scholarly journals Distinct Approaches in Managing Adult and Pediatric Trigger Finger

2021 ◽  
Vol 6 (2) ◽  
pp. 28-35
Author(s):  
Putu Feryawan Meregawa ◽  
John Nolan
Keyword(s):  
Treatment Outcomes ◽  
Adult Population ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Age Groups ◽  
Ring Finger ◽  
Trigger Finger ◽  
Common Disease ◽  
Consensus Recommendation ◽  
Cost Effective Treatment

Background: Trigger finger is the most common disease that causing pain in the adult population. Trigger finger may occur at any finger, which usually occurs in the thumb and ring finger. A1 pulley sheath or metacarpal-phalangeal joint. There is a different recommendation toward treatment options for trigger fingers in adults and pediatrics. Method: This paper is done by reviewing and searching journals with “trigger finger”, “treatment”, “pediatric trigger finger”, and “adult trigger finger” on the search engines. The authors found 45 journals that were suitable for our references. Outcome: Trigger finger treatments vary as there are many acceptable treatment options. There is a different choice of therapy that should be considered in adult and pediatric trigger fingers. This should be considered to get better treatment outcomes. Cost analysis is also important to choose the most cost-effective treatment for trigger finger patients. Conclusion: There is no exact consensus recommendation for choosing the exact treatment. pediatric trigger finger is caused by a multifactorial aspect resulting in unpredictable conservative treatment outcomes unlike in adults. The majority of trigger fingers in pediatrics will need surgical procedures while some cases of adult trigger fingers may resolve naturally. Further large studies are needed to develop a treatment algorithm in these two age groups that trigger fingers. Keywords: adult trigger finger, trigger finger, pediatric trigger finger, treatment.

scholarly journals Consensus recommendation on the use of therapeutic plasma exchange for adult neurological diseases in Southeast Asia from the Southeast Asia therapeutic plasma exchange consortium

2021 ◽  
Vol 13 ◽  
pp. 117957352110573
Author(s):  
Fu Liong Hiew ◽  
Win Min Thit ◽  
Mathew Alexander ◽  
Umapathi Thirugnanam ◽  
Sasitorn Siritho ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Plasma Exchange ◽  
Neurological Diseases ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Therapeutic Plasma Exchange ◽  
Clinical State ◽  
First Line ◽  
Consensus Recommendation ◽  
Satisfactory Outcome

Therapeutic plasma exchange (TPE) is an effective and affordable treatment option in most parts of Southeast Asia (SEA). In 2018, the SEA TPE Consortium (SEATPEC) was established, consisting of regional neurologists working to improve outcome of various autoimmune neurological diseases. We proposed an immunotherapeutic guideline prioritizing TPE for this region. We reviewed disease burden, evidence-based treatment options, and major guidelines for common autoimmune neurological disorders seen in SEA. A modified treatment algorithm based on consensus agreement by key-opinion leaders was proposed. Autoimmune antibody diagnostic testing through collaboration with accredited laboratories was established. Choice of first-line immunotherapies (IVIg/corticosteroid/TPE) is based on available evidence, clinicians’ experience, contraindications, local availability, and affordability. TPE could be chosen as first-line therapy for GBS, CIDP, MG (acute/short term), IgG, A paraproteinemic neuropathy, and NMDAR encephalitis. Treatment is stopped for acute monophasic conditions such as GBS and ADEM following satisfactory outcome. For chronic immune disorders, a therapy taper or long-term maintenance therapy is recommended depending on the defined clinical state. TPE as second-line treatment is indicated for IVIg or corticosteroids refractory cases of ADEM, NMOSD (acute), MG, and NMDAR/LGI1/CASPR2/Hashimoto’s encephalitis. With better diagnosis, treatment initiation with TPE is a sustainable and effective immunotherapy for autoimmune neurological diseases in SEA.

scholarly journals Treatment of paediatric trigger finger: a systematic review and treatment algorithm

