scholarly journals Molar Incisor Hypomineralization from Inception to Intervention–Evidence Based Review

2021 ◽  
pp. 113-125
Author(s):  
Rana A. Alamoudi
Keyword(s):  
Oral Health ◽  
Wide Spectrum ◽  
Treatment Plan ◽  
Treatment Strategies ◽  
Treatment Modalities ◽  
Evidence Based ◽  
Tailored Treatment ◽  
Dental Practitioners ◽  
Molar Incisor Hypomineralization

Background: Molar Incisor Hypomineralization (MIH) is considered a highly prevalent clinical problem worldwide. The etiology of MIH involves a complex interaction between systemic and environmental insults with possible genetic contribution. Early diagnosis is facilitated by collaboration between clinicians responsible for oral health management of the patient and is the key for enhancing the long-term prognosis and quality of life of affected children. MIH management is a formidable oral health challenge due to the wide spectrum of clinical presentation with the need for tailored treatment for the child affected by MIH condition. Objective: To provide dental practitioners with an updated and evidence-based overview of MIH etiology, diagnosis, and treatments modalities available for its management. Conclusion: In this review, recent clinical evidence on MIH etiology, diagnosis and treatment is presented. Given recent availability of sophisticated technologies there is an increasing number of treatment modalities now at the fingertips of all oral health clinicians alike, ranging from preventive measures, management of hypersensitivity to advanced restorative techniques. The tailored treatment plan should encompass a short and long-term approach requiring more frequent dental check-ups in order to achieve better outcomes and prognosis. Future translational clinical research to best practice that will enhance our understanding of the exact causes of MIH and allow development of standardized diagnostic criteria as well as optimal treatment strategies are warranted.

scholarly journals Different Treatment Modalities followed by Dental Practitioners for Ellis Class 2 Fracture – A Questionnaire-based Survey

2020 ◽  
Vol 14 (1) ◽  
pp. 59-65
Author(s):  
Jerry Jose ◽  
Ajitha P. ◽  
Haripriya Subbaiyan
Keyword(s):  
Traffic Accidents ◽  
Sports Injuries ◽  
Dental Trauma ◽  
Treatment Modalities ◽  
Practical Application ◽  
Traumatic Injuries ◽  
Adequate Knowledge ◽  
Dental Practitioners ◽  
Knowledge And Attitude

Introduction: Dental trauma is one of the most commonly seen injuries involving teeth and surrounding structures. The frequent causes of dental trauma are usually falls, traffic accidents, fights and sports injuries. Rapid treatment can prevent long-term damage to the orofacial structures and save the teeth. Ellis class 2 fracture is classified as the involvement of enamel and dentin excluding pulp. Dental practitioners are used to treating Ellis class 2 fracture very often in their dental practice and is usually considered as a dilemma among dental practitioners for the different treatment modalities followed for treatment of Ellis class 2 fracture. A survey is done among dental practitioners to assess the different treatment modalities followed by them in the case of Ellis class 2 fracture. Materials and Methods: A survey was done among 380 dental practitioners in the Chennai region in which 360 dental practitioners responded. The survey was distributed through electronic media and other means of communication. The survey data was collected, analysed and interpreted. Results: The results suggested that about 90% of dental practitioners had adequate knowledge and attitude towards the management of dental traumatic injuries. However, the practical application of the different treatment modalities was seen to be varied among dental practitioners. Based on this survey it was clear that majority of the dental practitioners in Chennai have good knowledge, attitude but there was a lack of clinical practice regarding the different treatment modalities followed by general practitioners for Ellis class 2 fracture. Conclusion: The survey shows that dental practitioners have a sound knowledge, attitude, but the practical application of the various treatment modalities available was seen to vary among various dental practitioners for Ellis class 2 fracture.

Cushing’s Syndrome: A Historic Review of the Treatment Strategies and Corresponding Outcomes in a Single Tertiary Center over the Past Half-Century

2018 ◽  
Vol 50 (04) ◽  
pp. 280-289 ◽  
Author(s):  
Anelia Nankova ◽  
Maria Yaneva ◽  
Atanaska Elenkova ◽  
Dimitar Tcharaktchiev ◽  
Marin Marinov ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Cushing’S Disease ◽  
Remission Rate ◽  
Treatment Strategies ◽  
Cushing's Syndrome ◽  
New Drugs ◽  
Cushing's Disease ◽  
Treatment Modalities ◽  
Tertiary Center

