scholarly journals Feasibility and outcomes of the removable prosthesis in medically compromised patients

2021 ◽  
Author(s):  
Abdullah F. Al-Hussain ◽  
Yahya S. Aljabri ◽  
Khalid A. Sindi ◽  
Abdulaziz Y. Thobab ◽  
Abdullah A. Khormi ◽  
...  
Keyword(s):  
Medical Condition ◽  
Treatment Plan ◽  
Gastrointestinal Disorders ◽  
Clinical Settings ◽  
Hygiene Practices ◽  
Adequate Care ◽  
Removable Prosthesis ◽  
Compromised Patients

Increasing awareness about providing the necessary care of oral health is essential for patients with a removable prosthesis. The awareness is less interested in dental disorders, being busier with the systemic ones. Planning prosthetic management should only be done after a thorough evaluation of the underlying systemic conditions because the treatment plan might vary accordingly. Previous studies have demonstrated that many systemic diseases are associated with removable prosthesis (RP) procedures. We aim to discuss the feasibility and outcomes of the removable prosthesis for medically compromised patients, including many conditions as diabetes mellitus, cardiovascular, renal, hematological, pulmonary, gastrointestinal disorders and immunocompromised patients. Taking adequate care of oral hygiene practices is recommended for these patients. In addition, it is necessary to have frequent care, but short follow-up visits to make sure that the modalities are still valid for additional use, and to investigate for potential complications and adverse events. Adequate prophylaxis against some diseases might also be the only convenient solution. Therefore, proper management of the medical condition might be associated with the enhanced success of the modality with favorable outcomes and better quality of life. Making unified protocols to deal with these patients is also suggested to enhance the practice among the different clinical settings.

scholarly journals Near-simultaneous bilateral reverse total shoulder arthroplasty for the treatment of bilateral fracture dislocations of the shoulder

2019 ◽  
Vol 12 (10) ◽  
pp. e230212 ◽  
Author(s):  
Alexander Wendling ◽  
Matthew L Vopat ◽  
Shang-You Yang ◽  
Bradley Saunders
Keyword(s):  
Shoulder Arthroplasty ◽  
Treatment Plan ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Left Shoulder ◽  
Fracture Dislocations ◽  
Bilateral Fracture ◽  
Reverse Total Shoulder

A man in his mid-80s presented with bilateral posterior fracture dislocations of the humerus after suffering a seizure. He had Parskinson’s disease and lived with his wife at home. His left shoulder was not felt to be reconstructable. The initial treatment plan was to perform reverse total shoulder arthroplasty (rTSA) on the left and non-operatively reduce his right shoulder. A left rTSA was performed, but his right shoulder was unstable due to a glenoid fracture and soft tissue instability. In order to preserve the patient’s quality of life, a right rTSA was performed 4 days later. In the follow-up period, the patient was able to regain enough pain-free range of motion on activities of daily living. The patient died from complications of Parkinson’s disease 10 months postoperatively.

scholarly journals Temporoparietal Fascia Free Flap for a Large Nasal Septal Perforation

2019 ◽  
Vol 04 (01) ◽  
pp. e42-e46
Author(s):  
Nicholas G. Cuccolo ◽  
Ryan P. Cauley ◽  
Brady A. Sieber ◽  
Syed M.D. Hussain ◽  
Laurel K. Chandler ◽  
...  
Keyword(s):  
Medical Condition ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Donor Site Morbidity ◽  
Nasal Septal Perforation ◽  
Temporoparietal Fascia ◽  
Versatile Tool ◽  
Underlying Medical Condition

AbstractReconstruction of large nasal septal perforations can be a considerable challenge for surgeons. Reconstructive modalities are often determined by the size of the defect and the quality of local tissue and vasculature. Local and regional flaps may not provide enough tissue to achieve successful closure in patients with large perforations and those with baseline compromise of the nasal mucosa and blood supply from prior intervention or underlying medical condition. Microvascular free tissue transfer is a possible approach to reconstruction in these patients. We report a case of a 30-year-old man who presented with a large, symptomatic, 4 × 3.5 cm perforation as a result of prior functional septoplasty at an outside hospital. Reconstruction of the defect was accomplished in this setting with a free temporoparietal fascia (TPF) flap anastomosed to the columellar branch of the labial artery and the angular vein. Postoperative follow-up visits showed successful closure of the perforation without complications. As illustrated by this case, TPF flap is a versatile tool for complex nasal reconstructions. With minimal donor-site morbidity and rich vascularity capable of promoting remucosalization without the need for prelamination, the TPF flap may be suited for the repair of large nasoseptal perforations.

