Conference Schedule

Day1: August 16, 2018

Keynote Forum

Biography

Selcuk Mistik graduated from Tarsus American College. He became a medical doctor after finishing Hacettepe University Medical School in 1994. He completed his residency in family medicine with the thesis ‘Assessment of nutritional status and its effects on morbidity and mortality in hemodialysis patients’ at Ankara Numune Training and Research Hospital in 1999. He started working at Erciyes University as a Medical Faculty in 2001, and was appointed as a full professor of family medicine in 2011. He has many studies published in international journals on various subjects concerning family medicine. He still works on university funded research projects. He has been the member of many scientific societies. He is the head of Department of Family Medicine in Erciyes University Medical Faculty.
 


Abstract

Analysis of data from Sore Throat in Primary Care Project provided a scoring system, called the Mistik Score, to diagnose viral sore throat. The predictive model for positive viral analysis included the following variables: absence of headache, stuffy nose, sneezing, temperature of ≥37.5°C on physical examination, and the absence of tonsillar exudate and/or swelling. The probability of a positive viral analysis for a score of 5 was 82.1%. Modified Centor Score-Suggestion of use 1. 0 and less score-no need for further test or antibiotics 2. 1-3 score-throat culture or rapid antigen test, antibiotics for positive test 3. 4 and over-empirical antibiotic use Recent Publications 1. Mistik S, GokahmetoÄŸlu S, Balci E and Onuk F A (2015) Sore throat in primary care project: a clinical score to diagnose viral sore throat. Family Practice 32(3):263-268.

Biography

Katharina Schmalstieg-Bahr is a general practitioner. She completed her post-graduate training at the Cleveland Clinic affiliated Akron General Hospital in Ohio, USA before returning to Germany. Since 2015 she holds a research position at the Department of General Practice at the University Medical Center Göttingen. One of her research interests focuses on prescribing hypnotics in general practice. She is also the German research coordinator of the SCREEN-AF trial, an international collaboration with Canada that explores an ambulatory screening method for arterial fibrillation. Furthermore she is involved in teaching medical students.
 


Abstract

Purpose: In Germany, almost every second prescription for benzodiazepines and Z-drugs is issued as an out-of-pocket prescription (“private prescription”). These prescriptions have to be funded by the patient, although almost 90% of the population has statutory health insurance (SHI) that covers medication costs. The purpose of this study is to understand why primary care physicians (PCPs) choose out-of-pocket prescriptions since a needed medication would be covered by the SHI and an unnecessary medication should not be given at all. Methods: In this qualitative study, 17 semi-structured interviews with a regional sample of PCPs were conducted, audiorecorded, and transcribed verbatim. Grounded theory was used to analyze the interviews and to develop a theoretical model to explain the PCPs’ behavior (“coding paradigm”: see image).
Results: We found a strong ambivalence toward the use of benzodiazepines and Z-drugs, caused by the PCPs’ perception that these drugs are effective but have significant risks as well. PCPs used different strategies, such as an out-of-pocket prescription to cope with this ambivalence. A closer look revealed the central phenomenon for this strategy: PCPs hoped to create a barrier for the patients by generating costs which, in their mind, should lead to a reduced medication intake. They found this strategy also attractive as they feared to be held accountable for the costs by the SHI if they prescribed these drugs too often and over a longer period than recommended. Conclusion: In contrast to guidelines, PCPs developed own strategies to cope with the risk-benefit ratio of benzodiazepines and Z-drugs, to avoid compensation claims and to maintain the doctor to patient relation. It is, however, rather unlikely that out-of-pocket prescriptions really limit the use of hypnotics and sedatives.
 

Biography

Malgorzata Pihut has completed her Graduation in Faculty of Medicine at the Jagiellonian University in Krakow, Poland. She is the Head of the Consulting Room of Temporomandibular Joints Dysfunction, Jagiellonian University Medical College. She is a Specialist in the field of General Dentistry and Dental Prosthetics, conducts training of students and has completed her Post-graduation in the field of Prosthetics. She is the author of over 150 publications, congress reports, and research in national and international journals. She is a Specialist in diagnosis and treatment of modern form of functional disorder in the stomatognathic system. She is a member of the ten national and international scientific societies, winner of the several prizes from Polish Ministry of Education.
 


Abstract

Temporomandibular joints dysfunctions are functional disorders consisting in abnormal functioning and pain of the mastication’s muscles, temporomandibular joints involved in dynamic movements of the mandible and surrounding structures, often associated with abnormal tooth occlusion in opposite arches. Main etiologic factors are; chronic excessive stress, parafunctional activity (teeth clenching, grinding-muscle hyperactivity) and occlusive abnormalities. Dysfunctions do not include all diseases related to the musculoskeletal system in the chewing organ, such as inflammation, degenerative states and joint tumors, as well as muscle lesions (multiple sclerosis, dermatomyositis, and fibromyalgia). The aim of the presentation is to discuss general principles of staged prosthetic treatment and supportive physiotherapeutic treatment, used in therapy of pain form of temporomandibular joint dysfunction. The use of relaxation and repositioning splints together with the principles of their use and devices used in the treatment of dysfunctions during orthodontic treatment will be presented. Intramuscular injection with botulinum toxin type A are often used to relax the chewing muscles as well. The aim of physiotherapeutic procedures is to reduce muscle and joint pain and restore the proper mobility of the mandible. Among physiotherapeutic methods often are used; manual therapy, kinesiotherapy, laser biostimulation, ultrasound therapy and soft tissue mobilization.
 

Tracks

  • Prosthodontics | Dental Hygiene and Oral Health | Pediatric Dentistry
  • General Practice and Family Practice | General Practice and Education & Research | General Practice and Public Health | General Practice and Cancer & Palliative Care
Location: Sorolla

Rosa Tarrago Gil

Hides Aragon, Spain

Chair

Elena Martinez Sanz

Complutense University of Madrid, Spain

Co Chair

Biography

Magdalena Orczykowska is a specialist in prosthodontics education in University of Jagiellonian, Medical College. She is a Faculty of Medicine and Dentistry in 1997-2002. She worked as an Private dental practician in 2002. Her research interests and achievements are Participation of numerous dental courses, national and international conferences and of their own. Since 2004 she is an author of several original papers printed in Polish magazines and also a member of the Polish Society of Dentistry.
 


