scholarly journals Advancing the Understanding and Treatment of the Thoracic Inlet and Incorporation of a New Still Technique—Part 1

2017 ◽  
Vol 27 (3) ◽  
pp. 19-24
Author(s):  
Drew D. Lewis
Keyword(s):  
Effective Treatment ◽  
Treatment Approach ◽  
Osteopathic Manipulative Treatment ◽  
Global Approach ◽  
Thoracic Inlet ◽  
Treatment Approaches ◽  
Structural Relationships ◽  
Somatic Dysfunction ◽  
Circulatory Model

Abstract The osteopathic profession has long emphasized the importance of improving homeostasis and overall health through the use of osteopathic manipulative treatment (OMT). The respiratory-circulatory model seeks to achieve these goals by resolving somatic dysfunctions (SD) that may restrict venous and lymphatic return. One of the most significant somatic dysfunctions to address in this model is the thoracic inlet. Despite the emphasis on this somatic dysfunction, classic treatment approaches of the thoracic inlet remain some of the most challenging corrections. In this article, an approach to somatic dysfunction of the thoracic inlet (SDTI) with a new application of Still technique principles is presented. This technique offers a safe, efficient, and effective treatment approach for patients who may present with substantial comorbidities. Considerations for difficult to correct SDTI are discussed. In addition, a more global approach is presented—with an awareness of the dynamic structural relationships and functionality of the region—to treat SDTI with enhanced success.

scholarly journals Very long-term sequelae of craniopharyngioma

2017 ◽  
Vol 176 (6) ◽  
pp. 755-767 ◽  
Author(s):  
Mark Wijnen ◽  
Marry M van den Heuvel-Eibrink ◽  
Joseph A M J L Janssen ◽  
Coriene E Catsman-Berrevoets ◽  
Erna M C Michiels ◽  
...  
Keyword(s):  
Health Effects ◽  
Treatment Approach ◽  
Health Conditions ◽  
Subtotal Resection ◽  
Adult Onset ◽  
Childhood Onset ◽  
Treatment Approaches ◽  
Cyst Aspiration

Objective Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Design Cross-sectional study based on retrospective data. Methods We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5–23 years). Initial craniopharyngioma treatment approaches included gross total resection (n = 25), subtotal resection without radiotherapy (n = 44), subtotal resection with radiotherapy (n = 25), cyst aspiration without radiotherapy (n = 8), and 90Yttrium brachytherapy (n = 21). Results Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Conclusions Long-term health conditions were comparable after different initial craniopharyngioma treatment approaches and were generally more frequent in patients with childhood- compared with adult-onset disease.

Assessing the Impact of an Outpatient Education Program for Patients With Gestational Diabetes

1995 ◽  
Vol 21 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Mary W. Smits ◽  
Tish H. Paulk ◽  
Carolync. Kee
Keyword(s):  
Gestational Diabetes ◽  
Treatment Approach ◽  
Nursing Intervention ◽  
Research Model ◽  
Treatment Approaches ◽  
Moderating Variables ◽  
Backward Elimination ◽  
Input Variables ◽  
The Impact ◽  
First Time

In this descriptive study, two treatment approaches designed to help women with gestational diabetes manage their pregnancies were compared: a hospital, outpatient-based, nursing intervention and the traditional, office-based care provided by obstetricians. A research model was constructed using three variables suggested by the literature: input variables (risk factors prior to gestation), moderating variables (conditions that occur during pregnancy), and outcome variables (normal vs abnormal outcomes for mother and infant). This research model was used to contrast the two treatment approaches. The principal statistical procedure employed was logistic regression, a backward elimination method where the dependent variable is expressed as an odds ratio. Neither treatment approach significantly reduced the risk of abnormal outcomes for mother or infant. First-time mothers, patients with gestational diabetes on medications, and patients with gestational diabetes experiencing complications during pregnancy had a significantly greater risk of having an infant with one or more abnormal outcomes.

scholarly journals Effectiveness of spelling treatment approaches for learners with dyslexia – A meta-analysis and systematic review

2019 ◽  
Author(s):  
Katharina Galuschka ◽  
Ruth Görgen ◽  
Julia Kalmar ◽  
Stefan Haberstroh ◽  
Xenia Schmalz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Approach ◽  
Meta Analysis ◽  
High Impact ◽  
Treatment Approaches ◽  
Spelling Performance ◽  
Morphological Instruction ◽  
Spelling Intervention ◽  
Adolescents And Adults ◽  
Sample Characteristics

This systematic review and meta-analysis investigated the efficacy of spelling interventions for the remediation of dyslexia and spelling deficits. Theoretically important moderators, such as the treatment approach as well as orthographic and sample characteristics, were also considered. Thirty-four controlled trials that evaluated spelling interventions in children, adolescents and adults with dyslexia and spelling deficits were included. Results show that treatment approaches using phonics, orthographic (graphotactic or orthographic phonological spelling rules), as well as morphological instruction had a moderate to high impact on spelling performance. A significant influence of interventions that teach memorization strategies to improve spelling could not be confirmed. This work shows that understanding the principles of an orthography is beneficial for learners with dyslexia or spelling deficits and presents key components for effective spelling intervention.

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