scholarly journals Clinician-Patient Dialogue About Preventive Chronic Migraine Treatment

2020 ◽  
Vol 11 ◽  
pp. 215013272095993
Author(s):  
Andrew M. Blumenfeld
Keyword(s):  
Chronic Migraine ◽  
Treatment Approach ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Severe Form ◽  
Migraine Treatment ◽  
Appropriate Treatment ◽  
The Individual ◽  
Practical Recommendations

Many new medications for the treatment of migraine are now available on the market. In the current evolving migraine treatment landscape, an individualized treatment approach is needed. This review provides practical recommendations on how to obtain a correct diagnosis and then engage in a long-term partnership with patients with the most severe form of migraine: chronic migraine (CM). Given the need to effectively treat this complex neurological disease, clinicians in primary care, general neurologists, and headache specialists are at the forefront to ease the burden of this disease for their patients. This manuscript will review how to discuss the currently available treatment options to help control migraine attacks, manage expectations, and, together with the patient, determine the most effective and appropriate treatment. The goal is to create an environment where the clinician partners with the patient in shared decision-making to choose the most effective appropriate treatment for the individual patient.

Approach to Radiculopathy

2021 ◽  
Vol 41 (06) ◽  
pp. 760-770
Author(s):  
Rafid Mustafa ◽  
Narayan R. Kissoon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Treatment Approach ◽  
Treatment Plan ◽  
Treatment Options ◽  
Accurate Diagnosis ◽  
Clinical Approach ◽  
Low Back ◽  
Appropriate Treatment ◽  
Neurology Clinic

AbstractLow back pain and neck pain, often with associated radiculopathy, are two of the most common reasons for referral to the outpatient neurology clinic. A thorough clinical evaluation remains paramount in establishing an accurate diagnosis and subsequently an appropriate treatment plan. In this article, we review anatomic considerations for spondylotic radiculopathy; outline the clinical approach for the evaluation of these patients, including discussion of electrodiagnostic and imaging modalities; and address treatment options based on a stratified treatment approach.

Cognitive behavioral therapy for chronic migraine

2017 ◽  
Vol 41 (S1) ◽  
pp. s500-s500 ◽  
Author(s):  
O. Onur ◽  
D.H. Ertem ◽  
D. Uludüz ◽  
Ç. Karşıdağ
Keyword(s):  
Chronic Migraine ◽  
Psychological Treatment ◽  
Treatment Options ◽  
Depression Scale ◽  
Migraine Treatment ◽  
Hamilton Depression Scale ◽  
Post Traumatic Stress ◽  
Current Standard ◽  
Significant Difference ◽  
Hamilton Anxiety

AimAlthough current standard treatment for migraine headache is medication, high levels of psychological comorbidity has led to migraine influencing by cognitive, emotional and environmental factors, as well as biological. Viewing migraine in a biopsychosocial framework introduces the possible utilisation of psychological treatment options, such as cognitive behavioural therapy (CBT). The aim of this study was to evaluate the efficacy of CBT for chronic migraine.MethodologyThirty-five participants diagnosed as chronic migraine were recruited from Headache Clinic. According to inclusion criteria 14 participants, underwent bi-weekly lasting 30 minutes CBT sessions for 6 months, were administered Hamilton Anxiety Scale, Hamilton Depression Scale, Visual Analog Scale (VAS) and the Migraine Disability Assessment Scale (MİDAS) before and after CBT.FindingsNine of the participants were female and 5 male. Mean age of group was 34.35 ± 8.17. Duration of illness was 13.07 ± 7.18 and 12 of participants had the history of a psychiatry illness whose diagnoses were depression (7), anxiety disorder (4) and post-traumatic stress disorder (1). Nine of the patients had prophylactic migraine treatment. There were statistically significant difference in Hamilton Depression scores between before CBT (29.07 ± 7.74) and after CBT (14.21 ± 7.7); in Hamilton Anxiety scores before CBT (26.8 ± 11.7) and after CBT (11.7 ± 2.6); in VAS scores before CBT (8.07± 0.91) and after CBT (3.71 ± 1.32); in frequency of migraine attacks between before CBT (10.85 ± 3.50 day) and after CBT (4.92 ± 2.70 day) and in MİDAS before CBT (55.5 ± 20.4) and after CBT (20.12 ± 16.6) (P < 0.05).ConclusionCBT might reduce the severity of symptoms in migraine patients especially with the comorbidity of psychiatric illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Pathological gambling: an overview of assessment and treatment

