A Perspective on Tongue Diagnosis in Patients with Breast Cancer

Introduction. Breast cancer (BC) is the most common cancer in women and patients with BC often undergo complex treatment. In Taiwan, nearly 80% of patients with BC seek traditional Chinese medicine (TCM) during adjuvant chemotherapy to relieve discomfort and side effects. This study investigated tongue features and pattern differentiation through noninvasive TCM tongue diagnosis in patients with BC. Materials and Methods. This cross-sectional, case-controlled, retrospective observational study collected patient data through a chart review. The tongue features were extracted using the automatic tongue diagnosis system (ATDS). Nine tongue features, including tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissures, ecchymoses, teeth marks, and red dots, were analyzed. Results and Discussion. Objective image analysis techniques were used to identify significant differences in the many tongue features between BC patients and non-BC individuals. A significantly larger proportion of patients with BC had a small tongue ( p < 0.001 ), pale tongue ( p < 0.001 ), thick fur ( p < 0.001 ), yellow fur ( p < 0.001 ), wet saliva ( p < 0.001 ), thick tongue fur ( p < 0.001 ), fissures ( p = 0.040 ), and ecchymoses in the heart-lung area ( p = 0.013 ). According to logistic regression, small tongue shape, pale tongue color, yellow fur color, wet saliva, and the amounts of fissures were associated with a significantly increased odds ratio for BC. Conclusions. This study showed significant differences in tongue features, such as small tongue shape, pale tongue color, thick fur, yellow fur color, wet saliva, fissure, and ecchymoses in the heart-lung area in patients with BC. These tongue features would imply yin deficiency, deficiencies of blood, stagnation of heat, and phlegm/blood stasis in TCM theory. There is a need to investigate effective and safe treatment to enhance the role of TCM in integrated medical care for patients with BC.

Survival Analysis Based on the Siddha Body Constitution of Asymptomatic SARS-CoV-2 Patients Under Integrative Management of Hydroxychloroquine (HCQ) and Kaba Sura Kudineer (KSK): A Retrospective, Cross-Sectional, Case Series in Tirupati

Objective: To analyse the duration of hospital stay of asymptomatic COVID-19 patients in Integrated Medical care of Hydroxychloroquine and Kaba Sura Kudineer (Herbal decoction). Design: A retrospective case series of 19 asymptomatic confirmed SARS-Cov-2 patients from District COVID Care Centre, Tirupati, India, between 23rd May to 7th June 2020. Method: Clinical data were collected using a standardised case report form containing demographic information, length of hospital stays and Siddha Yakkai Ilakkanam (Body Constitution) from the records. The association between length of hospital stay, age, gender, and Siddha YI after admissions for confirmed patients was compared and analysed by Kaplan Meier survival analysis method. Result: Patients in Aiyam group take at least 9 days of hospital stay, 80% take 10 or more days to cure the disease. 71.4% take more than 4 days and 3 days of hospital stay in Azhal and Vali groups, respectively. 75% of females take 9 days or more of hospital stay. 73.3% of males take 9 days or more of hospital stay. The age group, 19-40 years, has a minimum and maximum hospital stay varies from 2-15 days. Conclusion: This study explores the significance of integration of Siddha Medicine with Western medicine in the management of SARS Cov-2 infection. It recorded an overall median of 9 days in the length of stay and 8.5 days in overall mean survival time. This study emphasised higher speedy relief comparing Vietnam and China studies. Comparing those studies, the patient taking integrative treatment have savings of 9 days.

A Real-World Rheumatology Registry and Research Consortium: The German RHADAR Registry (Preprint)

UNSTRUCTURED Real-world data is crucial to continuously improve patients' management with rheumatic and musculoskeletal diseases (RMD). The German RHADAR registry encompasses a network of rheumatologists and researchers in Germany providing pseudonymized real-world patient data and allowing a timely and continuous improvement in RMD patients' care. The RHADAR modules allow automated anamnesis and adaptive coordination of appointments regarding individual urgency levels. Further modules focus on the collection and integration of electronic patient-reported outcomes in between consultations. The digital RHADAR modules ultimately allow a patient-centered, adaptive approach to integrated medical care starting as early as possible in the disease course. Such a closed-loop system consisting of various modules along the whole patient pathway enables comprehensive and timely patient management in an unprecedented manner.

The Engaged Patient

Patient engagement is ever more essential to developing innovative strategies that shape how comprehensive, integrated medical care is delivered to cancer patients and their families. With over 300 licensed professionals across the network, Cancer Support Community (CSC) is the largest nonprofit employer of psychosocial oncology mental health professionals in the United States. Through decades of working with cancer patients, families, and caregivers, CSC has developed a portfolio of evidence-informed programs that engage patients around their most pressing concerns—unwanted aloneness, loss of control, and lack of hope. CSC’s facilities, which provide support groups, education, exercise and nutrition classes, children’s programs, and social activities, are available at no cost for families. These services are replicated on CSC’s helpline and digital platforms. This chapter highlights a comprehensive integrated model of developing and delivering evidence-informed psychosocial programs and services in the community. The chapter also reviews CSC patient-centered research projects including (1) the Cancer Experience Registry®, an online observational study of cancer patients, survivors, and informal caregivers to identify and quantify their psychosocial experiences; (2) CancerSupportSource®, a reliable, valid, multidimensional distress screening program for patients and caregivers; and (3) Open To Options®, a shared decision-making program that helps patients prepare a highly personalized list of questions, concerns, and goals to share with their doctor. The extent to which the psychosocial oncology community can integrate care across healthcare systems, by leveraging new technologies, behavioral and implementation science principles, and community-based services, will determine its success in meeting the needs of cancer patients.

Research on the Obstacles and Optimized Path of the Development of the Mode of Combination of Medical and Support for the Aged in China

There are four relatively mature modes of the combination of medical and support for the aged in China, named “setting up pension services in the medical institution”, “setting up medical services in pension institution”, “medical and nursing cooperation” and community home care. But it is still facing problems like low enthusiasm of social forces to participate in the combination of medical and health care, low supply-demand matching degree of integrated medical care and pension service, insufficient caregivers, and poor professional quality. Therefore, it is significant to strengthen the attraction of social capital and mobilize the enthusiasm of social forces to participate in the combination of medical and health care. In addition, it is also necessary to construct a multi-layered model of integrated medical care and pension service and improve the salary and social cognitive level of nursing staff to retain talents.