Pilot Study of Personalized Video Visit Summaries for Patients With Cancer

2018 ◽  
pp. 1-8
Author(s):  
John C. Krauss ◽  
Vaibhav Sahai ◽  
Matthias Kirch ◽  
Diane M. Simeone ◽  
Lawrence An
Keyword(s):  
Treatment Plan ◽  
Office Visit ◽  
Management Plan ◽  
Patients With Cancer ◽  
Video Summary ◽  
Personalized Education ◽  
Short Video ◽  
Education Tool ◽  
Personalized Video

Purpose The treatment of cancer is complex, which can overwhelm patients and lead to poor comprehension and recall of the specifics of the cancer stage, prognosis, and treatment plan. We hypothesized that an oncologist can feasibly record and deliver a custom video summary of the consultation that covers the diagnosis, recommended testing, treatment plan, and follow-up in < 5 minutes. The video summary allows the patient to review and share the most important part of a cancer consultation with family and caregivers. Methods At the conclusion of the office visit, oncologists recorded the most important points of the consultation, including the diagnosis and management plan as a short video summary. Patients were then e-mailed a link to a secure Website to view and share the video. Patients and invited guests were asked to respond to an optional survey of 15 multiple-choice and four open-ended questions after viewing the video online. Results Three physicians recorded and sent 58 video visit summaries to patients seen in multidisciplinary GI cancer clinics. Forty-one patients logged into the secure site, and 38 viewed their video. Fourteen patients shared their video and invited a total of 46 visitors, of whom 36 viewed the videos. Twenty-six patients completed the survey, with an average overall video satisfaction score of 9 on a scale of 1 to 10, with 10 being most positive. Conclusion Video visit summaries provide a personalized education tool that patients and caregivers find highly useful while navigating complex cancer care. We are exploring the incorporation of video visit summaries into the electronic medical record to enhance patient and caregiver understanding of their specific disease and treatment.

scholarly journals HEALING OF A TRAUMATIC WOUND WITH HERBO-MEDICINAL OINTMENT; MARHAM-E-RAAL: A CASE STUDY

2020 ◽  
Vol 9 (6) ◽  
pp. 152-155
Author(s):  
Saiyad Shah Alam ◽  
Waseem Ahmad ◽  
Md Rizwanullah ◽  
Mohammad Muzammil
Keyword(s):  
Wound Healing ◽  
Treatment Plan ◽  
Type Ii Diabetes Mellitus ◽  
Management Plan ◽  
Complete Healing ◽  
Mucus Membrane ◽  
Traumatic Wound ◽  
Large Wound

Introduction: A wound can be defined as the discontinuity in skin or mucus membrane. Healing is nothing but neogranulation in the depth and neo-epithelialization at the edges of the wound which ultimately results in the complete repair of such discontinuity. This case report deals with a patient of traumatic large wound at the heel who receives Unani management for wound healing. He was diagnosed as avulsion of pad of right heel with type-II diabetes mellitus. The treatment plan included mechanical debridement, cleaning with solution of alum powder (Sufuf-e-zaaj/alusol) and dressing with Marham-e-raal. The patient was advised to continue oral hypoglycemic agent with subcutaneous injection of insulin. On 85th day of treatment, the wound was healed by almost 98% and on subsequent 1st and 2nd follow up, each with a gap of 15 days, no recurrence of wound was recorded. Methodology: A male patient of traumatic wound was taken into study and given Unani management plan which included debridement, cleaning and washing with solution of Alum powder (Alusol)/ or, in Unani, Sufuf-e-zaaj and dressing of the wound with Marham-e-raal with full aseptic precautions for a period of about 3 months. Discussion: Wound healing is credited to muhallil(anti-inflammatory), daf’eta’ffun (antimicrobial), mujaffif (desiccant) and mundamil (wound healing) properties of Marham-e-raal due to presence of several phytoconstituents like camphor, linalool, borneol, cineole, terpenoids, Bergenin, Phenols and flavonoids, hopeaphenol, Oligostilbenoids, Monoterpenes, kaempferol, Quercetin and Catechin. Result: The wound completely healed at the end of 3 months with no recurrence noted on the 15th day of follow up after complete healing.

