Success Of Medical Treatment Research Articles

Impact of Hyperparameter Optimization to Enhance Machine Learning Performance: A Case Study on Breast Cancer Recurrence Prediction

Accurate and early prediction of breast cancer recurrence is crucial to guide medical decisions and treatment success. Machine learning (ML) has shown promise in this domain. However, its effectiveness critically depends on proper hyperparameter setting, a step that is not always performed systematically in the development of ML models. In this study, we aimed to highlight the impact that this process has on the final performance of ML models through a real-world case study by predicting the five-year recurrence of breast cancer patients. We compared the performance of five ML algorithms (Logistic Regression, Decision Tree, Gradient Boosting, eXtreme Gradient Boost, and Deep Neural Network) before and after optimizing their hyperparameters. Simpler algorithms showed better performance using the default hyperparameters. However, after the optimization process, the more complex algorithms demonstrated superior performance. The AUCs obtained before and after adjustment were 0.7 vs. 0.84 for XGB, 0.64 vs. 0.75 for DNN, 0.7 vs. 0.8 for GB, 0.62 vs. 0.7 for DT, and 0.77 vs. 0.72 for LR. The results underscore the critical importance of hyperparameter selection in the development of ML algorithms for the prediction of cancer recurrence. Neglecting this step can undermine the potential of more powerful algorithms and lead to the choice of suboptimal models.

Assessing PCR-Positive Acanthamoeba Keratitis-A Retrospective Chart Review.

Ophthalmologists' diagnostic and treatment competence in Acanthamoeba keratitis varies widely. This investigator-initiated, retrospective, single-center chart review examined the electronic patient files regarding PCR-positive Acanthamoeba keratitis. We included corneal and contact lens assessments. We further reviewed the patient's medical history, corneal scraping results regarding viral or fungal co-infections, and the duration from symptom onset to final diagnosis. We identified 59 eyes of 52 patients from February 2010 to February 2023, with 31 of 52 (59.6%) being female patients. The median (IQR, range) patient age was 33 (25.3 to 45.5 [13 to 90]) years, and the mean (SD, range) time to diagnosis after symptom onset was 18 (10.5 to 35 [3 to 70]) days. Overall, 7 of 52 (7.7%) patients displayed a bilateral Acanthamoeba infection, and 48 (92.3%) used contact lenses at symptom onset. Regarding other microbiological co-infections, we found virologic PCR testing in 45 of 52 (86.5%) patients, with 3 (6.7%) positive corneal scrapings. Fungal cultures were performed in 49 of 52 (94.2%) patients, with 5 (10.2%) positive corneal scrapings. The medical treatment success rate was 45/46 (97.8%). This study raises awareness of patient education in contact lens handling and screens for further microbial co-infections in suspected Acanthamoeba cases.

The importance of self-management for better treatment outcomes for HIV patients in a low-income setting: perspectives of HIV experts and service providers

BackgroundSelf-management is the most important strategy to improve quality of life in patients with a chronic disease. Despite the increasing number of people living with HIV (PLWH) in low-income countries, very little research on self-management is conducted in this setting. The aim of this research is to understand the perspectives of service providers and experts on the importance of self-management for PLWH.MethodsA systematizing expert interview type of qualitative methodology was used to gain the perspectives of experts and service providers. The study participants had experience in researching, managing, or providing HIV service in east and southern African (ESA) countries. All the interviews were audio recorded, transcribed, and translated to English. The quality of the transcripts was ensured by randomly checking the texts against the audio record. A thematic analysis approach supported by Atlas TI version 9 software.ResultPLWH face a variety of multi-dimensional problems thematized under contextual and process dimensions. The problems identified under the contextual dimension include disease-specific, facility-related, and social environment-related. Problems with individual origin, such as ignorance, outweighing beliefs over scientific issues, low self-esteem, and a lack of social support, were mostly highlighted under the process dimensions. Those problems have a deleterious impact on self-management, treatment outcomes, and the quality of life of PLWH. Low self-management is also a result of professional-centered service delivery in healthcare facilities and health service providers’ incapacity to comprehend a patient’s need beyond the medical concerns. Participants in the study asserted that patients have a significant stake in enhancing treatment results and quality of life through enhancing self-management.Conclusion and recommendationHIV patients face multifaceted problems beyond their medical issues. The success of medical treatment for HIV is strongly contingent upon patients’ self-management practices and the supportive roles of their family, society, and health service providers. The development and integration of self-management practices into clinical care will benefit patients, their families, and the health system.

