scholarly journals Modern approaches to the assessment of comorbidity in patients

2019 ◽  
Vol 10 (1) ◽  
pp. 19-23
Author(s):  
Gulzhan I. Sarsenbayeva ◽  
Anar E. Tursynbekova
Keyword(s):  
Head And Neck ◽  
Rating Scale ◽  
Modern Medicine ◽  
Summary Score ◽  
Advantages And Disadvantages ◽  
Instrumental Assessment ◽  
Comorbidity Index ◽  
Comorbid Diseases ◽  
Index Index

Aim. To provide modern data on advantages and disadvantages of available international comorbidity scales and indices. Materials and methods. Data of 29 scientific sources published in Russian and foreign literature press within 1973-2018 are considered. Results. The presence of comorbidity in a patient is an issue of modern medicine. In most cases some comorbid diseases if timely diagnosed and managed in accordance with algorithms for medical care can be corrected and treated. In order to control risks of development of complications and to prescribe an effective therapy for comorbidity the international and national clinical guidelines have been created. They include algorithms for clinical and instrumental assessment of complications and provide scales and indices, such as Cumulative lllness Rating Scale (CIRS), Charlson comorbidity index, Kaplan-Feinstein index, Index of Co-Existent Disease (ICED), Geriatric Index of Comorbidity (GIC), Functional Comorbidity Index (FCI) et al. Data of Canadian comparative study of 5 international scales of comorbidity in patients with head and neck cancers showed a significant impact of comorbidity on survival of patients with different stages of neoplasms. It was emphasized that the index of comorbidity is necessary to control an impact of comorbid diseases on the patients' status in the long-term period. The Kaplan-Feinstein scale was the best index for assessing a survival of patients with head and neck cancer. According to V.de Groot, the most widely studied comorbidity index for predicting mortality is the Charlson index. Each index has its advantages and disadvantages and is used in different clinical situations. Conclusion. General comorbidity index is a comprehensive summary score of a disease combination or severity, which combines all conditions, problems and illnesses of patients, weights them by severity, and it significantly affects treatment tactics and outcome in a future.

Instrumental Assessment in Cleft Palate Care

2013 ◽  
Vol 23 (2) ◽  
pp. 49-61 ◽  
Author(s):  
Jamie Perry ◽  
Graham Schenck
Keyword(s):  
Cleft Palate ◽  
New Developments ◽  
Perceptual Evaluation ◽  
Advantages And Disadvantages ◽  
Instrumental Assessment ◽  
Speech Language Pathologist ◽  
Hypernasal Speech ◽  
Perceptual Assessment ◽  
Velopharyngeal Function ◽  
And Function

Despite advances in surgical management, it is estimated that 20–30% of children with repaired cleft palate will continue to have hypernasal speech and require a second surgery to create normal velopharyngeal function (Bricknell, McFadden, & Curran, 2002; Härtel, Karsten, & Gundlach, 1994; McWilliams, 1990). A qualitative perceptual assessment by a speech-language pathologist is considered the most important step of the evaluation for children with resonance disorders (Peterson-Falzone, Hardin-Jones, & Karnell, 2010). Direct and indirect instrumental analyses should be used to confirm or validate the perceptual evaluation of an experienced speech-language pathologist (Paal, Reulbach, Strobel-Schwarthoff, Nkenke, & Schuster, 2005). The purpose of this article is to provide an overview of current instrumental assessment methods used in cleft palate care. Both direct and indirect instrumental procedures will be reviewed with descriptions of the advantages and disadvantages of each. Lastly, new developments for evaluating velopharyngeal structures and function will be provided.

Head and Neck Paragangliomas Radiosurgery: Long-Term, Single-Institution Experience

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Marcello Marchetti ◽  
Valentina Pinzi ◽  
Francesco Prada ◽  
Elena De Martin ◽  
Valeria Cuccarini ◽  
...  
Keyword(s):  
Head And Neck ◽  
Single Institution ◽  
Head And Neck Paragangliomas

Problems of Distance Education

2018 ◽  
Vol 7 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Rostislav Fojtík
Keyword(s):  
Distance Education ◽  
Distance Learning ◽  
Computer Science ◽  
Full Time ◽  
Advantages And Disadvantages ◽  
E Learning ◽  
Educational Requirements

Abstract Distance learning and e-learning have significantly developed in recent years. It is also due to changing educational requirements, especially for adults. The article aims to show the advantages and disadvantages of distance learning. Examples of the 20-year use of the distance learning form of computer science describe the difficulties associated with the implementation and implementation of this form of teaching. The results of students in the full-time and distance form of teaching in the bachelor’s study of computer science are compared. Long-term findings show that distant students have significantly lower scores in the first years of study than full-time bachelor students. In the following years of study, the differences diminish, and students’ results are comparable. The article describes the possibilities of improving the quality of distance learning.