Evidence-Based Recommendations for Cancer Fatigue, Anorexia, Depression, and Dyspnea

2008 ◽  
Vol 26 (23) ◽  
pp. 3886-3895 ◽  
Author(s):  
Sydney M. Dy ◽  
Karl A. Lorenz ◽  
Arash Naeim ◽  
Homayoon Sanati ◽  
Anne Walling ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Treatment Effectiveness ◽  
Treatment Plan ◽  
Evidence Based ◽  
Initial Visit ◽  
Patients With Cancer ◽  
Associated Symptoms ◽  
Hastened Death ◽  
Underlying Causes

Purpose The experience of patients with cancer often involves symptoms of fatigue, anorexia, depression, and dyspnea. Methods We developed a set of standards through an iterative process of structured literature review and development and refinement of topic areas and standards and subjected recommendations to rating by a multidisciplinary expert panel. Results For fatigue, providers should screen patients at the initial visit, for newly identified advanced cancer, and at chemotherapy visits; assess for depression and insomnia in newly identified fatigue; and follow up after treatment for fatigue or a secondary cause. For anorexia, providers should screen at the initial visit for cancer affecting the oropharynx or gastrointestinal tract or advanced cancer, evaluate for associated symptoms, treat underlying causes, provide nutritional counseling for patients undergoing treatment that may affect nutritional intake, and follow up patients given appetite stimulants. For depression, providers should screen newly diagnosed patients, those started on chemotherapy or radiotherapy, those with newly identified advanced disease, and those expressing a desire for hastened death; document a treatment plan in diagnosed patients; and follow up response after treatment. For general dyspnea, providers should evaluate for causes of new or worsening dyspnea, treat or symptomatically manage underlying causes, follow up to evaluate treatment effectiveness, and offer opioids in advanced cancer when other treatments are unsuccessful. For dyspnea and malignant pleural effusions, providers should offer thoracentesis, follow up after thoracentesis, and offer pleurodesis or a drainage procedure for patients with reaccumulation and dyspnea. Conclusion These standards provide a framework for evidence-based screening, assessment, treatment, and follow-up for cancer-associated symptoms.

scholarly journals Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

2021 ◽  
pp. 1-4
Author(s):  
Reham Almasoud ◽  
Alaaeddin Nwilati ◽  
Saeb Bayazid ◽  
Mamoun Shafaamri
Keyword(s):  
Infectious Disease ◽  
Antibiotic Therapy ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Artery Aneurysm ◽  
Management Plan ◽  
Resected Tissue ◽  
Infectious Disease Specialists

We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by <i>Klebsiella pneumoniae</i>. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive <i>K. pneumoniae</i> and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

scholarly journals P071 Survey of rheumatology patient satisfaction with telephone consultations during the COVID-19 pandemic

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mia Rodziewicz ◽  
Terence O'Neill ◽  
Audrey Low
Keyword(s):  
Patient Satisfaction ◽  
Physical Examination ◽  
Management Plan ◽  
Service Development ◽  
Telephone Consultation ◽  
Face To Face ◽  
Communication Difficulties ◽  
Strongly Agree ◽  
The Uk

