Hansen, Dorte Gilså; K. Rasmussen, Niels; Munck, Anders P
doctors stated that the staff performed tasks in connection with weight control, vaccination of adults, blood pressure checks, lung function tests, alcohol abuse treatment and dietary counselling. A total of 72% of the doctors wished for greater staff involvement within one or more areas, especially...... dietary counselling and smoking cessation support. The staff was more frequently involved in the tasks for doctors who had a nurse employed compared with doctors who did not. Except for skin prick tests no connection was found between the staff's participation and the doctor's sex and age, the type and...... interest in the topic, there seems to be a basis for further staff involvement in this type of tasks. Further studies should, however, elucidate whether the participation of the staff substitutes the doctor's work to the extent desired and with sufficient quality. Udgivelsesdato: 2008-Jun-16...
Artiklen gennemgår udvalgt faglitteratur, der på et overordnet plan beskriver typer af spilleregler i musikterapi med (fortrinsvis) voksne klientgrupper. Udgangspunktet er Priestleys anvendelse af begrebet, og hendes inddeling af spilleregler i forhold til forskellige teknikker gennemgås, efterfu......Artiklen gennemgår udvalgt faglitteratur, der på et overordnet plan beskriver typer af spilleregler i musikterapi med (fortrinsvis) voksne klientgrupper. Udgangspunktet er Priestleys anvendelse af begrebet, og hendes inddeling af spilleregler i forhold til forskellige teknikker gennemgås...
Holdgaard, Paw Chr; Nielsen, Søren Steen; Wiggers, Henrik;
INTRODUCTION: Patients with ischemic heart failure and reversible dysfunctional myocardium (Hibernating myocardium, HIB) can benefit from revascularization. These patients can be selected with nuclear methods. The purpose of this study was to describe the results of the imaging procedures in...
Jørgensen, Anthon Sand
Mindst 1000.000 voksne opfylder ADHD-diagnosekriterierne, og en stor del af disse kan risikere at ende i kriminalitet, misbrug eller stå uden job......Mindst 1000.000 voksne opfylder ADHD-diagnosekriterierne, og en stor del af disse kan risikere at ende i kriminalitet, misbrug eller stå uden job...
Petersen, Karen Bjerg
Lektor, cand.mag. Karen Bjerg Petersens afhandling 'Undervisningsfaget dansk som andetsprog for voksne: Nogle udviklingstendenser' undersøger læreplansudviklingen i dansk som andetsprog (DsA) for voksne udlændinge med fokus på tiden efter 2003. Hovedfokus i undersøgelsen er formålet for undervisn...
Johansen, Lene Østergaard
Voksenundervisning (FVU) og særligt i faget FVU-matematik. Jeg har i mine analyser valgt at skelne mellem tre forskellige Diskurser: Politikernes Diskurs, Forskernes Diskurs og matematiklærernes Diskurs. Et af fokuspunkterne i mine analyser er, hvorledes Best Practice italesættes i de tre Diskurser, eller med andre...... ord - hvad er god undervisning for voksne ifølge politikerne, ifølge forskerne og ifølge matematiklærerne? I artiklen præsenterer og diskuterer jeg de tre Diskursers forskellige opfattelser af Best Practice i matematikundervisning for voksne....
Waldorff, Frans Boch; Haugbølle, Nils Wolff; Møller, Hans Christian;
INTRODUCTION: The aim was to describe and analyse signs that make caregivers suspect memory problems among elderly patients in general practice. METHODS: This prospective study was conducted in October and November 2002 among all patients aged 65 or older who consulted a GP in a total of 17...... practices in Copenhagen inner city. The patients who agreed to participate were asked to complete a questionnaire regarding memory, quality of life, etc. Their GP completed a questionnaire independently, and a MMSE was subsequently given to the patient. Where consent was obtained from a patient, a postal...... questionnaire regarding the patient's memory was mailed to a caregiver chosen by the patient. RESULTS: Out of 775 patients 62% (483) gave consent to contact a caregiver. Among the caregivers who received the questionnaire a total of 74% returned the questionnaire. A total of 88 (26%) of the caregivers suspected...
Kjeldsen, A D; Vase, P; Green, A
among the HHT patients younger than 60 years at inclusion the mortality of HHT patients was twice the expected. The excess mortality was fully explained by severe HHT symptoms contributing to death. Future research should aim at identification of HHT patients at particular risk of developing severe......Hereditary haemorrhagic telangiectasia (HHT) is a dominantly inherited disease characterized by telangiectatic lesions. The disease manifestations are variable in severity. Early death due to complications has been described. We report an investigation of the prevalence and mortality of HHT in a...
Ottesen, M M; Køber, L; Jørgensen, S;
with male gender, increased age, diabetes mellitus, left ventricular systolic function (wall motion index), onset from midnight to 6 a.m., onset on a weekday, history of angina pectoris, chest pain as initial symptom, ventricular fibrillation or-tachycardia, Killip class > or = 3, presence of ST......-elevation and ST-depressions. In conclusion, patient delay continues to be disappointingly long. This also applies to patients with a high risk of acute myocardial infarction (notably history of diabetes mellitus and angina pectoris). Udgivelsesdato: 1998-Mar-9...
Glasscock, David John; Carstensen, Ole; Dalgaard, Vita Ligaya Ponce
effects, was repeated again 4 and 10 months after inclusion. Treatment effects were assessed with validated scales: Perceived stress (PSS-10), mental health (GHQ-30), sleep quality (selected items from the BNSQ), and cognitive functioning (two subscales from the CFQ). There were also items concerning sick......The literature contains many empirical studies of interventions aimed at reducing work-related stress. These include randomized controlled trials (RCT). In general it has been found that cognitive behavioural interventions are more effective than other forms of intervention. However, the research......-leave. After inclusion, patients were randomly assigned to either an intervention group or a control group. Participants in the control group were subsequently only followed via questionnaires. The intervention contains both individual cognitive behavioural therapy, conducted by a psychologist, and the offer...
Tønnesen, Hanne; Møller, Henrik; Andersen, Jens Richard;
, liver, larynx, lung, pleura, and secondary cancer. The women had a significantly increased risk of cervical cancer (RR = 2.0). The men developed prostatic cancer significantly more frequently than expected (RR = 1.4). The relative risks of cancer of the stomach, pancreas, kidney and endocrine system......Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalized alcoholic men an women. Of 18,368 alcohol abusers who entered an out-patient clinic in Copenhagen between 1954-1987, 18,307 were followed. Their cancer incidence was compared to that...... of the total Danish population. The overall morbidity of cancer was significantly increased among alcohol abusers. The men developed 1441 cancer cases (RR = 1.6), and the women 182 cases (RR = 1.5). Significantly increased incidences were found for cancer of the tongue, mouth, pharynx, oesophagus...
Trier, H; Rasmussen, N K; Brønnum-Hansen, Henrik
The occurrence of upper respiratory symptoms among adult Danes was examined by the use of data from the Danish Health and Morbidity Survey 1986-1987. In this study, 14.0 per cent of 6,672 individuals reported complaints of colds or coughs (CC) during the two-week period preceding the interview...
Nielsen, Jørgen Lerche
Analyse af læring i virtuelle omgivelser. Målgruppen er unge og voksne, der kombinerer tilstedeværelsesundervisning med netbaserede og netunderstøttede læringsforløb. I bidraget ses både på de nye muligheder af faglig og social karakter, der åbner sig, og på de problemer og udfordringer der er fo...
Johansen, Lene Østergaard
analyseværktøjet til at sammenligne SIALS-opgaverne med de nye FVU-prøver, og derigennem finde svar på spørgsmålet: Hvorledes testes voksnes regnefærdigheder/numeralitet?  De tilsvarende tal for Norge, Sverige og Finland var: 33,2% af nordmændene havde utilstrækkelige læsefærdigheder og 29,7% havde...
Mikkelsen, Carsten Sauer; Mikkelsen, Dorthe Bisgaard; Jensen, Thøger Gorm;
parts of her body. The bullae ruptured easily and left a erythematous base. The histopathological changes were characteristic for adult SSSS. The patient was well-treated with intravenous dicloxacillin, topical antibiotic and antiseptic treatment. The patient had marked thrombocytosis, but no interest...
Kofod, Kasper; Jensen, Niels Rosendal
Bogen er en rapport over et forsknings- og udviklingsprojekt for Organisationen for Voksne Udviklingshæmmede i Ballerup Kommune, som er forløbet fra marfts 2008 til februar 2009. Rapporten er en forløbsrapport, som gør rede for processen i projektet og for de første analyser af de observerede...
Faber, C E; Grøntved, A M
The aim of this study was to assess the benefits and complications from cochlear implantation and to evaluate the average implant usage per day. Ten profoundly deaf adults were implanted during the period April 1994 to September 1997. The patients answered questionnaires one year or more after...... receiving their cochlear implants. The average implant usage per day was 16 hours. The patients would again opt for a cochlear implant and would recommend a cochlear implant for a deaf friend. A paired comparison showed that the implants led to statistically significant improvement in a number of factors...
Nielsen, Anette; Bylov, Frank
Spørgeskemaundersøgelse blandt brugerne af værksteds og botilbud i Varde kommune. Undersøgelsen foregik i samarbejde med ULF, Udviklingshæmmedes Landsforbund, der foretog interviewene i forb.m. spørgeskemaundesøgelsen, mens studerende fra socialrådgiveruddannelsen og læreruddannelsen var sekretærer...
Dreyer, Lene; Mellemkjaer, Lene; Hetland, Merete Lund
associated with an increased cancer incidence. MATERIAL AND METHODS: A descriptive study of cancer cases among 3,688 patients with rheumatic diseases who received anti-TNF therapy was performed. The patients were identified in the nationwide database DANBIO and had a total number of treatment years of 6...... continue. Future studies must reveal whether anti-TNF therapy is associated with an increased cancer risk. Planned Danish studies will include relevant control groups and adjustment for confounders. Udgivelsesdato: 2009-Feb-9......,092 years. All cancer cases were identified and the cancer diagnoses were subsequently confirmed by medical record review. RESULTS: A total of 30 cancers in 28 of 3,688 patients were registered in the DANBIO after initiation of anti-TNF therapy in the period from October 2000 to June 2007. Among these six...
Weis, N M; Skinnes, L; Vesterdal, B;
To investigate the use of condoms ("safe sex") as prevention of transmission with human immuno deficiency virus (hiv) among heterosexual couples, 57 hiv-positive heterosexual patients and their partners if there was one interviewed. Forty-three of the 57 patients were heterosexually infected. Five...... at being given the possibility of talking about problems regarding hiv-transmission and sexuality. In conclusion a discrepancy was found between knowledge about transmission of hiv and the use of condoms among heterosexual couples. Udgivelsesdato: 1999-Jun-14...
Burgdorf, Stefan K; Qvist, Niels; Gögenur, Ismail
Short bowel syndrome is the result of extensive surgical resection, inherited defects or loss of functional absorbing intestine. Parenteral nutrition is associated with high economical expenses, increased morbidity and decreased quality of life. Intestinal transplantation is associated with high...... morbidity and mortality rates. Segmental reversal of the small bowel can prolong the transit time in the small bowel and in many cases permanently end parenteral nutrition dependency. Segmental reversal of the small bowel should be integrated in the surgical treatment of adults with short bowel syndrome....
Nielsen, Ulrik Bräuner
Der er fundet store forskelle i kvalitet og udbytte blandt de afprøvede plustræer. Udvalg af de bedste plustræer til frøproduktion i frøplantagerne har lovende perspektiver. En række frøplantager er allerede etableret og i begyndende produktion - og de her præsenterede avlsværdier vil indgå som e...
Skak, Morten; Bloze, Gintautas
Rapporten belyser udviklingen i de ældre medborgeres flyttemønstre, indkomster og formuer over perioden 1986 til 2011. Vi definerer æl-dre medborgere som personer i alderen 65 år og derover (i kort form: 65+’erne). Årene efter, at alderen 65 er opnået, betegnes som pensionsårene for alle personer......, uanset om de er på arbejdsmarkedet eller er gået på pension. Rapporten baserer sig hovedsagelig på data udtrukket fra forskellige administrative registre, som ligger hos Danmarks Statistik. Derudover har vi trukket tal fra Statistikbanken, SHARE og Boligøkonomisk Videncenters (2011...... behandlinger og ind-læggelser på sygehuse er dog samtidig stigende for alle pensionister, og det samme gælder besøg hos tandlæger, kiropraktorer, fysio- og fodterapeuter. Efter et fald frem til sidste halvdel af 1990’erne er erhvervsfrekvensen blandt de ældre igen stigende. I 2011 var knap 10 procent af de...
Eskesen, Vagn; Springborg, Jacob Bertram; Unden, Johan;
Neurotrauma Committee has published new guidelines for the initial management of adult patients with minimal to moderate head injury. These categorize patients into five risk groups that should be handled by three different strategies: admission for observation, computed tomography or assessment of the...
Brasso, Klaus; Friis, Søren; Juel, K;
Until recently, expectant management of localised prostate cancer was the routine strategy in Denmark.......Until recently, expectant management of localised prostate cancer was the routine strategy in Denmark....
Hansen, P E; Wang, A G; Kragh-Sørensen, P
of comparing the antidepressant effect of newer selective serotonin reuptake inhibitors (SSRI), citalopram and paroxetine, with that of the tricyclic antidepressant drug, clomipramine. Diagnostic classification according to the Newcastle-I Scale into endogenous and nonendogenous depression was...
Rasmussen, Malin Lundberg
Forekomsten af type 1 diabetes er stigende og diabetisk retinopati er fortsat en af de primære årsager til nedsat syn blandt personer i den arbejdsdygtige alder. Derudover er andre mikrovaskulære komplikationer som diabetisk nefropati og neuropati blandt de primære årsager til nedsat nyrefunktion...... karanalyser af nethindens kar kan bruges som redskaber til fremtidig risikovurdering for patienter med type 1 diabetes og vidvinklet fotografering er en hurtig og nem metode, der ville kunne bruges i fremtidig screening....
Osler, M; Rasmussen, N K; Brønnum-Hansen, Henrik
foodstuffs in their diets for the same reason. The persons who particularly follow the dietary recommendations made in recent years, which consist of avoiding fat and including coarse bread, vegetables and fruit in the diet are women, aged 25-44 years, individuals with high net incomes and persons living in......By means of an interview investigation of a representative sample comprizing 4,753 adult Danes over the age of 15 years, the attempted dietary principles of the population are illustrated. 60% of the population try to avoid certain foodstuffs from the point of view of health and 75% include certain...... the suburbs of the capital and in the three largest Danish provincial towns. The efforts to achieve healthy dietary habits are, in addition, associated with non-smoking and moderate alcohol consumption. During the past five years, the proportion of Danes who try to alter dietary habits has increased...
Roed, Casper; Skinhøj, Peter
of the disease is abrupt onset of high fever, followed by conjunctivitis, lymphadenopathy, rash, oral mucosal erythema and erythema of palms and soles. The diagnosis of KS is based on the presence of fever of at least four-five days' duration, plus four of the remaining criteria. Udgivelsesdato: 2009...
Jensen, Jan Skov; Feldt-Rasmussen, Bo F; Strandgaard, Svend;
INTRODUCTION: The urinary excretion of albumin is positively correlated to the presence of ischaemic heart disease and atherosclerotic risk factors in subjects with arterial hypertension. The aim of this population-based, follow-up study of hypertensive patients was to assess the predictive impac...
Lohse, Nicolai; Hansen, Ann-Brit Eg; Pedersen, Gitte; Kronborg, Gitte; Gerstoft, Jan; Sørensen, Henrik Toft; Vaeth, Michael; Obel, Niels
It has been difficult to measure the median survival of HIV-infected patients by comparing selected HIV samples and control groups. Data from the Danish HIV Cohort Study combined with the Central Registration System has made it possible to accurately compare the survival of HIV-infected persons and...... uninfected persons. In 2000 to 2005, the median remaining lifetime at age 25 years in the general population was 51 years and 39 years for HIV-infected persons without hepatitis C virus infection. In conclusion, persons with HIV infection have a good, albeit far from normal, life expectancy. Udgivelsesdato...
Sundstrøm, Terje; Wester, Knut; Enger, Martine;
BACKGROUND In 2000, the Scandinavian Neurotrauma Committee (SNC) published evidence-based guidelines for the management of minimal, mild or moderate head injuries. Since then, considerable new evidence has emerged on the clinical use of these guidelines and on the radiation risks associated with...... S100B is for the first time recommended as an initial diagnostic measure for mild head injury patients with low risk. Of these patients, CT examination is only recommended for those who show a pathologically elevated S100B. CT examination is still the recommended routine for moderate head injury...... patients and for mild head injury patients with medium to high risk. An updated information sheet on head injuries has also been compiled for patients and their relatives.CONCLUSION The SNC recommends the implementation of these guidelines in Norway....
Høegh, Simon; Lohse, Nicolai; Hansen, Ann-Brit Eg; Gerstoft, Jan; Kronborg, Gitte; Larsen, Carsten S; Pedersen, Court; Pedersen, Gitte; Laursen, Alex L; Kvinesdal, Birgit; Møller, Axel; Obel, Niels
INTRODUCTION: The incidence of new HIV diagnoses in Denmark has remained stable since 1991, but it has increased among the subgroup of homosexual men in recent years. This may reflect an actual increase in newly infected, e.g. as a result of increased risk behaviour, or it may reflect increased HIV....... MATERIALS AND METHODS: Observational study based on the Danish HIV Cohort Study, which includes all adults seen at Danish HIV clinics since 1995. RESULTS: From 2000 to 2004 the number of newly-infected homosexual men increased (from 69 to 123), particularly in persons under 30 years (from 5 to 42). The...... from 0 in 2000 to 23 in 2004. The prevalence of patients with high viral load (and thus potentially at risk of transmitting HIV) decreased in all risk groups. CONCLUSION: Newly-diagnosed homosexual men present at an earlier stage of disease progression and with a better preserved immune system today...
Kim Jesper Herrmann
Full Text Available De senere års uddannelsespolitiske initiativer har belønnet studerende, der er hurtige til at vælge en videregående uddannelse, og som holder fast i den uddannelse, de nu engang har valgt. At vælge uddannelse er imidlertid ledsaget af tvivl, og nyere dansk forskning har vist, at studerende vedvarende forhandler deres position på uddannelsen. I dette studie undersøgte vi, hvor stor en andel af aktive universitetsstuderende, der stadig var i tvivl om deres valg af studie, og vi undersøgte baggrunden for denne tvivl. På baggrund af en kvantitativ analyse af svar fra 4.339 studerende på Aarhus School of Business and Social Sciences, Aarhus Universitet, fandt vi, at en tredjedel af de studerende, selv efter optagelse på deres uddannelse, stadig var i tvivl om, hvorvidt de havde valgt det rigtige studie, og at dette gjaldt for førsteårsstuderende såvel som for studerende på femte år. Analysen viste yderligere, at studietvivl var mere udbredt blandt studerende, som havde (i svært ved at se det interessante og relevante i fagene; (ii lav tiltro til egne akademisk evner; (iii opnået lave karakterer ved forudgående eksamener på universitetet. I artiklens perspektivering diskuterer vi, hvorvidt studietvivl må betragtes som et almindeligt og uproblematisk studie- og livsvilkår eller, om studietvivl må antages at være problematisk. Recent reforms of the Danish education system tend to favour those students who are quick to decide what higher education course they want to study and then stick to their decision. However, research has shown that the process of course selection and completion is not always linear and that students continuously negotiate their position in their study programme. In this study we examined how current university students experienced doubt about their choice of programme, and we examined the context surrounding this doubt. Based on a quantitative analysis of answers from 4339 students at the Aarhus School of
Shakoor, Tallat; Riis, Rie Wellendorf
Forskningsprojektet skal bidrage til at afdække etniske minoritetsunges drømme om og forståelse af det normale og trygge liv i senmoderniteten, som grundlag for tilrettelæggelse af en evt. fremtidig indsats. Fokus vil blive rettet mod den voksende gruppe "almindelige" unge med anden etnisk baggrund...
Prescott, E; Steendahl, Ulla; Damsgaard, M T
The preparation methylmethacrylate (MMA) an organic solvent which is employed inter alii in the production of prostheses, is regarded as neurotoxic. With the object of illustrating to what extent dental technicians have symptoms compatible with organic dementia as compared with a control group, a...... after very slight exposure. Revision of the occupational environment of dental technicians, including the current hygienic limits for MMA, is recommended.......The preparation methylmethacrylate (MMA) an organic solvent which is employed inter alii in the production of prostheses, is regarded as neurotoxic. With the object of illustrating to what extent dental technicians have symptoms compatible with organic dementia as compared with a control group, a...... cross-sectional questionnaire investigation was undertaken in a population consisting of 256 dental technicians and 160 opticians, all of whom were professionally active. The percentage replies for the two group were 88 and 85 respectively. The two groups do not differ from one another as regards...
Jensen, Christine Damsbo
Dette studie handler om, hvordan det opleves for den voksne depressive patient at gennemgå et ECT-behandlingsforløb (electroconvulsive therapy). Formålet med projektet er dels at undersøge, hvordan processen omkring ECT-behandlingen udspiller sig og dels at undersøge patienternes oplevelse......, reaktioner og tanker omkring ECT-behandlingen. Studiet bygger på den eksisterende viden om patienters oplevelse af ECT. Metoden er feltforskning med deltagende observation og etnografisk interview. Dette suppleres af to spørgeskemaer. Der blev inkluderet 8 patienter i undersøgelsen. Analysen udspringer af...... konstruktivistisk epistemiologisk vinkel. Ved en teoristyret analyse fremkom 2 overordnede temaer: Anspændthed og tryghed. Disse temaer blev behandlet i en procesorienteret forståelse af ECT-forløbet. Denne proces bestod af: Betingelser, interaktion og konsekvenser. Diskussionen er en kritisk diskussion af fund og...
Thomsen, Kristian Raun
will benefit from the ability to act in accordance with senior professional norms. Knowing your own worth, and to some extent to be able to take advantage of an extraordinary talent are regarded virtues in senior elite coaches and managers as well as among athletes that have successfully sustained...
Obel, Carsten; Dalsgaard, Søren; Arngrim, Torben;
ADHD is a well established condition in childhood, but much less attention has been given to this diagnosis among adults. It is estimated that 2-4% of the adult population has this condition. Adults with ADHD present symptoms that differ somewhat from those presenting in childhood and they are...... typically characterized by problems with planning of work and daily life activities as well as social persistence. The Adult ADHD Self-report Scale (ASRS) can be used in general practice as an introduction to the diagnostic process of ADHD in a psychiatry setting and to evaluate the effect of treatment....... ASRS is now available in Danish and is recommended as a screener for adult ADHD. Udgivelsesdato: 2009-Jan-19...
Obel, Carsten; Dalsgaard, Søren; Arngrim, Torben;
ADHD is a well established condition in childhood, but much less attention has been given to this diagnosis among adults. It is estimated that 2-4% of the adult population has this condition. Adults with ADHD present symptoms that differ somewhat from those presenting in childhood and they are...... typically characterized by problems with planning of work and daily life activities as well as social persistence. The Adult ADHD Self-report Scale (ASRS) can be used in general practice as an introduction to the diagnostic process of ADHD in a psychiatry setting and to evaluate the effect of treatment....... ASRS is now available in Danish and is recommended as a screener for adult ADHD. Udgivelsesdato: 2009-Jan-12...
Licht, Rasmus Wentzer; Straszek, Sune Puggaard Vogt
of recurrence. Many well-documented antimanic drugs are at hand, and the database has been carefully outlined in recent guidelines, also addressing factors of importance in choosing among the options. The real challenge is dealing with non-response, where the database is extremely poor....
Kristensen, Peter Lund
Kardiovaskulære sygdomme er blandt de væsentligste dødsårsager i det moderne vestlige samfund. Sygdommene observeres almindeligvis kun hos voksne, men den almene sundhedstilstand og sundhedsadfærd i barndommen anses for at spille en væsentlig rolle i udviklingen af disse sygdomme. Tidligere studi...
Ph.d. afhandlingen omhandler sammenhængen mellem hjernens blodtilførsel (CBF) og middelarterietrykket (MAP) hos patienter med akut bakteriel meningitis. Hos raske er CBF uafhængig af MAP, hvilket kaldes CBF autoregulation. Svækket autoregulation antages at øge risikoen for cerebral hypoperfusion og...... iskæmi under episoder med lavt MAP, og for cerebral hyperperfusion og vasogent ødem ved højt MAP. CBF autoregulationen undersøgtes hos tyve voksne patienter med akut bakteriel meningitis i den tidlige sygdomsfase (<24 timer efter diagnostisk lumbalpunktur). Idet autoregulationen fandtes svækket hos...... meningitis, men retableres ved klinisk restitution. Autoregulationen kan endvidere delvis retableres ved akut hyperventilation. Fundene har potentiel betydning for valg af supportiv terapi hos patienter med meningitis....
Lillebæk, Troels; Andersen, Ase Bengård; Seersholm, Niels Jørgen;
Active transmission of Mycobacterium tuberculosis (Mt) continues at surprisingly high rates in Denmark. The transmission is particularly observed in specific high risk segments of the population with social problems such as homelessness, alcohol, and/or drug abuse. The patients are infected with ...
Nexøe, J; Kragstrup, J; Rønne, T
Influenza epidemics are accompanied by considerable excess morbidity and mortality especially among the elderly and the chronically ill. In the influenza season 1995 a controlled, randomized trial was carried out to examine the impact of postal invitations and user fee on influenza vaccination...... invitations to influenza vaccination paying the usual fee ($40-$60 US). The last third served as a control group, being vaccinated on their own request and paying the usual fee. In the control group 25% (19-31%, 95% confidence interval) of the patients were vaccinated, compared to 49% (42-56%) in the group...... which received a postal reminder and paid the usual fee, and 72% (65-78%) in the group invited to be vaccinated free of charge. Udgivelsesdato: 1997-Jun-30...
Løite, Vibeke Brinkmann; Lund-Cramer, Pernille
er baseret på filosofisk-hermeneutisk fortolkning af individuelle, semi-strukturerede interviews. Ti informanter blev selekteret strategisk blandt deltagere i forskningsprojektet DANO-RUN (7 mænd, 3 kvinder, gennemsnitsalder 41,5 år). Interviewguiden blev udarbejdet med afsæt i Theory of Planned...... Behavior (TPB) og The Transtheoretical Model (TTM). Efterfølgende kodning og analyse af interviewene blev udført i analysesoftwaren NVivo 10. Resultater: TPB: Informanterne oplevede en erfaringsbaseret ændring i affective beliefs knyttet til løbeadfærden, som medvirkede til, at intentionen for at løbe...... of change anvendtes i størst omfang på action stage, hvorimod behavioral processes of change primært anvendtes på maintenance stage. Informanterne tillagde alle forpligtigelsen overfor DANO-RUN at have afgørende motiverende betydning. Konklusion: Denne undersøgelse viste, at individuelle faktorer i form af...
Wanscher, Jens Højberg; Faber, Christian Emil; Grøntved, Aksel Møller
INTRODUCTION: Our aim was to assess the effect of cochlear implant (CI) surgery on the mental quality of life in totally deaf adults using a generic type of questionnaire. MATERIALS AND METHODS: The survey comprised 40 adult CI users who answered a standard and a retrospective version of the Short...... mean scores of the equivalent subscales of the Danish population, whereas the post-implant mean scores in two out of three cases were above the mean scores of the Danish population. DISCUSSION: CI was shown to have a statistically significant positive impact on the quality of life of adult deaf...
Troelsen, Anders; Søballe, Kjeld
The periacetabular osteotomy is recognized as the surgical treatment of choice in young adults with symptomatic hip dysplasia. The procedure is performed to delay or prevent the development of osteoarthritis. The procedure has the ability to improve function and preserve hip joints in > 80% of...
Pedersen, Louise Ørnskov; Lund, Katrine Bak; Nielsen, Tine Jepsen;
At some Danish workplaces, healthy employees are offered an influenza vaccination, although vaccination has not been proven to have a protective effect on healthy adults. This article gives an overview of the effect of influenza vaccination on healthy adults based on the results from the Cochrane...
Nielsen, Jens Christian; Sørensen, Niels Ulrik
stor repræsentativ cpr-baseret spørgeskemaundersøgelse blandt 15-24-årige unge i Danmark og opfølgende kvalitative interview med udvalgte unge. Det er et ønske med hæftet, at forskningsprojektets viden og perspektiver kan bidrage til at gøre voksne og voksenverdenen bedre i stand til at spotte tegn på...
Slidsborg, Benjamin; Nielsen, Tasia; Weichel, Joachim Højer; Önnerth, Lars
Our paper examines the high suicide and suicide attempt rate among transgender people. We aim to identify possible reasons why transgender people are more prone to suicide than minorities in modern societies. We want to focus our analysis and interpretations on possible reasons for the high suicide rates among transgender people around Émile Durkheim’s work concerning the reasons for suicide and Judith Butler’s work on gender trouble. We want to combine aspects of Durkheim’s suicide theory...
Artiklen bygger på en større undersøgelse af gymnasielæreres oplevelse af at de som noget nyt skal indgå i tværfaglige team. Kravet indgår som led i de omfattende forandringer der i disse år sker i gymnasieskolen. Artiklen argumenterer for at i modsætning til hvad man kunne forvente, skaber disse...... kan anerkende medarbejderne samt rumme og lære af forskelle og konflikter. Dette ses som et afgørende led i bestræbelserne på at reducere stress på arbejdspladsen....
Due, Pernille; Holstein, Bjørn Evald; Jørgensen, Per Schultz
. Bullying was associated with low social class. Bullying varied considerably among schools. The victims had more problems as regards health, well-being and self-esteem; they smoked and drank less than others. Those who bullied others also had more problems but to a much smaller extent than the victims....... They had higher levels of risk behaviours such as smoking, drinking, and seat-belt avoidance, and were less satisfied with school. In conclusion, victims of bullying have a very high proportion of health problems, poor well-being and low self-esteem. To bully others is significantly associated with health...
Nielsen, Charlotte Aagaard
Sundhedsfremme er interessant, fordi det drejer sig om, hvordan vi lever livet på den bedste måde med os selv og hinanden, og sundhedsfremme har derfor mange interessenter: Samfundet, fordi det er billigst og mest produktivt at have sunde borgere. Arbejdsgiverne, fordi usunde medarbejdere har stø...... skolen i højere eller mindre grad støde ind i forskellige familiers normer, værdier, holdninger, rutiner, vaner og traditioner. Så spørgsmålet er, hvor tæt på familiens liv, skolen kan gå i det sundhedsfremmende arbejde. Det har jeg spurgt en gruppe af forældre om. Askov 2009...
Due, P; Holstein, B E; Marklund, U
children have experienced stomach-ache, back pain, bad temper and feeling dizzy. There are minor variations between countries and between age groups, but in almost all age groups in all countries more girls than boys report these symptoms. Approximately every fourth pupil have used medication against......The article reports data from the WHO cross-national study on health behaviour in schoolchildren. A sample of 11,774 children aged 11, 13 and 15 years in Denmark, Finland, Norway and Sweden answered a questionnaire on social situation, health, health behaviour and lifestyle. Self assessed health is...... reported excellent among approximately two thirds of the Swedish children, half the Danish children, one third of the Finnish children and one fifth of the Norwegian children. In Denmark, Norway and Sweden self-assessed health is better among boys than girls. The most frequent symptom reported by the...
artikel III anvendtes den samme studiepopulation som i artikel II. På profilrøntgenbillederne opmåltes dimensionerne af atlas og axis og ved en visuel vurdering blev det afdækket, om der var radiologiske tegn på anomalier i relation til de øverste 5 halshvirvler (fusioner eller hvirvelbue dehiscenser......). Atlas højde og længde samt højden på axis hvirvelbue var forøget hos HR patienter i forhold til KTR (p ≤ 0,001), og flere HR patienter (32%) end KTR (11%) havde fusioner (p = 0,003). I den samlede gruppe af voksne (n = 85) var højden af atlas hvirvelbue og længden af axis negativt korrelerede med...... kraniebasis vinklen (p = 0,017 hhv. p = 0,008), og atlas vertikale dimensioner var positivt korrelerede med den occipitale theca tykkelse (p ≤ 0,015). Atlas længde var positivt korreleret med den mandibulære prognati (angle s-n-pg) (p = 0,042). Forekomsten af fusioner var positivt korrelerede med tykkelsen af...
Necef, Mehmet Ümit
Artiklen gennemgår en række anmeldelser af filmen Flugten og fremfører, at både filmen selv og de positive anmeldelser er eksempler på infantilisering og enfoldiggø-relse af anti-racismen i Danmark. Udgivelsesdato: Sept 2009...
Ottesen, Mathilde Dagsvik
Denne studien undersøker Tinder som arena for selvpresentasjon. Gjennom kvalitative intervjuer med syv studenter mellom 20 og 30 år, har jeg søkt svar på hvordan en presenterer seg selv på Tinder, hvordan en vurderer andre brukeres selvpresentasjon, samt implikasjoner av Tinder. I samsvar med Bourdieu (1986), undersøker jeg Tinder som et sosi...
Thomsen, Per Hove; Plessen, Kerstin J; Houmann, Tine
ADHD, affecting 2-3% of children, is characterised by problems with attention, hyperactivity and impulsivity. Co-morbid psychiatric problems are very frequent. Causal factors are primarily genetics but environmental influences such as smoking during pregnancy or preterm birth are contributing...... factors. For children and adults psychoeducation is essential, for younger children training of the parents are recommended. The most efficient psychopharmacological treatment is with central stimulants or atomoxetine....
Poulsen, Frantz Rom; Meyer, Morten; Rasmussen, Jens Zimmer
Generation of new nerve cells (neurogenesis) is normally considered to be limited to the fetal and early postnatal period. Thus, damaged nerve cells are not expected to be replaced by generation of new cells. The brain is, however, more plastic than previously assumed. This also includes neurogen...
Johansen, Lene Østergaard
I sommeren 2000 blev resultaterne af OECD undersøgelsen "Second International Adult Literacy Survey" (SIALS) offentliggjort. Offentliggørelsen medførte et ramaskrig, idet den påviste, at henholdsvis 46% og 28% af den danske befolkningen mellem 16 og 66 år ikke var i besiddelse af tilstrækkelige...... trinopdelte og hvert trin kan afsluttes med en centralt stillet prøve. I mit oplæg vil jeg præsentere, hvorledes deltagerne er blevet testet for regnefærdigheder i SIALS, og hvad de er blevet testet i. Jeg vil sammenligne testen i SIALS med de nye opgavetyper, der er blevet udviklet til FVU-matematik og...
Background: The effect of psychopharmacology on clinical features of ongoing bipolar disorder episodes and the course of illness are good, but sometimes not sufficient for achieving remission. During the last decade manualized adjunctive psychosocial interventions have been developed. This review focuses on randomized controlled trials studying the effect of psychotherapy adjunctive to pharmacotherapy on recovery from depressive or manic phases, relapse prevention and functional improvement. ...
Berlac, P.A.; Lippert, F.K.; Torp-Pedersen, Christian Tobias
The new ERC guidelines on resuscitation emphasize the importance of quality CPR. BLS should be started as early as possible. Lay rescuers should not check for a pulse, they should call for help and start chest compressions immediately. Compression depth should be 4-5 cm at a rate of 100 compressi...... ventilations followed by a compression-ventilation ratio of 15:2. Automatic External Defibrillation should be used as early as possible Udgivelsesdato: 2008/11/17...
Poulsen, Frantz Rom; Meyer, Morten; Rasmussen, Jens Zimmer
Generation of new nerve cells (neurogenesis) is normally considered to be limited to the fetal and early postnatal period. Thus, damaged nerve cells are not expected to be replaced by generation of new cells. The brain is, however, more plastic than previously assumed. This also includes neurogen......Generation of new nerve cells (neurogenesis) is normally considered to be limited to the fetal and early postnatal period. Thus, damaged nerve cells are not expected to be replaced by generation of new cells. The brain is, however, more plastic than previously assumed. This also includes...... neurogenesis in the adult human brain. In particular two brain regions show continuous division of neural stem and progenitor cells generating neurons and glial cells, namely the subgranular zone of the dentate gyrus and the subventricular zones of the lateral ventricles. From the latter region newly generated...... neuroblasts (immature nerve cells) migrate toward the olfactory bulb where they differentiate into neurons. In the dentate gyrus the newly generated neurons become functionally integrated in the granule cell layer, where they are believed to be of importance to learning and memory. It is at present not known...