Survival of medical treatment success in primary open-angle glaucoma and ocular hypertension

Background/aimsTopical agents to lower intraocular pressure (IOP) are the most common initial therapeutic measure in glaucoma prevention. This study aims to assess treatment success duration among patients initiating or intensifying...

Retrospective cohort study comparing success of medical management of early pregnancy loss in pregnancies conceived with and without medical assistance

To compare the success rates of medical management using a combined mifepristone and misoprostol protocol in cases of early pregnancy loss (EPL) between women who conceived without medical assistance and those who conceived through invitro fertilization (IVF), after fresh or frozen embryo transfer, and evaluate for the predictive factors of success, time to first passage of tissue, and time to complete resolution of pregnancy. Retrospective cohort study. University hospital. Women who presented with EPL below 13 weeks of gestation between June 2013 and July 2021 who were managed medically with mifepristone 200 mg orally and misoprostol 800 mcg vaginally were included in the study. Medical management with mifepristone and misoprostol; conception without medical assistance vs. post-IVF, after fresh or frozen embryo transfer. We evaluated overall success and performed subgroup analysis according to the mode of conception and compared fresh vs. frozen-thawed embryo transfers for IVF pregnancies. In all groups, we also calculated success according to gestational age and compared the time to first passage of tissue. The potential predictive factors of treatment success were analyzed. The side effects and complications of treatment were recorded. A total of 930 women were included in the study, 99 (11%) of whom achieved pregnancy after IVF. The overall success of medical treatment was 89% with no statistically significant difference according to the mode of conception (89% vs. 89%) or type of transfer (fresh 89% vs. frozen 89%). Only lower gestational age by sonography was independently predictive of treatment success, showing a negative regression coefficient of β = -0.333 and an odds ratio of 0.717. The mean time to first passage of tissue was 5.0 ± 2.1 hours. Altogether, 666 women (72%) showed pregnancy resolution on the day of medication administration, an additional 110 women at 1-week follow-up, and a further 74 women after ≥4 weeks on ultrasound. Medical management of EPL with mifepristone and misoprostol is a highly successful treatment option that results in completed abortion in a timely fashion in both pregnancies conceived without medical assistance and those conceived after IVF.

Remote Monitoring of Patients after Allogeneic Stem Cell Transplantation: A Mobile Phone Application to Report Symptoms, Vital Signs and Activity in Real Time

Introduction: One of the major obstacles for early inpatient discharge after allogeneic stem cell transplantation (aSCT) is, aside from frailty and bloodwork required, the high risk for infections and the need for monitoring of graft versus host disease (GvHD). This requires frequent hospital visits which are often a challenge especially when travelling to hospitals imposes significant costs for the patient. Furthermore, structured data acquisition in the home care setting is missing. Methods: We have developed a fully patient centered, easy to operate mobile phone application for aHSCT patients that allows for treatment specific symptom reporting. In combination with a wearable device (smart watch), a blood pressure monitor and a thermometer, this application incorporates online monitoring of all major vital signs in almost real time. The application currently captures more than 50 static and dynamic metrics relevant for aSCT and provides a photo function to capture skin images in a patient specific image library. Daily symptom reporting can be performed as often as necessary and data from wearable devices are obtained in very high frequency. Symptom reporting includes information on general wellbeing, nausea, oral mucositis, bowel movement frequency and consistency, information on oral calorie and fluid uptake, and it captures and calculates body surface areas affected by rash. All data are streamed in almost real time and displayed on a browser-based dashboard to the healthcare team. The user interface for the physician dashboard was developed using the React JavaScript library whereas the mobile application utilized React Native to enable Android and iOS applications. The collection, storage, and presentation of patient data via the physician dashboard is facilitated using various AWS technologies such as Lambda, S3 and Timestream. Data can be stored according to federal laws and regulations the software is operating in. Access to the dashboard is center-specific and secured by a dual verification process. Summary: Daily symptom reporting by the patient is easy, comprehensive and can be completed within minutes. Data from wearable devices are obtained 24/7 at high frequency. All data are displayed on a dashboard to the corresponding physician with only a few minutes delay. The system captures vital signs (blood pressure, temperature, pulse, breathing rate, oxygen saturation, etc.) and GvHD related symptoms such as skin rash including body surface area affected, and frequency/volume of bowel movements. It provides information based on the patient's physical activity, food intake, fluid intake, sleeping patterns in a structured fashion. The physician's dashboard displays all transplant relevant static information like HLA match, conditioning regimen, type of immunosuppression, ABO incompatibility, serologies of patient and donor. It displays all data reported longitudinally and allows physicians to observe trends and developments providing interactive graphs on each metrics. It provides a medication plan that captures daily dosage, duration of treatment and calculates cumulative doses. Changes in medication and dosing will alert the patient on the mobile phone application. All data can be obtained in a structured fashion for research purposes by the participating institution. Conclusion: This mobile phone application in combination with a wearable device allows for remote monitoring of patients after aHSCT. Its function is comprehensive and not only provides structured data, but allows for monitoring success of medical treatment. It is developed in a modular fashion that can be easily adapted to specific requirements in other cell therapies such CAR CD19, AML induction therapies or autologous SCT.

