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Background/Objectives: Anemia is a prevalent comorbidity of diabetes, and although various mechanisms have been shown to link these two conditions, their interaction has not been sufficiently explored. Our cross-sectional, non-interventional study aimed to evaluate the prevalence of anemia and its subtypes, as well as their interactions, in patients with type 2 diabetes (T2D). Methods: A total of 227 patients previously diagnosed with T2D were enrolled. These patients were assessed regarding their medical history and the evolution of their diabetes, and were screened for anemia. Results: Anemia was encountered in 32.6% of the 227 hospitalized patients previously diagnosed with T2D enrolled in this study. Its presence was associated with a higher prevalence of complications and comorbidities, such as chronic kidney disease (CKD), retinopathy, and atrial fibrillation. The most common types of anemia observed were those associated with CKD, other chronic conditions, and iron deficiency. A moderate, positive correlation (r = 0.307; p < 0.0001) has been observed between estimated glomerular filtration rate (eGFR) and hemoglobin, and a moderate, negative correlation has been observed between age and hemoglobin (r = −0.351; p < 0.0001), with the results also analyzed using multiple regression and ROC curve analysis. Additionally, a weak, positive, yet statistically significant correlation was observed between glycemic values and hemoglobin levels, which requires further research. Conclusions: Anemia is frequently encountered in patients with T2D, especially in those with increased age, decreased eGFR, and additional chronic degenerative complications or other comorbidities; thus, a systematic screening for an early diagnosis and interdisciplinary management is recommended for improved outcomes related to morbidity, mortality, and quality of life. [ABSTRACT FROM AUTHOR]

Summary Management of type 2 diabetes includes medications that can unintentionally increase obesity and insulin resistance. This unblinded, single‐centre, randomised controlled trial focused on rural Australian adults with type 2 diabetes (aged 18–75 and body mass index [BMI] >30 kg/m2), measuring the effectiveness of a tailored interdisciplinary obesity care approach compared with usual diabetes care. Led by a nurse practitioner with allied health support (dietitian ± psychologist and physiotherapist), the bariatric treatment involved reducing weight‐gaining medications, a 500‐calories/day deficit, an unsupervised exercise program emphasising movement/strength and psychotherapy, 3‐monthly to 24‐months with support phone calls at weeks 2, 4, 8 and 10. Outcomes from the 224 (113 intervention/111 control) participants were differences in biomedical and physical markers within‐ and between‐groups estimated using multivariate mixed‐effects linear regression between recruitment and 6‐monthly follow‐ups. Greater change occurred in intervention compared with control groups at 12 and 24 months in mean: body weight (−5.9 kg [95% confidence interval, CI: −8.53, −3.23] and −9.0 kg [95% CI: −13.2, −4.77]); BMI (−2.03 kg/m2 [95% CI: −2.92, −1.15] and −3.51 kg/m2 [95% CI: −4.93, −2.08]); and glycated haemoglobin (−0.26% [95% CI: −0.69%, 0.18%] and −0.63% [95% CI: −1.17%, 0.08%]). The control group showed a significant increase in mean leptin level, resulting in a between‐group difference (−27.1 [95% CI: −42.7, −11.5]). Lipids and blood pressure differences were inconclusive, while exploratory analysis showed greater decline in estimated glomerular filtration rate in the control group. The interdisciplinary obesity approach, compared with usual diabetes care, resulted in sustained weight loss and improved diabetes control over 2 years. Trial registration number: ACTRN12622000240741. [ABSTRACT FROM AUTHOR]

Arteriovenous malformations (AVMs) are rare vascular abnormalities that can result from defects in blood vessels. They are not often found in the facial area, and this report describes a case of a high-flow AVM in an adult patient with swelling in the left mandibular region. Since there were no complications related to swelling, a comprehensive investigation ultimately resulted in the accurate identification of the AVM. The potential risks associated with these malformations highlight the importance of accurate diagnosis and comprehensive diagnostic approaches involving detailed patient history, clinical examination, and advanced imaging techniques. Computed tomography angiography confirmed the diagnosis before undergoing angioembolization and complete excision of the AVM. This case underscores how important accurate diagnosis is for preventing serious complications associated with AVMs and emphasizes using a multidisciplinary strategy when managing these uncommon vascular anomalies.