Abstract

Aim: In edentulous patients using complete dentures with incorrect construction, the symptoms of the temporomandibular system may occur. This is due to the unsymmetrical effects of chewing muscles and overloading of the temporomandibular joints. The aim of the study is to assess whether the proposed method of clinical-laboratory management affects the recovery of symptoms of masticatory system dysfunction in edentulous patients with functional disorders of the masticatory system. Materials & Methods: The study involved a group of 60 edentulous patients (58 to 68 years) using complete dentures up to 1.5 years with symptoms of functional disorders of the masticatory system. The patients underwent a physical examination, physical examination, a functional examination of the masticatory system and a clinical evaluation of the used dentures. In the first stage of treatment, patients underwent a modification of the occlusal surface of the used dentures with the use of a composite material in the position of the centric relation. Then the patients were divided into two groups. Group I (examined) - 30 patients with complete dentures made according to the bio functional system. Group II (control) - 30 patients who were eventually treated with dentures made according to the conventional method. After three months of using new dentures, clinical examinations were repeated in both groups. The obtained test results were subjected to statistical analysis. Results: After the implementation of the therapeutic procedure, the pain was eliminated already in the first stage of treatment. The use of new complete dentures has improved the range of jaw movements and regression of pain. Conclusions: The applied method of rehabilitation influences the restoration of the proper relation in the musculoskeletal system and the disappearance of symptoms of the masticatory system.
 

Biography

Ewa Ferendiuk graduated in Faculty of Medicine at the Jagiellonian University in Krakow/Poland. She is a member of team of the Consulting Room of Temporomandibular Joints Dysfunction, Jagiellonian University Medical College. She conducts training for students in the field of prosthetics, and author of several publications in national and international journals. She is a participant of conferences, courses and trainings in the field of TMJ-disorders, dental prosthetics, esthetic dentistry and implant prosthetics. She is a member of Polish Society of Temporomandibular Joint Disorders, International Team of Implantology, Society of Physiotherapists and Polish Dental Society.
 


Abstract

Temporomandibular joint disorders are characterized by pain located in temporomandibular joints or masseter muscles, acoustic symptoms and restricted mandibular movements- the classic triad of TMJ-dysfunctions. Our experience and data from the literature indicate decreasing the age of patients reporting for prosthetic treatment because of functional disorders of masticatory system. Therapy of TMJ-dysfunction in children and young adults requires separate treatment due to the masticatory system developing. The aim of study is to present methods of treating temporomandibular joint disorders in child and young adult using an interdisciplinary approach by cooperation with an orthodontist, osteopath and physiotherapist. Application of individual prosthetic and orthodontic appliances would provide a proper functioning of masticatory system according to the stage of it growth and development.
 

Biography

George Jones graduated from the University of Manchester in 2015. He completed General Professional Training in 2017, working in emergency care, oral surgery, paediatric dentistry and restorative dentistry. During this time, he was awarded the TC White Medal Award by the Royal College of Physicians and Surgeons of Glasgow for outstanding achievements as a postgraduate. He now works as an Oral and Maxillofacial Trainee in Middlesbrough, UK. He has published papers in the British Dental Journal and for the Royal College of Surgeons. 


Abstract

An assessment of the frequency of dentally unregistered paediatric patients requiring hospital admittance for dental infections: In 2014-2015, more than 26,000 hospital admissions were for dental infections in children age 5-9. The Royal College of Surgeons of England state that 42.1% of children did not visit an NHS dentist between 2015-2016. Based on “Delivering Better Oral Health” and NICE Guidelines, all children should be registered and have a recall frequency of no more than 1 year. We aimed to assess how often paediatric patients in our region were registered with a dentist, and how often hospital admittance and emergency surgery for dental abscesses was required, which is a serious dental public health issue in the UK. Results/Statistics: • 211 A+E maxillofacial presentations between March 2017-September 2017 • 49 dental swellings • 27/49 patients (55.1%) require admission into hospital for emergency surgery • 63.3% (31/49) GDP registered vs 36.7% (18/49) not GDP registered • 0% (0/18) of GDP unregistered children were given advice of how to register with a GDP Conclusions/Clinical Relevance: The results show that not all paediatric patients have regular exposure to dental care by not being registered with a GDP. Without regular recall and examination, dental swelling will continue to be a frequent presentation in A+E in the UK. Recommendations: 1. Staff to discuss with all paediatric patients and parents how to register with a dentist 2. Education advice on oral health to be sent to all nurseries/schools 3. Reaudit 6 months

Location: Sorolla

Jorgen Lous

University of Southern Denmark, Denmark

Chair

Katharina Schmalstieg-Bahr

University Medical Center Gottingen, Germany

Co Chair

Biography

Luckson Wandani Dullie is a current Executive Director of Partners in Health (APZU) in Malawi, in the remote and rural district of Neno. His specialties include experiential understanding of the challenges of rural medicine, development of training programs for effective delivery of comprehensive community oriented primary health care, negotiating public sector partnerships and an array of clinical skills spanning tropical medicine, obstetrics, and general surgery. At present he is a PhD Fellow at the Centre for International Health, Department of Global Public Health and Primary care of the University of Bergen in Norway. His research interest is in understanding patients’ perspectives of primary care interventionsv