There is hope that health care may deliver on its promise

Health care is an increasingly bureaucratic environment in which key services are delivered. Individual practitioners can do little to reduce overarching burdens of working in such conditions. It is possible, however, to improve the experience of those who are being served, or even to improve outcomes by paying attention to details that are rarely considered when planning healthcare improvements. The interaction between healthcare practitioners and patients takes place in a private space and involves physical, emotional, and social exchanges that have been shown to impact the success of medical treatment. This editorial identifies the elements of the consultation that warrant special attention.

A 5G-Enabled and Self-Powered Sensor Data Management Scheme for the Smart Medical Platform System

With the rapid development of information technology and the Internet, the advent of 5G era, combined with the self-powered sensors technology of the Internet of things, can meet the needs of the rapid popularization of intelligent devices and intelligent terminals. With the national economic growth and the continuous development of high-tech industry, the people’s demand for medical services and medical construction is gradually increasing. In order to improve the medical speed, treatment efficiency and treatment success rate of the medical platform, the intelligent medical system has become a system platform widely used in major hospitals. Based on 5G development and self-powered sensors development, this paper studies the construction of intelligent medical platform and system data management. We analyze the development of 5G and the application status of self-powered sensors in the medical field, and briefly describe the defects and problems existing in the intelligent medical system. Use 5G network propagation speed to optimize and improve the intelligent medical system, manage the system data information in the big data environment, and build an information integration platform. In the medical information data collection, the intelligent self-powered sensors technology is used to expand the retrieval range and improve the accuracy and reliability of the system. A set of intelligent medical data retrieval system is designed by using artificial intelligence algorithm and 5G communication technology to realize and optimize the function of patient service on the medical platform. Finally, the data management of medical platform is studied under the data security mechanism. Combined with advanced self-powered sensors technology, the purpose of dynamically monitoring patients’ heart rate and body test data is realized, and the information is transmitted to the medical management platform to help doctors and nurses analyze and diagnose. The results show that 5G technology and intelligent self-powered sensors technology play a good role in promoting the establishment of intelligent medical platform, and improve the overall accuracy and reliability of medical system.

Smart Smile: Revolutionizing Dentistry With Artificial Intelligence.