Impacted mandibular canines often result in a variety of clinical dilemmas. Orthodontic disimpaction of severely displaced mandibular canines may be extremely challenging and associated with significant patient discomfort and a high risk of iatrogenic damage. This case report demonstrates the interdisciplinary management of a horizontally impacted permanent mandibular canine, utilising a combination of three‐dimensional radiology, biomodel fabrication and subsequent endodontic treatment. © 2024 Australian Dental Association. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background In 2017, the German Academy for Rare Neurological Diseases (Deutsche Akademie für Seltene Neurologische Erkrankungen; DASNE) was founded to pave the way for an optimized personalized management of patients with rare neurological diseases (RND) in all age groups. Since then a dynamic national network for rare neurological disorders has been established comprising renowned experts in neurology, pediatric neurology, (neuro-) genetics and neuroradiology. DASNE has successfully implemented case presentations and multidisciplinary discussions both at yearly symposia and monthly virtual case conferences, as well as further educational activities covering a broad spectrum of interdisciplinary expertise associated with RND. Here, we present recommendation statements for optimized personalized management of patients with RND, which have been developed and reviewed in a structured Delphi process by a group of experts. Methods An interdisciplinary group of 37 RND experts comprising DASNE experts, patient representatives, as well as healthcare professionals and managers was involved in the Delphi process. First, an online collection was performed of topics considered relevant for optimal patient care by the expert group. Second, a two-step Delphi process was carried out to rank the importance of the selected topics. Small interdisciplinary working groups then drafted recommendations. In two consensus meetings and one online review round these recommendations were finally consented. Results 38 statements were consented and grouped into 11 topics: health care structure, core neurological expertise and core mission, interdisciplinary team composition, diagnostics, continuous care and therapy development, case conferences, exchange / cooperation between Centers for Rare Diseases and other healthcare partners, patient advocacy group, databases, translation and health policy. Conclusions This German interdisciplinary Delphi expert panel developed consented recommendations for optimal care of patients with RND in a structured Delphi process. These represent a basis for further developments and adjustments in the health care system to improve care for patients with RND and their families.

The aetiology of impacted canines is multi-factorial. Several theories have been proposed, such as lack of space, genetic predisposition, physical barriers like supernumerary teeth, odontomas and other conditions that interfere with the eruption pathway. One of the main complications that can be generated by impacted canines is the resorption of the root of the adjacent teeth. This case report examines the importance of interdisciplinary management of maxillary incisors with root resorption caused by impacted canines in a 13-year-old male patient. Careful traction of impacted canines and proper tissue management followed by space closure and retroclination of anterior incisors with orthodontic treatment. Finally, functional and aesthetic results using dental veneers for oral rehabilitation allowed the patient to obtain favourable results. [ABSTRACT FROM AUTHOR]

Background: Obesity is a multifactorial disorder characterized by increased body adiposity with a wide prevalence in our country, at any age, and linked to major adverse consequences, including the development of heart disease. Cardiac rehabilitation (CR) programs are interdisciplinary interventions aimed not only at restoring the lost functionality of patients who have suffered a cardiovascular outcome, but also at correcting those risk factors that led to it and that interfere with its adaptive results. Obesity contributes to perpetuating heart disease risk and is often resistant to conventional lifestyle modifications. Objective: Establish guidelines in the recognition of obesity with care guidelines for patients with heart disease within CR programs and their interdisciplinary approach. Method: Through an extensive bibliographical review and after an interdisciplinary discussion, this document was prepared to establish a position on the approach to obesity in the context of CR programs in patients with heart disease. Results and conclusions: Our Society recognizes the interdisciplinary approach of our patients with obesity and heart disease in its primary and secondary prevention, urges precision in its diagnosis and assessment, recommends that its primary axis must be based in the first instance on lifestyle modifications (physical training, nutritional care and psycho-emotional intervention), while pharmacological therapy and bariatric surgery could be coadjuvants in optimizing the results in selected patients. [ABSTRACT FROM AUTHOR]

Conventional excision of female genital skin cancers has high rates of local recurrence and morbidity. Few publications describe local recurrence rates (LRRs) and patient-reported outcomes (PROs) after Mohs micrographic surgery (MMS) for female genital skin cancers. To evaluate LRRs, PROs, and interdisciplinary care after MMS for female genital skin cancers. A retrospective case series was conducted of female genital skin cancers treated with MMS between 2006 and 2021 at an academic center. The primary outcome was local recurrence. Secondary outcomes were PROs and details of interdisciplinary care. Sixty skin cancers in 57 patients were treated with MMS. Common diagnoses included squamous cell cancer (n = 26), basal cell cancer (n = 12), and extramammary Paget disease (n = 11). Three local recurrences were detected with a mean follow-up of 61.1 months (median: 48.8 months). Thirty-one patients completed the PROs survey. Most patients were satisfied with MMS (71.0%, 22/31) and reported no urinary incontinence (93.5%, 29/31). Eight patients were sexually active at follow-up and 75.0% (6/8) experienced no sexual dysfunction. Most cases involved interdisciplinary collaboration 71.7% (43/60). Limitations include the retrospective single-center design, heterogeneous cohort, and lack of preoperative function data. Incorporating MMS into interdisciplinary teams may help achieve low LRRs and satisfactory function after genital skin cancer surgery. [ABSTRACT FROM AUTHOR]

