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1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 964-970, 2020 Oct 18.
Artículo en Chino | MEDLINE | ID: mdl-33047738

RESUMEN

OBJECTIVE: To evaluate the digital workflow coupling conic retention for the immediate restoration of adjacent posterior implants. METHODS: The patients with adjacent teeth missing in the posterior jaw seeking for implant restoration in the Department of Implantology, Peking University School and Hospital of Stomatology from March, 2017 to February, 2018 were recruited. After implant placement and commercial conic retention coping delivery, the patient had an intraoral scan for digital impression, and the computer-assisted design/computer-assisted manufacturing (CAD/CAM) technology was used for the fabrication of the immediate splinted prosthesis, which was made of polymethyl methacrylate (PMMA) and loaded immediately after delivery. Six months later, all the temporary prostheses were replaced by the permanent ones made of monolithic zirconia with CAD/CAM technology as well. The parallel periapical films were taken for the temporary and permanent prostheses post-delivery. The clinical effect of this workflow was evaluated by indices including the survival rates of implants and prostheses, the change of marginal bone level, and the implant-related and prosthesis-related complications; before the final restoration, the Visual Analogue Score (VAS) was used to evaluate the satisfaction of the patients. RESULTS: Ten patients (4 males and 6 females, 55.5 years old for average) were recruited. Totally 34 implants were placed; 14 prostheses were fabricated, temporary and permanent, respectively. After an observation period from 4 to 14 months, the survival rate for implants and prostheses were both 100%; the marginal bone level of the implants were (1.06±0.97) mm and (0.96±0.82) mm, immediate post-operation and 6 months later, respectively. The difference was not statistically significant (P>0.05). Neither implant- nor prostheses- related complications were observed. And the VAS of the patients' satisfaction was 87.2. CONCLUSION: For the adjacent posterior implants, the immediate prostheses manufactured by digital workflow, coupling conic retention, were clinically feasible and patient-satisfactory.


Asunto(s)
Diseño Asistido por Computadora , Flujo de Trabajo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Prótesis e Implantes , Implantación de Prótesis
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 729-736, 2020 Oct 09.
Artículo en Chino | MEDLINE | ID: mdl-33045783

RESUMEN

Objective: To explore and evaluate a three-dimensional (3D) digital simulated design and implementation technique in esthetic rehabilitation. Methods: Thirty patients with esthetic deficiency, who came to the Department of Prosthodontics, Peking University School and Hospital of Stomatology from December 2017 to July 2019, were recruited and randomly assigned into 2 groups. Four males and 11 females which were (36.0±10.5) years old in the experimental group, 6 males and 9 females which were (32.0±6.7) years old in the control group, were enrolled. In the experimental group, 3D digital simulated design was used to predict the post-treatment effect; and the final restorations were designed duplicating from the pre-treatment digital design confirmed by the patient and milled. In the control group, the final restorations were manufactured by the dental technician according to the design of two-dimensional (2D) digital smile design. The simulation degree of digital design and the similarity between preoperative design and postoperative rehabilitation were scored by the patients with visual analogue scales (VAS) in both groups; and the satisfaction rate to the restorations was evaluated by the patients. The quality of the restorations was accessed by a prosthodontist who did not know the grouping of patients according to the modified criteria of United States Public Health Service (USPHS). Results: Three-dimensional digital simulated design and implementation technique was successfully established. The VAS score on the simulation degree of digital design in the experimental group (8.5±0.5) was higher than that in the control group (7.2±0.7) (P<0.01); the VAS score on the similarity between preoperative design and postoperative rehabilitation in the experimental group (9.6±0.3) was higher than that in the control group (7.0±0.9) (P<0.01). The satisfaction rate of the patients to the restorations was significantly higher in the experimental group than in the control group (P<0.05). There was no significant difference of the quality of the restorations between the two groups on the anatomic form, the marginal adaption and the surface quality (P>0.05). Conclusions: Three-dimensional digital simulated design and implementation technique can help achieving 3D digital simulated design before treatment and duplication to the final restorations, and can improve the patients' satisfaction in esthetic rehabilitation.