Abstract Background/Aims  Rheumatology departments were required to switch rapidly from face-to-face (F2F) to remote consultations during the COVID-19 pandemic in the UK. We conducted a patient satisfaction survey on the switch to inform future service development. Methods  All patients [new (NP), follow-up (FU)] were identified between 1st to 5th June 2020. Patients who attended or did not attend (DNA) a pre-booked F2F consultation or cancelled were excluded. Of the remainder, half the patients was surveyed by phone using a standardised questionnaire and the other half was posted the same questionnaire. Both groups were offered the opportunity to complete the survey online. Patients were surveyed on the organisation and content of the consultation, whether they were offered a subsequent F2F appointment and future consultation preference. Results  233 consultations were scheduled during the study period. After 53 exclusions (34 pre-booked F2F, 16 DNA, 3 cancellations), 180 eligible consultations were surveyed (85 via mailshot, 95 by telephone). 75/180 patients (42%) responded within 1 month of the telephone consultation (20 NP, 47 FU, 8 missing). The organisation of the switch was positively perceived (Table). Patients were highly satisfied with 4 of the 5 consultation domains but were undecided whether a physical assessment would have changed the outcome of the consultation (Table). After the initial phone consultation, 7 of 20 NP and 19 of 47 FU were not offered subsequent F2F appointments at the clinicians’ discretion. Of those not offered subsequent F2F appointments, proportionally more NP (3/7, 43%) would have liked one, compared to FU (5/19, 26%). Reasons included communication difficulties and a desire for a definitive diagnosis. 48/75 (64%) would be happy for future routine FU to be conducted by phone “most of the time" or "always”; citing patient convenience and disease stability. Caveats were if physical examination was required or if more serious issues (as perceived by the patient) needed F2F discussion. Conclusion  Patients were generally satisfied with telephone consultations and most were happy to be reviewed again this way. NPs should be offered F2F appointments for first visits to maximise patient satisfaction and time efficiency. P071 Table 1:Median age, yearsFemale; n (%)Follow-up; n (%)All eligible for survey; n = 18056122 (68)133 (74)Sent mailshot; n = 855459 (69)65 (76)Surveyed by phone; n = 955663 (66)68 (72)Responder by mail; n = 166911 (69)13 (82)Responder by phone; n = 525437 (71)34 (65)Responder by e-survey; n = 7495 (71)UnknownOrganisation of the telephone consultation, N = 75Yes, n (%)No, n (%)Missing, n (%)Were you informed beforehand about the phone consultation?63 (84)11 (15)1 (1)Were you called within 1-2 hours of the appointed date and time?66 (88)6 (8)3 (4)Domains of the consultation, N = 75Strongly disagree, n (%)Disagree, n (%)Neutral, n (%)Agree, n (%)Strongly agree, n (%)Missing, n (%)During the call, I felt the clinician understood my problem3 (4)1 (1)1 (1)20 (27)49 (65)1 (1)During the call, I had the opportunity to ask questions regarding my clinical care1 (1)02 (3)16 (21)55 (73)1 (1)A physical examination would have changed the outcome of the consultation16 (21)18 (24)20 (27)11 (15)10 (13)0The clinician answered my questions to my satisfaction2 (3)06 (8)18 (24)49 (65)0At the end of the consultation, the clinician agreed a management plan with me3 (4)2 (3)6 (8)24 (32)39 (52)1 (1)Future consultations, N = 75Never, n (%)Sometimes, n (%)Most of the time, n (%)Always, n (%)Missing, n, (%)In the future, would you be happy for routine FU to be conducted by phone?5 (7)20 (27)16 (21)32 (43)2 (3) Disclosure  M. Rodziewicz: None. T. O'Neill: None. A. Low: None.

scholarly journals The Impact of Dental Implant Length on Failure Rates: A Systematic Review and Meta-Analysis

Materials ◽  
2021 ◽  
Vol 14 (14) ◽  
pp. 3972
Author(s):  
Maha Abdel-Halim ◽  
Dalia Issa ◽  
Bruno Ramos Chrcanovic
Keyword(s):  
Treatment Plan ◽  
Meta Analysis ◽  
Implant Failure ◽  
Failure Rates ◽  
Manual Search ◽  
Short Implants ◽  
The Many ◽  
The Impact ◽  
Implant Length

The present review aimed to evaluate the impact of implant length on failure rates between short (<10 mm) and long (≥10 mm) dental implants. An electronic search was undertaken in three databases, as well as a manual search of journals. Implant failure was the outcome evaluated. Meta-analysis was performed in addition to a meta-regression in order to verify how the risk ratio (RR) was associated with the follow-up time. The review included 353 publications. Altogether, there were 25,490 short and 159,435 long implants. Pairwise meta-analysis showed that short implants had a higher failure risk than long implants (RR 2.437, p < 0.001). There was a decrease in the probability of implant failure with longer implants when implants of different length groups were compared. A sensitivity analysis, which plotted together only studies with follow-up times of 7 years or less, resulted in an estimated increase of 0.6 in RR for every additional month of follow-up. In conclusion, short implants showed a 2.5 times higher risk of failure than long implants. Implant failure is multifactorial, and the implant length is only one of the many factors contributing to the loss of an implant. A good treatment plan and the patient’s general health should be taken into account when planning for an implant treatment.

