Efficacy of multidisciplinary treatment program on long-term outcomes of individuals with Parkinsons disease

2005 ◽  
Vol 42 (6) ◽  
pp. 779 ◽  
Author(s):  
William Carne ◽  
David X. Cifu ◽  
Paul Marcinko ◽  
Mark Baron ◽  
Treven Pickett ◽  
...  
Spine ◽  
2004 ◽  
Vol 29 (8) ◽  
pp. 850-855 ◽  
Author(s):  
Luke E. Patrick ◽  
Elizabeth M. Altmaier ◽  
Ernest M. Found

2020 ◽  
Vol 55 (5) ◽  
pp. 547-553
Author(s):  
Tommaso Dionisi ◽  
Carolina Mosoni ◽  
Giovanna Di Sario ◽  
Claudia Tarli ◽  
Mariangela Antonelli ◽  
...  

Abstract Aim People experiencing homelessness are often excluded from treatment programs for alcohol use disorder (AUD). The goal of this study was to describe the impact of a multidisciplinary treatment program on alcohol consumption and social reintegration in individuals with AUD experiencing homelessness. Methods Thirty-one individuals with AUD experiencing homelessness were admitted to an inpatient unit for 5–6 days for clinical evaluation and to treat potential alcohol withdrawal syndrome. A group of volunteers, in collaboration with the Community of Sant’Egidio, provided social support aimed to reintegrate patients. After inpatient discharge, all patients were followed as outpatients. Alcohol intake (number drinks/day), craving and clinical evaluation were assessed at each outpatient visit. Biological markers of alcohol use were evaluated at enrollment (T0), at 6 months (T1) and 12 months (T2). Results Compared with T0, patients at T1 showed a significant reduction in alcohol consumption [10 (3–24) vs 2 (0–10); P = 0.015] and in γ-glutamyl-transpeptidase [187 (78–365) vs 98 (74–254); P = 0.0021]. The reduction in alcohol intake was more pronounced in patients with any housing condition [10 (3–20) vs 1 (0–8); P = 0.008]. Similarly, compared with T0, patients at T2 showed significant reduction in alcohol consumption [10 (3–24) vs 0 (0–15); P = 0.001], more pronounced in patients with any housing condition [10 (3–20) vs 0 (0–2); P = 0.006]. Moreover, at T2 patients showed a significant reduction in γ-glutamyl-transpeptidase [187 (78–365) vs 97 (74–189); P = 0.002] and in mean cell volume [100.2 (95–103.6) vs 98.3 (95–102); P = 0.042]. Conclusion Patients experiencing homelessness may benefit from a multidisciplinary treatment program for AUD. Strategies able to facilitate and support their social reintegration and housing can improve treatment outcomes.


2020 ◽  
Vol 33 (5) ◽  
Author(s):  
Makoto Yamasaki ◽  
Kotaro Yamashita ◽  
Takuro Saito ◽  
Koji Tanaka ◽  
Tomoki Makino ◽  
...  

Summary Combined tracheal resection and anterior mediastinal tracheostomy (AMT) for esophageal cancer with tracheal invasion is a challenging treatment because of its high morbidity and the lack of evidence regarding long-term outcomes. The aim of this study was to assess the short- and long-term outcomes of AMT as part of the multidisciplinary treatment for esophageal cancer with tracheal invasion. This retrospective study included 27 consecutive patients with esophageal cancer with tracheal invasion who underwent combined tracheal resection and AMT in their multidisciplinary treatment for esophageal cancer. We evaluated postoperative complications, body weight loss, and survival and examined the prognostic value of preoperative factors. All patients underwent chemotherapy and/or chemoradiotherapy as prior treatment. R0 resection was achieved in all cases. Clavien–Dindo grade I or greater complications occurred in 17 patients (63%), and grade III or greater complications occurred in 12 (44%). Overall in-hospital mortality was 4%, with one patient dying on postoperative day 48 when the brachiocephalic artery ruptured from tracheal compression. The 30- and 90-day mortality rates were 0% and 4%, respectively. Median weight change in patients without recurrence in the year after surgery was −1.7% (−9.6–21%). All of these patients received nutrition by oral intake and were living independently at home without public assistance. The 3- and 5-year disease-free survival rates were 25.9% and 18.5%, respectively; 3- and 5-year overall survival rates were 38.6% and 25.7%, respectively. Multivariate analysis identified response to prior treatment as an independent prognostic factor in these patients. Combined tracheal resection and AMT may be adapted as part of the multidisciplinary treatment of esophageal cancer with tracheal invasion. Improving AMT safety and optimizing patient selection may improve prognosis among patients with this cancer.


2016 ◽  
Vol 33 (S1) ◽  
pp. S585-S585
Author(s):  
G. Rivera Arroyo

The problemLess than half of the more than 250 adolescents and young adults who are estimated to experience a first episode of psychosis in the city of Santa Cruz each year are ever diagnosed and receive treatment.Of those patients who are eventually diagnosed, the average duration of their symptoms of psychosis prior to receiving treatment is estimated to be over 2 years.The opportunityMultiple psychosocial variables, such as the reaction of patients and their families to symptoms of psychosis, which play a vital role in determining long-term outcomes, demonstrate their highest degree of flexibility during the period of early psychosis. Psychological, social and evidence-based pharmacological interventions undertaken during this time frame can have a profound impact on the life-course of an individual with psychosis.Our solutionWe propose to establish a pilot early psychosis intervention program that will provide age appropriate biopsychosocial treatment and support for 15–25 years old with first episode psychosis and their families in Santa Cruz. This will improve short and long-term outcomes for those with psychosis, increase speed of recovery, decrease the need for hospitalization, reduce family disruption and decrease rates of relapse.By utilizing a mobile, multidisciplinary treatment team that emphasizes the roles of trained case managers focused on providing intensive individual and family support in the home, this program will provide culturally appropriate care that will leverage contributions from a limited supply of psychiatrists and shift dependence away from a fragmented medical system.Disclosure of interestThe author has not supplied his declaration of competing interest.


2005 ◽  
Vol 20 (3) ◽  
pp. 161-167 ◽  
Author(s):  
William Carne ◽  
David Cifu ◽  
Paul Marcinko ◽  
Treven Pickett ◽  
Mark Baron ◽  
...  

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S465
Author(s):  
Wendy M. Miller ◽  
Victoria C. Lucia ◽  
Patrice M. Sartori ◽  
Peter A. McCullough ◽  
Barry A. Franklin

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