Abstract

Background: Assessing patients’ experience with primary care compliments measures of clinical health outcomes in evaluating its performance. Measuring patients’ experience and satisfaction are among Malawi’s health sector strategic goals. The purpose of this study was to investigate patients’ experience with primary care and to assess associated patients’ sociodemographic, healthcare and health characteristics. Methods: This was a cross sectional survey using questionnaires administered in primary care facilities in Neno district, Malawi. Face to face interviews using a validated Malawian version of the primary care assessment tool (PCAT-Mw) were carried out to collect data on patients’ primary care experience and their sociodemographic, healthcare and health characteristics. Total primary care and domain mean scores were derived for access, continuity, comprehensiveness and community orientation. Linear regression models were used to assess association between primary care attribute scores and patients’ characteristics. Results: From 631 completed questionnaires, first contact-access, relational continuity and comprehensiveness of services available scored below the accepted minimum. Sex, geographical location, self-rated health status, duration of contact with facility and facility affiliation were associated with patients’ experience with primary care. These factors explained 10.9% of the noted variance in total primary care scores; 25.2% in comprehensiveness of services available and 29.4% in first contact access. Conclusion: This paper presents results from the first use of the validated PCAT-Mw.  The study provides a baseline for defining quality improvement gaps and can be used alongside clinical health outcome studies to provide comprehensive evaluation of primary care performance in Malawi

Biography

Grant S Nolan is a junior surgeon from United Kingdom. His research Interest is Plastics and ENT Surgery.
 


Abstract

Background: In 2014, Oosthuizen audited ENT referrals to a Dublin hospital against the Irish College of General Practitioners (ICGP) referral template and found that they only included on average 16/37 recommended details. They suggested that standardized referral forms may provide superior information.  Aim & Methods: Five years later, in Benfield Park Medical Group, Newcastle upon Tyne, and all referrals to secondary care are electronic and most are standardized. We audited 183 referrals to ENT against the same ICGP guidelines to investigate if the addition of e-referrals has improved compliance. We also investigated if e-referrals were in line with current UK guidelines and how this affected definitive surgical management from ENT. Results & Conclusions: Our data shows that e-referrals have dramatically improved the quality of referrals from 16/37 to 26/37 details. We also found referrals in line with UK guidelines were more likely result in an ENT procedure and may be more likely to require an operation. Interestingly there are still patients being operated on whom does not fit into a nice criterion and GPs must continue to be allowed the flexibility to refer these patients if they see fit. Recent Publications 1. Oosthuizen J, Mc Shane D, Kinsella J and Conlon B (2015) General practitioner ENT referral audit. Irish Journal of Medical Science 184(1):143-146.

Biography

John Malaty is an academic family Physician, who is board certified by the American Board of Family Medicine and who also has prior Residency training in Otolaryngology, where he learned specialized clinical care skills about evaluating and managing ear, nose and throat problems that are frequently encountered in primary care. He has expertise in ear, nose and throat conditions in primary care. His expertise has led him to publish and present nationally and internationally in this field, with a number of solicited articles and presentations and to teach these skills to Family Medicine Residents in an academic Family Medicine Residency training program at the University of Florida. 


Abstract

Chronic Rhinosinusitis can be refractory and significantly impact loss of work productivity, work absence, disease-specific quality of life measures and annual health care costs. It is not felt to simply be an infectious problem and various inflammatory pathways and host factors play an important role in addition to biofilms. Medical management should be tailored to the specific comorbidities and concerns of an individual patient, while treating acute exacerbations with amoxicillin-clavulanate; second or third generation cephalosporins or fluoroquinolones. Treatment of nasal polyposis is important when present; and treatment of additionally targeting pertinent pathophysiology in asthma and cystic fibrosis improve treatment efficacy. In this presentation, I will discuss how to evaluate and effectively treat causes of chronic sinusitis in the primary care setting, in addition, discussing when to refer these patients for specialty care. Recent Publications 1. Holmes R L and Fadden C T (2017) Evaluation of the patient with chronic cough. American Family Physician 69(9):2159-2166. 2. Marlow N H, Malaty J, Jo A, Tanner R J, Beau de Rochars V M, Carek P J and Mainous A G (2017) Hearing impairment and undiagnosed disease: the potential role of clinical recommendations. Journal of Speech, Language and Hearing Research 60(1):231-237. 3. Carek P J, Malaty J, Dietrich E, Lombardi J, Porter M B, Blanc P and Samraj G (2016) Addressing hospital readmissions: impact of weekly meeting. Family Medicine 48(8):638-641. 4. Malaty J (2016) Medical management of chronic Rhinosinusitis in adults. Sinusitis 1:76-88. 5. Dieuvil M and Malaty J (2016) An uncommon cause of acute encephalopathy in liver cirrhosis. BMJ Case Reports

Biography

Jorgen Lous is a Doctor of Medicine and since from 1984. He has been working at the University of Aarhus and University of Southern Denmark. He worked parttime in General Practice and retired in 2016.


Abstract

Objective: Obesity and inequality in health is an increasing problem in Denmark. The objective was to evaluate the effect of structured well-prepared preventive consultations on weight loss in younger adults with over-weight and psycho-social problems. Method: A total of 495 younger adults (20-44 years old) with several psycho-social and lifestyle problems were randomized to preventive health consultations or control at their own GP after completing a 23 pages questionnaire on different life style and psycho-social issues. All were randomized to intervention or control. A total of 218 had overweight or obesity. Results: The 56 (26%) of the 218 were lost to follow-up after one year. The 77 with overweight in the control group were not asked about goals. The rest, 85 with overweight or obesity, were asked to prioritize one or two goals for a better life the next year. 22 had weight loss as the highest prioritized goal. One year after the first health consultation the 22 had a mean weight loss of 4.73 kg (95% Cl: 1.8 to 7.7) and the rest had lost 1.56 kg (-0.05 to 3.2). The over-weighty in the control group had a mean weight loss of 1.57 kg (0.12 to 3.0). In a logistic regression model the degree of overweight, consideration of a quick weight loss (within 30 days) at inclusion in the study, weight loss a high prioritized goal at the preventive consultation, having many problems, being a female, and being in the oldest half of the participants were predictors for weight loss. Conclusion: A significant change in weight loss could be obtained with well-prepared patient-focused consultations. Predictors for weight loss (yes/no) after 1 year in logistic regression model (n=159). Recent Publications 1. Freund K S and Lous J (2012) the effect of preventive consulations on young adults with psychosocial problems; a randomized trial. Health Educ Res 27(5):927-45. 2. Hansen E, Fonager K, Freund KS and Lous J (2014) The impact of non-responders on health and lifestyle outcomes in an intervention study. BMJ Res Notes 7:632-40. 3. Lous J and Freund K S (2016) Predictors of weight loss in young adults who are over-weight or obese and have psychosocial problems: a post hoc analysis. BMC Fam Pract 17(43):11.

