Aims: The principles of evidence-based medicine (EBM) are the foundation of modern medical practice. Surgeons are familiar with the commonly used statistical techniques to test hypotheses, summarize findings, and provide answers within a specified range of probability. Based on this knowledge, they are able to critically evaluate research before deciding whether or not to adopt the findings into practice.
View Article and Find Full Text PDFCOVID-19 presents a unique and significant challenge to healthcare systems across the globe. Dental workforce redeployment, in England, during the response to Coronavirus (COVID-19), is the first reported national effort to redeploy a professional body into new clinical environments. The policy decision to facilitate redeployment of the dental workforce, in March 2020, by the Office of the Chief Dental Officer (OCDO), increased flexibility within workforce systems and allowed increasing demand on healthcare services to be managed safely and effectively.
View Article and Find Full Text PDFThis guideline has been initiated by the task force Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology, including physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline that systematically reviewed the literature on mucous membrane pemphigoid (MMP) in the MEDLINE and EMBASE databases until June 2019, with no limitations on language. While the first part of this guideline addressed methodology, as well as epidemiology, terminology, aetiology, clinical presentation and outcome measures in MMP, the second part presents the diagnostics and management of MMP.
View Article and Find Full Text PDFThis guideline on mucous membrane pemphigoid (MMP) has been elaborated by the Task Force for Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology (EADV) with a contribution of physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline encompassing a systematic review of the literature until June 2019 in the MEDLINE and EMBASE databases. This first part covers methodology, the clinical definition of MMP, epidemiology, MMP subtypes, immunopathological characteristics, disease assessment and outcome scores.
View Article and Find Full Text PDFThe current scale of public and private testing cannot be expected to meet the emerging need for higher levels of community-level and repeated screening of asymptomatic Canadians for SARS-CoV-2. Rapid point-of-care techniques are increasingly being offered to fill the gap in screening levels required to identify undiagnosed individuals with high viral loads. However, rapid, point-of-care tests often have lower sensitivity in practice.
View Article and Find Full Text PDFBackground: The COVID-19 pandemic has stretched EDs globally, with many regions in England challenged by the number of COVID-19 presentations. In order to rapidly share learning to inform future practice, we undertook a thematic review of ED operational experience within England during the pandemic thus far.
Methods: A rapid phenomenological approach using semistructured telephone interviews with ED clinical leads from across England was undertaken between 16 and 22 April 2020.
In this commentary, we discuss the short-term and long-term implications of COVID-19 on postgraduate dental training in the UK, specifically Dental Core Training (DCT) and Specialty Training. Although this commentary focuses on the authors' experiences within Guy's and St Thomas' NHS Foundation Trust (GSTT) in London, we hope that our viewpoint will resonate with dental postgraduate trainees across Europe and may guide further discussion in this area. We also reflect on adaptations that may be required if there are any future disruptions to dental postgraduate training in the UK.
View Article and Find Full Text PDFBackground: Mucous membrane pemphigoid (MMP) is a rare autoimmune bullous disease predominantly affecting the oral mucosa. Optimal management relies upon thorough clinical assessment and documentation at each visit.
Objectives: The primary aim of this study was to validate the Oral Disease Severity Score (ODSS) for the assessment of oral involvement in MMP.
Background: Pemphigus vulgaris (PV) is a rare autoimmune bullous disease, which can present with recalcitrant oral mucosal lesions. Optimal management of PV relies upon careful clinical assessment and documentation.
Objectives: The primary aim of this study was to validate the Oral Disease Severity Score (ODSS) for the assessment of oral involvement in PV.
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries.
View Article and Find Full Text PDFOrofacial pain is a common complaint with the vast majority of cases the result of an acute dental cause. There are, however, a number of patients who experience chronic orofacial pain in whom no dental cause can be found, and it is therefore important to identify these patients in order to avoid unnecessary dental procedures. Successful management of chronic orofacial pain depends on the correct diagnosis and appropriate interventions with a biopsychosocial approach.
View Article and Find Full Text PDFBackground: Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development.
View Article and Find Full Text PDFOral ulceration is a common finding yet its classification, diagnosis and management remain a challenge for many hospital physicians. This article discusses the different types of oral ulceration and how to investigate and manage them.
View Article and Find Full Text PDFBoth at the individual and health system levels, the burden of complex illnesses associated with and which rise in mid- to later life, such as cancer, is expected to increase further. The advent of personalized medicine, or the use of a patient's genetic profile to guide medical decisions, is touted to substantially improve drug tolerance and efficacy and, in so doing, also improve the effectiveness and efficiency of oncological care. Amidst the hype and hope surrounding personalized cancer care, there is increasing concern about its unnecessary, unintended effects especially with regards to the financial burden of targeted therapies using specialty drugs.
View Article and Find Full Text PDFFollowing the identification of medical tourism as a growth sector by the Malaysian government in 1998, significant government sector and private-sector investments have been channeled into its development over the past 15 years. This is unfolding within the broader context of social services being devolved to for-profit enterprises and 'market-capable' segments of society becoming sites of intensive entrepreneurial investment by both the private sector and the state. Yet, the opacity and paucity of available medical tourism statistics severely limits the extent to which medical tourism's impacts can be reliably assessed, forcing us to consider the real effects that the resulting speculation itself has produced and to reevaluate how the real and potential impacts of medical tourism are--and should be--conceptualized, calculated, distributed, and compensated for.
View Article and Find Full Text PDFGlobally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts has been negligible and largely speculative. While proponents praise IMT's potential to make home health systems more responsive to the needs of market-savvy healthcare consumers, critics identify it as a way to further de-politicise the satisfaction of healthcare needs.
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