Diagnostic accuracy and clinical management by realtime teledermatology. Results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial

1998 ◽  
Vol 4 (2) ◽  
pp. 95-100 ◽  
Author(s):  
M A Loane ◽  
R Corbett ◽  
S E Bloomer ◽  
D J Eedy ◽  
H E Gore ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Management ◽  
Low Cost ◽  
Treatment Plan ◽  
Management Plan ◽  
Face To Face ◽  
Management Plans ◽  
Video Link ◽  
The Uk ◽  
Management Recommendations

Diagnostic accuracy and management recommendations of realtime teledermatology consultations using low-cost telemedicine equipment were evaluated. Patients were seen by a dermatologist over a video-link and a diagnosis and treatment plan were recorded. This was followed by a face-to-face consultation on the same day to confirm the earlier diagnosis and management plan. A total of 351 patients with 427 diagnoses participated. Sixty-seven per cent of the diagnoses made over the video-link agreed with the face-to-face diagnosis. Clinical management plans were recorded for 214 patients with 252 diagnoses. For this cohort, 44 of the patients were seen by the same dermatologist at both consultations, while 56 were seen by a different dermatologist. In 64 of cases the same management plan was recommended at both consultations; a sub-optimum treatment plan was recommended in 8 of cases; and in 9 of cases the video-link management plans were judged to be inappropriate. In 20 of cases the dermatologist was unable to recommend a suitable management plan by video-link. There were significant differences in the ability to recommend an optimum management plan by video-link when a different dermatologist made the reference management plan. The results indicate that a high proportion of dermatological conditions can be successfully managed by realtime teledermatology.

Cognitive variables associated with depressive and anxiety symptoms in patients with cancer: A five‐year follow‐up study

2021 ◽  
Author(s):  
Amador Priede ◽  
Noelia Rodríguez‐Pérez ◽  
Fernando Hoyuela ◽  
Patricia Cordero‐Andrés ◽  
Olga Umaran‐Alfageme ◽  
...  
Keyword(s):  
Anxiety Symptoms ◽  
Cognitive Variables ◽  
Patients With Cancer ◽  
Follow Up Study

Abstract 247: A Randomized Controlled Study of a Platform to Maximize Patient Knowledge of Health Goals After Acute Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Robin Mathews ◽  
Peter Shrader ◽  
Vladimir Demyaneko ◽  
Vincent Miller ◽  
Laura Webb ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Secondary Prevention ◽  
Outpatient Visit ◽  
Medication Use ◽  
Treatment Goals ◽  
Post Discharge ◽  
Risk Factor Control ◽  
Health Goals ◽  
Education Tool

Objectives: Patients vary in the degree to which they understand and engage in their health care. We hypothesized that a personalized patient health education tool will promote patient communication and align patient and provider treatment goals in follow-up visits in order to optimize guideline adherence, including evidence-based therapy use and cardiovascular risk factor control, after an acute myocardial infarction (AMI). Methods: We developed a personalized patient education tool that summarized each patient’s status at discharge of secondary prevention risk factors (blood pressure (BP), low density lipoprotein cholesterol (LDL-C) and glycemic control), medication use (aspirin, beta blocker, ACE inhibitor/ARB, statin, P2Y 12 inhibitor), and outpatient treatment goals. Patients were randomized 1:1 to usual care vs. receipt of the education tool within 2 weeks post-discharge (before the outpatient visit). We compared secondary prevention medication use, cardiovascular risk factor control, and awareness of treatment goals between randomized groups at 6 months post-discharge. Results: Among 192 enrolled AMI patients, the median age was 60 years, 42% female, and 35% African American; demographic and clinical characteristics were well balanced between randomized groups. We noted high rates of secondary prevention therapy use at 6 months (Table). By 6 months post-discharge, mean systolic BP decreased by 10 mmHg with 80% of patients <140/90 mmHg, and mean LDL-C decreased by 13 mg/dl with 64% of patients under 100mg/dl. Overall, 36% of patients participated in cardiac rehabilitation. We observed no significant differences between randomized groups in any of these outcomes. Only 9% of patients who received the education tool brought it to their outpatient visit for discussion. Conclusion: Though secondary prevention medication use remains reasonably high at 6 months, achievement of secondary prevention health goals remains suboptimal after a myocardial infarction. Few patients utilized the health tool in discussions with outpatient providers during their follow-up visit which likely explains the lack of outcomes differences between randomized groups. Further work is needed to find effective interventions to engage patients and promote sustained behavioral modification for secondary prevention.