Biography

Selcuk Mistik was born in Tarsus, Turkey in 1967. He has graduated from Tarsus American College. He became a medical doctor after finishing Hacettepe University Medical School in 1994. He completed his residency in family medicine with the thesis ‘Assessment of nutritional status and its effects on morbidity and mortality in hemodialysis patients’ at Ankara Numune Training and Research Hospital in 1999. He started working at Erciyes University Medical Faculty in 2001, and was appointed as a full professor of family medicine in 2011. He has many studies published in international journals on various subjects concerning family medicine. He still works on university funded research projects. He has been the member of many scientific societies. He is the head of Department of Family Medicine in Erciyes University Medical Faculty


Abstract

Statement of the Problem: Hypertension is very common in primary care patients. The diagnosis of hypertension is made by office measurements and home blood pressure measurements. The aim of this study was to define the normal variation levels of blood pressure in individuals in primary care by using ambulatory blood pressure measurement. Methodology & Theoretical Orientation: This study was performed in primary care. Individuals who had no hypertension history were included in the study. Subjects were evaluated by using three office measurements, seven days home blood pressure measurements and 24 hours ambulatory blood pressure measurement. The ambulatory blood pressure gave us the variations in blood pressure values. This study was funded by the Scientific Research Council of Erciyes University (ERUBAP, Project No. TTU-2017-7092) Findings: The study started in January 2018 and ended in May 2018. Of the 38 subjects, 71.1% were women and 28.9% were men. The mean age was 40.51. The most common educational level was elementary school graduates (35.1%). The most common occupation was housewives with 52.6%. Of the participants, 84.2% were married. At ambulatory blood pressure measurements, 37.0% of the subjects had mean systolic blood pressures (24 hours) between 120-129 mmHg. Of the diastolic blood pressure 24 hours mean values, 15.3% had values between 80-89, where 50.0% were between the 71-79 mmHg groups. The mean value of twenty four hours variation in systolic blood pressure was 15.75±18.59 (median 11.40, min. 8.80, max. 106.00). The 24 hours variation in the mean values of diastolic blood pressures was 12.12±10.90 (median 9.70, min. 6.80, max. 64.00). Conclusion & Significance: The results of this study demonstrated us that many individuals are in high risk group for hypertension according to some recent guidelines on the management of hypertension.
 

Biography

Jorgen Lous is a Doctor of Medicine and since from 1984. He has been working at the University of Aarhus and University of Southern Denmark. He worked parttime in General Practice and retired in 2016.


Abstract

Several elements have to be fulfilled to achieve a success in prevention in general practice. Motivated GPs got education: 50 (15%) of invited GPs from the County of North Jutland, Denmark participated in the 40 hour training program and 8.6% (28) recruited patient into the study. Exercise in patient-focused preventive consultation was an important part of the training. Fee for extra time: The GPs got a fee for courses and preventive health consultations. Find patients who need some intervention: A screening Questionnaire (Q33) on own resources, network, lifestyle and social conditions was completed by 2.056 patients 20-45 years old when coming to the clinic for any other reason. The 30% with most psycho social problems (>7) were invited to participate and were randomized to control or intervention (two consultations with their GP). All had oneyear postal follow-up. Motivate patients who feel they need some changes in their daily life: A baseline-questionnaire (QB) with 84 questions on life conditions, health, life style and social problems was priming the participants to the patient-focused consultation. Patients might choose one or two goals for a better life. Discuss resources, barriers and time schedule for chosen changes: important to explore the patient's own agenda and resources and support self-efficacy. A 20 minutes follow-up within three months: How is it going? What is difficult and why?, support self-efficacy again and A one-year questionnaire (Q1) like QB. What has changed during the year? After one year the intervention group had significant better SF-12 mental score 4.3 (95% confidence interval), fewer problems (from 10.0 to 8.2=1.8 problems) and the overweight who had prioritized weightloss had mean weight loss of 4.73 kg (95% Cl: 1.8 to 7.7). Recent Publications 1. Freund KS and Lous J (2012) The effect of preventive consulations on young adults with psychosocial problems; a randomized trial. Health Educ Res 27(5):927-45. 2. Hansen E and Fonager K Freund KS and Lous J (2014) The impact of non-responders on health and lifestyle outcomes in an intervention study. BMJ Res Notes 7:632-40 3. Lous J and Freund KS (2016) Predictors of weight loss in young adults who are over-weight or obese and have psychosocial problems: a post hoc analysis. BMC Fam Pract 17(43):11.
 

Day2: August 17, 2018

Keynote Forum

Biography

John Malaty has expertise in ear-nose-and-throat conditions in primary care. He is an academic family Physician, who is board-certified by the American Board of Family Medicine and who also has prior Residency training in Otolaryngology and recently made a Fellow of the American Academy of Family Physicians (FAAFP). He learned specialized clinical care skills about evaluating and managing ear-nose-and-throat problems that are frequently encountered in primary care. His expertise has led him to publish and present his research work nationally and internationally in this field, and to teach these skills to family medicine residents in an academic family medicine residency training program at the University of Florida