AbstractCushing’s syndrome (CS) is associated with serious comorbidities and an increased mortality rate that could be reduced only if strict biochemical control is achieved. The aim of this study was to show the 50-year experience of a single tertiary center in the management of CS patients – the different treatment modalities used over the years and the corresponding outcomes. It was a retrospective study of a large cohort of patients from the Bulgarian CS database: 613 patients (374 with ACTH-dependent and 239 with ACTH-independent CS). Pituitary surgery was applied to 242 patients with Cushing’s disease (CD) with initial remission rate of 74% of which 10% relapsed. Approximately 36% manifested with active disease during the long-term follow-up (26% with persistent disease, 10% relapses) most of which were subjected to a secondary treatment (13.6% to pituitary resurgery, 14% to pituitary radiotherapy, and 5.4% to bilateral adrenalectomy). A total of 294 CD patients received medical therapy with overall remission rates for the most commonly used drugs: dopamine agonists 20%, pasireotide 30%, and ketoconazole 63%. Significant improvement of results was achieved by combining drugs with different mechanisms of action. Regardless of the progress in the neurosurgery and radiotherapy techniques and new drugs discovery, the management of patients with CS remains a real challenge for physicians. Not only patients with adrenal carcinoma but also significant percentage of subjects with persistent and recurrent Cushing’s disease often require a polymodal approach and the efforts of a multidisciplinary highly qualified, experienced, and motivated team in order to achieve a long-term remission.

scholarly journals Current Clinical Concepts: Clinical Management of Patellar Tendinopathy

2021 ◽  
Author(s):  
Adam B. Rosen ◽  
Elizabeth Wellsandt ◽  
Mike Nicola ◽  
Matthew A. Tao
Keyword(s):  
Effective Treatment ◽  
Clinical Management ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Patellar Tendinopathy ◽  
Load Management ◽  
Evidence Based ◽  
Effective Treatment Option ◽  
Treatment Interventions

ABSTRACT Patellar tendinopathy is a common, yet misunderstood pathoetiology afflicting a variety of patient populations. This lack of unified understanding affects the capability of clinicians to provide effective treatment interventions. Patients with tendinopathy often report long-term and low to moderate levels of pain, diminished flexibility, and strength, as well as decreased physical function. Load-management strategies combined with exercise regimens focused on progressive tendon loading are the most effective treatment option for patients with patellar tendinopathy. This review will provide an evidence-based approach to patellar tendinopathy, including its pathoetiology, evaluation, and treatment strategies.

Clinical case of orthopaedic dental rehabilitation of a patient with Scheuthauer-Marie-Sainton syndrome

2021 ◽  
pp. 50-57
Author(s):  
V.G. Galonsky ◽  
N.V. Tarasova ◽  
E.S. Surdo ◽  
Gradoboev A.V.
Keyword(s):  
Clinical Case ◽  
Dental Treatment ◽  
Wide Spectrum ◽  
Diagnostic Algorithm ◽  
Cleidocranial Dysplasia ◽  
Dental Practitioners ◽  
Dental Rehabilitation ◽  
Short And Long Term ◽  
General Profile

The article presents results of content analysis of Russian and foreign reference materials, scientific and educational literature regarding a rare pathology: the Scheuthauer-Marie-Sainton syndrome (cleidocranial dysplasia). The results are provided in the form of an explicit diagnostic algorithm for dental practitioners revealing this disease in patients in orthopaedic dentistry and orthodontics practice being a guideline for involvement of allied general profile specialists in consulting of such a patient. The clinical case reflected in the paper describes orthopaedic dental treatment provided to a 19-years-old female patient with cleidocranial dysplasia as well as a complex and ambiguous clinical picture of the oral cavity. The case demonstrates possibilities in efficacy of dental rehabilitation procedures for this category of patients using minimally invasive methods as the most justified and predictable approach providing a wide spectrum of furtherclinical decisions in short- and long-term patient management after treatment

Cervical Radiculopathy

2018 ◽  
pp. 231-236
Author(s):  
Samuel W. Samuel ◽  
Eduardo E. Icaza
Keyword(s):  
Conservative Management ◽  
Treatment Strategies ◽  
Cervical Radiculopathy ◽  
Surgical Decompression ◽  
Evidence Based ◽  
Long Term Outcomes ◽  
Painful Condition ◽  
Surgical Treatments ◽  
Cervical Root

This chapter discusses cervical radiculopathy, a common, painful condition from cervical root compression, irritation, or both. A thorough history and physical exam can often help in diagnosing the affected nerve root, without the need for reflexive imaging. A series of provocative tests can aid in the differential diagnosis. Most cases will be resolved with conservative management within several weeks of symptoms onset. Evidence-based conservative management includes physical therapy and oral NSAIDs. If symptoms indicate myelopathic changes or are refractory to 6 to 8 weeks of conservative management, advanced imaging such as MRI should be considered. Patients with imaging evidence of a compressive etiology and refractory to conservative therapy should have a surgical consultation. Either an MRI or CT should be obtained before surgical decompression. Both interventional and surgical treatments have had positive outcomes in the short term, but long-term outcomes appear comparable to those with conservative therapies. It is recommended that conservative treatment strategies be used for 6–8 weeks before pursuing procedural or surgical intervention.