Impacted maxillary permanent incisor is a challenge for Oral Surgeon and Orthodontist. The incidence of this case is the third highest after unerupted third molars and canines and is more common in Asian races. Orthodontists and the oral surgeon must collaborate to define why the teeth are impacted. This report aims to describe the importance of interdisciplinary management and communication between the orthodontist and oral surgeon. This case report presents a patient 10-year-old boy with unerupted maxillary right permanent central incisor. The orthodontist and oral surgeon diagnosed it caused by odontoma. After the odontoma was removed, the tooth above the odontoma was seen mimicking the maxillary permanent central incisors. Further exploration and re-analysis show that the suspected tooth was a primary tooth that could not erupt. After a discussion, it was decided to take the primary teeth and re-explore them to look for permanent incisors. After four months of orthodontic treatment, permanent teeth erupted completely and the patient was very satisfied. Interdisciplinary management is very important to determine the right diagnosis and the success of the treatment. [ABSTRACT FROM AUTHOR]

Adult patients may present with compromised dentitions which require extensive oral rehabilitation. This case report shows the fulfilment of both functional and aesthetic treatment objectives for a patient with significant tooth wear through carefully planned interdisciplinary management. © 2022 Australian Dental Association. [ABSTRACT FROM AUTHOR]

The paper addresses chronic kidney disease (CKD), a condition that leads to the gradual loss of renal function and the accumulation of metabolic waste products in the body. The research focuses on analyzing scientific evidence and examining the dental management of patients with CKD, emphasizing the importance of interdisciplinary care. Common oral alterations in these patients were found, such as xerostomia and periodontal problems. Infection prevention and careful surgical approach are also highlighted aspects to ensure favorable treatment outcomes. The research underscores the significance of early evaluation, a multidisciplinary approach, and proper oral health management in CKD patients to enhance their quality of life and reduce complications. [ABSTRACT FROM AUTHOR]

This case report details a rare instance of a renal jejunal fistula accompanied by tuberculosis (TB) and parasitic infestation in a pediatric patient. It adds to the limited literature on renal fistulas involving the jejunum, particularly those compounded by infectious diseases, highlighting the diagnostic and therapeutic challenges in managing such complex cases. The patient initially presented with flank pain, a discharging sinus in the left flank region, cough, and general malaise, alongside symptoms of anemia. Clinical examination and diagnostics unveiled a non-functioning left kidney with multiple calculi and signs of severe pyelonephritis. However, surgery revealed an unexpected twist—a renal jejunal fistula with worm infestation. The main diagnoses included a renal jejunal fistula, tuberculosis, and parasitic infestation. The patient underwent a left nephrectomy to remove the affected kidney, and the fistula was repaired. Postoperative care involved TB treatment and deworming. The case underscored the necessity of a comprehensive diagnostic approach and readiness for unexpected intraoperative findings. This case highlights the importance of considering infectious diseases in the differential diagnosis of unusual renal or gastrointestinal symptoms, especially in pediatric patients from endemic regions. It demonstrates the necessity of interdisciplinary collaboration in managing rare and complex medical conditions and stresses the need for follow-up to assess long-term outcomes, which was limited in this case due to the patient's non-attendance at scheduled visits. • Rare renal jejunal fistula in pediatric TB and parasites • Worm infestation found during surgery • Managed by nephrectomy, fistula repair, and treatments • Highlights infectious causes in renal pathologies • Shows need for interdisciplinary pediatric care [ABSTRACT FROM AUTHOR]

Background: Cardiac implantable electronic devices (CIEDs), including pacemakers, have undeniably revolutionized the treatment of cardiac conditions. However, just like any other treatment or intervention some significant challenges can be encountered in CIEDs, mainly, CIED infections. With reported incidence rates ranging from 1 % to 15 % these infections can pose lead to dangerous complications. Our case report presents an occurrence of late-onset pacemaker endocarditis, which despite proper antibiotic therapy required an open-heart surgery as the only curative option., Case Presentation: Our patient is a 50-year-old female known to have a pacemaker implanted twenty years ago, she presented with fever and purulent discharge from her pacemaker site. After thorough investigations, diagnostic tests confirmed a Serratia marcescens infection and despite antibiotic treatment, the patient's symptoms persisted, an echocardiography revealed tricuspid valve involvement with vegetations. Surgical intervention, by complete removal of the old and new pacemaker leads, tricuspid valvuloplasty, and installation of an epicardial pacemaker, was performed., Conclusion: Our case highlights the rarity and complexity of Serratia marcescens-related pacemaker endocarditis and all CIEDs in general, while emphasizing the importance of interdisciplinary management to optimize patient outcomes. Early diagnosis, prompt treatment, and comprehensive surgical approaches are essential in managing CIED infections and achieving successful outcomes., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Georgio EL KOUBAYATI reports was provided by Lebanese University. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Abstract Background Hip fractures are common in elderly patients, in whom it is important to monitor blood loss; however, unnecessary transfusions should be avoided. The primary objective of this study was to assess whether the employment of a dedicated orthogeriatrician in an Orthopaedic Department allows to optimise the clinical conditions of patients, influencing blood loss and consequently the number of transfusions. The secondary objective was to determine whether the influence of the orthogeriatrician differs according to the type of surgical treatment. Methods A total of 620 elderly patients treated for hip fracture were included in the study. These patients were divided into two groups according to the presence or not of the orthogeriatrician. For each patient, age, sex, comorbidities, type of fracture, surgical treatment, length of hospital stay, time from hospitalisation and surgery, time from surgery to discharge, haemoglobin (Hb) values (admission, 24h post-surgery, lowest Hb reached, discharge) and the number of transfusions were recorded. Results Regardless of the surgical procedure performed, in patients managed by the orthogeriatrician, the Hb at discharge was significantly higher (p = 0.003). In addition to the highest Hb at discharge, in patients who underwent hemiarthroplasty, the number of transfusions per patient is significantly reduced (p = 0.03). Conclusion The introduction of the orthogeriatrician in an orthopaedic ward for the management of elderly patients treated for hip fracture allows to discharge the patients with higher Hb values, reducing the risk of anemisation and the costs related to possible re-admission.