2018 ◽  
Vol 12 (3) ◽  
pp. 209-217 ◽  
Author(s):  
M. E. Womack ◽  
J. C. Ryan ◽  
V. Shillingford-Cole ◽  
S. Speicher ◽  
G. D. Hogue
Keyword(s):  
Systematic Review ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Surgical Techniques ◽  
Rare Condition ◽  
Small Sample ◽  
Trigger Finger ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Number Of Patients

Purpose Paediatric trigger finger (PTF) is a rare condition as seen by the lack of studies published about paediatric populations. Due to this general lack of information, the steps to employ to correct this disorder, whether surgically or non-surgically, have not yet reached consensus status. The objective of this study is to review the published literature regarding treatment options for PTF in order to develop a proposed step-wise treatment algorithm for children presenting with trigger finger. Methods A systematic review of the literature was conducted on PubMed to locate English language studies reporting on treatment interventions of PTF. Data was collected on number of patients/fingers seen in the study, the category of the fingers involved, the number of patients/fingers undergoing each intervention and reported outcomes. Results Seven articles reporting on 118 trigger fingers were identified. In all, 64 fingers were treated non-surgically, with 57.8% (37/64) resolving. In all, 54 fingers were initially surgically treated, with 87% (47/54) resolving. In total, 34 fingers did not have resolution of symptoms following primary treatment, and 27 fingers received follow-up treatment, with 92.6% (25/27) resolving. Overall, 92.4% (109/118) of fingers achieved resolution of symptoms after all treatments were completed. Conclusion Limitations for this study included few prospective studies and small sample sizes. This is likely due to the rarity of PTF. This review of the literature indicated that a step-wise approach, including non-operative and surgical techniques, should be employed in the management of PTF. Level of Evidence III This work meets the requirements of the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).

scholarly journals The Management of Co-Morbidities in Patients with Heart Failure – Obstructive Sleep Apnoea

2017 ◽  
Vol 10 ◽  
Author(s):  
Andrew Coats
Keyword(s):  
Heart Failure ◽  
Obstructive Sleep Apnoea ◽  
Adult Population ◽  
Treatment Options ◽  
Sleep Apnoea ◽  
Response To Treatment ◽  
Consensus Recommendation ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Artery Disease

Heart failure (HF) patients are older and frequently present with multiple co-morbidities. Co- morbidities worsen patient symptoms and may contribute to the progression of heart failure, increase mortality or limit the therapeutic response to treatment. Obstructive sleep apnoea (OSA) affects 2–4% of the adult population world-wide and is associated with similar risk factors to HF, meaning it is a frequent finding in HF patients, including HFrEF, HFmrEF and HFpEF. OSA has consistently been shown to be associated with hypertension, coronary artery disease, arrhythmias, heart failure, and stroke. A thorough understanding of the diagnosis and treatment options of OSA is of paramount importance to the practising HF clinician. Patients may present to the HF specialist having been diagnosed by a formal sleep study or may be suspected of OSA because of symptoms of snoring, reports of obstructed breathing by the sleep partner or day-time sleepiness. The mainstay of treatment for OSA is a positive airway pressure mask which can be used in mild moderate and severe OSA. The need for therapy should be discussed with the patient and if the AHI is above 15/hr then treatment is indicated to reduce this to below 15. This is a consensus recommendation and no adequately powered clinical trials have shown this improves either mortality or the risk of disease progression. Other options are discussed

scholarly journals Evolution of the prevalence of obesity in the adult population in France, 2013–2016: the Constances study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sébastien Czernichow ◽  
Adeline Renuy ◽  
Claire Rives-Lange ◽  
Claire Carette ◽  
Guillaume Airagnes ◽  
...  
Keyword(s):  
Linear Trend ◽  
Adult Population ◽  
Age Groups ◽  
French Population ◽  
Obesity Prevalence ◽  
Point Change ◽  
Men And Women ◽  
Class 1 ◽  
Prevalence Of Obesity ◽  
Age And Sex

