scholarly journals The Role of Telemedicine for Symptoms Management in Oral Medicine: Retrospective Study

Author(s):  
Zahra Alsafwani ◽  
Caroline Shiboski ◽  
Alessandro Villa

Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had devastating effect on access to care in many specialties and dental services including oral medicine. Following the shelter‐in‐place orders in March 2020, we implemented Tele(oral)medicine practices for the diagnosis and management of some oral medicine conditionsObjectives: To assess the effectiveness of telemedicine visits with respect to pain control among patients affected by oral diseases. Methods: A retrospective chart review for all the new patients seen at their first visit via telemedicine between April 2020 and December 2020. The patient-reported pain score was recorded at each visit using a 0-10 scale. Differences in oral pain from the first fist to the follow-up visit of the patients were evaluated using the Wilcoxon signed-rank test. Results: A total of 137 new patients were included with a median age of 56 years. If seen in person, patients would have travelled a median distance of 65 miles. The most common oral conditions seen were reactive/inflammatory lesions. There was a 3-point median pain reduction from the first video visit to the first follow-up (p<0.05) and a self-reported 65% median improvement of oral symptoms. Conclusion: Tele(oral)medicine was an effective method for symptoms management of oral medicine conditions.

2020 ◽  
Vol 19 ◽  
pp. 153473542098347
Author(s):  
Ellen Conte ◽  
Mark Legacy ◽  
Athanasios Psihogios ◽  
Anne Pitman ◽  
Andrea Redway ◽  
...  

Background: Lung cancer is the leading cause of cancer mortality in Canada, yet patients are often under-supported. A six-week program called Inspire Now, created to address unmet supportive care needs, was evaluated in this study. Feasibility and preliminary outcomes were assessed in order to inform future changes to the program. Objectives: (1) Assess the feasibility of the program and its evaluation; (2) pilot the collection of patient-reported outcomes; (3) identify outcomes that may be positively influenced; and (4) inform program modifications. Methods: Participants were recruited from the first session of Inspire Now for an observational pilot study. The primary outcome was feasibility. Secondary outcomes included within-person changes in Functional Assessment of Cancer Therapy – Lung (FACT-L) and Measure Yourself Concerns and Wellbeing (MYCaW), and program satisfaction and qualitative experiences of participants and facilitators through internally-developed questionnaires and semi-structured interviews. Analysis was primarily descriptive, within person changes in FACT-L and MYCaW were analyzed using the Wilcoxon signed-rank test and qualitative data was assessed for common themes. Results: The program and its evaluation were feasible; 8 of 9 (89%) participants consented to the study, median attendance was 6 of 6 sessions (IQR 4.5-6), and questionnaire completion was 100% at baseline and 75% at follow-up. There were clinically meaningful improvements in MYCaW concern 1 (−1.2, 95% CI −2.0 to −0.4) and overall wellbeing (−0.9, 95% CI −2.1 to 0.4). Seven of eight FACT-L sub-sections trended toward improvement, with absolute changes ranging from −1.7 to 10.8%. Participant feedback was overwhelmingly positive; group support and social interactions were highly valued. Conclusions: The group intervention for people with lung cancer was feasible to both run and evaluate. Participants responded positively to the program. Findings will inform changes to future sessions and an analysis of multiple sessions is planned.


Author(s):  
Debanjali Sinha ◽  
Sumantro Mondal ◽  
Arijit Nag ◽  
Debasish Lahiri ◽  
Alakendu Ghosh

Background: The objective of the present study was to monitor the disease activity of Takayasu arteritis clinically by the Indian Takayasu Activity Score 2010 (ITAS) and ultra sonographically by Colour Doppler Ultrasound-Kolkata (CDUS-K) Score after 12months of treatment with methotrexate and steroid, and to find the correlation between these two scores.Methods: Around 25 Angiographically proven Takayasu arteritis patients were treated with Methotrexate (15mg weekly) and Steroids (1mg/kg/day for 6weeks and then tapered) for 12months. Wilcoxon matched pair signed rank test was done to assess the change in ITAS 2010 with treatment. A correlation study was done between ITAS 2010 and change in CDUS-K scores at the end of 12months.Results: By Wilcoxon’s matched pair signed rank test, a non-significant change of ITAS 2010 (p=0.066) was observed at the end of 12months, which means that the treatment helps to control the disease progression by preventing a significant increase in ITAS 2010. Strong correlation (correlation coefficient of 0.878, 95% CI = 0.602 to 1.000) was found between the ITAS 2010 and change in CDUS-K scores at 12months follow up.Conclusions: The combination of Methotrexate and steroids helps to control the disease progression in Takayasu arteritis. Colour doppler ultrasonography may serve as a reliable and safe surrogate disease activity measure at follow up, as it avoids the radioactivity exposure and invasiveness of angiography.


