scholarly journals Diagnosis and Treatment of Keloids and Hypertrophic Scars—Japan Scar Workshop Consensus Document 2018

2019 ◽  
Vol 7 ◽  
Author(s):  
Rei Ogawa ◽  
Sadanori Akita ◽  
Satoshi Akaishi ◽  
Noriko Aramaki-Hattori ◽  
Teruyuki Dohi ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Treatment Guidelines ◽  
Malignant Tumors ◽  
Specific Treatment ◽  
Diagnostic Algorithm ◽  
The Body ◽  
Diagnosis And Treatment ◽  
Hypertrophic Scars ◽  
Treatment Protocols ◽  
Consensus Document

Abstract There has been a long-standing need for guidelines on the diagnosis and treatment of keloids and hypertrophic scars that are based on an understanding of the pathomechanisms that underlie these skin fibrotic diseases. This is particularly true for clinicians who deal with Asian and African patients because these ethnicities are highly prone to these diseases. By contrast, Caucasians are less likely to develop keloids and hypertrophic scars, and if they do, the scars tend not to be severe. This ethnic disparity also means that countries vary in terms of their differential diagnostic algorithms. The lack of clear treatment guidelines also means that primary care physicians are currently applying a hotchpotch of treatments, with uneven outcomes. To overcome these issues, the Japan Scar Workshop (JSW) has created a tool that allows clinicians to objectively diagnose and distinguish between keloids, hypertrophic scars, and mature scars. This tool is called the JSW Scar Scale (JSS) and it involves scoring the risk factors of the individual patients and the affected areas. The tool is simple and easy to use. As a result, even physicians who are not accustomed to keloids and hypertrophic scars can easily diagnose them and judge their severity. The JSW has also established a committee that, in cooperation with outside experts in various fields, has prepared a Consensus Document on keloid and hypertrophic scar treatment guidelines. These guidelines are simple and will allow even inexperienced clinicians to choose the most appropriate treatment strategy. The Consensus Document is provided in this article. It describes (1) the diagnostic algorithm for pathological scars and how to differentiate them from clinically similar benign and malignant tumors, (2) the general treatment algorithms for keloids and hypertrophic scars at different medical facilities, (3) the rationale behind each treatment for keloids and hypertrophic scars, and (4) the body site-specific treatment protocols for these scars. We believe that this Consensus Document will be helpful for physicians from all over the world who treat keloids and hypertrophic scars.

scholarly journals COVID-19: APPROACH TO DIAGNOSIS AND TREATMENT STRATEGY IN VIETNAM

2021 ◽  
Vol 506 (1-2) ◽  
Author(s):  
Ngo Van Cong
Keyword(s):  
Medical Staff ◽  
Treatment Guidelines ◽  
Specific Treatment ◽  
Diagnosis And Treatment ◽  
Treatment Protocols ◽  
Comprehensive Information ◽  
Medical Facilities ◽  
The World ◽  
Practical Guidelines ◽  
Progression Risk

Introduction: the Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread all over the world. This situation brings medical facilities into an emergency state and the huge need for medical staff in the diagnosis and treatment of infected patients. Therefore, it is necessary to standardize knowledges and therapeutics agents of hospitalized patients or field hospitals. The article was aimed to summarize the clinical progression, risk factors and treatment protocols for COVID-19 patients around the world and practical guidelines in Vietnam. These help new medical staff that update knowledges quickly. Methods: review the latest approaches and guidelines of the Vietnamese Ministry of Health on the diagnosis and treatment of Covid-19 patients. Results: we summarize specific treatment guidelines for Covid-19 patients into treatment protocols according to the level of severity. The regimen is being applied at medical facilities, field hospitals, and Covid-19 treatment hospitals in Vietnam. Conclusion: the strategy of COVID-19 treatment is monitoring and detecting cases with signs of severe progression and limiting mortalities. Management protocols according to the level of severity provides standardized regimens and comprehensive information of COVID-19.

scholarly journals Diagnostic and treatment barriers to persistent somatic symptoms in primary care – representative survey with physicians

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marco Lehmann ◽  
Nadine Janis Pohontsch ◽  
Thomas Zimmermann ◽  
Martin Scherer ◽  
Bernd Löwe
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Rating Scales ◽  
Treatment Guidelines ◽  
Somatic Symptoms ◽  
Diagnosis And Treatment ◽  
Treatment Barriers ◽  
Adequate Treatment ◽  
Physical Disease ◽  
Federal States

