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Treatment Possibilities (treatment + possibility)
Selected AbstractsFS05.1 Treatment of hand eczemaCONTACT DERMATITIS, Issue 3 2004Niels K Veien Hand eczema is a common skin disease that often becomes chronic, and treatment of the disease is often challenging. Skin protection is of great importance for the prevention of hand eczema and is a fundamental aspect of the treatment of hand eczema. Emollients have been shown to be successful in the primary prevention of hand eczema as well as in reducing eczema activity. Topical corticosteroids are still the mainstay of treatment, but randomised controlled trials of their efficacy are needed. A combination of tacrolimus and topical corticosteroids may reduce the risk of steroid-associated side-effects. UV-therapy and Grenz rays can also suppress hand eczema. Systemic treatment with immunosuppressants such as cyclosporine and methotrexate show promising results, and acitretin may suppress keratotic hand eczema. Treatment possibilities for hand eczema, indications and side effects will be discussed. [source] Retraining automatic action-tendencies to approach alcohol in hazardous drinkersADDICTION, Issue 2 2010Reinout W. Wiers ABSTRACT Aims The main aim of this study was to test whether automatic action-tendencies to approach alcohol can be modified, and whether this affects drinking behaviour. Design and participants Forty-two hazardous drinkers were assigned randomly to a condition in which they were implicitly trained to avoid or to approach alcohol, using a training variety of the alcohol Approach Avoidance Test (AAT). Participants pushed or pulled a joystick in response to picture-format (landscape or portrait). The pictures depicted alcoholic or non-alcoholic drinks. Participants in the avoid-alcohol condition pushed most alcoholic and pulled most non-alcoholic drinks. For participants in the approach-alcohol condition these contingencies were reversed. After the implicit training, participants performed a taste test, including beers and soft drinks. Automatic action tendencies at post-test were assessed with the AAT, including both trained and untrained pictures, and with a different test (Implicit Association Test, IAT). We further tested effects on subjective craving. Results Action tendencies for alcohol changed in accordance with training condition, with the largest effects in the clinically relevant avoid-alcohol condition. These effects occurred outside subjective awareness and generalized to new pictures in the AAT and to an entirely different test using words, rather than pictures (IAT). In relatively heavy drinking participants who demonstrated changed action tendencies in accordance with their training condition, effects were found on drinking behaviour, with participants in the approach-alcohol condition drinking more alcohol than participants in the avoid-alcohol condition. No effect was found on subjective craving. Conclusions Retraining automatic processes may help to regain control over addictive impulses, which points to new treatment possibilities. [source] Shared decision making observed in clinical practice: visual displays of communication sequence and patternsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2001Glyn Elwyn BA MSc FRCGP Abstract The aim of the study was to examine the communication strategies of general practitioners attempting to involve patients in treatment or management decisions. This empirical data was then compared with theoretical ,competences' derived for ,shared decision making'. The subjects were four general practitioners, who taped conducted consultations with the specific intent of involving patients in the decision-making process. The consultations were transcribed, coded into skill categorizations and presented as visual display using a specifically devised sequential banding method. The empirical data from these purposively selected consultation from clinicians who are experienced in shared decision making did not match suggested theoretical frameworks. The views of patients about treatment possibilities and their preferred role in decision making were not explored. The interactions were initiated by a problem-defining phase, statements of ,equipoise' consistently appeared and the portrayal of option information was often intermingled with opportunities to allow patients to question and reflect. A decision-making stage occurred consistently after approximately 80% of the total consultation duration and arrangements were consistently made for follow-up and review. Eight of the 10 consultations took more than 11 min , these specific consultations were characterized by significant proportions of time provided for information exchange and patient interaction. The results demonstrate that some theoretical competences are not distinguishable in practice and other stages, not previously described, such as the ,portrayal of equipoise', are observed. The suggested ideal of a shared decision-making interaction will either require more time than currently allocated, or alternative strategies to enable information exchange outside the consultation. [source] Vancomycin-resistant Enterococcus spp.: validation of susceptibility testing and in vitro activity of vancomycin, linezolid, tigecycline and daptomycinAPMIS, Issue 1 2010MATHIAS RATHE Rathe M, Kristensen L, Ellermann-Eriksen S, Thomsen MK, Schumacher H. Vancomycin-resistant Enterococcus spp.: validation of susceptibility testing and in vitro activity of vancomycin, linezolid, tigecycline and daptomycin. APMIS 2010; 118: 66,73. Vancomycin-resistant enterococci (VRE) have emerged to become a significant nosocomial pathogen. However, detection may be challenging and treatment possibilities are limited. Reports of resistance to linezolide, daptomycin and tigecycline underline the need for reliable susceptibility testing with respect to these compounds. We evaluated the in vitro activity of vancomycin, linezolid, daptomycin and tigecycline against a panel of VRE and vancomycin-susceptible enterococci by broth microdilution (BMD). Etest for determination of minimum inhibitory concentration of these four antibiotics and two disc diffusion assays for detecting VRE and for susceptibility testing against tigecycline and linezolid were evaluated. Before susceptibility testing, all isolates were classified by polymerase chain reaction as vanA or vanB gene positive or vanA/B gene negative. Linezolid, daptomycin and tigecycline had excellent in vitro activity towards all isolates. For daptomycin and tigecycline, the overall agreement between BMD and Etest was suboptimal. For both disc diffusion assays, use of current break points was inadequate to detect vancomycin resistance for isolates carrying the vanB gene. Inspection of the inhibition zone for a diffuse edge, as recommended, accurately predicted presence of the vanB gene. [source] | ||||||||||