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1.
Fam Pract ; 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39016242

RESUMO

INTRODUCTION: Self-help interventions may offer a scalable adjunct to traditional care, but their effectiveness in relapse prevention is not well-established. Objectives: This review aimed to assess their effectiveness in preventing relapses among individuals with mood disorders. METHODS: We systematically reviewed the pertinent trial literature in Web of Science, EMBASE, PubMed, PsycINFO, and Cochrane databases until May 2024. Randomized controlled trials that examined the self-help interventions among individuals diagnosed with major depressive disorder (MDD) or bipolar disorder (BD) were included. The random-effects model computed the pooled risk ratios of relapse, with subgroup analyses and meta-regression analyses to explore heterogeneity sources. RESULTS: Fifteen papers and 16 comparisons of randomized trials involving 2735 patients with mood disorders were eligible for this meta-analysis. Adjunct self-help interventions had a small but significant effect on reducing the relapse rates of major depressive disorder (pooled risk ratio: 0.78, 95% confidence interval (CI): 0.66-0.92, P = 0.0032, NNT = 11), and were marginally better in bipolar disorder (pooled risk ratio: 0.62, 95% CI: 0.40-0.97, P = .0344, NNT = 12), as compared to treatment as usual (TAU). No subgroup difference was found based on intervention components, settings, delivery method, or guidance levels. The average dropout rate for self-help interventions (18.9%) did not significantly differ from TAU dropout rates. The examination of treatment adherence was highly variable, precluding definitive conclusions. CONCLUSIONS: Self-help interventions demonstrate a modest preventative effect on relapse in mood disorders, despite low to very low certainty. Future research is essential to identify which elements of self-help interventions are most effective.

2.
J Gen Intern Med ; 39(4): 690-695, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37973709

RESUMO

Healthcare delivery has become more complicated, particularly with the addition of digital tools and advanced technologies that can further exacerbate existing disparities. New approaches to solve complex, multi-faceted problems are needed. Human-centered design (HCD), also known as design thinking, is an innovative set of methods to develop solutions to these types of issues using collaborative, team-based, and empathetic approaches focused on end user experiences. Originally advanced in technology sectors, HCD has garnered growing attention in quality improvement, healthcare redesign, and public health and medical education. During the COVID-19 pandemic, our healthcare organization recognized notable differences in utilization of virtual (video-based) services among specific patient populations. In response, we mobilized, and using HCD, we collectively brainstormed ideas, rapidly developed prototypes, and iteratively adapted solutions to work toward addressing this digital divide and clinic and systems-level struggles with improving and maintaining digital health access. HCD approaches create a cohesive team-based structure that permits the dismantling of organizational hierarchies and departmental silos. Here we share lessons learned on implementing HCD into clinical care settings and how HCD can result in the development of site-specific, patient-centered innovations to address access disparities and to improve digital health equity.


Assuntos
COVID-19 , Educação Médica , Humanos , Saúde Digital , Pandemias , Instituições de Assistência Ambulatorial
3.
Matern Child Health J ; 28(1): 116-124, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37922058

RESUMO

OBJECTIVES: To evaluate the impacts of the COVID-19 pandemic on parents and caregivers with young children in King County, Washington using data from a local population-based survey, the Best Starts for Kids Health Survey (BSKHS). METHODS: 7033 parents and caregivers in King County, Washington with children 5th grade and younger participated in the BSKHS in 2021. Three evaluators adopted a framework method approach to thematic analysis for open-ended survey responses regarding the impacts of COVID-19 on families. RESULTS: Children aged 0-5 years missed important social development opportunities, while elementary-school children missed social interactions and felt isolated during remote schooling. Parents were exhausted by the competing demands of work and schooling/childcare, with mothers bearing the brunt of additional responsibilities. Many families faced financial uncertainty and were unable to meet basic needs. Yet, families were grateful for more quality time with family members. CONCLUSIONS FOR PRACTICE: Parents expressed that children aged 0-5 years missed out on social development opportunities with both adults and children their own age and elementary-school children and felt isolated while schools were closed to in-person schooling.


