Diagnosis and treatment of basilar artery perforator aneurysm: A 20-year review with proposed treatment guidelines

Abstract Background In 2018, an estimated 228 million cases of malaria occurred worldwide. Countries are far from having achieved reasonable levels of national protocol compliance among health workers. Lack of awareness of treatment protocols and treatment resistance by prescribers threatens to undermine progress when it comes to reducing the prevalence of this disease. This study sought to evaluate the degree of knowledge and practices regarding malaria diagnosis and treatment amongst prescribers working at the public health facilities of Bata, Equatorial Guinea. Methods A cross-sectional survey was conducted in October-December 2017 amongst all public health professionals who attended patients under the age of 15 years, with suspected malaria in the Bata District of Equatorial Guinea. Practitioners were asked about their practices and knowledge of malaria and the National Malaria Treatment Guidelines. A bivariate analysis and a logistic regression model were used to determine factors associated with their knowledge. Results Among the 44 practitioners interviewed, 59.1% worked at a Health Centre and 40.9% at the District Hospital of Bata. Important differences in knowledge and practices between hospital and health centre workers were found. Clinical diagnosis was more frequently by practitioners at the health centres (p = 0.059), while microscopy confirmation was more frequent at regional hospital (100%). Intramuscular artemether was the anti-malarial most administrated at the health centres (50.0%), while artemether-lumefantrine was the treatment most used at the regional hospital (66.7%). Most practitioners working at public health facilities (63.6%) have a low level of knowledge regarding the National Malaria Treatment Guidelines. While knowledge regarding malaria, the National Malaria Treatment Guidelines and treatment resistances is low, it was higher amongst hospital workers than amongst practitioners at health centres. Conclusions It is essential to reinforce practitioners’ knowledge, treatment and diagnosis practices and use of the National Malaria Treatment Guidelines in order to improve malaria case management and disease control in the region. A specific malaria training programme ensuring ongoing updates training is necessary in order to ensure that greater experience does not entail obsolete knowledge and, consequently, inadequate diagnosis and treatment practices.

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Diagnostic and treatment barriers to persistent somatic symptoms in primary care – representative survey with physicians

BMC Family Practice ◽

10.1186/s12875-021-01397-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Marco Lehmann ◽

Nadine Janis Pohontsch ◽

Thomas Zimmermann ◽

Martin Scherer ◽

Bernd Löwe

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Rating Scales ◽

Treatment Guidelines ◽

Somatic Symptoms ◽

Diagnosis And Treatment ◽

Treatment Barriers ◽

Adequate Treatment ◽

Physical Disease ◽

Federal States

Abstract Background Many patients consult their primary care physician with persistent somatic symptoms such as pain or sickness. Quite often these consultations and further diagnostic measures yield no medical explanation for the symptoms – patients and physicians are left in uncertainty. In fact, diagnostic and treatment barriers in primary care hinder timely health-care provision for patients suffering from persistent somatic symptoms (PSS). The significance of individual barriers is still unknown. We compare and quantify these barriers from the perspective of primary care physicians and identify subpopulations of primary care physicians who experience particular barriers as most severe. Methods We mailed a questionnaire to primary care physicians (PCP) in Germany and asked them which barriers they consider most important. We invited a random sample of 12,004 primary care physicians in eight federal states in Germany. Physicians provided anonymous mailed or online responses. We also mailed a postcard to announce the survey and a mail reminder. Main measures were Likert rating scales of items relating to barriers in the diagnosis and treatment of PSS in primary care. Information on demography and medical practice were also collected. Results We analyzed 1719 data sets from 1829 respondents. PCPs showed strongest agreement with statements regarding (1.) their lack of knowledge about treatment guidelines, (2.) their perceptions that patients with PSS would expect symptom relief, (3.) their concern to overlook physical disease in these patients, and (4.) their usage of psychotropic drugs with these patients. More experienced PCPs were better able to cope with the possibility of overlooking physical disease than those less experienced. Conclusions The PCPs in our survey answered that the obligation to rule out severe physical disease and the demand to relieve patients from symptoms belong to the most severe barriers for adequate treatment and diagnosis. Moreover, many physicians admitted to not knowing the appropriate treatment guidelines for these patients. Based on our results, raising awareness of guidelines and improving knowledge about the management of persistent somatic symptoms appear to be promising approaches for overcoming the barriers to diagnosis and treatment of persistent somatic symptoms in primary care. Trial registration German Clinical Trials Register (Deutschen Register Klinischer Studien, DRKS) https://www.drks.de/drks_web/setLocale_EN.do The date the study was registered: October 2nd 2017 The date the first participant was enrolled: February 9th 2018 DRKS-ID: DRKS00012942