Copyright of Der Kardiologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Adult patients may present with complex malocclusions requiring extensive oral rehabilitation. This case report demonstrates how carefully planned interdisciplinary management can provide pleasing outcomes despite the considerable initial clinical challenges.

For several reasons, cerebral visual impairment (CVI) is emerging as a major cause of visual impairment among children in the developing world and we are seeing an increasing number of such children in our clinics. Owing to lack of early training about CVI and it being a habilitation orientated subject, we need to become equipped to optimally help the affected children. In this paper we have explained our pragmatic approach in addressing children who present with low functioning CVI. Initially we explain briefly, how vision is processed in the brain. We then present what should be specifically looked for in these children in regular clinics as a part of their comprehensive ophthalmic examination. We discuss the process of functional vision evaluation that we follow with the help of videos to explain the procedures, examples of how to convey the conclusions to the family, and how to use our findings to develop intervention guidelines for the child. We explain the difference between passive vision stimulation and vision intervention, provide some common interventions that may be applicable to many children and suggest how to infuse interventions in daily routines of children so that they become relevant and meaningful leading to effective learning experiences.

Background: Hip fractures are common in elderly patients, in whom it is important to monitor blood loss; however, unnecessary transfusions should be avoided. The primary objective of this study was to assess whether the employment of a dedicated orthogeriatrician in an Orthopaedic Department allows to optimise the clinical conditions of patients, influencing blood loss and consequently the number of transfusions. The secondary objective was to determine whether the influence of the orthogeriatrician differs according to the type of surgical treatment. Methods: A total of 620 elderly patients treated for hip fracture were included in the study. These patients were divided into two groups according to the presence or not of the orthogeriatrician. For each patient, age, sex, comorbidities, type of fracture, surgical treatment, length of hospital stay, time from hospitalisation and surgery, time from surgery to discharge, haemoglobin (Hb) values (admission, 24h post-surgery, lowest Hb reached, discharge) and the number of transfusions were recorded. Results: Regardless of the surgical procedure performed, in patients managed by the orthogeriatrician, the Hb at discharge was significantly higher (p = 0.003). In addition to the highest Hb at discharge, in patients who underwent hemiarthroplasty, the number of transfusions per patient is significantly reduced (p = 0.03). Conclusion: The introduction of the orthogeriatrician in an orthopaedic ward for the management of elderly patients treated for hip fracture allows to discharge the patients with higher Hb values, reducing the risk of anemisation and the costs related to possible re-admission. [ABSTRACT FROM AUTHOR]

Non-surgical camouflage orthodontic treatment can be effective for the management of carefully selected patients with mild to moderate Class III malocclusion. This case report demonstrates how a synergistic combination of camouflage orthodontic treatment and appropriate adjunctive restorative procedures can provide a pleasing treatment outcome for a patient with a significant skeletal Class III malocclusion and diminutive maxillary lateral incisors. [ABSTRACT FROM AUTHOR]

A congenitally missing lateral incisor tooth is commonly associated with both short and long-term clinical dilemmas, particularly for a growing patient. A unilaterally missing maxillary lateral incisor tooth creates a significant dental asymmetry in the critical aesthetic zone of the smile and potentially increases the difficulty of any subsequent orthodontic and restorative treatment. Carefully planned interdisciplinary management is required to address the challenges of anterior dental asymmetry, unilateral orthodontic space closure and to alleviate the concerns that accompany restorative implant placement in the anterior maxilla. The use of skeletal temporary anchorage devices has increased the predictability of orthodontic space closure, particularly for missing maxillary lateral incisor cases which were previously considered to be unsuitable., (© 2024 The Author(s). Australian Dental Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Dental Association.)

Streff syndrome is a non-malingering visual disturbance commonly affecting near and color vision, which is prevalent in the younger population. This case report presents Streff-like syndrome in a middle-aged woman. A 47-year-old woman with underlying major depressive disorder presented with bilateral reduced vision and a constricted visual field for one week. These symptoms were accompanied by additional neurological complaints of headache, weakness, and numbness triggered after a stressful event that affected her work performance. Examinations revealed reduced vision more toward near, diminished red saturation, color vision deficiencies, and bilateral tubular visual fields. Notably, the relative afferent pupillary defect was negative, with both anterior and posterior segments normal. Neuroimaging and inflammatory workup results were within normal limits. An additional +1.00 lens improved her symptoms and visual acuities. Collaborative management involving psychiatry, neurology, and ophthalmology, including psychotherapy, led to significant symptom improvement. At the five-month follow-up, the patient experienced a complete resolution of her visual symptoms. Although Streff syndrome is a primary visual problem, additional psychogenic factors may add to variable cases. This case underscores the importance of recognizing stress-induced psychogenic manifestation, particularly in patients with underlying mental health conditions, and emphasizes an interdisciplinary management approach., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Zahari et al.)