Assuntos
COVID-19 , Criança , Adulto , Feminino , Humanos , Pré-Escolar , COVID-19/epidemiologia , Washington/epidemiologia , Pandemias , Pais , Mães , Inquéritos Epidemiológicos
4.
Public Health Rep ; 139(1): 18-25, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38031714

RESUMO

Individual and community-level COVID-19 mitigation policies can have effects beyond direct COVID-19 health outcomes, including social, behavioral, and economic outcomes. These social, behavioral, and economic outcomes can extend beyond the pandemic period and have disparate effects on populations. Public Health-Seattle & King County (PHSKC) built on the Centers for Disease Control and Prevention's community mitigation strategy framework to create a local project tracking near-real-time data to understand factors affected by mitigation approaches, inform decision-making, and monitor and evaluate community-level disparities during the pandemic. This case study describes the framework and lessons learned from PHSKC's collation, use, and dissemination of local data from 20 data sources to guide community and public health decision-making. Social, behavioral, economic, and health indicators were regularly updated and disseminated through interactive dashboards and products that examined data in the context of applicable policies. Data disaggregated by demographic characteristics and geography highlighted inequities, but not all datasets contained the same details; local surveys or qualitative data were used to fill gaps. Project outcomes included informing city and county emergency response planning related to implementation of financial and food assistance programs. Key lessons learned included the need to (1) build on existing processes and use automated processes and (2) partner with other sectors to use nontraditional public health data for active dissemination and data disaggregation and for real-time data contextualized by policy changes. This project provided programs and communities with timely, reliable data to understand where to invest recovery funding. A similar framework could position other health departments to examine social and economic effects during future public health emergencies.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias/prevenção & controle , Saúde Pública , Washington
5.
Ophthalmic Genet ; 44(4): 403-407, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36330599

RESUMO

PURPOSE: To report a case of concurrent pantothenate kinase-associated neurodegeneration (PKAN) and oculocutaneous albinism (OCA) with dual PANK2 and OCA2 variants in a Chinese patient who presented with early-onset reduced vision, nyctalopia, and neurological symptoms. MATERIALS AND METHODS: Based on the ocular phenotype and provisional diagnosis of rod-cone dystrophy, genetic testing was pursued. Peripheral blood DNA extraction was carried out with the next-generation sequencing technique, which involved a population-specific medical exome virtual panel. Pre- and post-test counseling were carried out by clinical geneticists. RESULT: Homozygous missense variants in PANK2 {NM_153638.3}:c.655 G>A (p.(Gly219Ser)) and OCA2{NM_025160.6}:c.1327 G>A(p.(Val443Ile)) were identified. The molecular diagnoses of pantothenate kinase associated neurodegeneration (OMIM#234200) and albinism, oculocutaneous, type II (OMIM#203200) were supported by clinical findings. CONCLUSION: Two rare autosomal recessive diseases, pantothenate kinase-associated neurodegeneration (PKAN) and oculocutaneous albinism (OCA) were detected in our patient. Ocular and systemic manifestations, as well as neuroimaging findings were compatible with the diseases identified. Genetic analysis is imperative in making an accurate molecular diagnosis in these rare conditions to allow timely counseling, disease prognostication and management.


Assuntos
Albinismo Oculocutâneo , Neurodegeneração Associada a Pantotenato-Quinase , Distrofias Retinianas , Humanos , Mutação , Neurodegeneração Associada a Pantotenato-Quinase/diagnóstico , Neurodegeneração Associada a Pantotenato-Quinase/genética , Albinismo Oculocutâneo/diagnóstico , Albinismo Oculocutâneo/genética , Distrofias Retinianas/diagnóstico , Distrofias Retinianas/genética , Fosfotransferases (Aceptor do Grupo Álcool)/genética , Proteínas de Membrana Transportadoras/genética
6.
Artigo em Inglês | MEDLINE | ID: mdl-36078235

RESUMO

The COVID-19 pandemic and the associated mitigation measures to reduce the spread of disease affected the social, economic, and overall health of individuals. Quantitative administrative datasets typically did not contain demographic information that allowed for reporting or analysis of the impacts of COVID-19 on people living with disabilities. Understanding the experiences of this population during the pandemic can inform the design of public health responses that are more robust and better connected to community. This paper describes a qualitative participatory study with a diverse sample of people living with disabilities in King County, WA. Through 2 listening sessions and 35 semi-structured interviews, it examines what impacts COVID-19 brought for people living with disabilities; elucidates the supports that were helpful in addressing COVID-19 impacts; examines inequities faced by the disability community; and sheds light on how to engage with this community to inform the public health emergency response. The process, protocols, findings, and lessons learned are replicable by other local health departments and could be incorporated as part of routine data collection and considered for future public health emergencies.


