Hereditary angioedema: Comprehensive management plans and patient support

2020 ◽  
Vol 41 (6) ◽  
pp. S38-S42
Author(s):  
Diane Paige ◽  
Njeri Maina ◽  
John T. Anderson

Hereditary angioedema (HAE) is a rare disease. Regardless, patients with HAE have access to multiple state-of-the-art medications available for on-demand use and prevention that reduce the frequency and burden of HAE attacks. These treatments have greatly reduced the burden of disease and helped patients achieve improved quality of life. However, with greater numbers of therapeutic options, HAE care has become more complex. In this review, we addressed essential elements of an individualized comprehensive management plan for a patient with HAE. We focused on access to an expert physician, ongoing patient education, access to effective treatment options, coordination of care and management of treatment logistics, ongoing monitoring of attacks and treatments, and other resources for patient support. This plan will need to be communicated with the patient and other care providers, especially during emergent conditions, and accommodate the patient’s lifestyle with consideration for work, school, travel, etc. Periodically, the physician and the patient will need to review information about attacks, triggers, and treatments to identify areas for improvement and update the plan.

2004 ◽  
Vol 16 (1) ◽  
pp. 45-49 ◽  
Author(s):  
P.Y. Lee ◽  
E.M. Khoo

70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced. Asia Pac J Public Health 2004; 16(1): 45-49.


2021 ◽  
pp. 107815522110082
Author(s):  
Ali Cherif Chefchaouni ◽  
Youssef Moutaouakkil ◽  
Badr Adouani ◽  
Yasmina Tadlaoui ◽  
Jamal Lamsaouri ◽  
...  

Introduction Drug shortages have been a growing global problem in recent years. Some of them are of vital necessity and importance for the patient, such as those used to treat pathologies in clinical hematology and oncology departments. The objectives of this study are to determine the impact of anti-cancer drugs shortages on both: treatment and patient in the hematology and oncology departments, to describe the actions that have been put in place to manage the shortages and to survey patients about their perspectives and experiences. Materials and methods It was a prospective, observational study, it took place in the oncology and hematology departments. It was carried out with the help of an operating sheet, which contained two parts: patient and treatment data. This sheet was filled out after the interview with the patient and on the basis of the medical file. Results Of the 101 patients interviewed, 67.3% were impacted by the shortage of drugs. The treated pathology that was most impacted by the rupture was Non-Hodgkin lymphoma (55.8%), vincristine was the drug most responsible for the shortages (34%). Most patients (51.4%) went to a non-local pharmacy to buy the medicine that was in short supply in the hospital. Delayed care was the main impact of the drug shortage (42.6%). As a result of these shortages, the majority of patients (45.6%) were frustrated and anxious about the situation. Conclusion Drug shortages have a profound impact on patient safety, clinical outcomes, quality of treatment, hospital management and other important factors. In-depth collaboration between different health actors and timely communication strategies are essential elements of an effective drug shortage management plan.


2021 ◽  
Vol 12 ◽  
pp. 215013272199219
Author(s):  
Danielle J. O’Laughlin ◽  
Brittany Strelow ◽  
Nicole Fellows ◽  
Elizabeth Kelsey ◽  
Sonya Peters ◽  
...  

To review the anxiety and fear risk factors, pathophysiology, symptoms, screening and diagnosis while highlighting treatment considerations for women undergoing a pelvic examination. Methods: We reviewed the literature pertaining to anxiety and fear surrounding the pelvic examination to help guide health care providers’ on available screening options and to review options for individualized patient management. Results: Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures. This exam can provoke negative physical and emotional symptoms such as pain, discomfort, anxiety, fear, embarrassment, and irritability. These negative symptoms can interfere with preventative health screening compliance resulting in delayed or avoided care and significant health consequences. Conclusion: Assessing women for anxiety related to pelvic examinations may help decrease a delay or avoidance of examinations. Risk factor and symptom identification is also a key component in this. General anxiety questionnaires can help identify women with anxiety related to pelvic examinations. Strategies to reduce anxiety, fear and pain during a pelvic examination should routinely be implemented, particularly in women with high-risk factors or those identified with screening techniques as having anxiety, fear or pain with examinations. Treatment options should be targeted at understanding the patient’s concerns, starting conversations about pelvic examinations early, educating patient’s about the examination and offering the presence of a chaperone or support person. During an examination providers should ensure the patient is comfortable, negative phrases are avoided, the correct speculum size is utilized and proper lubrication, draping, dressing and positioning are performed. Treating underlying gynecologic or mental health conditions, consideration of cognitive behavioral therapy and complementary techniques such as lavender aromatherapy and music therapy should also be considered when appropriate.


1998 ◽  
Vol 4 (2) ◽  
pp. 95-100 ◽  
Author(s):  
M A Loane ◽  
R Corbett ◽  
S E Bloomer ◽  
D J Eedy ◽  
H E Gore ◽  
...  

Diagnostic accuracy and management recommendations of realtime teledermatology consultations using low-cost telemedicine equipment were evaluated. Patients were seen by a dermatologist over a video-link and a diagnosis and treatment plan were recorded. This was followed by a face-to-face consultation on the same day to confirm the earlier diagnosis and management plan. A total of 351 patients with 427 diagnoses participated. Sixty-seven per cent of the diagnoses made over the video-link agreed with the face-to-face diagnosis. Clinical management plans were recorded for 214 patients with 252 diagnoses. For this cohort, 44 of the patients were seen by the same dermatologist at both consultations, while 56 were seen by a different dermatologist. In 64 of cases the same management plan was recommended at both consultations; a sub-optimum treatment plan was recommended in 8 of cases; and in 9 of cases the video-link management plans were judged to be inappropriate. In 20 of cases the dermatologist was unable to recommend a suitable management plan by video-link. There were significant differences in the ability to recommend an optimum management plan by video-link when a different dermatologist made the reference management plan. The results indicate that a high proportion of dermatological conditions can be successfully managed by realtime teledermatology.