Abstract

Although chronic cough in adults can be caused by many etiologies, these patients can be effectively evaluated in primary care by considering the most common causes, which alone, or in combination, make up the vast majority of cases: upper airway cough syndrome (UACS), gastroesophageal reflux disease (GERD)/laryngopharyngeal reflux disease (LPR), asthma and non-asthmatic eosinophilic bronchitis (NAEB). These should be evaluated clinically and spirometry performed if indicated. Empiric treatment should be initiated while considering angiotensin converting enzyme inhibitors, environmental triggers, tobacco use, chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) as potential causes. Chest X-ray can rule out concerning infectious, inflammatory and malignant thoracic conditions and empiric treatment of the aforementioned etiologies can also be diagnostic. In rare cases, chronic refractory cough may be present and one may then consider referral to pulmonology and/or otolaryngology, in addition to trial with gabapentin, pregabalin and/or speech therapy. In this presentation, the author will discuss how to evaluate and effectively treat these causes of chronic cough in the primary care setting, in addition to discussing when to refer these patients for specialty care. Recent Publications 1. Michaudet C and Malaty (2017) Evaluation of the patient with chronic cough. American Family Physician 96(9):575-580. 2. Marlow N H, Malaty J Jo A, Tanner R J, Beau de Rochars V M, Carek P J and Mainous A G (2017) Hearing impairment and undiagnosed disease: the potential role of clinical recommendations. Journal of Speech, Language, and Hearing Research 60(1):231-237. 3. Carek PJ, Malaty J, Dietrich E, Lombardi J, Porter MB, Blanc P and Samraj G (2016) Addressing hospital readmissions: impact of weekly meeting. Family Medicine 48(8):638-641. 4. Malaty J (2016) Medical management of chronic rhinosinusitis in adults. Sinusitis 76-88. 5. Dieuvil M and Malaty J (2016) An uncommon cause of acute encephalopathy in liver cirrhosis. BMJ Case Reports. 

Biography

Malgorzata Pihut has completed her Graduation in Faculty of Medicine at Jagiellonian University, Poland. She is the Head of the Consulting Room of Temporomandibular Joints Dysfunction, Jagiellonian University Medical College. She is a Specialist in the field of General Dentistry and Dental Prosthetics, conducts training of students and has completed her Post-graduation in the field of Prosthetics. She is the author of over 150 publications, congress reports, and research in national and international journals. She is a Specialist in diagnosis and treatment of modern form of functional disorder in the stomatognathic system. She is a member of the ten national and international scientific societies, winner of the several prizes from Polish Ministry of Education.
 


Abstract

Aim: Temporomandibular joints dysfunctions are functional disorders consisting in abnormal functioning and pain of the mastication muscles, temporomandibular joints involved in dynamic movements of the mandible and surrounding structures, often associated with abnormal tooth occlusion in opposite arches. The aim of this study was to evaluate the regression of temporomandibular pain as a result of intra-articular injections of platelet-rich plasma (PRP) and hyaluronic acid to patients with temporomandibular joint dysfunction (disc displacement with reduction) subjected to prosthetic treatment. Materials & Methods: The baseline study material consisted of 60 patients, males and females, aged 28 to 53 years, treated due to disc displacement with reduction. All patients were carried out to a specialist functional examination of stomatognathic system. The intensity of pain (muscles and temporomandibular joints) was measured by VAS+WNRS score. Group I consisted of 30 patients, who had 1.5% hyaluronic acid intra-articular injections and group II 30 patients as well, who used platelet rich plasma obtain from own blood. The injection places were determined by the method used during arthroscopic surgical procedures. Following aspiration, 0.4 ml of PRP or hyaluronic acid was injected into both temporomandibular joints. Results: The comparison of the intensity of pain and the result of clinical examination during all visits suggests a beneficial effect of both procedures. Conclusion: Application of the intra-articular injections of platelet-rich plasma and hyaluronic acid into the temporomandibular joints have a positive impact on the reduction of the intensity of pain experienced by patients treated for temporomandibular joint dysfunction.
 

Tracks

  • General Practice and Child Health | Prosthodontics | General Practice and Education & Research | Dental Hygiene and Oral Health | General Practice and Public Health | Geriatric Dentistry | General Practice and Infectious Disease | Dental Research and Dental Marketing
Location: Sorolla

Michele Aubin

Laval University, Canada

Chair

Malgorzata Pihut

Jagieollonian University, Poland

Co Chair

Biography

Magdalena Orczykowska is a specialist in prosthodontics education in University of Jagiellonian, Medical College. She is a Faculty of Medicine and Dentistry in 1997-2002. She worked as an Private dental practician in 2002. Her research interests and achievements are Participation of numerous dental courses, national and international conferences and of their own. Since 2004 she is an author of several original papers printed in Polish magazines and also a member of the Polish Society of Dentistry.
 


Abstract

Aim: The quality of life conditioned by the state of health defines the patient's self-assessment regarding the impact of the disease and the treatment used on its functioning in the physical, mental and social spheres. Edentulousness is a disease that significantly affects the proper functioning of the body and adversely affects the mental sphere of the patient. The aim of the study was to evaluate the impact of the construction of dentures made according to two different methods of clinicallaboratory proceedings on improving the quality of life of edentulous patients. Material and Methods: The study involved a group of 60 edentulous patients (58 to 68 years) of both sexes, using complete dentures. Patients were divided into two groups: Group I (30 patients) using complete dentures made according to the bio functional system. Group II (30 patients) using dentures made according to the conventional method. All patients underwent a physical, physical and clinical examination of the used dentures. For a subjective assessment of the quality of life associated with oral health, the General Oral Health Assessment Index (GOHAI) was used. The questionnaire study was conducted in patients of both groups before and after the treatment. The obtained results were subjected to statistical analysis. Conclusions: Improvement of the quality of life of patients using complete dentures is associated with the construction of dentures, which improves the chewing capacity, aesthetic appearance. The quality of life of patients using full dentures is statistically significantly better after the use of dentures made according to the biofunctional system.
 

Biography

Ewa Ferendiuk graduated in Faculty of Medicine at the Jagiellonian University in Krakow/Poland. She is a member of team of the Consulting Room of Temporomandibular Joints Dysfunction, Jagiellonian University Medical College. She conducts training for students in the field of prosthetics, and author of several publications in national and international journals. She is a participant of conferences, courses and trainings in the field of TMJ-disorders, dental prosthetics, esthetic dentistry and implant prosthetics. She is a member of Polish Society of Temporomandibular Joint Disorders, International Team of Implantology, Society of Physiotherapists and Polish Dental Society.
 