Assuntos
COVID-19 , Pessoas com Deficiência , COVID-19/epidemiologia , Humanos , Pandemias , Pesquisa Qualitativa , Washington/epidemiologia
7.
ANZ J Surg ; 92(10): 2607-2612, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35848587

RESUMO

BACKGROUND: Sentinel lymph node biopsy (SLNB) has been pivotal for pathological assessment of nodal status in cutaneous melanoma (CM) and oral cavity squamous cell carcinoma (OCSCC) thus crucial for staging. An ideal agent for lymphatic mapping should have a standardized preparation, appropriate accumulation in first-echelon nodes and no side effects. Tilmanocept, a CD206-receptor targeted novel radiotracer fulfils these properties. This study investigated Tilmanocept for lymphoscintigraphy and intraoperative identification of sentinel lymph nodes (SLN) in CM and OCSCC. METHODS: This prospective cross sectional study examined patients who presented to Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney. Patients had biopsy proven tumours with clinically and radiologically negative regional lymph nodes. Tilmanocept guided lymphoscintigraphy was followed by intraoperative SLNs identification via handheld gamma probe. Primary endpoints were detection and retrieval rate of SLNs while secondary endpoints included pathological status of SLNs. RESULTS: Thirty-five patients were included (26 with CM and 9 with OCSCC) with the most common primary tumour site for CM on the extremities (33.3%). Lymphoscintigraphy with Tilmanocept identified at least 1 SLN (sensitivity 100%) in all patients. SLNs were retrieved in all of patients intraoperatively (100% retrieval rate) with positive nodes found in 20% of patients. Tilmanocept also demonstrated 100% tissue specificity, with lymph nodal tissue confirmed histologically, with no false positives. CONCLUSION: Tilmanocept is a reliable radiotracer for assessing the nodal status in patients with CM and OCSCC. Our group is the first to evaluate the use of Tilmanocept in the Australian setting, adding to the limited studies worldwide.


Assuntos
Carcinoma de Células Escamosas , Melanoma , Neoplasias Bucais , Neoplasias Cutâneas , Austrália , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Estudos Transversais , Humanos , Linfonodos/patologia , Metástase Linfática/patologia , Melanoma/diagnóstico por imagem , Melanoma/patologia , Melanoma/cirurgia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Estudos Prospectivos , Compostos Radiofarmacêuticos , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/patologia , Pentetato de Tecnécio Tc 99m , Melanoma Maligno Cutâneo
9.
Int J Surg Pathol ; 30(8): 908-911, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35313753

RESUMO

We report a 77-year-old male with biopsy proven adnexal adenocarcinoma where there was only mass deposit of basement membrane material in the therapeutic excision. To our knowledge, this finding is extremely rare and has not been previously described in the literature and necessitates distinction from other conditions which cause eosinophilic hyaline deposits within the dermis.


Assuntos
Adenocarcinoma , Masculino , Humanos , Idoso , Membrana Basal , Biópsia , Adenocarcinoma/diagnóstico
10.
J Oral Maxillofac Surg ; 80(6): 1134-1142, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35304106