Artificial intelligence (AI) has emerged as a transformative technology in various industries, and its potential in dentistry is gaining significant attention. This abstract explores the future prospects of AI in dentistry, highlighting its potential to revolutionize clinical practice, improve patient outcomes, and enhance the overall efficiency of dental care. The application of AI in dentistry encompasses several key areas, including diagnosis, treatment planning, image analysis, patient management, and personalized care. AI algorithms have shown promising results in the automated detection and diagnosis of dental conditions, such as caries, periodontal diseases, and oral cancers, aiding clinicians in early intervention and improving treatment outcomes. Furthermore, AI-powered treatment planning systems leverage machine learning techniques to analyze vast amounts of patient data, considering factors like medical history, anatomical variations, and treatment success rates. These systems provide dentists with valuable insights and support in making evidence-based treatment decisions, ultimately leading to more predictable and tailored treatment approaches. While the potential of AI in dentistry is immense, it is essential to address certain challenges, including data privacy, algorithm bias, and regulatory considerations. Collaborative efforts between dental professionals, AI experts, and policymakers are crucial to developing robust frameworks that ensure the responsible and ethical implementation of AI in dentistry. Moreover, AI-driven robotics has introduced innovative approaches to dental surgery, enabling precise and minimally invasive procedures, and ultimately reducing patient discomfort and recovery time. Virtual reality (VR) and augmented reality (AR) applications further enhance dental education and training, allowing dental professionals to refine their skills in a realistic and immersive environment. AI holds tremendous promise in shaping the future of dentistry. Through its ability to analyze vast amounts of data, provide accurate diagnoses, facilitate treatment planning, improve image analysis, streamline patient management, and enable personalized care, AI has the potential to enhance dental practice and significantly improve patient outcomes. Embracing this technology and its future development will undoubtedly revolutionize the field of dentistry, fostering a more efficient, precise, and patient-centric approach to oral healthcare. Overall, AI represents a powerful tool that has the potential to revolutionize various aspects of society, from improving healthcare outcomes to optimizing business operations. Continued research, development, and responsible implementation of AI technologies will shape our future, unlocking new possibilities and transforming the way we live and work.

The role of systemic immune inflammation index in predicting treatment success in tuboovarian abscesses.

The aim of this study was to determine the predictability of the systemic immune inflammation index (SII) on the response to medical treatment in tubo-ovarian abscess (TOA). 296 patients with TOA in a tertiary center were enrolled in the study. Patients were divided into two groups: Group1 (n = 165) included patients in whom medical treatment was successful, and Group2 (n = 131) included patients in whom surgery was required. Demographic, sonographic and laboratory findings were compared between groups. SII was calculated using peripheral blood parameters [SII = (platelets ∗ neutrophils)/lymphocytes]. Age, BMI, gravida, parity, smoking and menopausal status, CRP levels of patients were similar in both groups (p > 0.05). Mass size (4.398 ± 0.306 vs 7.683 ± 0.689, p < 0.001), white blood cell (WBC) (8685.08 ± 3981.98 vs 9994.35 ± 4468.024, p = 0.008), Hb (12.18 ± 1.65 vs 11.68 ± 1.65, p = 0.010), platelet to lymphocyte ratio (PLR) (151.26 ± 74.83 vs 230.77 ± 140.25, p < 0.001), neutrophil to lymphocyte ratio (NLR) (4.21 ± 3.27 vs 6.07 ± 6.6, p = 0.003), monocyte to lymphocyte ratio (MLR) (0.300 ± 0.177 vs 0.346 ± 0.203, p = 0.041) and SII (1014.18 ± 781.71 vs 2094.088 ± 2117.58, p < 0.001) were statistically higher in group 2. ROC Analysis was used to determine the predictability of the variables and PLR (AUC = 0.718, p < 0.001), NLR (AUC = 0.593, p = 0.593), MLR (AUC = 0.576, p = 0.024), SII (AUC = 0.723, p < 0.001) and size of mass (AUC = 0.670, p < 0.001) were found to be significant. The SII, size of mass and bilateral involvement of adnexa were found to be the strongest prognostic factors for surgical intervention (OR:1.004 (1.002-1.005), OR:1.018 (1.010-1.027), OR:3.397 (1.338-8.627); p < 0.001, p < 0.001, p = 0.010 resspectively). SII, size of mass and bilaterality can be used to predict medical treatment success in patients with TOA.

