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Multidisciplinary approach

Jafar Y Al-Jawad, Hassan M Alsaffar, Douglas Bertram, Robert M Kalin
A holistic Integrated Water Resources Management (IWRM) model can be difficult to implement and the associated high-dimension optimization problems' complexity often forces the decision makers to downscale such problems. These challenges however have motivated this research to develop a comprehensive Optimum IWRM approach (OP-IWRM) using a many-objective optimization algorithm to solve complex and large-scale problems. The approach employs the social, economic, and environmental objectives; ground and surface water resources; and water infrastructure for river basin management to: (1) improve the relevant revenues, (2) enhance community welfare, and (3) pave the road for the decision makers to set better investment policy...
March 19, 2019: Journal of Environmental Management
Meng Wang, Sanjay K Mohanty, Shaily Mahendra
Increasing pollution of global water sources and challenges in rapid detection and treatment of the wide range of contaminants pose considerable burdens on public health. The issue is particularly critical in rural areas, where building of centralized water treatment systems and pipe infrastructure to connect dispersed populations is not always practical. Point-of-use (POU) water supply systems provide cost-effective and energy-efficient approaches to store, treat, and monitor the quality of water. Currently available POU systems have limited success in dealing with the portfolio of emerging contaminants, particularly those present at trace concentrations...
March 22, 2019: Accounts of Chemical Research
Juan D Garisto, Julien Dagenais, Daniel Sagalovich, Riccardo Bertolo, Brian Rini, Jihad Kaouk
OBJECTIVE: To demonstrate our surgical technique of robotic partial nephrectomy (RPN) in a patient with a solitary kidney who received neoadjuvant Pazopanib, highlighting the multidisciplinary approach. MATERIALS AND METHODS: In our video, we present the case of 77-year-old male, Caucasian with 6.6cm left renal neoplasm in a solitary kidney. An initial percutaneous biopsy from the mass revealed clear cell RCC ISUP 2. After multidisciplinary tumor board meeting, Pazopanib (800mg once daily) was administered for 8 weeks with repeat imaging at completion of therapy...
February 10, 2019: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Hannah J Mackay, Katrina L Campbell, Barbara S van der Meij, Shelley A Wilkinson
AIM: To establish an evidence-based dietetics service in an in-centre haemodialysis unit utilising implementation science. METHODS: The service was developed through the Knowledge-to-Action Framework. The steps of the Action Cycle were addressed through a literature review, identification of evidence-based guidelines, benchmarking and local staff engagement. The theoretical domains framework (TDF) was used to identify barriers/enablers, and behaviour change wheel to determine appropriate interventions...
March 21, 2019: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
Thorsten Send, Izabela Tuleta, Tim Koppen, Thore Thiesler, Klaus W Eichhorn, Mattis Bertlich, Friedrich Bootz, Mark Jakob
BACKGROUND: Sarcoidosis is a chronic disease, which predominantly affects the lung. Since sinonasal sarcoidosis is rare, little is known about the sarcoidosis manifestation at this site. Therefore, the aim of our study was to detect the prevalence of sinonasal sarcoidosis, its clinical occurrence, diagnosis, and therapy. METHODS: The database of all patients having visited the otorhinolaryngology departments of the universities in Göttingen and in Bonn between 2003 and 2016 was searched for the diagnosis of sinonasal sarcoidosis...
March 21, 2019: European Archives of Oto-rhino-laryngology
Muhammad Ibaad Ur Rehman Alvi, Omar Pathmanaban, Raj Bhalla, Navin Mani
A well 74 -year-old woman presented to routine ophthalmology clinic instituted following treatment of a frontoethmoidal sarcoma initially excised in 1989 and diagnosed then as a sinus mucosal melanoma. At review in ophthalmology clinic, a reduction in right visual fields was noted. CT scan showed recurrence of a mass now involving the frontoethmoidal region, frontal sinus and abutting the cribiform plate. Endoscopic biopsy confirmed the recurrence as a low-grade biphenotypic sarcoma. This was discussed at the sarcoma multidisciplinary meeting...
March 20, 2019: BMJ Case Reports
E P V Le, Y Wang, Y Huang, S Hickman, F J Gilbert
This article reviews current limitations and future opportunities for the application of computer-aided detection (CAD) systems and artificial intelligence in breast imaging. Traditional CAD systems in mammography screening have followed a rules-based approach, incorporating domain knowledge into hand-crafted features before using classical machine learning techniques as a classifier. The first commercial CAD system, ImageChecker M1000, relies on computer vision techniques for pattern recognition. Unfortunately, CAD systems have been shown to adversely affect some radiologists' performance and increase recall rates...