Asunto(s)
Estética Dental , Sonrisa , Adulto , Odontólogos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Prostodoncia , Estados Unidos
4.
Cancer Control ; 27(1): 1073274820964800, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33023342

RESUMEN

Emergence of the COVID-19 crisis has catalyzed rapid paradigm shifts throughout medicine. Even after the initial wave of the virus subsides, a wholesale return to the prior status quo is not prudent. As a specialty that values the proper application of new technology, radiation oncology should strive to be at the forefront of harnessing telehealth as an important tool to further optimize patient care. We remain cognizant that telehealth cannot and should not be a comprehensive replacement for in-person patient visits because it is not a one for one replacement, dependent on the intention of the visit and patient preference. However, we envision the opportunity for the virtual patient "room" where multidisciplinary care may take place from every specialty. How we adapt is not an inevitability, but instead, an opportunity to shape the ideal image of our new normal through the choices that we make. We have made great strides toward genuine multidisciplinary patient-centered care, but the continued use of telehealth and virtual visits can bring us closer to optimally arranging the spokes of the provider team members around the central hub of the patient as we progress down the road through treatment.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neoplasias/diagnóstico , Aceptación de la Atención de Salud , Habitaciones de Pacientes/organización & administración , Neumonía Viral/epidemiología , Telemedicina/métodos , Realidad Virtual , Comorbilidad , Humanos , Neoplasias/epidemiología , Pandemias , Satisfacción del Paciente
5.
Medicine (Baltimore) ; 99(35): e22035, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-32871960

RESUMEN

Imbalances in the gut microbiota mediate the progression of neurodegenerative diseases such as Parkinson's disease (PD). Fecal microbiota transplantation (FMT) is currently being explored as a potential therapy for PD. The objective of this study was to assess the efficacy and safety of FMT on PD. Fifteen PD patients were included, 10 of them received FMT via colonoscopy (colonic FMT group) and 5 received FMT via nasal-jejunal tube (nasointestinal FMT group). The score of PSQI, HAMD, HAMA, PDQ-39, NMSQ and UPDRS-III significantly decreased after FMT treatment (all P < .05). Colonic FMT group showed significant improvement and longer maintenance of efficacy compared with nasointestinal FMT (P = .002). Two patients achieved self-satisfying outcomes that last for more than 24 months. However, nasointestinal FMT group had no significant therapeutic effect, although UPDRS-III score slightly reduced. There were no patients were satisfied with nasointestinal FMT for more than 3 months. Among 15 PD patients, there were 5 cases had adverse events (AEs), including diarrhea (2 cases), abdominal pain (2 cases) and flatulence (1 case). These AEs were mild and self-limiting. We conclude that FMT can relieve the motor and non-motor symptoms with acceptable safety in PD. Compared with nasointestinal FMT, colonic FMT seems better and preferable.


Asunto(s)
Trasplante de Microbiota Fecal/estadística & datos numéricos , Enfermedad de Parkinson/terapia , Anciano , Colonoscopía , Trasplante de Microbiota Fecal/efectos adversos , Trasplante de Microbiota Fecal/métodos , Femenino , Humanos , Intubación Gastrointestinal , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Proyectos Piloto , Adulto Joven
6.
Arthroscopy ; 36(9): 2464-2465, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32891247

RESUMEN

Despite its overall good results, meniscal allograft transplantation is considered a salvage procedure, and abstention from sport practice is considered a valid solution to preserve the transplanted meniscus as long as possible. However, many patients want to return to sport, and this is often beneficial for them. Therefore, we should know how meniscal allograft transplantation performs in terms of return to sport to better counsel our patients. It is thus of primary importance to discuss general and sport-related expectations with each patient, whom should be informed of the potential short- and long-term risks of strenuous or light sport activities. In particular, the high risk of reoperation, the long recovery time, and the potentially deleterious effect of sporting activity on graft survival should be quite clear to both surgeons and patients because, when it comes to return-to-sport decisions, "It takes two to tango"!