ARTICULATING VERSUS STATIC SPACERS IN THE TREATMENT OF HIP ARTHROPLASTY PROSTHETIC JOINT INFECTION (PJI)

Surgical treatment of Hip PJI by resection of the infected implants and tissue and placement of a “spacer” which elutes antibiotic via antibiotic loaded cement is an accepted treatment option. There is some controversy over whether this “spacer” should be articulating or static. Proponents of the articulating option argue that there is improved function and maintenance of the soft tissue envelop. Critics have suggested that additional biomaterials may compromise eradication of infection. This study compares our results of the 2 treatment options.A review of our institutional PJI database between 2016 and 2021 identified 87 patients who were treated with resection arthroplasty for unilateral total hip PJI. The cohort was analyzed for demographics and type for surgery, as well as medical comorbidities, survivorship, and treatment success.44 patients were female, the mean age of all patients was 62. 44 patients were treated with Articulating apacers, and 43 patients treated with static spacers. There was no significant difference between ASA or Elixhauser score, and no significant difference between mortality or treatment failure.This study did not show any difference between the patients who receive static spacers, from those who received articulating spacers, and deomstrated similar treatment success rates. From this data there does not appear to be any difference in success rates between those patients that were treated with static spacers and those that were treated with articulating spacers.

The Role of Clinical and Inflammatory Parameters to Predict the Success of Medical Treatment in Patients with Tubo-ovarian Abscess

The Role of Clinical and Inflammatory Parameters to Predict the Success of Medical Treatment in Patients with Tubo-ovarian Abscess

Molecular Mechanisms and Therapeutic Implications of Endothelial Dysfunction in Patients with Heart Failure

Heart failure is a complex medical syndrome that is attributed to a number of risk factors; nevertheless, its clinical presentation is quite similar among the different etiologies. Heart failure displays a rapidly increasing prevalence due to the aging of the population and the success of medical treatment and devices. The pathophysiology of heart failure comprises several mechanisms, such as activation of neurohormonal systems, oxidative stress, dysfunctional calcium handling, impaired energy utilization, mitochondrial dysfunction, and inflammation, which are also implicated in the development of endothelial dysfunction. Heart failure with reduced ejection fraction is usually the result of myocardial loss, which progressively ends in myocardial remodeling. On the other hand, heart failure with preserved ejection fraction is common in patients with comorbidities such as diabetes mellitus, obesity, and hypertension, which trigger the creation of a micro-environment of chronic, ongoing inflammation. Interestingly, endothelial dysfunction of both peripheral vessels and coronary epicardial vessels and microcirculation is a common characteristic of both categories of heart failure and has been associated with worse cardiovascular outcomes. Indeed, exercise training and several heart failure drug categories display favorable effects against endothelial dysfunction apart from their established direct myocardial benefit.

The potential interaction between medical treatment and radioiodine treatment success: A systematic review.

Radioactive iodine (RAI) therapy is a critical component in the post-surgical management of thyroid cancer patients, as well as being a central therapeutic option in the treatment of hyperthyroidism. Previous work suggests that antithyroid drugs hinder the efficacy of RAI therapy in patients. However, the effects of other background medications on RAI treatment efficacy have not been evaluated. Therefore, we performed a systematic review and meta-analysis investigating the potential off-target effects of medication on RAI therapy in patients with thyroid cancer and hyperthyroidism. Systematic review and meta-analysis according to the 2020 PRISMA guidelines. Databases searched: MEDLINE, EMBASE and Cochrane Library for studies published between 2001 and 2021. Sixty-nine unique studies were identified. After screening, 17 studies with 3313 participants were included. One study investigated thyroid cancer, with the rest targeted to hyperthyroidism. The majority of studies evaluated the effects of antithyroid drugs; the other drugs studied included lithium, prednisone and glycididazole sodium. Antithyroid drugs were associated with negative impacts on post-RAI outcomes (n = 5 studies, RR = 0.81, p = 0.02). However, meta-analysis found moderate heterogeneity between studies (I2 = 51%, τ2 = 0.0199, p = 0.08). Interestingly, lithium (n = 3 studies), prednisone (n = 1 study) and glycididazole (n = 1 study) appeared to have positive impacts on post-RAI outcomes upon qualitative analysis. Our systematic review strengthens previous work on antithyroid medication effects on RAI, and highlights that this field remains under researched especially for background medications unrelated to thyroid disease, with very few papers on non-thyroid medications published. https://www.crd.york.ac.uk/prospero/display_record.php, identifier CRD42021274026.

Clinical Presentation as a Predictor of the Response to Methotrexate Therapy in Patients with Ectopic Pregnancy.