2005 ◽  
Vol 11 (6) ◽  
pp. 450-456 ◽  
Author(s):  
Sanju George ◽  
Vijaya Murali
Keyword(s):  
Pathological Gambling ◽  
Psychiatric Comorbidity ◽  
Treatment Strategies ◽  
Appropriate Treatment ◽  
Assessment And Treatment ◽  
Scant Attention ◽  
Assessment Techniques ◽  
The Individual ◽  
The Uk

Pathological gambling has so far received scant attention in the psychiatric literature. It has a prevalence rate of about 1% in most countries, and with the deregulation of gambling in the UK the prevalence is set to rise here. Pathological gambling can adversely affect the individual, family and society, and also carries high rates of psychiatric comorbidity. Early identification and appropriate treatment can limit the long-term adverse consequences and improve outcome. This article reviews assessment techniques and tools, and treatment strategies for pathological gambling.

scholarly journals Chronic Migraine

Migraine ◽  
2020 ◽  
Author(s):  
Diana Obelieniene ◽  
Ruta Pestininkaite ◽  
Daiva Rastenyte
Keyword(s):  
Valproic Acid ◽  
Chronic Migraine ◽  
Migraine Headache ◽  
Treatment Options ◽  
Migraine Treatment ◽  
Evidence Based ◽  
New Developments ◽  
Onabotulinumtoxin A ◽  
History Of ◽  
Over Time

Chronic migraine as a disease was initially recognized in patients with a large burden of disability from frequent headaches and a history of prior migraines. Over time, this observation was operationalized into multiple diagnostic criteria with requirements for frequent headache days, typically 15 or more, which, on at least 8 days in a month, have the features of migraine headache. Chronic migraine affects 1–2% of the general population, and about 8% of patients with migraine. Understanding disease mechanisms still remains a challenge. Inflammation and central sensitization play significant role in the evolutive mechanisms of chronic migraine. Treatment of this condition should primarily focus on the prevention. The currently available evidence-based prophylactic treatment options are topiramate, valproic acid, onabotulinumtoxin A and recently developed promising anti-CGRP monoclonal antibodies. Chronic migraine research is a dynamic and rapidly advancing area. New developments in this field have the potential to improve the diagnosis, to provide more personalized treatments and to reduce burden of disability.

scholarly journals The multidisciplinary approach of a patient with Sjögrenś Syndrome in the dental office - case report

2019 ◽  
Vol 2 (2) ◽  
pp. 235-240
Author(s):  
Tatiana-Maria Coman ◽  
Anca-Diana Mănărăzan ◽  
Adelin-Sebastian Cîrstea ◽  
Dorin-Ioan Cocoș
Keyword(s):  
Case Report ◽  
Negative Impact ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Well Being ◽  
Gingival Hyperplasia ◽  
Oral Rehabilitation ◽  
Advantages And Disadvantages ◽  
Lichenoid Reactions ◽  
The Individual