Surgery of aggressive pituitary adenomas and pituitary carcinomas is part of the interdisciplinary management of these difficult to treat tumors. Invasion, giant size and unusual, asymmetric extent of these tumors frequently require modifications or extensions of the standard approaches for transsphenoidal and transcranial surgery. Frequently, only debulking procedures can be performed. In aggressive and hormone secreting adenomas, the remission rates achieved by surgery alone are relatively poor and adjuvant medical treatments or irradiation are needed. Safe resection of as much tumor as possible and symptomatic control is aimed at, rather than remission. Many procedures are required for rapid progression of lesions or recurrences, in order to extend the survival of the patients. Metastases of pituitary carcinomas within the cranial cavity or spine can be attacked. Since they can occur anywhere in the brain or spinal canal they require the entire battery of neurosurgical approaches. Unfortunately, in this group of pituitary tumors, the complication rates are higher than in primary operations of enclosed adenomas. The respective techniques with their facilities and limitations are reviewed in this article. [ABSTRACT FROM AUTHOR]

Intracardial migration of a ventriculoperitoneal (VP) shunt (ICMVP) is a rare complication that has been described in only single case reports. Here we report the successful interdisciplinary management of an ICMVP and provide a review of the relevant literature. A 38-year-old-patient with shunt-dependent hydrocephalus caused due to a Blake's pouch cyst presented in our hydrocephalus outpatient clinic with thoracic pain and nocturnal cough at 7 months after VP shunt implantation (with initially a proper location on computed tomography scan of the head and X-ray of the abdomen). A new X-ray of the abdomen and the thorax revealed a dislocated shunt with migration of the distal catheter into the superior cava vein, right atrium, and right heart ventricle, with some loops in both pulmonary arteries. The catheter was successfully removed by an interdisciplinary team in general anesthesia under ultrasound, X-ray guidance, and cardiovascular parameter control by withdrawing the shunt into the superior cava vein and removing the remnant portion of the distal catheter (with a knot) by interventional snaring. Cardiac and vascular surgeons were on standby. The management of an ICMVP is complex and carries a high risk for severe potential complications. Two different pathophysiological mechanisms have been discussed in the literature, including gradual erosion into an adjacent vein and transvenous catheter placement of the initial shunt secondary to subcostal placement of shunt tunneling instruments. The suction effect of the venous system results in gradual pulling of the catheter into the venous system. [ABSTRACT FROM AUTHOR]

Background/aims: Chronic pain in central neurological disorders is common and the current management of chronic pain is through an interdisciplinary approach. The aim of this study was to compare outpatient interdisciplinary-based treatment for chronic pain in patients with central neurological disorders to those without central neurological disorders. Methods: This was a retrospective study and pain-related outcome measures were collected from a clinical outcomes registry (electronic Persistent Pain Outcomes Collaboration). This registry contained data on people who attended a pain management service who, for the purpose of this study, were categorised into those with a central neurological disorder and those without a central neurological disorder. The two sample t-test was used to determine the significance of the difference between the groups and statistical significance was defined as P<0.05. Outcome measures compared included the Brief Pain Inventory, Depression, Anxiety and Stress Scale 21, Patient Self-efficacy Questionnaire and Patient Catastrophisation Scale. Results: There was a total of 1924 participants with a central neurological disorder. The electronic Persistent Pain Outcomes Collaboration registry shows that after engagement with an interdisciplinary pain management service, there was a reduction in pain severity scores, interference, mean depression, anxiety and stress in both groups at end of an episode of care compared to referral. There was a significant difference in mean changes for pain catastrophising between those with a central neurological disorder (−10.3) and those without (−7.8). Conclusions: This study shows that people with central neurological disorders can also benefit from interdisciplinary management and have similar results to those without these conditions. [ABSTRACT FROM AUTHOR]

Background: Collaborative orthodontic-endodontic approaches are vital in addressing complex dental cases. However, existing literature reveals a notable dearth in understanding and implementing this approach among dental practitioners. Objective: This study aimed to bridge the gap in understanding current practices among dental practitioners, fostering enhanced patient care and ethical standards. This cross-sectional survey, conducted from September 1st to 30th, 2023, involved distributing a validated questionnaire to dental practitioners in the Hazara Division, yielding 96 responses from 105 visited clinics and 44 from hospitals. Descriptive statistics were used for frequencies and percentages using SPSS version 23. Methodology: The survey involved 78.6% general dentists, 13.6% orthodontists, and 7.9% endodontists. Varying levels of correct responses were observed for the knowledge-based questions. Results: Positive attitudes were seen, with 70% of respondents expressing an interest in enhancing knowledge through educational programs, and 73% agreeing to adhere to interdisciplinary guidelines. Furthermore, 79.3% of practitioners had experience treating cases requiring both orthodontic tooth movement and endodontic therapy. Conclusion: Notably, orthodontists and endodontists showed higher percentages of accurate responses compared to general dentists. In conclusion, this study underscores the need for improved education, standardized protocols, and better patient communication for effective interdisciplinary dental care specifically in general dental practitioners. [ABSTRACT FROM AUTHOR]

