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Available Treatment Options (available + treatment_option)
Selected AbstractsLocoregional Cutaneous Metastases of Malignant Melanoma and their ManagementDERMATOLOGIC SURGERY, Issue 2004Ingrid H. Wolf MD The correct classification of locoregional metastases of malignant melanoma to skin is central to the planning of treatment. Local recurrence means persistence of neoplastic cells at the local site by virtue of incomplete excision of the primary melanoma. Standard treatment is excisional surgery. In contrast, locoregional metastases of malignant melanoma (satellites, in-transit metastases) are metastases around a primary melanoma or between a primary melanoma and regional lymph nodes. They represent intralymphatic or hematogenous spread of neoplastic cells. We present a variety of available treatment options and discuss especially topical imiquimod as a novel approach for the palliative treatment of locoregional cutaneous melanoma metastases in selected patients. [source] How psychiatrists inform themselves and their patients about risks and benefits of antipsychotic treatmentACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009R. Mendel Objective:, In order to choose the best treatment option, physicians have to inform themselves and their patients about both the benefits and risks of available treatment options equally. Our study aims to investigate whether psychiatrists actually do conduct such a balanced information search and presentation. Method:, Psychiatrists' information search and information presentation to a patient with schizophrenia were studied using two separate experiments. In both, participants were presented with hypothetical case vignettes and descriptions of fictitious antipsychotics. Results:, When searching for information, psychiatrists looked more for risks than benefits of antipsychotic treatment options (t = ,3.4, df = 74, P = 0.001). However, when informing a patient, they named more benefits than risks (t = 17.1, df = 224, P < 0.001). Conclusion:, The risk-biased information search presumably follows the principle of ,primum non nocere'. The benefit-biased information presentation might be motivated by the wish to persuade patients to accept the proposed therapy. [source] Advances in the treatment of root dentine sensitivity: mechanisms and treatment principlesENDODONTIC TOPICS, Issue 1 2006D.G. GILLAM There are limited studies specifically on the prevalence of root dentine hypersensitivity or root sensitivity per se; most of the published information relates to the prevalence of dentine hypersensitivity (DH). Several investigators have suggested that there may be some justification on the basis of differing pathologies of distinguishing between those individuals complaining of DH who have relatively healthy mouths with those who complain of DH as a result of periodontal disease and/or its treatment. It is generally recognized that those individuals diagnosed with periodontal disease and having periodontal therapy including scaling procedures may have a higher prevalence than those who present with healthy mouths and evidence of gingival recession. The availability of a vast array of treatments, however, would indicate either that there is no one effective desensitizing agent for completely resolving the discomfort or that the condition, due to its highly subjective nature, is difficult to treat irrespective of the available treatment options. The importance of implementing preventative strategies in identifying and eliminating predisposing factors in particularly erosive factors (e.g. dietary acids) cannot be ignored if the practitioner is going to treat this troublesome clinical condition successfully. This paper will review the published literature and provide information as to the prevalence of the condition, its etiology and causal factors, as well as recommendations for the clinical management of the problem. [source] Functional electrical stimulation in neurological disordersEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2008O. K. Sujith Functional electrical stimulation (FES) refers to electrical stimulation of muscles in order to improve the impaired motor function. This is achieved by activating skeletal muscles with constant frequency trains of stimulations. This method has been found useful in various neurological disorders like hemiplegia, foot drop and paraplegia including spinal cord injuries. The first half of this review focuses on the broad clinical applications of functional electrical stimulation, its mechanism of action and the complications of this mode of therapy. Advanced Parkinson's disease (PD) is characterized by marked slowing of gait and frequent freezing episodes. Medical and surgical treatments are often ineffective in managing freezing episodes. The second half of this review discusses briefly the gait abnormalities in PD and the available treatment options. The possible role of FES in improving gait in parkinsonism and the importance of future research in this direction are highlighted. [source] Orthodontic treatment of anterior open biteINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2008CHUI SHAN TERESA NG Objective. To review the currently available treatment options of anterior open bite. Methods. Search all major dental journals and literature on treatment and management of anterior open bite. Medline search (1960,2006). Literature and data on treatment and management of anterior open bite with keywords ,open bite', ,anterior open bite', ,orthodontic treatment', ,long face', ,vertical dentoalveolar problem' and ,vertical skeletal problem'. Results. Over 50 articles were found and relevant information and data were reviewed by the authors. It was found that the multifactorial nature of anterior open bite makes its management difficult and various treatment modalities are being used. Clinicians must be able to diagnose the problem and choose the best treatment. Conclusion. Successful treatment of anterior open bite greatly relies on both diagnosis and therapeutics. Although