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Journal of Behavioral Medicine Feb 2019During the 40 years since the Yale conference on Behavioral Medicine and the founding of the Journal of Behavioral Medicine considerable progress has been made in... (Review)
Review
During the 40 years since the Yale conference on Behavioral Medicine and the founding of the Journal of Behavioral Medicine considerable progress has been made in understanding the role of psychosocial risk and management of physical diseases. We here describe the development of these fundamental concepts from early research on stress through studies of the Type A behavior pattern to more contemporary approaches to the relationship between psychosocial risks and benefits in relation to disease processes. This includes the relationship of psychosocial risk to cancers, cardiovascular diseases (CVD), cardiometabolic disorders, Human Immunodeficiency Virus (HIV)/Acquired Human Immune Deficiency Syndrome. During the past 40 years the effects of prolonged distress responses in the pathogenesis of some cancers and CVD have been well-established and modifiable behavioral, cognitive and social factors have been shown to produce favorable outcome components in the management of such diseases as breast cancer, coronary heart disease and HIV.
Topics: Chronic Disease; Disease Management; Humans; Risk Factors
PubMed: 30632000
DOI: 10.1007/s10865-018-00007-y -
Immunology and Allergy Clinics of North... Feb 2011Allergy describes a constellation of clinical diseases that affect up to 30% of the world's population. It is characterized by production of allergen-specific IgE, which... (Review)
Review
Allergy describes a constellation of clinical diseases that affect up to 30% of the world's population. It is characterized by production of allergen-specific IgE, which binds to mast cells and initiates a cascade of molecular and cellular events that affect the respiratory tract (rhinitis and asthma), skin (dermatitis, urticaria), and multiple systems (anaphylaxis) in response to a variety of allergens including pollens, mold spores, animal danders, insect stings, foods, and drugs. The underlying pathophysiology involves immunoregulatory dysfunctions similar to those noted in highly stressed populations. The relationships in terms of potential for intervention are discussed.
Topics: Asthma; Disease Management; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Immunomodulation; Inflammation; Stress, Psychological
PubMed: 21094923
DOI: 10.1016/j.iac.2010.09.009 -
Survey of Ophthalmology 2017The understanding, diagnosis, and treatment of retinopathy of prematurity have changed in the 70 years since the original description of retrolental fibroplasia... (Review)
Review
The understanding, diagnosis, and treatment of retinopathy of prematurity have changed in the 70 years since the original description of retrolental fibroplasia associated with high oxygenation. It is now recognized that retinopathy of prematurity differs in appearance worldwide and as ever smaller and younger premature infants survive. New methods are being evaluated to image the retina, diagnose severe retinopathy of prematurity, and determine windows of time for treatment to save eyes and improve visual and neural outcomes. New treatments to promote physiologic retinal vascular development, vascular repair, and inhibit vasoproliferation by regulating proteins involved in vascular endothelial growth factor, insulin-like growth factor, or erythropoietin signaling. Reducing excessive oxidative/nitrosative stress and understanding progenitor cells and neurovascular and glial vascular interactions are being studied.
Topics: Angiogenesis Inhibitors; Animals; Disease Management; Humans; Laser Coagulation; Retinopathy of Prematurity
PubMed: 28012875
DOI: 10.1016/j.survophthal.2016.12.004 -
Praxis 2020
Topics: Humans; Pain; Pain Management; Stress, Psychological
PubMed: 32183652
DOI: 10.1024/1661-8157/a003390 -
Revista de Neurologia Sep 2020The stress that the coronavirus pandemic has produced on the health services and the disruption it has caused in the care of other pathologies and their follow-up in... (Review)
Review
The stress that the coronavirus pandemic has produced on the health services and the disruption it has caused in the care of other pathologies and their follow-up in outpatient visits have led us to promote and incorporate telemedicine in our routine medical practice. Telemedicine refers to remote or non-face-to-face medical attention, a new method of administering medical care by accredited professionals, which optimises resources and increases their scope. One drawback for child teleneurology is that our diagnoses require direct observation of the child and carrying out an examination as though playing a game. Mainly in the youngest stages, a new patient evaluated by telemedicine can be more difficult to diagnose and manage, and therefore some neuropaediatricians have chosen to carry out only follow-up visits, medication management and outcome reviews. Telemedicine, however, also has many benefits, such as the possibility of giving rapid advice, coordination among professionals and reaching the patient where and when it is difficult for classical medicine to do so. The aim of this article is to review the possible indications of telemedicine in child neurology, starting out from the fact that we should never delay the diagnosis of something that can be treated, both at the present time and in an eventual situation of resurgence of the pandemic. The advance of telemedicine will depend on the implementation of technology, on solving legal and security/privacy issues, on its clinical outcomes and on the extent to which patients demand and accept these virtual visits.
Topics: Adolescent; Aftercare; Child; Child, Preschool; Disease Management; Humans; Infant; Interdisciplinary Communication; Length of Stay; Neurology; Neuropsychiatry; Patient Care Team; Patient Education as Topic; Pediatrics; Telemedicine
PubMed: 32729111
DOI: 10.33588/rn.7105.2020304 -
Current Opinion in Psychology Aug 2019Many of today's most common, chronic, and costly diseases-from high blood pressure, to chronic pain-are related to stress. Mindfulness, considered a state, a trait, and... (Review)
Review
Many of today's most common, chronic, and costly diseases-from high blood pressure, to chronic pain-are related to stress. Mindfulness, considered a state, a trait, and a training, might help treat or prevent stress-related physical symptoms. A concise review of current scientific evidence shows that both higher levels of trait mindfulness as well as mindfulness training are associated with better psychological well-being, coping, and quality of life. Effects on objective measures of disease, however, are often non-significant or await replication. Larger trials with active control groups, clear diagnostic criteria, objective outcome measures, and longer-term follow-up are needed to generate better quality evidence. Yet, many studies do support integrating mindfulness into health care as part of self-care and disease management.