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Parkinson's disease and Movement Disorders. Diagnosis and Treatment Guidelines for the Practicing Physician. 2000. Edited by Charles H. Adler, J. Eric Ahlskog. Published by Humana Press. 480 pages. C$187.00 approx.

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100052732 ◽

2001 ◽

Vol 28 (1) ◽

pp. 97-97

Author(s):

Connie Marras

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Movement Disorders ◽

Treatment Guidelines ◽

Diagnosis And Treatment

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Chinese Society of Clinical Oncology (CSCO) diagnosis and treatment guidelines for persistent/recurrent and metastatic differentiated thyroid cancer 2018 (English version)

Chinese Journal of Cancer Research ◽

10.21147/j.issn.1000-9604.2019.01.06 ◽

2019 ◽

Vol 31 (1) ◽

pp. 99-116

Author(s):

CSCO thyroid cancer working group ◽

Keyword(s):

Thyroid Cancer ◽

Clinical Oncology ◽

Differentiated Thyroid Cancer ◽

Treatment Guidelines ◽

Diagnosis And Treatment ◽

Chinese Society ◽

English Version

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Skin care physicians insight on epidemiological patterns, diagnosis and treatment modalities for female pattern hair loss

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20204997 ◽

2020 ◽

Vol 7 (1) ◽

pp. 11

Author(s):

Krishna Rajesh Kilaru ◽

Suhasini Attada ◽

Pooja Munnangi ◽

Manogna Chowdary Kilaru

Keyword(s):

Side Effects ◽

Hair Loss ◽

Treatment Guidelines ◽

Age Of Onset ◽

Platelet Rich Plasma ◽

Diagnosis And Treatment ◽

Treatment Modalities ◽

Common Side Effect ◽

Medication Cost ◽

Female Pattern Hair Loss

Background: Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. The underlying pathophysiology is multifactorial. There are no universally agreed treatment guidelines available. The objective of the study was to understand the diagnosis and treatment pattern of female pattern hair loss and the role of minoxidil topical formulation and its combination in the management of FPHL.Methods: Predesigned questionnaire on FPHL was prepared based on review of literature and was filled by 80 consultant dermatologists. Recorded data was statistically analyzed.Results: Common age of onset of FPHL was between 20 to 30 years. Majority (96.25%) have reported FPHL in association with psychological morbidity. The most preferred treatment in mild and severe FPHL was minoxidil 5% and platelet rich plasma (PRP) plus minoxidil respectively. Most dermatologists (47.5%) treated with minoxidil for over 6 months. Majority (27.5%) reported flaking as the most common side effect with minoxidil followed by dryness, scalp irritation and itching. Majority (27.5%) observed that long treatment duration was contributing to non-compliance followed by medication cost and side effects. Majority of the dermatologists (90%) felt the need for treatment guidelines in the current Indian scenario.Conclusions: Minoxidil was the most common preferred treatment for mild and severe FPHL. PRP is the most common choice of combination therapy with minoxidil. Minimizing side effects, patient education and universal treatment guidelines can help manage FPHL better.

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