Understanding Patients’ Attitudes Toward Cancer Multidisciplinary Meetings: A Mixed Methods Study

2020 ◽  
Vol 16 (2) ◽  
pp. e175-e182
Author(s):  
Bianca Devitt ◽  
Jennifer Philip ◽  
Madhu Singh ◽  
Sue-Anne McLachlan
Keyword(s):  
Mixed Methods ◽  
Medical Treatment ◽  
Treatment Plan ◽  
Quality Care ◽  
Treatment Modalities ◽  
Evidence Based ◽  
Theory Approach ◽  
Previous Diagnosis ◽  
Diagnosis Of Cancer ◽  
A Current

PURPOSE: Multidisciplinary cancer meetings (MDMs) are an integral component of quality care; however, little research exists regarding patients’ views on this model of care. We aimed to explore and understand the attitudes of patients toward MDMs. METHODS: A mixed methods exploratory design was used. Qualitative data from patients with a current or previous diagnosis of cancer were collected and analyzed using a grounded theory approach. Results informed the development of a questionnaire survey that was administered to patients with a current or previous diagnosis of cancer. Results were analyzed using descriptive statistics. RESULTS: Nine patients participated in 3 focus groups, and 152 patients (response rate, 90%) completed the questionnaire. Patients were strongly supportive of MDMs and thought that all patients with cancer should be routinely discussed. More than 90% of surveyed patients believed MDMs were reassuring, meant all treatment modalities were considered, and led to evidence-based treatment recommendations. Patients wanted MDMs to focus on medical treatment planning rather than psychosocial issues, and 87% regarded the meeting as confidential. Patients described a preference for doctor-led decision making, and most (84%) wanted MDM treatment decisions to be discussed with them in a subsequent consultation, with 73% of patients also wanting this in a written format. CONCLUSION: Patients strongly endorse MDMs as a means to develop an evidence-based, medical treatment plan agreed to by consensus. They want to be purposely informed of the meeting and its outcomes. Results from this study can help inform future guidelines on the conduct of MDMs.

scholarly journals Pregnancy-related lumbopelvic pain – treatment modalities

2017 ◽  
Vol 31 (2) ◽  
pp. 69-78
Author(s):  
Małgorzata Starzec ◽  
Aleksandra Truszczyńska
Keyword(s):  
Pregnant Woman ◽  
Pain Treatment ◽  
Current Knowledge ◽  
Functional Limitations ◽  
Treatment Modalities ◽  
Evidence Based ◽  
Everyday Activity ◽  
Current State ◽  
Common Complaint

Abstract Introduction: Pregnancy-related lumbopelvic pain is a common complaint which often limits everyday activity of a pregnant woman. Accurate and individualized treatment is needed as, if ignored, pain can become a long term condition. The aim of this article is to present the current state of knowledge about possible treatment modalities for pregnancy-related lumbopelvic pain. Summary: Current knowledge gives us a variety of effective tools which help reduce pain and functional limitations with no harm to a mother and foetus. There is no single and most effective treatment strategy. A combination of evidence-based methods produces the best treatment outcomes.

Exophiala Jeanselmei Infection in a Patient with Two Primary Malignancies

1997 ◽  
Vol 1 (4) ◽  
pp. 229-231
Author(s):  
Diana M. Chen
Keyword(s):  
Central Nervous System ◽  
Squamous Cell Carcinoma ◽  
Wide Spectrum ◽  
Treatment Modalities ◽  
Dematiaceous Fungi ◽  
Internal Organs ◽  
Exophiala Jeanselmei ◽  
Immunosuppressive Medications ◽  
The Central Nervous System