Aarvelta, Heidi Marie Guterud
Most immune cells express vitamin D-receptor (VDR). In vitro trials show that vitamin D affects the function of immune cells. It is therefore possible that vitamin D affects immune function also in vivo. On this foundation the hypothesis that low serum levels of vitamin D affects the risk of acute respiratory tract infections has been posted. Observational studies consistently show that low serum levels of vitamin D are associated with an increased risk of acute respiratory infections. On the...
Uhrenfeldt, Lisbeth; Hall, Elisabeth; Fegran, Liv; Aagaard, Hanne; Ludvigsen, Mette Spliid; Meyer, Gabriele
Abstract (396 ord): Baggrund. Overflytning mellem afsnit/klinikker og hospitaler er et hyppigt fænomen for alle patientgrupper, ældre, voksne, unge mennesker såvel som nyfødte og deres forældre. For kliniske sygeplejersker inkluderer fænomenet overflytning, tilbageflytning og modtagelse af en pat...
Exposure to electromagnetic fields and the risk of disease in the central nervous system in employees at Danish electric companies; Udsaettelse for elektromagnetiske felter og risiko for sygdomme i det centrale nervesystem blandt ansatte ved danske elselskaber
Introduction: Occupational exposure to electromagnetic fields has been associated with neurological diseases, such as amyotrophic lateral sclerosis, senile dementia, Parkinson's disease and Alzheimer's disease. Material and method: I studied the incidence of disease in the central nervous system in 30,631 persons employed at Danish electric companies between 1900 and 1993. I linked the cohort to the nationwide, population-based Danish National Register of Patients and compared the number of cases of these diseases found between 1978 and 1993 with the corresponding rates in the general population. In addition, I fit the data on utility workers to a multiplicative Poisson regression model in relation to estimated levels of exposure to 50 Hz electromagnetic fields. Results: Overall, there was an increase in the risk of senile dementia and motor neuron diseases combined. The incidence of Parkinson's disease, Alzheimer's disease and other diseases of the central nervous system were essentially unrelated to exposure to electromagnetic fields. A decreased risk of epilepsy compared with the general population probably reflects a healthy worker effects; I observed an increased risk of epilepsy based on internal comparisons. Discussion: The increased risk of senile dementia and motor-neuron diseases may be associated with above average levels of exposure to electromagnetic fields. (au)
Lunding, S; Hansen, K S; Krogsgaard, K; Rosdahl, N; Smith, E; Wantzin, P S
The objective of this study was to examine whether the prevalence of hepatitis C, like hepatitis B, is increased among the mentally retarded in Denmark. The prevalence of serological markers of hepatitis B and C was examined in an institution for the mentally retarded. A total of 126 out of 178......-HBc-positive and 30% were HBsAg-positive as compared to 32% and 3.8% respectively among others. In conclusion, hepatitis C infection seems to be uncommon among mentally retarded persons in Denmark and the risk of acquiring infection not significantly increased as compared to that of the general population. The...
Boldsen, J L; Jeune, B; Bach-Rasmussen, K L;
The average age at the menarche has decreased from the 1850s to the 1950s. It is controversial whether there has been a continued decrease since the 1950s. The object of this investigation is to illustrate whether this trend has continued into the 1980s. This study is based on the ages at the...... menarche as recalled by 908 girls aged 14-16 years in 40 schools in Odense. The information was obtained during intervals of differing lengths and consequently, the parameters of the distribution of the age at the menarche were estimated in a randomly grouped normal distribution. The average age at the...... menarche was found to be the same throughout the municipality (13.27 years; 95% confidence limit 13.20-13.35). The variations were found to be significantly differentiated by the type of school district. The variations were low in the suburbs and in the surrounding rural districts, higher in the inner city...
Holstein, B E; Due, E P
among both girls and boys. Five percent are injured at home, 5% at school, 9% are injured at a sport facility, and 4% in the street/road. Ten percent report a sports injury, 4% an injury by falling, and 3% by riding a bicycle. Most common injuries are sprain/strain/pull of a muscle (9%), broken or...
Wisborg, Kirsten; Obel, Carsten; Henriksen, Tine Brink;
intervene. We reviewed the Scandinavian and English randomized controlled intervention studies directed towards smoking cessation during pregnancy. The intervention studies were classified according to the method of intervention namely antismoking advice, self-help manuals, measurements of smoking dependent...... chemical factors and multifactorial methods. We conclude that it is possible to reduce smoking during pregnancy only by an efficient and personal effort performed by a committed person towards each pregnant woman. Udgivelsesdato: 1994-Jul-11...
Due, P; Holstein, B E; Ito, H;
A total of 1,671 school children aged 11, 13 and 15 years answered a questionnaire on diet, other health behaviour, social background, social network, health and life satisfaction. The proportions who ate fruit, vegetables, and rye bread every day were 77%, 64% and 94%. Moreover, 78% had fibre......-containing breakfast every day and 79% had a regular lunch meal every day. 26% of the children received an optimal diet containing all of these five components every day, and 19% received less than three of these components every day. The proportions who consumed five unhealthy diet components every day (candy, chips......, French fries, sausages/hamburgers, and sweet longdrinks) were 32%, 12%, 5%, 5%, and 18%. 39% received at least one of these unhealthy diet components every day. There was no association between intake of healthy and intake of unhealthy diet components. We found no age differences among boys regarding the...
Nielsen, Signe Smith; Nørredam, Marie; Christensen, Karen Louise;
-seeking children showed evidence of having a psychiatric disorder. The results from the SDQ were supported by the results from the HBSC which showed that asylum-seeking children had numerous physical and psychological symptoms, poor self-perceived quality of life and a fragile social network. CONCLUSION: Emotional......INTRODUCTION: There is growing concern for the mental health of asylum-seeking children due to protracted periods of stay at asylum centres and an increasing need for psycho-social measures. The objective of this study is to survey asylum-seeking children's mental health in Denmark. MATERIALS AND...
Nielsen, Signe Smith; Nørredam, Marie Louise; Christiansen, Karen Louise; Olsen, Carsten; Krasnik, Allan
and Difficulties Questionnaire (SDQ) samt fire spørgsmål fra Health Behaviour in School-aged Children-spørgeskemaet (HBSC). For de 4-11-årige udfyldte pædagoger og lærere spørgeskemaer, de 11-16-årige besvarede derudover også selv spørgeskemaer. Resultaterne viste, at 35% af de 4-16-årige asylbørn...... adskillige fysiske og psykiske symptomer, ringe selvvurderet livskvalitet og skrøbeligt socialt netværk....
Prescott, E I; Osler, M; Hein, H O;
Studies reporting increased mortality in smokers are abundant, but only few have included large numbers of heavily smoking women. Based on three large Danish population studies we calculated median survival in smokers and never-smokers and compared the impact of smoking in men and women. Seventee...
Due, P; Holstein, B E; Ito, H; Groth, M V
-containing breakfast every day and 79% had a regular lunch meal every day. 26% of the children received an optimal diet containing all of these five components every day, and 19% received less than three of these components every day. The proportions who consumed five unhealthy diet components every day (candy, chips...
Benjaminsen, Sigurd E.; Thomsen, Rita L T; Balsløv, Kim D.;
family and social circle. Significantly more attempters suffered from depressive disorder, feelings of hopelessness, anxiety attacks, agoraphobia, substance abuse or cluster B personality disorders (dissocial, impulsive, borderline, and histrionic). Also significantly more suicide attempters had...... committed crimes and received early pension. Assessment of coping showed that suicide attempters had a significantly lower tendency to make plans or to make the best of a stressful situation by growing from it They were significantly more likely to show mental disengagement, to resort to denial and drink...... alcohol or take drugs when faced with stressful events or difficulties. When evaluated on the Addiction Severity Index Scale, the suicide attempters were found to have a significantly greater need of treatment....
This pilot study sought to find out the efficacy and effectiveness of a new combination of two therapeutic techniques in the research field of stress management and prevention: Eutony Psychophysical Education and Multimodal therapy. 31 nurses from a public Danish Hospital in Copenhagen participated......). The originality of this project arises from the unique combination of multimodal therapy and Eutony Psychophysical education in relation to stress management. There is no systematic study in which the combination of these two techniques has been tested before. From an historic view point, this is the...... participants descriptions of their own experiences and process of mastering their daily stress, both at work and at home. At first, the participants described stress as a process and as a state in which they experienced an interruption of the interaction, the relation and communication between them (each...
Bennedsen, Anne; Ibfelt, Else Helene; Hansen, Jane Lindschou;
-grade students (aged 15 to 16 years), including 264 first-generation and 391 second-generation immigrants from non-Western countries. Self-reported health and self-efficacy, defined as the belief in the ability to affect one's own health, were included in the analyses, using SPSS cross-tabulations and logistical...
Alinia, Sevil; Tetens, Inge
Forekomsten af overvægt og fedme blandt de voksne på verdensplan er høj med en stigende tendens. Effektive strategier i forhold til kropsvægtregulering målrettet mod opretholdelse af en normal kropsvægt samt forebyggelse af en for stor vægtøgning er derfor påkrævede. Disse mål kan måske opnås ved at reducere kostens energidensitet. Kostens energidensitet kan reduceres ved at erstatte energitætte fødevarer med mindre energitætte fødevarer såsom frugt og grøntsager. Frugt og grøntsager anses fo...
The focus groups (FG) are a “carefully planned series of discussions designed to obtain perceptions on a defined area of interest in a permissive, non-threatening environment” (Krueger and Casey, 2000). The aim of the FG is to raise a discussion among the participants that makes the research to see a certain phenomenon from the participants’ perspective. In Periscope the Focus Group Methodology (FGM) will be used as a supplement to the quantitative methods in order to obtaining background inf...
Christensen, Lene Møller; Kørup, Karsten; Trolle, Ellen;
tre hovedmåltider og tre mellemmåltider samt hverdag/weekend. Resultaterne vises for mænd og kvinder separat og samlet. Rapporten er baseret på data fra Den nationale undersøgelse af danskernes kostvaner og fysiske aktivitet indsamlet i 2005-2008. I alt 537 mænd og 535 kvinder i alderen 20-75 år...
Gottschalk, Georg; Buch Hansen, C.; Nicolajsen, E.
I de senere år der sket en udvikling af institutioner og bofællesskaber for udviklingshæmmede, sindslidende og fysisk handicappede. Tilsammen dækker tilbuddene hele skalaen fra den meget specialiserede institution til bostøtteformer, hvor de pågældende personer bor spredt i egne lejligheder med e...
Musikterapi kan have en signifikant effekt på de primære problematikker ved autismeforstyrrelsen, som f.eks. social interaktion, initierende adfærd og social-emotionel gensidighed. Kapitlet giver et indblik i de ’unikke og essentielle’ træk ved musikterapeutiske interventioner, der ifølge en nyli...
Two international trends are presented by some central documents as they constitute important general frames for understanding and coping with students in mathematics difficulty: A trend towards a political focus on math-containing competence for all, which stresses the need to further work in...... research and practice. And a trend towards political and economical interest in inclusive schools, which challenges thinking on normality and organisation and where concept of inclusion need to be given a mathematical dimension. The article suggests a model for conceptualising mathematics difficulties, and...
Birkelund, Regner; Søndergaard Larsen, Lene
occasionally, the opposite was experienced too. Less typically, the patients experienced interaction with fellow patients as a burden and referred to it in negative terms. Conclusions: Patients’ interaction resembled care as well as self-care. Patient–patient interaction was an important part of the social...... subcategories representing significance of patients’ interaction with fellow patients. Results: The qualitative analysis resulted in two main categories: (i) Caring for fellow patients and (ii) Sharing illness information with fellow patients. Each of the main categories was elucidated through several...... subcategories. Our findings clearly showed that interpersonal interaction with fellow patients was of utmost importance when it came to care and support and when they needed information about their illness. Typically, the interpersonal interaction was experienced as giving and referred to in positive terms, but...
Pedersen, Mette Bjerggaard; Giraldi, Annamaria; Kristensen, Ellids;
Seksuallivet er vigtigt for vores livskvalitet. Blandt mænd og kvinder, der har haft type 2 diabetes i lang tid, er seksuelle problemer hyppige. I ADDITION-studiet om tidlig opsporing og intensiv behandling af type 2-diabetes i almen praksis blev patienterne stillet forskellige spørgsmål om deres...... seksualitet ved 5-års opfølgningsundersøgelsen. Disse spørgsmål dannede baggrund for vores undersøgelse, som viser, at seksuelle problemer også er hyppige blandt mænd og kvinder med diabetes opdaget tidligt i deres sygdomsforløb. Omkring halvdelen af kvinderne og en fjerdedel af mændene i studiet oplevede...
Holstein, B E; Due, P; Ito, H; Deckert, H
% of the children spend 0-10 hours weekly watching television, 35% 11-27 hours, 15% 28-37 hours and 3% more than 37 hours. Boys spend more time watching television than girls, younger pupils more than older and children from lower social classes more than children from higher social classes. The time...... spent watching television increases with increasing degree of urbanisation. Children who spend many hours watching television have more problems in life satisfaction, health and social network compared with children who spend a few hours watching television. Udgivelsesdato: 1991-Jun-3......A material of 1,671 schoolchildren replied to a questionnaire about health, time spent watching television, the demographic and social situation, social network, and life satisfaction. These pupils spend two hours daily watching television and one tenth of this time is spent on video programmes. 48...
Simonsen, Kirsten Wiese; Andersen, Lis Sahl; Jensen, Britt Toftgård;
discussed. The study included 47 drug addicts. Median age was 34, age span: 20-43. The main cause of death was poisoning by heroin. In 28% of the drug addicts cocaine was detected and in 13% amphetamine. About half had used benzodiazepines. Few were employees, most were criminals and eight were homeless...
Jensen, Britt Toftgård; Simonsen, Kirsten Wiese; Rasmussen, Christian;
. The greater part of the deaths were caused by heroin, which is found in different concentrations in the illegal market. Five of the dead persons had just been released from prison and three people had just left 24-hour care centers when they were found dead. Co-operation between the various, treating...
Juel, K; Mosbech, Johannes; Hansen, Eva Støttrup
, circulatory diseases and other natural causes. Mortality due to lung cancer was particularly low. The suicide mortality was increased for both sexes, in particular because of an increased number of suicides by poisoning. Compared with the general population the doctors' mortality was low, but the mortality......This study examines mortality rates of Danish doctors and describes pattern and causes of death for the period 1973-1992. The study comprises 21,943 medical doctors, 6012 of whom were women. At the end of 1992 there were 2387 recorded deaths. The doctors had lower mortality rates than the general...... population. A significant lower mortality was seen for male medical specialists compared to general practitioners. A gender-difference was seen among the youngest doctors with the female doctors suffering a considerably higher mortality than the male doctors did. Both sexes showed SMR below unity for cancer...
Prescott, E; Steendahl, Ulla; Damsgaard, M T
The preparation methyl metacrylate (MMA) an organic solvent which is employed inter alii in the production of prostheses, is regarded as neurotoxic. With the object of illustrating to what extent dental technicians have symptoms compatible with organic dementia as compared with a control group, a...... after very slight exposure. Revision of the occupational environment of dental technicians, including the current hygienic limits for MMA, is recommended.......The preparation methyl metacrylate (MMA) an organic solvent which is employed inter alii in the production of prostheses, is regarded as neurotoxic. With the object of illustrating to what extent dental technicians have symptoms compatible with organic dementia as compared with a control group, a...... cross-sectional questionnaire investigation was undertaken in a population consisting of 256 dental technicians and 160 opticians, all of whom were professionally active. The percentage replies for the two groups were 88 and 85 respectively. The two groups do not differ from one another as regards...
Graff, V; Madsen, Mette; Nielsen, P E
In an investigation including 2,233 Danish doctors, nurses and midwives between 72 and 96% replied that they found definite proof of connections between smoking and the diseases: cancer of the lung, cardiac infarction and chronic bronchitis. The highest percentages were found among doctors and, in...... hospitals and places of work for health staff should be free from smoke, so that none of the staff smoked at work. Half of the doctors and 3/4 of the nurses and midwives replied that they received insufficient teaching about the deleterious effects of tobacco smoking on health. All of the participants were...
Madsen, Mette; Pedersen, J T; Nielsen, P E
conduct of a questionnaire investigation among a representative section of Danish doctors, nurses and midwives about smoking habits and attitudes to the tobacco problem. The random sample consisted of 2,997 persons, of whom 2,606 (87%) replied to the question about daily smoking habits. In all of the age...... nurses and midwives as compared with 46% in the normal population. The frequency of smoking among doctors has decreased considerably since 1980. Very few heavy smokers were found among health staff, particularly among doctors, and many male doctors smoked pipes (47% of the smokers). Even though health...... groups, the frequency of smoking was considerably lower among health staff than in the population as a whole, primarily because many had stopped smoking. The frequency among men was 23% for doctors as compared with 50% in the normal population (age 20-69 years) and 15% for female doctors, 29-30% for...
Stegger, Sara; Munch, Kathrine; Madsen, Josefine
Abstract The point of departure for this project is to shed light on the individual asylum seekers’ sense of belonging to the culture and user-driven drop-in centre the Trampolinhouse, thus this is where the gathering of the empirical data has been collected. The empirical data in this project relies on a mixture of participant observations and qualitative interviews with four users of the house, one of the informants works at the house whereas the remaining three are asylum seekers. T...
Forstholm, Malene Merete; Langhoff-Roos, Jens; Lidegaard, Øjvind
While multiparous women, who wish for planned Caesarean, indicating "maternal request" (MRS), often do so due to previous natal complications, our knowledge of why more nulliparous (P0) wish for MRS is sparse. The aim of the study was to illuminate reasons why an increasing proportion of P0 want...... MRS....
Mønsted, Mette; Edqvist, Charles; Gabrielsson, Jonas;
entrepreneurs in Norway. In the report we focus on entrepreneurs and growth entrepreneurs with a tertiary education. In Denmark we define tertiary education as a university master degree, based on five years of university study. In Norway we define tertiary education as a master degree or equivalent, based on...... more than four years of university study. In Sweden we define a tertiary education as three years of university study or more than three years. The university studies vary depending on the study subject. In order to be able to compare the data from the three countries we use the definition four years...... or more in the chapter comparing data from the three national studies. The statistic data in the report is based on figures on academic entrepreneurs starting their company in 2004 and following the development in the number of entrepreneurs until 2008. Growth entrepreneurs are defined as...
Steno, Anne Mia; Friche, Nanna
Interessen for mad, råvarer og gastronomi er stor i disse år. Forskning peger på, at kokkefagets brede popularitet i offentligheden virker til at tiltrække elever til uddannelsen. Mediekokke bliver forbilleder, og de unge vil gerne lære at lave den smarte mad, som de spiser på byens cafeer (Møberg...
Hasle, H; Jeune, B
had been exposed to physically strenuous work, too rapid a tempo and a long series of unpleasant working conditions. In addition, disability pensioners had frequently experienced periods of unemployment. No differences were observed as regards piece work, shift work or the number of places of...
Eksisterer det klassiske arbejderkollektiv, på hvilke betingelser og hvorfor? Det er denne afhand-lings problemstilling. Undersøgelsen foregår i 2 industrivirksomheder, og i alt 80 industriarbejdere er interviewet. I den ene case møder industriarbejderne efter en virksomhedsoverdragelse ledelsens krav om fleksibilitet i stor skala. Det undersøges, hvordan en fagpolitisk stærk industriarbejder-gruppe fornyer interessetolkningerne. I den anden case er fagligt arbejde under opbygning i en nyopre...
Vestergaard, L; Andersen, Klaus Ejner
steroid allergens, and 17 had a positive reaction to at least one of these (2.6%). Budesonide allergy was most often encountered, followed by hydrocortisone, tixocortol pivalate and hydrocortisone-17-butyrate. Betamethasone valerate, triamcinolone acetonide and clobetasol propionate rarely caused contact...
Karen Fog Olwig
Full Text Available Siden slaveriets ophør midt i 1800-tallet har Caribien været præget af en stærk migrationstradition. Forskere har påvist, at denne tradition har fået næring afhistorier om den succesrige returmigrant, som rig på penge og materielle goder vender tilbage efter år i udlandet. I denne artikel argumenterer jeg for, at disse historier indskriver sig i et 'mandligt' narrativ, der primært fokuserer på muligheden for at opnå social og økonomisk mobilitet gennem migration. Gennem en analyse af livshistorieinterviews med kvindelige returmigranter på den vestindiskeø Nevis viser jeg, at der parallelt med det mandlige narrativ findes et komplementært 'kvindeligt' narrativ, som omhandler den gode slægtning, der udvandrer for at hjælpe familien i hjemlandet ved forsendelser af penge, tøj og andre materiellegoder. Denne migrant kan derfor vende tilbage som et højt respekteret familiemedlem til trods for de beskedne materielle ressourcer, vedkommende selv besidder. Selv om de to narrativer knytter sig til henholdsvis mænd og kvinder, drager både mandlige og kvindelige migranter på dem, afhængigt af deres særligeerfaringer i udlandet og de specifikke aspekter af deres liv de beretter om. Analysen peger på, at narrativerne ikke er faktuelle redegørelser for migrantforløb, men snarere kulturelt specifikke måder hvorpå migranter skaber mening ogsammenhæng i deres liv. Ikke desto mindre er narrativerne med til at præge de forventninger og erfaringer, der knytter sig til migration, og de spiller derfor en vigtig rolle i de migrationsprocesser, der rent faktisk finder sted.Migration Narratives:Stories of the good Relative among Caribbean WomenSince the abolishment of slavery during the middle of the nineteenth century, the Caribbean has been characterized by a strong migration tradition. Research on Caribbean migration has shown that this tradition has been nourished by narrativesof the successful return migrant, who moves back home rich in money and material goods. In this article I will argue that this is a ‘male’ narrative emphasizing the importance of achieving social and economic mobility through migration.Through life story interviews with female return migrants on the Caribbean island of Nevis, this article points to the existence of a complementary ‘female’ narrative revolving around the good relative who migrates to help the family left behind. In this narrative a successful return is not measured by material gain, but rather by the extent to which support has been sent to the family and the respect this engenders in the local community. The analysis shows that, while the twonarratives of return are gendered, individuals may draw on both, depending on their particular experiences abroad and the specific aspects of their life story they are recounting. The narratives therefore should not be viewed as factual accountsof migration, but rather as culturally specific modes of representation that give meaning and purpose to individual lives. Nevertheless, the narratives shape individuals’understandings and practices of migration, and they therefore play an important role in actual migration processes.
Karen Fog Olwig
Siden slaveriets ophør midt i 1800-tallet har Caribien været præget af en stærk migrationstradition. Forskere har påvist, at denne tradition har fået næring afhistorier om den succesrige returmigrant, som rig på penge og materielle goder vender tilbage efter år i udlandet. I denne artikel argumenterer jeg for, at disse historier indskriver sig i et 'mandligt' narrativ, der primært fokuserer på muligheden for at opnå soci...
Olsen, Else Marie; Johannsen, Trine Holm; Moltesen, Bodil; Skovgaard, Anne Mette
Failure to thrive, defined as insufficient weight gain according to age, is a well-known condition among infants and toddlers. The aim of the study was to investigate the prevalence of diagnosed failure to thrive and possible comorbidity in hospitalised 0-2 year-old children in the County of...
Rasmussen, Mette; Damsgaard, Mogens T; Due, Eva Pernille;
INTRODUCTION: The objective was to study the correlation between male and female smoking prevalence in elementary school classes at grade nine through group-level analysis. MATERIAL AND METHODS: Data was collected by the 1998 Danish contribution to the cross-national study Health Behaviour in Sch...... effect of the classroom environment on the students' smoking behaviour must be considered differently for boys and girls. Udgivelsesdato: 2002-Dec-2...
Nielsen, Nete Munk; Paerregaard, Anders; Fischer, Thea Kølsen
Rotavirus (RV) is the most frequent causative agent of severe diarrhoea in infants and young children worldwide, also in Denmark. However, the actual number of diagnosed RV cases among Danish children is unknown. If a new RV-vaccine is to be introduced in Denmark, updated data on RV disease burde...
Høegh, Simon; Lohse, Nicolai; Hansen, Ann-Brit Eg;
INTRODUCTION: The incidence of new HIV diagnoses in Denmark has remained stable since 1991, but it has increased among the subgroup of homosexual men in recent years. This may reflect an actual increase in newly infected, e.g. as a result of increased risk behaviour, or it may reflect increased HIV....... MATERIALS AND METHODS: Observational study based on the Danish HIV Cohort Study, which includes all adults seen at Danish HIV clinics since 1995. RESULTS: From 2000 to 2004 the number of newly-infected homosexual men increased (from 69 to 123), particularly in persons under 30 years (from 5 to 42). The...... median CD4 cell count at the time of diagnosis increased in this group (median 19.1 cells/microL per year [95% CI: 3.7-11.3]), while it remained stable among heterosexually infected. The number of newly-diagnosed homosexually infected under 30 years with a CD4 cell count over 400 cells/microL increased...
Søgaard, Lisa Eilenberg; Christensen, Cathrine Lundgaard; Bilenberg, Niels
The present paper is a review of recent research on the prevalence of deliberate self-harm (DSH) in a non-clinical background population of adolescents during the period 2002-2008. Cutting and overdosing are the most common methods used, and the majority of adolescents engaging in DSH are girls. A...
Petersen, Lone Kjeld; Vaesel, Hanne; Brønsgaard, Poul Hede;
INTRODUCTION: Cervical cancer is caused by oncogenic human papilloma virus (HPV) serotypes. Types 16 and 18 are responsible for approximately 75% of all cases in Europe. Low-malignant serotypes like HPV 6 and 11 are the cause of approximately 90% of all cases of conyloma accuminata. Approximately...
Full Text Available Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. Patient satisfaction is thus a proxy but a very effective indicator to measure the success of doctors and hospitals. This article discusses as to how to ensure patient satisfaction in dermatological practice.
Hatlevik, Frode Severin
This Master's thesis addresses the need for further development of programs facilitating basic training in ICT for adults unfamiliar with the technology. Three different training options for self-intruction in ICT available to the Norwegian public are compared. One of theese, DataPower Learning eBorger, is studied in detail, and an empirical study following one participant's use of this program is carried out and summarized. eBorger is the Norwegian term for e-Citizen, a framework for bas...
Hellesen, Mia Iden
Introduction: Inactivity is a major public health challenge in today's society and it is important to find strategies on prevention. In Norway only 20% of the adult population meets the daily recommendations of 30 minutes of physical activity. Objective: The purpose of this study is to investigate whether CrossFit can contribute to changes in physical fitness and body composition in physically inactive men and women between 20 and 40 years. Furthermore, this study aims to see t...
Christensen, Kaj Sparle; Haugen, Wenche; Sirpal, Manjit K; Haavet, Ole Rikard
Ifølge WHO bidrager depression væsentligt til den globale sygdomsbyrde. Depressioner hos voksne har ofte deres debut i ungdomsårene. Korte, pålidelige depressionsskalaer er fremmende for tidlig identifikation af depressioner. Formålet med denne undersøgelse var at validere WHO-5 og HSCL-6...... spørgeskemaer til opsporing af depression blandt unge. Projektet blev gennemført som et multicenter-studie i almen praksis i Danmark og Norge. I alt 294 unge i alderen 14-16 år deltog ved at besvare et papir- eller webbaseret spørgeskema og gennemførte efterfølgende et Composite International Diagnostic...... Interview (CIDI), som blev brugt som diagnostisk standard. Depression blev i undersøgelsen defineret ud fra ICD-10 kriterier. Kriterievaliditeten blev undersøgt i form af Receiver Operating Curve analyser og cut-offs for depression blev beregnet ved anvendelse af Youden-indekset. Forekomsten af depression...
Ejrnæs, Morten; Gabrielsen, G.; Nørrung, Per
"Social opdrift - social arv" stiller på flere måder spørgsmål ved begrebet social arv. Bogen konkluderer blandt andet, at langt de fleste børn, der opvokser i en socialt belastet familie, bliver velfungerende voksne. Professionelle, der møder socialt belastede familier, har derfor et stort ansvar....... Naturligvis skal der tages hånd om udsatte børn, men det kræver samtidig stor opmærksomhed at sørge for, at fokuseringen på den sociale arv ikke tager overhånd, så det bliver en selvopfyldende profeti."Social opdrift - social" arv viser, hvordan forskningsresultater er blevet fremlagt på en måde, som har...... medvirket til at skabe en skæv opfattelse af, at forældrenes problemer er hovedårsag til børns sociale problemer. I selvstændige analyser vises, hvordan data, der normalt bruges som "bevis" for den sociale arvs betydning, tydeligt illustrerer, at det er en undtagelse, at børn får sociale problemer af samme...
Ludvigsen, Mette Spliid
Background: The hypothesis for the study is that the informal relationships amongst patients during hospitalisation have more influence on wellbeing, understanding of own illnesses and recovery than we until now have recognised in nursing. Aim: The purpose is to describe patients' experiences of ...
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice? The CPD article discussed the importance of effective planning when discharging patients from acute care hospitals. It emphasised the benefit of early assessment and planning, and outlined the essential principles that should be followed when discharging a patient. PMID:27332612
Lunde, Anita; Johannessen, Helle
Baggrund: Interessen for komplementær og alternativ behandling (KAB) er stadig stigende, og der kan dokumenteres et større forbrug af KAB blandt kræftpatienter. Patienter anvender primært KAB som supplement til deres konventionelle behandling, og mange så gerne KAB som en integreret praksis. Fler...
Lindeman, C A
The 120 studies included in this review were grouped in relation to five categories of variables basic to a theory of instruction in patient education. Findings in the studies related to the characteristics of the patient as learner support the following variables as significant for a theory of instruction: demographic characteristics including age, race, duration and type of illness, educational level, and family preparedness. Selected psychological variables are significant as they interact with teaching approaches. Given only two studies in which the characteristics of the nurse as teacher were the main variables, no inferences for a theory of instruction could be drawn. However, the findings from those studies combined with results from studies in which characteristics of the nurse were secondary variables support the importance of this category of variables. The educational preparation, motivation, values, and job description of the nurse implementing patient teaching appear to be significant variables for a theory of instruction. Investigators explored a wide range of teaching strategies in the studies of patient teaching. The setting for teaching, group and individual teaching, and a variety of instructional strategies all prove promising at the operational level. The instructional strategies were too diverse to allow analysis at a level of abstraction beyond the operational. Findings in this review also support characteristics of the health care setting as an important category of variables for a theory of instruction. The organizational structure, a quality assurance framework, and valuing patient teaching appear to be significant variables. Patient education research provides a rich data source for future developments in theory, practice, and research. The effectiveness of patient education as a nursing intervention is clearly established. Furthermore, positive learning outcomes are associated with a broad range of teaching strategies, content areas, and
Full Text Available Background . Complementary and alternative medicine (CAM practices for cancer have become popular among oncology patients. An increasing interest in alternative medicine can be explained by the inefficiency of conventional treatment, dissatisfaction with treating patients like objects, and the will to use all available treatment methods. Objectives . The authors assessed how often patients use CAM methods, and which of them are most popular. Material and methods . The study was conducted in Military Hospital no. 109 and the Independent Public Clinical Hospital no. 1 in Szczecin among 100 chemotherapy patients. This survey-based study was performed using an original questionnaire. Results. Most respondents (68% did not use alternative methods to fight the disease. The most popular treatment methods were: herbal medicine (50%, alternative medicine preparations (38% and diet (25%, and the least common: hypnosis (3% and aromatherapy (3%. Analyzed sociodemographic factors had no effects on a choice of a CAM method. Patients obtained information about CAM methods mainly from the Internet (40%, medical staff (37% and literature (31%. Conclusions . 1. Using CAM by patients receiving chemotherapy for neoplasms is quite a common phenomenon. 2. CAM were more often chosen by women. Neither the duration of the disease nor sociodemographic data had effects on making the decision to use CAM methods. 3. The most popular CAM were: herbal medicine, alternative medicine preparations, and diet. 4. Cancer patients should receive special support from nurses and doctors as well as other members of the therapeutic team. Oncology patients should never be left on their own so that they were forced to seek help and support in therapies unconfirmed by scientific investigation.
accounting for the views of consumers and of holding providers accountable for their care. These movements are shown to entail the staging and stabilizing of “knowing patients” in both senses of the term: these are patients that are equipped and empowered as consumers with knowledge about quality and their...
... do anything to deserve this. Find ways to increase relaxation. Patients often report that their tinnitus is less burdensome when they are relaxed. Find the activities and behaviors that best help you relax: exercise, yoga, meditation, soothing music, anything that helps you ...
... A Patient’s Perspective Live Living With Kidney Cancer Cancer Nutrition Information (AICR) Emotional Well-Being Patient Empowerment Support ... want to help themselves. Vitamin supplements and good nutrition have a role to play in cancer care. However, large doses of some supplements may ...
Valeras, Aimee Burke
This short story focuses on refugee patients. Family members talk about the horrific struggles of civil war, refugee camps, and promises of US resettlement. Their harsh reception into a brutal world includes unemployment, food scarcity, and isolation. (PsycINFO Database Record PMID:27270253
Tina Wilchen Christensen
Full Text Available Artiklen vil belyse de mekanismer, der ligger til grund for et velfungerende fællesskab i en af Indre Missions ungdomsforeninger i Århus. Troen har på forskellige måder en central position i fællesskabet, og denne artikel vil argumentere for de unges tro som en social identitet, idet deres habitus synes at have en afgørende betydning for den og deres oplevelse af det religiøst funderede fællesskab. Artiklenvil også belyse, hvordan Biblen og dens fortællinger udgør den fortolkningsramme, som de unge er opvokset med og forstår livet igennem. Artiklen viser desuden den rolle, det kollektive samvær spiller i de unges konstruktion af Gud og egen identitet som kristen.Faith as common ground- community feeling among young evangelicals in DenmarkThe aim of this article is to demonstrate the mechanisms that underlie a youth association in the so-called Home Mission, a branch of the Evangelical Lutheran Church of Denmark. It is the result of anthropological research focusing on the sense of community among members aged between 15 and 27. In a number of ways faith plays a central role in the community, and the main argument of the article is that the young people's faith constitutes a social identity, since their habitus seems to have a decisive impact on their experience of the faith-based community. The article further demonstrates how the Bible and its narratives form the framework of interpretation with which the young people have grown up, and which, in their present life as adults, continues to mould their understanding and view of life, as well as the role that collective interaction plays in the young people's construction of God and their own identity as Christians. A core argument in the article is that faith is a socialization into a structure which results in all participants having the same frame of reference and therefore experiencing a strong feeling of community with one another within this particular wing of the Church of Denmark.
Thorsen, Anne; Devantier, Louise; Ovesen, Therese
about the child's hearing status. The most significant reason for this attitude was that it would make it possible to prepare for having a deaf child. Only 6% thought that the obtained knowledge would lead to termination of pregnancy. CONCLUSION: In consistency with these parents' point of view...
Allergic and toxic initiative symptoms from skin, eyes and respiratory tract are well known among gardeners This study reports the prevalence of these symptoms among gardeners working with Ficus Benjamina (Fb) and Hedera helix (Hh).......Allergic and toxic initiative symptoms from skin, eyes and respiratory tract are well known among gardeners This study reports the prevalence of these symptoms among gardeners working with Ficus Benjamina (Fb) and Hedera helix (Hh)....
Juel, K. [Statens Insti. for Folkesundhed, Copenhagen (Denmark); Engholm, G.; Storm, H. [Kraeftens Bekaempelse, Copenhagen (Denmark)
January 21st, 1968, an American B52 bomber with nuclear weapons aboard crashed close to the Thule air-base in Greenland. In 1986 suspicions arose that there might be increased disease incidences and death rate among the employees at the base that were involved in the clearing operations. During 1986 - 1995, several health studies were made of the Thule workers. These studies of death rate, cancer, hospitalization, and fertility did not show any differences between the Thule workers from the clearing operations and those not involved in the clearing. The present study shows no difference in total death rate among the clearing workers compared to other workers. The same results were found for cancer mortality, circulatory diseases, pulmonary diseases, natural causes, and accidents. As the previous studies showed, the present study shows that there were a slightly less number of suicides among the clearing workers. The data analyses show with great certainty that the Thule workers as a group do not have a great excessive mortality or an increased cancer incidence caused by the aircraft crash. Thus, the present results fall in line with the previous investigations. (ln)
Holstein, Bjørn E; Henriksen, Pia Elena; Krølner, Rikke;
The increasing prevalence of overweight and obesity among children and adolescents suggests a need to study the development in main predictors of obesity, like eating habits and physical activity. The objective was to describe self-reported vigorous physical activity versus physical inactivity...... among children and adolescents over a period of 14 years, 1988-2002....