RESUMO

PURPOSE: Sentinel lymph node biopsy (SLNB) is being increasingly used worldwide as a minimally invasive option to stage the clinically node-negative neck (N0) in patients with early oral cavity squamous cell carcinomas (OCSCC). We performed this trial to assess the reliability and validity of the technique. METHODS: We did this prospective interventional nonrandomized study in patients with early (cT1-T2 OCSCC) and with negative neck. All patients underwent preoperative lymphoscintigraphy; SLNB was followed immediately by completion neck dissection (CND), thus each patient serving as their own control. The primary outcomes evaluated are sentinel lymph node (SLN) detection rate, SLN retrieval rate, and SLN status (positive or negative) compared with pathology of CND specimen to detect any false negatives. The secondary outcomes included SLN analyses (tumor burden, location in different levels of the neck, laterality, extracapsular spread, and total nodes positive) and overall survival. RESULTS: Of 60 patients, 59 (98%) had successful SLN detection with the lymphoscintigram failing to localize in 1 patient. Of the remaining 59 patients, 58 (96%) had all the SLNs retrieved, resulting in 96.4% sentinel node retrieval rate. In total, 24 (41%) SLNs were positive with 1 false negative. Using a combination of SLN and CND findings as the gold standard for lymph node involvement status, SLNB had a sensitivity of 96% (95% confidence interval [CI]: 80-100%), a specificity of 100% (95% CI: 90-100%), and negative predictive value of 97% (95% CI: 85-100%). CONCLUSION: The results of this study suggest that SLNB is an accurate technique to assess the nodal status in patients with cT1-T2 N0 OCSCC and should be considered for eligible patients.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/cirurgia , Estadiamento de Neoplasias , Estudos Prospectivos , Reprodutibilidade dos Testes , Biópsia de Linfonodo Sentinela/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço
11.
Disabil Rehabil ; 44(8): 1294-1304, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-32772583

RESUMO

PURPOSE: The long-term and specific impacts on the physical and mental health for Chinese people with major depressive disorders (MDD) are not well-studied. The aim of the study is to investigate both short-and long-term effects of a structured physical rehabilitation program on the physical and mental health and pain for Chinese patients with MDD. METHODS: 84 Chinese patients with MDD were randomized to intervention (n = 42) or control group (n = 42). Intervention group received a 12-week physical rehabilitation program and the control group with 12-week waiting period followed the same pathway as the intervention group afterwards for longitudinal analysis. Data were collected at baseline (T1), end of 12-week program (T2) and 9-month follow-up period (T3). RESULTS: Significant pre- and post-intervention improvements were noted in cardiopulmonary function, depressive symptoms, pain, body composition, muscle strength and flexibility for the intervention group. Although mild attenuation is noted from T2 to T3, subjects without exercise habit experienced significant decline in cardiopulmonary function, depressive symptoms and pain (p < 0.05) but not in those who developed exercise habit (p > 0.05). CONCLUSION: Structured physical rehabilitation program could improve physical and mental fitness and pain for Chinese MDD patients. Its effects could be sustained up to 9 months after cessation of the program provided that people establish their own exercise habit.IMPLICATIONS FOR REHABILITATIONExercise is an effective means of improving physical and mental health and pain for people with major depressive disorders (MDD).People with MDD have multiple reasons, both physically and psychosocially, for physical deconditioning and hurdles for exercise.Structured supervised exercise program can enhance physical and mental health and may likely enhance exercise compliance in this population.


Assuntos
Transtorno Depressivo Maior , Transtorno Depressivo Maior/psicologia , Terapia por Exercício , Seguimentos , Hong Kong , Humanos , Saúde Mental , Dor , Aptidão Física/fisiologia , Qualidade de Vida
12.
J Craniofac Surg ; 33(3): e329-e333, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34593744

RESUMO

ABSTRACT: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known risk following dental extraction in patients taking certain medications. Pathological fracture secondary to MRONJ often requires complex operative intervention.This case demonstrates the conservative management of pathological fracture secondary to MRONJ in a patient with multiple comorbidities. The patient developed MRONJ with pathological fracture following extraction of the mandibular second molar. The patient presented with significant surgical risk factors, having hypertension and a recent stroke, causing dense left hemiparesis, subsequently resulting in transition to high-level nursing care. Given the high risk of reconstructive surgery, nonoperative management was undertaken. Following a course of long-term antibiotics with resolution of signs of infection, the case was managed conservatively with chlorhexidine-based mouthwash and soft diet.With routine clinico-radiographic assessment and optimal oral health care, the pathological fracture did not require operative intervention. Healing progressed well with no clinical complications and radiographic evidence of good healing at 6- and 12-month follow-up on orthopantomogram.A role for conservative management of pathological fractures secondary to MRONJ yet exists, especially in the elderly population. This case highlights the importance of developing treatment plans based on individual patient context and clinical assessment.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Fraturas Espontâneas , Osteonecrose , Idoso , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Conservadores da Densidade Óssea/efeitos adversos , Tratamento Conservador , Difosfonatos/efeitos adversos , Humanos , Osteonecrose/induzido quimicamente , Radiografia Panorâmica
13.
Clin Diabetes ; 39(4): 415-423, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34866783