AbstractThis study provides trends in obesity prevalence in adults from 2013 to 2016 in France. 63,582 men and women from independent samples upon inclusion from the Constances cohort were included. Anthropometrics were measured at Health Screening Centers and obesity defined as a Body mass index (BMI) ≥ 30 kg/m2; obesity classes according to BMI are as follows: class 1 [30–34.9]; class 2 [35–39.9]; class 3 [≥ 40 kg/m2]. Linear trends across obesity classes by sex and age groups were examined in regression models and percentage point change from 2013 to 2016 for each age category calculated. All analyses accounted for sample weights for non-response, age and sex-calibrated to the French population. Prevalence of obesity ranged from 14.2 to 15.2% and from 14 to 15.3% in women and men respectively from 2013 to 2016. Class 1 obesity category prevalence was the only one to increase significantly across survey years in both men and women (p for linear trend = 0.04 and 0.01 in women and men respectively). The only significant increase for obesity was observed in the age group 18–29 y in both women and men (+ 2.71% and + 3.26% point increase respectively, equivalent to an approximate rise of 50% in women and 93% in men, p = 0.03 and 0.02 respectively). After adjustment for survey non-response and for age and sex distribution, the results show that class 1 obesity prevalence has significantly increased in both women and men from 2013 to 2016, and only in young adults in a representative sample of the French population aged 18–69 years old.

scholarly journals Music Interventions for Older Adults in Clinical Trials and Research Studies Across Cultures and Settings

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 930-930
Author(s):  
Tara Rose ◽  
Elyse Manzo ◽  
Katherine Erickson ◽  
Joshua Valenzuela
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Music Therapy ◽  
Psychological Symptoms ◽  
Treatment Options ◽  
Age Groups ◽  
Memory Loss ◽  
Music Intervention ◽  
Eligibility Criteria ◽  
The U.S

Abstract Music interventions and music therapy have become more common globally as nonpharmacological treatment options for memory loss, pain management, reduction of behavioral and psychological symptoms, and increased quality of life. Knowledge of multiethnic interventions is important when creating evidence-based programs within culturally diverse countries, such as the U.S. The purpose of this systematic review is to analyze music interventions for older adults across the globe to better understand emerging best practices. A review of all trials registered at clinicaltrials.gov and registries in the WHO Registry Network containing the key words “music therapy” were included, regardless of intervention type. Of the 627 studies generated, 449 met the eligibility criteria, with 11% enrolling only older adults and 89% enrolling older adults along with other age groups. Studies were conducted in 6 continents, 48 countries (23% in the U.S.), and in 23 languages. Music interventions for specific medical conditions (64%) or medical procedures (24%) were the primary foci in studies. While studies crossed multiple continents, less than 2% referenced ethnicity or culture in the study details. Detailed data on intervention types, demographics, measures, settings, and methodology will be presented. Results suggest that best practices in music therapy are being developed world-wide for the multitude of health challenges faced by older adults and demonstrate the diversity of music interventions in both medical and community settings. Information from this review can be used to improve the implementation of music intervention programs and may be particularly beneficial in countries with diverse multicultural populations.

scholarly journals Analysing the impact of the COVID-19 outbreak on everyday travel behaviour in Germany and potential implications for future travel patterns

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Viktoriya Kolarova ◽  
Christine Eisenmann ◽  
Claudia Nobis ◽  
Christian Winkler ◽  
Barbara Lenz
Keyword(s):  
Public Transport ◽  
Online Survey ◽  
Adult Population ◽  
Activity Patterns ◽  
Age Groups ◽  
Travel Behaviour ◽  
German Population ◽  
Travel Patterns ◽  
Home Office ◽  
The Impact

Abstract Introduction The global Coronavirus (COVID-19) pandemic is having a great impact on all areas of the everyday life, including travel behaviour. Various measures that focus on restricting social contacts have been implemented in order to reduce the spread of the virus. Understanding how daily activities and travel behaviour change during such global crisis and the reasons behind is crucial for developing suitable strategies for similar future events and analysing potential mid- and long-term impacts. Methods In order to provide empirical insights into changes in travel behaviour during the first Coronavirus-related lockdown in 2020 for Germany, an online survey with a relative representative sample for the German population was conducted a week after the start of the nationwide contact ban. The data was analysed performing descriptive and inferential statistical analyses. Results and Discussion The results suggest in general an increase in car use and decrease in public transport use as well as more negative perception of public transport as a transport alternative during the pandemic. Regarding activity-related travel patterns, the findings show firstly, that the majority of people go less frequent shopping; simultaneously, an increase in online shopping can be seen and characteristics of this group were analysed. Secondly, half of the adult population still left their home for leisure or to run errands; young adults were more active than all other age groups. Thirdly, the majority of the working population still went to work; one out of four people worked in home-office. Lastly, potential implications for travel behaviour and activity patterns as well as policy measures are discussed.