Jensen, Mille Elhøj
This thesis deals with narrative sensemaking among primary school leaders in Copenhagen. Based upon seven narrative meaning interviews, the thesis discusses the development of school leadership, from traditionally having being influenced by a professional leadership paradigm to now being increasingly influenced by a leadership paradigm dealing with the principles of New Public Management. This has a number of consequences for the leaders personally, as well as for the school's community of pr...
Forskningsråd. Undersøgelsen blev udført som en anonym, webbaseret spørgeskemaundersøgelse, hvor der blev stillet spørgsmål inden for 8 tekniske områder: Generelt kendskab til it-sikkerhed, Datasikring, Adgangskoder, Virus og andet ondskabsfuldt programmel, E-mail, Download, E-banking og ehandel og...
Hasle, H; Jeune, B
The significance of the conditions in childhood and adolescence for awarding of disability pension is illustrated by means of a case-control design with persons matched according to age, sex and type of work. The group investigated consisted of 581 general male workers who received middle or...... investigated and the control group. Unskilled work results in confounding as it is associated not only with poor childhood conditions and also with a high incidence of disability pension. Poor childhood conditions are not found more frequently within the group of general workers among the disability pensioners...
Faergemann, Christian; Larsen, Lars Binderup
INTRODUCTION: Since 1990, the number of persons treated at the Odense University Hospital for injuries following road traffic with registered motor vehicles has increased. In this study we wanted to examine if the increase included an increase in more severe injuries. MATERIAL AND METHODS: The...... study included all inhabitants in the Municipality of Odense treated at the Odense University Hospital for more severe injuries (MAIS > or = 3) following road traffic accidents as drivers or passengers in registered motor vehicles during the period January 1st 1990 to December 31st 1999. RESULTS: 241...... persons were included. 177 (73 per cent) were men. The median age was 29.5 years for men and 57 years for women. The total incidence was 1.3 injuries per inhabitant/year. No significant increase was recorded during the period 1990 to 1998. Single accidents without counterpart were the most frequent type...
Wieclaw, Joanna; Paludan, Merete; Rosenkilde, Mikael;
INTRODUCTION: Employees in departments of oncology in Denmark are faced with the public's expectations of increased productivity and quality. Understaffing is a serious obstacle to the fulfillment of these expectations. In 2006, the psychosocial work environment was examined among junior physicians...... and predictability at work, the assessment of the psychosocial work environment is significantly poorer. There is considerable inter-departmental variation. The junior physicians call for more staff, a higher prioritization of education, and an improved psychosocial work environment. CONCLUSION...
Holstein, Bjørn E; Henriksen, Pia Elena; Krølner, Rikke; Rasmussen, Mette; Due, Pernille
INTRODUCTION: The increasing prevalence of overweight and obesity among children and adolescents suggests a need to study the development in main predictors of obesity, like eating habits and physical activity. The objective was to describe self-reported vigorous physical activity versus physical...... collection used the standardised HBSC questionnaire which included items about vigorous physical activity (VPA) outside school hours per week. We defined physically inactivity as 0 hours of VPA per week and high activity as at least 7 hours of VPA per week. RESULTS: The prevalence of high activity was higher...... among boys than girls and increased by age. The prevalence of physically inactive students increased from 1988 to 2002, especially among the 15 year olds. The proportion of students with high activity decreased from 1988 to 2002, especially among the 15 year olds. CONCLUSION: A large proportion of...
Lau, Sofie Rosenlund; Christensen, Søren Troels; Andreasen T., Jesper
To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone.......To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone....
Lucio-Villegas Menéndez, M Eulalia; González, Laura López; Gutiérrez Pérez, M Isabel; Lluch, Natalia Aresté; Morató Agustí, M Luisa; Cachafeiro, Santiago Pérez
In wound care, knowing what to do is as important as knowing what not to do. The first step is to evaluate the severity of the lesion and to know whether it is necessary to attend a health center or not. If the wound is simple, the recommended course of action is cleansing with serum or water after washing one's hands, followed by wound disinfection with the most appropriate antiseptic. Antiseptics not should be used for wound cleansing (physiological serum or tap water should be used) or for wound healing with granulation tissue. Equally, antiseptics should not be used in the ear or near the eyes; if there is accidental application, the eye should be washed in abundant water. Povidone iodine should not be used in pregnant women, nor should iodine preparations be used in neonates, in patients with thyroid alterations or in those allergic to iodine. Currently, merbromine/mercurochrome is not used because of its mercury content. Before an antiseptic is applied, all inorganic residues (foreign bodies) and dead tissue should be removed; detritus, slough, purulent exudate, scabs… This will aid healing and the action of antiseptics, since they become inactive in the presence of organic material. PMID:24998084
Oseeva А.О.; Soboleva L.A.; Bulkina N.V.; Shuldyakov A.A.
The article presents the study of formation mechanisms and periodontitis course in patients with subclinical stage of HIV-infection. The examination of 45 patients has enabled the division of patients into three basic groups: patients with periodontitis and HIV-infection; patients with periodontitis; and HIV patients without periodontitis. It has been determined that the patients with periodontitis and subclinical HIV-infection have developed local inflammatory reaction with infection, activa...
Itri, Jason N
Patient-centered care (ie, care organized around the patient) is a model in which health care providers partner with patients and families to identify and satisfy patients' needs and preferences. In this model, providers respect patients' values and preferences, address their emotional and social needs, and involve them and their families in decision making. Radiologists have traditionally been characterized as "doctor-to-doctor" consultants who are distanced from patients and work within a culture that does not value patient centeredness. As medicine becomes more patient driven and the trajectory of health care is toward increasing patient self-reliance, radiologists must change the perception that they are merely consultants and become more active participants in patient care by embracing greater patient interaction. The traditional business model for radiology practices, which devalues interaction between patients and radiologists, must be transformed into a patient-centered model in which radiologists are reintegrated into direct patient care and imaging processes are reorganized around patients' needs and preferences. Expanding radiology's core assets to include direct patient care may be the most effective deterrent to the threat of commoditization. As the assault on the growth of Medicare spending continues, with medical imaging as a highly visible target, radiologists must adapt to the changing landscape by focusing on their most important consumer: the patient. This may yield substantial benefits in the form of improved quality and patient safety, reduced costs, higher-value care, improved patient outcomes, and greater patient and provider satisfaction. PMID:26466190
Zimmermann, Esther; Ekholm, Ola; Juel, Knud;
INTRODUCTION: Smoking is the largest modifiable risk factor for early death in Denmark, and reduction of the number of smokers is a high-priority health goal. The aim of this study was to investigate the importance of tobacco consumption and social position on smoking cessation in a representative...... sample of the Danish population. This had not previously been done in Denmark. MATERIALS AND METHODS: The data were derived from the Danish Health and Morbidity Surveys of 1994 and 2000. The study population consisted of persons between 25 and 64 years of age who smoked in 1994 and who were re...
Lange, Synne De
Diabetes type 2 får i dag tittelen ”klodens moderne epidemi”, da omtrent 344 millioner mennesker lever med denne sykdommen. Forskning viser at diabetes type 2 pasienter har betydelig dårligere livskvalitet enn personer uten denne sykdommen, der egenomsorgen ofte er svært redusert. Etter et sterkt møte med to diabetes pasienter med svært forskjellig egenomsorgsbehov, vekket interessen for hvordan jeg som sykepleier kunne styrke egenomsorgen til diabetes type 2 pasienter. Dorothea Orem er en po...
Caregivers awareness of sexualityThis study deals with the results from two focus group interviews with 13 students from education in "Sexology and Disability" by Oslo and Akershus University College (HIOA). The purpose of this study was to highlight the experiences and perceptions of employees in their work with the theme of sexuality.Findings from the study show that it is still difficult to talk openly about people with developmental disabilities and their sexuality. Many see it as a taboo...
Full Text Available Caregivers awareness of sexualityThis study deals with the results from two focus group interviews with 13 students from education in "Sexology and Disability" by Oslo and Akershus University College (HIOA. The purpose of this study was to highlight the experiences and perceptions of employees in their work with the theme of sexuality.Findings from the study show that it is still difficult to talk openly about people with developmental disabilities and their sexuality. Many see it as a taboo area. The study shows that both the caregiver and care recipient are in need of training. Staff working with the theme of sexuality may feel stigmatized by colleagues. They get little support from managers and colleagues.Management must ensure good care for the client. The study indicates that employees should have knowledge and methods to meet the challenges of sexual education and prevent abuse.
Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim
CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical...
Houston, Robert E.
Over 25 years ago, Kubler-Ross identified anger as a predictable part of the dying process. When the dying patient becomes angry in the clinical setting, all types of communication become strained. Physicians can help the angry dying patient through this difficult time by using 10 rules of engagement. When physicians engage and empathize with these patients, they improve the patient's response to pain and they reduce patient suffering. When physicians educate patients on their normal response...
Pii, Kathrine Hoffmann
Intro: This paper discusses a central professional dilemma in patient-centred education: on one hand the concern for ensuring patients autonomy and right to make their own decisions regarding their treatment and, on the other hand, a concern for getting patients to make the “right” decisions that...... will improve their health condition. The patient-centred approach (and related concepts: patient participation, involvement, and empowerment) is being promoted both in healthcare politics and by healthcare professionals as a way to achieve more active self-managing and self-caring patients. Patient......-centredness is thus promoted as a way to organize health more effectively (in terms of cost and treatment outcomes) and as a way to ensure patients’ autonomy and fundamental right to make their own decisions regarding their treatment. Critical voices within social and nursing theory have however argued that the...
Department of Veterans Affairs — The Patient Assessment File (PAF) database compiles the results of the Patient Assessment Instrument (PAI) questionnaire filled out for intermediate care Veterans...
Full Text Available Physician-patient relationship is unique in some aspects and not-so-unique in other aspects when compared to other human interactions. Until-unless for the sake of health promotional activities, this relationship is almost always conceived in the times of human sufferings and consequently culminated when those sufferings have subsided as well as sought out happiness has ensued/been achieved. However, not all physician-patient relationships follow the normal course and/or meet the natural ends. These abnormal relationships are not inconsequential in terms of numbers and/or their effects (short-term and long term on both patients and physicians. Every country has its own baggage in the wake of why, how and what about these abnormal ends to physician-patient relationships; however, the most common causes are the patients’ inability to pay their medical bills, the conflicting goals of physicians and their patients in regards to patients’ sufferings’ management and finally the behavioral issues (patients’ and/or physicians’ interfering these relationships. Irrespective of any cause, the physicians should never forget that the patient can always discharge their physicians and discontinue their relationship with their physicians without any reason (until unless the physicians deem those patients either incapable/non-consentable to do so and/or potential threat to their own personal safety or other people’s safety. Contrarily, physicians can also discharge patients from their care but cannot abandon these patients (1-3 which mean that physicians have to ensure their discharged patients either are referred to or have sought another physician within appropriate time frame post-relationship-discontinuation. Each country has their own medico-legal liabilities that vary in terms of penalties imposed; however, irrespective of the feared legal concerns, the physicians should not forget that ethical essence of medicine is the art of healing that
Bredland, T; Duesund, R
This article reviews the concept of day surgery and shows how the treatment can be organized pre-, per- and post-operatively. It can be established in a hospital-integrated unit, a unit separate from the hospital, but connected with it, or a satellite ambulatory facility. Because the patient spends only a short time in hospital it is necessary to have structured preparations before admission, for the benefit of both patient and staff. It should be easy to identify patients suitable for day surgery from the waiting lists, and preparations should be directed at treatment by day surgery right from the start. Rules must be worked out for selecting patients, as well as guidelines for information to patients. It is also necessary to plan the operation programme, and to agree how nurses and doctors should take care of the patient during the different steps of treatment. PMID:8658453
Campbell, Catherine; Scott, Kerry; Skovdal, Morten;
, physical cleanliness, honesty, gratitude and lifestyle adaptations (taking pills correctly andcoming to the clinic when told). As healthcare workers may decide to punish patients who do not live up the‘good patient persona’, many patients seek to perform within the confines of the ‘good patient persona’ to...
Barfod, S.; Saunders, J.; Wutzke, S.
Artiklen omtaler de danske resultater af en spørgeskemaundersøgelse blandt praktiserende læger i 16 lande. Af de 304 besvarelser angiver 91%, at de højst behandler 2 patienter om måneden for alkoholproblemer. Læger med erfaring i alkoholbehandling, og læger, der arbejder mest, spørger oftere dere...
Nielsen, Mette Kjaergaard; Neergaard, Mette Asbjoern; Jensen, Anders Bonde;
Sorgsymptomer under sygdomsforløbet blandt pårørende til terminalt syge patienter har været forbundet med både forværret og forbedret sorgreaktion efter dødsfaldet. Dette systematiske review viste, at pårørende med svær grad af sorgsymptomer før patientens død har øget risiko for at udvikle alvor...
Pedersen, Anette Fischer; Vedsted, Peter
Udbrændthed er et stigende problem blandt alment praktiserende læger i Danmark. Dette studie viser, at alment praktiserende læger med en stor andel af socialt udsatte patienter på deres liste har større risiko for at være udbrændte sammenlignet med alment praktiserende læger med en lille andel af...
Pors, Anja Svejgaard
target groups for which information can be standardized. In the latter approach (market orientation), the patient is also a resource for organizational development. Overall, the strategy presents an information-pursuing patient figure that makes it possible to streamline the organization's care...... in Copenhagen, Denmark. Based on situational analysis of internal documents, the paper gives an empirical account of the work of strategic documents and explores how the documents organize patient communication through displacements of the patient. This paper shows that the hospital’s patient...... communication is not only about disease treatment, but also about ‘information treatment’ for the purpose of increasing patient satisfaction at the hospital. The goal of patient satisfaction addresses both a care-oriented approach to the patient and also deploys market perceptions of patients as homogeneous...
Pors, Anja Svejgaard
as an affective care recipient, as a citizen with rights and as an individual need-oriented user on the one hand. On the other hand, the goal of patient satisfaction also deploys market perceptions of patients as homogeneous target groups to which information can be standardised. In the latter......The analysis is based on an empirical study of a hospital’s communication strategy entitled: 'The Perspective of the Patient'. The paper asks how the strategy organizes communication work as situated displacements of the patient. Based on methodological elements from situational analysis (Clarke...... 2005) the analysis examines how the hospital’s patient communication is not just about disease treatment, but rather about information treatment of the patient in order to attain a high level of patient satisfaction. The goal of patient satisfaction addresses care-oriented understandings of the patient...
Pors, Anja Svejgaard
a care-oriented approach to the patient and also deploys market perceptions of patients as homogeneous target groups to which information can be standardized. In the latter approach (market orientation), the patient is also a resource for organizational development. Overall, the strategy presents an......This analysis is based on an empirical study of a Danish hospital‟s communication programme entitled: 'The Perspective of the Patient'. The paper explores how strategic documents of the programme organize the communication work through situated displacements of the patient. Based on methodological...... elements from situational analysis (Clarke 2005) the analysis examines how the hospital‟s patient communication is not only about disease treatment, but rather about information treatment of the patient in order to attain a high level of patient satisfaction. The goal of patient satisfaction addresses both...
... contact us TEXT SIZE IMF Multiple Myeloma Patient Handbook 2016 One of the most daunting aspects of ... with each of these steps. The IMF’s Patient Handbook is meant to furnish you with the tools ...
... Professional Learning Series Webcasts CPPS Review Course E-Learning Patient Safety Curriculum CPPS Review Course Patient Blood Management Reducing Diagnostic Error Health Info Technology Publications Ask Me 3 For ...
Ludvigsen, Mette Spliid
Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients in...... hospitals today. Purpose The purpose was to explore how informal relationships between patients affect their hospital experiences in the hospital. The assumption is that, on the one hand, the impacts on patients' suffering affect the way they act and experience encounters with fellow patients for good or....... Methods The study is designed within a phenomenological-hermeneutical philosophic frame of reference and is based on ethnographic fieldwork among hospitalised patients in a Danish university hospital. Data for the study were collected through participant observations over a period of 18 months. Nine males...
Sestoft, Bodil; Larsen, Birgit; Erlandsen, Mogens;
INTRODUCTION: The aim of this study was to answer the questions: Which kind of positioning injuries occurred in anaesthetized orthopaedic patients undergoing spine surgery who were prone-positioned for more than two hours? What was the incidence of positioning injuries? Which patients were at...... particular risk of developing positioning-related injuries? MATERIAL AND METHODS: Follow-up study comprising 299 patients. A patient record followed the patient from the day of surgery until discharge. Selected pre-disposing factors related to positioning injuries as well as positioning-related injuries were...... registered. One year after surgery, localisation, duration and treatment of positioning-related injuries were registered. A total of 299 patients were included. Among these, 60 patients died within the first year, and 52 could not be reached. The remaining 187 patients were interviewed by telephone one year...
... of these new biomarkers can indepen- dently pred ict that a patient with SMM has an 80% ... stop or adjust doses on your own. Patient education sheets on preventing blood clots and thromboembolic events, ...
Henriksen, Ann-Helen; Ringsted, Charlotte
Prior research on the use of patients as teachers has focused on testing the effectiveness of this practice and exploring its benefits for students. However, very little is known about the added value of patient teaching and how it relates to patient-centred learning. The aim of this study was to...
Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J
National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. PMID:27046182
Curtis, Ffion; Hurlin, Claire; Tomlinson, Sarah; Thatcher, Rhys; Rice, Sam
Aims and Objectives: To assess the feasibility of conducting a randomised control trial to evaluate the effectiveness of a patient delivered education programme for Type 2 diabetes in a Welsh population and to explore a range of factors that could inform future delivery of such a programme. Design: A randomised case control study was deployed. 60 newly diagnosed Type 2 diabetes patients were recruited (40 into a treatment arm and 20 into a control arm). Participants were randomly allocated...
Oropeza, Athamaica Ruiz; Mikkelsen, Søren; Bindslev-Jensen, Carsten;
intramuskulær adrenalin (64 % ifølge Sampson’s skala og 76 % ifølge Muraro’s). Af de 38 patienter der blev set i Odense fik 66 % intravenøs (IV) binyrebarkhormon, 63 % IV antihistamin og 5 % IV adrenalin (blandt dem med moderat til svær anafylaksi fik op til 77 % IV binyrebarkhormon og op til 82 % IV...... antihistamin). Blandt de 55 patienter i resten af Region Syddanmark fik 80 % IV binyrebarkhormon, 78 % IV antihistamin og 7 % IV adrenalin (blandt dem med moderat til svær anafylaksi fik op til 94 % IV binyrebarkhormon og op til 90 %, IV antihistamin). Af dem der fik IV adrenalin havde 2 ud af 2 tidligere fået...... intramuskulær adrenalin i Odense-området og 1 ud af 4 i resten af Region Syddanmark. Konklusion: Over 50 % af de reporterede tilfælde af allergi efter bi- og hvepsestik kunne gradueres som moderat til svær anafylaksi. Lang de fleste fik behandling med IV binyrebarkhormon og antihistamin, men kun omkring 50 % af...
Full Text Available The article presents the study of formation mechanisms and periodontitis course in patients with subclinical stage of HIV-infection. The examination of 45 patients has enabled the division of patients into three basic groups: patients with periodontitis and HIV-infection; patients with periodontitis; and HIV patients without periodontitis. It has been determined that the patients with periodontitis and subclinical HIV-infection have developed local inflammatory reaction with infection, activation of anti-inflammatory cytokines in parodontal recess fluid. It has been proved that the causative factor of frequent and durable relapses in parodontal pathology with clinical HIV-infection was the development of pathologic process with endotoxicosis syndrome and imbalance of lipid peroxidation and antioxidant system
Patient-centered care focuses on the patient and the individual's particular health care needs. The goal of patient-centered health care is to empower patients to become active participants in their care. This requires that physicians, radiologic technologists and other health care providers develop good communication skills and address patient needs effectively. Patient-centered care also requires that the health care provider become a patient advocate and strive to provide care that not only is effective but also safe. For radiologic technologists, patient-centered care encompasses principles such as the as low as reasonably achievable (ALARA) concept and contrast media safety. Patient-centered care is associated with a higher rate of patient satisfaction, adherence to suggested lifestyle changes and prescribed treatment, better outcomes and more cost-effective care. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store. According to one theory, most patients judge the quality of their healthcare much like they rate an airplane flight. They assume that the airplane is technically viable and is being piloted by competent people. Criteria for judging a particular airline are personal and include aspects like comfort, friendly service and on-time schedules. Similarly, patients judge the standard of their healthcare on nontechnical aspects, such as a healthcare practitioner's communication and "soft skills." Most are unable to evaluate a practitioner's level of technical skill or training, so the qualities they can assess become of the utmost importance in satisfying patients and providing patient-centered care.(1). PMID:19901351
Full Text Available It is not enough to consider treatment and care depression in the oncology that is the most common psychiatric illness in cancer patient affects of cancer treatment and the patient`s quality of life negatively, which is determined through researches in the field. With development of psycho-oncology it has been demonstrated to establish an important link between the cancer patient`s treatment as well as psycho-social support for the patient and psychiatric treatment and care for the if it is needed. With this connection between them it has been proposed to use of bio-psycho-social-model in cancer patient to improve their care. To achieve this goal, it is expected from medical personnel to realize patients psychosocial need und if he/she has a psychiatric disorders or syndromes. For the medical personnel that work in oncology services, it is inevitable to organize in order to raise the awareness of depression in the cancer patients. In the present study, it is focused on raising the awareness of depression in cancer patient for the medical personnel. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 186-198
Stroke is one of the most serious health problems in the world, cited as being the second leading cause of death. After stroke, there is a greater risk of suffering second and further subsequent stroke-events. Given the heavy burden of disease present by stroke, there is a great need to improve patient education for stroke survivors, who are at an increased risk of another cerebrovascular accident. The purpose of this thesis is to develop the quality of patient education in nursing care o...
Gross, B; Ketema Wassie, F; Agnholt, Hanne;
Music for hemodialysis patients Background Patients starting a new regimen of dialysis often experience anxiety and other psychological disturbances. They struggle with the unknown situation, feelings of uncertainty and on top of that, a high level of sophisticated technological equipment. Music...... is known from literature to influence and dampen anxiety and tension and has been used for millennia in the treatment of illness. Here we report a study on the influence of music on patients undergoing dialysis and whether music has a potential for lowering discomfort in patients during first-time dialysis....... Purpose To investigate whether music can reduce feelings of anxiety, tension and restlessness in patients new to dialysis treatment and make them more relaxed during the treatment. Method Twenty patients aged 42-84 were selected for participation in the study, which took place over two separate dialysis...
van Brummelen, S E; de Vries, E; Schneeberger, P M; van Binnendijk, R S; Lestrade, P; Wever, P C
Two patients, men aged 17 and 19 years respectively, were admitted with parotitis epidemica and orchitis caused by mumps. The second patient also had meningitis. PCR analysis revealed that, in both cases, the causative agentwas a mumps virus that was genetically related to a wild-type virus responsible for an outbreak in Singapore. This viral strain was also responsible for a mumps outbreak at Hotel School The Hague in September 2004. Both patients were not fully vaccinated. Both patients were from regions in which clustering of patients with clinical signs of mumps has been seen. Interestingly, a number of patients with confirmed mumps had been fully vaccinated. Possible explanations for the increase in mumps cases include low vaccination and immunity levels, primary and secondary vaccine failure and the emergence of genetically disparate mumps viruses. PMID:16924947
Feitelberg, Steven P
The KP Patient Safety Executive Walkarounds Program in the KP San Diego Service Area was developed to provide routine opportunities for senior KP leaders, staff, and clinicians to discuss patient safety concerns proactively, working closely with our labor partners to foster a culture of safety that supports our staff and physicians. Throughout the KP San Diego Service Area, the Walkarounds program plays a major part in promoting responsible identification and reporting of patient safety issue...
A patient robot with an oral cavity mimicking unexpected movement due to vomiting and pain and functions to induce bleeding and saliva flow was developed and used for clinical training. Trainee students and clinical residents were asked to complete a questionnaire about the patient robot. The results showed the patient robot to be effective as a means of training students to respond to unexpected movements during surgical procedures. In the future, the author intend to incorporate additional ...
Christensen, Dorthe Wiinholdt; Andersen, Rene Richard; Rydahl-Hansen, Susan
Between 50 and 83 per cent of patients with a tracheostomy have difficulty swallowing. A study comprising 553 patients found aspiration and silent aspiration in respectively 48.8 per cent and 36.8 per cent of patients. As aspiration into the lungs is the commonest cause of hospital-acquired infec......Between 50 and 83 per cent of patients with a tracheostomy have difficulty swallowing. A study comprising 553 patients found aspiration and silent aspiration in respectively 48.8 per cent and 36.8 per cent of patients. As aspiration into the lungs is the commonest cause of hospital...... fluid/food when the tracheostomy is cuffed; whether nurses should ideally test patients for mis-swallowing and the extent to which nurses can prevent mis-swallowing. A systematic review showed that it makes a difference whether the patient is cuffed or uncuffed when fluid/food is administered. We also...... found a number of tools suitable for use in testing for dysphagia. We still do not know whether dysphagia can be prevented in tracheostomy patients, as we did not find answers to this question in the scientific literature.....
Damsgaard, Janne Brammer; Bastrup, Lene; Norlyk, Annelise; Birkelund, Regner
back patient and what back patients consider important when dealing with the healthcare system. Methods: The method draws on James Thomas' and Angela Hardens approach in "Methods for the thematic synthesis of qualitative research in systematic reviews" (2008). The thematic synthesis aims to systematise...... and integrate findings of qualitative studies. Results: The analysis reveals that many back patients feel that their experiences and perceptions are ignored by the health professionals, who are often concerned about identifying the cause. This can result in patients feeling mistrusted, marginalised...
Denne ph.d. afhandling omhandler 3D ganganalyse af raske og apopleksipatienter. Formålet med afhandlingen var at estimere referenceværdier for power i et udvalg af underekstremitetens muskelgrupper, samt at estimere ændringer i muskelgruppers power, når ganghastigheden øges blandt raske og...... baseret på fire artikler, som alle er indsendt til ”peer-review” tidsskrifter. Power af plantarfleksorerne, hofteekstensorerne, hoftefleksorerne, hofteabduktorerne og knæekstensorerne blev vurderet i et 3D ganganalysesystem ved en foretrukken ”normal” ganghastighed (studie et til tre). Ligeledes blev...... ganghastighed og gangsymmetri, målt som (1) absolut skridtlængde ratio, (2) en svingfase ratio og (3) enkeltstandfase tiden på hemiparetiske ben (studie fire), vurderet ved hjælp af ganganalyse. Resultaterne viste, at reference power værdier beskrevet med et forventet ”normalom-råde” var et anvendeligt klinisk...
Odlaug, Brian Lawrence; Weinhandl, Eric; Mancebo, Maria C;
Over the past 30 years, clinical trials have resulted in several successful pharmacotherapies for obsessive-compulsive disorder (OCD), yet patients in clinical settings often report inadequate response. This study compares clinical characteristics of treatment-seeking OCD patients to the inclusion...
Clinicians need a better understanding of transgender populations and a systematic approach to treating transgender patients medically and psychologically while managing any potential judgment or bias. This article explains key concepts, describes transgender patient health concerns, and discusses how to perform a comprehensive history. PMID:27228044
The issue of whether patients should always be told the truth regarding their diagnosis and prognosis has afforded much debate in healthcare literature. This article examines telling the truth from an ethical perspective. It puts forward arguments for and against being honest with patients, using a clinical example to illustrate each point.
Hsu, D H
Dyspnea is common in terminally ill patients and is often fairly difficult to control. If specific causes cannot be identified or treated, general measures to relieve symptoms should be used. Nondrug measures (eg, discussion and explanation with the patient) and drug measures (eg, morphine) can be used to control the dyspnea, although side effects, such as sedation, can be problematic.
Full Text Available Managing a bleeding patient is very challenging for the perioperative physician. Bleeding in a patient would be due to inherited or acquired disorders of haemostasis. Identifying the patients at risk of bleeding and utilising prophylactic treatment protocols has good outcomes. Along with clinical signs, trends in monitoring coagulation parameters and analysing blood picture are necessary. Management of patients in the postoperative period and in intensive care unit should be focused on normalization of coagulation profile as early as possible with available blood and its products. Available recombinant factors should be given priority as per the approved indications. Exploring the surgical site should be considered for persistent bleeding because haemodynamic compromise, excessive transfusion of fluids, blood and its products and more inotropic support may have a negative impact on the patient outcome.
Sørensen, Dorthe; Frederiksen, Kirsten; Grøfte, Thorbjørn;
Objectives: This paper provides a theoretical account of nurses’ collaboration with patients with chronic obstructive pulmonary disease during non-invasive ventilation treatment in hospital. Background: Despite strong evidence for the effect of non-invasive ventilation treatment, success remains a...... huge challenge. Nurse-patient collaboration may be vital for treatment tolerance and success. A better understanding of how nurses and patients collaborate during non-invasive ventilation may therefore contribute to improvement in treatment success. Design: A constant comparative classical grounded...... theory. Method: The data comprised sessions of qualitative participant observation during the treatment of 21 patients with non-invasive ventilation that included informal conversations with the nurses and semi-structured interviews with 11 patients after treatment completion. Data were collected at...
The objectives of this study were to determine the entrance surface dose to the patient and to estimate the dose to the uterus and ovaries due to hysterosalpingography (HSG) diagnostic examinations performed in Recife-Pe, Brazil. The entrance doses were measured using four thermoluminescent dosimeters per patient, attached to anatomical landmarks on the patient's skin. The study was carried out on 25 patients between 21 and 45 years of age who underwent the HSG examinations in two training hospitals and one private radiodiagnostic institute. The number of exposures performed ranged from 4 to 15 radiographs per patient measured. Entrance surface doses varied between 4.99 and 36.6 mGy, with an average of 12.6mGy. The doses to the ovaries and uterus ranged from 0.80 mGy to 5.8 mGy and 1.10mGy to 8.05 mGy, respectively. (author)
Holmes-Rovner, M; Rovner, D R
Patient decision support (PDS) tools or decision aids have been developed as adjuncts to the clinical encounter. Their aim is to support evidence-based patient choice. Clinical trials of PDS tools have used an array of outcome measures to determine efficacy, including knowledge, satisfaction, health status and consistency between patient choice and values. This paper proposes that the correlation between 'subjective expected utility' (SEU) and decision may be the best primary endpoint for trials. SEU is a measure usually used in behavioural decision theory. The paper first describes how decision support tools may use decision analysis to structure the presentation of evidence and guide patient decision-making. Uses of expected utility (EU) are suggested for evaluating PDS tools when improving population health status is the objective. SEU is the theoretically better measure when internal consistency of patient choices is the objective. PMID:11083037
Bagger, Bettan; Taylor Kelly, Hélène; Hørdam, Britta
Every year millions of patients worldwide suffer injury or death due to unsafe care, thus improving patient safety is both a national and international priority. A developmental project involving University College Zealand and clinical partners in the region focused upon the improvement of patient...... safety by optimizing the theory-practice connection with respect to the development of students’ competencies and the reporting of clinical errors. Population: 2nd year nursing students at University College Zealand (N: 56). Informed consent and full anonymity. Aims: - To increase patient safety by...... raising student awareness with respect to the role of the reporting of clinical errors and thus increase patient safety - To prepare a structured and systematical teaching program Methodology: an explorative, longitudinal study - Identification of students’ self-evaluated knowledge, skills and competences...
Pedersen, Anette Fischer; Hansen, Rikke P; Vedsted, Peter
Blødning fra endetarmen ses normalt som et alarmsymptom på kolorektalkræft. Alligevel vælger mange patienter at lade være med at opsøge lægen. Denne artikel ser nærmere på sammenhængen mellem et alarmsymptom (rektal blødning), forsinkelser i patientforløbet og tanker om kræft. Resultaterne viser,...
Bagger, Bettan; Taylor Kelly, Hélène; Hørdam, Britta
Improving patient safety is both a national and international priority as millions of patients Worldwide suffer injury or death every year due to unsafe care. University College Zealand employs innovative pedagogical approaches in educational design. Regional challenges related to geographic......, social and cultural factors have resulted in a greater emphasis upon digital technology. Attempts to improve patient safety by optimizing students’ competencies in relation to the reporting of clinical errors, has resulted in the development of an interdisciplinary e-learning concept. The program makes...
Patient exposures arising from radiological procedures form the largest part of the population exposure from artificial sources of radiation. According to United Nations Scientific Committee on the Effects of Atomic Radiation, the annual frequency of X ray examinations is 360 per 1000 individuals worldwide. Owing to the associated risk of radiation detriment to the patient, there is a clear need to monitor and control these exposures, and to optimize the design and use of the X ray imaging equipment so that the patient dose is reduced as far as possible, consistent with achieving the required clinical image quality
Waaddegaard, Mette; Davidsen, Michael; Kjøller, Mette
disorders and also to SF-36 and Perceived Stress Scale (PSS). RESULTS: Women with risk behaviour for eating disorders have a lower score on all subscales of SF-36 than women without risk behaviour. The differences are significant for the subscales for mental health, vitality, social function and general......INTRODUCTION: To improve the early identification of eating disorders the study tested whether women with risk behaviour for eating disorders have lower health-related life quality and more perceived stress than women without risk behaviour. MATERIAL AND METHODS: The study was a representative...... health. They also have a higher mean score on PSS than women without risk behaviour. CONCLUSION: Women with risk behaviour for eating disorders have lower mental health-related life quality than women without risk behaviour. They also experience daily life as more unpredictable, stressful and difficult...
Holstein, B E; Ito, H; Due, P
A total of 1,671 schoolchildren aged 11, 13 and 15 years answered an anonymous questionnaire in 1988 on their social backgrounds, social networks, health, life satisfaction and health behaviour. The proportions who had tried to smoke were 24%, 51%, and 66% in the three age groups; the proportions...... of smokers were 3%, 8%, and 29%, and the proportions of daily smokers were 0%, 2% and 6%. More girls than boys were smokers but there was almost no difference if place of residence, social class, or family type were considered. Almost the entire variation could be explained by best friends' smoking...
Idéen om denne Ph.D. et vokset ud af et ønske om at afdække de faktorer, der ligger til grund for, at personer med høretab oplever stress, som kan resultere i stressrelateret sygefravær fra arbejdspladsen. Målgruppen er erhvervsaktive personer med høretab, som anvender det talte og auditive sprog som det primære. Studiet bygger på en biopsykosocial stressforståelse og en salutogenetisk overbevisning, der handler om, at forskellige aspekter og kontekster i livet hænger uløseligt sammen og at h...
Jørgensen, Marianne Johansson
respondenternes alkoholindtagelse hele livet samt det sidste år, og en høj floor effekt for det item, der relaterede sig til alkoholindtagelsen den sidste måned. Både Rosenbergs Self-esteem skala og kondom Self-efficacy skalaerne viste god intern overensstemmelse (α>0,8), og spørgeskemaets test...
Nordestgaard, Børge G; Benn, Marianne; Schnohr, Peter;
We followed 13,981 Danes for 26 years, during which 1,793 developed myocardial infarction and 7,818 died. Women with elevated non-fasting triglycerides had hazard ratios for myocardial infarction of 2.2 for triglycerides of 1-1.99 mmol/L, 4.4 for 2-2.99 mmol/L, 3.9 for 3-3.99 mmol/L, 5.1 for 4......-4.99 mmol/L, and 17 for > or = 5 mmol/L versus women with triglycerides Hazard ratios for death were 1.3, 1.7, 2.2, 2.2, and 4.3 in women and 1.3, 1.4, 1.7, 1.8, and 2.0 in men with increasing triglycerides versus
Holstein, B E; Ito, H; Due, P
A total of 1,671 children aged 11, 13 and 15 years from a nationwide random sample of schools completed an anonymous questionnaire on their social backgrounds, social networks, health, life satisfaction, and health behaviour. The proportion practising outdoor activities at least three times a week...... do physical exercise at the age of 20. High intensity of physical activity was associated with high social class, strong social integration in the peer group, easy contact with parents and friends, physical exercise among parents and best friends, high degree of life satisfaction, and good health...