Possibilities and prospects of conservative therapy for endometriosis, as a chronical progressing disease (review of literature)

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Tatyana Yu. Pestrikova ◽  
Elena A. Yurasova ◽  
Igor V. Yurasov
Keyword(s):  
Quality Of Life ◽  
Abnormal Uterine Bleeding ◽  
Modern Medicine ◽  
Reproductive Age ◽  
Aim Analysis ◽  
Scientific Publications ◽  
Terra Incognita ◽  
Positive Effect

Relevance. Endometriosis is a common gynecological disease that affects up to 10% of women of reproductive age worldwide and is the main cause of pain and infertility. Endometriosis is a disease, although it has been known for a long time, nevertheless, in many ways it represents terra incognita for modern medicine. Aim. Analysis of literature on the feasibility of long-term and the use of the drug dienogest 2 mg (Vizanne), which has a positive effect on the quality of life of patients with endometriosis. Materials and methods. To write this review, a search was made for domestic and foreign publications in Russian and international search engines (PubMed, eLibrary, etc.) over the past 13 years. The review included articles from peer-reviewed literature. Results. The review presents data on the difficulties of verifying the diagnosis of endometriosis due to a combination of this pathology with pain, infertility, abnormal uterine bleeding. The pathogenesis of the origin of endometriosis-associated pain is presented. The efficacy of the use of the drug dienogest (Vizanne), which has a powerful antiproliferative effect that reduces the main symptoms of endometriosis (pain, bleeding), is substantiated. The expediency of long-term and safe use of the drug dienogest (Vizanne), which has a positive effect on the quality of life of patients with endometriosis, has been proved. Conclusions. Numerous scientific publications confirm the feasibility of prolonged use of the drug dienogest (Vizanne), to achieve remission during endometriosis.

Long-Term Follow-up on an Intensified Treatment Regimen for Advanced Resectable Head and Neck Squamous Cell Carcinomas

2001 ◽  
Vol 19 (2) ◽  
pp. 127-136 ◽  
Author(s):  
John C. Grecula ◽  
David E. Schuller ◽  
Roy Smith ◽  
Chris A. Rhoades ◽  
Subir Nag ◽  
...  
Keyword(s):  
Head And Neck ◽  
Treatment Regimen ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Long Term Follow Up

scholarly journals FRI0412 DOES SEVERE ACUTE POSTOPERATIVE PAIN RESULT IN MORE LONG-TERM PAIN AFTER TOTAL HIP OR KNEE ARTHROPLASTY (THA OR TKA) FOR OSTEOARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 805.2-805
Author(s):  
D. A. J. M. Latijnhouwers ◽  
C. H. Martini ◽  
R. G. H. H. Nelissen ◽  
H. M. J. Van der Linden ◽  
T. P. M. Vliet Vlieland ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Missing Values ◽  
Rating Scale ◽  
Acute Postoperative Pain ◽  
Preoperative Pain ◽  
Mixed Effect ◽  
Total Hip ◽  
Chronic Postsurgical Pain

Background:Chronic pain is a frequently reported unfavourable outcome of total hip and knee arthroplasties (THA/TKA) (7-23% and 10-34%, respectively) in osteoarthritis (OA) patients (1), which is difficult to treat as underlying mechanisms are not fully understood. Acute postoperative pain has been identified as risk factor for development of long-term pain in other surgical procedures, such as mastectomy and thoracotomy (2). However, the effect of acute postoperative pain on development of long-term pain in THA and TKA patients is unknown.Objectives:To investigate if acute pain following THA/TKA in OA patients is associated with long-term pain and if acute pain affects the course of pain up to 1-year postoperatively.Methods:From a longitudinal multicenter study, OA patients scheduled for primary THA or TKA were included. Acute pain scores, using Numeric Rating Scale (NRS), were routinely collected as part of standard care (≤72 hours after surgery). In case of ≥2 NRS scores the two highest scores were averaged (n=160), else the single score was taken. Pain was dichotomized into severe (NRS≥5) and mild (NRS<5). Pain was assessed preoperatively, at 3 (only THA), 6 and 12 months postoperatively using HOOS/KOOS subscale pain. Separate mixed-effect models for THA and TKA patients were used, with dichotomized acute pain as fixed-effect and long-term pain as outcome, while adjusting for confounders (age, sex, BMI, preoperative pain, mental component scale of the SF12 (MCS-12), and duration of the surgery and hospitalization). We included an interaction between time of measurement and acute postoperative pain to analyse whether effect modification was present. Missing values in preoperative pain and MCS-12 were imputed using multiple imputation methods.Results:81 THA and 87 TKA patients were included, of whom 32.1% and 56.3% reported severe acute pain. The results did not show an associated between severe acute pain and long term pain (THA: β=2.0, 95%-CI:-10.9-7.0; TKA: β=3.8, 95%-CI:-10.6-2.9). Furthermore, It seems that there is no effect present of difference in severity of acute pain and the course of pain over time (THA 6-months: β=6.4, 95%-CI:1.9-10.9 and 12-months: β=0.2, 95%-CI:-4.4-4.8; TKA 12-months: β=3.2, 95%-CI:-0.5-6.8).Conclusion:We did not find an association between acute pain and the development of long-term pain nor that severity of acute pain affects the course of postoperative pain in THA and TKA patients. The fact that THA and TKA patients often experience chronic preoperative pain might be a possible explanation for this finding. Nonetheless, future studies including additional measures of acute pain and pain sensitization in patients with chronic preoperative pain are necessary to draw stronger conclusions.References:[1]Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ open. 2012;2(1):e000435.[2]Katz J, Seltzer Ze. Transition from acute to chronic postsurgical pain: risk factors and protective factors. Expert review of neurotherapeutics. 2009;9(5):723-44.Acknowledgments:We would like to thank the study group that consists of: B.L. Kaptein, Leiden University Medical Center, Leiden; S.B.W Vehmeijer, Reinier de Graaf Hospital, Delft; R. Onstenk, Groene Hart Hospital, Gouda; S.H.M. Verdegaal, Alrijne Hospital, Leiderdorp; H.H. Kaptijn, LangeLand Hospital, Zoetermeer; W.C.M. Marijnissen, Albert Schweitzer Hospital, Dordrecht; P.J. Damen, Waterland Hospital, Hoorn; the NetherlandsDisclosure of Interests:None declared