2021 ◽  
Vol 12 (11) ◽  
pp. 22-28
Author(s):  
Asif Jeelani ◽  
Shafat Sideeq Lone ◽  
Hilal Rather

Background: COVID-19 diagnosis should serve as an impetus for smokers to discontinue its use. The study was conducted to estimate the change in cigarette dependence among newly diagnosed COVID-19 cases. Aims and Objectives: COVID-19 diagnosis should serve as an impetus for smokers to discontinue its use. The study was conducted to estimate change in cigarette dependence among newly diagnosed COVID-19 cases. Materials and Methods: Study was conducted between October and December 2020 and newly diagnosed male COVID-19 patients who were current smokers at diagnosis were recruited from two hospitals involved in testing and treatment of COVID-19. Baseline socioclinical information was recorded at diagnosis in addition to the estimation of cigarette dependence using Fagerstrom Test for Nicotine Dependence (FTND) and health status using Post-COVID-19 Functional Scale (PCFS). Follow-up was done at 2 weeks after recovery using both FTND and PCFS scales. Wilcoxon signed-rank test, paired t-test, and ANOVA were used for univariate analysis and multivariate regression was done. Results: A total of 171 subjects with mean age of 43.79 years were included in the study. FTND scores decreased significantly from the day of diagnosis to follow-up visit with 79% of subjects reporting a decrease. On univariate analysis, decrease in FTND had a significant association with presence of comorbidity, any symptoms, presence of respiratory symptoms, and if supplemental oxygen was administered. On multivariate analysis, symptomatic COVID-19 disease, higher age, PCFS at baseline, and PCFS at follow-up had a significant association with decreased PCFS values at follow-up. Conclusion: COVID-19 diagnosis was followed by significant decrease in FTND score, particularly for symptomatic and older subjects. Post-COVID follow-up visits should be used asan opportunity by health providers to ensure its sustainability and for achieving cessation.


2020 ◽  
Vol 10 (4) ◽  
pp. 166-156
Author(s):  
Fatma Ülkü Yıldız ◽  
Aysel Cagdas ◽  
Gokhan Kayili

It was the aim of this study to follow-up for 2 years the mathematics and daily living skills of children whose mothers participated in the Montessori training programme for mothers (MTPM) and to determine whether the children still maintained these skills 2 years after the intervention. In 2016–2017, the MTPM was administered to the mothers of 4–5-year-old children who received Montessori education at preschool. The first follow-up was carried out 6 months after the training programme was completed; the second follow-up took place 6 months after the first follow-up and the third one was carried out12 months after the second follow-up. Eleven children included in the study group in the 2016–2017 school year were all reached. ‘Basic School Skills Inventory 3 – Mathematics and Daily Living Skills subtests – Age 4–8 years’ were used for data collection. The data were provided by the teachers. Statistical analysis of the data was carried out using Wilcoxon’s signed-rank test and Statistical Package for the Social Sciences 20.0 data analysis package programme. The results showed that the MTPM maintained its effect on mathematics and daily living skills of the experimental group children 24 months after the implementation of the programme.   Keywords: Montessori training programme for mothers, mathematics, daily living skills.


2019 ◽  
Vol 7 (4) ◽  
pp. 299-303
Author(s):  
Nadia Waqas ◽  
Muhammad Amer Saleem