Hjøllund, Niels Henrik; Jensen, Tina Kold; Bonde, Jens Peter;
Mental distress has often been suggested as a cause of unexplained infertility. However, the causal direction may well be from infertility to distress, and prospective data are needed. We therefore followed 393 couples, who were planning their first pregnancy, with prospective collection of infor...... was based on a small number of observations. It is concluded that psychological distress may be a risk factor for reduced fertility in women with long menstrual cycles.......Mental distress has often been suggested as a cause of unexplained infertility. However, the causal direction may well be from infertility to distress, and prospective data are needed. We therefore followed 393 couples, who were planning their first pregnancy, with prospective collection of...... information on distress from termination of birth control until pregnancy for a maximum of six menstrual cycles. The analyses included 1,475 menstrual cycles, and mental distress was measured in each cycle by the General Health Questionnaire (GHQ). Urine samples from each period of vaginal bleeding were...
Mørkeberg, Stine Enslev
During the last few years there has been a lot of news in the mass media about crime, violence and vandalism in the district of Tingbjerg in Copenhagen. In these news young men of other ethnicity than Danish are often connected with the negative activities. In this context this project explores the self-perceptions and the experiences of categorization among young men of other ethnicity than Danish from the district Tingbjerg in Copenhagen. The method of the project is qualitative and soci...
Waaddegaard, Mette; Davidsen, Michael; Kjøller, Mette
INTRODUCTION: To improve the early identification of eating disorders the study tested whether women with risk behaviour for eating disorders have lower health-related life quality and more perceived stress than women without risk behaviour. MATERIAL AND METHODS: The study was a representative...... disorders and also to SF-36 and Perceived Stress Scale (PSS). RESULTS: Women with risk behaviour for eating disorders have a lower score on all subscales of SF-36 than women without risk behaviour. The differences are significant for the subscales for mental health, vitality, social function and general...... health. They also have a higher mean score on PSS than women without risk behaviour. CONCLUSION: Women with risk behaviour for eating disorders have lower mental health-related life quality than women without risk behaviour. They also experience daily life as more unpredictable, stressful and difficult...
Brøndum, Eva; Lange, Peter; Vestbo, Jørgen
We wanted to examine the factors that were of importance for the hospital outpatient treatment of teenagers with asthma.......We wanted to examine the factors that were of importance for the hospital outpatient treatment of teenagers with asthma....
U.S. Department of Health & Human Services — The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...
Damsgaard, Janne Brammer; Bastrup, Lene; Norlyk, Annelise; Birkelund, Regner
and integrate findings of qualitative studies. Results: The analysis reveals that many back patients feel that their experiences and perceptions are ignored by the health professionals, who are often concerned about identifying the cause. This can result in patients feeling mistrusted, marginalised...... and reluctant to speak out. Therefore, telling about experiences and perceptions is important for back patients in order to feel accepted and acknowledged. The health professionals must incorporate the patients’ narratives as an integral part of the care and treatment. Conclusions: In order to...... acknowledge the back patient the narrative must be complemented by a different perspective that includes the issue of ethical responsibility. It is therefore also a question of adopting certain norms as binding; to be bound by obligation or loyalty. Thus, the literature review argues for a more process...
Geiker, Nina Rica Wium
(Paper I). The present study is, to my knowledge, the only study investigating the validity of performed nutritional risk screenings by comparing them with medical records. Eight per cent of patients were correctly screened for nutritional risk. A total of 24% of 2393 patients were nutritionally screened......Malnutrition, under-nutrition and/or obesity, may develop due to disease but may also cause disease. The prevalence of under-nutrition among hospitalized patients is high: 40-60% are either already under-nourished on admittance or at-risk of becoming malnourished. As in the general population...... of prescription medication, and take longer to recover. Acknowledging the adverse effects of malnutrition on health, since 2006 it has been mandatory to screen all patients for nutritional risk within 24 hours of admittance at all hospitals in the Capital Region, Denmark. The compliance to and the validity...
U.S. Department of Health & Human Services — A list of the state averages for the HCAHPS survey responses. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent...
It has been suggested that it is very important to position patients reproducibly at different stages of radiotherapy treatment planning and treatment, or similar procedures. Devices have been described for positioning a patient's upper and lower thorax. This invention provides reproducible positioning for a female patient's breasts, for example in planning treatment of and treating breast tumours. The patient is placed prone, using for example an upper thorax device. A support device is placed central to and beneath her breasts to partially displace them outwards. The device may be triangular in section with one apex contacting the chest wall at the sternum. Restraining straps may be provided to hold the breasts against the support device. Means may be provided to take a healthy breast from the path of radiation through the tumour. (author)
Federal Laboratory Consortium — he National Capital Area (NCA) Medical Simulation Center is a state-of-the-art training facility located near the main USU campus. It uses simulated patients (i.e.,...
Department of Veterans Affairs — This database is part of the National Medical Information System (NMIS). The Patient Treatment File (PTF) contains a record for each inpatient care episode provided...
Conclusion: Traumatic asphyxia is a clinical condition caused by blunt thoracoabdominal trauma, and with good trauma management patients can be discharged with less mortality and morbidity. [Cukurova Med J 2014; 39(4.000: 914-917
Kirti Rajesh Bendre; Tanvi Vijay Tuteja; Geeta Madhav Niyogi
Background: Objectives: To review all obstetric patients admitted in Intensive Care Unit (ICU) to access ethiology, required interventions, maternal mortality and to identify the conditions associated with maternal death. Methods: This is a retrospective study carried out in a medical college with tertiary hospital facility in Mumbai. The ICU admissions for a period of 5 years from October 2005 to October 2010 were reviewed. Results: Over 5 years, 48 out of 10800 obstetric patients wer...
King-Wing Ma, Terry; Kam-Tao Li, Philip
Depression is the most common psychiatric illness in patients with end-stage renal disease (ESRD). The reported prevalence of depression in dialysis population varied from 22.8% (interview-based diagnosis) to 39.3% (self- or clinician-administered rating scales). Such differences were attributed to the overlapping symptoms of uraemia and depression. Systemic review and meta-analysis of observational studies showed that depression was a significant predictor of mortality in dialysis population. The optimal screening tool for depression in dialysis patients remains uncertain. The Beck Depression Inventory (BDI), Patient Health Questionnaire (PHQ) and Center for Epidemiologic Studies Depression Scale (CESD) have been validated for screening purposes. Patients who scored ≥14 using BDI should be referred to a psychiatrist for early evaluation. Structured Clinical Interview for DSM disorders (SCID) remains the gold standard for diagnosis. Non-pharmacological treatment options include cognitive behavioural therapy and exercise training programs. Although frequent haemodialysis may have beneficial effects on patients' physical and mental well-being, it cannot and should not be viewed as a treatment of depression. Selective serotonin reuptake inhibitors (SSRIs) are generally effective and safe in ESRD patients, but most studies were small, non-randomized and uncontrolled. The European Renal Best Practice (ERBP) guideline suggests a trial of SSRI for 8 to 12 weeks in dialysis patients who have moderate-major depression. The treatment effect should be re-evaluated after 12 weeks to avoid prolonging ineffective medication. This review will discuss the current understanding in the diagnosis and management of depression in dialysis patients. PMID:26860073
Sabio Paz, Verónica; Panattieri, Néstor D; Cristina Godio, Farmacéutica; Ratto, María E; Arpí, Lucrecia; Dackiewicz, Nora
Patient safety and quality of care has become a challenge for health systems. Health care is an increasingly complex and risky activity, as it represents a combination of human, technological and organizational processes. It is necessary, therefore, to take effective actions to reduce the adverse events and mitigate its impact. This glossary is a local adaptation of key terms and concepts from the international bibliographic sources. The aim is providing a common language for assessing patient safety processes and compare them. PMID:26294153
To measure the frequency of depression and its risk factors in patients under going hemodialysis. It is a cross-sectional prospective study conducted at Hemodialysis unit of Shalamar Hospital and Shaikh Zayed Hospital, Lahore from 1/sup st/ January 2006 to 30/sup th/ April 2006. All patients getting regular hemodialysis for more than three months were included. Beck's Depression Inventory- II (BDI-II; adapted in Urdu) was administered on all the patients who were able to read or understand it. Blood sample were drawn at the same time for routine hematological, biochemical parameters and viral markers (Anti HCV and HbsAg). Diagnosis was made as per Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) for correlation of psychological variables with clinical, hematological and biochemical parameters. Eighty nine patients were enrolled which included fifty two (58.4%) were male and seventy seven (86.5%) were married. Major causes of renal failure were diabetes, hypertension and chronic glomerulonephrotis. Duration of dialysis was from 03 to 49 months with mean of 19.64 +- 11.7 months. Severity of depression was categorized in to mild, moderate and severe on the basis of BDI score. Majority of the patients fifty (56.1%) were moderately to severely depressed and there was no gender difference in the prevalence of depression. Majority of patients undergoing hemodialysis were depressed. Major risk factors for depression were marital status, illiteracy, number of children, socioeconomic factors, gender, hypertension and hypoalbuminemia. Patients with anemia, hyponatremia and hyperkalemia had suicidal tendency. Patients with hepatitis C and disturbed liver function have strong correlation with psychological parameters. (author)
Wenner, Allen R.
Instant Medical History®1 is an interrogation expert system that uses the patient to generate the initial portion of the electronic medical record. Prior to a decision about what type of medical intervention is required, the patient uses an interactive voice response telephone system to respond to branching questions based on the answer to the previous question. The responses are translated into medical terminology and presented to medical personnel who can quickly determine the level of enco...
Sex education evokes a wide variety of responses in the community and from teachers. Consequently, physicians have a responsibility to present sex education material in a factual, objective way. Many people are misinformed about sexual behavior. Physicians can help patients and the community by being aware of appropriate sex education for each age group. A curriculum for sex education, and opportunities to provide sex information for patients of different ages and stages in the lifecycle, are...
Galya Ivanova Gancheva
Leptospirosis is a re-emerging zoonosis with broad clinical spectrum and high mortality in severe forms. The aim of this study was to analyze clinical manifestations, laboratory findings, epidemiological data, and management in elderly patients with leptospirosis. Toward that end, we performed a descriptive analysis of 15 leptospirosis elderly cases (age 60-78 years) treated at the Clinic of Infectious Diseases of University Hospital - Pleven (1976-2012). Patients were serologically confirmed...
Wellbery, Caroline; Chan, Melissa
Much has been written about the symbolic function of the white coat: its implications of purity, its representation of authority and professionalism, and its role in consolidating a medical hierarchy. By contrast, the medical literature has paid almost no attention to the patient gown. In this article, we argue that in order to understand the full implications of the white coat in the doctor-patient relationship, we must also take into account patients' dress, and even undress. We explore contemporary artistic images of white coat and patient gown in order to reveal the power differential in the doctor-patient relationship. Artistic representations capture some of the cultural ambivalence surrounding the use of the white coat, which confers professional status on its wearer, while undermining his or her personal identity. At the other end of the sartorial spectrum, hospital gowns also strip wearers of their identity, but add to this an experience of vulnerability. Although compelling reasons for continuing to wear the white coat in circumscribed settings persist, physicians should be mindful of its hierarchical implications. Ample room remains for improving patients' privacy and dignity by updating the hospital gown. PMID:24687912
Panek, W C; Holland, G N; Lee, D A; Christensen, R E
The records of 100 patients (161 eyes) with uveitis were reviewed retrospectively to determine the prevalence of increased intraocular pressure, the forms of uveitis most commonly associated with glaucoma, and the forms that require specific glaucoma therapy. Secondary glaucoma was present in 23 patients (31 eyes): three of 24 patients with acute uveitis (three eyes, 12% of acute uveitis patients) and 20 of 76 patients with chronic uveitis (28 eyes, 26% of chronic uveitis patients). Eighteen ...
Introduction: Two thirds of patients (ptes) cancer present slimming recognized a negative prognostic factor. Anorexia cachexia syndrome (SCA) results from the interaction of multiple factors and causes death of 22% of these patients. Nutritional support produces a moderate recovery weight without affecting the underlying metabolic disorders. Objectives: Conduct a review of current knowledge of the underlying pathophysiology and management the cachexia-anorexia syndrome in cancer patients. Designing indications possible policy interventions in the management of these patients. Method: Performed an a literature review on SCA. Conclusions: We identify patients at risk for early implementation of non-pharmacological measures preventive. The control side effects to treatment oncospecific with particular attention to the need for antiemetics, laxatives / antidiarrheal control dental and proper pain management is fundamental. Keep track enteral is a priority. In those with swallowing disorders or dysphagia, nasogastric feeding tube should be considered early. Indications for gastrostomy / jejunostomy and total parenteral nutrition (TPN) are very limited. The NPT is a complementary treatment maneuver a temporary and reversible complication, in order to prevent deterioration
Dike, Charles C; Nicholson, Elizabeth; Young, John L
Patients in a forensic psychiatric facility often require escorted transport to medical facilities for investigations or treatments of physical health ailments. Transporting these patients presents significant safety and custody challenges because of the nature of patients housed in forensic psychiatric facilities. A significant proportion of these patients may be transfers from the Department of Corrections (DOC) under legal mandates for psychiatric evaluation and treatment better provided in a hospital setting, and most of them will return to the DOC. Although departments of correction have protocols for escorting these potentially dangerous individuals, it is unclear whether receiving psychiatric hospitals have established procedures for maintaining the safety of others and custody of these individuals during transportation outside the hospital facility. The literature is sparse on precautions to be observed when transporting dangerous forensic psychiatric patients, including those with high escape risk. In this article, we describe one forensic inpatient facility's procedure for determining the appropriate level needed to transport these individuals outside of the forensic facility. We also describe the risk assessment procedure for determining level of transport. These are quality improvement measures resulting from a critical review of an incident of escape from the forensic facility several years ago. PMID:26668224
Full Text Available Humanoids have increasingly become the focus of attention in robotics research in recent years, especially in service and personal assistance robotics. This paper presents the application developed for humanoid robots in the therapy of dementia patients as a cognitive stimulation tool. The behaviour of the robot during the therapy sessions is visually programmed in a session script that allows music to play, physical movements (dancing, exercises, etc., speech synthesis and interaction with the human monitor. The application includes the control software on board the robot and some tools like the visual script generator or a monitor to supervise the robot behaviour during the sessions. The robot applicationʹs impact on the patientʹs health has been studied. Experiments with real patients have been performed in collaboration with a centre of research in neurodegenerative diseases. Initial results show a slight or mild improvement in neuropsychiatric symptoms over other traditional therapy methods.
Joginder Pal Attri
Full Text Available Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient′s physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse.
Høy, Bente; Hall, E.O.C.; Wagner, L.
This study shows how care providers in hospital practice perceive the elderly patient's dignity as a core value in health promoting care towards the elderly. Fifteen focus group interviews were conducted with care providers who told about their nursing practice experience. The interviews were...... analysed using a phenomenological hermeneutical approach. The results disclose that when caring for the elderly patient's health potential, care providers saw dignity as the core value of health. Dignity was found to capture three themes: autonomy, identity, and worthiness. These themes reflect the...... principles of nursing practice, protecting, enhancing and promoting the elderly patient's health potential. It is suggested that these themes of dignity provide a frame of reference in elder care; they shape the understanding of when health issues become a concern for health-promoting care for the elderly...
Natalya Victorova Strueva; Galina Afanas'evna Melnichenko; Mikhail Gur'evich Poluektov; Larisa Victorovna Savel'eva; Gul'nara Victorovna Katsiya; Nikolay Petrovich Goncharov
Objectives: The aim of the study was to investigate the influence of duration and individual characteristics of sleep and chronotype on body weight, eating behavior, anxiety, depression, life quality, metabolic and hormonal parameters of obese patients. Materials and methods: 200 patients with primary obesity were studied: 83 men and 117 women at age from 18 to 61 years old, median age 41,5 years [31,0; 50,0]; body weight 107 kg [94; 128,5], waist circumference 112 cm [102; 124]; neck circumf...
A patient support system for use in computerized tomography (CT) is described. The system is particularly useful for CT scanning of the brain and also of the abdominal area. The support system consists of two moveable tables which may be translated into position for X-ray scanning of the patient's body and which may be translated incrementally and automatically to obtain scans at adjacent locations. For use with brain scans, the second table is replaced by a detachable restraint assembly which is described in detail. The support system is so designed that only a small volume of low density material will intercept the X-ray beam. (UK)
Thengilsdóttir, G; Pottegård, Anton; Linnet, K;
their prescription dispensed within a year from issuing (primary non-adherent) was assessed, as well as the time from issue until dispensing. Associations between demographic factors and primary non-adherence were estimated using logistic regression. RESULTS: The overall primary non-adherence was 6...... when a prescription is issued until it is dispensed. METHODS: Data on patients receiving a new prescription for a statin or an antidepressant from the Primary Health Care database were linked with dispensing histories from The Icelandic Prescription Database. The proportion of patients who did not have...
Eke, F; Balfe, J W; Hardy, B E
Three boys were treated for arteritis of the aorta and great vessels and bilateral renal artery stenosis. One presented at age 6 months with failure to thrive, excessive sweating, and vomiting: hypertension and cardiac failure were subsequently diagnosed. The two older boys (7 and 14 years) presented with symptomless hypertension. The clinical and angiographic findings in the three patients suggest that the illness may have been Takayasu's arteritis, which should be included in the differential diagnosis of hypertension in infancy and childhood. Renal autotransplantation was performed in all three patients with good results. Early renal autotransplantation may reduce the morbidity associated with this disease. PMID:6148918
Reynard, John; Stevenson, Peter
Following recent high profile cases of surgical error in the UK and USA, patient safety has become a key issue in healthcare, now placed at heart of junior doctor's training. Errors made by doctors are very similar to those made in other high risk organisations, such as aviation, nuclear and petrochemical industries. Practical Patient Safety aims to demonstrate how core principles of safety from these industries can be applied in surgical and medical practice, in particular throughtraining for health care professionals and healthcare managers.Whilst theoretical aspects of risk management form
Baldwin, Mike; Spong, Andrew; Doward, Lynda; Gnanasakthy, Ari
Internet communication is developing. Social networking sites enable patients to publish and receive communications very easily. Many stakeholders, including patients, are using these media to find new ways to make sense of diseases, to find and discuss treatments, and to give support to patients and their caregivers. We argue for a new definition of patient-reported information (PRI), which differs from the usual patient-reported outcomes (PRO). These new emergent data from the social web ha...
Ennis, Jeffrey H
The physician-patient relationship, like any human relationship, blends two types of interactions described by philosopher Martin Buber. In an “I-It” interaction, the physician objectifies the patient and his or her problem; in an “I-Thou” interaction, the physician perceives the patient as an emotional being. My encounters with medical practitioners as a patient with brachial neuritis and Guillain-Barré syndrome illustrate these forms of the physician-patient relationship.
Pors, Anja Svejgaard
Purpose - The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and healthcare organizations. Design/methodology/approach - The paper provides an analysis of four documents collected as part of an ethnographic case study regarding "The Perspective of the Patient" - a Danish Hospital's patient-centred communication programme. Mapping methods inspired by Grounded Theory are used to qualify the analysis. Findings - The paper shows that strategic patient-centred communication addresses both a care-oriented approach to the patient and deploys market perceptions of patients. Market and care is seen as co-existing organizing modes that entail expectations to the patient. In the communication programme the patient is constructed in six information-seeking patient figures: affective patient; target group patient; citizen with rights; patient as a competent resource; user as active partner; and consumer. As a result, the patient-centred communication programme renders the patient as a flexible figure able to fit organizational demands of both care orientation and market concerns. Originality/value - This study contributes to qualitative research in organizational health communication by combining two subfields - patient-centredness and health communication - in an empirical study of how market and care are intertwined in a patient-centred communication programme. The argument goes beyond the prevalent prescriptive approaches to patient-centredness and healthcare communication, instead providing a critical analytical perspective on strategic communication and patient-centredness and showing how expectations are posed to both patient and organization. PMID:27052626
Aaltio, Laura; Huhtamaa, Iina
Cardiovascular diseases affect many people in Finland. One way to support this patient group is patient education. Since the time spent in the inpatient settings is limited, treatment and education of cardiovascular patients is currently focused mainly on the outpatient settings. This creates pressure for the nurses due to the strict time-frame and high turnover of patients. The purpose of this final project was to find evidence-based knowledge on the patient education of a cardiac patie...
Caffarella, Rosemary S.
Patient education is recognized by health care providers and patients themselves as an important component of adequate health care for hospital patients. Through this informational process, patients receive information about specific health problems, learn the necessary competencies to deal with them, and develop accepting attitudes toward the…
Ameri, Cinzia; Fiorini, Fulvio
If the "old economy" preached standardization of products/services in order to reduce costs, the "new economy" is based on the recognition of the needs and the management of information. It is aimed at providing better and more usable services. One scenario is a national health service with regional management but based on competition between hospitals/companies.This led to a different handling of the user/patient, which has become the center of the health system: marketing seeks to retain the patient, trying to push a client-patient to not change their healthcare service provider. In costs terms, it is more economical to retain a customer rather than acquire a new one: a satisfied customer is also the best sounding board for each company. Customer equity is the management of relations with patients which can result in a greater customer value: it is possible to recognize an equity of the value, of the brand and of the report. Loyalty uses various marketing activities (basic, responsive, responsible, proactive and collaborative): each hospital/company chooses different actions depending on how many resources it plans to invest in loyalty. PMID:27374397
Andersen, Tariq Osman
This paper introduces the concept of the “participatory patient” as a vehicle to promote attention to patients¿ dual enactment of participation on participatory design (PD) projects in healthcare. By an empirical case-story from an ongoing PD project in healthcare, I illustrate the relationship...
Hvidt, Niels Christian
Faith and hope in divine healing figure in most religious traditions. This chapter looks at faith in healing miracles and explores how following that faith may involve both risks and advantages. On the one hand, it may imply a risk by camouflaging a deferring attitude as when patients decline...
Selberg, Hanne; Madsen, Trine Stougaard
Right patient, Right Blood Simulation based training in blood transfusion practice in nursing education Background: In spite of strict checking procedures to handling transfusion of blood severe adverse reactions are likely to happen and the major cause of morbidity occurs to be liable to human...
Fibromyalgia: The Information and the Care You Deserve PATIENT HANDBOOK e Fibromyalgia: You Need the Facts Fibromyalgia (fi’bro-mi-al’je- ) affects more than ... occur in men as well. 1 People with fibromyalgia may experience the following symptoms: 2 • Chronic, widespread ...
O'Donnell, Joseph F
Insomnia affects up to 50% of patients with cancer, but has received little attention from the oncology community compared with other symptoms such as pain and fatigue. Insomnia and subsequent sleep disturbances can lead to fatigue, mood disturbances, and contribute to immunosuppression, which can have a profound impact on quality of life and perhaps affect the course of disease. Insomnia in cancer patients must be distinguished from cancer-related fatigue. Although they are 2 distinct conditions, insomnia and fatigue are interrelated. Insomnia often leads to daytime fatigue that interferes with normal functioning. Conversely, daytime fatigue can lead to behaviors such as napping, which result in insomnia. The primary goal of insomnia treatment should first be to relieve any underlying disorder (eg, cancer pain, depression, anxiety) that may be causing the sleep disturbance. Because insomnia in this patient population may be due to a variety of causes, treatment must be multimodal and include both pharmacologic and nonpharmacologic therapies. A plan that combines attention to sleep hygiene and cognitive-behavioral therapy with prescription of hypnotic medications can help relieve the symptoms of insomnia in cancer patients and improve their quality of life. PMID:15675652
Salama Abo-elyazed Ouf; Tarek Abd-elgawaad Moussa; Alshimaa Saber Mohamed Abd-Elmegeed; Samar Mohamed Rajaee Eltahlawy
Objective: To study the occurrence and prevalence of dermatomycosis in special patient populations suffering from diabetes, cancer and heart diseases. Methods: A total of 640 patients suffering from diabetes, 280 patients suffering from cancer and 210 patients suffering from heart diseases from Cairo City were evaluated for dermatophytosis at the dermatology clinics of four different hospitals from January 2005 to December 2006. Results: It is estimated that diabetic patient...
Son, Yu Ri; Choi, Kyoung Hyo; Kim, Tae Gyun
Objective To identify risk factors for dysphagia in tongue cancer patients. Dysphagia is a common complication of surgery, radiotherapy, and chemotherapy in tongue cancer patients. Previous studies have attempted to identify risk factors for dysphagia in patients with head and neck cancer, but no studies have focused specifically on tongue cancer patients. Methods This study was conducted on 133 patients who were diagnosed with tongue cancer and who underwent a videofluoroscopy swallowing stu...
van Sluijs, E. M.
This large-scale study describes the way in which physical therapists currently inform, instruct and advise their patients. The study is based on 2000 audiotaped sessions of physical therapy treatments and 1600 patient questionnaires. The results show that patients receive much information and advice during treatment but that patient's compliance is unsatisfactory. The study shows which factors are related to patients' non-compliance. Finaly the book gives an explanatory model for short-term ...
Ehrensvärd, Martin Gustaf
Ibn 'Arabi¯ (1165-1240) er blandt de mest indflydelsesrige og kontroversielle islamiske mystikere, kendt blandt hans tilhængere som ’den største mester’ og blandt hans modstandere som ’den største kætter’. Af hans meget omfattende forfatterskab foreligger der indtil videre kun nogle fa° sider i...
Der er en tæt sammenhæng mellem den pædagogstuderendes fysiske aktivitet i barndommen og fysiske aktivitet i det voksne liv. Den sociale vane (habitus) spiller i denne sammenhæng en afgørende rolle for praksis i det voksne liv! Pædagogstuderende har generelt et positivt forhold til fysisk aktivit...
Horwitz, Anna; Reuther, Lene; Andersen, Stig Ejdrup
in Copenhagen. RESULTS: A total of 111 patients were included. Eighty-eight patients (79%) always or often read the patient information leaflets. Among these, 77% attached importance to adverse effects. A mere 13% attached importance to all leaflet information. In all, 21% never or rarely read patient......-five patients (32%) stated that they had stopped taking medication due to the information about adverse effects. CONCLUSION: The patient information leaflet is an important source of drug information as most patients read the leaflet and nearly a third of the patients stated that information about the adverse...... information leaflets, but relied on the doctor or the pharmacist. 62% of the interviewed had no problems reading or understanding the patient information leaflets. Among the 38% with reading problems, 57% had difficulties due to text-size, and 33% found the written language difficult to understand. Thirty...
Bostan, Sedat; Acuner, Taner; Yilmaz, Gökhan
The expectations of patient are one of the determining factors of healthcare service. The purpose of this study is to measure the Patients' Expectations, based on Patient's Rights. This study was done with Likert-Survey in Trabzon population. The analyses showed that the level of the expectations of the patient was high on the factor of receiving information and at an acceptable level on the other factors. Statistical meaningfulness was determined between age, sex, education, health insurance, and the income of the family and the expectations of the patients (p<0.05). According to this study, the current legal regulations have higher standards than the expectations of the patients. The reason that the satisfaction of the patients high level is interpreted due to the fact that the level of the expectation is low. It is suggested that the educational and public awareness studies on the patients' rights must be done in order to increase the expectations of the patients. PMID:17028043
Jensen, Andrew; Boyle, Justin; Khanna, Sankalp
We describe the development of a method to distil routinely collected clinical data into patient flow information to aid hospital bed management. Using data from state-wide emergency department and inpatient clinical information systems, a user-friendly interface was developed to visualise patient flow conditions for a particular hospital. The historical snapshots employ a variable time scale, allowing flow to be visualised across a day, week, month or year. Flow information includes occupancy, arrival and departure rates, length-of-stay and access block observations, which can be filtered by age, departure status, diagnosis, elective status, triage category, and admission unit. The tool may be helpful in supporting hospital bed managers in their daily decision making. PMID:22797023
Bro Brask, Kirsten; Birkelund, Regner
The aim of this study was to research how the staff experience care expressed during the brief encounter with the patients in a diagnostic imaging department. This was a qualitative study with a phenomenological and hermeneutical frame of reference. The data were collected using field observations...... and semistructured interviews and analyzed according to the guidelines for meaning condensation by Giorgi. The imaging staff found that care is expressed in an administrative, an instrumental, and a compassionate sense. The imaging staff perceived care in a way that clearly differs from the traditional perception...... of care understood as the close relations between people. In their self-understanding, the staff found that care not only comprised the relational aspect but also that it was already delivered during the preparatory phases before the actual meeting with the patient and up until the image...
Pandey M; Thomas B
With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent ...
A 52-year-old Caucasian man presented to hospital with confusion and was treated for a urinary tract infection. He developed new and unexpected signs and symptoms during his stay in hospital. On further questioning, the story of his social background unfolded and, following further investigation, he was diagnosed with human immunodeficiency virus (HIV). This case reminds all clinicians to think about HIV in the older patient and it also gives direction for investigation and management of simi...
Sreelatha, Omana Kesary; Ramesh, Sathyamangalam VenkataSubbu
Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes. PMID:26929592
Eke, F.; Balfe, J W; Hardy, B E
Three boys were treated for arteritis of the aorta and great vessels and bilateral renal artery stenosis. One presented at age 6 months with failure to thrive, excessive sweating, and vomiting: hypertension and cardiac failure were subsequently diagnosed. The two older boys (7 and 14 years) presented with symptomless hypertension. The clinical and angiographic findings in the three patients suggest that the illness may have been Takayasu's arteritis, which should be included in the differenti...
DEMİRÇEKEN, Fulya G.; SOYKAN, İrfan; KULOĞLU, Zarife; ÇETİNKAYA, Hülya; ÖZDEN, Ali
Background and Aims: The etiology of functional (nonulcer) dyspepsia is unknown and many factors are suspected. Giardia lamblia is the most common protozoan isolated from the gastrointestinal tract, and chronic giardiasis is considered as a cause of dyspepsia. Our aim was to determine the frequency of giardiasis in patients undergoing upper gastrointestinal endoscopy for dyspepsia and to compare with results of stool examination by microscopy. Materials and Methods: One hundred and four dyspe...
Dintinjana, Renata Dobrila; Redžović, Arnela; Čubranić, Aleksandar; Dintinjana, Marin; Vanis, Nenad
Cachexia is defi ned as an unintended loss of stable weight exceeding 10%. Patients with advanced cachexia express anorexia, early satiety, severe weight loss, weakness, anemia, and edema. Anorexia represents the result of a failure of the usual appetite signals whereas cachexia is the debilitating state of involuntary weight loss. This syndrome, referred to as the »cancer anorexia-cachexia syndrome« (CACS) and usually consists of a combination of anorexia, tissue wasting, malnutr...
Singh, S; Hamdy, S.
Swallowing musculature is asymmetrically represented in both motor cortices. Stroke affecting the hemisphere with the dominant swallowing projection results in dysphagia and clinical recovery has been correlated with compensatory changes in the previously non‐dominant, unaffected hemisphere. This asymmetric bilaterality may explain why up to half of stroke patients are dysphagic and why many will regain a safe swallow over a comparatively short period. Despite this propensity for recovery, dy...
care staff and patients. So, knowing that patient-centred communication and good inter-collegial communication is for the benefit of both health professionals and patients, the relevance of improving health care professionals' communication skills and investigating the effect on both professionals and......Although patient-centred communication has provided a focus point in health care for many years, patient surveys continuously reveal serious communication problems as experienced by patients, due to poor communication. Likewise, poor inter-collegial communication can cause problems for both health...
Zerbe, Tony R.; Zerbe, Shirleen D.
Historically, analysis of patient service time (patient tracking) in ambulatory clinics has been performed manually. A case study of Eye and Ear Clinic in Pittsburgh, PA, revealed that this approach to patient data collection was prone to clerical error and did not satisfy the clinic's information-processing needs. Initial attempts at automation identified the features required of a successful computerized scheduling and patient tracking system.
Martin, Leslie R; Williams, Summer L; Haskard, Kelly B; Dimatteo, M Robin
Quality healthcare outcomes depend upon patients' adherence to recommended treatment regimens. Patient nonadherence can be a pervasive threat to health and wellbeing and carry an appreciable economic burden as well. In some disease conditions, more than 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice. While no single intervention strategy can improve the adherence of all patients, decades of research studies agree that successful attempts to improve patient adherence depend upon a set of key factors. These include realistic assessment of patients' knowledge and understanding of the regimen, clear and effective communication between health professionals and their patients, and the nurturance of trust in the therapeutic relationship. Patients must be given the opportunity to tell the story of their unique illness experiences. Knowing the patient as a person allows the health professional to understand elements that are crucial to the patient's adherence: beliefs, attitudes, subjective norms, cultural context, social supports, and emotional health challenges, particularly depression. Physician-patient partnerships are essential when choosing amongst various therapeutic options to maximize adherence. Mutual collaboration fosters greater patient satisfaction, reduces the risks of nonadherence, and improves patients' healthcare outcomes. PMID:18360559
Dellson, Pia; Nilbert, Mef; Carlsson, Christina
future simplified and more attractive informed consent forms. CONCLUSIONS: The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language......, structured text and illustrations to improve the informed consent process and thereby patient enrolment into clinical trials....
Full Text Available Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA. Patient satisfaction is a complex concept that is influenced by multiple factors. A patient's viewpoint and knowledge plays an influential role in patient satisfaction with ambulatory surgery. Medical optimization and psychological preparation of the patient plays a pivotal role in the success of ambulatory surgery. Postoperative pain, nausea, and vomiting are the most important symptoms for the patient and can be addressed by multimodal drug regimens. Shared decision making, patient–provider relationship, communication, and continuity of care form the main pillars of patient satisfaction. Various psychometrically developed instruments are available to measure patient satisfaction, such as the Iowa Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, but none have been developed specifically for ambulatory surgery. The ASA has made recommendations for data collection for patient satisfaction surveys and emphasized the importance of reporting the data to the Anesthesia Quality Institute. Future research is warranted to develop a validated tool to measure patient satisfaction in ambulatory surgery. Keywords: patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives
M.B. Haeseker (Michiel); S. Croes (Ser); C. Neef (Cees); C.A. Bruggeman (Cathrien); L. Stolk (Lisette); A. Verbon (Annelies)
textabstractBackground: To compare vancomycin pharmacokinetic parameters in patients with and without neutropenia.Methods: Patients ≥18 years admitted on general wards were included. Routinely vancomycin trough and peak plasma concentrations were measured with a fluorescence polarization immunoassay
Paice, B.; Gray, J M; McBride, D; Donnelly, T; Lawson, D H
Significant hyperkalaemia occurred in 406 out of 29 063 patients admitted to a major Scottish teaching hospital in one year (1.4%). Mortality was higher in these patients than in control patients and was strongly correlated with the severity of the hyperkalaemia. Overall seven deaths were directly due to hyperkalaemia (out of 58 deaths among patients with hyperkalaemia). Factors contributing to a poor prognosis were severity and speed of onset of hyperkalaemia and the presence of appreciable ...
C. Van Eck
Study Design: Clinical PerspectiveObjective: To provide back care education for patients with low back pain. Background: Understanding the internal and external forces the body issubjected to, as well as the spine’s response to these forces, can better equipphysiotherapists in educating patients with low back pain. Methods and Measures: The focus of the clinical perspective is to providephysiotherapists with clinically sound reasoning when educating patients. Results: Providing a patient han...
Fuhrmann, Lone; Hesselfeldt, Rasmus; Lippert, Anne; Perner, Anders; Ostergaard, Doris
. MATERIAL AND METHODS: Prospective observational study at Herlev Hospital, Copenhagen, Denmark. Study personnel measured vital signs on all patients present on five wards during the evening and night and interviewed nursing staff about patients with abnormal vital signs. Subsequently, patient records were...
Fuhrmann, L.; Hesselfeldt, R.; Lippert, A.; Perner, A.; Ostergaard, D.
. MATERIAL AND METHODS: Prospective observational study at Herlev Hospital, Copenhagen, Denmark. Study personnel measured vital signs on all patients present on five wards during the evening and night and interviewed nursing staff about patients with abnormal vital signs. Subsequently, patient records were...