Topics: Adaptation, Psychological; Disease Management; Humans; Mindfulness; Noncommunicable Diseases; Personal Satisfaction; Quality of Life; Stress, Psychological
PubMed: 30785067
DOI: 10.1016/j.copsyc.2018.12.014 -
The Canadian Journal of Cardiology Dec 2017Presyncope and syncope are common medical findings, with a > 40% estimated lifetime prevalence. These conditions are often elicited by postural stress and can be... (Review)
Review
Presyncope and syncope are common medical findings, with a > 40% estimated lifetime prevalence. These conditions are often elicited by postural stress and can be recurrent and accompanied by debilitating symptoms of cerebral hypoperfusion. Therefore, it is critical for physicians to become familiar with the diagnosis and treatment of common underlying causes of presyncope and syncope. In some patients, altered postural hemodynamic responses result from a failure of compensatory autonomic nervous system reflex mechanisms. The most common presentations of presyncope and syncope secondary to this autonomic dysfunction include vasovagal syncope, neurogenic orthostatic hypotension, and postural tachycardia syndrome. The most sensitive method for diagnosis is a detailed initial evaluation with medical history, physical examination, and resting electrocardiogram to rule out cardiac syncope. Physical examination should include measurement of supine and standing blood pressure and heart rate to identify the pattern of hemodynamic regulation during orthostatic stress. Additional testing may be required in patients without a clear diagnosis after the initial evaluation. Management of patients should focus on improving symptoms and functional status and not targeting arbitrary hemodynamic values. An individualized structured and stepwise approach should be taken for treatment, starting with patient education, lifestyle modifications, and use of physical counter-pressure manoeuvres and devices to improve venous return. Pharmacologic interventions should be added only when conservative approaches are insufficient to improve symptoms. There are no gold standard approaches for pharmacologic treatment in these conditions, with medications often used off label and with limited long-term data for effectiveness.
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Cardiology; Diagnostic Imaging; Disease Management; Humans
PubMed: 29102451
DOI: 10.1016/j.cjca.2017.09.008 -
Chest Sep 2012Obesity prevalence continues to increase globally, with figures exceeding 30% of some populations. Patients who are obese experience alterations in baseline pulmonary... (Review)
Review
Obesity prevalence continues to increase globally, with figures exceeding 30% of some populations. Patients who are obese experience alterations in baseline pulmonary mechanics, including airflow obstruction, decreased lung volumes, and impaired gas exchange. These physiologic changes have implications in many diseases, including ARDS. The unique physiology of patients who are obese affects the presentation and pathophysiology of ARDS, and patients who are obese who have respiratory failure present specific management challenges. Although more study is forthcoming, ventilator strategies that focus on transpulmonary pressure as a measure of lung stress show promise in pilot studies. Given the increasing prevalence of obesity and the variable effects of obesity on respiratory mechanics and ARDS pathophysiology, we recommend an individualized approach to the management of the obese patient with ARDS.
Topics: Comorbidity; Disease Management; Humans; Obesity; Prevalence; Respiratory Distress Syndrome; Respiratory Mechanics; Risk Factors
PubMed: 22948584
DOI: 10.1378/chest.12-0117 -
Journal of the American College of... Mar 2016The implantable-cardioverter defibrillator (ICD) lead is the most vulnerable component of the ICD system. Despite advanced engineering design, sophisticated... (Review)
Review
The implantable-cardioverter defibrillator (ICD) lead is the most vulnerable component of the ICD system. Despite advanced engineering design, sophisticated manufacturing techniques, and extensive bench, pre-clinical, and clinical testing, lead failure (LF) remains the Achilles' heel of the ICD system. ICD LF has a broad range of adverse outcomes, ranging from intermittent inappropriate pacing to proarrhythmia leading to patient mortality. ICD LF is often considered in the context of design or construction defects, but is more appropriately considered in the context of the finite service life of a mechanical component placed in chemically stressful environment and subjected to continuous mechanical stresses. This clinical review summarizes LF mechanisms, assessment, and differential diagnosis of LF, including lead diagnostics, recent prominent lead recalls, and management of LF and functioning, but recalled leads. Despite recent advances in lead technology, physicians will likely continue to need to understand how to manage patients with transvenous ICD leads.
Topics: Defibrillators, Implantable; Disease Management; Equipment Failure; Heart Failure; Humans
PubMed: 26988958
DOI: 10.1016/j.jacc.2015.12.067 -
Qualitative Health Research May 2011In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of... (Review)
Review
In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of cancer risk in which participants were concerned with having a good life, which relied heavily on balancing processes. This led us to the qualitative literature about balance in the context of health, which was large and in need of synthesis. We identified 170 relevant studies and used Thomas and Harden's technique of thematic synthesis to identify key balance-related themes and develop these into more abstract analytic categories. We found that balance and balancing were salient to people in three health-related contexts: health maintenance, disease or disability management, and lay or professional caregiving. In each of these contexts, balance or imbalance could be a state or a process. In addition, those using the word balance had either an internally or externally focused orientation to the world around them. Clinicians and public health practitioners might benefit from using these insights in their research and communication.
Topics: Adaptation, Psychological; Communication; Disease Management; Health Behavior; Health Status; Humans; Interpersonal Relations; Postural Balance; Psychological Theory; Qualitative Research; Risk; Sensation Disorders; Social Support; Stress, Psychological
PubMed: 21343435
DOI: 10.1177/1049732311399781