Asunto(s)
Menisco , Volver al Deporte , Aloinjertos , Humanos , Meniscos Tibiales , Satisfacción del Paciente
7.
Soins ; 65(845): 20-22, 2020 May.
Artículo en Francés | MEDLINE | ID: mdl-32862958

RESUMEN

Over 40 patients benefited from remote iconographic follow-up of wounds in an oncology centre. This system is piloted by three expert nurses. They carry out an initial analysis of the photographs received, seek medical expertise if necessary and liaise with the city's professionals. This system makes it possible to expertly accompany professionals and patients while avoiding unnecessary travel. The satisfaction survey conducted in 2018 established full satisfaction of patients and professionals (> 95%) and a guarantee in terms of the safety and quality of care of the wounds.


Asunto(s)
Cuidados Posteriores/métodos , Instituciones Oncológicas , Satisfacción del Paciente/estadística & datos numéricos , Consulta Remota/métodos , Heridas y Traumatismos/terapia , Encuestas de Atención de la Salud , Humanos , Enfermería Oncológica , Fotograbar , Proyectos Piloto
10.
J Pregnancy ; 2020: 4318197, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32908704

RESUMEN

Background: The maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skill birth attendant (SBA), and postnatal care (PNC) within 48 hours of delivery. It is one of the essential strategies for reducing maternal and newborn mortality. This study aimed to assess the factors associated with the completion of a continuum of maternal healthcare services among mothers who gave birth in the past five years. Methods: A community-based cross-sectional study was conducted from May 01 to June 29, 2019, among 565 randomly selected mothers who gave birth in five years before the study in primary healthcare project implementation districts of north Gondar zone, Amhara National Regional State, Ethiopia. Bivariable and multivariable logistic regression analysis were computed, and in the multivariable logistic regression analysis, adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p value of less than 0.05 were used to identify the associated factors with completion of the continuum of maternal healthcare services. Results: The study revealed that the overall completion of the continuum of maternal healthcare services was 21.60% (95% CI: 18.20, 24.90). Women who were able to read and write (AOR: 2.70, 95% CI: 1.22, 6.04), using car/motorcycle as a means of transportation to get the health facility (AOR: 5.59, 95% CI: 2.29, 9.50), travel time less than an hour to get the health facility (AOR: 4.98, 95% CI: 2.97, 8.38), being satisfied with the service delivery (AOR: 1.89, 95% CI: 1.15, 3.11), and getting health education on maternal healthcare services in the last 6 months (AOR: 2.77, 95% CI: 1.52, 5.05) were factors associated with the completion of the continuum of maternal healthcare services. Conclusions: The completion of the continuum of maternal healthcare services was relatively low, indicating that women were not getting the likely health benefit from the present health services. Therefore, interventions should focus on increasing women's awareness, improving the availability of services at nearby health facilities, and improving service delivery by considering women's preferences and needs to increase their satisfaction are essential to increase the completion of maternal healthcare services.


Asunto(s)
Prestación de Atención de Salud , Accesibilidad a los Servicios de Salud , Servicios de Salud Materna/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Atención Primaria de Salud , Adolescente , Adulto , Concienciación , Estudios Transversales , Etiopía/epidemiología , Femenino , Educación en Salud , Instituciones de Salud , Humanos , Persona de Mediana Edad , Satisfacción del Paciente , Atención Posnatal , Embarazo , Atención Prenatal , Adulto Joven
11.
Am J Orthod Dentofacial Orthop ; 158(4): e17-e27, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32863088