Abstract

Temporomandibular joint disorders are a common problem in clinical practice. Therapy of TMJ-dysfunctions using occlusal splints and other supporting methods are only pre-treatment stage of subsequent occlusion reconstruction. The key to success in rehabilitation patients with functional disorders is to create the correct jaw placement with condyles centralization that will guarantees proper functioning of masticatory system. The aim of study is to present methods of comprehensive treatment patients with TMJ-disorders based on own clinical cases. The work described the combined orthodontic, prosthetic and implant-prosthetic treatment patients with functional disorders of masticatory system. 

Biography

Muna Kilani has completed her Graduation at University of Jordan in 1996. Then she finished a Pediatric Residency at Case Western Reserve (Metro Health Medical Centre) in Cleveland, USA in 2001, from there she went on to finish a Pediatric Pulmonology Fellowship at Indiana University (Riley Hospital for Children), in 2004. She worked as a Clinical Assistant Professor at Riley Hospital for Children for five years before moving on to work at CGH Medical Centre in Sterling Illinois. In 2016, she moved to Jordan and joined the faculty of medicine at Hashemite University. She is interested in integrating evidence-based medicine into the medical field in Jordan as well as incorporating primary preventive pediatric medical care into the Jordanian health system, both the public and the private sectors


Abstract

Statement of the Problem: Primary prevention is a key component not only for the health of the individual but for the health of the community at large. While primary prevention and wellness check-ups are a major component of health services in the US and Western Europe they have not been readily adopted in Jordan. It may in part be due to a cultural knowledge gap in the community as well as due to the limited clinical training physicians receive towards primary prevention services. Methodology & Theoretical Orientation: The research focused on assessing family readiness to adopt the use of primary prevention and well child check-ups in Jordan, and which primary prevention programs families were more likely to participate in. Using a prospective study design, parents attending a regional government hospital for pediatric visits participated in a short personal interview, then parents were told about 3 evidence based programs they could choose to participate in that day during their wait with medical students. Findings: Of 505 families surveyed 66.7% expressed a desire for child primary prevention visits, with 63.8% wanting to have access 1-2 times annually. However, only 35.6% chose to participate in a primary prevention class during their waiting time. Of those who participated the majority chose a child development program, followed by nutrition and lastly injury prevention. Conclusion & Significance: There appears to be an expressed interest in pediatric prevention visits for families in Jordan and a recognized need for them. However there is still a gap between this desire and access/utilization to such services. Recommendations: Programs need to be developed that increase awareness and access to pediatric primary prevention services and regional medical schools should adopt new ways of integrating primary prevention into their clinical training, and increasing the opportunities for families to have access. Recent Publications 1. Dev Peters, R Petrunka, K Khan, S Howell-Moneta, A Nelson, G Pancer M and Loomis C (2015) Cost saving analysis of the better beginnings, better futures community based project for children and their families: a 10 year follow-up. Prevention Science 2. Beaglehole R, Jordan J, Patel V, Chopra M, Ebrahim D, Kidd M and Haines A (2008). Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care The Lancet 372(9642):940-949. 3. Mond JM (2016). Optimizing prevention programs and maximizing public health impact are not the same. Eating Disorders, 24(1):20-28. 4. Parbhoo A, Louw Q A and Gimmer-Somers K (2010). Burn prevention programs for children in developing countries require urgent attention a targeted literature review. Burns, 36:164-175. 5. Mercy J A and Saul J (2009). Creating a healthier future through early interventions for children Jama, 301(21):22622264.

Biography

Omid Tavakol Graduated from high school with ‘A’ grade. He entered Shiraz dental school in 2000 and graduated in 2006, he started post-graduation program in prosthodontics in 2008 and graduated as a board certified Prosthodontist in 2012. He got approval from bu ICOI as implant fellowship in 2016. He is also a Head of prosthodontics department of Shiraz Azad dental school since 2015 and Head of Dr Tavakkol dental clinic since 2013.
 


Abstract

Today, despite of modern oral and dental care and preventive dentistry, the prevalence of partial and total edentulism is increasing every year. According to Micsh’s dental implant text book, there are more than 20,000,000 patients in the United States who suffer from complete edentulism. The consequences of edentulism can vary from lack of ability to chew, to psychological effects which affects all aspects of patient’s life and patient’s appearance in society. The effect of edentulism on general health and psychological health of patients is of great importance. Inability to take hard foods, vegetables, not only induces the feeling of disability but also induces nutrition deficiency which causes serious problems like avitaminosis which could lead to depression or other disease like GI problems. The role of prosthodontics in replacement the missing tissues and structures of dentomaxillofacial area is so important in reconstruction of both the appearance and the function of oral and maxillofacial area. There are several methods to replace missing teeth and surrounding structures such as old removable dentures or new implant supported prosthesis. The field of maxillofacial prosthesis is gone under big revolution by introducing dental implants. All these prosthesis are to be maintained by oral hygiene procedures that are different by the type of prosthesis. In this lecture, author is going to explain the consequence of edentulism on general health and psychological health of patients and the relationship of edentulism and the relevant diseases introduced by. Then he is going to introduce new methods in prosthodontics which improves oral care. After that he is going to introduce the new methods in maintaining prosthesis, which includes new appliances, new materials and drugs and the way the patients should use.

Biography

Michele Aubin is a family physician working in a family medicine teaching unit affiliated to the Department of Family Medicine and Emergency Medicine, Laval University, Quebec, (QC), Canada. She is also professor in that department, and she holds the Research Chair of Palliative Care at the Faculty of Medicine, Laval University. Finally, she is a clinical researcher working in projects related to improvement of primary care and of palliative care services, as well as health services organization (implementation and evaluation of innovative interventions).
 