Abstract P138: Lifestyle Goals in Pediatric Preventive Cardiology: Practical Clinical Application

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Justin P Zachariah ◽  
Michael M Mendelson ◽  
Suzanne Griggs ◽  
Heather H Ryan ◽  
Annette L Baker ◽  
...  
Keyword(s):  
Real World ◽  
Fast Food ◽  
Lipid Level ◽  
Laboratory Data ◽  
Management Plan ◽  
Trans Fat ◽  
Lipid Management ◽  
Preventive Cardiology ◽  
Low Hdl

BACKGROUND: Lifestyle change is recommended by the 2011 NHLBI Expert Panel Integrated Guidelines as the cornerstone of pediatric lipid management. Using a Standardized Clinical Assessment and Management Plan (SCAMP)© (IRCDA Inc, Boston MA) as an implementation tool, we examined in a real-world setting the effect of making 3 lifestyle goals on lipid levels in youth referred to a pediatric Preventive Cardiology clinic. METHODS: Prospectively collected anthropometric, clinical, and laboratory data were analyzed on youth referred for lipid abnormalities between September 2010 and March 2014. Percent change in lipid fractions from baseline to last follow-up was calculated. Lifestyle recommendations given at initial visit were predictors of interest considered individually and as groups of 3. Multivariable adjusted linear regression was used to identify lifestyle combination trios that were associated with dyslipidemia change. RESULTS: Among 325 patients (55% female, median follow-up time 17 [IQR 10,28] months; mean age 13±4yrs], high LDL (>130 mg/dL) was present in 62%, high TG (> 150 mg/dL) in 35%, and low HDL (<40 mg/dL) in 28%. In those with the relevant lipid abnormality, LDL decreased by 11±17%, TG declined by 22±35% and HDL improved by 15±35%. Overall, BMI percentile declined by 2 points. The most common lifestyle goals given were ‘decrease saturated/trans fat’ (63%), ‘increase vegetables/fruit’ (61%), ‘increase exercise’ (55%), ‘continue exercise’ (35%), and ‘decrease glycemic index’ (30%). In those with HDL<40 adjusted for age and sex, ‘increase fish and nuts’ was associated with HDL improvement (6.52mg/dL[ 2.38,10.66];p=0.002) but, unexpectedly, ‘increase vegetables/fruit’ was associated with worse HDL (-3.87mg/dL[95%CI-6.75,-0.99]; p=0.01). In those with TG>150 as expected, ‘decrease fast food/eating out’ was associated with lower TG (37%[13,54]; p=0.006). After adjustment for age, sex, baseline lipid level, and BMI percentile change, the trio of ‘increasing vegetables/fruit’, ‘decreasing saturated/trans fat’, and ‘continue exercise’ was associated with lower LDL (-17.64mg/dL[-3.62,-31.56];p=0.01). Intriguingly, substituting ‘increase exercise’ instead of ‘continue exercise’ in this trio was not associated with lipid change. CONCLUSIONS: In a real-world cohort of dyslipidemic youth, providing lifestyle goals was associated with favorable lipid changes, with some combinations showing particular benefits. More data is warranted to explore the effect of specific lifestyle goal combinations in youth.

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