RESUMEN

INTRODUCTION: The objective of this research was to evaluate the treatment outcomes, long-term occlusal changes, and patient satisfaction after 37 years of nonextraction and extraction treatments. METHODS: Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term posttreatment (T3) ages of 13.2, 15.0, and 50.3 years, respectively. Mean treatment time (T2 - T1) and long-term follow-up time (T3 - T2) were 1.8 and 35.2 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with mean ages at T1, T2, and T3 of 13.3, 15.6, and 53.6 years, respectively. Mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 2.3 and 37.9 years, respectively. The Peer Assessment Rating (PAR) index and Objective Grading System (OGS) indexes were evaluated at T1, T2, and T3 stages. The subjects also answered an online questionnaire regarding esthetic and occlusal self-perception at T3. Intergroup comparison was performed with t tests. RESULTS: The PAR index improved with treatment and similarly worsened at T3 for both groups. OGS scores were close to the passing score at T2 for both groups. The nonextraction group presented worse OGS scores at T3 than the extraction group. Nonextraction patients perceived more changes in alignment over time, but overall satisfaction was similar. CONCLUSIONS: The PAR index improved with treatment, and the PAR and OGS scores showed a significant increase, indicating great occlusal changes in the long-term stage. The nonextraction group showed more occlusal changes and perceived more changes in their alignment over time, but overall patient satisfaction was similar in both groups.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Satisfacción del Paciente , Diente Premolar , Estética Dental , Humanos , Persona de Mediana Edad , Ortodoncia Correctiva , Extracción Dental , Resultado del Tratamiento
12.
Yakugaku Zasshi ; 140(9): 1107-1117, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-32879243

RESUMEN

The true central aim of pharmaceutical research and education is to strive for the patient's satisfaction, i.e., "for the sake of the patient". Our research focuses to bridge the gap between the ideal and current situation in pharmaceutical science. We also investigated/questioned the united roles of pharmacists and pharmacies, with the ambition of changing the work culture of pharmacists. This paper reviews the history of our research and discusses the future of pharmaceutical research and education.


Asunto(s)
Biofarmacia/educación , Educación en Farmacia/tendencias , Investigación/tendencias , Análisis de Datos , Humanos , Satisfacción del Paciente , Farmacéuticos , Farmacia
13.
Minerva Stomatol ; 69(4): 256-268, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32945635

RESUMEN

INTRODUCTION: In this systematic review, several masticatory function parameters assessed during mandibular single-implant overdenture (SIO) use were compared to pre- SIO placement values in edentulous patients with aim of contributing to a consensus regarding denture treatment options. EVIDENCE ACQUISITION: This study was registered a priori in the PROSPERO database (CRD42018106567). Two independent reviewers carried out electronic searches in eight databases, without language or time frame limitations, to collate clinical studies comparing masticatory function of edentulous patients before versus after SIO installation with the implant placed on the mandibular midline. Risk of bias was assessed with a before-and-after tool and evidence certainty level was evaluated with the Grading of Recommendations Assessment, Development and Evaluation program. EVIDENCE SYNTHESIS: Eleven studies were included in this review (1 prospective, 3 crossover trials, 4 randomized clinical trials, 2 paired clinical trials, and 1 pilot). Enrolled patients were mostly over 60 years old; all patients were using conventional complete dentures (CD) prior to SIO installation. Masticatory performance, masticatory efficiency, bite force, and muscle activity were improved after the SIO placement compared to during mandibular CD use. Mandibular movement and masticatory ability data were inconclusive. Most of the studies had low risk of bias, but all had very low certainly level ratings due to methodological heterogeneity. CONCLUSIONS: Placement of SIO improves masticatory function, as reflected mostly by masticatory performance and efficiency data, relative to CD use. Further studies comparing dental rehabilitation options, including SIOs, are needed to improve the quality of evidence in the literature.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado , Humanos , Mandíbula , Masticación , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos
14.
Monaldi Arch Chest Dis ; 90(4)2020 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-32959627

RESUMEN

The National Health Service (NHS) has rapidly adopted telemedicine solutions as an alternative to face-to-face consultations during the COVID-19 pandemic. The majority of HCPs (Healthcare Professionals) were unfamiliar with Telemedicine prior to the current pandemic. Remote consultation is expected to continue for the foreseeable future, thus we designed this survey. A survey designed to evaluate the use of telephone consultation by HCPs, assessing its implementation, challenges and drawbacks. A web link survey conducted through SurveyMonkey was sent to HCPs across six UK Trusts the period of May 2020. The survey received 114 responses (84%) being doctors. 95% of respondents had not received training prior to engaging in telemedicine consultations. 64% were unaware of the updated General Medical Council guidance concerning remote consultations. The most common barrier in remote consultation was the inability to access patient records raised by 37% of respondents. However, 73% of respondents felt that patients understood their medical condition and the instructions given to them over the phone, and 70% agreed that videoconference consultations would add to patients care. Telemedicine can be used for selected groups of patients in the post COVID-19 era, and the HCPs carrying that should have the sufficient experience and knowledge expected to operate these clinics.