Abstract Background Many patients consult their primary care physician with persistent somatic symptoms such as pain or sickness. Quite often these consultations and further diagnostic measures yield no medical explanation for the symptoms – patients and physicians are left in uncertainty. In fact, diagnostic and treatment barriers in primary care hinder timely health-care provision for patients suffering from persistent somatic symptoms (PSS). The significance of individual barriers is still unknown. We compare and quantify these barriers from the perspective of primary care physicians and identify subpopulations of primary care physicians who experience particular barriers as most severe. Methods We mailed a questionnaire to primary care physicians (PCP) in Germany and asked them which barriers they consider most important. We invited a random sample of 12,004 primary care physicians in eight federal states in Germany. Physicians provided anonymous mailed or online responses. We also mailed a postcard to announce the survey and a mail reminder. Main measures were Likert rating scales of items relating to barriers in the diagnosis and treatment of PSS in primary care. Information on demography and medical practice were also collected. Results We analyzed 1719 data sets from 1829 respondents. PCPs showed strongest agreement with statements regarding (1.) their lack of knowledge about treatment guidelines, (2.) their perceptions that patients with PSS would expect symptom relief, (3.) their concern to overlook physical disease in these patients, and (4.) their usage of psychotropic drugs with these patients. More experienced PCPs were better able to cope with the possibility of overlooking physical disease than those less experienced. Conclusions The PCPs in our survey answered that the obligation to rule out severe physical disease and the demand to relieve patients from symptoms belong to the most severe barriers for adequate treatment and diagnosis. Moreover, many physicians admitted to not knowing the appropriate treatment guidelines for these patients. Based on our results, raising awareness of guidelines and improving knowledge about the management of persistent somatic symptoms appear to be promising approaches for overcoming the barriers to diagnosis and treatment of persistent somatic symptoms in primary care. Trial registration German Clinical Trials Register (Deutschen Register Klinischer Studien, DRKS) https://www.drks.de/drks_web/setLocale_EN.do The date the study was registered: October 2nd 2017 The date the first participant was enrolled: February 9th 2018 DRKS-ID: DRKS00012942

Delay in diagnosis and treatment of soft tissue sarcomas (STS): Causes of late intervention and their role in prognosis—A prospective, multidisciplinary group study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10055-10055
Author(s):  
Alessandro Comandone ◽  
Elisa Berno ◽  
Antonella Boglione ◽  
Cristiano Oliva ◽  
Manuela Ingui' ◽  
...  
Keyword(s):  
Median Time ◽  
Primary Care Physicians ◽  
Malignant Tumors ◽  
Soft Tissue Sarcomas ◽  
Diagnosis And Treatment ◽  
Medical Visit ◽  
Anatomic Site ◽  
Optimal Care ◽  
General Hospitals ◽  
Multidisciplinary Group

10055 Background: STS are 1% of malignant tumors in adults. Rarity, heterogeneity in presentation, low expertise in primary care physicians (PCP) or in general hospitals, organisation problems in specialized centers may cause a delay in both diagnosis and treatment. Aim of this study is to acknowledge the barriers to optimal care and the consequences of the delay on prognosis. Methods: Patients with STS of the extremities, trunk, retroperitoneum treated and followed from 1999 to 2011 by the same multidisciplinary group were included. Time and pattern of symptoms onset, anatomic site, tumor volume, patients’ age, gender and home, interval between diagnosis and surgical treatment or neoadjuvant chemotherapy; time to start adjuvant RT or CT were considered in a univariate - multivariate analysis. Results: 449 adult patient (53% F, 47% M, median age 55 years) were followed for a median time of 116.38 months. 65.7% of STS were at the extremities, 17.6% retroperitoneal, 16.7% at the trunk wall. Median volume at diagnosis was 8 cm for trunk and extremities; 15 cm for retroperitoneum. Commonest histologies: liposarcoma. 18.2%; leiomyo 16.8%; mixofibro 13.6%. Increasing mass, pain, and abdominal disconfort were the main revealing signs of diseases. Median time of delay were: from onset of symptom to first medical visit 68 days for trunk and extremities, 82 for retroperitoneum; 104 days from symptoms to histological diagnosis; 129 days from symptoms to start of therapy. Time to surgery after definitive diagnosis was 12 days in extremities and 21 in abdomen. Adjuvant CT started 22 days after surgery for extremities, 25 in trunk, 35 in retroperitoneum. RT initiated after 78 days. Longer delay in treatment lead to worse prognosis: MS 89.95 months if delay was > 3 months; 190.40 months if wait was < 3 months (p 0.007). Conclusions: Low self consciousness of the patient; misdiagnosis or inadequate approach in general hospitals; late referral to specialized centres are 75% of the cause of wasted time. Organization problems at the referral Centre concur for 25% of delay. Guidelines implementation and educational programme among general population and PCP are necessary.