Abstract Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature. While standard antineoplastic therapy is associated with immunosuppression and infections, some of the recent approaches induce overwhelming inflammation and autoimmunity. Cytokine-release syndrome (CRS) describes a complex of symptoms including fever, hypotension, and skin reactions as well as lab abnormalities. CRS may occur after the infusion of monoclonal or bispecific antibodies (MABs, BABs) targeting immune effectors and tumor cells and is a major concern in recipients of chimeric antigen receptor (CAR) modified T lymphocytes as well. BAB and CAR T-cell treatment may also be compromised by central nervous system (CNS) toxicities such as encephalopathy, cerebellar alteration, disturbed consciousness, or seizures. While CRS is known to be induced by exceedingly high levels of inflammatory cytokines, the pathophysiology of CNS events is still unclear. Treatment with antibodies against inhibiting immune checkpoints can lead to immune-related adverse events (IRAEs); colitis, diarrhea, and endocrine disorders are often the cause for ICU admissions. Respiratory distress is the main reason for ICU treatment in cancer patients and is attributable to infectious agents in most cases. In addition, some of the new drugs are reported to cause non-infectious lung complications. While drug-induced interstitial pneumonitis was observed in a substantial number of patients treated with phosphoinositol-3-kinase inhibitors, IRAEs may also affect the lungs. Inhibitors of angiogenetic pathways have increased the antineoplastic portfolio. However, vessel formation is also essential for regeneration and tissue repair. Therefore, severe vascular side effects, including thromboembolic events, gastrointestinal bleeding or perforation, hypertension, and congestive heart failure, compromise antitumor efficacy. The limited knowledge of the pathophysiology and management of life-threatening complications relating to new cancer drugs presents a need to provide ICU staff, oncologists, and organ specialists with evidence-based algorithms.

Cleft lip and palate (CLP) are the most common congenital craniofacial malformations. The Diamond-Blackfan anemia or congenital erythroblastic anemia is a selective red cell hypoplasia associated with heart, kidney, malformed hands, hypertelorism and stunted alterations. The presentation of Cleft lip and palate in patients with Diamond-Blackfan anemia is 10.3% of cases. Aim: To present a case report of a patient of 12 years with Diamond-Blackfan anemia and Cleft lip and palate sequel from the Interdisciplinary Clinic LPH of the Pontificia Universidad Javeriana (Bogota Colombia) where the interdisciplinary approach, behavior management and psychological support provided to the family were instrumental in achieving the expected therapeutic results. Results: Adherence to treatment and its success in supporting other health specialties during two years is slown. Conclusions: The multidisciplinary and interdisciplinary management with dental specialties, medical, and health in general for the management of patients with FLP and associated syndromes, it is important for successful treatment.

For several reasons, cerebral visual impairment (CVI) is emerging as a major cause of visual impairment among children in the developing world and we are seeing an increasing number of such children in our clinics. Owing to lack of early training about CVI and it being a habilitation orientated subject, we need to become equipped to optimally help the affected children. In this paper we have explained our pragmatic approach in addressing children who present with low functioning CVI. Initially we explain briefly, how vision is processed in the brain. We then present what should be specifically looked for in these children in regular clinics as a part of their comprehensive ophthalmic examination. We discuss the process of functional vision evaluation that we follow with the help of videos to explain the procedures, examples of how to convey the conclusions to the family, and how to use our findings to develop intervention guidelines for the child. We explain the difference between passive vision stimulation and vision intervention, provide some common interventions that may be applicable to many children and suggest how to infuse interventions in daily routines of children so that they become relevant and meaningful leading to effective learning experiences. [ABSTRACT FROM AUTHOR]

Copyright of Timisoara Physical Education & Rehabilitation Journal is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper applies a methodology for interdisciplinary Facilities Management (FM) by alingment between Building Information Modeling (BIM) and Lean. Initially, the literature review of BIM, FM and Lean principles. Afterwards, the research applies the Digital Obeya Room for improved FM and describes its application on a real-world case study. Lastly, the work presents a survey with specialists to assess the relevance of each BIM-Lean concepts and correlate their perceptions with the empirical results. The main collaborations of this work are: a conceptual framework that relates the PDCA (Plan-Do-Check-Act) cycle with BIM-Lean approaches; the identification of the most relevant BIM functionalies and Lean principles; and the real-world application of the framework procedures on FM.