Asunto(s)
Actitud del Personal de Salud , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Telemedicina , Betacoronavirus , Ginecología , Humanos , Enfermeras Clínicas , Obstetricia , Pandemias , Satisfacción del Paciente , Médicos , Cirujanos , Encuestas y Cuestionarios , Reino Unido/epidemiología
15.
Artículo en Inglés | MEDLINE | ID: mdl-32926003

RESUMEN

Horizontal and vertical reduction of the ridge has to be expected after tooth extraction. Immediate implant placement and provisionalization is a viable treatment option that can help to minimize those changes. Additionally, it can better meet a patient's expectations about the treatment, reducing time and invasiveness. The aim of this prospective study is to evaluate the stability of the hard and soft tissues surrounding single immediate implants placed in the esthetic zone, as well as evaluating patient satisfaction. A total of 16 implants were placed, and 15 could be evaluated at the 3-year follow-up. Radiographic and clinical data was recorded after this period. Some marginal bone level reduction was detected after 3 years but was not statistically significant. The soft tissues, measured at 3 points, showed stability and even better positions with respect to the day of the final restoration placement. Patient satisfaction was analyzed using the modified Oral Health Impact Profile questionnaire (OHIP-14), and high satisfaction values were reported. The implementation of a precise surgical and prosthetic protocol when an immediate implant is placed into a fresh extraction socket is likely to result in high survival and success rates combined with excellent patient satisfaction. After the 3-year follow-up, favorable results were present.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Estética Dental , Estudios de Seguimiento , Humanos , Satisfacción del Paciente , Estudios Prospectivos , Extracción Dental , Alveolo Dental/cirugía , Resultado del Tratamiento
16.
Int J Prosthodont ; 33(5): 513-522, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32956432

RESUMEN

PURPOSE: To compare clinical and esthetic outcomes between immediately loaded single implants placed with and without a fully guided surgical procedure. MATERIALS AND METHODS: Patients with a missing maxillary tooth (second premolar to second premolar) were considered for inclusion in this 1-year prospective nonrandomized study. Exclusion criteria were general health contraindications for oral surgery besides the need for bone grafting or ridge augmentation. One group received digital implant planning, fully guided surgery, and immediate loading (DIL). The other group received freehand surgery and immediate loading (IL). Outcome measures were implant survival, marginal bone loss, soft tissue changes, papilla index, pink and white esthetic scores (PES and WES, respectively), and patient-reported outcome measures (PROMs). RESULTS: Two of 21 implants failed in the DIL group soon after placement, resulting in a 1-year implant survival rate of 90.5%, while no implants failed in the IL group. Significantly higher papilla index scores and lower soft tissue changes were found for the DIL group compared to the IL group. No differences were found after 1 year regarding marginal bone loss, PES, WES, or PROMs. CONCLUSION: Within the limitations of this study, immediate loading in combination with fully guided surgery might negatively affect implant survival. Immediate loading, fully guided surgery, and a digital workflow appear to have a positive effect on early soft tissue adaptation.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Estética Dental , Humanos , Maxilar/cirugía , Satisfacción del Paciente , Estudios Prospectivos , Resultado del Tratamiento
17.
Evid Based Dent ; 21(3): 89, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32978535