Abstract

Statement of the Problem: Family caregivers (FC) of patients with cancer often report high distress. The purpose of this study is to assess the effectiveness of an intervention to improve supportive care for FCs. Methodology: FCs of patients with lung cancer were randomized to the intervention or the control group. The intervention included: 1) systematic FC distress screening and problem assessment near their relative´s cancer diagnosis, and every 2 months; 2) privileged contact with an oncology nurse (ON) to further identify and address FC problems; 3) liaison by the ON with the family physician of FCs reporting high distress (thermometer score ≥ 4/10). FCs completed validated questionnaires every 3 months, up to 9 months. The primary outcome was distress. Secondary outcomes included quality of life, preparedness to the caregiving role and perceived burden. Individual interviews were conducted with a purposive sample of FCs from the experimental group (EG) to assess the perceived usefulness and relevance of the intervention. Findings: A total of 109 FCs were enrolled from of a single center specialized in lung cancer, in Quebec, Canada. Compared to baseline level, FC distress decreased over time, but no difference was found between groups. Similarly, there were no differences on any of the secondary outcomes. However, FCs from the GE felt better prepared to play their caregiving role than the controls (p=0.05). Ten FCs from the EG were interviewed and they all considered the intervention useful and relevant, even though they under used it. Knowing they could contact the ON served as a security net. Conclusion & Significance: Although the intervention was not found effective, some of its aspects were positively perceived by FCs. Building on these results, an improved intervention may be developed to support FCs in their role and address their distress, as it remains an important problem. Recent Publications 1. Girgis A, Lambert SD, McElduff P, Bonevsky B, Lecathelinais C, Boyes A, Stacey F (2013) some things change, some things stay the same: a longitudinal analysis of cancer caregivers’ unmet supportive care needs. Psycho-Oncol 22(7). 2. Chambers SK, Girgis A, Occhipinti S, Hutchison S, Turner J, Morris B, Dunn J (2012) Psychological distress and unmet supportive care needs in cancer patients and carers who contact cancer helplines. Eur J Cancer 21(2): 213-223. 3. Bee PE, Barnes P, Luker KA (2009) A systematic review of informal caregivers’ need in providing home based end of life care to people with cancer. J Clin Nurs; 18(10): 1379-1393. 4. Aubin M, Vézina L, Verreault R, Simard S, Tremblay L, Desbiens JF, Dumont S, Fillion L, Dogba MJ, Gagnon P (2017) Effectiveness of an intervention to improve supportive care for family caregivers of patients with lung cancer: study protocol for a randomized controlled trial. Trials 18(1): 304. 5. Northouse L, Williams AL, Given B, McCorkle R (2012) Psychosocial care for family caregivers of patients with cancer. J Clin Oncol 30(11): 1227-1234. 6. Fridriksdorrir N, Saevarsdottir O, Halfdanardottir SI, et al. (2011) Family members of cancer patients: needs, quality of life and symptoms of anxiety and depression.Acta oncologica 50: 252-258.
 

Biography

Elham khalid holding a bachelor degree in dentistry. Since she was a student and so much interest in public health, she always investigated the methodologies for conducting important and updated medical topics to the mass, and so she found her way through social media. With knowledge, time, effort and discipline she became as consequence an important medical figure in social media mainly in the field of dentistry. Major health sectors (governmental & private) noticed her social activities, the interest & respond of the public to her statues regarding health and her personal signature in providing the medical information. And so she started to cover major conferences, updated mass directed dental health topics.
 


Abstract

Social networks or social media are all terms that have made the world as a small village in terms of its impact on the world of communication, exchanging ideas among people and facilitating the transmission of information and news with others. There is no doubt how important the social media or the social networks have become in the last years; whether in terms of their impact on our daily life or our practical life through the exchange of information or the easy way of accessing to it. The social network websites are one of the most prominent aspects of the modern media that did make a quantum leap in the field of communication and the transfer of information in a synchronization with the revolution of the Internet that crystallized in forums, blogs and many of the programs have become one of the most important ways in introducing and knowing the news and the science such as: Facebook, Twitter, Instagram and many more. The social media has been able to impose a itself in the modern media world as it became a reliable source for many media people and media institutions. And it became a beacon of interest in public opinion to identify the issues of society where most of the people resort to it to participate, to know about events and to exchange ideas. From this point of view I started my career in raising awareness and advising the society by: 1. Making simple lessons and explanations for people in how to maintain teeth at home. 2. Educating people about the ways to maintain children's teeth. 3. Explaining some of the wrong habits that people doesn’t aware of. 4. And so many other important topics with simple explanations Results: Information is easier to be spread and increasing interaction, participation of members of the community and public demand for attendance and continuous communication. Ease of expression and freedom of opinions, also breaking barriers and red lines. It’s eliminating cultural differences between communities, dissemination of ideas that aim to raise the awareness and the consciousness of people.  So our role as dentists is not limited to treatment only. But it begins to intensify efforts to educate the community about the correct methods of treating teeth and to clarify preventive methods that reduce the diseases and the problems of the mouth and the teeth. Prevention is the basis of any treatment and the axis from which it starts the spirit of the profession of a doctor through all the ways that it’s available if it’s digital or else.
 

Biography

Rehana B Ahmed is a General Practitioner from Edmonton, and is currently working in Ireland. She recently qualified with registration of MICGP in Ireland. She has a strong interest in primary prevention and her main interest in general practice is modifying risk factors rather than treating disease. 