RESUMO

OBJECTIVE: To review the new ultra-rapid-acting insulin analogs and describe the benefits and limitations compared with other bolus insulins. SUMMARY: The options for bolus insulins, which are usually taken at mealtime or for correction of hyperglycemia, are expanding, with recent approvals of faster-acting insulin aspart and insulin lispro-aabc. These new-generation insulins contain additives that enhance absorption and accelerate onset of action. Clinical studies demonstrate that, although these insulins are faster acting, their efficacy for A1C lowering and safety in terms of hypoglycemia risk are similar to those of other available bolus insulin options such as rapid-acting insulin analogs. However, their use resulted in significant reductions in 1- and 2-hour postprandial glucose levels. CONCLUSION: Novel ultra-rapid-acting insulins provide additional bolus insulin options, and their quick onset of action provides additional dosing flexibility for people with diabetes. Given their comparable efficacy and safety compared to other quick-acting insulins, health care providers should engage in shared decision-making with patients and their caregivers regarding possible use of ultra-rapid-acting insulin, taking into account their preferences, individualized considerations, and insurance formulary coverage. These new insulin formulations may be a suitable option for people with diabetes who are not able to achieve postprandial glycemic targets with other bolus insulins.

14.
Am J Public Health ; 111(S3): S215-S223, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34709876

RESUMO

Public Health 3.0 approaches are critical for monitoring disparities in economic, social, and overall health impacts following the COVID-19 pandemic and its associated policy changes to slow community spread. Timely, cross-sector data as identified using this approach help decisionmakers identify changes, track racial disparities, and address unintended consequences during a pandemic. We applied a monitoring and evaluation framework that combined policy changes with timely, relevant cross-sector data and community review. Indicators covered unemployment, basic needs, family violence, education, childcare, access to health care, and mental, physical, and behavioral health. In response to increasing COVID-19 cases, nonpharmaceutical intervention strategies were implemented in March 2020 in King County, Washington. By December 2020, 554 000 unemployment claims were filed. Social service calls increased 100%, behavioral health crisis calls increased 25%, and domestic violence calls increased 25%, with disproportionate impact on communities of color. This framework can be replicated by local jurisdictions to inform and address racial inequities in ongoing COVID-19 mitigation and recovery. Cross-sector collaboration between public health and sectors addressing the social determinants of health are an essential first step to have an impact on long-standing racial inequities. (Am J Public Health. 2021;111(S3):S215-S223. https://doi.org/10.2105/AJPH.2021.306422).


Assuntos
COVID-19 , Política de Saúde , Acessibilidade aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Saúde Pública , COVID-19/economia , COVID-19/prevenção & controle , Humanos , Saúde Mental , Vigilância da População , Desemprego/estatística & dados numéricos , Washington
15.
Ann Nutr Metab ; 77(5): 251-261, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34569523

RESUMO

INTRODUCTION: The effectiveness of probiotics in patients with abnormal glucose metabolism has not been clearly demonstrated. It is also unclear if outcomes are consistent across different probiotic formulations. METHODS: A literature search was conducted using PubMed, EMBASE, and Cochrane CENTRAL database from inception through May 2020. Randomized controlled trials that evaluated the effect of probiotics on fasting blood glucose (FBG) or hemoglobin A1c (HbA1c) in patients with prediabetes, type 2 diabetes mellitus, or gestational diabetes were included. Outcomes of interest included FBG, HbA1c, fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of ß-cell function (HOMA-B), and quantitative insulin sensitivity check index (QUICKI). Weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated using the DerSimonian and Laird random-effects model. RESULTS: 31 studies involving 1,948 participants were included in this analysis. Compared to control, probiotics had a significant favorable effect on FBG (WMD -5.77 mg/dL, 95% CI -8.48 to -3.06), HbA1c (WMD -0.32%, 95% CI -0.47 to -0.18), fasting insulin (WMD -2.95 µIU/mL, 95% CI -3.76 to -2.14), HOMA-IR (WMD -0.82, 95% CI -1.05 to -0.59), HOMA-B (WMD -14.86, 95% CI -24.57 to -5.16), and QUICKI (WMD 0.015, 95% CI 0.011-0.019). Further, probiotics were associated with favorable outcomes on all parameters at doses between 1 and 10 × 109 colony-forming unit per day (p < 0.004 for all) and formulations containing 2-4 strains (p < 0.05 for all). DISCUSSION/CONCLUSION: Probiotics appear to have a modest effect on glycemic parameters in patients with abnormal glucose metabolism. Due to the limited number of trials conducted in patients with prediabetes, more studies are warranted in this population.


Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Probióticos , Glicemia/metabolismo , Feminino , Glucose , Hemoglobinas Glicadas/metabolismo , Humanos , Probióticos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Curr Pharm Teach Learn ; 13(10): 1339-1345, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34521529

RESUMO

INTRODUCTION: Objectives include (1) To create an opportunity for students enrolled in pharmacy programs to enhance their presentation skills by delivering research podium presentations at a regional conference; (2) To probe students' experience about podium presentations at the inaugural American Association for the Advancement of Science Pacific Division (AAAS PD) - American Association of Colleges of Pharmacy Students' Symposium; and (3) To introduce student pharmacists to science-oriented research. METHODS: The student presenters were asked to anonymously answer 15 questions before and after the symposium. Question topics included factual information about students' background and favorability perceptions about symposia. Scores were compared between pharmacy students and non-pharmacy students, and favorability ratings were compared before and after the symposium. RESULTS: Thirteen students delivered their podium presentations at the symposium entitled "Pharmaceutical Research and Development: From Bench to Patient-Centered Care" that was held in Pomona, California at the 99th Annual Meeting of the AAAS PD in 2018. Pharmacy and non-pharmacy students provided similar responses on favorability perceptions. Post-symposium perceptions were more favorable towards symposia compared to pre-symposium scores. CONCLUSIONS: Favorability scores revealed a positive perception of the event and what it offered in terms of scientific benefits, networking opportunities, and enhancing soft skills. Participating students had the chance to (1) prepare and independently deliver a podium presentation on pharmacy-related research topics at a regional meeting; (2) network and learn from each other and professionals in the audience about pharmacy research; and (3) practice soft skills such as communication, time-management, teamwork, scientific writing, and presentation skills.


Assuntos
Educação em Farmácia , Assistência Farmacêutica , Farmácias , Farmácia , Estudantes de Farmácia , Humanos
17.
Curr Pharm Teach Learn ; 13(9): 1215-1220, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34330401

RESUMO

BACKGROUND AND PURPOSE: The purpose of the new transitions of care (TOC) elective to the pharmacy curriculum is to train pharmacy students to address TOC medication-related problems, assess students' knowledge and perceptions of the TOC pharmacist's role, and explore the impact on interest in post-graduate career planning. EDUCATIONAL ACTIVITY AND SETTING: Third-year pharmacy students were enrolled in the two-credit TOC elective course. The course was designed to include relevant TOC concepts and application of the Pharmacists' Patient Care Process. The pre- and post-assessment surveys were distributed at the beginning and end of the course by a staff administrator to eliminate survey bias. Students were asked to anonymously respond to nine survey questions using a five-point Likert scale (strongly disagree = 1, strongly agree = 5). FINDINGS: Ninety-two percent (n = 23) of the pharmacy students responded to the pre- and post-assessment surveys, and results were subsequently analyzed. Statistically significant responses existed to eight of nine questions regarding students' perceptions of increased knowledge of the TOC concepts and pharmacists' role, communication skills, confidence in providing comprehensive patient care, and interest in recommending the TOC elective course to their peers. There was interest in pursuing additional training opportunities, such as post-graduate residency or fellowship training, but the survey item was not statistically significant. SUMMARY: The TOC elective course provides an opportunity for pharmacy students to learn about the TOC pharmacist's role, improve knowledge on the TOC patient care process, develop practical skills, and engage with clinical pharmacists.