RESUMEN

Data sources Data was collected utilising Medline (OVID interface), Google Scholar and Cochrane Library. Systematic reviews with/without meta-analysis were selected which included patient satisfaction and oral health-related quality of life as outcome measures. The literature search performed included systematic reviews with publication dates ranging from 1946 to 2018. PROSPERO was also used to incorporate systematic reviews that had been completed after the last search in August 2018.Study selection Studies were selected using the PICO model, selecting systematic reviews analysing adult edentulous patients with conventional complete dentures and/or implant-retained overdentures. The systematic reviews chosen assessed satisfaction and oral health-related quality of life, while comparing results to adult edentulous patients with no replacement teeth or prosthesis.Data extraction and synthesis All of the articles located from the database searches were uploaded to reference management software. Articles were screened independently by two authors to reduce bias and to assess the articles against the predetermined inclusion criteria. The EndNote filter Service was applied to avoid duplication of articles. Guidance from the Centre for Reviews and Dissemination (University of York) was incorporated to present data narratively, with text and tables. Eight reviews were included in data synthesis.Results Of the eight reviews included, six were systematic reviews without meta-analysis, one systematic review with meta-analysis was included and one was meta-analysis. Conclusions The results of this systematic review highlight the greater benefits of implant retained overdentures compared with conventional complete dentures when assessing patient satisfaction and oral health-related quality of life. The superiority of implant retained overdentures is most evident when patients cannot tolerate conventional complete dentures. However, consideration most be given to the adaptive capabilities of patients and the financial implications of implant-retained overdentures.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Adulto , Prótesis Dental de Soporte Implantado , Dentadura Completa , Humanos , Salud Bucal , Satisfacción del Paciente , Satisfacción Personal , Atención Primaria de Salud , Calidad de Vida
18.
Medicine (Baltimore) ; 99(37): e22144, 2020 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-32925769

RESUMEN

The aim of this study was to determine the effectiveness of a skin stretching technique with adjustable external fixators in treating skin defects.Eighteen patients treated with a skin-stretching technique with adjustable external fixators for skin defects from April 2017 to October 2019 were included. Visual Analogue Scale (VAS) scores were collected during therapy. The skin defects gradually became smaller until they were completely resolved according to the blood flow of the affected limb and wound skin (the color, temperature, elasticity, and capillary response). The defect sizes ranged from 4 cm × 2 cm to 20 cm × 6 cm.The 18 adjustable external fixators were dismantled in 2 to 9 days (mean, 4.05 days) after the operation, and the defects were completely closed and the sutures were removed after 2 to 3 weeks. The average VAS score was 5.97. The follow-up period was 4 to 12 months (mean, 6.3 months); 17 patients healed well with linear small scar, and no infections or patients of necrosis were observed. Sensory recovery was assessed using the Medical Research Council scale, and all the sensation scores were S3+. Eight patients were healed after the first stage. Nine patients were closed totally while small sinus or skin defect were observed after sutures were removed; 3 patients were healed after the second debridement, and 6 patients finally healed after the dressings were changed. Patellar osteomyelitis recurred in 1 patient who was transferred to the Orthopedic Department for further treatment, and a flap graft procedure was performed.The operation was simple and obviously reduced the course of the disease, the costs, and the damage to the donor site, and it is also significantly superior to skin graft or flap transplantation procedures in terms of the resulting skin sensation, color, texture, elasticity, and appearance.


Asunto(s)
Fijadores Externos , Procedimientos Quirúrgicos Reconstructivos/métodos , Cicatrización de Heridas/fisiología , Heridas y Traumatismos/terapia , Adulto , Anciano , Elasticidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Satisfacción del Paciente , Pigmentación de la Piel , Temperatura Cutánea , Factores de Tiempo
19.
Plast Reconstr Surg ; 146(4): 913-919, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32970013