This paper applies a methodology for interdisciplinary Facilities Management (FM) by alingment between Building Information Modeling (BIM) and Lean. Initially, the literature review of BIM, FM and Lean principles. Afterwards, the research applies the Digital Obeya Room for improved FM and describes its application on a real-world case study. Lastly, the work presents a survey with specialists to assess the relevance of each BIM-Lean concepts and correlate their perceptions with the empirical results. The main collaborations of this work are: a conceptual framework that relates the PDCA (Plan-Do-Check-Act) cycle with BIM-Lean approaches; the identification of the most relevant BIM functionalies and Lean principles; and the real-world application of the framework procedures on FM. [ABSTRACT FROM AUTHOR]

Anorexia nervosa is a disease with potentially severe effects on body, psyche and the social situation, in extremis leading to disability and death.Those affected often do not feel ill and are unresponsive to the treatment. The behavior of the patients often leads to conflicts with their loved ones. Fears and constraints prevent these patients from behaving and eating normally. It is important to recognize and understand anorexia nervosa early, allowing for a quick treatment and a better disease-specific prognosis. The education of the patients and their relatives about the disease, its complications and the treatment options is part of the interdisciplinary therapy. [ABSTRACT FROM AUTHOR]

Aim: Patients with a compromised periodontal condition, multiple missing teeth and pathological migration of tooth may require an interdisciplinarymanagement. To demonstrate that combined periodontic-surgical-restorative-prosthodontic-orthodontic treatment can achieve an improved periodontal condition, masticatory function, esthetics and occlusion. Materials and Methods: This report describes the case of a 55-year-old woman with severely compromised periodontal tissues, multiple missing teeth and malocclusion. An interdisciplinary, periodontic-surgicalrestorative- prosthodontic-orthodontic approach with strict plaque control during treatment was carried out. Results: Clinical examination revealeda well-functioning dentition, natural inappearance and in a harmonious occlusion and periodontalstate of health.The treatment outcomes, includingthe periodontal condition and the orthodontic treatment, were stable at the age of 60 years. Conclusion: Successful functional and esthetic results were achieved by an interdisciplinary management. [ABSTRACT FROM AUTHOR]

One of the main problems the construction industry faces is the high cost and slow execution time due to inadequate planning, which results in poor use of human resources. A common solution for reducing time and costs is the adoption of prefabricated components (prefabs). This paper proposes a novel methodology for interdisciplinary man­agement of construction projects by integrating Building Information Modeling (BIM) and Lean Thinking to improve the production planning and control of pipe-rack modules in an industrial facility. The article first presents a literature review to assess the key synergies between BIM and Lean Thinking. These led to the development of a new integrated work methodology named Digital Obeya Room. This model focuses on the required workflows, the analysis of collected data, and the visual management of construction planning and control. A real-world empirical study in the Oil and Gas industry evaluated how the newly devised practices could improve prefabrication and preassembly planning. The pro­posed methodology was capable of reducing the welding-time in 8.7% related on global prefabrication average in con­struction projects from Fails Management Institute (FMI) prefabrication report survey 2017.

One of the main problems the construction industry faces is the high cost and slow execution time due to inadequate planning, which results in poor use of human resources. A common solution for reducing time and costs is the adoption of prefabricated components (prefabs). This paper proposes a novel methodology for interdisciplinary management of construction projects by integrating Building Information Modeling (BIM) and Lean Thinking to improve the production planning and control of pipe-rack modules in an industrial facility. The article first presents a literature review to assess the key synergies between BIM and Lean Thinking. These led to the development of a new integrated work methodology named Digital Obeya Room. This model focuses on the required workflows, the analysis of collected data, and the visual management of construction planning and control. A real-world empirical study in the Oil and Gas industry evaluated how the newly devised practices could improve prefabrication and preassembly planning. The proposed methodology was capable of reducing the welding-time in 8.7% related on global prefabrication average in construction projects from Fails Management Institute (FMI) prefabrication report survey 2017. [ABSTRACT FROM PUBLISHER]

Objective To improve the confidence of the final year dental students in completing occlusal and oral rehabilitation of patients, with complexities beyond their scope, based on full analysis of the biomechanical and esthetic considerations of each case. Material & methods Two comprehensive patient situations presenting with special difficulties including extensive, reduced vertical dimension of occlusion, limited interocclusal space and maxillary alveolar bone for implant insertion necessitating bone augmentation and a sinus lift surgery was managed by two students at our institute. Procedures like surgical crown lengthening, sinus lifting, and bone augmentation were performed by senior faculty with the respective two students’ assisting as well as following up at the healing phase and reporting progress of healing and any possible complications to the supervisor. Students’ reported significant improvement in decision making skills; time management; interpersonal skills, management of cases in an evidence –based interdisciplinary approach as well as increase in their confidence in managing complex cases independently. Follow up with both cases showed optimum outcome and patients’ satisfaction. Results Students’ reported significant improvement in decision making skills; time management; interpersonal skills, management of cases in an evidence –based interdisciplinary approach as well as increase in their confidence in managing complex cases independently. Follow up with both cases showed optimum outcome and patients’ satisfaction. Conclusions Exposing students to manage complex oral rehabilitation including procedures like sinus lifting and bone augmentation, through an evidence-based interdisciplinary approach during the undergraduate comprehensive clinical dentistry course enhances their confidence and clinical acumen as an independent practitioner. [ABSTRACT FROM AUTHOR]