Assuntos
Educação em Farmácia , Farmácia , Estudantes de Farmácia , Currículo , Avaliação Educacional , Humanos , Percepção
18.
Int J Surg Case Rep ; 82: 105909, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33957400

RESUMO

INTRODUCTION AND IMPORTANCE: Having two or more sites of simultaneous ectopic thyroid tissue is a rare phenomenon. Thyroid ectopia should be considered in congenital hypothyroidism where no eutopic thyroid gland is found. CASE PRESENTATION: This case describes an incidental finding of dual ectopic thyroid tissue on computer tomography scan in an adult with known congenital hypothyroidism that was previously attributed to thyroid agenesis. The decision was made to proceed with a Sistrunk procedure to excise the ectopic submental thyroid as it became more noticeable after weight loss following bariatric surgery, and to monitor the remaining lingual thyroid with a combination of clinical symptomology, imaging and thyroid function studies given its challenging location. CLINICAL DISCUSSION: The literature on pathophysiology, imaging modalities, and common considerations for surgical extirpation is reviewed. CONCLUSION: The utility of thyroid scintigraphy may be limited in patients with known thyroid ectopia; other investigative modalities are helpful. The Sistrunk procedure was used to excise an ectopic thyroid, based on its embryological migration from the foramen caecum to the usual pretracheal position along the thyroglossal tract, and is a suitable technique for excision of submental thyroid tissue causing an unsightly mass and where thorough histopathological examination is required to exclude malignancy.

19.
Cureus ; 13(12): e20399, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35036228

RESUMO

Thyroglossal duct cyst (TDC) commonly occurs in the neck just below the hyoid bone. Uncommon sites of TDC have been documented, and of these, an intra-thyroid location is very rare. We report such a rare intra-thyroid TDC (ITTDC) initially identified by ultrasound examination as an incidental thyroid imaging reporting and data system (TI-RADS) three lesion in the left thyroid lobe of a 59-year-old male patient with primary hyperparathyroidism due to a parathyroid adenoma. The preoperative ultrasound-guided fine-needle aspiration biopsy (US-FNAB) cytology of the thyroid lesion was interpreted as Bethesda III (atypia of undetermined significance or follicular lesion of undetermined significance). A left hemithyroidectomy and left superior parathyroidectomy were performed. The postoperative histology revealed the thyroid lesion to be an ITTDC. An incidental papillary thyroid microcarcinoma was also histologically revealed. The 2.5-year postoperative follow-up was uneventful. Based on literature searches, the clinical features, fine-needle aspiration biopsy (FNAB) cytology, histology, differential diagnosis, treatment, and follow-up of ITTDC were reviewed and discussed. A proposal to categorize ITTDC into two anatomical location subtypes is made. The liability of ITTDC to be misinterpreted on FNAB cytology due to rarity and lack of morphological specificity is emphasized.

20.
Surv Ophthalmol ; 66(2): 198-212, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33278403

RESUMO

Endoscopy provides unique optical properties to circumvent anterior segment opacities and visualize difficult-to-access anatomical regions, including retroirideal, retrolental, ciliary body, and anterior retinal structures. We summarize the basic principles and utilization of endoscopic vitreoretinal surgery, along with recent technological advances in the field base on a structured literature search in Pubmed, Embase, and Google Scholar database up to February, 2020. Endoscopy has been used in the management of retinal detachment, ischemic retinopathies with neovascular glaucoma, severe ocular trauma, endophthalmitis, lens-related disorders in the posterior segment, pediatric vitreoretinal diseases, and implantation of retinal prostheses. Ongoing development of endoscopic technology aims to provide higher resolution images with endoscopes of smaller diameter. New surgical techniques supported by the adoption of endoscopy are available to manage challenging surgical scenarios. Endoscopy can be a useful adjunct to microscope wide-angle viewing systems in the management of complex vitreoretinal diseases.


Assuntos
Descolamento Retiniano , Doenças Retinianas , Cirurgia Vitreorretiniana , Criança , Endoscopia/métodos , Humanos , Descolamento Retiniano/cirurgia , Doenças Retinianas/cirurgia , Estudos Retrospectivos , Vitrectomia/métodos , Cirurgia Vitreorretiniana/métodos
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