Abstract

Erectile dysfunction (ED) and ischaemic heart disease (IHD) tend to share similar risk factors, such as obesity, diabetes, smoking, hypertension, dyslipidemia and metabolic syndrome. Additionally, the extent of cardiovascular disease has been shown to have a connection with the prevalence of ED. Early intervention to modify these risk factors may reduce the risk of future vascular events. The aim of this study was to evaluate the prevalence of ED and its relationship with coronary artery disease in a patient population between the ages of 35-75 who received a prescription for erectile dysfunction. We tested the hypothesis that ED prevalence is related to coronary artery disease, resulting in a cardiac event, such as stroke, myocardial infarction, or documented ischemic heart disease. The end goal was to determine the connection between erectile dysfunction and cardiovascular disease and implement those changes into our primary prevention cardiovascular risk program. This study is a retrospective descriptive study analysing the electronic medical record (EMR) from year 2007 to 2017. A search was done to identify any patients prescribed Sildenafil, Tadalfil or Vardenafil in the last 10 years. Further analysis of EMR consisted of the following information at diagnosis and prescription of ED: smoking history, alcohol abuse, BMI to determine if patients were overweight or obese, Framingham risk score at the beginning of the study and at the end of the ten years was included, Blood Pressure (BP), total cholesterol and HDL, evidence of established CVD and a diagnosis of diabetes. The average Framingham at the beginning of the 10 year study was 17% and at the end of the 10 years was 25% which showed a progression of disease and risk of an 8% increase in 10 years. We determined that ED is a cardiovascular disease rather than a sexual dysfunction. Hypertension, diabetes and a HDL<1 are all directly correlated with erectile dysfunction, which leaves us with a change in perspective. It’s time we start to look at ED as a cardiovascular risk factor. There was a statistical significance (p value<0.05) in patients with a diagnosis of a hypertension, an HDL<1 and in type II diabetics and having established CVD/CAD/IHD. We have recommended that all patients that have documented ED be screened for CVD.

Biography

Omar Amer Elhag Abdalla is a faculty member of Dentistry department of oral and maxillofacial surgery in University of Gezira. He completed his M.D oral and maxillofacial surgery in Sudan medical specialization Board 2009. FSAOCMF oral and maxillofacial surgery in Medical University centre, Hamburg, Germany and BDS in Khartoum University 1997. His research interest includes oral and maxillofacial surgery. 


Abstract

Background: Lymphatic malformation (LM) is rare vascular malformations. Objective: To define the clinical characteristics of children with (LM) and their management Methods: We performed  a retrospective hospital based cross – sectional study with descriptive  & analytic component using data collection sheets stating the name , age ,gender and residence of the patients . Demographic and clinical features diagnostic imagining   treatment and complications were recorded. Result: Nine males and eleven females patients with LM were identified  .the anatomical location of LM involved the right  site of the neck and the lip more frequently 30% followed by the tongue and check with equal 20% . According to the consistency soft swelling presented in 11 patients 55% seven patients presented with firm 35%. According to the surface 80% smooth and 4% non smooth .blue and normal skin texture were the most common color 30%,pink 20% red 10% yellowish 10% . Half of the LM  found compressible .according to the shape 75% diffuse in shape 25% rounded the main age was 14.8 (6 months to 49 years )  . Infants and and children were more affected than anther age groups. Adult patients who were exposed to trauma or radiation may be at risk. Patients treated either by surgery or sclerotherapy. LM causes morbidity and death in one child. Conclusion: LM is heterogeneous vascular malformations that may result in significant morbidity diagnosis is often delayed. And cystic hygroma is risk factor for air way obstruction Multidisciplinary approach to management including dermatology, diagnostic and interventional radiology, paediatric surgery is important.

Biography

Sara Deroy is a Public Health Honours student at the University of Wollongong, NSW, and Australia. Sara also works at an Aboriginal Health Service on the south coast of NSW. Her research interests include health services research in regards to Aboriginal and Torres Strait Islander peoples. She is passionate about closing the health gap between Aboriginal and Torres Strait Islander Australians and other Australians.
 


Abstract

Introduction: Aboriginal Health Workers are key to prevention efforts for Aboriginal peoples by providing appropriate health care. Aboriginal Health Workers are often affected by high rates of employment turnover, stress and burnout. Waminda South Coast Women's Health and Welfare Aboriginal Corporation is leading the way with very high staff retention rates (94%). Exploring Waminda’s strengths can help provide leadership for other health services. Methods: Qualitative case study: Ten semi-structured interviews were conducted face-to-face with current and past staff (last 5 years) employed as health and wellbeing workers at Waminda. Participants were asked six broad questions exploring what factors influenced their length of employment at Waminda. Interviews were transcribed verbatim. Themes were identified using Braun and Clarke’s thematic analysis framework. Results: Five main themes were identified. Staff valued: The satisfaction they received by giving back to Community; the culturally safe working environment; strong relationships with co-workers and management, and trusting relationships with other service providers allowing for successful collaborations; strong leadership and management from supervisors and the CEO, and support from counsellors and psychologists; flexible working arrangements, opportunities for further study and role progression as well as recognition for work performed. Conclusion: Implementing strategies to reduce staff burnout and turnover is paramount to a healthy workforce and continuity of patient care. Showcasing exemplar organisations can assist other health services to implement similar effective strategies.

Biography

Rabia Mahmood Khan is a Staff Family Physician and also a Lecturer of Department of Medical Education in Liaquat National Hospital, Pakistan.


Abstract

Background: Our elders are at a high risk of falling within their homes rather than outside homes. To be able to help prevent falls people need to know what actually causes them and then ways to help reduce the risks. This public survey will help identify areas we as physicians can highlight in our consultations to educate our public regarding prevention of falls among the elderly. Method: A questionnaire was administered through the social media (Facebook, email, WhatsApp, Facebook Messenger). The questionnaire investigated knowledge related to falls among the elderly and its prevention at home.  Results: 400 people, 75% of whom belonged to Pakistan and the rest from different parts of the world, participated in the survey with age ranging from 19 years to >65 years. 43% and 27% respondents were not sure if poor hearing and multiple medications, respectively, were possible reasons for falls among the elderly. Residents belonging to countries with high income status were twice as likely to take the elderly for assessment of their mobility problem to a general practitioner, than residents of Pakistan, who were just as likely to take the elderly to a specialist like orthopedic surgeon, neurologist or a rheumatologist, than to a general practitioner. Conclusion: Through the questionnaire, certain knowledge gaps were identified regarding the reasons for falls among the elderly. It was clear that the public was well aware of prevention of falls within homes, but in case of mobility assessment of the elderly, the role of general practitioner needs to be highlighted more