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International Journal of Medical, Medicine and Health Sciences

ISSN: 2517-9969

Total 5 content found

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The Relationship of the Dentate Nucleus with the Pyramid of Vermis: A Microneurosurgical Anatomical Study

Year: 2019 Volume: 13 Issue: 1 22 - 30 Pages

Abstract: The region of dentate nucleus is a common site for various pathologies like hematomas, tumours, etc. We aimed to study in detail the relationship of this region with the vermis, especially the pyramid using microscopic fibre dissection technique. To achieve this aim, 20 cerebellar hemispheres were studied from the 11 cerebellums. Dissection was performed using wooden spatulas and micro dissectors under a microscope following Klingler’s preservation technique. The relationship between the pyramid of vermis and the dentate nucleus was studied in detail. A similar relationship was studied on the MRI of randomly selected trigeminal neuralgia patients and correlated with anatomical findings. Results show the mean distance of the lateral margin of the dentate nucleus from the midline on anatomic specimens was 21.4 ± 1.8 mm (19-25 mm) and 23.4 ± 3.4 mm (15-29 mm) on right and left side, respectively. Similar measurements made on the MRI were 22.97 ± 2.0 mm (20.03-26.15 mm) on the right side and 23.98 ± 2.1 mm (21.47-27.67 mm) on the left side. The amount of white matter dissection required to reach the dentate nucleus at the pyramidal attachment area was 7.3 ± 1.0 mm (6-9 mm) on the right side and 6.8 ± 1.4 mm (5-10 mm) on the left side. It was concluded that the pyramid of vermis has a constant relationship with the dentate nucleus and can be used as an excellent landmark during surgery to localise the dentate nucleus on the suboccipital surface.

Collaboration in Palliative Care Networks in Urban and Rural Regions of Switzerland

Year: 2019 Volume: 13 Issue: 1 18 - 21 Pages

Abstract: Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

Assessment of Menus in a Selected Social Welfare Home with Regard to Nutritional Recommendations

Year: 2019 Volume: 13 Issue: 1 13 - 17 Pages

Abstract: The aim of the study was to assess diets of residents of nursing homes. Provided by social welfare home, 10 day menus were introduced into the computer program Diet 5 and analyzed in respect of protein, fats, carbohydrates, energy, vitamin D and calcium. The resulting mean values of 10-day menus were compared with the existing Nutrition Standards for Polish population. The analysis menus showed that the average amount of energy supplied from food is not sufficient. Carbohydrates in food supply are too high and represent 257% of normal. The average value of fats and proteins supplied with food is adequate 85.2 g/day and 75.2 g/day. The calcium content of the diet is 513.9 mg/day. The amount of vitamin D supplied in the age group 51-65 years is 2.3 µg/day. Dietary errors that have been shown are due to the lack of detailed nutritional guidelines for nursing homes, as well as state-owned care facilities in general.

Visualizing Imaging Pathways after Anatomy-Specific Follow-Up Imaging Recommendations

Year: 2019 Volume: 13 Issue: 1 7 - 12 Pages

Abstract: Radiologists routinely make follow-up imaging recommendations, usually based on established clinical practice guidelines, such as the Fleischner Society guidelines for managing lung nodules. In order to ensure optimal care, it is important to make guideline-compliant recommendations, and also for patients to follow-up on these imaging recommendations in a timely manner. However, determining such compliance rates after a specific finding has been observed usually requires many time-consuming manual steps. To address some of these limitations with current approaches, in this paper we discuss a methodology to automatically detect finding-specific follow-up recommendations from radiology reports and create a visualization for relevant subsequent exams showing the modality transitions. Nearly 5% of patients who had a lung related follow-up recommendation continued to have at least eight subsequent outpatient CT exams during a seven year period following the recommendation. Radiologist and section chiefs can use the proposed tool to better understand how a specific patient population is being managed, identify possible deviations from established guideline recommendations and have a patient-specific graphical representation of the imaging pathways for an abstract view of the overall treatment path thus far.

A Recommendation to Oncologists for Cancer Treatment by Immunotherapy: Quantitative and Qualitative Analysis

Year: 2019 Volume: 13 Issue: 1 1 - 6 Pages

Abstract: Today, the treatment of cancer, in a relatively short period, with minimum adverse effects is a great concern for oncologists. In this paper, based on a recently used mathematical model for cancer, a guideline has been proposed for the amount and duration of drug doses for cancer treatment by immunotherapy. Dynamically speaking, the mathematical ordinary differential equation (ODE) model of cancer has different equilibrium points; one of them is unstable, which is called the no tumor equilibrium point. In this paper, based on the number of tumor cells an intelligent soft computing controller (a combination of fuzzy logic controller and genetic algorithm), decides regarding the amount and duration of drug doses, to eliminate the tumor cells and stabilize the unstable point in a relatively short time. Two different immunotherapy approaches; active and adoptive, have been studied and presented. It is shown that the rate of decay of tumor cells is faster and the doses of drug are lower in comparison with the result of some other literatures. It is also shown that the period of treatment and the doses of drug in adoptive immunotherapy are significantly less than the active method. A recommendation to oncologists has also been presented.