March 18, 2019: Clinical Radiology
Henri Azaïs, Victoire Pauphilet, Jérémie Belghiti, Maryam Nikpayam, Clémentine Gonthier, Philippe Maingon, Rosa Conforti, Catherine Uzan, Geoffroy Canlorbe
Vulvar cancer is a rare disease, which represents 4% of gynecological tumors with an incidence of 0.5 to 1.5 per 100,000 women per year in France. Vulvar cancers are induced in 30 to 69% of cases by the presence of papillomavirus (HPV), in particular HPV 16 and 18, and can also occur in an inflammatory context. The diagnosis is made by histological examination of a vulvar biopsy. The histological subtype is a squamous cell carcinoma in 90% of cases. The 5-year survival of patients with vulvar cancer ranges from 86% for localized stages (FIGO I and II) to 57% for advanced stages (FIGO III and IVA), and 17% in case of metastatic disease (FIGO IVB)...
March 18, 2019: Bulletin du Cancer
C Carriere, G Michel, C Féart, H Pellay, O Onorato, P Barat, H Thibault
PURPOSE: Binge eating disorder (BED) is associated with higher psychopathology, including emotional and personality disorders, in the adult population, whether or not they are obese; although few data are available on adolescents, particularly among obese adolescents. OBJECTIVE: To explore the association of both emotional disorders and personality dimensions with BED in obese adolescents. METHODS: The sample consisted of 115 French adolescents enrolled at a clinical unit for the multidisciplinary care of their overweight or obesity...
March 18, 2019: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Jin Yong Shin, Si-Gyun Roh, Suk Choo Chang, Nae-Ho Lee
Diabetic foot infection (DFI) should be treated by a multidisciplinary team to prevent amputation and morbid status. As physicians encountering DFI in outpatient clinic, a proper selection of antibiotic treatment and diagnostic approach for a vascular status is essential. We retrospectively investigated the patients with DFI from 2016 to 2017. All patients were examined for vascular status, wound status, and pathologic culture preceding the treatment. No statistical significance was observed between PEDIS grade 1 and 2 and 3 and 4 in culture status and culture results...
March 2019: Medicine (Baltimore)
Sarah Taylor, Suzanne C Purdy, Bianca Jackson, Katrina Phillips, Javier Virues-Ortega
OBJECTIVE: To evaluate a home-based behavioral treatment model for children with tube dependency. METHODS: Nine children (aged 4-14 years) dependent on nasogastric and gastrostomy tubes were consecutively admitted into a home-based behavioral treatment program. A psychologist specializing in applied behavior analysis led the assessment and treatment phases with the support of caregivers and a multidisciplinary team. Caregivers participated in a caregiver training program and continued the intervention once the service was discontinued...
March 21, 2019: Journal of Pediatric Psychology
Sourabh Gupta, Ruchika Kumar, Archana Agrawal
Osteopetrosis is a rare congenital disease presenting with recurrent fractures, hematopoietic insufficiency and hepatosplenomegaly. Though osteomyelitis is a known complication in osteopetrosis, osteopetrosis presenting as osteomyelitis is rare. Management consists of multidisciplinary approach for complications and bone marrow transplant for the infantile form of disease.
March 21, 2019: Tropical Doctor
Federico Ravaioli, Antonio Colecchia, Luigina Vanessa Alemanni, Amanda Vestito, Elton Dajti, Giovanni Marasco, Mariarosaria Sessa, Andrea Pession, Francesca Bonifazi, Davide Festi
Veno-occlusive-disease (VOD), known also as sinusoidal-obstruction-syndrome (SOS), is one of the main complications of haematopoietic stem cell transplantation and is related to the treatment with pyrrolizidine alkaloids or other toxic agents (chemotherapy for liver-metastasis). Clinical diagnosis using the recent criteria from the European Society for Blood and Marrow Transplantation, is the reference for VOD/SOS diagnosis. However, increasing evidence suggests the emerging role of several imaging methods that could help the clinician in VOD/SOS assessment...
March 21, 2019: Expert Review of Gastroenterology & Hepatology
H Reis, T Szarvas
Urachal cancer is a rare but aggressive disease. In addition to the non-glandular tumors, non-cystic urachal adenocarcinomas are nowadays distinguished from the primary cystic variant. (Immunohistochemical) markers are only of minor differential diagnostic value and, therefore, the diagnosis is primarily established in a multidisciplinary approach. The non-cystic variant accounts for the majority of cases (83%), is more common in men (63%), shows a median age at diagnosis of 51 years and has a 5-year survival rate of about 50%...