RESUMEN

BACKGROUND: Even before seeing a physician, patients must first gain access to the hospital system. At large hospitals with high patient volumes, access to specialty care can pose a particular challenge. This study examines the effects of specific initiatives to increase clinic capacity, appointment use, and ease of scheduling on both patient satisfaction and hospital revenue. METHODS: In 2017, a task force at a large, multidisciplinary pediatric hospital instituted a number of initiatives to increase patient access to ambulatory specialty clinics. Clinic sessions were standardized to a 4-hour template, and unscheduled, "held" appointment slots were required to be made available ("flipped") 72 hours before the appointment. A patient-centered electronic scheduling platform was also implemented. Patient satisfaction was assessed using Press Ganey scores. Revenue estimates were calculated for increases in "new" and "return" patient appointments. RESULTS: Total new appointment slots increased by over 44 percent, with over 53,000 appointments added annually. The number of held appointment slots declined by 93 percent. A total of 17,996 annual appointments were added in surgical subspecialties, and an additional 14,756 more surgical appointments were completed. Over 2000 appointments were scheduled by means of the online patient portal. Press Ganey "ease-of-scheduling" scores increased from 57 percent to 72 percent over the intervention period. Hospitalwide, these initiatives generated an estimated $8.3 million in revenue opportunity. CONCLUSION: Standardizing clinic sessions and optimizing clinic availability generates new appointment opportunities, improves patient experience, and increases hospital revenue.


Asunto(s)
Instituciones de Atención Ambulatoria/economía , Instituciones de Atención Ambulatoria/organización & administración , Citas y Horarios , Eficiencia Organizacional/economía , Hospitales Pediátricos/economía , Hospitales Pediátricos/organización & administración , Satisfacción del Paciente/estadística & datos numéricos , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Niño , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Estudios Retrospectivos
20.
JMIR Mhealth Uhealth ; 8(8): e19433, 2020 08 14.
Artículo en Inglés | MEDLINE | ID: mdl-32795985

RESUMEN

BACKGROUND: Dental visits are unpleasant; sometimes, patients only seek treatment when they are in intolerable pain. Recently, the novel coronavirus (COVID-19) pandemic has highlighted the need for remote communication when patients and dentists cannot meet in person. Gingivitis is very common and characterized by red, swollen, bleeding gums. Gingivitis heals within 10 days of professional care and with daily, thorough oral hygiene practices. If left untreated, however, its progress may lead to teeth becoming mobile or lost. Of the many medical apps currently available, none monitor gingivitis. OBJECTIVE: This study aimed to present a characterization and development model of a mobile health (mHealth) app called iGAM, which focuses on periodontal health and improves the information flow between dentists and patients. METHODS: A focus group discussed the potential of an app to monitor gingivitis, and 3 semistructured in-depth interviews were conducted on the use of apps for monitoring gum infections. We used a qualitative design process based on the Agile approach, which incorporated the following 5 steps: (1) user story, (2) use cases, (3) functional requirements, (4) nonfunctional requirements, and (5) Agile software development cycles. In a pilot study with 18 participants aged 18-45 years and with different levels of health literacy, participants were given a toothbrush, toothpaste, mouthwash, toothpicks, and dental floss. After installing iGAM, they were asked to photograph their gums weekly for 4 weeks. RESULTS: All participants in the focus group believed in the potential of a mobile app to monitor gingivitis and reduce its severity. Concerns about security and privacy issues were discussed. From the interviews, 2 themes were derived: (1) "what's in it for me?" and (2) the need for a take-home message. The 5 cycles of development highlighted the importance of communication between dentists, app developers, and the pilot group. Qualitative analysis of the data from the pilot study showed difficulty with: (1) the camera, which was alleviated with the provision of mouth openers, and (2) the operation of the phone, which was alleviated by changing the app to be fully automated, with a weekly reminder and an instructions document. Final interviews showed satisfaction. CONCLUSIONS: iGAM is the first mHealth app for monitoring gingivitis using self-photography. iGAM facilitates the information flow between dentists and patients between checkups and may be useful when face-to-face consultations are not possible (such as during the COVID-19 pandemic).


Asunto(s)
Atención Odontológica/métodos , Gingivitis/prevención & control , Aplicaciones Móviles , Fotograbar , Telemedicina , Adolescente , Adulto , Infecciones por Coronavirus/epidemiología , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Satisfacción del Paciente/estadística & datos numéricos , Proyectos Piloto , Neumonía Viral/epidemiología , Investigación Cualitativa , Interfaz Usuario-Computador , Adulto Joven
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