Wang, Sheila C; Anderson, John Ae; Jones, Duncan Vb; Evans, Robyn
The objectives of this study were to provide an assessment of photographic documentation of the wound from the patients' perspective and to evaluate whether this could improve patients' understanding of and involvement in their wound care. Our results revealed that most patients visiting the wound care clinic have difficult-to-see wounds (86%). Only 20% of patients monitor their wounds and instead rely on clinic or nurse visits to track the healing progress. There was a significant association between patients' ability to see their wound and their subsequent memory of the wound's appearance. This was especially true for patients who had recently begun visiting the wound care clinic. This relationship was not present in patients who had visited the clinic for 3 or more years. Patients reported that the inability to see their wounds resulted in feeling a loss of autonomy. The majority of patients reported that photographing their wounds would help them to track the wound progress (81%) and would afford them more involvement in their own care (58%). This study provides a current representation of wound photography from the patients' perspective and reveals that it can motivate patients to become more involved in the management of their wounds - particularly for patients with difficult-to-see wounds. PMID:24872018
This chapter deals with important aspects of patient care, which may become the radiographer's responsibility in the absence of dedicated nursing staff. Although large pediatric centers usually employ nurses for bedside patient management, the general radiographer should be familiar with some aspects of routine patient care. This knowledge guarantees the safety and well-being of children entrusted to the technologist
Rouslan Kotchetkov; Ameen Patel; Omid Salehian
Ventricular tachycardia although not common, can occasionally complicate pregnancy. Its presence may indicate an underlying cardiac structural abnormality, or undiagnosed congenital arrhythmic disease. However, some pregnant patients with ventricular tachycardia have structurally normal hearts. Two cases of ventricular tachycardia in pregnant patients with structurally normal hearts are presented and an approach to diagnosis and management of such patients are discussed.
Cooksley, T.; Nanayakkara, P. W. B.; Nickel, C. H.;
readmission but have not been validated in international populations. AIM: To perform an external independent validation of the HOSPITAL and LACE scores. DESIGN: An unplanned secondary cohort study. METHODS: Patients admitted to the medical admission unit at the Hospital of South West Jutland (10...... discriminatory power of both scores decreased with increasing age. CONCLUSION: Readmissions are a complex phenomenon with not only medical conditions contributing but also system, cultural and environmental factors exerting a significant influence. It is possible that the heterogeneity of the population and...
Bech, Camilla Louise Nørgaard; Brabrand, M.; Lassen, Annmarie Touborg
assessing potential risk factors associated with adverse outcomes and mortality. Our aim was to describe ambulance transports to the ED and identify prognostic factors accessible in the prehospital phase and associated with 7-day mortality. Methods We included all adult patients (>18 years) with a first......-based healthcare registers in order to identify comorbid conditions and information on mortality. Demographic factors and first registered vital sign were analysed by univariate logistic regression analysis, with 7-day mortality as outcome. Results In total, 18,572 first-time ambulance contacts were identified in...
Jensen, S M; Lippert, A; Ostergaard, D
handover, and to bring suggestions on how to optimize this process. A literature search on handovers to EDs was performed in PubMed, Embase, Web of Science and Cochrane databases. A total of 18 papers were included. Issues regarding transfer of information are highlighted. Newer studies suggest that....... Giving and taking over responsibility is an important issue. The handover of patients to the ED has the potential to be improved. Cultural issues and a lack of professional recognition of handover importance need to be approached. Multidisciplinary training in combination with a structured tool may have...
Eulália Maria Martins da SILVA
Full Text Available Introduction: With the population aging, the number of chronic and degenerative illnesses, own of the old age, it will appear more frequently. Objective: The objective of this study was to do a literature revision in order to approach the illnesses that more they attack the patients of the third age (from the chronic diseases even the degenerative chronic diseases. Para that, a description will be accomplished as the concept and the signs and symptoms of the illnesses observed more frequently in the senior patients that will be depression, stress, loss of the memory, aterosclerose, osteoporosis, arthritis reumatóide and disorder temporomandibular, arterial hypertension, vascular diseases, heart diseases, obesity, diabetes mellitus, urinary incontinence, hearing and visual disturbances, disease of Parkinson and still the disease of Alzheimer. Conclusion: Based on the literature revision, we ended that, not only the professionals of the health, as well as all those that work with the seniors in general, they should have the concern of treating him with larger attention, patience and perseverance, to the point of to minimize the limitations that each one presents.
Natalya Victorova Strueva
Full Text Available Objectives: The aim of the study was to investigate the influence of duration and individual characteristics of sleep and chronotype on body weight, eating behavior, anxiety, depression, life quality, metabolic and hormonal parameters of obese patients. Materials and methods: 200 patients with primary obesity were studied: 83 men and 117 women at age from 18 to 61 years old, median age 41,5 years [31,0; 50,0]; body weight 107 kg [94; 128,5], waist circumference 112 cm [102; 124]; neck circumference 41 cm [38; 46], body mass index (BMI 36,9 [32,8; 42,3]. Results: We found an association between sleep duration, chronotype and the emotional eating. Significant sleep reduction (to less than 6 hours was associated with high level of anxiety, depression, emotional eating and insomnia. Younger age, early onset and shorter duration of obesity and brisk weight gain during last is connected to the evening chronotype. The emotional eating associated with hypersomnolence in the absence of statistically significant increase of anxiety and depression in individuals with evening chronotype. Sleep duration and chronotype have no significant effect on the body weight, metabolic, hormonal parameters and the dynamics of body. weight after 7±1 months of treatment of obesity.
Norrbrink, Cecilia; Löfgren, Monika; Hunter, Judith P; Ellis, Jaqueline
Nociceptive and neuropathic pain (NP) are common consequences following spinal cord injury (SCI), with large impact on sleep, mood, work, and quality of life. NP affects 40% to 50% of individuals with SCI and is sometimes considered the major problem following SCI. Current treatment recommendations for SCI-NP primarily focus on pharmacological strategies suggesting the use of anticonvulsant and antidepressant drugs, followed by tramadol and opioid medications. Unfortunately, these are only partly successful in relieving pain. Qualitative studies report that individuals with SCI-related long-lasting pain seek alternatives to medication due to the limited efficacy, unwanted side effects, and perceived risk of dependency. They spend time and money searching for additional treatments. Many have learned coping strategies on their own, including various forms of warmth, relaxation, massage, stretching, distraction, and physical activity. Studies indicate that many individuals with SCI are dissatisfied with their pain management and with the information given to them about their pain, and they want to know more about causes and strategies to manage pain. They express a desire to improve communication with their physicians and learn about reliable alternative sources for obtaining information about their pain and pain management. The discrepancy between treatment algorithms and patient expectations is significant. Clinicians will benefit from hearing the patient´s voice. PMID:23459087
Hooten, Doug; Zavadsky, Matt
We're arguably at the most pivotal time in our young profession. The ACA has provided EMS an unprecedented opportunity to become a part of the healthcare system, a move that many of us have dreamed about for decades. We need to pay attention to the changing dynamics of the environment in which we operate. The factors that currently impact hospitals, doctors and other healthcare providers will also impact us sooner than we think. Take the time to help shape our future and how we participate in this new healthcare system. It's time to focus on the patient and the patient's experience with our service. Wayne Gretzky said two important things during an interview when he was asked what makes him such a great hockey player. One was, "You miss 100% of the shots you don't take." The other was, "A good hockey player plays where the puck is. A great hockey player plays where the puck is going to be. I skate to where the puck is going to be, not where it has been." Our advice to you is to go ahead, take the shot, get ahead of the other team and focus on improved customer satisfaction sooner rather than later. PMID:24660359
Beumer, J. III; Curtis, T.A.; Morrish, R.B. Jr.
Complete dentures were fabricated for 88 patients following completion of cancericidal doses of radiation therapy to the head and neck regions. All were followed for at least 6 months after delivery. All patients received dentures resting within the radiation field. Three patients developed osteoradionecroses directly attributable to their dentures. These three had been dentulous prior to therapy and had either pre- or posttreatment extractions. Of the 58 patients who had been edentulous prior to therapy, none developed osteoradionecrosis. Five patients developed soft tissue necroses secondary to the use of dentures.
Complete dentures were fabricated for 88 patients following completion of cancericidal doses of radiation therapy to the head and neck regions. All were followed for at least 6 months after delivery. All patients received dentures resting within the radiation field. Three patients developed osteoradionecroses directly attributable to their dentures. These three had been dentulous prior to therapy and had either pre- or posttreatment extractions. Of the 58 patients who had been edentulous prior to therapy, none developed osteoradionecrosis. Five patients developed soft tissue necroses secondary to the use of dentures
Strøm, Thomas; Pande-Rolfsen, Guri; Hagen, Christine;
Interest in and the quantity of publications on delirium in critically ill patients have grown increasingly over the last decade. Critically ill patients have traditionally been sedated to facilitate mechanical ventilation. This practice impeded the recognition of delirium in the critically ill...... patients, and consequently the disorder was underdiagnosed. Delirium in the critically ill patients is associated with increased morbidity and mortality. Less sedation, guided by protocols with daily wake up trials, and validated delirium scoring systems, have improved the opportunities to diagnose and...... monitor delirium in the critically ill patients. Udgivelsesdato: 2009-Oct-19...
Dambaugh, Lori A; Ecklund, Margaret M
Obese patients have complex needs that complicate their care during hospitalization. These patients often have comorbid conditions, including hypertension, heart failure, obstructive sleep apnea, pressure ulcers, and difficulty with mobility. Obese patients may be well served in the progressive care setting because they may require more intensive nursing care than can be delivered in a general care unit. Progressive care nurses have core competencies that enable them to safely and effectively care for obese patients. A plan of care with interdisciplinary collaboration illustrates the integrative care for obese progressive care patients. (Critical Care Nurse 2016; 36:58-63). PMID:27481802
This paper assesses the use of a patient stretcher that directly docks to a CT scanner for acutely injured and/or critically ill patients. The stretcher permits performance of radiography and acts as a platform for critical care monitoring and patient support devices. During a 1-year period, the prototype CT-docking stretcher was used for 35 patients sustaining acute trauma and 25 patients from critical care units. Observations were elicited from physicians, nurses and technologists concerning the advantages or disadvantages of the docking stretcher. Advantages of the CT-docking stretcher included time saved in moving patients to the CT table from the admitting/emergency ward, transfer of critically ill patients onto the stretcher in the controlled environment of the intensive care unit rather than the CT suite, increasing CT throughput by direct docking of the patient stretcher to the CT scanner rather than manual transfer of complex support and monitoring devices with the patient, decreased risk associated with physical movement of patients with potentially unstable spinal injuries or unstable physiologic status, and decrease in potential for injury to medical personnel performing patient transfer
Wilkins, Alasdair R; Venkat, Manu V; Brown, Adam S; Dong, Jessica P; Ran, Nina A; Hirsch, James S; Close, Kelly L
Given that a new wave of biosimilar insulins will likely enter the market in coming years, it is important to understand patient perspectives on these biosimilars. A survey (N = 3214) conducted by the market research company dQ&A, which maintains a 10 000-patient panel of people with type 1 or type 2 diabetes in roughly equal measure, investigated these perspectives. The survey asked whether patients would switch to a hypothetical less expensive biosimilar insulin that was approved by their provider. Approximately 66% of respondents reported that they would "definitely" or "likely" use a biosimilar insulin, while 17% reported that they were "unlikely" to use or would "definitely not use" such a product. Type 2 diabetes patients demonstrated slightly more willingness to use biosimilars than type 1 diabetes patients. Common patient concerns included whether biosimilars would be as effective as reference products (~650 respondents), whether side effect profiles would deviate from those of reference products (~220 respondents), and the design of the delivery device (~50 respondents). While cost savings associated with biosimilar insulins could increase patient uptake, especially among patients without health insurance (some recent estimates suggest that biosimilars will come at a substantial discount), patients may still need assurance that a cheaper price tag is not necessarily associated with substandard quality. Overall, the dQ&A survey indicates that the majority of patients are willing to consider biosimilar insulins, but manufacturers will need to work proactively to address and assuage patient concerns regarding efficacy, safety, drug administration, and other factors. PMID:24876533
El Imam M
Full Text Available In this paper we describe the causes, patterns of presentation, and management of obstructive uropathy in Sudanese patients in a retrospective multi-center audit. All patients who presented with obstructive uropathy during 2005 were included in this study. All of the patients were subjected to serial investigations including imaging and tests of renal function. Diversion, stenting, and/or definitive surgery were performed in order to relieve the obstruction. Five hundred twenty patients were diagnosed with obstructive uropathy during this period; 345 (66% patients presented with chronic obstruction and 175 (34% with acute obstruction. Of the study patients, 210 (40% presented with significant renal impairment; 50 (23% of them required emergent dialysis. The patterns of clinical presentation of the obstructed patients included pain at the site of obstruction in 48%, lower urinary tract symptoms in 42%, urine retention in 36.5%, mass effect in 22%, and anuria in 4%. Patients in the pediatric age group constituted 4% of the total. The common causative factors of obstruction included congenital urethral valves, pelvi-ureteral junction obstruction, urolithiasis, and iatrogenic trauma, especially in the obstetric practice. Renal function was completely recovered with early management in 100% of patients with acute obstruction and was stabilized in 90% of patients with chronic obstruction. Four patients were diagnosed with end-stage renal failure; two of them were transplanted. The mortality rate in this study was less than 0.3%.
Background: As a result of increased interest and public demand, providing patients with adequate information about radiooncology has become more and more difficult for the doctor. Insufficient patient information can not only cause anxiety for the patient, but can also lead to legal action against the physician. In order to gain a deeper insight into our clinical practice of providing patient information, we developed a special questionnaire. We describe our first experiences in using this questionnaire at our institute. Patients and methods: We examine the amount of information and level of satisfaction, as well as the agreement of assessment between patient and physician after the provision of standard patient information before and at the end of radiotherapy. 51 consecutive patients were interviewed with a newly designed questionnaire. The first questioning with 13 items was carried out before radiotherapy and the second with ten items was done at the end of treatment. Sum scores for information and satisfaction were defined and agreement was measured by the weighted κ coefficient. Results: Global level of information and satisfaction was good, and a significant increase in information level and a significant decline in satisfaction were seen between questionnaire 1 and 2. Agreement between patient and physician was fair, for example intent of treatment resulted in a κ coefficient of 0.34, and poor for the doctor's role with a κ coefficient of -0.002. Only 52% of the patients who received palliative radiotherapy rated correctly the non-curative intent of treatment, whereas 86% of the patients who received curative radiotherapy made a correct statement. Before radiotherapy, emotional state was often both negatively and positively assessed by the patients. Conclusion: Our short questionnaire is simple and easy to understand. It provides insights into patient information with respect to assessment of the information, satisfaction level, and agreement between
Kirti Rajesh Bendre
Methods: This is a retrospective study carried out in a medical college with tertiary hospital facility in Mumbai. The ICU admissions for a period of 5 years from October 2005 to October 2010 were reviewed. Results: Over 5 years, 48 out of 10800 obstetric patients were admitted in ICU (0.4%. Most common reasons for admissions were obstetric hemorrhage and preeclampsia. The most common intervention done was transfusion of blood and blood products. Conclusions: We need better information about high risk obstetrics in order to improve maternal care. The study identifies the risk factors for maternal mortality and severe maternal morbidity, most significant being obstetric hemorrhage. Lack of antenatal care and delay in referral to intensive care unit adversely affect the maternal outcome. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 370-372
Schindler, Karin; Brix, Johanna; Dämon, Sabine; Hoppichler, Friedrich; Kruschitz, Renate; Toplak, Hermann; Ludvik, Bernhard
Evidence demonstrates that medical diabetes treatment has to be accompanied by lifestyle modifications. Structured nutrition interventions and increased physical activity will help patients to normalise, respectively maintain their body weight. The main target of a diabetes therapy is aimed at achieving normal or nearly normal blood glucose levels. Reaching this goal may be facilitated by the following nutritional patterns: Using mainly carbohydrates from vegetables, whole grains, legumes and fruits, Restriction of mono- and disaccharides are often important factors in normalising body weight and blood glucose, Reduction of dietary fat could be indicated. However, the primary goal is the limitation of saturated fatty acids which to high percentage are consumed with animal products. There is not sufficient evidence to recommend a dietary protein consumption of more than 20% of energy intake. Individuals with diabetes should be aware of the importance of acquiring daily vitamin and mineral requirements. Natural food sources should be preferred. PMID:27052240
Worsøe, Line Brink; Tordsson, Emma Mathilde
I efteråret 2007 gennemførte forfatterne af denne artikel en undersøgelse af fertilitetspatienters kommunikation på nettet. Undersøgelsen var en del af kandidatspecialet i Sprogpsykologi "Fra Person til Patient - en narrativ undersøgelse af fertilitetspatienters kommunikation". Sigtet med specialet...... var at afdække hvilke ændringer af psykologiske processer en person gennemgår når denne indgår i et behandlingsforløb i det danske sygehusvæsen. Det er et emne tidligere behandlet af sundhedspsykologien. Et af de vigtigste fund i denne forbindelse blev imidlertid, at nok kunne de psykologiske...
Santiago Herrero; Jose Antonio Lapuerta-Irigoyen
The elderly population consists of those over age 75 years and appears to represent the fastest-growing segment of the population.Intravenous thrombolytic therapy (TT) is the most common strategy for the treament of acute myocardial infarction (AMI) in many parts of the world. However, TT carries a higher risk of intra-cranial hemorrhage (ICH) in the elderly patients. Primary percutaneous transluminal coronary angioplasty and stenting (PCI) represents an important alternative in these elderly individuals with contraindications to TT. In developing countries, or in areas without availability of primary PCI, TT remains the only therapeutic modality. Dedicated randomized trials are needed to provide a comprehensive understanding of AMI management in the elderly group.
Rao, Bharat R.; Sandilya, Sathyakama; Niculescu, Radu; Germond, Colin; Goel, A.
We describe REMIND, a data mining framework that accurately infers missing clinical information by reasoning over the entire patient record. Hospitals collect computerized patient records (CPR's) in structured (database tables) and unstructured (free text) formats. Structured clinical data in the CPR's is often poorly recorded, and information may be missing about key outcomes and processes. For instance, for a population of 344 colon cancer patients, important clinical outcomes, such as dise...
Wong, Jean; Shah, Ushma; Wong, David
Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA). Patient satisfaction is a complex concep...
Park, Kwang Ok; Lee, Yoon Young
Background Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control. Methods OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and...
Full Text Available Given the importance of patient's rights in healthcare, special attention has been given to the concept of patient's rights by the Ministry of Health and Medical Education in Iran. Iranian patient's rights charter has been compiled with a novel and comprehensive approach. This charter aims to elucidate rights of recipients of health services as well as observing ethical standards in medicine. This paper presents the Iranian patient's rights charter. Based on a study done from 2007 to 2009, the charter has been finalized through an extensive consultation involving all stakeholders, patients, physicians, nurses, lawyers, patient associations and health policy makers. The developed charter was adopted by the Ministry of Health in December 2009. Iranian patient's rights charter has been formulated in the framework of 5 chapters and 37 articles including vision and an explanatory note. The five chapters concern right to receiving appropriate services, right to access desired and enough information, right to choose and decide freely about receiving healthcare, right to privacy and confidentiality, and finally right to access an efficient system of dealing with complaints which have been explained in 14, 9, 7, 4 and 3 articles, respectively. The paper concludes that, adopting the patient's rights charter is a valuable measure to meet patient's rights; however, a serious challenge is how to implement and acculturate observing patient's rights in practice in our healthcare system in Iran.
Mehmet Fuat Eren
Full Text Available Venous thromboembolism (VTE is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8% in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT and pulmonary embolism (PE is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH or low molecular weight heparin (LMWH. Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.
Johansen, Kamilla; Pedersen, Didde; Kragbak, Nina;
, Nursing education in Århus, Hedeager 2, 8200 Aarhus N, Denmark. Background: Medical treatment and care of patients with infections may include source isolation of the patient, to avoid spreading of the infection. However, isolation is a potential physiological and psychological stress factor to the....... Quality of Care: The patients felt abandoned and forgotten by the nurses, because of fewer visits and time limited communication. This led to emotions such as frustrations, insecurity and neglect. While isolated the patients felt it difficult to achieve contact and have an optimal relation with the nurses...... experience both positive and negative effects of source isolation, and areas of potential interest for developing new strategies to improve care of isolated patients were identified. Surprisingly, despite both verbal and written information, the information has not been understood by the patients. Repetitive...
Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen
BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...... than 24 hours, as such short admissions could indicate that the patients had not been severely ill and that it might have been possible in these cases to avoid hospitalization. METHODS: Medical records were examined to determine the number of patients aged 75 or more who passed through the emergency...... department over a period of two months, and the proportion of those patients who were discharged after less than 24 hours. The reasons for the hospitalization, the diagnoses and the treatment given were noted. RESULTS: There was a total of 595 hospitalizations of patients aged 75 or above in the emergency...
Willard, S G; McDermott, B E; Woodhouse, L M
Recent cases in our Eating Disorders Clinic suggest that patients diagnosed with bulimia nervosa seeking surgical fat removal may be exhibiting a variant of the purging behavior seen in bulimic patients. These same patients exhibit historical or concurrent abuse of laxatives and/or diuretics or self-induced vomiting in a pathologic attempt to obtain or maintain an idealized body image. This paper presents two case studies that illustrate the bulimic patient's compulsive quest for lipectomy with unrealistic expectations that surgical alteration of the body will be an emotional and physical panacea. Plastic surgeons must be cautioned regarding this potential manifestation of bulimia nervosa and the dangers inherent in colluding with the patient in a pathologic request for surgery. It is important for plastic surgeons to recognize appropriate use of lipectomy as an alternative to traditional purging behavior in the bulimic patient. PMID:8764715
Full Text Available Distributed virtual patient record system is proposed for diagnosis and analysis. It permits physicians located at various places to consult on the status of the patient. In spite of patient data located at various sites, the data can be assembled and the patient record can be constructed dynamically by using the patient’s Social Security Number (SSN. Later, a graphical model could be constructed through which consulting physicians can derive useful information about the current status of the patient. It uses modern distributed objects and emerging telecollaboration tools. In this study, we describe the meaning of distributed virtual patient record, the barriers for implementing the system, requirements of the system and services. In addition, an example named “TeleMed” which implements this concept has been described.
Thygesen, Ruth Hauerberg
extensive care than the target group throughout the day. The target group participates in various activities, e.g. travels abroad arranged by the social workers together with the inhabitants of the house-share, to strengthen the weak social networks of the target group. The research question is: “How do...... was experienced as “being their own choice” to receive it. The inhabitants in the house-share were to some extent seen as adequate companionship for various activities (travel etc.), as an alternative to loneliness. Yet some clients would rather spend more time with somebody more in alignment with...... workers when they accompany them on travels. Another research issue was whether the clients’ expressed opinions presented to the staff/leaders could influence the future support as a result of organizational learning. The findings support this, judged from the views expressed by the staff during the...
Barré, Chantal; Falcou, Marie-Christine; Mosseri, Véronique; Carrié, Sylvie; Dolbeault, Sylvie
It is important to support patients with cancer during their care pathway and even beyond. They undergo long and difficult treatments, all anxiety-causing situations and sources of stress. Sophrological techniques help patients to find calm, lessen their fears and offer them the opportunity to work on themselves through simple easily reproducible exercises. This observation has been verified by a study carried out at the Institut Curie with patients undergoing chemotherapy. PMID:26567064
Ahmad Haerian; Ali Moemen; Saeede Asgari; Farzane Vaziri
Introduction: health literacy is a fundamental part of the healing promotion. The aim of this study was to evaluate periodontal health literacy among patients. Materials and methods: 296 patients attending periodontal clinic who were above 16 years old participated in this study. Gathering data was based on screening questions on a 5-point Likert scale. After completion questionnaire, data was analyzed by Mann-Whitney and Kruskal-Wallis test. Based on the scores of questions, patients were cl...
Psychodynamic psychotherapy is effective as an approach to understanding the psychological conflicts and the psychiatric symptoms of cancer patients as well as to planning useful psychological interventions. The author recommends that the psychotherapist who treats cancer patients be familiar with the following: 1) the natural course and treatment of the illness, 2) a flexible approach in accord with the medical status of the patient, 3) a common sense approach to defenses, 4) a concern with ...
L Downey; Lloyd, Hilary
There are a number of circumstances that may affect an individual's ability to maintain personal hygiene. Hospitalised patients, and in particular those who are bedridden, may become dependent on nursing staff to carry out their hygiene needs. Assisting patients to maintain personal hygiene is a fundamental aspect of nursing care. However, it is a task often delegated to junior or newly qualified staff. This article focuses on the principles of bed bathing patients in hospital, correct proced...
Ziting Wang; Anantharaman Vathsala; Ho Yee Tiong
Haematuria has a prevalence of 12% in the postrenal transplant patient population. It heralds potentially dangerous causes which could threaten graft loss. It is important to consider causes in light of the unique, urological, and immunological standpoints of these patients. We review the literature on common causes of haematuria in postrenal transplant patients and suggest the salient approach to the evaluation of this condition. A major cause of haematuria is urinary tract infections. There...
The identification of patient plays a key role in the quality and safety of radiotherapy. It does impact on all professional staff and on patients. After the regulatory authority approval (Cnil), a pilot study has been performed on 1901 patients. Acceptance has been very high (> 93%) with a low risk of mis-identification (< 0.1%). The next step will be to implement and test a bimodal system in order to improve registration capacity and sensitivity. (authors)
Bel, E.H.D.; Weersink, E.J.M.; Rijssenbeek-Nouwens, L.H.M.
Control of asthma, the goal of asthma treatment, seems hard to obtain. However, it is largely unknown why control of asthma remains difficult in many patients in spite of available powerful medication. In this thesis we studied non-pharmacological factors influencing asthma control: patient related factors, such as adherence and health status, as well as environmental related factors such as exposure to house dust mite allergen. Finally we studied the effect of a combination of these patient ...
Full Text Available Abstract Background Patients have the potential to provide a rich source of information on both organisational aspects of safety and patient safety incidents. This project aims to develop two patient safety interventions to promote organisational learning about safety - a patient measure of organisational safety (PMOS, and a patient incident reporting tool (PIRT - to help the NHS prevent patient safety incidents by learning more about when and why they occur. Methods To develop the PMOS 1 literature will be reviewed to identify similar measures and key contributory factors to error; 2 four patient focus groups will ascertain practicality and feasibility; 3 25 patient interviews will elicit approximately 60 items across 10 domains; 4 10 patient and clinician interviews will test acceptability and understanding. Qualitative data will be analysed using thematic content analysis. To develop the PIRT 1 individual and then combined patient and clinician focus groups will provide guidance for the development of three potential reporting tools; 2 nine wards across three hospital directorates will pilot each of the tools for three months. The best performing tool will be identified from the frequency, volume and quality of reports. The validity of both measures will be tested. 300 patients will be asked to complete the PMOS and PIRT during their stay in hospital. A sub-sample (N = 50 will complete the PMOS again one week later. Health professionals in participating wards will also be asked to complete the AHRQ safety culture questionnaire. Case notes for all patients will be reviewed. The psychometric properties of the PMOS will be assessed and a final valid and reliable version developed. Concurrent validity for the PIRT will be assessed by comparing reported incidents with those identified from case note review and the existing staff reporting scheme. In a subsequent study these tools will be used to provide information to wards/units about their
Reporting patient satisfaction has become an increasingly common component of studies evaluating treatment outcomes. However the construct of "patient satisfaction" is one that is complex and context dependent. While there is no question that careful, reliable, and valid measurement of this important aspect of patient care is required, tools for achieving this objective have not been fully developed. Measures of patient satisfaction that reflect the unique role of the hand in everyday life will require the same approach to instrument development as has been used to move forward the field of outcome measurement in general. PMID:27570227
Full Text Available Erectile dysfunction (ED is a common problem seen among patients on hemodialysis (HD, but it is still a taboo subject in our country. The attention given to this sexual problem remained low, and the prevalence of ED among these patients has not been well characterized. We carried out this study in order to determine the prevalence and severity of ED in HD patients. We conducted a descriptive cross-sectional study in our HD unit in March 2013. ED was evaluated using the International Index Erection Function. Thirty patients with a mean age of 49.1 years were eligible for this study. The main causes of chronic kidney disease were hypertension (62.5% and diabetes (41.6%. The prevalence of ED was 80%, including 33.3% severe ED. Plasma levels of gonadotropins: luteinizing hormone (LH, follicule-stimulating hormone were in the standards except for one patient who had an elevated level of LH. Prolactin was elevated in four cases. ED was present in 8.4% of patients before the discovery of renal failure and in 91.6% of patients at the beginning of dialysis. For 19 patients (79.1%, the ED had increased during the dialysis sessions. A significant number of our HD patients presented with ED of varying degrees. Nephrologists should pay attention to the problem of ED in order to improve the quality of their life.
C. S. Rand
Full Text Available Although there are very few published studies on adherence to treatment regimens in chronic obstructive pulmonary disease (COPD, the evidence that exists suggests that, as with asthma therapy, adherence is poor. Patient beliefs about COPD, as well as their motivation and expectations about the likelihood of success of medical interventions, can influence adherence rates. Other critical factors include the patient's understanding of their illness and therapy, and the complexity of the prescribed treatment regimen. Incorrect inhaler technique is also a common failing. When prescribing in primary or specialist care, healthcare professionals should address adherence as a vital part of the patient consultation. Improved patient education may also increase adherence rates.
Quik, E. H.; Feenstra, T. L.; Postmus, D.; Slotman, B. J.; Leemans, C. R.; Krabbe, P. F. M.; Langendijk, J. A.
Background and purpose: Proton therapy is an emerging technique in radiotherapy which results in less dose to the normal tissues with similar target dose than photon therapy, the current standard. Patient-level simulation models support better decision making on which patients would benefit most. Ma
Dellson, Pia; Nilbert, Mef; Carlsson, Christina
of future simplified and more attractive informed consent forms. CONCLUSIONS: The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language...
Objectives: To stratify patients into various stages, calculate average patient delay and study various causes of delay to presentation. Methodology: This was a one year hospital based cross sectional study at Khyber Teaching Hospital, using non probability consecutive sampling. A simplified staging was used for this study; Early (Stage I), Intermediate (Stage II, III), and Late (Stage IV). A patient was labelled delay when >3 months had elapsed between first symptom perception and first doctor consultation. Results: 80 patients were included with age 21-80 years (mean 45.28+-13.15). 80% of the patients were married, 76.3% (n=61/80) were poor with annual income of <500 US $, 85% of patients were illiterate. The participants from Rural and Urban areas were similar (37 % vs 31%); 15% were from Afghanistan. 80% patients presented with a delay of >3 months. Most common cause of delay was false symptom interpretation in 25.3% (n=17) patients. Conclusion: Late clinical presentation is because of lack of health education, unawareness, misconceptions about treatment and strong belief in traditional medicine resulting in advanced disease. This is worsened by poverty and unavailability of health care services especially in rural areas. (author)
Full Text Available The Telemedicine system comprises of both hardware and software components at both the patient and doctor ends. A leading field for application of telemedicine is in the field of cardiology where ECG is the major tool for diagnosis. The proposed project in this paper provides an image based techniques to acquire and analyse a constant streaming of ECG signal through digital camera for image capturing, information extraction and analysis performed using MATLAB tools as well as data sending system based on internet network. The method captures the vital signs and parameters from the ICU monitoring machine using a webcam and transmits the image through the internet. This original image is then availed to the consulting doctor via an ANDROID cell phone. In case of anomaly a notification is send to the doctor’s phone. The paper proposes a method to capture, compare and generate alert regarding the patient’s condition using the heart rate and make the captured image be available to the physician.
Daniela de Araújo Lamino
Full Text Available Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ to assess the caregivers’ comfort. The caregivers’ GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. Caregivers, who didn’t have a paid job or leisure’s activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers’ comfort, as well as needs that can be modified through health professionals’ interventions.
The traditional approach to patient safety in health care has ranged from reticence to outward denial of serious flaws. This undermines the otherwise remarkable advances in technology and information that have characterized the specialty of medical practice. In addition, lessons learned in industries outside health care, such as in aviation, provide opportunities for improvements that successfully reduce mishaps and errors while maintaining a standard of excellence. This is precisely the call in medicine prompted by the 1999 Institute of Medicine report ''To Err Is Human: Building a Safer Health System.'' However, to effect these changes, key components of a successful safety system must include: (1) communication, (2) a shift from a posture of reliance on human infallibility (hence ''shame and blame'') to checklists that recognize the contribution of the system and account for human limitations, and (3) a cultivation of non-punitive open and/or de-identified/anonymous reporting of safety concerns, including close calls, in addition to adverse events. (orig.)
Bagian, James P. [National Center for Patient Safety, Department of Veterans Affairs, Ann Arbor, MI (United States)
The traditional approach to patient safety in health care has ranged from reticence to outward denial of serious flaws. This undermines the otherwise remarkable advances in technology and information that have characterized the specialty of medical practice. In addition, lessons learned in industries outside health care, such as in aviation, provide opportunities for improvements that successfully reduce mishaps and errors while maintaining a standard of excellence. This is precisely the call in medicine prompted by the 1999 Institute of Medicine report ''To Err Is Human: Building a Safer Health System.'' However, to effect these changes, key components of a successful safety system must include: (1) communication, (2) a shift from a posture of reliance on human infallibility (hence ''shame and blame'') to checklists that recognize the contribution of the system and account for human limitations, and (3) a cultivation of non-punitive open and/or de-identified/anonymous reporting of safety concerns, including close calls, in addition to adverse events. (orig.)
There is a very high prevalence of Erectile Dysfunction (ED) in dialysis patients. There is no as such available data on ED and factors affecting it in our patients. Analytical, cross-sectional, hospital based study conducted from January to March 2008, Haemodialysis unit of Shalimar and Mayo Hospital, Lahore. All male patients of end stage renal disease (ESRD) on maintenance haemodialysis therapy, whose spouses are alive and able to perform intercourse, were included in the study. Patient with cognitive and communication deficits were excluded from study. International index of erectile function-5 (IIEF-5), adopted in Urdu was used for the determination of prevalence of erectile function. Categorization of erectile dysfunction was done as mild, moderate and severe. Demographic data were collected and certain laboratory parameters (haemoglobin, haematocrit, urea, HBsAg and Anti HCV) were sent. Total numbers of patient were fifty. Major cause of ESRD was diabetes mellitus 28 (56%). Most of the patients 33 (66%) have passed 10th grade or they were under 10th grade. Prevalence of ED was 86% with mean IIEF-5 score of 10.36+-7.13. Majority of patients 33 (64.7%) were suffering from severe degree of ED. Factors responsible for ED are diabetes mellitus, age more than 50 year, high pre dialysis urea and Anti HCV positive patients. In this study, smoking, duration of dialysis and monthly spending is not related with ED. Majority of the patients suffering from ESRD, on maintenance haemodialysis are having ED. None of the patients suffering from ED were taking any treatment for it. Haemodialysis does not improve sexual dysfunction. Major factors responsible for ED are diabetes mellitus, age more than 50 years, high pre dialysis urea and Anti HCV positive patients. (author)
Tigaran, S; Rasmussen, V; Dam, M;
To investigate the frequency of ECG abnormalities suggestive of myocardial ischaemia in patients with severe drug resistant epilepsy and without any indication of previous cardiac disease, assuming that these changes may be of significance for the group of epileptic patients with sudden unexpected...
The risks of radiation therapy in patients with Fanconi's anemia who have cancer are not clear. Possible toxicity was reported in six of 14 patients: 1/1 with vaginal cancer, 4/10 with head and neck or esophageal cancer, and 1/3 with oral cancer following bone marrow transplant
Epstein, S K
Mechanical ventilation assumes the work of breathing, improves gas exchange, and unloads the respiratory muscles, all of which require good synchronization between the patient and the ventilator. Causes for patient-ventilator dyssynchrony include both patient factors (abnormalities of respiratory drive and abnormal respiratory mechanics) and ventilator factors (triggering, flow delivery, breath termination criteria, the level and mode of ventilator support, and imposed work of breathing). Although patient-ventilator dyssynchrony can often be detected on physical exam, careful analysis of ventilator waveforms (pressure-time, flow-time) allows for more precise definition of the underlying cause. Patient-ventilator interaction can be improved by reversing patient factors that alter respiratory drive or elevate patient ventilatory requirements and by correcting factors that contribute to dynamic hyperinflation. Proper setting of the ventilator using sensitive triggering mechanisms, satisfactory flow rates, adequate delivered minute ventilation, matching machine T(I) to neural T(I), and applying modes that overcome the imposed work of breathing, further optimize patient-ventilator synchrony. PMID:16088669
Kensing, Finn; Strand, Dixi Louise; Bansler, Jørgen P.;
In this paper, we discuss PD issues and concerns in the context of a national initiative the purpose of which is to provide IT support for the communication and collaboration within a heterogeneous network of patients/citizens and health care professionals. We present the notion of patient...