2021 ◽  
Vol 46 (11) ◽  
pp. 3-4
Author(s):  
Molly Antone ◽  

Dying today looks dramatically different than it did a century ago, largely due to wider treatment options and more specialized medical practices. Often missing from these advancements is the focus on factors relative to a patient’s total circumstances. Especially in light of the recent pandemic, it is incumbent upon Catholic health care providers to treat who whole person rather than simply focus on more utilitarian philosophies of care.


Author(s):  
David A Parker ◽  
Corey Scholes ◽  
Thomas Neri

Knee osteoarthritis in younger patients can be a challenging condition to manage. The patient and clinician have a range of non-operative management options available, although the guidance to effectively apply these options is lacking. The following review summarises a range of non-operative treatment options as an accessible reference for primary care providers to establish a coordinated care plan in consultation with the patient as part of a shared decision making process. Options are summarised in non-pharmacological and pharmacological treatments. These options are based on the latest guidelines based on authoritative recommendations, as well as recent articles with a good level of evidence that have not yet been incorporated into these official contents. The coordination of treatment using a range of modalities remains poorly explained in the literature and the current review proposes a conceptual model for coordinated care to be provided. In this model, the patient is central to the interaction between the coordinator and specialist providers, and the treatment plan is tailored to provide the optimal pain relief and functional benefit specific to the patient.


2021 ◽  
Vol 25 (04) ◽  
pp. 846-854
Author(s):  
Alessandro Ribeiro Morais ◽  
◽  
Mariana Nascimento Siqueira ◽  
Roniel Freitas-Oliveira ◽  
Daniel Brito ◽  
...  

Protected areas are the most frequently used tool for the mitigation of threats to biodiversity. However, without effective management, the creation of new protected areas may be ineffective. In Brazil, protected areas must have both a governing body (consultative or deliberative council) and an official management plan. Here, we analyzed general trends and patterns in the approval of the management plans for Brazilian federal protected areas. We considered all federal protected areas, and compiled data on (i) the year the area was created, (ii) the type of protected area (integral protection vs. sustainable use), (iii) year its management plan was approved, (iv) year in which the management plan was revised after its approval, (v) total area (in hectares), and (vi) the biome in which the area is located. We stablished three groups of protected area: 1) Group A: protected areas created prior to 1979, 2) Group B: protected areas created between 1979 and 1999, and 3) Group C: protected areas created between 2000 to the present time. Finally, we tested whether time for the approval of the management plan suffered a simultaneous effect of the type of biome and type of categories of protected area (strictly protected vs. sustainable use areas). We found 211 (63.17% of the 334) protected areas with management plan. On average, the time taken for the creation and approval of a management plan far exceeds the deadlines (5 yrs.) defined under current Brazilian law. All Brazilian biomes are poorly covered by protected areas with effective management plans, with the highest and lowest value observed in the Pantanal (100%) and Caatinga (46.42%), respectively. Our results suggest that the effectiveness of many federal protected areas in Brazil can be reduced considerably by the lack of a management plan, with deleterious consequences for the country’s principal conservation strategies.


Author(s):  
Dian Primadia Putri ◽  
Brama Ihsan Sazli

Background: Acromegaly is an uncommon clinical disorder driven by high serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Over 99% of patients with acromegaly harbor a GH emitting pituitary adenoma. Pituitary tumors represent about 15% of essential intracranial neoplasms. Case presentation: A 38 years old woman, was referred to the H. Adam Malik central public hospital on December 15th, 2020, with chief complaints of enlarged fingers and toes. The patient complained that the patient's fingers and toes were getting bigger in the past 2 years. The brain MRI was performed showed intrasella spherical intensity lesions measuring ± 2.3x1.5x2 cm with the impression of macroadenoma. The patient later diagnosed with acromegaly due to pituitary macroadenoma. Therefore the patient was treated with administration of sandostatin injection, novorapid 6-6-6 IU SC, then 0-0-12 IU SC, 3x1 salt capsules. The patient is also consulted to the neurosurgery department for surgical management plans and a consulted to the Ophthalmology Department. Conclusion: We report an instance of acromegaly suspected because of pituitary macroadenoma in a patient with unmistakable clinical highlights, with comprehensive management.


2018 ◽  
Author(s):  
Tomas Nygren ◽  
Matilda Berg ◽  
Ali Sarkohi ◽  
Gerhard Andersson

BACKGROUND Recent years have seen an increase in Arabic-speaking immigrants in Sweden and other European countries, with research showing this group to suffer from elevated levels of various forms of psychological disorders. There is a lack of treatment options for immigrants with mild to moderate mental health problems, with barriers including lack of accessible services and concerns that problems will not be understood by health care providers. OBJECTIVE This study aims to describe the process of developing a transdiagnostic internet-based cognitive behavioral therapy self-help program in Arabic for mild to moderate symptoms of common psychological problems such as anxiety, depression, and insomnia. METHODS The iterative development process, including feedback from 105 pilot users as well as 2 focus groups, is described. RESULTS Overall, the modules were rated as acceptable by the pilot users, with overall ratings ranging from 3 to 4 points on average for the respective modules on a 5-point Likert scale. Feedback from the 2 focus groups was overall positive with regard to the content and structure of the program but also included suggestions for improving the Arabic translation as well as the usability of the material. CONCLUSIONS An internet-based self-help program that is deemed acceptable by an Arabic-speaking audience can be successfully developed, thus providing increased access to psychological help for an at-risk population. However, further research regarding the efficacy of this type of intervention is warranted.


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