specialist treatment
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2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Michael Linden ◽  
Ulrike Linden ◽  
David Goretzko ◽  
Jochen Gensichen

AbstractMultimorbidity is more than just the addition of individual illnesses, and its diagnosis and treatment poses special problems. General practitioners play an important role in looking after multimorbid patients. The aim of this study is to assess the prevalence and pattern of acute and chronic multimorbidity in primary care patients, regardless of body system and age group. A convenience sample of 2099 patients treated by 40 general practitioners was assessed using the Burvill scale. This measure of multimorbidity differentiates according to organ system and covers both acute and chronic illnesses. It also allows severity ratings to be assessed for both acute and chronic conditions, and thus patients’ actual need for general practice care. Patients reported an average of 3.5 (SD = 2.0) acute and/or chronically affected body systems. Overall, 12.7% of patients reported only one health problem, 83.0% at least two, 65.8% at least three, 46.1% at least four, and 29.7% five or more. The most frequent problems were musculoskeletal (62.5%) and psychological (56.6%). Some morbidities were interrelated, while others co-occurred despite being medically independent. In primary care, multimorbidity is the rule rather than the exception. Acute and chronic morbidity both contribute to the burden of illness. Body systems reflect treatment needs. Instead of specialist treatment for individual illnesses, an integrative treatment approach is needed. This is the specialty of general practitioners.


2022 ◽  
pp. 207-219
Author(s):  
Roman Gumzej ◽  
Lidija Fošnarič

Multidisciplinary cooperation of participating healthcare professionals, use of common standards in diagnostics, and clinical pathways in the treatment of vascular patients should provide for a higher-quality clinical practice. Using telemedicine, a more efficient way of obtaining specialist treatment is achievable. However, its introduction may raise safety and security issues, which originate from its enabling information technology. In this chapter, a model of patient-telemonitoring after revascularization procedures in the lower extremities is presented. A protocol for proper authentication and authorization to access medical equipment and patient medical records has been introduced. The associated clinical study has shown that most post-operative follow-up examinations can successfully be performed by trained nurses. Hence, improvements to healthcare logistics, mainly due to shortening waiting times for specialist treatment and the reduction of follow-up examinations on the secondary healthcare level, can be achieved using telemedicine.


Author(s):  
Barbara Rafałowicz ◽  
Leopold Wagner ◽  
Juliusz Rafałowicz

AbstractSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is characterized by variable clinical features, different durations, and several previously unheard-of late complications. Knowledge about this infection is constantly evolving.The aim of the study is to present selected cases of the most common symptoms of long COVID in the oral cavity.Among the 1,256 studied patients, 32% of them had discoloration, ulceration, and hemorrhagic changes on the oral mucosa, 29.69% had mycosis located on the tongue, 25.79% of patients had aphthous-like lesions on the hard palate, and in 12.5% atrophic cheilitis was observed. During the anamnesis, approximately 60% of patients reported salivary secretory disorders in the initial period of infection, which is 6.68% prolonged up to 4 months after systemic symptoms disappeared. In an extreme case, an aphthous-like lesion was located on the hard palate, which persisted for 6 months. Approximately 36% of patients did not agree to the proposed treatment. As a result, they only received recommendations on the use of oral hygiene products and received weekly check-ups. In this group of patients, most pathological changes spontaneously cleared after 3 weeks. The elderly with coexisting diseases, persons with a more severe SARS-CoV-2, and hospitalized patients had more extensive and severe lesions in the oral cavity that persisted for a long time after infection.In patients after the SARS-CoV-2 infection and suspected of this infection, a detailed intraoral examination should be performed, and the patient must be obligatorily monitored for a minimum period of 6 months. Depending on the patient's clinical condition, changes in the oral cavity require observation, basic or specialist treatment. In the case of changes in the cavity without pain symptoms, observation should be made for approximately 4 weeks and wait for the spontaneous regression of the changes. However, when pain occurs, a good solution is to use laser biostimulation. In the case of complex pathological changes occurring in the oral cavity, the patient should be directed for specialist treatment.


UK-Vet Equine ◽  
2021 ◽  
Vol 5 (5) ◽  
pp. 222-224
Author(s):  
Marie Rippingale

Many donkeys are now kept as pets rather than working animals. This means they often live longer, with many now reaching 20-years-old and being classed as geriatric. These donkeys often require specialist treatment and management, as they are prone to certain conditions such as dental disease and arthritis. The owner should be fully involved with treatment plans and supported through any environmental changes. When the time comes, the quality of life of the geriatric donkey should be assessed carefully, and the owner should be guided through the resulting decisions with support and dignity for their much-loved companion.


2021 ◽  
Author(s):  
◽  
Carlos Riegelhaupt-Landreani

<p>This study aimed to explore how the use of music therapy can support prisoners in a specialist treatment unit at a prison in Aotearoa New Zealand. The research was initially designed using action research methodology to evaluate how I, a music therapy student, can support men at a special treatment unit in a prison setting in Aotearoa New Zealand. Seven weeks into my placement a rapidly escalating response to the Covid-19 global pandemic put my placement on hold indefinitely. In response to the challenges of not being able to attend placement, the research framework was changed to exploratory research. My question evolved into a theoretical exploratory study seeking to find out how music therapy can provide support in prisons. Documentation of music therapy is scarce in the New Zealand context; thus, the exploration was guided by a broad international literature search. Thematic analysis was used to develop themes about the reviewed literature and from reflective data identified in my clinical journal. The findings provide a broad scope of understanding of how music therapy is used in prisons and three main themes were identified in the analysis. These were: the ecologies of music in prisons, practicing self-care, and awareness of theory in developing specific aims and goals. The results show that music can support prison populations in various ways depending on which context takes place; from an musicological viewpoint music facilitates the expression of cultural spheres, whereas from a medical standpoint, therapeutic approaches to music therapy provide effective rehabilitation and treatment for psychological ailments. Ample theoretical, clinical, and cultural preparation should be taken into account by therapists before embarking on any work into the prison environment.</p>


