The Past ◽  
New Treatment ◽  
New Evidence

Abstract This guideline addresses the emergency management of convulsive status epilepticus (CSE) in children and infants older than 1 month of age. It replaces a previous position statement from 2011, and includes a new treatment algorithm and table of recommended medications based on new evidence and reflecting the evolution of clinical practice over the past several years. This statement emphasizes the importance of timely pharmacological management of CSE, and includes some guidance for diagnostic approach and supportive care.

Principles of a new treatment algorithm in multiple sclerosis

2011 ◽  
Vol 11 (3) ◽  
pp. 351-362 ◽  
Author(s):  
Hans-Peter Hartung ◽  
Xavier Montalban ◽  
Per Soelberg Sorensen ◽  
Patrick Vermersch ◽  
Tomas Olsson
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Algorithm ◽  
New Treatment

Hidradenitis Suppurativa in 64 Female Patients: Retrospective Study Comparing Oral Antibiotics and Antiandrogen Therapy

2007 ◽  
Vol 11 (4) ◽  
pp. 125-131 ◽  
Author(s):  
John N. Kraft ◽  
Gordon E. Searles
Keyword(s):  
Hidradenitis Suppurativa ◽  
Chart Review ◽  
Polycystic Ovary ◽  
Management Strategies ◽  
Retrospective Chart Review ◽  
Oral Antibiotic ◽  
Test Statistic ◽  
Female Patients ◽  
Hormonal Manipulation ◽  
Antiandrogen Therapy

Background: Hidradenitis suppurativa (HS) is a recurrent disease confined to apocrine gland-bearing areas causing painful, deep-seated lesions and draining sinus tracts. Uniformly effective therapy is lacking. Improvements in current medical management strategies are needed. Objective: We sought to determine the success rate for a variety of treatments in our female HS patients and whether androgen-related tests can predict a response to antiandrogen therapy. As HS has been linked to a hyperandrogen state, we sought to determine if it is also associated with polycystic ovary syndrome (PCOS). Methods: A retrospective chart review was performed examining hormonal profiles and the response to a variety of treatments in female patients with HS. Results: Sixty-four female HS patients were identified (mean age 33 years). Antiandrogen therapy was superior to oral antibiotic therapy (55% vs 26%) based on a two-sample, two-sided, t-test statistic (p < .04). The prevalence of PCOS among our study patients in whom androgen markers were available was 8 of 21 (38.1%), and even if taken over all study patients, not necessarily investigated for PCOS, the prevalence was 8 of 64 (12.5%). This reflects a greater than expected prevalence among all women (10%). Conclusion: As a proof-of-concept study, despite limitations inherent in a retrospective chart review, there is sufficient signal to suggest that a hormonal manipulation approach to therapy should be considered in all women presenting with HS. Female patients presenting with HS should prompt investigations for underlying PCOS and insulin resistance.

scholarly journals Occurrence and molecular characterization of cyst nematode species (Globodera spp.) associated with potato crops in Colombia

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0241256
Author(s):  
Daniela Vallejo ◽  
Diego A. Rojas ◽  
John A. Martinez ◽  
Sergio Marchant ◽  
Claudia M. Holguin ◽  
...  
Keyword(s):  
Management Strategies ◽  
Nematode Species ◽  
Globodera Pallida ◽  
Rrna Gene ◽  
Potato Cyst Nematodes ◽  
28S Rrna ◽  
Cyst Nematodes ◽  
Nucleotide Substitutions ◽  
Internal Transcribed Spacer Region ◽  
The Status

Potato cyst nematodes (PCN) from the genus Globodera spp. cause major losses in the potato (Solanum tuberosum) industry worldwide. Despite their importance, at present little is known about the status of this plant pathogen in cultivated potatoes in Colombia. In this study, a total of 589 samples collected from 75 geographic localities in nine potato producing regions of Colombia (Cundinamarca, Boyacá, Antioquia, Nariño, Santander, Norte de Santander, Tolima, Caldas and Cauca) were assayed for the presence of potato cyst nematodes. Fifty-seven percent of samples tested positive for PCN. Based on phylogenetic analysis of the internal transcribed spacer region (ITS1-5.8S-ITS2) of the rRNA gene and D2-D3 expansion segments of the 28S rRNA gene, all populations but one were identified as Globodera pallida. Sequences of G. pallida from Colombia formed a monophyletic group closely related to Peruvian populations, with the lowest average number of nucleotide substitutions per site (Dxy = 0.002) and net nucleotide substitutions per site (Da = 0.001), when compared to G. pallida populations from Europe, South and North America. A single sample formed a well-supported subclade along with G. rostochiensis and G. tabacum from Japan, USA and Argentina. To our knowledge this is the first comprehensive survey of Globodera populations from Colombia that includes genetic data. Our findings on species diversity and phylogenetic relationships of Globodera populations from Colombia may help elucidate the status and distribution of Globodera species, and lead to the development of accurate management strategies for the potato cyst nematodes.

scholarly journals A New Classification for Hemorrhoidal Disease: The Creation of the “BPRST” Staging and Its Application in Clinical Practice