Background: Dematiaceous fungi are emerging as an important pathogen, particularly in individuals on immunosuppressive medications. These fungi produce brown to black pigment and are responsible for a wide spectrum of diseases, including superficial infections of the skin and eye and, uncommonly, deep infections involving the central nervous system and internal organs. Objective: We present a male patient with localized, cutaneous Exophiala jeanselmei infection. Methods: We review the literature and present a brief discussion of phaeohyphomycotic infections, their clinical features, and their treatment modalities. Results: Workup of our patient revealed an underlying hepatic lymphoma and pulmonary squamous cell carcinoma. Conclusions: Phaeohyphomycotic infections, although uncommon, are increasingly recognized as important pathogens in patients who are immunologically compromised as a result of long-term steroid or other immunosuppressive therapy. Infections by these organisms in healthy-appearing individuals should prompt one to consider an immunodeficiency state and appropriate workup should be performed.

scholarly journals Implementation of a multidisciplinary infections conference improves the treatment of spondylodiscitis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
D. Ntalos ◽  
B. Schoof ◽  
D. M. Thiesen ◽  
L. Viezens ◽  
H. Kleinertz ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Treatment Strategies ◽  
Autologous Bone Graft ◽  
Treatment Modalities ◽  
Post Intervention ◽  
Operative Revision ◽  
Significant Difference ◽  
Spinal Segments ◽  
Patient Groups ◽  
Single Discipline

AbstractEstablishing a multidisciplinary approach regarding the treatment of spondylodiscitis and analyzing its effect compared to a single discipline approach. 361 patients diagnosed with spondylodiscitis were included in this retrospective pre-post intervention study. The treatment strategy was either established by a single discipline approach (n = 149, year 2003–2011) or by a weekly multidisciplinary infections conference (n = 212, year 2013–2018) consisting of at least an orthopedic surgeon, medical microbiologist, infectious disease specialist and pathologist. Recorded data included the surgical and antibiotic strategy, complications leading to operative revision, recovered microorganisms, as well as the total length of hospital and intensive care unit stay. Compared to a single discipline approach, performing the multidisciplinary infections conference led to significant changes in anti-infective and surgical treatment strategies. Patients discussed in the conference showed significantly reduced days of total antibiotic treatment (66 ± 31 vs 104 ± 31, p < 0.001). Moreover, one stage procedures and open transpedicular screw placement were more frequently performed following multidisciplinary discussions, while there were less involved spinal segments in terms of internal fixation as well as an increased use of intervertebral cages instead of autologous bone graft (p < 0.001). Staphylococcus aureus and Staphylococcus epidermidis were the most frequently recovered organisms in both patient groups. No significant difference was found comparing inpatient complications between the two groups or the total in-hospital stay. Implementation of a weekly infections conference is an effective approach to introduce multidisciplinarity into spondylodiscitis management. These conferences significantly altered the treatment plan compared to a single discipline approach. Therefore, we highly recommend the implementation to optimize treatment modalities for patients.

Overview of behaviour change

2013 ◽  
Author(s):  
Blánaid Daly ◽  
Paul Batchelor ◽  
Elizabeth Treasure ◽  
Richard Watt
Keyword(s):  
Oral Health ◽  
Behaviour Change ◽  
Health Professionals ◽  
Health Behaviours ◽  
Minor Role ◽  
Dental Practitioners ◽  
Oral Health Behaviours ◽  
Practical Factors ◽  
Individual Behaviour Change

Many dental practitioners become very frustrated with their patients when they fail to follow advice given to improve their oral health. This failure can often be interpreted by dentists as a sign of disinterest, lack of motivation, or sometimes even stupidity! Such an approach helps no one. As has already been identified, to successfully promote oral health the dental team need to work with their patients in a number of ways. For example, to help them select a healthy diet, maintain good oral hygiene, or stop smoking, the dental team need to understand what factors influence these behaviours and how they can be altered successfully. This chapter therefore aims to review behaviour change to help you understand more fully how you as a clinician can help your patients successfully alter their behaviour to promote and maintain their oral health. Theories and models of behaviour change will be reviewed and consideration will also focus on the practical factors influencing the process of change. Before reviewing the theoretical detail of behaviour change it is important to restate a core principle of public health, that is, the importance of the underlying social determinants of health. A wealth of evidence has highlighted that individual behaviours have a relatively limited influence on health outcomes compared to economic, environmental, and social factors (Marmot and Wilkinson 2006 ; Wilkinson 1996). Indeed, oral health behaviours play a somewhat minor role in explaining oral health inequalities (Sabbah et al . 2009; Sanders et al. 2006). Any exploration of individual behaviour change therefore needs to take into account the influence of the broader factors operating at a macro level. However, for health professionals working with individual patients, helping people change their behaviour is still an important task within their clinical practice. Traditionally, health professionals have focused largely upon giving their patients information in an attempt to change their behaviour. Such an approach has, however, been mostly unsuccessful at securing long-term changes in behaviour (Sprod et al. 1996; Yevahova and Satur 2009).

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