there are many different treatment modalities available, stability after treatment is still a critical issue as evidence on long term stability of various treatment options is lacking. Thus, clinicians should pay more attention during retention phase and long-term studies on post-treatment changes and stability should be encouraged. [source] Managing hyponatremia in patients with syndrome of inappropriate antidiuretic hormone secretion,JOURNAL OF HOSPITAL MEDICINE, Issue S3 2010Joseph G. Verbalis MD This review will address the management of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in hospitalized patients. To do so requires an understanding of the pathogenesis and diagnosis of SIADH, as well as currently available treatment options. The review will be structured as responses to a series of questions, followed by a presentation of an algorithm for determining the most appropriate treatments for individual patients with SIADH based on their presenting symptoms. Journal of Hospital Medicine 2010;5:S18,S26. © 2010 Society of Hospital Medicine. [source] Prioritising stop-smoking services and available treatment optionsPRESCRIBER, Issue 10 2009MRPharmS, Steve Chaplin MSc The DoH publication NHS Stop Smoking Services: Service and Monitoring Guidance 2009/10 outlines the provisions that should be made to support smokers trying to quit and the available treatment options. Copyright © 2009 Wiley Interface Ltd [source] Current management of juvenile idiopathic arthritisPRESCRIBER, Issue 5 2009FRCP(Glasg), FRCPCH, Paul Galea MD Our series Prescribing in children gives practical advice for successful management of childhood problems in general practice. Here, the author describes the available treatment options for juvenile idiopathic arthritis and their place in management. Copyright © 2009 Wiley Interface Ltd [source] Assessment and treatment options for erectile dysfunctionPRESCRIBER, Issue 8 2008Michael Cummings MD Erectile dysfunction is a common disorder that can also be associated with underlying diabetes or cardiovascular disease. Here, the author describes the assessment of ED and currently available treatment options. Copyright © 2008 Wiley Interface Ltd [source] Survival in pulmonary hypertension associated with the scleroderma spectrum of diseases: Impact of interstitial lung diseaseARTHRITIS & RHEUMATISM, Issue 2 2009Stephen C. Mathai Objective Pulmonary hypertension (PH) is an important cause of mortality in systemic sclerosis (SSc), where it can be isolated (pulmonary arterial hypertension [PAH]) or associated with interstitial lung disease (ILD). This study was undertaken to characterize determinants of survival among SSc patients with either type of PH who received PAH-specific therapy. Methods Consecutive SSc patients with PAH or ILD-associated PH confirmed by right heart catheterization were included in the study. Kaplan-Meier and Cox proportional hazards models were used to compare survival between SSc patients with PAH and those with ILD-associated PH and to identify predictors of survival. Results Fifty-nine patients (39 with PAH and 20 with ILD-associated PH) were identified. The majority (15 of 20 with ILD-associated PH and 27 of 39 with PAH) received an endothelin receptor antagonist as initial therapy. Median followup time was 4.4 years (range 2.7,7.4 years). Survival was significantly worse in SSc patients with ILD-associated PH than in those with PAH (1-, 2-, and 3-year survival rates 82%, 46%, and 39% versus 87%, 79%, and 64%, respectively; P < 0.01 by log rank test). In a multivariable analysis, ILD-associated PH was associated with a 5-fold increase in risk of death compared with PAH. Pulmonary vascular resistance index was also an independent predictor of mortality in the overall cohort (hazard ratio 1.05, P < 0.01) and was a significant univariable risk factor in each group separately. Type of initial PAH therapy and the use of warfarin were not related to survival. Conclusion Survival in SSc complicated by PH remains poor despite currently available treatment options. While therapy may be associated with improved survival in PAH compared with historical controls, the prognosis for patients with ILD-associated PH is particularly grim. Early diagnosis and treatment may improve outcomes since worsening hemodynamic factors were associated with reduced survival. [source] ,Hitting you over the head': Oncologists' disclosure of prognosis to advanced cancer patientsBIOETHICS, Issue 2 2003Elisa J. Gordon The disclosure of prognosis to terminally ill patients has emerged as a recent concern given greater demands for patient involvement in medical decision-making in the United States. As part of the informed consent process, American physicians are legally and ethically obligated to provide information to such patients about the risks, benefits, and alternatives of all available treatment options including the use of experimental therapies. Although not legally required, the disclosure of a terminal prognosis is ethically justified because it upholds the principle of self-determination and enables patients to make treatment decisions consistent with their life goals. To understand oncologists' attitudes about disclosing prognostic information to cancer patients with advanced disease, we interviewed fourteen oncologists and conducted one focus group of medical fellows. Although oncologists reported to disclose prognosis in terms of cancer not being curable, they tend to avoid using percentages to convey prognosis. Oncologists' reported reluctance to disclosing prognosis was conveyed through the use of metaphors depicting the perceived violent impact of such information on patients. Oncologists' reluctance to disclose prognosis and preserve patient hope are held in check by their need to ensure that patients have ,realistic expectations' about therapy. We discuss these data in light of the cultural, ethical, and legal dimensions of prognosis disclosure, patient hope and the doctor,patient relationship, and recommend ways to enhance the communication process. [source] | ||||||||||