2020 ◽  
Vol 36 (4) ◽  
pp. 249-255 ◽  
Author(s):  
Carlos Walter Sobrado Júnior ◽  
Carlos de Almeida Obregon ◽  
Afonso Henrique da Silva e Sousa Júnior ◽  
Lucas Faraco Sobrado ◽  
Sérgio Carlos Nahas ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Strong Association ◽  
Management Strategies ◽  
Hemorrhoidal Disease ◽  
New Classification ◽  
The Past ◽  
Internal Hemorrhoids ◽  
New Treatment ◽  
Treatment Alternatives

Purpose: Present an updated classification for symptomatic hemorrhoids, which not only guides the treatment of internal hemorrhoids but also the treatment of external components. In addition, this new classification includes new treatment alternatives created over the last few years.Methods: Throughout the past 7 years, the authors developed a method to classify patients with symptomatic hemorrhoids. This study, besides presenting this classification proposal, also retrospectively analyzed 149 consecutive patients treated between March 2011 and November 2013 and aimed to evaluate the association between the management adopted with Goligher classification and our proposed BPRST classification.Results: Both classifications had a statistically significant association with the adopted management strategies. However, the BPRST classification tended to have fewer management discrepancies when each stage of disease was individually analyzed.Conclusion: Although there is much disagreement about how the classification of hemorrhoidal disease should be updated, it is accepted that some kind of revision is needed. The BPRST method showed a strong association with the management that should be adopted for each stage of the disease. Further studies are needed for its validation, but the current results are encouraging.

Analysis of unilateral complex orbital fractures with a new treatment algorithm

2014 ◽  
Vol 49 (2) ◽  
pp. 121-126 ◽  
Author(s):  
Mehtap Karamese ◽  
Osman Akdağ ◽  
Muhammed Nebil Selimoğlu ◽  
Tugba Gun Koplay ◽  
Berker Bakbak ◽  
...  
Keyword(s):  
Treatment Algorithm ◽  
Orbital Fractures ◽  
New Treatment

“I’m Just Forgetting and I Don’t Know Why”: Exploring How People Living With HIV-Associated Neurocognitive Disorder View, Manage, and Obtain Support for Their Cognitive Difficulties

2018 ◽  
Vol 28 (6) ◽  
pp. 859-872 ◽  
Author(s):  
Alexander R. Terpstra ◽  
Catherine Worthington ◽  
Francisco Ibáñez-Carrasco ◽  
Kelly K. O’Brien ◽  
Aiko Yamamoto ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Professionals ◽  
Management Strategies ◽  
Well Being ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cognitive Difficulties ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

HIV-associated neurocognitive disorder (HAND) is common, but the lived experience of HAND is not well-understood. In this descriptive qualitative study, we explored how adults with HAND view, manage, and obtain support for cognitive difficulties. We interviewed 25 participants (20% female; median age = 51 years) who were diagnosed with HAND using neuropsychological assessment and a clinical interview. Semistructured interviews, co-developed with community members living with HIV, focused on how cognitive difficulties manifested and progressed, impacted well-being, and were discussed with others. We analyzed interview transcripts using a team-based, thematic approach. Participants described concentration, memory, and multitasking difficulties that fluctuated over time, as well as potential risk factors, management strategies, and psychosocial consequences. They reported they seldom discussed cognitive impairment with health care professionals, and that receiving a HAND diagnosis was validating, informative, yet somewhat disconcerting. Conversations between health care professionals and people living with HIV about HAND may provide opportunities for education, assessment, and support.

Management of Child and Adolescent Obesity: Attitudes, Barriers, Skills, and Training Needs Among Health Care Professionals

PEDIATRICS ◽  
2002 ◽  
Vol 110 (Supplement_1) ◽  
pp. 210-214 ◽  
Author(s):  
Mary T. Story ◽  
Dianne R. Neumark-Stzainer ◽  
Nancy E. Sherwood ◽  
Katrina Holt ◽  
Denise Sofka ◽  
...  
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Management Strategies ◽  
Child And Adolescent ◽  
Adolescent Obesity ◽  
Behavioral Management ◽  
Registered Dietitians ◽  
Pediatric Nurse Practitioners ◽  
And Training

Objective. The primary aim of this study was to evaluate among health care professionals their attitudes, perceived barriers, perceived skill level, and training needs in the management of child and adolescent obesity. Methods. A national needs assessment consisting of a mailed questionnaire was conducted among a random sample of health care professionals. The survey was completed by 202 pediatricians, 293 pediatric nurse practitioners, and 444 registered dietitians. Results. The majority of all respondents felt that childhood obesity was a condition that needs treatment (75%–93%), and affects chronic disease risk (76%–89%) and future quality of life (83%–93%). The most frequent barriers were lack of parent involvement, lack of patient motivation, and lack of support services. Registered dietitians were less likely to identify barriers to treatment compared with pediatricians or pediatric nurse practitioners. The most common areas of self-perceived low proficiency were in the use of behavioral management strategies, guidance in parenting techniques, and addressing family conflicts. All 3 groups expressed high interest in additional training on obesity management of children and adolescents, especially in the area of behavioral management strategies and parenting techniques. Those practitioners with &gt;10 years of practice reported the greatest interest in training. Conclusions. Pediatric practitioners view child and adolescent obesity with concern and feel that intervention is important. However, several important barriers interfere with treatment efforts and will need to be addressed. There is also a need for increased training opportunities related to obesity prevention and treatment. The results of this study provide directions and priorities for training, education, and advocacy efforts.

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