Objective: To study the effect of combination of two therapies i.e. Microneedling with Dermaroller alternating with Chemical Reconstruction Skin Scar (CROSS) peeling with 30% TCA in management of acne induced scarring.Patients and Methods: This experimental study was conducted in the department of Dermatology, Benazir Bhutto Hospital, Rawalpindi from March 2017 to December 2017. A total of 20 patients underwent microneedling with dermaroller at week=0 (baseline) and were subjected to CROSS peeling with 30% TCA on follow up after 2 weeks. Four sessions of each procedure were repeated at 2 weeks’ interval. Photographs were taken at baseline and 4 weeks after the end of therapy (week=18). The baseline and final photographs were assessed for acne scar grading as per Goodman and Baron qualitative scale by two dermatologists who were blinded to the whole study.Results: Out of 20 patients, 16 (80%) of the patients had grade IV acne scarring and 4 (20%) had grade III scarring at baseline (week=0). On assessment at 4 weeks after the end of therapy (week=18), 16 patients who were having grade IV acne 6 (37.5%) improved to grade III, and 10 (62.5%) improved to grade II. Out of 4 patients who were initially having grade III at week=0, all 4 (100%) improved to grade II by week=18. A Wilcoxon signed rank test showed highly significant improvement in the grading of scarring (z=-3.92, p=0.00008).Conclusion: The combination therapy of microneedling with dermaroller, alternating with CROSS peeling with 30% TCA was highly effective in treating all types of atrophic acne scarring.


2020 ◽  
Author(s):  
Wenbin Tan ◽  
Guiling Li ◽  
Li Du ◽  
Xiuqi Wei ◽  
Xiaoling Cao ◽  
...  

Abstract Background: COVID-19 patients develop hypolipidemia. However, it is unknown whether lipid levels have improved in recovered patients.Objective: In this follow-up study, we evaluated serum lipidemia and other physiopathological laboratory values in recovered patients.Methods: A 3–6 month follow-up study was performed between June 15 and September 3, 2020, to examine serum levels of laboratory values in 107 discharged COVID-19 patients (mild = 59; severe/critical = 48; diagnoses on admission). 61 patients had a revisit chest CT scan. A Wilcoxon signed-rank test was used to analyze changes in laboratory values at admission and follow-up.Results: LDL-c and HDL-c levels were significantly higher at follow-up than at admission in severe/critical cases (p < 0.05). LDL-c levels were significantly higher at follow-up than at admission in mild cases (p < 0.05). With adjustment of the factor of traditional Chinese medicine, LDL-c and HDL-c levels were significantly improved at follow-up than at admission in severe/critical cases (p < 0.05). Coagulation and liver laboratory values were significantly lower at follow-up than at admission for patients (p < 0.05). Increases in HDL-c significantly correlated with increases in numbers of white blood cells (p<0.001) and decreases in levels of C-reactive protein (p < 0.05) during patients’ recovery. Residue lesions were observed in CT images in 69% (42 of 61) of follow-up patients.Conclusions: Improvements of LDL-c, HDL-c and incomplete absorption of lung lesions were observed at 3–6 month follow-up for recovered patients, indicating that a long-term recovery process could be required.


Biomimetics ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 17 ◽  
Author(s):  
Sonja Steinert ◽  
Kai Zwanzig ◽  
Helga Doenges ◽  
Joern Kuchenbecker ◽  
Frederic Meyer ◽  
...  

The aim of this observational study was to analyze the effect of a toothpaste with biomimetic zinc hydroxyapatite (HAP) on subjective parameters after a four-week home use. Patients with subjective dentin hypersensitivity were recruited at three dental practices in Germany and received a questionnaire with visual analogue scales and Likert scales both at baseline and follow-up. The questionnaire was specifically developed for this study and focused on questions about subjective parameters like dentin hypersensitivity, tooth surface texture, tooth color, and freshness after toothbrushing. Patients answered the questionnaire both at baseline and after a four-week home use (follow-up) of the HAP toothpaste. Data of 46 patients were analyzed by paired t-test and non-parametric Wilcoxon signed-rank test, respectively. Subjective parameters on dentin hypersensitivity were reduced after the four-week use of the HAP toothpaste (p < 0.001). Additionally, patients assessed their tooth surface as smoother (p < 0.001), tooth color as whiter (p = 0.003), and reported a stronger feeling of freshness after toothbrushing (p = 0.014) after four-week use of the HAP toothpaste compared to the previously used toothpaste. In conclusion, the tested toothpaste with biomimetic HAP is well-suited for individuals suffering from dentin hypersensitivity, because subjective symptoms on dentin hypersensitivity were reduced. Additionally, patients reported smoother and whiter teeth after using the HAP toothpaste.