As the population ages, the incidence of dementia increases. All types of dementia, whether they are reversible or irreversible, lead to loss of intellectual function and judgment, memory impairment, and personality changes. The skills to feed oneself, use eating utensils, and consume items recognized as food, thereby maintaining nutrition status, may be lost as dementia progresses. Reports indicate that nutrition status may be maintained when patients are hand fed, but this is labor intensive and therefore expensive. Feeding via a percutaneous endoscopic gastrostomy tube is often chosen as an acceptable alternative. Research indicates that there is little benefit in this population when aggressive nutrition support is instituted. Providing tube feeding to patients with dementia does not necessarily extend life, increase weight, or reduce the incidence of pressure ulcers or aspiration. There are many legal and ethical issues involved in the decision to place a feeding tube in demented patients. The primary issue in patients with dementia may be autonomy and the right of an individual to decide whether or not a tube should be placed at all. Legally, there is clear precedent that the courts see the insertion of a feeding tube as extraordinary care that the patient has the right to refuse. However, much of case law is derived from cases of patients who were in a persistent vegetative state. Advance directives help to determine what the patient would want for himself. Considering all the options before the patient can no longer make decisions is the most desirable course. PMID:16556924
Kjærgaard, Benedict; Rudolph, Søren Finnemann; Lucas, Alexander;
Treatment of the hypothermic patient depends more on the clinical condition than on the core temperature. Unconscious patients need thorough investigation, and they can often be rewarmed with warm water in the pleural cavities. Cardiac arrest requires cardio pulmonary rescue until rewarming can b...
Pii, Kathrine Hoffmann; Villadsen, Kaspar
This article presents findings from an empirical study among patients and professionals involved in a preventive health program at a Danish hospital. It shows how patients enrolled in the program interact with health professionals in ways that challenge assumptions common to governmentality studi...
Control of asthma, the goal of asthma treatment, seems hard to obtain. However, it is largely unknown why control of asthma remains difficult in many patients in spite of available powerful medication. In this thesis we studied non-pharmacological factors influencing asthma control: patient related
Tan, Zaldy S.; Mulhausen, Paul L.; Smith, Stephen R.; Ruiz, Jorge G.
The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators…
Slator, R; Harris, D L
Rhinoplasty patients have long been considered to be psychologically unstable and therefore a "risky" group upon which to operate. Patients who had rhinoplastic operations more than 5 years ago were contacted by post and their psychological health assessed by the use of psychometric tests. The results show no evidence to support earlier suggestions that requests for rhinoplasty may be early symptoms of severe psychiatric disease. However, several points do emerge. Male patients show more symptoms of anxiety and depression than normal, and female patients who give no history of injury preceding their operation behave in a more extrovert and sociable manner than normal. Furthermore, patients of both sexes who give no history of injury before their operation, even though pleased with the operative results, are more self-conscious of their appearance than those who were injured prior to their rhinoplasty. PMID:1623348
Johnstone, M; Parashos, P
Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient. PMID:25762039
Masterton, Malin; Renberg, Tobias; Kälvemark Sporrong, Sofia
(Pmore critical than men regarding which species are used for what purposes (Pmore positive attitude towards animal testing is not shared to an equal degree with patients, who are the intended end-users and beneficiaries of medical......A strong argument for the practice of animal testing in medical research is the potential benefit to patients in getting improved pain relief, minimising morbidity and mortality. However, patients’ opinions on the ethics of animal testing are seldom sought, despite their role as principal...... stakeholders. This study compared the attitudes of patients and researchers on animal testing. Focus-group interviews were held with patients suffering from chronic inflammatory diseases, resulting in a questionnaire that was distributed January–May 2011. The questionnaire was posted to patient members...
With increasingly larger numbers of irradiated patients in our population, it seems likely that all dentists will eventually be called upon to manage the difficult problems that these patients present. Of utmost concern should be the patient's home care program and the avoidance of osteroradionecrosis. Endodontics and periodontics are the primary areas for preventing or eliminating the infection that threatens osteoradionecrosis. Endodontic treatment must be accomplished with the utmost care and maximum regard for the fragility of the periapical tissues. Pulpally involved teeth should never be left open in an irradiated patient, and extreme care must be taken with the between-visits seal. If one is called upon for preradiation evaluation, routine removal of all molar as well as other compromised teeth should be considered. Attention should be directed to the literature for further advances in the management of irradiated patients
With increasingly larger numbers of irradiated patients in our population, it seems likely that all dentists will eventually be called upon to manage the difficult problems that these patients present. Of utmost concern should be the patient's home care program and the avoidance of osteroradionecrosis. Endodontics and periodontics are the primary areas for preventing or eliminating the infection that threatens osteoradionecrosis. Endodontic treatment must be accomplished with the utmost care and maximum regard for the fragility of the periapical tissues. Pulpally involved teeth should never be left open in an irradiated patient, and extreme care must be taken with the between-visits seal. If one is called upon for preradiation evaluation, routine removal of all molar as well as other compromised teeth should be considered. Attention should be directed to the literature for further advances in the management of irradiated patients.
C. Van Eck
Full Text Available Study Design: Clinical PerspectiveObjective: To provide back care education for patients with low back pain. Background: Understanding the internal and external forces the body issubjected to, as well as the spine’s response to these forces, can better equipphysiotherapists in educating patients with low back pain. Methods and Measures: The focus of the clinical perspective is to providephysiotherapists with clinically sound reasoning when educating patients. Results: Providing a patient handout, educating them in how to incorporate back care knowledge into their dailyactivities.Conclusion: Physiotherapists can play a significant role in empowering patients through education to take responsi-bility for their disability.
Full Text Available Introduction. Cardiovascular disease are the major cause of mortality in developed countries. CHF is also a chronic cardiovascular disorder. Teaching the self care plays a major role in its prevention and chronic complications. Regarding the importance of self care investigating the, effect of self care education on the knowledge of the patients on CHF is so important. Methods. In this study 42 patients with CHF were selected in the first exam held 15 days before and after a two hour training class. A training booklet was given to them. Data was collected by a questionnarie which includ 5 section as follows. The 1st section included the demographic charactristics. The 2nd section, 7 questions about anatpmy and physiology of the heart, the 3rd section included eight questions about drugs history, the 4th section included nine questions about regimen of the patients and the 5th section included 6 questions about physical activity. Results. The self care knowledge of patients increased 95 percent after education. There was no correlation between the effects of self care education and the age of all units studied. Statistical tests showed no correlation between the effects of self care education and educational level. Discussion. The knowlegde of the patients is low regarding the self care. The self care education to patients is the main duty of nurses. So, it is recommended to be considered as the first nursing intervention regarding these patients.
S P Sawant
Full Text Available Aims and Objectives: Pulmonary embolism (PE is rare in the Indian population and is under-reported in patients with malignancy. We studied the clinical profile and outcome of patients with PE and cancer in the Indian population. Materials and Methods: Data of cancer patients with PE, admitted in a tertiary cancer centre, was analyzed. The prevalence of PE was calculated as the number of patients with PE per 10,000 hospital admissions. The demographic data, details of cancer, co-morbidities, details of PE, and treatment given for PE and their outcomes were recorded and analyzed. Results: There were 56,425 hospital admissions in the study period. The prevalence of PE was 6.4 per 10,000 hospital admissions .Thirty-six cancer patients were diagnosed to have PE. In females, gynecological malignancies (36.84% and in males gastrointestinal, head and neck cancers, and hematological malignancies were the most common sites (17.7% each. PE was associated with DVT in 41.7%. Dyspnea was the most common presenting symptom. Five patients (13.88% were asymptomatic and were incidentally detected to have PE . The most common echocardiographic finding was right ventricular dysfunction (55.55%. Mortality among the treated patients was 22% (7 / 31 and in untreated patients it was 80% (4 / 5. The factors that had an impact on a three-month survival were, the presence of massive PE (P = 0.019 and the presence of RV dysfunction at presentation (P = 0.005. Conclusion: The prevalence of PE and mortality due to PE is high in cancer patients. Risk stratification for venous thromboembolism (VTE should be done in all cancer patients and thromboprophylaxis should be optimally used.
Wu, Clayton; Melnikow, Joy; Dinh, Tu; Holmes, James F.; Gaona, Samuel D.; Bottyan, Thomas; Paterniti, Debora; Nishijima, Daniel K.
Introduction Understanding patient perceptions and preferences of hospital care is important to improve patients’ hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions. Methods This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed-ended questionnaire. Results Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated “very important,” while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated “very important.” When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference. Conclusion Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed. PMID:26587095
Boehm, O; Baumgarten, G; Hoeft, A
Postoperative mortality remains alarmingly high with a mortality rate ranging between 0.4% and 4%. A small subgroup of multimorbid and/or elderly patients undergoing different surgical procedures naturally confers the highest risk of complications and perioperative death. Therefore, preoperative assessment should identify these high-risk patients and stratify them to individualized monitoring and treatment throughout all phases of perioperative care. A "tailored" perioperative approach might help further reduce perioperative morbidity and mortality. This article aims to elucidate individual morbidity-specific risks. It further suggests approaches to detect patients at the risk of perioperative complications. PMID:27396802
Ros, Wynand J.G
Introduction In 2010 the UMC Utrecht started with the introduction of patient portals for patients with chronic conditions. The evaluation concerned portals of three patient groups: adults with HIV, adolescents with CF and parents of children with CF. The portals had six modules: ‘overview treatment appointments’, ‘overview of medication and test results’, ‘e-consult (a-synchronous)’, ‘request for medical prescription’, ‘diaries’ and ‘questionnaires’. Aim and objectives To evaluate patient’s ...
Célia Harumi Tengan; Acary S. Bulle de Oliveira; Alberto Alain Gabbai
Twenty patients with periodic paralysis were evaluated and the aspects studied included epidemiological data, clinical manifestations, ancillary tests, treatment and evolution. Sixteen patients had the hypokalemic form (5 familiar, 5 sporadic, 5 thyrotoxic and 1 secondary). No patient with the normokalemic form was detected. Predominance of men was found (14 patients), especially in the cases with hyperthyroidism (5 patients). No thyrotoxic patient was of oriental origin. Only 4 patients had ...
Nicole M. Reusser
Full Text Available Human papillomavirus (HPV infection is the most common sexually transmitted disease worldwide and can result in pre-malignancies or overt malignancies of the skin and mucosal surfaces. HPV-related illnesses are an important personal and public health problem causing physical, mental, sexual and financial detriments. Moreover, this set of malignancies severely affects the immunosuppressed population, particularly HIV-positive patients and organ-transplant recipients. There is growing incidence of HPV-associated anogenital malignancies as well as a decrease in the average age of affected patients, likely related to the rising number of high-risk individuals. Squamous cell carcinoma is the most common type of HPV-related malignancy. Current treatment options for HPV infection and subsequent disease manifestations include imiquimod, retinoids, intralesional bleomycin, and cidofovir; however, primary prevention with HPV vaccination remains the most effective strategy. This review will discuss anogenital lesions in immunocompromised patients, cutaneous warts at nongenital sites, the association of HPV with skin cancer in immunocompromised patients, warts and carcinomas in organ-transplant patients, HIV-positive patients with HPV infections, and the management of cutaneous disease in the immunocompromised patient.
Since the late '90s citizens have been increasingly involved in healthcare, thanks to a shift in access to healthcare information, greater patients' and citizens' awareness about their rights and needs, and a change in physicians' attitudes and behavior. At the same time, to ensure the sustainability of the national health services, patients' needs are increasingly being examined in relation to the services and interventions needed, and to foster informed demand by patients and citizens, and appropriate prescriptions by physicians. Nowadays, patients already have a section in an authoritative medical journal. Working with clinicians, they set research priorities and the outcomes to be studied. Especially in UK and USA, they are invited to participate in the design and development of trials and in deciding which trials should be funded. The situation varies widely in different countries, though involving citizens in healthcare decisions is a common mantra. Even when they consult a clinician, the patients' role has evolved. People ask for information more often and want an active part in decisions about their health. Physicians start to pay more attention to the person and the social context, feelings and emotions, and person-centered care has become a reference in the doctor-patient relationship. This article offers an overview of the changing roles of patients and citizens in healthcare. PMID:27030220
Salama A Ouf; Tarek A Moussa; Alshimaa M Abd-Elmegeed; Samar R Eltahlawy
Objective:To study the occurrence and prevalence of dermatomycosis in special patient populations suffering from diabetes, cancer and heart diseases. Methods: A total of 640 patients suffering from diabetes, 280 patients suffering from cancer and 210 patients suffering from heart diseases from Cairo City were evaluated for dermatophytosis at the dermatology clinics of four different hospitals from January 2005 to December 2006. Results: The presence of diabetes looks a risk factor for tinea pedis and tinea corporis. Tinea cruris and tinea unguium were not common among diabetics, while tinea capitis and tinea versicolor were completely missed. Tinea capitis followed by tinea pedis are the most common among cancer patients. Thirty cases were recorded for tinea among 210 patients with heart diseases of which tinea capitis and tinea versicolor were recorded once while the other clinical types of tinea were estimated in 6-8 patients for each type. Conclusions: The present investigation shows that diabetes remains to be a risk factor for dermatophytosis and cancer comes next due to the use of radioactive irradiation.
Belkis Mercedes Vicente Sánchez
Full Text Available Introduction: Diabetes mellitus is a significant health problem worldwide, since it is one of the most frequent non-transmissible diseases as for the variety and intensity of complications associated with it. Objective: To assess some physical, psychic and social aspects related with life quality of these patients. Methods: A descriptive, cross-sectional study was developed in the in the Centre for Care and Education of Diabetic Patients, between 2006 and 2007. The universe was formed by 148 diabetic patients (type II that received ambulatory assistance in that institution. Variables: age, sex, years suffering from that disease, associated diseases and nutritional assessment according to the body mass index. Results: There was grater incidence of females, most of the patients were between 40 and 59 years; it was significant the association of diabetes with hypertension, mainly in overweight patients. Life quality was poorer with more years of diseases evolution, the obese patients and those with peripheral vascular disease. Conclusion: Even when life quality of diabetic patients is not generally deteriorated, there is a negative disposition towards the disease.
N. V. Vakhnina
Full Text Available Hypertension is one of the most common vascular diseases. The brain as target organs in hypertension is damaged more often and earlier. Neurological complications due to hypertension are frequently hyperdiagnosed in Russian neurological practice. Thus, headache, dizziness, impaired recall of recent events, nocturnal sleep disorders, and many other complaints in a hypertensive patient are usually regarded as a manifestation of dyscirculatory encephalopathy. At the same time headaches (tension headache and migraine in hypertensive patients are predominantly primary; headache associated with dramatic marked elevations in blood pressure is encountered in only a small number of patients. The role of cerebrovascular diseases in the development of dizziness in hypertensive patients is also overestimated. The vast majority of cases, patients with this complaint are in fact identified to have benign paroxysmal postural vertigo, Mеniеre’s disease, vestibular neuronitis, or vestibular migraine. Psychogenic disorders or multisensory insufficiency are generally responsible for non-systemic vertigo in hypertensive patients. Chronic cerebral circulatory insufficiency may cause non-systemic vertigo as a subjective equivalent of postural instability.Cognitive impairments (CIs are the most common and earliest manifestation of cerebrovascular lesion in hypertension. In most cases, CIs in hypertension were vascular and associated with cerebrovascular lesion due to lacunar infarcts and leukoaraiosis. However, mixed CIs frequently occur when hypertensive patients are also found to have signs of a degenerative disease, most commonly in Alzheimer’s disease.
Orozco, Federico; Anders, María; Mella, José; Antinucci, Florencia; Pagano, Patricia; Esteban, Paula; Cartier, Mariano; Romero, Gustavo; Francini, Bettina; Mastai, Ricardo
Relative adrenal insufficiency (RAI) is a common finding in cirrhotic patients with severe sepsis, and increased mortality. Its significance is unknown in stable conditions. The aim of this study was to evaluate the prevalence of RAI in stable cirrhotic patients at different stages of the disease. Also, the impact of RAI on the survival was evaluated and basal cortisol levels between plasma and saliva was correlated in control subjects and cirrhotic patients. Forty seven ambulatory patients and 16 control subjects were studied. RAI was defined as a serum cortisol increase of less than 9 υg/dl from baseline after the stimulation with 250 mg of synthetic ACTH. Twenty two had Child-Pugh = 8 and 25 = 9. The prevalence of RAI in patients with stable cirrhosis was 22%. A higher incidence of RAI was observed in patients with a Child-Pugh = 9 (8/32) than in those with = 8 (3/13, p developed this complication (79% and 51%, p < 0.05, respectively). In summary, the prevalence of RAI is frequent in patients with stable cirrhosis and that it is related to the severity of liver diseaseand increased mortality. PMID:27576278
Aelbrecht, Karolien; Rimondini, Michela; Bensing, Jozien; Moretti, Francesca; Willems, Sara; Mazzi, Mariangela; Fletcher, Ian; Deveugele, Myriam
Good doctor-patient communication may lead to better compliance, higher patient satisfaction, and finally, better health. Although the social variance in how physicians and patients communicate is clearly demonstrated, little is known about what patients with different educational attainments actually prefer in doctor-patient communication. In…
Carlsen, Berit Christina; Andersen, Klaus Ejner; Menné, Torkil;
limited. This review presents the current knowledge on the topic and discusses the evidence and characteristics of an increased susceptibility factor, possible causes to and genetic markers for the increased susceptibility, composition of the patient group and identification of patients at risk of...... developing multiple contact allergies. Evidence of allergen clusters among polysensitized individuals is also reviewed. The literature supports the idea that patients with multiple contact allergies constitute a special entity within the field of contact allergy. There is no generally accepted definition of...
A wide variety of musculoskeletal abnormalities may be seen in patients with chronic renal failure. Recently a destructive spondyloarthropathy has been described in patients undergoing hemodialysis. The characteristic features include marked disk space narrowing associated with vertebral end-plate erosion and sclerosis, without significant osteophyte formation. Ten patients with changes of destructive spondyloarthropathy involving the cervical or lumbar spine are presented in this exhibit. The appearance on plain radiographs, multiplanar tomography, CT and MR imaging is discussed. The importance of recognizing these changes as un unusual manifestation of chronic renal failure and their differentiation from infection are stressed
Riiskjær, Erik; Ammentorp, Jette; Nielsen, Jørn Flohr;
. Eight public hospitals in a Danish county. Participants. 32 809 inpatients and 1842 nurses on 84 wards. Main Outcome Measure. Optimal organizational level for measuring patient satisfaction and correlations between overall patient satisfaction and organizational context. Results. In all, 71.......4% of the departments chose to have the survey results specified at the subunit level or for specific diagnostic groups. Substantial differences in patient satisfaction between wards are illustrated. On the wards with the highest improvement potential, we found significantly higher occupancy rates, acute rates, rates...
S.V. Medina-León; A. Medina-Palomera; A. González-Ángeles; Rogers, P; M. Gil-Samaniego-Ramos; J. Ceballos-Corral; V. Nuño-Moreno
There has been much research where the flow of patients was improved, but most of this study is case-specific and only a few papers offer guidelines for patient flow analysis and improvement. In this study a general framework for the analysis and improvement of patient flow is presented, based on a literature review and on experience from a case study in a hospital in Mexico dealing with identifying improvement opportunities that reduced waiting times in the obstetrics/gynecology area of the ...
Stoy, W A
Medic 27 responds to a report of a fall victim at 27 West Pinnacle Lane. En route, the crew learns from dispatch that the patient fell approximately 25 feet from the roof of a three-story structure onto the roof of an adjacent garage. The caller reports the patient "going in and out of consciousness." The EMS crew requests the dispatch of a rescue unit and ladder company to assist on scene and the placement of a medical helicopter on standby. On scene, the patient's wife reports her husband accidentally disturbed a hornets' nest as he secured a weather vane to the top of the family home. She says the hornets stung her husband repeatedly. In his attempt to avoid the stings, his movements jarred the ladder, causing him to fall to the roof below. As you walk to the side of the patient's home, his wife adds that her husband has a cardiac condition and now complains of chest pain and trouble breathing. You wonder what you'll find when you reach the victim. Is he a medical patient with traumatic injuries or a trauma patient with medical complications? PMID:11213605
Grando, Maria Adela; Bates, David
The authors explore novel information-based mechanisms that are changing the way patients are involved in their own health care. The book covers models, frameworks and technologies to improve patient-to-provider communication, patient interaction with information technologies, patient education and involvement in health care decision processes, and patient access, understanding and control over their clinical data.
Bennett, Ariana H; Hassinger, Jane A; Martin, Lisa A; Harris, Lisa H; Gold, Marji
Research indicates that health care teams are good for staff, patients, and organizations. The characteristics that make teams effective include shared objectives, mutual respect, clarity of roles, communication, trust, and collaboration. We were interested in examining how teams develop these positive characteristics. This paper explores the role of sharing stories about patients in developing patient-centered teams. Data for this paper came from 1 primary care clinic as part of a larger Providers Share Workshop study conducted by the University of Michigan. Each workshop included 5 facilitated group sessions in which staff met to talk about their work. This paper analyzes qualitative data from the workshops. Through an iterative process, research team members identified major themes, developed a coding scheme, and coded transcripts for qualitative data analysis. One of the most powerful ways group members connected was through sharing stories about their patients. Sharing clinical cases and stories helped participants bond around their shared mission of patient-centered care, build supportive relationships, enhance compassion for patients, communicate and resolve conflict, better understand workflows and job roles, develop trust, and increase morale. These attributes highlighted by participants correspond to those documented in the literature as important elements of teambuilding and key indicators of team effectiveness. The sharing of stories about patients seems to be a promising tool for positive team development in a primary care clinical setting and should be investigated further. PMID:26348238
... be more susceptible to adverse scarring due to melanin, a brown pigment, found in the skin. Keloids ... such as laser skin resurfacing, chemical peels, laser hair removal and dermabrasion. Ethnic patients should be cautious ...
Hampton, H L
Adolescent patients need knowledge and motivation to practice a healthy lifestyle. The provider of adolescent health care is uniquely qualified to provide factual health information and practical advice. Enlisting parental support for confidential adolescent health services usually is not problematic when parents and health care providers share common goals and responsibility. The health care provider must develop rapport to foster high-risk health behavior disclosure and must promote health messages that are stronger than those received from peers, television, movies, and magazines. Adolescents who elect to abstain from sexual activity need as much support as sexually active patients. Depression, substance abuse, and eating disorders must be recognized and treated. Preventative health care services for adolescents can be optimized when office staff understand the special needs of these young women. The physician's concerns regarding the health of adolescent patients will be welcomed by patients, their parents, and the community. PMID:10693179
Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit;
PURPOSE: The aims of this study were to assess how communication with health care staff is perceived by Danish cancer patients and to characterise those patients who report problems in communication. METHODS: In a cross-sectional survey, a nationally representative sample of 2,202 cancer patients...... consultations, and whether doctors criticised other doctors. RESULTS: A total of 1,490 cancer patients responded to the questionnaire. Of these, 24 % reported one or more problems with the areas of communication measured. The problem most frequently reported (by 12 %) was not having sufficient time for...... who had been in contact with a hospital department during the past year was invited to respond to a questionnaire. Communication with doctors and nurses was assessed separately as were their abilities as listeners, doctors' use of an understandable language, timing of the information, duration of...
U.S. Department of Health & Human Services — Reducing Costs, Protecting Consumers - The Affordable Care Act on the One Year Anniversary of the Patients Bill of Rights For too long, too many hard working...
Full Text Available There has been much research where the flow of patients was improved, but most of this study is case-specific and only a few papers offer guidelines for patient flow analysis and improvement. In this study a general framework for the analysis and improvement of patient flow is presented, based on a literature review and on experience from a case study in a hospital in Mexico dealing with identifying improvement opportunities that reduced waiting times in the obstetrics/gynecology area of the emergency department. The framework involves an initial analysis using basic tools followed by the selection of a strategy based on system complexity; financial investment required and team participation. The alternative strategies considered were use of advanced analysis tools; use of kaizen events; or direct recommendations. The aim of the framework is to serve as guideline in patient flow improvement projects by helping select the most appropriate improvement path, resulting in project success.
Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, looks at what the NHS can learn about good customer service from the private sector, and how Always Events can improve patient care. PMID:27523767
dos Santos, Regina Maria; Viana, Ivea Rayane M N; da Silva, Josefa Rita; Trezza, Maria Cristina Soares Figueiredo; Leite, Joséte Luzia
This is a qualitative study about the relationship among nurses of a university hospital and their patients when they need to undress those patients to take care. The purpose was to analyze speech of seven nurses in this situation. The information was taken by transcribing the semi-structured interviews which were analyzed according Michel Foucault's thought. The results demonstrated that the relationship among nurses and patients at the time when nudity is needed to perform nursing care is full of power, to which the nurses don't feel always prepared. Also the nurses don't think that, acting as they act, they exert power over the patients. It is suggested to Nursing schools to perform seminars about the care with the naked body. PMID:21308217
Coleman, R; Body, J J; Aapro, M;
There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...... morbidity including fractures, severe pain, nerve compression and hypercalcaemia. Through optimum multidisciplinary management of patients with bone metastases, including the use of bone-targeted treatments such as potent bisphosphonates or denosumab, it has been possible to transform the course of advanced...... cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...
... This helps the skin stay healthy and prevents bedsores. Turning a patient is a good time to ... M, et al. Risk assessment and prevention of pressure ulcers: a clinical practice guideline from the American College ...
Department of Veterans Affairs — The National Patient Care Database (NPCD), located at the Austin Information Technology Center, is part of the National Medical Information Systems (NMIS). The NPCD...
Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas
A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported. PMID:24907215
Full Text Available Pyoderma gangrenosum (PG has previously been reported in very few patients with HIV infection. We describe here a 30-year-old housewife with HIV infection having multiple ulcerations over lower limbs characteristic of PG.
Hoffman, Kenneth J.
In today's world, medical information on patients is usually recorded by a variety of health care providers who write their thoughts either on paper or in a word processing program. Telemedicine and other high technology initiatives add to the existing information database. However, most stored data are not easily linked. This makes it difficult to do process evaluations and nearly impossible to determine treatment effectiveness. Any aggregate data analysis must rely on the very few standardized patient data points that may include some demographic information, diagnosis and codable procedures. This paper demonstrates the utility of business process reengineering techniques using Integrated Computer Assisted Manufacturing Definition modeling to create a data model in which patient information is used to build an analyzable database. This provides the infrastructure in which to store all patient data.
... site. Top of Page Preventing fungal infections in cancer patients Fungi are difficult to avoid because they are a natural part of the environment. Fungi live outdoors in soil, on plants, trees, and other vegetation. They are also on ...
... HAIs HICPAC One & Only Campaign A Patient Safety Threat – Syringe Reuse Recommend on Facebook Tweet Share Compartir ... need to be aware of a very serious threat to their health - the reuse of needles or ...
Danholt, Peter; Bødker, Keld; Hertzum, Morten;
This short paper outlines a recently initiated research project that concerns healthcare information systems and patient empowerment. Drawing on various theoretical backgrounds, Participatory Design (PD), Computer Supported Cooperative Work (CSCW), Computer Mediated Communication (CMC), and Science...
Both patients and caregivers but also treating physicians are concerned about complications along with surgical interventions. A major problem is abrupt cessation of anti-Parkinson medication, which leads to manifold disturbances, sometimes even to an akinetic crisis. There are several means to guarantee continuous dopaminergic stimulation even in patients that are not allowed to take medication orally before they undergo surgery. Amongst others rectally applied levodopa, amantadine infusions, and especially the use of a rotigotine patch are good means to overcome oral intake. Perioperative management is important due to the fact that in Germany alone each year more than 10 000 PD patients undergo surgery. Main reasons for this are fractures, but also elective interventions. Further emergency situations that cause treatment as an inpatient are psychosis, motoric disability, but also pneumonia and cardiovascular disturbances. In contrast PD patients suffer less often from cancer. PMID:27276074
Idorn, L; Jensen, A S; Juul, K; Reimers, J.I.; Johansson, P I; Sørensen, K E; Ostrowski, S R; Søndergaard, L
. Using a population-based design, we retrospectively identified all TEs in 210 Fontan patients. Whole blood assays (thromboelastography, thromboelastography functional fibrinogen and Multiplate) reflecting global hemostasis, clot strength and platelet aggregation were analyzed prospectively in 112...
Jensen, Lotte Groth
investigate the creation of overview in daily clinical practice and further investigates how respectively a paper-based patient record and an EPR supports the creation of clinical overview. That the change from paper-based patient record to EPR can cause difficulties, interruptions and challenges...... or rendered visible in detail. Studies have been conducted on the differences on using respectively a paper-based patient record and an EPR, but few studies have focused on the creation of overview in daily clinical practice in connection with this transition. Therefore, the aim of this PhD dissertation...... of clinical overview. Considering the change from paper-based patient record to EPR, the dissertation also investigates how the two artefacts support the creation of clinical overview. The present dissertation is primarily based on ethnographic inspired observational studies and semi-structured interviews...
Bakken, R; van Walraven, A-M; Egeland, T
The article discusses views and recommendations of the World Marrow Donor Association concerning ethical issues related to the donation of hematopoietic stem cell products with respect to recruitment, evaluation, workup, and follow-up of unrelated donors. Particular emphasis is placed upon commitment of individual donors, in particular, with respect to the needs of patients to find HLA-matched donors, who may be asked to donate stem cell and other cell products more than once for given patients. PMID:14628078
CNS infections caused by infective agents are rare in immunocompetent hosts, but more frequent in immunocompromised patients. In addition, the spectrum of causative agents is completely different. There are no pathognomonic alterations in radiologic imaging, even in clinically severely ill patients imaging is often non-specific or inconspicious. This article gives a review of the most frequent infective agents and image alterations. Modern radiology is not yet able to replace the gold standard of pathogen detection. (orig.)
Sabry Alaa; Abo-Zenah Hamdy; Wafa Ehab; Mahmoud Khaled; El-Dahshan Khaled; Hassan Ahmed; Abbas Tarek; Saleh Abd El-Baset; Okasha Kamal
The prevalence of sleep disorders is higher in patients with kidney failure than the general population. We studied the prevalence of sleep disorders in 88 (mean age; 41.59 ± 16.3 years) chronic hemodialysis (HD) patients at the Urology and Nephrology Center, Mansoura Uni-versity, Egypt over 4-month period. The investigated sleep disorders included insomnia, restless leg syndrome (RLS), obstructive sleep apnea syndrome (OSAS), excessive daytime sleepiness (EDS), narcolepsy and sleep walk...
Jensen, Helene Christine Kildegaard; Brabrand, Mikkel; Vinholt, Pernille Just;
. METHODS: We conducted a prospective cohort study involving all first time admissions (n=11988) to the Acute Medical Department at Odense University Hospital linking potassium level at admission with registry data on patient characteristics, laboratory data, redeemed prescriptions and time of death for the...... or betagonist use. CONCLUSIONS: In a mixed population of hospitalized medical patients, hypokalemia is common and plasma [K(+)]<2.9 mmol/l is associated with increased 7-day and 8-30 day mortality....
Johnson Space Center teamed up with Sarasota, Florida-based METI (now CAE Healthcare) through the STTR program to ruggedize the company’s patient simulators for training astronauts in microgravity environments. The design modifications were implemented in future patient simulators that are now used to train first responders in the US military as well as fire departments and other agencies that work in disaster zones.
Alabiso, Giulia; Alio, Luigi; Arena, Saverio; Barbasetti di Prun, Allegra; Bergamini, Valentino; Berlanda, Nicola; Busacca, Mauro; Candiani, Massimo; Centini, Gabriele; Di Cello, Annalisa; Exacoustos, Caterina; Fedele, Luigi; Fuggetta, Eliana; Gabbi, Laura; Geraci, Elisa; Imperiale, Ludovica; Lavarini, Elena; Incandela, Domenico; Lazzeri, Lucia; Luisi, Stefano; Maiorana, Antonio; Maneschi, Francesco; Mannini, Luca; Mattei, Alberto; Muzii, Ludovico; Pagliardini, Luca; Perandini, Alessio; Perelli, Federica; Pinzauti, Serena; Porpora, Maria Grazia; Remorgida, Valentino; Leone Roberti Maggiore, Umberto; Seracchioli, Renato; Solima, Eugenio; Somigliana, Edgardo; Tosti, Claudia; Venturella, Roberta; Vercellini, Paolo; Viganò, Paola; Vignali, Michele; Zannoni, Letizia; Zullo, Fulvio; Zupi, Errico
A panel of experts in the field of endometriosis expressed their opinions on management options in a 28-year-old patient, attempting pregnancy for 1 year, with severe cyclic pelvic pain and with clinical examination and imaging techniques suggestive of adenomyosis. Many questions this paradigmatic patient may pose to the clinician are addressed, and all clinical scenarios are discussed. A decision algorithm derived from this discussion is also proposed. PMID:26772777
Burney, Basil O.; Garcia, Jose M.
Prevalence of hypogonadism in men with cancer has been reported between 40% and 90%, which is significantly higher than in the general population. Hypogonadism is likely to affect the quality of life in these patients by contributing to non-specific symptoms, including decreased energy, anorexia, sarcopenia, weight loss, depression, insomnia, fatigue, weakness, and sexual dysfunction. Pathogenesis of hypogonadism in cancer patients is thought to be multi-factorial. Inflammation may play an im...
Feroze Kaliyadan; Ambika Kumar
Vitiligo is known to be associated with social stigma and a decreased quality of life, especially when lesions are located over the face. While there are numerous treatment options for vitiligo, most of these need a long time to produce good cosmetic results. Camouflaging the skin lesions can be a useful option in such patients. The proper use of camouflage has been shown to improve the quality of life in patients with vitiligo. In this article, we discuss the different camouflage options ava...
Dumitrescu, T Pene; Fossler, MJ; Schmith, VD
Pharmacometrics, whether using simple or complex models, has contributed to rational and efficient drug development,1–3 with the main focus on early drug development.4 This article describes why opportunities more directly focused on the patient abound in late stage development, illustrating the concept with three innovative examples which focus on benefits to patients, enabling drugs that are truly efficacious to reach the market faster in diseases with high unmet medical needs, while maintaining adequate safety. PMID:26225220
Bastounis, E.; Pikoulis, E; Leppaniemi, A.; Alexiou, D.; Tsigris, C; Tsetis, A.
With improvements in medical technology, more and larger surgical procedures are performed in haemophiliac patients, but rarely reported in the surgical literature. A retrospective study from a 10 year period from one referral centre identified a total of 68 operations performed in haemophiliac patients. The levels of the defective factors were carefully monitored preoperatively and postoperatively, and replaced according to a standard formula. Special caution was taken to avoid any postopera...
Full Text Available Mechanical ventilation significantly affects cerebral oxygenation and cerebral blood flow through changes in arterial carbon dioxide levels. Neurosurgical patients might require mechanical ventilation for correction and maintenance of changes in the pulmonary system that occur either due to neurosurgical pathology or following surgery during the acute phase. This review discusses the basics of mechanical ventilation relevant to the neurosurgeon in the day-to-day management of neurosurgical patient requiring artificial support of the respiration.
Patel, Manish S; Carson, Jeffrey L.
Anemia is commonly encountered in the preoperative patient. With variable etiology, determination of the cause of the anemia can impact perioperative surgical and medical management and outcome. Red blood cell transfusions are often administered during the perioperative time period in patients with preoperative anemia, although evidence to support the optimal transfusion threshold is limited. We review the evaluation of anemia, as well as evidence regarding perioperative blood transfusions. R...
Bogdan Popescu; Oana Păun; Răzvan V. Scăunașu; Cristian Bălălău; Șerban V. Berteșteanu
Larynx cancer is one of the most susceptible form of cancer susceptible to induce alteration of the patient’s psychological profile due to the social role that the larynx has in communication. Oral communication is severely impaired even after voice rehabilitation of the laryngectomized patients, so that the social rehabilitation is somewhat not only a medical but also a social problem. The psychological profile of these patients is altered in a way that dealing with the disease is sometimes ...
Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.