scholarly journals Atypical Carcinoid of the Larynx: A Case Report

2021 ◽  
pp. 014556132110248
Author(s):  
Yue Hu ◽  
Xing Guo ◽  
Feifei Jiang ◽  
Aihui Yan
Keyword(s):  
Case Report ◽  
Gastrointestinal Tract ◽  
Neuroendocrine Carcinoma ◽  
Malignant Tumors ◽  
The Body ◽  
Neuroendocrine Cells ◽  
Diagnosis And Treatment ◽  
Atypical Carcinoid ◽  
Rare Type ◽  
Neuroendocrine Carcinomas

Neuroendocrine carcinomas are a spectrum of rare and highly heterogeneous malignant tumors. Neuroendocrine carcinomas mainly arise from neuroendocrine cells scattered throughout the body. They mainly occur in the lung and gastrointestinal tract. Atypical carcinoid of the larynx is a rare type of neuroendocrine carcinoma, which is easily misdiagnosed as hemangioma in appearance. We mainly feature the disease to you through the diagnosis and treatment of a case of atypical carcinoid of the larynx.

scholarly journals CXCR4 Based Therapeutics for Non-Small Cell Lung Cancer (NSCLC)

2018 ◽  
Vol 7 (10) ◽  
pp. 303 ◽  
Author(s):  
Ori Wald
Keyword(s):  
Lung Cancer ◽  
Chemokine Receptor ◽  
Immune Cell ◽  
Malignant Tumors ◽  
Checkpoint Inhibitors ◽  
The Body ◽  
Cell Trafficking ◽  
Receptor System ◽  
Treatment Protocols ◽  
Distant Spread

Lung cancer is the second most common malignancy. Unfortunately, despite advances in multimodality therapeutics for the disease, the overall five-year survival rate among newly diagnosed lung cancer patients remains in the range region of 15%. In addition, although immune checkpoint inhibitors are increasingly being incorporated into lung cancer treatment protocols, the proportion of patients that respond to these agents remains low and the duration of response is often short. Therefore, novel methodologies to enhance the efficacy of immunotherapy in lung cancer are highly desirable. Chemokines are small chemotactic cytokines that interact with their 7 transmembrane G-protein–coupled receptors, to guide immune cell trafficking in the body under both physiologic and pathologic conditions. Tumor cells highjack a small repertoire of the chemokine/chemokine receptor system and utilize it in a manner that benefits local tumor growth and distant spread. The chemokine receptor, CXCR4 is expressed in over 30 types of malignant tumors and, through interaction with its ligand CXCL12, was shown exert pleotropic pro-tumorigenic effects. In this review, the pathologic roles that CXCL12/CXCR4 play in lung cancer propagation are presented. Furthermore, the challenges and potential benefits of incorporating drugs that target CXCL12/CXCR4 into immune-based lung cancer therapeutic protocols are discussed.

scholarly journals EVALUATION OF MARMA POINT STIMULATION IN AVABAHUKA WITH RESPECT TO PERIARTHRITIS SHOULDER

2021 ◽  
Vol 9 (9) ◽  
pp. 2267-2270
Author(s):  
Neha Sharma ◽  
Gaurav Parma ◽  
Anil Dutt
Keyword(s):  
Shoulder Joint ◽  
Treatment Plan ◽  
Adhesive Capsulitis ◽  
Frozen Shoulder ◽  
Specific Treatment ◽  
Signs And Symptoms ◽  
The Body ◽  
Treatment Protocols ◽  
Restricted Movement ◽  
Selection Of

Periarthritis Shoulder is common in people who are middle-aged or older. As shoulder joint is the most mobile joint in the body making it vulnerable to problems, ultimately leading to restricted shoulder movements. A 67 years old male patient diagnosed with Avabahuka (Adhesive capsulitis), managed with MARMA CHIKITSA. After completion of the treatment, pain, swelling, tenderness and restricted movement of the humero-glenoid joint were reduced. As the signs and symptoms of this disease are not mentioned in Ayurvedic classics, specific treatment protocols and formulations cannot be given. The selection of drugs may differ from case to case. The treatment plan followed in this study may be adopted in future cases changing the selection of drugs based upon the necessity to obtain good results. Keywords: Marma Chikitsa, Periarthritis Shoulder, Avabahuka, Frozen shoulder.

scholarly journals Combined Blunt Splenic Injury in Adults: Modern Approach to Diagnosis and Treatment