scholarly journals Adherence therapy for people with schizophrenia

2006 ◽  
Vol 189 (6) ◽  
pp. 508-514 ◽  
Author(s):  
Richard Gray ◽  
Morven Leese ◽  
Jonathan Bindman ◽  
Thomas Becker ◽  
Lorenzo Burti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Education ◽  
Controlled Trial ◽  
Clinical Settings ◽  
Clinical Instability ◽  
Randomised Controlled ◽  
To Receive ◽  
Adherence Therapy

BackgroundThere is equivocal evidence of the effectiveness of adherence therapy in improving treatment adherence and clinical outcomes for people with schizophrenia.AimsTo evaluate the effectiveness of adherence therapy in improving quality of life for people with schizophrenia.MethodA 52-week, single-blind, multicentre randomised controlled trial of the effectiveness of adherence therapy. Participants were individually randomised to receive eight sessions of adherence therapy or health education. Assessments were undertaken at baseline and at 52-week follow-up.ResultsAdherence therapy was no more effective than health education in improving quality of life.ConclusionsThis effectiveness trial provides evidence for the lack of effect of adherence therapy in people with schizophrenia with recent clinical instability, treated in ordinary clinical settings.

scholarly journals Internet-Delivered Cognitive Behavioral Therapy for Children With Pain-Related Functional Gastrointestinal Disorders: Feasibility Study

2017 ◽  
Vol 4 (3) ◽  
pp. e32 ◽  
Author(s):  
Maria Lalouni ◽  
Brjánn Ljótsson ◽  
Marianne Bonnert ◽  
Erik Hedman-Lagerlöf ◽  
Jens Högström ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Disorders ◽  
School Absence ◽  
Abdominal Symptoms ◽  
Irritable Bowel ◽  
Anxiety Depression

Background Pain-related functional gastrointestinal disorders (P-FGIDs; eg, irritable bowel syndrome) are highly prevalent in children and associated with low quality of life, anxiety, and school absence. Treatment options are scarce, and there is a need for effective and accessible treatments. Internet-delivered cognitive behavior therapy (Internet-CBT) based on exposure exercises is effective for adult and adolescent irritable bowel syndrome, but it has not been evaluated for younger children. Objective The objective of this study was to assess acceptability, feasibility, and potential clinical efficacy of Internet-CBT for children with P-FGIDs. Methods This was a feasibility study with a within-group design. We included 31 children aged 8-12 years and diagnosed with P-FGID, according to the ROME III criteria. Mean duration of abdominal symptoms at baseline was 3.8 years (standard deviation [SD] 2.6). The treatment was therapist-guided and consisted of 10 weekly modules of exposure-based Internet-CBT. The children were instructed to provoke abdominal symptoms in a graded manner and to engage in previously avoided activities. The parents were taught to decrease their attention to their children’s pain behaviors and to reinforce and support their work with the exposures. Assessments included treatment satisfaction, subjective treatment effect, gastrointestinal symptoms, quality of life, pain intensity, anxiety, depression, and school absence. Data were collected at pretreatment, posttreatment, and 6-month follow-up. Means, standard errors (SEs), and Cohen d effect sizes were estimated based on multi-level linear mixed models. Results Most children 25/31 (81%) completed 9 or 10 of the 10 treatment modules. Almost all children, 28/31 (90%), reported that the treatment had helped them to deal more effectively with their symptoms, and 27/31 (87%) children declared that their symptoms had improved during the treatment. Assessments from the parents were in accordance with the children’s reports. No child or parent reported that the symptoms had worsened. We observed a large within-group effect size on the primary outcome measure, child-rated gastrointestinal symptoms from pretreatment to posttreatment (Cohen d=1.14, P<.001, 95% CI 0.69-1.61), and this effect size was maintained at 6-month follow-up (Cohen d=1.40, P<.001, 95% CI 1.04-1.81). We also observed significant improvements from pretreatment to posttreatment on a wide range of child- and parent-rated measures including quality of life, pain intensity, anxiety, depression, and school absence. All results remained stable or were further improved at 6-month follow-up. Conclusions This study shows that children with longstanding P-FGIDs, and their parents, perceive exposure-based Internet-CBT as a helpful and feasible treatment. The included children improved significantly despite a long duration of abdominal symptoms before the intervention. The treatment shows potential to be highly effective for P-FGIDs. The results need to be confirmed in a randomized controlled trial (RCT).