This is the first article in a four-part continuing education series addressing patient care and the clinical management of disease. This series is not directed at nuclear medicine procedures themselves, but focuses on topics related to patients referred for nuclear medicine studies. After reading this article, the reader should be able to: 1) discuss the diagnosis of pulmonary embolism; and 2) discuss conventional versus thrombolytic approaches to therapy
Ultrasound B-scan examination of traumatized eve is safe, cheap and easy diagnostic method for visualization of the posterior pole of the eye. Ophthalmoscopic visualization of the fundus of traumatized eye can be obscured by corneal opacity, anterior chamber hyphema, cataractous change of the lens, or hemorrhage of the citreous. Ultrasound B-scan examination of the posterior pole is imperative in such cases to detect any intraocular damage and the presence of a foreign body. So we performed ultrasound B-scan examination of traumatized eye seventy eight patients and analyzed those findings. All cases were confirmed by follow up examination of ophthalmoscopy and ultrasound, or surgery. The results were as follows; 1. The most common cause of the ocular injury was traffic accidents (19 patients, 24.4%),male was more commonly injured (63 patients, 80.8). and the most common age group was their 4th decade. 2. Summary of sonographically detected intraocular lesions were as follows; 1) Corneal opacity (44 patients)-hyphema 15, traumatic cataract 24, vitreous hemorrhage 31, retinal detachment 20, intraocular foreign body 4, etc. 2) Hyphemal (16 patients)-hyphema 16, vitreous hemorrhage 11, tretinal detachment 5, etc. 3) Traumatic cataract with no corneal or lens opacity (6 patients)-vitreous hemorrhage with or without retinal detachment 3, normal vitreous and retina 3. 4) Vitreous opacity(12 patients)-vitreous hemorrhage 12, retinal detachment 4, intraocular foreign body 3, etc. In all seventy eight patients with ocular trauma , we could demonstrate characteristic findings for each intraocular lesion. So we recognized the important role and high diagnostic accuracy of ultrasound B-scan examination for the evaluation of the posterior pole of traumatized eye
Full Text Available Preliminary data are reported from experiments in which Warrington's (1984 Recognition Memory Tests were given to patients with misidentification delusions including the Capgras type and to psychotic patients. The results showed a profound impairment on face recognition for most groups, especially those with the Capgras delusion. It was rare to find a patent whose score on the word test was anything but normal.
Flávio Jota de Paula
Full Text Available Tuberculosis (TB was diagnosed in 25 of 466 patients who underwent renal transplant over a period of 15 years. TB developed from 1 month to 9 years post-transplant. In 56% of the cases the onset was within the first post-transplant year. TB affected several isolated or combined organs. Pulmonary involvement was present in 76% of cases, either as isolated pleuro-pulmonary (56% or associated with other sites (20%. The non-pulmonary sites were: skin, joints, tests, urinary tract, central nervous system and lymphonodules. The diagnosis was confirmed by biopsy in 64% of the cases, by identification of tubercle bacilli in 24% and only at necropsy in 12% Biopsy specimens could be classified in three histological forms: exudative, that occurred in early onset and more severe cases granulomatous in late onset and benign cases; and mixed in intermediate cases. Azathioprine dosages were similar along post-transplant time periods in TB patients and in the control groups; and in TB patients who were cured and who died. The number of steroid treated rejection crises was greater in TB than in the control group. Prednisone doses were higher and the number of rejection crises was greater in TB patients who died than in those who were cured. Fifteen patients were cured and ten died, two of them of causes unrelated to TB. Six of the eight TB-related deaths occurred in the first 6 post-transplant months. The outcome was poor in patients in whom TB arose early in post-transplant period and where the exudative or mixed forms were present; whereas the prognosis was good in patients with late onset and granulomatous form of TB. In one patient TB was transmitted by the allograft.
M. R. Nodel
pathy in Parkinson's disease (PD) patients is one of the least studied manifestations of a broad range of neuropsychic disorders. According to numerous researchers, the rate of apathy in PD patients is 17–80%. The structural and neurochemical changes associated with PD have been considered to be the leading pathophysiological factors of apathy. The possible general pathophysiological mechanisms are discussed for apathy and hypokinesia, depression, executive (frontal) cognitive functions, and ...
D'Ivernois, Jean-François; Gagnayre, Rémi; Assal, Jean-Philippe; Golay, Alain; Libion, France; Deccache, Alain
Over the past thirty years, therapeutic patient education (TPE) has become an essential part of the treatment of long-term diseases. Evaluations of this new practice are expected, and are sometimes imposed according to protocols and criteria that do not always reflect the complexity of changes taking place within patients and healthcare providers. Sometimes, expected results are not achieved because evaluation methods are inappropriate. These guidelines, drawn up by three university centres h...
Bensing, J.M.; Visser, S.; Saan, H.
This article presents the development of patient education (PE) in The Netherlands from a historical perspective. A description is given of the first pioneering years from the 70s till the late 80s, in which early topics like the organization of PE, the orchestration of PE between different disciplines, the role of the social environment, the provision of PE in difficult patient groups and -most of all- the technical development of educational materials took the time and attention of the grow...
Morphological imaging, based on the use of various techniques including ultrasound, X-ray computed tomography (CT), and magnetic resonance imaging (MRI), plays an important role in the characterization, diagnosis and follow-up of patients with Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS). While the presence of thoracic infections, the most frequently observed illnesses in AIDS patients, can best be performed by using conventional chest films and CT, the assessment of cerebral involvement in AIDS patients - characterized by the presence of focal masses, demyelination, meningitis, and infarction - is best achieved using MRI. The work-up of patients with gastrointestinal symptoms should include the use of ultrasound for the evaluation of visceral involvement and lymphadenopathy, completed by CT to further characterize pathologic conditions in either the bowel or visceral organs. Ultrasound is the screening exam of choice in AIDS patients with suspected renal disease, but other methods may be necessary for the assessment of the complications due to pharmacological treatment. Musculoskeletal complications may require the combined use of all the above methods, since they may be caused by infections, tumors and rheumatologic illness. The use of the radiographic methods for the detection of the numerous forms of infections and malignancies in AIDS patients is described in detail for the various body districts
Shin, Takeshi; Miyata, Akane; Arai, Gaku; Okada, Hiroshi
Testicular cancer(TC)is the most common and curable cancer affecting men of reproductive age. Successful treatment approaches have resulted in longer life expectancy in TC survivors. The most frequently used treatment for TC is a combination of inguinal orchiectomy, and either radiotherapy or cisplatin-based chemotherapy. In many TC patients, sperm quality is already abnormal and there may even be a lack of viable spermatozoa at the time of diagnosis. Therefore, the effect of cancer treatment on fertility is a potentially significant issue. Fertility preservation in these men has become essential and needs to be discussed prior to the start of cancer treatment. The only currently established fertility preservation method is the cryopreservation of sperm before therapy. For most patients seeking cryopreservation, the semen sample is collected via masturbation. If the patient is unable to ejaculate for any reason, other techniques such as vibratory stimulation and electroejaculation can be performed. In azoospermic or severely oligozoospermic patients, testicular sperm extraction at the time of the inguinal orchiectomy is a useful technique for obtaining spermatozoa before cytotoxic therapy. We herein present an overview of the current topics on fertility in TC patients, including the effects of surgery, chemotherapy, and radiation therapy. We also describe the strategy for fertility preservation in these patients. PMID:25812494
Current literature on dental radiology was reviewed in order to seek justification for radiological protection of patients in dental radiography, to explore the different factors affecting patient dose and to derive practical guidance on how to achieve radiological protection of patients in dentistry. Individual doses incurred in dental radiology are in general relatively low, however it is generally accepted that there is no safe level of radiation dose and that no matter how low the doses received are, there is a mathematical probability of an effect. Hence appropriate patient protection measures must be instituted to keep the exposures as low as reasonably achievable (ALARA). The literature review demonstrated that there is considerable scope for significant dose reductions in dental radiology using the techniques of optimisation of protection. The techniques of optimization of protection that can be used to ensure patient dose is as low as reasonably achievable whilst achieving clinically adequate image quality include the following: image receptor selection, image receptor holders, collimation, beam filtration, operating potential and exposure time, patient protective equipment, film exposure and processing, film storage, image viewing, quality assurance, diagnostic reference levels, technique charts and training and education.(au)
Smaragdi Marinaki; John N Boletis; Stratigoula Sakellariou; Ioanna K Delladetsima
Despite reduction of hepatitis C prevalence afterrecognition of the virus and testing of blood products,hemodialysis （HD） patients still comprise a high riskgroup. The natural history of hepatitis C virus （HCV）infection in dialysis is not fully understood whilethe clinical outcome differs from that of the generalpopulation. HD patients show a milder liver diseasewith lower aminotransferase and viral levels depicted bymilder histological features on liver biopsy. Furthermore,the ＂silent＂ clinical course is consistent with a slowerdisease progression and a lower frequency of cirrhosisand hepatocellular carcinoma. Potential explanations forthe ＂beneficial＂ impact of uremia and hemodialysis onchronic HCV infection are impaired immunosurveillanceleading to a less aggressive host response to the virusand intradialytic release of ＂hepatoprotective＂ cytokinessuch as interferon （IFN）-α and hepatocyte growthfactor. However, chronic hepatitis C is associated witha higher liver disease related cardiovascular and allcausemortality of HD patients. Therapy is indicated inselected patients groups including younger patients withlow comorbidity burden and especially renal transplantcandidates, preferably after performance of a liverbiopsy. According to current recommendations, choice oftreatment is IFN or pegylated interferon with a reportedsustained viral response at 30%-40% and a withdrawalrate ranging from 17% to 30%. New data regardingcombination therapy with low doses of ribavirin whichprovide higher standard variable rates and good safetyresults, offer another therapeutic option. The newprotease inhibitors may be the future for HCV infectedHD patients, though data are still lacking.
Borza, Liana Rada; Gavrilovici, Cristina; Stockman, René
The present paper revisits the ethical models of patient--physician relationship from the perspective of patient autonomy and values. It seems that the four traditional models of physician--patient relationship proposed by Emanuel & Emanuel in 1992 closely link patient values and patient autonomy. On the other hand, their reinterpretation provided by Agarwal & Murinson twenty years later emphasizes the independent expression of values and autonomy in individual patients. Additionally, patient education has been assumed to join patient values and patient autonomy. Moreover, several authors have noted that, over the past few decades, patient autonomy has gradually replaced the paternalistic approach based on the premise that the physician knows what is best for the patient. Neither the paternalistic model of physician-patient relationship, nor the informative model is considered to be satisfactory, as the paternalistic model excludes patient values from decision making, while the informative model excludes physician values from decision making. However, the deliberative model of patient-physician interaction represents an adequate alternative to the two unsatisfactory approaches by promoting shared decision making between the physician and the patient. It has also been suggested that the deliberative model would be ideal for exercising patient autonomy in chronic care and that the ethical role of patient education would be to make the deliberative model applicable to chronic care. In this regard, studies have indicated that the use of decision support interventions might increase the deliberative capacity of chronic patients. PMID:26204658
Falzone, Elisabeth; Hoffmann, Clément; Keita, Hawa
Elderly people represent the fastest-growing segment of our society and undergo surgery more frequently than other age groups. Effective postoperative analgesia is essential in these patients because inadequate pain control after surgery is associated with adverse outcomes in elderly patients. However, management of postoperative pain in older patients may be complicated by a number of factors, including a higher risk of age- and disease-related changes in physiology and disease-drug and drug-drug interactions. Physiological changes related to aging need to be carefully considered because aging is individualized and progressive. Assessment of pain management needs to include chronological age, biological age with regard to renal, liver and cardiac functions, and the individual profile of pathology and prescribed medications. In addition, ways in which pain should be assessed, particularly in patients with cognitive impairment, must be considered. Cognitively intact older patients can use most commonly used unidimensional pain scales such as the visual analogue scale (VAS), verbal rating scale (VRS), numeric rating scale (NRS) and facial pain scale (FPS). VRS and NRS are the most appropriate pain scales for the elderly. In older patients with mild to moderate cognitive impairment, the VRS is a better tool. For severe cognitively impaired older patients, behavioural scales validated in the postoperative context, such as Doloplus-2 or Algoplus, are appropriate. For postoperative pain treatment, most drugs (e.g. paracetamol, nonsteroidal anti-inflammatory drugs, nefopam, tramadol, codeine, morphine, local anaesthetics), techniques (e.g. intravenous morphine titration, subcutaneous morphine, intravenous or epidural patient-controlled analgesia, intrathecal morphine, peripheral nerve block) and strategies (e.g. anticipated intraoperative analgesia or multimodal analgesia) used for acute pain management can be used in older patients. However, in view of pharmacokinetic
... Anxiety in Migraine Patients Depression and Anxiety in Migraine Patients Todd A. Smitherman, PhD and Steven M. ... health care provider if you experience these symptoms. Migraine, Depression, and Anxiety Many migraine patients suffer from ...
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Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients......Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients...
Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke; Jensen, Steen Lund
Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....
Versteeg, Henneke; Starrenburg, Annemieke; Denollet, Johan;
Patient device acceptance might be essential in identifying patients at risk for adverse patient-reported outcomes following implantation of an implantable cardioverter defibrillator (ICD). We examined the validity and reliability of the Florida Patient Acceptance Scale (FPAS) and identified...
Matiti, Miliica Ruth
This research is concerned with patient dignity in nursing. It proposes the introduction of the concept of Perceptual Adjustment Level (PAL) in order to resolve the problem of the definition of patient dignity and its maintenance within nursing care. The aims of the study are to identify how patients and nurses perceive patient dignity, to investigate the extent to which patient dignity is maintained and to identify nursing care activities in maintaining patient dignity. The im...
Aylin Gözübüyükoğulları; Duru Tabanlıoğlu Onan; Nuran Allı
Background and Design: The aim of our study was to determine the frequency of fibromyalgia syndrome in chronic urticaria patients. Materials and Methods: The study was carried out with the participation of 100 chronic urticaria patients and 61 control group patients. Chronic urticaria patients were investigated for the etiology of urticaria and the autologous serum skin test was performed in those patients. Both the chronic urticaria patients and the controls were evaluated for fibromyalgi...
Visser, Adriaan; Deccache, A.; Bensing, J.
This issue of Patient Education and Counseling presents the state of the art of patient education in several European countries. It is based on papers presented at a meeting in Paris on the evolution and development of patient education in western, central and eastern Europe (May 1999). Also patient education in the US is presented in this issue. Patient education is defined as all the educational activities directed to patients, including aspects of therapeutic education, health education an...
O'Toole, Sam M; Fan, Stanley L; Yaqoob, M Magdi; Chowdhury, Tahseen A
Burgeoning levels of diabetes are a major concern for dialysis services, as diabetes is now the most common cause of end-stage renal disease in most developed nations. With the rapid rise in diabetes prevalence in developing countries, the burden of end stage renal failure due to diabetes is also expected to rise in such countries. Diabetic patients on dialysis have a high burden of morbidity and mortality, particularly from cardiovascular disease, and a higher societal and economic cost compared to non-diabetic subjects on dialysis. Tight glycaemic and blood pressure control in diabetic patients has an important impact in reducing risk of progression to end stage renal disease. The evidence for improving glycaemic control in patients on dialysis having an impact on mortality or morbidity is sparse. Indeed, many factors make improving glycaemic control in patients on dialysis very challenging, including therapeutic difficulties with hypoglycaemic agents, monitoring difficulties, dialysis strategies that exacerbate hyperglycaemia or hypoglycaemia, and possibly a degree of therapeutic nihilism or inertia on the part of clinical diabetologists and nephrologists. Standard drug therapy for hyperglycaemia (eg, metformin) is clearly not possible in patients on dialysis. Thus, sulphonylureas and insulin have been the mainstay of treatment. Newer therapies for hyperglycaemia, such as gliptins and glucagon-like peptide-1 analogues have become available, but until recently, renal failure has precluded their use. Newer gliptins, however, are now licensed for use in 'severe renal failure', although they have yet to be trialled in dialysis patients. Diabetic patients on dialysis have special needs, as they have a much greater burden of complications (cardiac, retinal and foot). They may be best managed in a multidisciplinary diabetic-renal clinic setting, using the skills of diabetologists, nephrologists, clinical nurse specialists in nephrology and diabetes, along with
Full Text Available "nBackground: Antiself humoral immune responses have been detected not only in classical autoimmune diseases, but autoantibodies have also been found in sera of patients suffering from chronic parasitic diseases. We aimed to investigate the role of fasciolosis as a trigger factor of autoimmune reactivity by searching some antibodies related to hepatobiliary systems, in patients with fasciolosis. "nMethods: Thirty-two patients (17 males, 15 females with fasciolosis were included in this case-control study. Anti-nuclear antibodies (ANA Screen (antigen mixture of dsDNA, histones, nRNP/Sm, Sm, SS-A, SS-B, Scl-70, Jo-1, ribosomal P-proteins, centromere ELISA and single-antigen ELISAs for detection of some antibodies (dsDNA, Anti-M2, Anti- liver-kidney microsomes type 1 (LKM-1 and Myeloperoxidase (MPO were carried out. "nResults: ANA-screen, M-2, LKM-1, MPO and anti-dsDNA positivity were detected with ELISA in 7, 7, 4, 2 and 2 of 32 patients with fasciolosis, consecutively. No statistically significant difference was detected for any of the autoantibodies' frequency between patients with fasciolosis and control group. However, autoantibody positivity rate was significantly higher in patients with fasciolosis (50 % than control group (12.5 %. Absorbance values of all autoantibodies in patients with fasciolosis were statistically significant higher than controls. "nConclusion: These results lent support to the role of fasciolosis as a trigger factor of autoimmune reactivity by the breakdown of tolerance. In spite of the extensive knowledge that has accumulated, the specific relationship between fasciolosis and autoimmunity is still obscure.
Full Text Available Introduction. Anxiety, as a primary symptom, includes all conditions of indefinite fear and psychic disorders dominated by fear. All dialysis patients suffer from anxiety as an independent phenomenon, or as part of another disease. Material and Methods. This study included 753 patients on chronic hemodialysis in Bosnia and Herzegovina (B&H in the period 1999-2004. The patients were divided into two groups: the first group included 348 patients with Balkan Endemic Nephropathy (BEN, and the control group included 405 patients with other diagnoses causing renal insufficiency (N18. The study was designed as a comparative cross sectional study, and patients were tested using questionnaires assessing anxiety, depression and general mental health status. Statistical analysis was done using standard descriptive and analytical methods. Results. Socio-demographic data showed highly significant differences between BEN and N18 in relation to place of residence (urban/rural (c2 = 23.970 p<0.01; in the incidence of renal comorbidity (c2 = 23.970 p<0.01; familial renal comorbidity (c2 = 23.970 p<0.01; and migrations (c2 = 4.874 p<0.01. Beck Anxiety Inventory Scores were highly significantly different between the two groups p<0.001, in regard to the incidence and variables. Hamilton Depression Rating Scale demonstrated a group significance p<0.001, and variables pointed to somatization, general anxiety and depression. This was confirmed by mini-mental state examination pointing to generalmental weakness. Conclusion. Anxiety appeared in all tested dialysis patients. It may be independent, somatized as part of another mental disorder or reinforced by a cognitive damage. Structured anxiety and depression result in pre-suicidal risk. .
Madsen, Marlene Dyrløv
,demonstrating significant, consistent and sometimes large differences in terms of safety culture factors across the units participating in the survey. Paper 5 is the results of a study of the relation between safety culture, occupational health andpatient safety using a safety culture questionnaire survey......, and those of patients who experience the physical effect of poor patient safety. The dissertationconsists of nine papers and an appendix. Paper 1 describes the results of doctors and nurses attitudes towards reporting and the handling of adverse events. Paper 2 is a study and “review” of the international...
Griva, B.L. E-mail: firstname.lastname@example.org
Lymph node involvement is very frequent in paracoccidioidomycosis (PBM) mainly in its juvenile form. PBM also affects the lymphatic system of patients with the chronic form as it was confirmed by bipedal lymphangiography and autopsy. Lymphoscintigraphy has been used to evaluate lymphedema and cancer. The purpose of this investigation was to study the lymphoscintigraphic variables in a critical manner, to functionally evaluate the lymphatic system of patients with different forms of PBM, and to evaluate the influence of the antifungal treatment on the lymphoscintigraphic variables by lymphoscintigraphy of the extremities. Forty-six patients with PBM were studied. Twenty-one had the juvenile and 25 the chronic form. Patients with the juvenile form were divided again into three subgroups according to age. Eleven healthy volunteers were evaluated as controls. All of them were injected with 37 MBq of dextran 500-99mTc into the first interdigital space of each foot, and blood was obtained for serum albumin determination. Twenty-nine patients were evaluated after the beginning of the antifungal treatment. The time elapsed between both exams was smaller in patients with the juvenile form than in those with the chronic form. Semi-quantitative variables, such as the intensity of visualization of the radiotracer and the pattern of the time-activity curve with regions of interest over ilioinguinal lymph nodes and legs, were studied. Quantitative variables were also evaluated including the velocity of visualization of the lymph nodes, lymph flow ratio, and lymph node radiotracer uptake. The error propagation was calculated to assess the lymph flow ratio accuracy. Correlation between variables and serum albumin was done. The intensity and velocity of visualization of the radiotracer, the lymph flow ratio, and the pattern of the time-activity curve were useful variables to the evaluation of patients with the juvenile and the chronic form of PBM. The lymph flow ratio calculated by
Liistro, Francesco; Colombo, Antonio
Developed nations are experiencing an unprecedented growth in the number of elderly citizens. Thanks to the modernization of both society and medical care, over the past century, life expectancy in most countries has nearly doubled. The elderly (80 years or over) represent the fastest-growing segment of our population. Owing to their age, the elderly are more afflicted with chronic diseases, including coronary artery disease. Recently, clinicians became more aggressive in the use of invasive cardiovascular diagnostic tests in these patients. With regard to younger patients, we have a wealth of data from large, randomized trials that defined which subsets of patients benefit from revascularization therapies. However, because the very elderly were severely underrepresented in these randomized studies, we have almost no information concerning the choice of treatment in these patients. Initial results of percutaneous revascularization procedures in elderly patients come from retrospective analysis performed during the pre-stent era. In these studies a procedural mortality risk 5-fold higher in patients > 80 years compared with those 80 years). The comparison between the percutaneous approach and the surgical approach to coronary artery disease in the elderly has its major limitation in the lack of data from randomized trials. The available information suggests similar results with the two different strategies (5-year survival rate: 85.7% for the coronary artery bypass grafting group vs 81.4% for the percutaneous revascularization group) with a clear benefit in favor of surgery only in diabetic patients. The only constant difference is the need of a repeat intervention which is significantly higher for the percutaneous approach. Furthermore, the introduction of newer percutaneous devices suitable for the recanalization of totally occluded coronary arteries could increase the completeness of the revascularization achieved with the percutaneous approach with a positive
Lymph node involvement is very frequent in paracoccidioidomycosis (PBM) mainly in its juvenile form. PBM also affects the lymphatic system of patients with the chronic form as it was confirmed by bipedal lymphangiography and autopsy. Lymphoscintigraphy has been used to evaluate lymphedema and cancer. The purpose of this investigation was to study the lymphoscintigraphic variables in a critical manner, to functionally evaluate the lymphatic system of patients with different forms of PBM, and to evaluate the influence of the antifungal treatment on the lymphoscintigraphic variables by lymphoscintigraphy of the extremities. Forty-six patients with PBM were studied. Twenty-one had the juvenile and 25 the chronic form. Patients with the juvenile form were divided again into three subgroups according to age. Eleven healthy volunteers were evaluated as controls. All of them were injected with 37 MBq of dextran 500-99mTc into the first interdigital space of each foot, and blood was obtained for serum albumin determination. Twenty-nine patients were evaluated after the beginning of the antifungal treatment. The time elapsed between both exams was smaller in patients with the juvenile form than in those with the chronic form. Semi-quantitative variables, such as the intensity of visualization of the radiotracer and the pattern of the time-activity curve with regions of interest over ilioinguinal lymph nodes and legs, were studied. Quantitative variables were also evaluated including the velocity of visualization of the lymph nodes, lymph flow ratio, and lymph node radiotracer uptake. The error propagation was calculated to assess the lymph flow ratio accuracy. Correlation between variables and serum albumin was done. The intensity and velocity of visualization of the radiotracer, the lymph flow ratio, and the pattern of the time-activity curve were useful variables to the evaluation of patients with the juvenile and the chronic form of PBM. The lymph flow ratio calculated by
People with genetic cancer syndromes have a special interest in imaging. They also have special risk factors with respect to radiation. They need to utilize the potential of imaging while keeping in mind concerns about cumulative radiation exposure. Before imaging, early detection of problems was limited. With imaging, issues can be identified when they are small and a good plan of action can be developed early. Operations can be planned and metastatic cancer avoided. The positive contribution of imaging to the care of these patients can be profound. However, this additional surveillance is not without cost. An average patient with 1 of these syndromes will undergo 100 or more scans in their lifetime. Imaging professionals should be able to describe the risks and benefits of each scan in terms that the patient and the ordering physician can understand to make smart decisions about the ordering of scans. Why CT versus MRI? When are x-ray or ultrasound appropriate, and when are they not? What are the costs and the medical risks for the patient? What value does this picture add for the physician? Is there a way to answer the medical question with a test other than a scan? Medicine is a team sport, and the patient is an integral member of the team. PMID:24589397
Sabry, Alaa A; Abo-Zenah, Hamdy; Wafa, Ehab; Mahmoud, Khaled; El-Dahshan, Khaled; Hassan, Ahmed; Abbas, Tarek Medhat; Saleh, Abd El-Baset M; Okasha, Kamal
The prevalence of sleep disorders is higher in patients with kidney failure than the general population. We studied the prevalence of sleep disorders in 88 (mean age; 41.59 +/- 16.3 years) chronic hemodialysis (HD) patients at the Urology and Nephrology Center, Mansoura University, Egypt over 4-month period. The investigated sleep disorders included insomnia, restless leg syndrome (RLS), obstructive sleep apnea syndrome (OSAS), excessive daytime sleepiness (EDS), narcolepsy and sleep walking, and we used a questionnaire in accordance with those of the International Restless Legs Syndrome Study Group, the Berlin questionnaire, Italian version of Epworth Sleepiness Scale, International Classification of Sleep Disorders, and the specific questions of Hatoum's sleep questionnaire. The prevalence of sleep disorders was 79.5% in our patients, and the most common sleep abnormality was insomnia (65.9%), followed by RLS (42%), OSAS (31.8%), snoring (27.3%), EDS (27.3%), narcolepsy (15.9%), and sleep walking (3.4%). Insomnia correlated with anemia (r=0.31, P= 0.003), anxiety (r=0.279, P= 0.042), depression (r=0.298, P= 0.24) and RLS (r=0.327, P= 0.002). Also, RLS correlated with hypoalbuminemia (r=0.41, P= Sleep disorders are quite common in the HD patients, especially those who are anemic and hypoalbuminemic. Assessment of sleep quality, preferably with polysomnography, is necessary to confirm our results. Interventional studies for management of sleep disorders in HD patients are warranted. PMID:20228517
Full Text Available Introduction: Due to a variety of circumstances and world-wide research findings, patient safety andquality care during hospitalization have emerged as major issues. Patient safety deficits may burdenhealth systems as well as allocated resources. The international community has examined severalproposals covering general and systemic aspects in order to improve patient safety; several long-termprograms and strategies have also been implemented promoting the participation of health-relatedagents, and also government agencies and non-governmental organizations.Aim: Those factors that have negative correlations with patient safety and quality healthcare weredetermined; WHO and EU programs as well as the Greek health policy were also reviewed.Method: Local and international literature was reviewed, including EU and WHO official publications,by using the appropriate keywords.Conclusions: International cooperation on patient safety is necessary in order to improvehospitalization and healthcare quality standards. Such incentives depend heavily on establishing worldwideviable and effective health programs and planning. These improvements also require further stepson safe work procedures, environment safety, hazard management, infection control, safe use ofequipment and medication, and sufficient healthcare staff.
MA Ying; LI Hui-chun; ZHENG Lei-lei; YU Hua-liang
Objective: This study is aimed at exploring the relationship between hemodynamic changes and depressive and anxious symptom in depression patients. Methods: The cardiac function indices including the left stroke index (LSI), ejection fraction (EF), heart rate (HR), diastolic pressure mean (DPM), systolic pressure mean (SPM), left ventricle end-diastolic volume (LVDV), effective circulating volume (ECV), resistance total mean (RTM) and blood flow smooth degree (BFSD) were determined in 65 patients with major depressive disorders and 31 healthy normal controls. The clinical symptoms were assessed with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA). Results: In patients with depression without anxiety,LSI, EF, LVDV, DPM, SPM, ECV, BFSD were significantly lower than those in controls, while RTM was higher than that in controls. Patients with comorbidity of depression and anxiety showed decreased LVDV, ECV, BFSD, and increased HR in comparison with the controls. The anxiety/somatization factor score positively correlated with LSI, EF, LVDV, but negatively correlated with RTM. There was negative correlation between retardation factor score and DPM, SPM, LVDV. Conclusion: The study indicated that there are noticeable changes in left ventricle preload and afterload, blood pressure, peripheral resistance, and microcirculation in depressive patients, and that the accompanying anxiety makes the changes more complicated.
Burney, Basil O; Garcia, Jose M
Prevalence of hypogonadism in men with cancer has been reported between 40% and 90%, which is significantly higher than in the general population. Hypogonadism is likely to affect the quality of life in these patients by contributing to non-specific symptoms, including decreased energy, anorexia, sarcopenia, weight loss, depression, insomnia, fatigue, weakness, and sexual dysfunction. Pathogenesis of hypogonadism in cancer patients is thought to be multi-factorial. Inflammation may play an important role, but leptin, opioids, ghrelin, and high-dose chemotherapy through different mechanisms have all been implicated as the cause. Hypogonadism is also associated with poor survival in cancer patients. Data looking into the treatment of hypogonadal male cancer patients with testosterone are limited. However, improvements in body weight, muscle strength, lean body mass, and quality of life have been shown in hypogonadal men with other chronic diseases on testosterone replacement therapy. Prospective and interventional trials are needed to test the efficacy and safety of testosterone treatment in improving quality of life of these patients. PMID:22528986
Hurst, Victor; Doerr, Harold K.; Bacal, Kira
The Medical Operational Support Team (MOST) has been tasked by the Space and Life Sciences Directorate (SLSD) at the NASA Johnson Space Center (JSC) to integrate medical simulation into 1) medical training for ground and flight crews and into 2) evaluations of medical procedures and equipment for the International Space Station (ISS). To do this, the MOST requires patient models that represent the physiological changes observed during spaceflight. Despite the presence of physiological data collected during spaceflight, there is no defined set of parameters that illustrate or mimic a 'space normal' patient. Methods: The MOST culled space-relevant medical literature and data from clinical studies performed in microgravity environments. The areas of focus for data collection were in the fields of cardiovascular, respiratory and renal physiology. Results: The MOST developed evidence-based patient models that mimic the physiology believed to be induced by human exposure to a microgravity environment. These models have been integrated into space-relevant scenarios using a human patient simulator and ISS medical resources. Discussion: Despite the lack of a set of physiological parameters representing 'space normal,' the MOST developed space-relevant patient models that mimic microgravity-induced changes in terrestrial physiology. These models are used in clinical scenarios that will medically train flight surgeons, biomedical flight controllers (biomedical engineers; BME) and, eventually, astronaut-crew medical officers (CMO).
Nora Sexto Delgado
Full Text Available Background: Buccal health as integral and determinant part of general health makes us find different ways and methods to elevate life quality in the population. Objective: To establish the risk of suffering from dental cavities in asthmatic patients. Methods: A non match case and control study constituted by 100 children selected at simple random from the universe of asthmatic patients belonging to the General Comprehensive doctor offices number 7,9,10, 11, 43, and 44 from Area II in Cienfuegos municipality. The controlled group was selected in the same offices but from the universe of non asthmatic children. The age in both groups was from 6 to 15 years old. Visits to the children´s home were carried out for the record of the information through health oral dental and buccal health knowledge surveys. Results: The index of cavities, lost, and obturated permanent teeth was higher (3, 28 than in the control group (0, 44. The buccal hygiene indexes and the level of knowledge in both groups did not show significant differences. The most used drugs in asthma therapy were salbutamol and ketotifeno which change the buccal milieu. The odds ratio technique between asthmatic and non asthmatic patients showed 4, 9 times more at risk of suffering from dental cavities in the first group. Finally, it can be stated that the asthmatic patients are more at risk of suffering from cavities than the non asthmatic ones, so a program for buccal health in these patients should be performed.
Introduction: Historically, education of patients was paternalistic where people have been conditioned to do as the 'doctor' tells them. Traditionally this worked as people tended to have limited access to knowledge of treatment regimen available. However, in the information age, this knowledge is more readily available and it is now common practice to educate people diagnosed with cancer about their treatment and disease process. In fact, dissemination of information is now an intrinsic part of cancer care. Purpose: The primary aim of this study was to investigate the practice of patient education for gynaecological cancers treated with brachytherapy and review the feasibility of designing a distance learning information tool to inform patients about a clinical treatment option available to them in the cancer agency. Methods: The study was divided into two parts. Part 1 was a review of adult learning principles and clinical application. Part 2 explored the feasibility of moving from face-to-face to distance learning in this situation. Conclusions: Adaptation of clinical patient education from a face-to-face learning situation to distance education could be very successful if the basic principles of adult education and facilitation are followed and special care given to maintaining open lines of communication/support for the distant patient
Mitchell, Fiona [Radiation Therapy, BC Cancer Agency, 600 West 10th Avenue, Vancouver, BC V5Z 4E6 (Canada)]. E-mail: email@example.com
Introduction: Historically, education of patients was paternalistic where people have been conditioned to do as the 'doctor' tells them. Traditionally this worked as people tended to have limited access to knowledge of treatment regimen available. However, in the information age, this knowledge is more readily available and it is now common practice to educate people diagnosed with cancer about their treatment and disease process. In fact, dissemination of information is now an intrinsic part of cancer care. Purpose: The primary aim of this study was to investigate the practice of patient education for gynaecological cancers treated with brachytherapy and review the feasibility of designing a distance learning information tool to inform patients about a clinical treatment option available to them in the cancer agency. Methods: The study was divided into two parts. Part 1 was a review of adult learning principles and clinical application. Part 2 explored the feasibility of moving from face-to-face to distance learning in this situation. Conclusions: Adaptation of clinical patient education from a face-to-face learning situation to distance education could be very successful if the basic principles of adult education and facilitation are followed and special care given to maintaining open lines of communication/support for the distant patient.
Kim, S. K.; Lee, H. S.; Cho, K. H.; Suh, C. O.; Kim, G. E. [Yonsei University College of Medicine, Seoul (Korea, Republic of)
Between Jan. 1977 and Dec. 1984, 14 patients diagnosed of thymoma has been analyzed retrospectively. 6 patients(6/14 patients 43%) had myasthenia gravis. 12 patients (12/14 patients 86%) had invasive thymoma. Complete resection was carried out in 6 patients (43%), 2 patients had partial resection (14%) and 6 patients had only biopsy (43%). Postoperative or radical radiotherapy was given to 8 patients, of whom 5 patients was still alive (4 yr. 2.8 yr. 1.6 yr. 1.4 yr. 1.3 yr) and 3 patients died (1 yr. 0.6 yr. 0.6 yr). External irradiation ranges 1,950-7,000 rads (mean 4,500, median 4,000 rads)
Holdaas, Hallvard; Holme, Ingar; Schmieder, Roland E; Jardine, Alan G; Zannad, Faiez; Norby, Gudrun E; Fellström, Bengt C; Ladefoged, Søren Daustrand
A randomized, placebo-controlled trial in diabetic patients receiving hemodialysis showed no effect of atorvastatin on a composite cardiovascular endpoint, but analysis of the component cardiac endpoints suggested that atorvastatin may significantly reduce risk. Because the AURORA (A Study to...... Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events) trial included patients with and without diabetes, we conducted a post hoc analysis to determine whether rosuvastatin might reduce the risk of cardiac events in diabetic patients...... receiving hemodialysis. Among the 731 participants with diabetes, traditional risk factors such as LDL-C, smoking, and BP did not associate with cardiac events (cardiac death and nonfatal myocardial infarction). At baseline, only age and high-sensitivity C-reactive protein were independent risk factors for...
Full Text Available Human adenoviruses belong to the Adenoviridae family and they are divided into seven species, including 56 types. Adenoviruses are common opportunistic pathogens that are rarely associated with clinical symptoms in immunocompetent patients. However, they are emerging pathogens causing morbidity and mortality in recipients of hematopoietic stem cell and solid organ transplants, HIV infected patients and patients with primary immune deficiencies. Clinical presentation ranges from asymptomatic viraemia to respiratory and gastrointestinal disease, haemorrhagic cystitis and severe disseminated illness. There is currently no formally approved therapy for the treatment of adenovirus infections.This article presents current knowledge about adenoviruses, their pathogenicity and information about available methods to diagnose and treat adenoviral infections.
