• Title/Summary/Keyword: Multidisciplinary approach

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구강건조증과 구취 : 최신 지견의 고찰 (Xerostomia and halitosis : A review and current concepts)

  • 이연희
    • 대한치과의사협회지
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    • 제55권9호
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    • pp.640-656
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    • 2017
  • Xerostomia is usually caused by a reduced salivary flow or by changes in the biochemical composition of saliva. Halitosis or oral malodor is an offensive odor usually originating from the oral cavity. Halitosis can lead to anxiety and psychosocial embarrassment. The occurrence of halitosis closely related with intraoral conditions including the presence of xerostomia. Especially, the relationship between xerostomia and halitosis is prominent in elderly patients receiving polypharmacy with at least two systemic diseases. This study is a review of the update literature of xerostomia and halitosis. A large number of papers have been searched and identified using the words , , , , , , and . Papers not relevant to the issue were removed reducing the entries to 79 only. Most of identified papers were systematic reviews, non-systematic reviews, and observational studies. With a proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach. It is significant to highlight the necessity of an interdisciplinary method for the treatment of xerostomia and halitosis to prevent misdiagnosis or unnecessary treatment. This article concisely focuses on the development of a systemic flow of events to come to the proper treatment of the xerostomia and halitosis.

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Structure Analyses of Rubber/Filler System under Shear Flow by Using Time Resolved USAXS Method

  • Nishitsuji, Shotaro;Takenaka, Mikihito;Amino, Naoya;Ishikawa, Yasuhiro
    • Elastomers and Composites
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    • 제54권2호
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    • pp.156-160
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    • 2019
  • The changes in the dispersion of carbon black in liquid polyisoprene under shear flow with time have been investigated by time-resolved ultra small-angle X-ray scattering (USAXS) method. The analyses of USAXS profile immediately after the start of shear flow clarified that the aggregates of carbon black with a mean radius of gyration of 14 nm and surface fractal dimension of 2.5 form the fractal network structure with mass-fractal dimension of 2.9. After the application of the shear flow, the scattering intensity increases with time at the observed whole entire q region, and then the a shoulder appears at $q=0.005nm^{-1}$, indicating that the agglomerate is broken and becomes smaller by shear flow. The analysis by the Unified Guinier/Power-law approach yielded several characteristic parameters, such as the sizes of aggregate and agglomerate, mass-fractal dimension of agglomerate, and surface fractal dimension of the primary particle. While the mean radius of gyration of the agglomerate decreases with time, the mean radius of gyration of the aggregate, mass fractal dimension, and surface fractal dimension don't change with time, indicating that the aggregates peel off the surface of the agglomerate.

만성 구강안면통증의 조절을 위한 약물치료적 접근 (Pharmacological approaches for the management of chronic orofacial pain)

  • 정재광;변진석;최재갑
    • 대한치과의사협회지
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    • 제57권4호
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    • pp.233-240
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    • 2019
  • Chronic orofacial pain is an umbrella term as a kind of painful regional syndromes to describe unremitting and prolonged pains in orofacial area. It is frequently characterized with the intractable pain without the proportionally corresponding tissue pathology over 3 months. Accordingly, it is difficult or almost impossible to establish the causally oriented treatment strategies in those cases, while multidisciplinary approaches were usually considered for preventing prolonged pain conditions from limiting daily life. Among a variety of approaches, pharmacological approach was clinically based on proper applications of several groups of drugs useful to relieve or alleviate pain. These drugs usually encompass several analgesics, muscle relaxants, anti-depressants, anticonvulsants and so on. Therefore, it is essential for dental clinician to be aware of the many peculiarities of these medications applied for management of chronic orofacial pain disorders. This review focused on the clinical considerations for the careful drug selection and application including dosages and adverse drug reactions.

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Extracorporeal Pedicles for Free Flap Reconstruction in Diabetic Lower Extremity Wounds

  • Alejandro R. Gimenez;Daniel Lazo;Salomao Chade;Alex Fioravanti;Olimpio Colicchio;Daniel Alvarez;Ernani Junior;Sarth Raj;Amjed Abu-Ghname;Marco Maricevich
    • Archives of Plastic Surgery
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    • 제49권6호
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    • pp.782-784
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    • 2022
  • Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

Current concepts of vascular anomalies

  • Tae Hyung Kim;Jong Woo Choi;Woo Shik Jeong
    • 대한두개안면성형외과학회지
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    • 제24권4호
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    • pp.145-158
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    • 2023
  • Vascular anomalies encompass a variety of malformations and tumors that can result in severe morbidity and mortality in both adults and children. Advances have been made in the classification and diagnosis of these anomalies, with the International Society for the Study of Vascular Anomalies establishing a widely recognized classification system. In recent years, notable progress has been made in genetic testing and imaging techniques, enhancing our ability to diagnose these conditions. The increasing sophistication of genetic testing has facilitated the identification of specific genetic mutations that help treatment decisions. Furthermore, imaging techniques such as magnetic resonance imaging and computed tomography have greatly improved our capacity to visualize and detect vascular abnormalities, enabling more accurate diagnoses. When considering reconstructive surgery for facial vascular anomalies, it is important to consider both functional and cosmetic results of the procedure. Therefore, a comprehensive multidisciplinary approach involving specialists from dermatology, radiology, and genetics is often required to ensure effective management of these conditions. Overall, the treatment approach for facial vascular anomalies depends on the type, size, location, and severity of the anomaly. A thorough evaluation by a team of specialists can determine the most appropriate and effective treatment plan.