Author(s):  
Anne Fischer ◽  
Christian Vorländer ◽  
Hüdayi Korkusuz

Abstract Purpose To investigate the effectiveness of high-intensity focused ultrasound (HIFU) of solid and complex benign thyroid nodules. Methods Fifty-eight patients with benign thyroid nodules were treated with HIFU at two centers from 2014–2019. The device, EchoPulse (Teraclion, Malakoff, France), heats the nodes to 80–90 °C. Nodal volumes were measured by ultrasound at regular intervals before and up to 12 months after therapy. In a retrospective long-term two-center study, average volume reductions in relation to baseline volume were statistically analyzed by the Wilcoxon signed-rank test. Side effects were documented. Results In solid nodules, the average percent volume reductions at the 3, 6, 9, and 12-months follow-up were 49.98%, 46.40%, 65.77%, and 63.88%, respectively. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3, 6, and 9-months follow-up. In complex nodules, the average percent volume reduction was 35.2% at 3 months, 36.89% at 6 months, and 63.64% at twelve months follow up. The results were significant with p<0.05 in the Wilcoxon signed-rank test at the 3- and 6-months follow-up. The complication rate was 5.2%. All complications occurred in patients with solid nodules. Conclusion The study showed that HIFU is an effective treatment method for both solid and complex nodules. The complication rate is relatively high at 5.2%. No long-term complications occurred. The solid nodules responded better to HIFU than complex nodules.


2019 ◽  
Author(s):  
Tania Santiago ◽  
Mariana Santiago ◽  
Margarida Coutinho ◽  
Maria Joao Salvador ◽  
JAP Da Silva

Abstract Objective To assess changes in skin stiffness in SSc patients using SWE during a five-year follow-up. Methods Skin stiffness [i.e. shear-wave velocity values (SWV) in m/s] was assessed by SWE ultrasound (using virtual touch image quantification) at the 17 sites of the mRSS, in each participant, at baseline and follow-up. mRSS was performed at both time points. Differences between groups were analysed using the related-samples Wilcoxon Signed Rank test and the Mann–Whitney U test. Results We included 21 patients [85.7% females; mean age 56.3 (10.4) years at baseline, 57.1% with limited SSc] and, 15 healthy controls [73.3% females; mean age 53.6 (14.1) years)]. The median follow-up was 4.9 (0.4) years. Skin stiffness decreased significantly at all Rodnan sites (p≤0.001), (except in the fingers), in SSc patients, over time. The same phenomenon occurred in controls, but to a lesser degree, in terms of percentage change. The percentage reduction in skin stiffness varied in the different Rodnan sites and in different phases of the disease. In addition, SWV values also decreased significantly in 15/16 skin sites with local normal Rodnan at baseline, whereas local Rodnan skin score only changed significantly in the upperarm (p=0.046) and forearm (p=0.026). Conclusion This study provides first-time evidence suggesting that skin SWV values are more sensitive to change over time than mRSS, and reduce significantly over time in SSc and normal controls.


2020 ◽  
Author(s):  
Guiling Li ◽  
Li Du ◽  
Xiaoling Cao ◽  
Xiuqi Wei ◽  
Yao Jiang ◽  
...  

AbstractCOVID-19 patients develop hypolipidemia. However, it is unknown whether lipid levels have improved in recovered patients. In this study, a 3–6 month follow-up study was performed to examine serum levels of laboratory values in 107 discharged COVID-19 patients (mild = 59; severe/critical = 48; diagnoses on admission). 61 patients had a revisit chest CT scan. A Wilcoxon signed-rank test was used to analyze changes in laboratory values. LDL-c and HDL-c levels were significantly higher at follow-up than at admission in severe/critical cases (p < 0.05). LDL-c levels were significantly higher at follow-up than at admission in mild cases (p < 0.05). With adjustment of the factor of traditional Chinese medicine, LDL-c and HDL-c levels were significantly improved at follow-up than at admission in severe/critical cases (p < 0.05). Increases in HDL-c significantly correlated with increases in numbers of white blood cells (p<0.001) and decreases in levels of C-reactive protein (p < 0.05) during patients’ recovery. Residue lesions were observed in CT images in 69% (42 of 61) of follow-up patients. We concluded that improvements of LDL-c, HDL-c and incomplete absorption of lung lesions were observed at follow-up for recovered patients, indicating that a long-term recovery process could be required.


Sign in / Sign up

Export Citation Format

Share Document