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Breast cancer is the most common neoplasia in women, being defined by genetic heterogeneity and having a wide spectrum of clinical manifestations with different types of aggresivity in different patients. Therefore, it is a major challenge of both diagnosis and treatment. We report the case of a 42-year-old woman who was admitted in the Department of Obstetrics and Gynecology of the University Emergency Hospital Bucharest for a palpable tumor located in the supero-lateral quadrant of the right breast. According to paraclinic examination, surgery was performed. After an extensive histopathological examination with immunohistochemistry analysis, she was diagnosed with intraductal papilloma with areas of atypical hyperplasia and in situ ductal carcinoma. The diagnosis of breast cancer was established rapidly in an early stage due to efficient collaboration between specialists in: Obstetrics-Gynecology, Histopathology, Oncology and Radiotherapy. In order to improve the prognostic, interdisciplinary management is essential in patients with breast tumors. [ABSTRACT FROM AUTHOR]

Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature.While standard antineoplastic therapy is associated with immunosuppression and infections, some of the recent approaches induce overwhelming inflammation and autoimmunity. Cytokine-release syndrome (CRS) describes a complex of symptoms including fever, hypotension, and skin reactions as well as lab abnormalities. CRS may occur after the infusion of monoclonal or bispecific antibodies (MABs, BABs) targeting immune effectors and tumor cells and is a major concern in recipients of chimeric antigen receptor (CAR) modified T lymphocytes as well. BAB and CAR T-cell treatment may also be compromised by central nervous system (CNS) toxicities such as encephalopathy, cerebellar alteration, disturbed consciousness, or seizures. While CRS is known to be induced by exceedingly high levels of inflammatory cytokines, the pathophysiology of CNS events is still unclear. Treatment with antibodies against inhibiting immune checkpoints can lead to immune-related adverse events (IRAEs); colitis, diarrhea, and endocrine disorders are often the cause for ICU admissions.Respiratory distress is the main reason for ICU treatment in cancer patients and is attributable to infectious agents in most cases. In addition, some of the new drugs are reported to cause non-infectious lung complications. While drug-induced interstitial pneumonitis was observed in a substantial number of patients treated with phosphoinositol-3-kinase inhibitors, IRAEs may also affect the lungs.Inhibitors of angiogenetic pathways have increased the antineoplastic portfolio. However, vessel formation is also essential for regeneration and tissue repair. Therefore, severe vascular side effects, including thromboembolic events, gastrointestinal bleeding or perforation, hypertension, and congestive heart failure, compromise antitumor efficacy.The limited knowledge of the pathophysiology and management of life-threatening complications relating to new cancer drugs presents a need to provide ICU staff, oncologists, and organ specialists with evidence-based algorithms. [ABSTRACT FROM AUTHOR]

Due to the high incidence of sports concussion, various health and medical providers are likely to encounter athletes who have sustained such an injury. Management of concussion necessitates coordinated care by the members of the sports medicine team due to its pathophysiology and complexity of management during recovery. All members of the sports medicine team must possess contemporary knowledge of concussion management as well as strong interprofessional communication skills to ensure effective care and safe return to sports participation. Therefore, the aim of this manuscript is to review the current best practices in interdisciplinary management of sports concussion with a special emphasis on the required interprofessional communication among the sports medicine team. [ABSTRACT FROM AUTHOR]

Interdisciplinary treatment is becoming an ever-increasing part of modern-day orthodontic practice. This case report details the successful orthodontic-periodontal management of an epileptic patient with a significant drug-induced gingival hyperplasia. The problems that such patient′s present are discussed before considering the specific orthodontic techniques employed. Recommendations are made for practitioners managing such cases.

Background: Obesity is a multifactorial disorder characterized by increased body adiposity with a wide prevalence in our country, at any age, and linked to major adverse consequences, including the development of heart disease. Cardiac rehabilitation (CR) programs are interdisciplinary interventions aimed not only at restoring the lost functionality of patients who have suffered a cardiovascular outcome, but also at correcting those risk factors that led to it and that interfere with its adaptive results. Obesity contributes to perpetuating heart disease risk and is often resistant to conventional lifestyle modifications., Objective: Establish guidelines in the recognition of obesity with care guidelines for patients with heart disease within CR programs and their interdisciplinary approach., Method: Through an extensive bibliographical review and after an interdisciplinary discussion, this document was prepared to establish a position on the approach to obesity in the context of CR programs in patients with heart disease., Results and Conclusions: Our Society recognizes the interdisciplinary approach of our patients with obesity and heart disease in its primary and secondary prevention, urges precision in its diagnosis and assessment, recommends that its primary axis must be based in the first instance on lifestyle modifications (physical training, nutritional care and psycho-emotional intervention), while pharmacological therapy and bariatric surgery could be coadjuvants in optimizing the results in selected patients.