AbstractIntroduction: Oral rehabilitation is based on establishing a correct diagnosis and designing a plan to give appropriate treatment to each clinical case. Patients’ aesthetic requirements show an increasing trend in current practice. Sjögren’s syndrome and obesity can have a negative impact on a person’s quality of life, and it is therefore imperative to identify and reduce these significant barriers to paving the way for better oral health and the overall well-being of the individual. Hypertension NYHA II type patients may present oral manifestations like ageusia, burning sensation, xerostomia, lichenoid reactions or gingival hyperplasia. Case presentation: This time, at our clinic, a 71-year-old man requested a complex oral rehabilitation. He presented partial edentulism at both arches. We are talking about a non-smoking patient, with chronical medication treatment for the mentioned pathology. Conclusions: A well-controlled hypertensive patient is not a risk in clinical practice. When choosing an implant based therapy, the old age of the patient can be considered a negative factor for successful results, but it is not a strict contraindication. This case report shows the most suitable treatment solution, regarding all the advantages and disadvantages of other treatment options, represented by implant supported fixed prosthetic restaurations.

scholarly journals Practical Recommendations for the Management of Benign Adnexal Masses

2020 ◽  
Vol 42 (09) ◽  
pp. 569-576
Author(s):  
Rodrigo Manieri Rocha ◽  
Ionara Diniz Evangelista Santos Barcelos
Keyword(s):  
Ovarian Reserve ◽  
Treatment Options ◽  
Diagnosis And Treatment ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Adnexal Masses ◽  
Future Fertility ◽  
Long Term Impact ◽  
Practical Recommendations

Abstract Objective To perform a comprehensive review to provide practical recommendations regarding the diagnosis and treatment of benign adnexal masses, as well as information for appropriate consent, regarding possible loss of the ovarian reserve. Methods A comprehensive review of the literature was performed to identify the most relevant data about this subject. Results In total, 48 studies addressed the necessary aspects of the review, and we described their epidemiology, diagnoses, treatment options with detailed techniques, and perspectives regarding future fertility. Conclusions Adnexal masses are extremely common. The application of diagnosis algorithms is mandatory to exclude malignancy. A great number of cases can be managed with surveillance. Surgery, when necessary, should be performed with adequate techniques. However, even in the hands of experienced surgeons, there is a significant decrease in ovarian reserves, especially in cases of endometriomas. There is an evident necessity of studies that focus on the long-term impact on fertility.

scholarly journals Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management

Medicina ◽  
2010 ◽  
Vol 46 (11) ◽  
pp. 790 ◽  
Author(s):  
Giedrė Sakalauskienė ◽  
Dovilė Jauniškienė
Keyword(s):  
Treatment Modalities ◽  
Treatment Programs ◽  
Health Providers ◽  
Effective Interventions ◽  
Lack Of Information ◽  
Appropriate Treatment ◽  
Short And Long Term ◽  
The Individual

Etiology, epidemiology, and impact of osteoarthritis on an individual, society, and nation and the main principles of management of this disease are reviewed in the article. Treatment should be tailored to the needs of an individual patient. Physicians should be familiar with pharmacologic and nonpharmacologic treatment modalities to maximize effective utilization and a thorough understanding of short- and long-term complications and costs. Severity of osteoarthritis should be taken into physician’s and patient’s consideration while applying an appropriate treatment. A stepwise management of osteoarthritis has to be taken into account. As effective interventions remain underused, state arthritis programs, including osteoarthritis programs, have to be developed to build an appropriate scientific base in public health, observe burden and impact, assess and disseminate evidence-based interventions, and work to reduce and delay disability, and improve quality of life among people with arthritis. Adequate studies on the costs of osteoarthritis are urgently required so that cogent arguments can be made to governments to appropriately fund prevention and treatment programs for this condition. Its recognition as a major cause of disability, particularly in the aging population, should increase community focus on this important condition. Osteoarthritis as a pathogenic process and its impact on an individual and society should be taken into special consideration by health providers and officers developing the national health policy in Lithuania, because there is a lack of information related to the prevalence of osteoarthritis, risk factors, also osteoarthritisassociated disability, and costs of the management of this disease among Lithuanian inhabitants.