Dancing with the Surgeon: Neoadjuvant and Adjuvant Immunotherapies from the Medical Oncologist's Perspective

  • Sehhoon Park
    • Journal of Chest Surgery
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    • 제56권2호
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    • pp.67-74
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    • 2023
  • Perioperative treatment with conventional cytotoxic chemotherapy for resectable non-small cell lung cancer (NSCLC) has proven clinical benefits in terms of achieving a higher overall survival (OS) rate. With its success in the palliative treatment of NSCLC, immune checkpoint blockade (ICB) has now become an essential component of treatment, even as neoadjuvant or adjuvant therapy in patients with operable NSCLC. Both pre- and post-surgery ICB applications have proven clinical efficacy in preventing disease recurrence. In addition, neoadjuvant ICB combined with cytotoxic chemotherapy has shown a significantly higher rate of pathologic regression of viable tumors compared with cytotoxic chemotherapy alone. To confirm this, an early signal of OS benefit has been shown in a selected population, with programmed death ligand 1 expression ≥50%. Furthermore, applying ICB both pre- and post-surgery enhances its clinical benefits, as is currently under evaluation in ongoing phase III trials. Simultaneously, as the number of available perioperative treatment options increases, the variables to be considered for making treatment decisions become more complex. Thus, the role of a multidisciplinary team-based treatment approach has not been fully emphasized. This review presents up-to-date pivotal data that lead to practical changes in managing resectable NSCLC. From the medical oncologist's perspective, it is time to dance with surgeons to decide on the sequence of systemic treatment, particularly the ICB-based approach, accompanying surgery for operable NSCLC.

Strategies for the Universities to be Locally Engaged while Globally Visible

  • Ramakrishna, Seeram
    • Asian Journal of Innovation and Policy
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    • 제4권3호
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    • pp.271-287
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    • 2015
  • Universities are now operating in a post-globalized world. They need to be locally engaged while globally visible for continued success. Specific strategies include 1) unbundling education using fractal modules approach to facilitate more flexible and customized learning expectations of net generation of students; 2) open-source software and hardware platforms to facilitate collaborations around a short or multi-year, multidisciplinary brain stretching projects motivated by the real world challenges; 3) new courses on innovation and entrepreneurship to nurture experience seeking and enterprising mindset of students; 4) cross-border university- public- private partnerships for developing solutions specific to the local needs and can be scalable for the world; and 5) encouraging faculty members with glocal mindset.

Simulated Annealing 알고리즘을 이용한 방음벽의 최적 설계 (Optimal Design of Noise Barriers Using Simulated Annealing Algorithm)

  • 김병희;김진형;최태묵;박일권;조대승
    • 한국소음진동공학회논문집
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    • 제13권8호
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    • pp.619-625
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    • 2003
  • A successful design approach for noise barriers should be multidisciplinary because noise reduction goals influence both acoustical and non-acoustical considerations, such as maintenance, safety, physical construction, cost, and visual impact. These various barrier design options are closely related with barrier dimensions. In this study, we have proposed an optimal design method of noise barriers using simulated annealing algorithm, providing a harrier having the smallest dimension and achieving the specified noise reduction at a receiver region exposed to the noise due to Industry and infrastructure, to help a successful barrier design.

화학요법을 받고 있는 암환아의 구토 및 식이양상 (The Survey of Nausea-vomiting and Diet Patterns among Pediatric Cancer Patient Received Chemotherapy)

  • 박성희
    • Child Health Nursing Research
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    • 제3권1호
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    • pp.62-70
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    • 1997
  • The incidence of chemothrapy related among pediatric cancer patient was 90.1%. Adequate oral intake and nutrition have been shown to be important. These consideration prompted the decision to survey by means of a questionaire. The questionaire were included nausea-vomiting peak time, causing factor, coping method, education need, diet pattern change and food preference. Results are fellow 1. Almost(90.1%) pediatric cancer patient experienced nausea-vomiting during chemotherapy and required coping method or reducing method. 2 . The food preference form were Identified. Those were fluid form, cold and small amout and frequentry eating form. The patients preferred noodles, chickens, soap, juice. The results of the survey indicate that nasea-vomiting relief nursing intervention are required pediatric cancer patient received chemotherapy. Health care personnels recognize the pediatric cancer patient's diet pattern and encourage the nutritional counselling. The care of patient should be multidisciplinary team approach and the nurse occupies a key position with in this team, which includes the pediatrician, nutrionist.

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Cancer Survivorship에 대한 이해와 전망 (Understanding Cancer Survivorship and Its New Perspectives)

  • 김수현
    • 종양간호연구
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    • 제10권1호
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    • pp.19-29
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    • 2010
  • Purpose: The purpose of this article was to review and discuss the current status, issues, and nursing perspectives of cancer survivorship. Methods: A comprehensive literature review was conducted. Results: The major areas of concern for the survivors included recurrence, secondary malignancies, and long-term treatment sequalae which affect their quality of life. The four essential components of survivorship are prevention, surveillance, intervention, and coordination. Cancer survivorship care plan should address survivor's long-term care, such as types of cancer, treatment modalities, potential side effects, and recommendations for follow-up. It also needs to include preventive practices, health maintenance and well-being, information on legal protections regarding employment and health insurance, as well as psychosocial services in the community. Survivorship care for cancer patients requires multidisciplinary efforts and team approach. Conclusion: Nurses are uniquely positioned to play a key role in ensuring quality services for cancer survivors and family members. Nurses should review the care plans for cancer survivorship with patients and families by instructing them when to seek medical treatment, promoting any recommended surveillance protocols, and encouraging healthy life styles for health promotion and quality of life.