2021 ◽  
Vol 10 (2) ◽  
pp. 347-356
Author(s):  
V. V. Aleksandrov ◽  
S. S. Maskin ◽  
V. V. Matyukhin
Keyword(s):  
High Frequency ◽  
Splenic Injury ◽  
Damage Control ◽  
Diagnostic Algorithm ◽  
The Body ◽  
Diagnosis And Treatment ◽  
Modern Approach ◽  
Blunt Splenic Injury ◽  
Endovascular Interventions ◽  
Literary Sources

Background. The high frequency of injuries of the spleen, as well as its important immunocompetent role in the body, dictate the need to develop a standardized approach to the diagnosis and treatment of this category of patients.Aim. Standardization of the treatment and diagnostic approach for combined blunt splenic injury to improve treatment results.Material and methods. The analysis of literary sources of Russian and foreign authors on this issue.Results. The therapeutic and diagnostic algorithm was developed for combined blunt splenic injury based on the severity of the patient, and a detailed description of non-operative and damage control surgical treatment was given.Conclusion. The use of endovascular interventions in the treatment of splenic injuries, as well as their gradual treatment in conditions of severe polytrauma, helps to reduce mortality. 

Physiological and Hereditary Hyperbilirubinemia in Athletes: Role in Reducing Efficiency and Correction Methodology

2020 ◽  
Vol 5 (5) ◽  
pp. 386-393
Author(s):  
L. M. Gunina ◽  
◽  
Kazys Mylashyus ◽  
Voitenko V. L. ◽  
◽  
...  
Keyword(s):  
Physical Activity ◽  
Functional State ◽  
Oxygen Demand ◽  
Diagnostic Algorithm ◽  
Drug Prevention ◽  
The Body ◽  
Erythrocyte Membranes ◽  
Pharmacological Agents ◽  
Bilirubin Metabolism ◽  
The Individual

Under high-intensity loads, the athlete's bodies take place a number of biochemical reactions and physiological processes that can lead to hyperbilirubinemia. The factors that can initiate the onset of this phenomenon include the syndrome of micro-damage muscle, violation of the integrity of erythrocyte membranes, decreased blood pH, malnutrition and increase oxygen demand of the body. Degree of expression of manifestations of physiological bilirubinemia depends on the level of adaptation of the athlete to the physical activities offered. Hyperbilirubinemia in athletes can be one of the components of the deterioration of the functional state, forming the symptoms of endogenous intoxication. The relevance of this problem in sport lies in the relatively low detection rate of hyperbilirubinemia due to the lack of regular screening studies. However, in drawing up a plan of nutritional- metabolic support for training and competitive activity and recovery measures, must not only the individual reaction of the athlete body to physical activity, but also the severity of shifts in the indicators of bilirubin metabolism and their ratio. The article describes the reasons for the increase in bilirubin levels, which can be caused by both the effect of physical activity and by the presence of pathological processes in athletes. The factors influencing the blood serum’s bilirubin content are also highlighted, which include the state of erythrocyte cell membranes and the rate of hemoglobin destruction, the functional state of the liver, the specifics of physical loads and the use of ergogenic pharmacological agents by athletes. Particular accent has been placed on the illumination of hereditary hyperbilirubinemias, which may have been detected at the stage of selection of athletes. The most common phenomenon is Gilbert's syndrome, which occurs in 2-5% of cases in the general population, is characterized in the clinic by a benign flow and is manifested by episodes of jaundice and an increase in total bilirubin content to moderate values due to indirect. The frequency of detection of hyperbilirubinemias in the population of athletes is 4.68%, among which Gilbert's disease accounts for almost half (48.7%). Conclusion. The work highlighted the pathogenesis and diagnostic algorithm of Gilbert's disease, and also emphasized that its drug prevention and correction in athletes to maintain functional and physical fitness should be carried out taking into account anti-doping rules, which requires upon diagnosis timely receipt of a therapeutic exclusion

The new in monitoring of provision of cancer care in the Russian Federation

2019 ◽  
Vol 2019 (4) ◽  
pp. 35-37
Author(s):  
Наталья Стадченко ◽  
Natal'ya Stadchenko
Keyword(s):  
Russian Federation ◽  
Treatment Guidelines ◽  
Malignant Tumors ◽  
Patient Specific ◽  
Insurance Fund ◽  
Medical Aid ◽  
Proven Case ◽  
The Russian Federation ◽  
Positive Results ◽  
Made In

The Federal Compulsory Medical Insurance Fund created the system of a monitoring of medical aid provided for the oncology patients, which allows realizing control over execution of the treatment guidelines on every stage. Changes been made in the governing documents, aimed at development of patient-specific records of provided medical aid at suspicion on the malignant tumors or in proven case of the malignant tumors. The article presents the data on control and expert activities demonstrating positive results of that work.

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