scholarly journals Oxidative Stress as a Possible Target in the Treatment of Toxoplasmosis: Perspectives and Ambiguities

2021 ◽  
Vol 22 (11) ◽  
pp. 5705
Author(s):  
Karolina Szewczyk-Golec ◽  
Marta Pawłowska ◽  
Roland Wesołowski ◽  
Marcin Wróblewski ◽  
Celestyna Mila-Kierzenkowska
Keyword(s):  
Oxidative Stress ◽  
Animal Studies ◽  
Treatment Options ◽  
Natural Antioxidants ◽  
Redox Status ◽  
Host Cells ◽  
Common Disease ◽  
Parasite Viability

Toxoplasma gondii is an apicomplexan parasite causing toxoplasmosis, a common disease, which is most typically asymptomatic. However, toxoplasmosis can be severe and even fatal in immunocompromised patients and fetuses. Available treatment options are limited, so there is a strong impetus to develop novel therapeutics. This review focuses on the role of oxidative stress in the pathophysiology and treatment of T. gondii infection. Chemical compounds that modify redox status can reduce the parasite viability and thus be potential anti-Toxoplasma drugs. On the other hand, oxidative stress caused by the activation of the inflammatory response may have some deleterious consequences in host cells. In this respect, the potential use of natural antioxidants is worth considering, including melatonin and some vitamins, as possible novel anti-Toxoplasma therapeutics. Results of in vitro and animal studies are promising. However, supplementation with some antioxidants was found to promote the increase in parasitemia, and the disease was then characterized by a milder course. Undoubtedly, research in this area may have a significant impact on the future prospects of toxoplasmosis therapy.

scholarly journals Neighbourhood characteristics as a predictor of adherence to dietary recommendations: A population-based cohort study of Finnish adults

2020 ◽  
pp. 140349482097149
Author(s):  
Hanna Lagström ◽  
Jaana I. Halonen ◽  
Sakari Suominen ◽  
Jaana Pentti ◽  
Sari Stenholm ◽  
...  
Keyword(s):  
Population Density ◽  
Dietary Habits ◽  
Metabolic Diseases ◽  
Adult Population ◽  
Age Groups ◽  
Population Based ◽  
Dietary Recommendations ◽  
Neighbourhood Characteristics ◽  
Severe Life Events ◽  
Dietary Score

Aims: To investigate the association of six-year cumulative level of socioeconomic neighbourhood disadvantage and population density with subsequent adherence to dietary recommendations, controlling for preceding dietary adherence, in adults in Finland. Methods: Population-based Health and Social Support (HeSSup) study participants from four age groups (20–24, 30–34, 40–44 and 50–54 years at baseline in 1998). Data on diet and alcohol consumption were obtained from the 2003 and 2012 surveys and information on neighbourhoods from Statistics Finland Grid database ( n = 10,414 men and women). Participants diet was measured as adherence to Nordic Nutrition recommendation (score range 0–100). Neighbourhood disadvantage was measured by median household income, proportion of those with primary education only and unemployment rate, and population density by the number of adult population between years 2007 and 2012. Linear models were used to assess the associations of neighbourhood characteristics with the score for adherence to dietary recommendations in 2012. Results: Cumulative neighbourhood socioeconomic disadvantage was associated with slightly weaker (1.49 (95% confidence interval (CI) −1.89 to −1.09) point decrease in dietary score) adherence while higher population density was associated with better (0.70 (95% CI 0.38−1.01) point increase in dietary score) adherence to dietary recommendations. These associations remained after controlling for prior dietary habits, sociodemographic, chronic cardio-metabolic diseases, and severe life events. Conclusions: These longitudinal findings support the hypothesis that neighbourhood characteristics affect dietary habits.