scholarly journals The impact of Healthy Conversation Skills training on health professionals’ barriers to having behaviour change conversations: a pre-post survey using the Theoretical Domains Framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenna L. Hollis ◽  
Lucy Kocanda ◽  
Kirsty Seward ◽  
Clare Collins ◽  
Belinda Tully ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Health Behaviour ◽  
Health Professionals ◽  
Theoretical Domains Framework ◽  
Clinical Settings ◽  
Conversation Skills ◽  
Health Behaviour Change ◽  
The Impact

Abstract Background Changing people’s behaviour by giving advice and instruction, as traditionally provided in healthcare consultations, is usually ineffective. Healthy Conversation Skills (HCS) training enhances health professionals’ communication skills and ability to empower and motivate people in health behaviour change. Guided by the Theoretical Domains Framework (TDF), this study examined the impact of HCS training on health professional barriers to conducting behaviour change conversations in both clinical and non-clinical settings. Secondary aims were to i) identify health professionals’ barriers to having behaviour change conversations, and explore the ii) effect of HCS training on health professionals’ competence and attitudes to adopting HCS, iii) feasibility, acceptability and appropriateness of using HCS in their clinical and non-clinical roles, and iv) acceptability and quality of HCS training. Methods HCS training was conducted in October-November 2019 and February 2020. Pre-training (T1), post-training (T2) and follow-up (T3; 6-10 weeks post-training) surveys collected data on demographics and changes in competence, confidence, importance and usefulness (10-point Likert scale, where 10 = highest score) of conducting behaviour change conversations. Validated items assessing barriers to having these conversations were based on eight TDF domains. Post-training acceptability and quality of training was assessed. Data were summarised using descriptive statistics, and differences between TDF domain scores at the specific time points were analysed using Wilcoxon matched-pairs signed-rank tests. Results Sixty-four participants consented to complete surveys (97% women; 16% identified as Aboriginal), with 37 employed in clinical settings and 27 in non-clinical settings. The training improved scores for the TDF domains of skills (T1: median (interquartile range) = 4.7(3.3-5.3); T3 = 5.7(5.3-6.0), p < 0.01), belief about capabilities (T1 = 4.7(3.3-6.0); T3 = 5.7(5.0-6.0), p < 0.01), and goals (T1 = 4.3(3.7-5.0); T3 = 4.7(4.3-5.3), p < 0.01) at follow-up. Competence in using ‘open discovery questions’ increased post-training (T1 = 25% of responses; T2 = 96% of responses; T3 = 87% of responses, p < 0.001), as did participants’ confidence for having behaviour change conversations (T1 = 6.0(4.7-7.6); T2 = 8.1(7.1-8.8), p < 0.001), including an increased confidence in having behaviour change conversations with Aboriginal clients (T1 = 5.0(2.7-6.3); T2 = 7.6(6.4-8.3), p < 0.001). Conclusions Provision of additional support strategies to address intentions; memory, attention and decision processes; and behavioural regulation may enhance adoption and maintenance of HCS in routine practice. Wider implementation of HCS training could be an effective strategy to building capacity and support health professionals to use a person-centred, opportunistic approach to health behaviour change.

scholarly journals Preliminary Study of Pet Owner Adherence in Behaviour, Cardiology, Urology, and Oncology Fields

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Zita Talamonti ◽  
Chiara Cassis ◽  
Paola G. Brambilla ◽  
Paola Scarpa ◽  
Damiano Stefanello ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Treatment Protocol ◽  
Behavioural Medicine ◽  
Preliminary Study ◽  
Pet Owner ◽  
Time Assessment ◽  
Over Time ◽  
Significant Data

Successful veterinary treatment of animals requires owner adherence with a prescribed treatment plan. The aim of our study was to evaluate and compare the level of adherence of the owners of patients presented for behavioural, cardiological, urological, and oncological problems. At the end of the first examination, each owner completed a questionnaire. Then, the owners were called four times to fill out another questionnaire over the phone. With regard to the first questionnaire, statistically significant data concern behavioral medicine and cardiology. In the first area the owner’s worry decreases during the follow-up and the number of owners who would give away the animal increases. In cardiology, owners who think that the pathology harms their animal’s quality of life decreased significantly over time. With regard to the 9 additional follow-up questions, in behavioural medicine and urology the owner’s discomfort resulting from the animal’s pathology significantly decreases over time. Assessment of adherence appears to be an optimal instrument in identifying the positive factors and the difficulties encountered by owners during the application of a treatment protocol.

Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Personality Traits ◽  
Rating Scales ◽  
Suicide Attempts ◽  
World Health ◽  
Life Questionnaire ◽  
Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

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