Preliminary Report of Arthroscopically Assisted Sauvé–Kapandji Procedure for Distal Radioulnar Joint Arthritis

2021 ◽  
Author(s):  
Yukio Abe ◽  
Youhei Takahashi ◽  
Kenzo Fujii
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Kirschner Wire ◽  
Distal Radioulnar Joint ◽  
Contralateral Side ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Advantages And Disadvantages ◽  
Arthroscopically Assisted ◽  
Therapeutic Study

Abstract Background The arthroscopically assisted Sauvé–Kapandji (S-K) procedure has been described as a safe and promising technique for distal radioulnar joint (DRUJ) arthrodesis. Our purpose was to investigate the advantages and disadvantages of the arthroscopically assisted S-K procedure. Methods Eight patients underwent an arthroscopically assisted S-K procedure. All patients were diagnosed as DRUJ osteoarthritis (OA), including six primary DRUJ OA, one OA following a distal radius fracture, and one rheumatoid arthritis (RA). Arthroscopy was performed in neutral forearm rotation with vertical traction. The surface of the DRUJ was debrided through arthroscopy to expose the subchondral surface, and the DRUJ was fixed with a cannulated screw and Kirschner wire (K-wire) with zero or minus ulnar variance in the same posture. Bone graft was not performed. Results Bone union was achieved at 2 to 3.5 months postoperatively. At an average of 17-month follow-up, the pain intensity on 10-point numerical rating scale (NRS) decreased from 10 preoperatively to 0.4 postoperatively, average range of pronation significantly improved from 77 degrees to 89 degrees, and average grip strength as a percentage of contralateral side improved from 76 to 104%. Conclusion Satisfactory outcomes were achieved with the arthroscopically assisted S-K procedure. Advantages of this procedure included the ability to achieve union without bone grafting, preservation of the extensor mechanism integrity, and easy reduction of the ulnar head due to its wrist positioning. No major complications were encountered. Disadvantages included its required use of arthroscopic technique and potential contraindication for cases with severe deformity at the sigmoid notch. Level of Evidence This is a Level IV, therapeutic study.

scholarly journals Immune Check-Point Inhibitors and Standard Chemoradiotherapy in Definitive Head and Neck Cancer Treatment

2021 ◽  
Vol 11 (5) ◽  
pp. 393
Author(s):  
Francesca De Felice ◽  
Daniela Musio ◽  
Vincenzo Tombolini
Keyword(s):  
Clinical Trials ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Therapeutic Strategies ◽  
Check Point ◽  
Clinical Tool ◽  
Cancer Management ◽  
Check Point Inhibitors

In head and neck cancer management, there is a need for tailored approaches to optimally implement clinical outcomes. Based on the assumption that efficacy and long-term toxicity are not satisfactory for standard concurrent platinum-based chemoradiotherapy, several trials have been designed to test whether induction immunotherapy and/or concomitant immunotherapy and radiotherapy result in improved survival and toxicity outcomes. Here, we present an overview of the most recent concomitant therapeutic strategies for head and neck cancer, focusing on the knowledge available regarding check-point inhibitors. The aim is to present the characteristics of the main check-point inhibitors and to summarize the clinical trials on the combination of immune check-point inhibitors and (chemo)radiotherapy in the definitive HNC setting, in order to provide a useful clinical tool for further research.

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