Educational Session: Managing Chronic Myeloid Leukemia as a Chronic Disease

Hematology ◽  
2011 ◽  
Vol 2011 (1) ◽  
pp. 128-135 ◽  
Author(s):  
Andreas Hochhaus
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Blast Crisis ◽  
Treatment Options ◽  
Age Groups ◽  
Continuous Treatment ◽  
Symptomatic Therapy ◽  
Therapeutic Success

Abstract Elucidation of the pathogenesis of chronic myeloid leukemia (CML) and the introduction of tyrosine kinase inhibitors (TKIs) has transformed this disease from being invariably fatal to being the type of leukemia with the best prognosis. Median survival associated with CML is estimated at > 20 years. Nevertheless, blast crisis occurs at an incidence of 1%-2% per year, and once this has occurred, treatment options are limited and survival is short. Due to the overall therapeutic success, the prevalence of CML is gradually increasing. The optimal management of this disease includes access to modern therapies and standardized surveillance methods for all patients, which will certainly create challenges. Furthermore, all available TKIs show mild but frequent side effects that may require symptomatic therapy. Adherence to therapy is the key prerequisite for efficacy of the drugs and for long-term success. Comprehensive information on the nature of the disease and the need for the continuous treatment using the appropriate dosages and timely information on efficacy data are key factors for optimal compliance. Standardized laboratory methods are required to provide optimal surveillance according to current recommendations. CML occurs in all age groups. Despite a median age of 55-60 years, particular challenges are the management of the disease in children, young women with the wish to get pregnant, and older patients. The main challenges in the long-term management of CML patients are discussed in this review.

scholarly journals The spatial epidemiology of alcohol-related mortality among the Czech adult population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Kazmer ◽  
I Kulhanova ◽  
M Lustigova
Keyword(s):  
Local Community ◽  
Spatial Epidemiology ◽  
Adult Population ◽  
Age Groups ◽  
Health Determinants ◽  
Mortality Data ◽  
Annual Data ◽  
Cross Sectional ◽  
Inequalities In Health ◽  
Related Mortality

Abstract Background In Czechia, alcohol-induced deaths account for a significant portion of preventable mortality. As inequalities in health are both socially and spatially determined, the paper aims at the detailed examination of socio-geographic inequalities of this phenomenon. Methods The 2011-2015 annual data on both ICD-10 cause-specific deaths (K70; F10; X45/64; Y15) and mid-year population were obtained from the official Czech registries - the data were cross-classified by gender, 5-year age-groups, and permanent residence (N = 6,302 small area spatial units). The selected socio-demographic indicators (education, unemployment, religious population) from the Czech 2011 Census were spatially merged to the mortality dataset. From the data on education and unemployment, composite deprivation index (DI) was derived. In the adult population aged 25+, the age-standardised mortality ratios (SMR) were computed for each of the spatial units, separately by genders. The SMRs were spatially modelled by the Besag-York-Mollié (BYM) autoregressive approach, applying a fully bayesian framework integrated within the INLA R-package. The study applied cross-sectional design and employed ecological regression conducted on observational data. Results Compared to the Czech average, the highest SMRs were located in the historical regions of Moravia [SMR=1.15; 95%CI: 1.11-1.19] and Silesia [SMR=1.59; 95%CI: 1.52-1.66]. The SMRs were significantly correlated with DI among males [Rel.Risk=1.15; 95%CI: 1.11-1.19], and with religiousness rate among females [Rel.Risk=0.83; 95%CI: 0.77-0.90]. Conclusions Significant socio-geographic inequalities were detected, particularly with respect to the Czech historical regions. Among males, higher mortality was associated with a structural deprivation. Among females, protective effect of religiousness rate was found to be significant. The results highlight an importance of both socially and spatially integrated efforts for public health promotion. Key messages The inequalities in health are both socially and spatially contextualised. The paper presents robust empirical evidence in favour of the proposition, as examined on alcohol-related mortality data. The health determinants may be gender sensitive. Males might be more responsive to a structural disadvantage. Among females, cultural factors related to a local community might be more relevant.

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