March 20, 2019: Der Pathologe
Lachlan J Smith, Lara Silverman, Daisuke Sakai, Christine L Le Maitre, Robert L Mauck, Neil R Malhotra, Jeffrey C Lotz, Conor T Buckley
Intervertebral disc degeneration is strongly associated with chronic low back pain, a leading cause of disability worldwide. Current back pain treatment approaches (both surgical and conservative) are limited to addressing symptoms, not necessarily the root cause. Not surprisingly therefore, long-term efficacy of most approaches is poor. Cell-based disc regeneration strategies have shown promise in preclinical studies, and represent a relatively low-risk, low-cost, and durable therapeutic approach suitable for a potentially large patient population, thus making them attractive from both clinical and commercial standpoints...
December 2018: JOR Spine
Pei-Ling Tang, Hung-Chih Chen, Wei-Chun Huang, Shuo-Fang Li, Hsiao-Ching Kuo
Background/purpose: Avoiding mortality has been the ultimate goal in the management of head and neck cancer (HNC) patients with emergency department (ED) visits, however, risk factors and causes of mortality are not well studied. The objective of the present study is to verify the factors associated with long-term mortality of patients with HNC who visited ED. Materials and methods: We retrospectively collected data of 1660 HNC patients who made ED visits from the Longitudinal Health Insurance Database 2000 during 2000-2012 in Taiwan...
September 2018: Journal of Dental Sciences
Florina Nedelea, Alina Veduta, Simona Duta, Ana-Maria Vayna, Anca Panaitescu, Gheorghe Peltecu, Hans-Christoph Duba
We present a family in which the first child was diagnosed with dopa-responsive dystonia based on biochemical findings only. Dopa-responsive dystonia is a severe heterogeneous genetic disease. The possibly involved genes are GCH1 and TH. In their second pregnancy, the parents came for genetic counseling and prenatal diagnosis late, at 12 weeks of gestation. Genetic testing in the affected child was performed, but the results were difficult to interpret. The identified mutations were classified as VOUS - variants of unknown clinical significance...
October 2018: Journal of Medicine and Life
Mauro Sinopoli, Valentina Lauria, Germana Garofalo, Teresa Maggio, Tiziana Cillari
Since the early 1990s of last century the spread of Caranx crysos a thermophilic fish species in the Mediterranean Sea has increased due to sea warming. Simultaneously, a large and unregulated use of fish aggregating devices has been recorded, and these devices seem to influence fish spatial distributions. Here we used a multidisciplinary approach to investigate the influence of environmental change and FAD presence on the spatial distribution of the tropical affinity fish species Caranx crysos across the Mediterranean Sea...
March 20, 2019: Scientific Reports
Sun Hye Shin, Hyun Lee, Hyung Koo Kang, Joo Hyun Park
Few data are available regarding treatment outcomes in lung cancer patients with metastasis who initiated mechanical ventilation in the emergency department (ED). We aimed to evaluate 28-day mortality in lung cancer patients with metastasis who initiated mechanical ventilation in the ED. Patients with solid malignancy who initiated mechanical ventilation in the ED of a tertiary hospital were retrospectively identified and stratified into four groups according to the presence of lung cancer and metastasis. Among 212 included patients, the mortality rates by the 28th hospital day were as follows: 44...
March 20, 2019: Scientific Reports
Ties L Janssen, Christina A Mosk, Chantal C H A van Hoof-de Lepper, Daphne Wielders, Tom C J Seerden, Ewout W Steyerberg, Adriaan J van Gammeren, Dominique C de Lange, René van Alphen, Martine van der Zee, René M de Bruijn, Jolanda de Vries, Jan H Wijsman, Gwan H Ho, Paul D Gobardhan, Lijckle van der Laan
BACKGROUND: Due to the increase in elderly patients who undergo major abdominal surgery there is a subsequent increase in postoperative complications, prolonged hospital stays, health-care costs and mortality rates. Delirium is a frequent and severe complication in the 'frail' elderly patient. Different preoperative approaches have been suggested to decrease incidence of delirium by improving patients' baseline health. Studies implementing these approaches are often heterogeneous, have a small sample and do not provide high-quality or successful strategies...
March 20, 2019: BMC Geriatrics
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