Contextual Thematic Group Treatment for Individuals With Dementia

2009 ◽  
Vol 19 (4) ◽  
pp. 135-141
Author(s):  
Jane Pimentel
Keyword(s):  
Group Treatment ◽  
Treatment Approach ◽  
Lesson Plan ◽  
Term Care ◽  
Group Interactions ◽  
Reminiscence Therapy ◽  
Successful Group ◽  
The Individual

Abstract Purpose: Group treatment for individuals with dementia is an option to target activity and participation for residents in long-term care facilities to engage them in meaningful conversation and potentially improve their quality of life. The purpose of this article is to describe a theme-based group treatment approach that capitalizes on the use of the environment through context. Method: Rationale for this group treatment approach is presented, including a brief description and evidence supporting clinical techniques utilized. These include reminiscence therapy, multisensory stimulation, and use of environmental aids. In addition, background is provided regarding capitalizing on memory and linguistic strengths and compensating for weaknesses. Modifications of clinician behaviors are presented to best facilitate successful group interactions. Results and Conclusions: The article culminates in a detailed description of contextual thematic group treatment. This description includes an example lesson plan with corresponding rationale for activities. Data supporting the individual clinical techniques utilized in this group treatment approach are adequate; however, the evidence supporting the combination of these techniques in this format is meager and requires further investigation.

scholarly journals Long-term drug treatment of a giant liver hydatid cyst in a child

2020 ◽  
Author(s):  
Valeri Velev ◽  
George Donkov ◽  
Yordanka Mitova-Mineva
Keyword(s):  
Conservative Treatment ◽  
Diagnostic Imaging ◽  
Treatment Options ◽  
Cost Effective ◽  
Intermediate Hosts ◽  
Appropriate Treatment ◽  
Effective Manner ◽  
Ionizing Radiations

Abstract BackgroundCystic еchinococcosis is a chronic parasitosis caused by the larvae of the tapeworm Echinococcus granulosus. Humans act as intermediate hosts and the larvae can affect any organ in the form of cysts. They are most often found incidentally by diagnostic imaging, where they have become large in size, with treatment being primarily invasive. Conservative treatment with albendazole is one of the appropriate treatment options, but it features a low success rate in cysts over 5 cm.Case presentationWe describe a case of an 14-year-old girl with an active 12 cm cyst in the liver. Two consecutive courses with albendazole, with duration 3 months each, were conducted. The cyst reached a safe inactive stage and no relapses have been observed for 1 year since the last administration of the medication.ConclusionsOur experience shows that with large cysts albendazole courses may be extended including in childhood. Ultrasonography has clearly demonstrated its ability to follow-up patient in a cost effective manner and avoiding ionizing radiations.

scholarly journals Endo-perio lesions: diagnosis and interdisciplinary treatment options

2020 ◽  
Vol 3 (1) ◽  
pp. 257-261
Author(s):  
Timea Dakó ◽  
Ana Petra Lazăr ◽  
Cristina Ioana Bică ◽  
Luminița Lazăr
Keyword(s):  
Tooth Loss ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Functional Relation ◽  
Interdisciplinary Approach ◽  
Treatment Method ◽  
Interdisciplinary Treatment ◽  
Periodontal Tissues ◽  
Endodontic Infection ◽  
Appropriate Treatment

AbstractAbout 50% of tooth loss is caused by either endodontic infection, periodontal disease or the combination of the two in the form on endo-perio lesions (EPL). Combined EPL develop due to the intimate anatomic and functional relation between endodontic and periodontal tissues. Both the pulp and periodontium share the same embryologic and anatomic origin. The various pathways connecting the two, added up to the extremely alike microorganisms in both illnesses’ etiology, create a complex condition in which interdisciplinary approach is required. Despite numerous decades of literature describing these lesions, they remain a continuous challenge for practitioners in both diagnosing and managing. The purpose of this article is to present a comprehensive review of various aspects of the combined EPL and to emphasize the importance of making a correct diagnosis and adopting the appropriate treatment method in the management of these challenging situations.

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