2021 ◽  
Author(s):  
Carlos Riegelhaupt-Landreani

<p>This study aimed to explore how the use of music therapy can support prisoners in a specialist treatment unit at a prison in Aotearoa New Zealand. The research was initially designed using action research methodology to evaluate how I, a music therapy student, can support men at a special treatment unit in a prison setting in Aotearoa New Zealand. Seven weeks into my placement a rapidly escalating response to the Covid-19 global pandemic put my placement on hold indefinitely. In response to the challenges of not being able to attend placement, the research framework was changed to exploratory research. My question evolved into a theoretical exploratory study seeking to find out how music therapy can provide support in prisons. Documentation of music therapy is scarce in the New Zealand context; thus, the exploration was guided by a broad international literature search. Thematic analysis was used to develop themes about the reviewed literature and from reflective data identified in my clinical journal. The findings provide a broad scope of understanding of how music therapy is used in prisons and three main themes were identified in the analysis. These were: the ecologies of music in prisons, practicing self-care, and awareness of theory in developing specific aims and goals. The results show that music can support prison populations in various ways depending on which context takes place; from an musicological viewpoint music facilitates the expression of cultural spheres, whereas from a medical standpoint, therapeutic approaches to music therapy provide effective rehabilitation and treatment for psychological ailments. Ample theoretical, clinical, and cultural preparation should be taken into account by therapists before embarking on any work into the prison environment.</p>


2021 ◽  
Vol 10 (9) ◽  
pp. e10010917691
Author(s):  
Carla Danielle Dias Costa ◽  
Diogo Sousa Rodrigues ◽  
Flávia Neri Meira ◽  
Sérgio Henrique Nascente Costa ◽  
Vania Rodriguez ◽  
...  

The aim of this study was to estimate the prevalence of use of licit and illicit drugs and verify the behavioral profile among truck drivers. A total of 697 truck drivers were interviewed at a gas station on BR-153, between from February 2014 to February 2015. The questionnaire ASSIST was applied to screening the use of alcoholic beverages, tobacco and illicit drugs. Sociodemographic information and professional were also collected. Urine samples were screened for licit and illicit drugs. All of truckers were male, median age of 42 years, most of them married and low scholarity. 47% related moderate or high consumption of alcohol and tobacco and need a brief intervention. 21% use of cocaine, cannabinoids, amphetamine, hypnotics/sedatives, opioids, inhalants and need specialist treatment. From the 697 participants, 94% provided urine samples. 10,5% were positive for drugs. 5,2% were positive for cocaine, 2,6% for cannabinoids, 2,0% for amphetamine, 0,4% for benzodiazepines, 0,3% positive for methamphetamines and 1,4% for combined use of two drugs. Young and single truckers use tobacco, cannabis and amphetamines and need to receive brief intervention for these drugs. Truck drivers in the northern region of low education, require specialized treatment for tobacco. Truck drivers make high use of tobacco, alcohol, cocaine and other ilicit drugs. Measures are needed to improve quality of life to the drivers, as well as to prevent and treat individuals who use licit and illicit drugs in order to reduce engagement with traffic accidents.


2021 ◽  
Vol 10 (13) ◽  
pp. 2822
Author(s):  
Sébastien Lobet ◽  
Merel Timmer ◽  
Christoph Königs ◽  
David Stephensen ◽  
Paul McLaughlin ◽  
...  

The physiotherapist plays an essential role for people with haemophilia, an inherited bleeding disease responsible for musculoskeletal complications. Yet, with the advent of new and advanced therapies, the medical landscape is changing, and physiotherapy must adapt alongside. This paper considers whether there will still be a need for physiotherapy in the era of advanced therapies, and discusses ways in which services should evolve to complement emerging treatment paradigms for haemostasis in people with haemophilia. Ultimately, physiotherapy will remain an important element of care, even for people with little joint damage and low risks in the era of the new mild phenotype. However, competencies will need to evolve, and physiotherapists in both primary care and specialist treatment centres should work with haematology colleagues to develop more sensitive tools for detecting early joint changes. Physiotherapists will also play a crucial role in counselling and physically coaching, monitoring the musculoskeletal status of people with haemophilia who have transitioned to new treatments.


2021 ◽  
pp. flgastro-2020-101719
Author(s):  
Mara Popescu ◽  
Mohamed Mutalib

Constipation is common in children and adults with varied worldwide prevalence. The majority of children have functional constipation as defined by Rome clinical criteria and respond favourably to standard medical therapy; up to one-third can develop difficult-to-treat constipation requiring investigation and specialist treatment. Colon function tests aim to assess the neuromuscular integrity, the movement of faeces across the colon and evaluate/predict response to the therapy. The ‘ideal’ test should be practical, non-invasive, widely available and cost-effective. None of the available diagnostic tools is designed to provide a comprehensive assessment of colon function and clinicians often have to combine more than one test to answer different questions. In this review, we aim to assess the strengths and limitations of the commonly available diagnostic investigations (radiopaque marker studies, scintigraphy, wireless motility capsule and colonic manometry) used to assess colon transit in children and to provide guidance on the most appropriate test for particular clinical settings.


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