Ectopic pregnancy can be fatal if not diagnosed and timely treated. There is an increase in ectopic pregnancy rate which attributes in part to fertility medications and procedures and early diagnosis. Methotrexate, a folic acid antagonist, is widely used in the medical treatment of ectopic pregnancy. Many studies examined the safety and success rate of methotrexate looking into factors affecting the success rate, if the patient may present with symptoms such as abdominal pain, and some consider this as impeding rupture and it might affect the success of medical treatment. This study evaluates the success rate of methotrexate treatment outcomes in regard to presentation and looks into other factors that can help choosing a single or multiple dose modality. This is a retrospective review of 154 cases of ectopic pregnancy treated with methotrexate from January 2011 to December 2020 at King Khalid University Hospital (KKUH). Demographic data, clinical presentation, treatment progress, and outcome and failure rate were collected and analyzed. Student's t-test was used for statistical analysis of associations in SPSS. 154 patients were treated with MTX; of those patients, 25 received more than one dose. The difference between the responses to MTX treatment in symptomatic and asymptomatic individuals was not significant (p = 0.267). 131 (85%) had successful treatment. There were no associations between patient BMI, ectopic mass size, or ectopic mass site, the presence or absence of pelvic fluid on ultrasound at diagnosis, and the treatment success rate. There was a significant decline in the treatment success rate with increasing β-hCG levels on the presentation day (p = 0.035) and on day 4 (p value <0.001) of treatment. MTX treatment can be used to manage symptomatic patients with ectopic pregnancy. The success rate in symptomatic patients is not different from that in asymptomatic patients. β - hCG levels > 5000 IU/L. Pretreatment and on day 4 posttreatment is associated with higher failure rate.

Management of Unusual Not Scar Ectopic Pregnancy: A Multicentre Retrospective Case Series

Background: Management of unusual not scar ectopic pregnancies (UNSEPs) is an unexplored clinical field because of their low incidence and lack of guidelines. Objective: To report the clinical presentation, the first- and second-line treatment and outcomes of UNSEPs. Methods: We retrospectively collected patients treated for UNSEP (namely cervical, interstitial, ovarian, angular, abdominal, cornual and intramural), their baseline characteristics, risk factors, symptoms, diagnostic pathway and the type of first-line treatment (medical, surgical or combined). We further collected treatment failures and the type of second- line treatment. We assessed treatment outcomes, time to serum beta human chorionic gonadotropin (β-hCG) level negativity, length of recovery, follow up and return to a normal menstrual cycle. Results: From 2009 to 2019, we collected 79 cases. Of them, 27 (34%), 23 (29%), 12 (15%), 8 (10%), 6 (8%) and 3 (4%) were cervical, interstitial, ovarian, angular, abdominal and cornual, respectively. Forty women (50.6%) were submitted to medical treatment, mostly methotrexate based; conversely, 36 patients (45.6%) underwent surgery and only 3 women (3.8%) received a combined treatment. The success of first-line treatment rate, regardless of UNSEP location, was 53% and 89% for medical and surgical treatment, respectively. Treatment failures (21 patients) were submitted to second-line treatment, respectively 47.6% and 52.4% to medical and surgical approach. Of interest, cervical pregnancies achieved the lowest rate of first-line medical treatment success (22%) and received more frequently (69%) a subsequent surgical approach with no hysterectomy. Interstitial pregnancies were submitted to surgery mostly for a matter of urgency (71%), otherwise, they were treated with a medical approach both at first- and second-line treatment. Ovarian pregnancies were treated with ovariectomy in 44% of the cases submitted to surgery. Angular pregnancies underwent surgery more often, while all the abdominal pregnancies underwent endoscopic or open surgery. Cornual pregnancies received cornuostomy in 75% of the cases. Overall, the need for blood transfusion was 23.1% among the patients submitted to surgery. The median length of hospitalisation was shorter for women submitted to surgical first-line treatment (5 vs. 10 days; p = 0.002). In case of first-line medical treatment and in case of failure, we found an increase of 3 days (CI95% 0.6-5.5; p = 0.01) and of 3.6 days (CI95% 0.89-6.30; p = 0.01) in the length of hospitalisation, respectively. Negative β-HCG levels were obtained earlier in the surgical group (median 25 vs. 51 days; p = 0.001), as well as the return to normal menstrual cycle (median 31 vs. 67 days; p &lt; 0.000). Post-treatment follow-up, regardless of the failure of first-line treatment was shorter in the surgical group (median 32 versus 68 days; p= 0.003). Conclusion: Cervical pregnancies were successfully managed with a surgical approach without hysterectomy, and hence, we suggest avoiding medical treatment. No consensus emerged for other UNSEPs. Ovarian, angular and interstitial pregnancies are burdened by a non-conservative approach on the utero-ovarian structures. The surgical approach led to shorter recovery, earlier β-hCG negativity and shorter follow-up, even though there is an increased risk for blood transfusion.

The potential interaction between medical treatment and radioiodine treatment success: a systematic review

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Psychogenic dysphagia in children, and the success of family-based treatment

There is a close relationship between a person's mental health and gastrointestinal disorders. Psychogenic dysphagia is a rare condition related to swallowing disorders with no structural cause or organic diseases such as neurological deficits or other physical disorders. The mechanism of this swallowing disorder is still not well understood. Based on various studies that have been conducted, the condition of psychogenic dysphagia has comorbidity with psychological disorders such as anxiety disorders, depression, and post-traumatic stress. In this case report, we will present a case of a 7-year-old male patient who had difficulty swallowing due to fear of vomiting with disturbed psychosocial conditions, and no organic disorders were found after the examination. The BDI examination showed a score of 18, which is within the border of clinical depression. So that the patient was diagnosed with psychogenic dysphagia which was included in the category of Avoidant/Restrictive Food Intake Disorder in DSM 5. Holistic and multidisciplinary treatment was needed in this case. It was also reported that the success of medical treatment to reduce the patient's vomiting symptoms from pediatrics and psychologist department, combined with supportive psychotherapy and family-based treatment increases the patient's recovery rate.

The role of the personal profile of an elderly person in making effective communication between a dentist and a patient. Systematic review

Relevance. The success of medical treatment in the elderly often depends on the doctor’s ability to find an individual approach to a patient, including their personality characteristics, comorbidities and compliance level.Materials and methods. A systematic search of the literature was carried out of studies published between 2000 to 2020 in the online databases: PubMed, Google Search, and eLibrary. The articles were reviewed if the criteria for inclusion and exclusion were met.Results. The primary electronic search found 4,314 studies. Upon removing the duplicates and checking the publications for the title and abstract availability, 1,013 studies were selected, whereas the remaining 3,301 publications were excluded as not meeting the above requirements. Subsequently, in exploring the titles and abstracts, full-text of 509 studies was assessed. Of these, 455 publications were excluded for the lack of doctor-patient interaction evaluation. The systematic review included 54 studies for assessment and numerical comparison in this study.Conclusion. The success of dental treatment in the elderly depends on the patient’s personality profile, their preparedness to follow doctor’s recommendations, and dentist treatment skills and psychological competencies in approaching patients of this age group.

Do obstetric factors have an effect on success of medical treatment of anal fissure seen in women?

Objective: The aim of this study is to examine the effect of obstetric factors on the medical treatment success of anal fissure in women.&#x0D; Material and methods: A total of 324 women, who were diagnosed with anal fissure, who applied to the General Surgery outpatient clinic between 2015 and 2020, were included in the study. The patients were divided into two groups; group I (medical treatment was successful) and group II (medical treatment failed - surgery performed). Both groups were compared in terms of age, body mass index (BMI), number of births, delivery type, birth weight, breastfeeding rate, constipation, diarrhea, smoking and anal fissure symptoms.&#x0D; Results: Medical treatment was applied to all of the 324 patients we included in our study, and it was observed that 45.7% of them had successful medical treatment and 54.3% had undergone surgical treatment (lateral internal sphincterotomy) because of unsuccessful medical treatment. It was found that age, BMI, number of births, number of vaginal births, breastfeeding rate, constipation rates were higher in those who failed medical treatment (p 0.05). While gas incontinence was observed in 44.1% of those who underwent surgical treatment, this rate was found to be 1.4% in those who benefited from medical treatment.&#x0D; Conclusion: In our study, it was found that while maternal age, number of births, vaginal delivery and breastfeeding rates had a negative effect on the success of anal fissure medical treatment, cesarean delivery and baby birth weight were not effective.