Diagnostic radiology in cancer patients suffering from limb edemas serves two main purposes: to detect or to rule out lymph node metastases, recurrent cancer, or secondary malignancies, and to differentiate venous edema from lymphedema. The authors suggest an algorithmic pathway where the non-invasive imaging modalities, real-time ultrasonography and computed tomography are recommended as the initial diagnostic step. Both techniques are equally well suited to detect enlarged lymph nodes with high accuracy. In addition, computed tomography allows to a certain degree to separate venous from lymphedema. Phlebography is rarely needed in these patients. Lymphography should only be considered in patients undergoing microsurgical reconstructive operations of the lymphatics (e.g. lymphovenous anastomoses) because this invasive study carries the risk of deteriorating the edematous limb. (orig.)
Peters, P.E.; Groth, W.
Diagnostic radiology in cancer patients suffering from limb edemas serves two main purposes: to detect or to rule out lymph node metastases, recurrent cancer, or secondary malignancies, and to differentiate venous edema from lymphedema. The authors suggest an algorithmic pathway where the non-invasive imaging modalities, real-time ultrasonography and computed tomography are recommended as the initial diagnostic step. Both techniques are equally well suited to detect enlarged lymph nodes with high accuracy. In addition, computed tomography allows to a certain degree to separate venous from lymphedema. Phlebography is rarely needed in these patients. Lymphography should only be considered in patients undergoing microsurgical reconstructive operations of the lymphatics (e.g. lymphovenous anastomoses) because this invasive study carries the risk of deteriorating the edematous limb.
Renau Escrig, Ana I; Salavert, Miguel; Vivó, Carmen; Cantón, Emilia; Pérez Del Caz, M Dolores; Pemán, Javier
Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge. PMID:26931414
Zarski, J P; Leroy, V
Hepatitis C virus (HCV) is usually but not exclusively transmitted by the parenteral route. Some precautions are recommended for infected patients as well as his/her close contacts and family members. The risk of sexual transmission and from household contacts is very low. Use of condoms is only recommended in cases of multiple partners and for those at high risk of transmission. Some personal objects should not be shared, i.e. razors, toothbrushes and nail clippers, but it is not necessary to avoid sharing eating utensils. Sexual partners may be tested for anti-HCV HCV-positive individuals should refrain from donating blood, organs and tissue. Clear and evidenced-based information should be provided to patients as to the means of prevention with special attention to individual risk groups such as IV drug abusers. The risk of HCV transmission after needlestick injury, although low, justifies universal precaution measurements for health-care workers. Nosocomial transmission has been described after medical procedures, especially haemodialysis and endoscopy. Thus, disinfection procedures as well as universal precautions are essential for all health-care workers. It is also important for HCV patients to inform health-care workers beforehand about their HCV status. Perinatal transmission is rare and is usually related to the degree of maternal viral load. Pregnancy is not contra-indicated in HCV. infected individuals and breast-feeding is allowed. Finally, HCV patients with active disease should be advised to refrain from alcohol intake, especially during antiviral therapy. After HCV infection it is necessary to consider not only diagnostic and therapeutic steps but also the risk of transmission in the patient's circle and consequences for the patient. PMID:10622576
AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy.METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients' mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors,calcium antagonists, anticoagulants, antithrombotics,antidepressants, anti-epileptics.RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident.Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13),sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury.CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients.Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere,and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.
Purpose: To evaluate the utility of an infrared-guided patient setup (iGPS) system to reduce the uncertainties in the setup of lung cancer patients. Methods and Materials: A total of 15 patients were setup for lung irradiation using skin tattoos and lateral leveling marks. Daily electronic portal device images and iGPS marker locations were acquired and retrospectively reviewed. The iGPS-based shifts were compared with the daily electronic portal device image shifts using both the central axis iGPS marker and all five iGPS markers. For shift calculation using the five markers, rotational misalignment was included. The level of agreement between the iGPS and portal imaging to evaluate the setup was evaluated as the frequency of the shift difference in the range of 0-5 mm, 5-10 mm, and >10 mm. Results: Data were obtained for 450 treatment sessions for 15 patients. The difference in the isocenter shifts between the weekly vs. daily images was 0-5 mm in 42%, 5-10 mm in 30%, and >10 mm in 10% of the images. The shifts seen using the iGPS data were 0-5 mm in 81%, 5-10 mm in 14%, and >10 mm in 5%. Using only the central axis iGPS marker, the difference between the iGPS and portal images was 10 mm in 7% in the left-right direction and 73%, 18%, and 9% in the superoinferior direction, respectively. When all five iGPS markers were used, the disagreements between the iGPS and portal image shifts >10 mm were reduced from 7% to 2% in the left-right direction and 9% to 3% in the superoinferior direction. Larger reductions were also seen (e.g., a reduction from 50% to 0% in 1 patient). Conclusion: The daily iGPS-based shifts correlated well with the daily electronic portal device-based shifts. When patient movement has nonlinear rotational components, a combination of surface markers and portal images might be particularly beneficial to improve the setup for lung cancer patients
This book addresses patient-specific modeling. It integrates computational modeling, experimental procedures, imagine clinical segmentation and mesh generation with the finite element method (FEM) to solve problems in computational biomedicine and bioengineering. Specific areas of interest include cardiovascular problems, ocular and muscular systems and soft tissue modeling. Patient-specific modeling has been the subject of serious research over the last seven years and interest in the area is continually growing and this area is expected to further develop in the near future.
Since February 1990 public information evenings pertaining to respiratory tract diseases have been held every month in the cities of Fellbach, Backnang and at times in Waiblingen. These sessions have met with a great show of interest from patients, doctors and the public in general, as indicated by the consistently large number of over 100 participants. This continual educational work with its accompanying measures, such as, asthma-sport, breathing exercises, and books and videos on loan, represents an effective alternative to the formally structured, patient training programs limited to a specific time period. A broad range of effectiveness is attained by engaging public media in the informative process. PMID:1438125
September 1994 sees the publication of guidelines on radiology standards for primary dental care, a report by a joint Working Party of the Royal College of Radiologists (RCR) and NRPB. Central to these guidelines is the potential to reduce collective dose to patients and to improve the diagnostic quality of radiographs. This article presents the basis for the derivation of the collective dose to patients from dental radiology and identifies the amount by which the annual collective dose of some 170 man Sv can be reduced. The guidelines are described elsewhere in this bulletin. (Author)
Full Text Available Vitiligo is known to be associated with social stigma and a decreased quality of life, especially when lesions are located over the face. While there are numerous treatment options for vitiligo, most of these need a long time to produce good cosmetic results. Camouflaging the skin lesions can be a useful option in such patients. The proper use of camouflage has been shown to improve the quality of life in patients with vitiligo. In this article, we discuss the different camouflage options available in vitiligo - products and techniques with their relative advantages and disadvantages.
Lordick, Florian; Hacker, Ulrich
Cancer patients are regularly affected by malnutrition which often leads to a worsened quality of life and activity in daily living, more side effects and complications during anticancer treatment and shorter survival times. The early diagnosis and treatment of malnutrition are therefore relevant components of oncological treatment. The assessment of the nutritional status and determination of the body-mass-index should be done in every patient with cancer. The clinical examination delivers important findings and indications for malnutrition. Bioimpedance analysis can deliver additional objective information. The treatment of malnutrion should start early and follows a step-wise escalation reaching from nutritional counseling to enteral nutritional support to parenteral nutrition. PMID:26886037
Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann
For mentalization theorists, implicit mentalization is a key component of all forms of therapy. However, it has been difficult to grasp and to describe precisely how implicit mentalization works. It is said to take place partly by mirroring others in posture, facial expression and vocal tone. Based...... consultations with patients with depression. We wanted to see how implicit mentalizing unfolds in physician–patient interactions. Consultations were videorecorded and analysed within the framework of conversation analysis. GPs and psychiatrists differed substantially in their propensity to mirror body movements...
This patent specification describes an E.M.I. claim relating to a patient positioning and support arrangement for a computerised axial tomography system, the arrangement comprising a curved platter upon which the patient can be disposed, a table having a curved groove to accommodate the platter, and means for driving the platter slidably along the groove; the platter being formed of a substantially rigid platform shaped to conform to the groove, and a shroud, secured to the platter and disposed between the platter and the surface of the groove, so as to permit the platter to slide smoothly. (U.K.)
The project Serum-proteomics in melanoma patients funded by 'Programma Oncologico Italia-USA' Oncoproteomica has the general aim to collect serum samples from melanoma patients and to analyze the expression profile of several cytokines, in order to identify whether significant differences are evident between patients and controls, or among different patients subgroups with different staging or therapy
Visser, Adriaan; Deccache, A.; Bensing, J.
This issue of Patient Education and Counseling presents the state of the art of patient education in several European countries. It is based on papers presented at a meeting in Paris on the evolution and development of patient education in western, central and eastern Europe (May 1999). Also patient
Bak, Søren; Stenager, E N; Stenager, Egon;
The aim of the present study was to assess, through an epidemiological study, whether suicide risk is increased in patients with motor neuron disease (MND). The study involved 116 patients with MND. In the study period 92 patients died, 47 males and 45 females. No patients committed suicide. The...
Andersen, Marianne; Hagen, Casper; Frystyk, Jan;
OBJECTIVES: Patients with prolactinomas and patients with acromegaly often have heterogenous adenomas. In this study we have focused on patients with prolactinomas who developed acromegaly and acromegalic patients with hyperprolactinaemia. Our hypothesis is that some patients with...... hyperprolactinaemia may develop clinical acromegaly. METHODS: We have included patients examined at department M, Odense University Hospital between 1996 and 2001. Seventy-eight patients with prolactinomas, 65 females and 13 males, with a median age (range) of 30 Years (14-74) and 47 Years (20-66), respectively, were...
of patient involvement in health care. This framework is used to analyse key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care. Findings – Patient involvement is important in Denmark at the...... research results may lack generalisability. Practical implications – The paper includes implications for the development of patient involvement in health care. Originality/value – This paper fulfils a need to study different types of patient involvement and to develop a theoretical framework for...... characterizing and analysing such involvement strategies. Keywords: patient involvement, health care...
Johannsen, Peter; Ehlers, L; Abelskov, K E; Gulmann, N C; Christensen, T; Gjedde, A; Jakobsen, J K
Case reports of 110 patients referred to a neurological dementia clinic were reviewed to evaluate a standardized diagnostic program. The patients were evaluated by a neurologist, a gerontopsychiatrist, and a neuropsychologist. ICD-10 criteria were used. Fifty-two patients had dementia while 58 had...... medication. Ten patients received acetylsalicylic acid (150 mg Q.D.) and two a levo-dopa-type drug. Twenty-six patients were followed by gerontopsychiatric district care. Because only 47% of the patients suspected of dementia actually fulfilled dementia criteria, the evaluation suggests that patients...
With the occurrence of an intestinal obstruction, many patients may need an intestinal stoma. This decision is often taken in an emergency context but may also be planned. The treatment will be multi-disciplinary involving the surgeon, anaesthetist, nurse, health care assistant, physiotherapist, dietician and stoma therapist. PMID:26743367
Kargiotis, Odysseas; Markoula, Sofia; Kyritsis, Athanasios P.
Abstract Purpose Epileptic seizures in patients with malignancies usually occur as a consequence of brain metastases from systemic cancer or the presence of a primary brain tumor. Other less-frequent causes include metabolic disorders such as electrolyte abnormalities, hypoglycemia, hypoxia and liver failure, paraneoplastic encephalitis, leptomeningeal carcinomatosis, side effects of certain chemotherapeutic agents, central nervous system infections, and ...
Cardiovascular diseases are the first cause of death in Spain. The most usual procedures in interventional cardiology are coronariography and PTCA. The first is a diagnostic technique, and the second one is interventional. Our goal has been to study procedures made during the first six months in the Interventional Cardiology Unit of the Juan Ramon Jimenez Hospital (Huelva-Spain), taking into account radiation protection issues. We have studied 178 patients; 145 of them underwent coronariography, and 33 of the patients had PTCA too. Every case was analyzed taking into account technical and dosimetric parameters. We show parameters values gathered: Diagnostic techniques (valvular and non-valvular patients), and interventional techniques (coronariography and PTCA in different or in the same intervention). Higher doses were obtained with valvular patients, although the number of frames was similar. Attending to therapeutic procedures, the highest values were gotten with the 'double' interventions. Interventional procedures exceed in 60% doses gotten in diagnostic studies: this is because of the number of series and number of frames per series. Similar values obtained by other authors have been gotten. (author)
Berger, Art; Giovan, Marti
Describes the use of poetry, music, and creative writing with forensic patients at a state mental health institute. Demonstrates that expressive interventions were helpful in group treatment by promoting verbalization, decision making, and the recognition of personal responsibility for incarceration. (SR)
To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,
Fang, Qi-Gen; Shi, Shuang; Sun, Chang-Fu
The purpose was to evaluate our 20-year experience of pediatric odontogenic lesions. Pediatric patients with a diagnosis of odontogenic lesion were identified. Three hundred ten patients were odontogenic; dentigerous cyst was seen in 62.0% of the cases. Most (70.2%) of them occurred in mixed dentition period, and it had a male preponderance. Odontogenic keratocystic tumor occurred in the permanent dentition period. It had an equal site distribution. Odontoma was seen in 20.0% of the cases. Its site of predilection was the mandible. Ameloblastoma was the most common odontogenic tumor. Most of the cases occurred in the permanent dentition period. It affected the male and female equally. Calcifying epithelioma odontogenic tumor was seen in 11.8% of the cases. All the lesions occurred in the primary dentition period. It had no sex or site preponderance. Myxoma was seen in 3.6% of the cases. It was most common in the permanent dentition period, and it was more frequent in the male. Iliac crest bone graft was successfully performed in 28 patients, postoperative infection occurred in 2 patients, and no donor-site dysfunctions were reported. The observed differences in lesion type and distribution in this study compared with previous researches may be attributable to genetic and geographic variation in the populations studied. Iliac crest bone graft was suggested for pediatric mandible reconstruction. PMID:24785745
Full Text Available Haematuria has a prevalence of 12% in the postrenal transplant patient population. It heralds potentially dangerous causes which could threaten graft loss. It is important to consider causes in light of the unique, urological, and immunological standpoints of these patients. We review the literature on common causes of haematuria in postrenal transplant patients and suggest the salient approach to the evaluation of this condition. A major cause of haematuria is urinary tract infections. There should be a higher index of suspicion for mycobacterial, fungal, and viral infection in this group of immunosuppressed patients. Measures recommended in the prevention of urinary tract infections include early removal of foreign bodies as well as prophylactic antibiotics during the early transplant phase. Another common cause of haematuria is that of malignancies, in particular, renal cell carcinomas. When surgically managing cancer in the setting of a renal transplant, one has to be mindful of the limited retropubic space and the need to protect the anastomoses. Other causes include graft rejections, recurrences of primary disease, and calculus formation. It is important to perform a comprehensive evaluation with the aid of an experienced multidisciplinary transplant team.
Chris Wiegand, CEO of Jibestream, a software development company for digital interactive technologies with bases in Toronto and Arlington, Virginia, explains how technologies including Wi-Fi, GPS, RFID, and Bluetooth LE are enhancing wayfinding in healthcare facilities, and, in the process, simplifying the patient journey and helping reduce the stress and anxiety often associated with a visit to the hospital. PMID:27017656
Gibson, G; Saunders, D. E.
Gays and lesbians are a part of our society and our practices: real people with real lives, not stereotypes. Understanding their inner world and their social milieu is the first step to providing care that is holistic and appropriate. The "coming out" process and other unique health issues are described. Guidance is provided on how to identify and relate to gay and lesbian patients.
Khakabimamaghani, Sahand; Ester, Martin
The move from Empirical Medicine towards Personalized Medicine has attracted attention to Stratified Medicine (SM). Some methods are provided in the literature for patient stratification, which is the central task of SM, however, there are still significant open issues. First, it is still unclear if integrating different datatypes will help in detecting disease subtypes more accurately, and, if not, which datatype(s) are most useful for this task. Second, it is not clear how we can compare different methods of patient stratification. Third, as most of the proposed stratification methods are deterministic, there is a need for investigating the potential benefits of applying probabilistic methods. To address these issues, we introduce a novel integrative Bayesian biclustering method, called B2PS, for patient stratification and propose methods for evaluating the results. Our experimental results demonstrate the superiority of B2PS over a popular state-of-the-art method and the benefits of Bayesian approaches. Our results agree with the intuition that transcriptomic data forms a better basis for patient stratification than genomic data. PMID:26776199
Alcohol abusers have a threefold increased risk of post-operative morbidity after surgery. The most frequent complications are infections, cardiopulmonary insufficiency, and bleeding episodes. Pathogenesis is suppressed immune capacity, subclinical cardiac dysfunction, and haemostatic imbalance....... The economic implications of alcohol abuse in surgical patients are tremendous. Interventional studies are required to reduce future increases in post-operative morbidity....
Ciraj-Bjelac Olivera F.
Full Text Available The objective of this work is to assess patient organ doses, effective doses and entrance surface doses in conventional diagnostic radiology procedures for standard adult patient. The survey consists of measurements of doses delivered to 239 patients in nine types of X-ray examinations. Three types of data were collected: X-ray machine data, patient data, and output measurements. Entrance surface dose was assessed based on the survey data and subsequently, using conversion coefficients, the organ doses and effective doses were calculated. Values of the entrance surface dose and the effective dose were estimated to be 0.4 to 5.8 mGy and 0.03 to 3.00 mSv for different examinations. Derived doses were compared with recommended general diagnostic reference levels. The impact of examination parameters on dose values was discussed. Except for posterior-anterior chest examination, all estimated doses are lower than stated reference levels. Survey data are aimed at helping development of national quality control and radiation protection programmed for medical exposures.
There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality
The Role of Radiotherapy is treatment modalities for cancer which is generally assumed that 50 to 60% of cancer patients will benefit from radiotherapy. It constitutes a peaceful application of ionizing radiation and an essential part of cancer management. The two aims of radiation protection Prevention is of deterministic effect and Reduction of the probability of stochastic effects. The Shielding fundamentals is to limit radiation exposure of staff, patients, visitors and the public to acceptable levels it also optimize protection of patients, staff and the public. Diagnosis is important for target design and the dose required for cure or palliation while Simulator is often used twice in the radiotherapy process where Patient data acquisition - target localization, contours, outlines and Verification. The Prescription is the responsibility of individual clinicians, depending on the patient’s condition, equipment available, experience and training. An ultimate check of the actual treatment given can only be made by using in vivo dosimetry. Treatment records must be kept of all relevant aspects of the treatment – including Session and Summary Record information, Records all treatment parameters, Dose Calculations and Dose Measurements
Fisk, T A; Brown, C J; Cannizzaro, K G; Naftal, B
Many hospitals are considering enhanced approaches to patient satisfaction measurement and guest relations--or service management. Some are building in-house satisfaction management systems. Others are evaluating the growing number of systems commercially available for purchase. The authors review the successful design, testing, introduction, and nearly 5-year use of an in-house system. PMID:10105197
Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: firstname.lastname@example.org [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)
There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.
te Poele, EM; Kamps, WA; Tamminga, RYJ; Leew, JA; Postma, A; de Bont, ESJM
Chemotherapy-induced neutropenia is a major dose-limiting side effect of intensive chemotherapy in cancer patients. Recently, pegfilgrastim (a product with a long half-life, resulting in once-per-cycle dosage) was introduced to prevent neutropenia in adults. The authors report 32 episodes of pegfilg
Full Text Available The aim of this study was to evaluate the prevalence of primary pulmonary hypertension (PHT among hemodialysis patients and search for possible etiologic factors. The prevalence of PHT was prospectively estimated by Doppler echocardiogram in 62 long-term hemodialysis patients on the day post dialysis. PHT (> 35 mm Hg was found in 32 (51.6% patients with a mean systolic pulmonary artery pressure of 39.6 ± 13.3 mmHg. The hemoglobin and albumin levels were significantly lower in the PHT subgroup (11.1 ± 1.86 vs 9.8 ± 1.97 g/dL and 3.75 ± 0.44 vs 3.38 ± 0.32 g/dL, p = 0.01 and 0.02, respectively. Our study demonstrates a surprisingly high prevalence of PHT among patients receiving long-term hemodialysis. Early detection is important in order to avoid the serious consequences of the disease.
There are increasing numbers of initiatives in healthcare institutions focusing on the benefits of essential oils. Received positively by patients who appreciate the resulting wellbeing, these innovative approaches around aromatherapy are based on the initiative of pioneering caregivers. Following on from an international congress held each year in Grasse, this article presents some example schemes. PMID:25065196
Full Text Available Larynx cancer is one of the most susceptible form of cancer susceptible to induce alteration of the patient’s psychological profile due to the social role that the larynx has in communication. Oral communication is severely impaired even after voice rehabilitation of the laryngectomized patients, so that the social rehabilitation is somewhat not only a medical but also a social problem. The psychological profile of these patients is altered in a way that dealing with the disease is sometimes neglected and the interaction with the outside world in terms of oral communication is totally abandoned. The starting point for depression in these cases is the acknowledgement of the disease and is, in some cases, the entire medical environment. Facial scarring, the inability to verbally interact with other human, as well as the presence of the tracheostoma, are all deciding factors in the presence of a low self-esteem for these particular patients. Psychological counseling is a mandatory approach for laryngectomized patients, in order to improve their ability to cope with cancer and providing better recovery chances.
Zinck Pedersen, Kirstine
The key trope of patient safety policy is learning. With the motto of going from ‘a culture of blame to a learning culture’, the safety program introduces a ‘systemic perspective’ to facilitate openness and willingness to talk about failures, hereby making failures into a system property. Within...
Lønnberg, A S; Skov, Lone; Skytthe, A;
We read with interest the report by Fang and colleagues of the relationship between psoriasis and asthma in a large retrospective case-control study from Taiwan . The study found a 1.38-fold increased risk of asthma among patients with psoriasis, and with an increasing risk according to higher...
Full Text Available Introduction: Patients with chronic and advanced kidney failure undergo hemodialysis treatment and because of various drug therapies have basic problems in their life style which affects their psychosocial operation. The purpose of this study was to determine the hemodialysis patients’ quality of life in Abadan and Khorramshahr in 2011. Methods: This is a cross - sectional study in which all patients (80 cases referring to Abadan and Khorramshahr hemodialysis clinics completed a questionnaire which included two sections of demographic data and kidney diseases quality of life (KDQOL. Data analysis was done using SPSS-17 software and statistical tests such as ANOVA, Pearson correlation coefficient, and Independent T test were used. Results: The mean score of life quality of the participants was 47.22 ± 8.82 which indicates their low quality of life. Result showed that between quality of life and age (P = 0.04 & r = 0.5 and ESRD patience period (P=0.03 & r= 0.23, there exists a statistically significant relationship. A positive and significant association was also observed between education and quality of life (p= 0.003 and between income level and quality of life (P<0.0001. Conclusion: Life quality of Hemodialysis patients is low and authorities need to provide these patients with more social support and see into their welfare.
Buckalew, L. W.; Sallis, R. E.
Addresses problem of patient noncompliance with regimens of prescribed medication, with attention to incidence and illogical nature of this behavior. Psychological theory of cognitive dissonance is suggested as appropriate to understanding some aspects of noncompliance because medicinal preparations represent stimuli that are not necessarily…
Full Text Available Abstract Distinction between true negative and depressive symptoms in schizophrenia is difficult. In the present study we seek to establish the psychological profile of depression-prone schizophrenic patients. We addressed the issue by comparing the expression of psychological indices, such as the feelings of being in control of events, anxiety, mood, and the style of coping with stress in depressive and non-depressive schizophrenics. We also analyzed the strength of the association of these indices with the presence of depressive symptoms. A total of 49 patients (18 women and 31 men, aged 23-59 were enrolled into the study, consisting of a self-reported psychometric survey. We found that the prevalence of clinically significant depression in schizophrenic patients was 61%. The factors which contributed to the intensification of depressive symptoms were the external locus of control, anxiety, gloomy mood, and the emotion-oriented coping with stress. We conclude that psychological testing may discern those schizophrenic patients who would be at risk of depression development and may help separate the blurred boundaries between depressive and negative symptoms of schizophrenia.
Meyers, David G; Hoestje, Sara M; Korentager, Richard A
Given the increased level of adrenergic stimulation in burn patients, it would be expected that they would experience an increased incidence of cardiac arrhythmias and other cardiac events. We performed a retrospective chart review of 56 acute burn patients matched by age, length of hospital stay, and sex to 56 trauma patients, all of whom had been continuously monitored electrocardiographically. Burn and trauma patients were similar in injury severity, admission laboratory values, and prior history of cardiopulmonary diseases. Arrhythmias were noted in 34% of burn patients and 28% of trauma patients. One myocardial infarction and six deaths occurred in burn patients. No myocardial infarctions or deaths were observed in trauma patients. A past history of cardiopulmonary disease increased the risk of myocardial infarction or death by 6.6 times. Cardiac arrhythmias and other events are relatively infrequent and benign in burn patients and are similar to those experienced by other patients with acute injuries. PMID:12781616
Full text: Introduction: The lung is one of the most commonly affected organs in immunocompromised patients. Primary complication is pulmonary infection which is associated with high morbidity and mortality. Although radiography and CT, as main diagnostic tools are reliable and credible methods, often there is difficulty with the correct diagnose. The reasons for this are that immunocompromised patients are potentially susceptible to infection by various microorganisms and that the radiographic findings are rarely specific for detecting a particular pathogen. What you will learn : Our objective is to present general nosological classification of pulmonary infections in immunocompromised patients, and to evaluate and analyze new imaging methods and discuss their correlation with the clinical setting, which aims to facilitate the diagnosis and to take a decision for the treatment. The experience indicates that a clinical environment conducive the immunocompromised patients to infection with certain pathogens, thereby changing the frequency of their occurrence. The most commonly cited fungal infections, cytomegalovirus infections, Pneumocystis carinii pneumonia and Pulmonary tuberculosis (PTB) of which convincing is the Imaging diagnosis primarily in fungal infections, and Pneumocystis carinii pneumonia and less accurate - in bacterial and viral infections. Discussion: The term 'immunocompromised' describes a subject with an increased risk for life-threatening infection as a result of congenital or acquired abnormalities of the immune system. Over the past few decades, the number of immunocompromised patients has grown considerably, reflecting the increased use of immunosuppressive drugs, and the syndrome of acquired immunodeficiency. Given the high incidence of pulmonary infections in immunocompromised patients (lung is one of the most commonly affected organs, such as lung infection is about 75% of pulmonary complications), rapid and accurate diagnosis is important
Vaisbich, Maria Helena; Pache de Faria Guimaraes, Luciana; Shimizu, Maria Heloisa Mazzola; Seguro, Antonio Carlos
Background/Aims Nephropathic cystinosis (NC) is a severe systemic disease and cysteamine improves its prognosis. Lysosomal cystine accumulation is the hallmark of cystinosis and is regarded as the primary defect due to mutations in the CTNS gene. However, there is great evidence that cystine accumulation itself is not responsible for all abnormalities observed in NC. Studies have demonstrated altered ATP metabolism, increased apoptosis, and cell oxidation. An increased number of autophagosomes and autophagic vacuoles have been observed in cystinotic fibroblasts and renal epithelial cells, suggesting that altered autophagy plays a role in NC, leading to increased production of reactive oxygen species. Therefore, cystinosis patients can be more susceptible to oxidative stress (OS) and it can contribute to the progression of the renal disease. Our goal was to evaluate a marker of OS (serum TBARS) in NC children, and to compare the results with those observed in healthy controls and correlated with renal function parameters. Methods The study included patients aged under 18 years, with good adherence to the treatment and out of renal replacement therapy. The following parameters were evaluated: serum creatinine, BUN, creatinine clearance estimated by stature and serum TBARS levels. Results We selected 20 patients aged 8.0 ±3.6 years and observed serum TBARS levels of 4.03 ±1.02 nmol/ml. Serum TBARS levels in the 43 healthy controls, aged 7.4 ±1.1 years, were 1.60 ±0.04 nmol/ml. There was a significant difference between the plasma TBARS levels among the 2 groups (p < 0.0001). We detected no significant correlation between plasma TBARS levels and renal function. Conclusion An increased level of serum TBARS in patients with NC was observed and this abnormality was not correlated with the renal function status degree. This is the first report that shows increased oxidative stress in serum of NC patients. PMID:22470381
Full Text Available The prevalence of sleep disorders is higher in patients with kidney failure than the general population. We studied the prevalence of sleep disorders in 88 (mean age; 41.59 ± 16.3 years chronic hemodialysis (HD patients at the Urology and Nephrology Center, Mansoura Uni-versity, Egypt over 4-month period. The investigated sleep disorders included insomnia, restless leg syndrome (RLS, obstructive sleep apnea syndrome (OSAS, excessive daytime sleepiness (EDS, narcolepsy and sleep walking, and we used a questionnaire in accordance with those of the International Restless Legs Syndrome Study Group, the Berlin questionnaire, Italian version of Epworth Sleepiness Scale, International Classification of Sleep Disorders, and the specific ques-tions of Hatoum′s sleep questionnaire. The prevalence of sleep disorders was 79.5% in our pa-tients, and the most common sleep abnormality was insomnia (65.9%, followed by RLS (42%, OSAS (31.8%, snoring (27.3%, EDS (27.3%, narcolepsy (15.9%, and sleep walking (3.4%. Insomnia correlated with anemia (r=0.31, P= 0.003, anxiety (r=0.279, P= 0.042, depression (r=0.298, P= 0.24 and RLS (r=0.327, P= 0.002. Also, RLS correlated with hypoalbuminemia (r=0.41, P= < 0.0001, anemia (r=0.301 and P= 0.046, hyperphosphatemia (r=0.343 and P= 0.001. EDS correlated with OSAS (r=0.5, P= < 0.0001, snoring (r=0.341, P= 0.001, and social worry (r=0.27, P= 0.011. Sleep disorders are quite common in the HD patients, especially those who are anemic and hypoalbuminemic. Assessment of sleep quality, preferably with polysomno-graphy, is necessary to confirm our results. Interventional studies for management of sleep disor-ders in HD patients are warranted.
Elderly patients, or those individuals over 65 or 70 depending on the different authors, represent the majority of cancer patients who treated with radiation therapy (RT), however there are very few publications that we provide information needed to evaluate the use of RT in the treatment elders regarding: indication of dose, tissue tolerance, toxicity and association with other therapeutic modalities. In the treatment process must take into account RT radiobiology Clinical applied to each patient and is more relevant in the elderly in which often are comorbid conditions and functional limitations normal tissues increases with age and disease coexisting vascular and connective influencing RT treatment. Chronological age does not correlate with the biological age for tolerance normal tissue, however frequently refers to healthy tissue in the elderly are less tolerant than healthy tissue RT adults young but no data in the literature to support it and perhaps those claims probably based on the presence of comorbid conditions or diseases associated or previous surgeries that influence the risk of tissue damage healthy. Studies conducted by the EORTC not show differences in toxicity acute and late age-related. Elderly patients tolerate RT like younger patients with comparable side effects. In the case of concurrent chronic diseases should take into account a possible modification of the dose and volume irradiated to prevent the risk develop permanent damage or sector body lest un irradiated able to compensate for the loss of function of the irradiated tissue; but we should always note that the dose reduction while reducing the risk of complications also decreases the chance of cure
Maria Helena Vaisbich
Full Text Available Background/Aims: Nephropathic cystinosis (NC is a severe systemic disease and cysteamine improves its prognosis. Lysosomal cystine accumulation is the hallmark of cystinosis and is regarded as the primary defect due to mutations in the CTNS gene. However, there is great evidence that cystine accumulation itself is not responsible for all abnormalities observed in NC. Studies have demonstrated altered ATP metabolism, increased apoptosis, and cell oxidation. An increased number of autophagosomes and autophagic vacuoles have been observed in cystinotic fibroblasts and renal epithelial cells, suggesting that altered autophagy plays a role in NC, leading to increased production of reactive oxygen species. Therefore, cystinosis patients can be more susceptible to oxidative stress (OS and it can contribute to the progression of the renal disease. Our goal was to evaluate a marker of OS (serum TBARS in NC children, and to compare the results with those observed in healthy controls and correlated with renal function parameters. Methods: The study included patients aged under 18 years, with good adherence to the treatment and out of renal replacement therapy. The following parameters were evaluated: serum creatinine, BUN, creatinine clearance estimated by stature and serum TBARS levels. Results: We selected 20 patients aged 8.0 ±3.6 years and observed serum TBARS levels of 4.03 ±1.02 nmol/ml. Serum TBARS levels in the 43 healthy controls, aged 7.4 ±1.1 years, were 1.60 ±0.04 nmol/ml. There was a significant difference between the plasma TBARS levels among the 2 groups (p Conclusion: An increased level of serum TBARS in patients with NC was observed and this abnormality was not correlated with the renal function status degree. This is the first report that shows increased oxidative stress in serum of NC patients.
Coscarelli, S; Verrecchia, L; Coscarelli, A
Dysphagia is a frequent finding in neurological patients and is a symptom related to the severity of the clinical picture. The swallowing impairments, in these patients, increase the risk of aspiration pneumonia, that leads to death, in at least 6% of patients, within the first year. Therefore, evaluation of the swallowing status is essential in patients with dysphagia and videofluoroscopic study of swallowing (VFSS) is the method of choice. It cannot be performed in all patients on account o...
The paper discusses the moral difficulties physicians encounter when determining the level of formality they will use when addressing their patients. It is argued that physicians ought not to use a patient's first name unless the patient also uses the physician's first name. In short, physicians and patients should always address each other with the same level of formality. It is argued that this is so even when patients invite physicians to address them informally.
Bravo, P.; Edwards, A.; Barr, P J; Scholl, I.; Elwyn, G; McAllister, M
BACKGROUND: In recent years, interventions and health policy programmes have been established to promote patient empowerment, with a particular focus on patients affected by long-term conditions. However, a clear definition of patient empowerment is lacking, making it difficult to assess effectiveness of interventions designed to promote it. The aim in this study was to develop a conceptual map of patient empowerment, including components of patient empowerment and relationships with other co...
Zwaag, M. van der; Tijs, T.J.W.; Westerink, J.H.D.
Patient anxiety is a frequently occurring concern as it decreases patient satisfaction, increases consultation duration, and can influence successful medical outcome. To illustrate, for some diagnosis methods as PET scans patients need to be relaxed for successful medicaloutcome. Music can possibly reduce patients stress. However, hospital selected music has not always shown its effectiveness, and patient selected music has shown it could be arousing instead of relaxing.In two experiments the...
Abhinav Agrawal; Sayee Sundar Alagusundarmoorthy; Sarfaraz Jasdanwala
Elevation of pancreatic enzymes is often observed in patients admitted to intensive care units in the United States. Elevated pancreatic enzymes can occur due to acute pancreatitis or numerous non-specific reasons. Non-specific enzyme elevation can be seen in patients with head injury, acute renal failure, diabetic ketoacidosis or patients on hemodialysis. Patients with severe acute pancreatitis can be admitted to the intensive care units for intensive care or patients admitted to the intensi...
Wiklander Maria; Samuelsson Mats; Jokinen Jussi; Nilsonne Åsa; Wilczek Alexander; Rylander Gunnar; Åsberg Marie
Abstract Background It has been suggested that shame may be an important feature in suicidal behaviors. The disposition to react with shame, “shame-proneness”, has previously not been investigated in groups of attempted suicide patients. We examined shame-proneness in two groups of attempted suicide patients, one group of non-suicidal patients and one group of healthy controls. We hypothesized that the attempted suicide patients would be more shame-prone than non-suicidal patients and healthy...
Gaebel, Jan; Cypko, Mario A; Lemke, Heinz U
Clinical decision support systems (CDSS) are developed to facilitate physicians' decision making, particularly for complex, oncological diseases. Access to relevant patient specific information from electronic health records (EHR) is limited to the structure and transmission formats in the respective hospital information system. We propose a system-architecture for a standardized access to patient specific information for a CDSS for laryngeal cancer. Following the idea of a CDSS using Bayesian Networks, we developed an architecture concept applying clinical standards. We recommend the application of Arden Syntax for the definition and processing of needed medical knowledge and clinical information, as well as the use of HL7 FHIR to identify the relevant data elements in an EHR to increase the interoperability the CDSS. PMID:27139392
Ronda, Maaike C. M.; Dijkhorst-Oei, Lioe-Ting; Rutten, Guy E. H. M.
Objective A diabetes patient web portal allows patients to access their personal health record and may improve diabetes outcomes; however, patients' adoption is slow. We aimed to get insight into patients' experiences with a web portal to understand how the portal is being used, how patients perceiv
Pedersen, Michael Svendsen
Med inspiration fra et økologisk perspektiv på sproglæring diskuteres mulighederne for videreudvikling af en kommunikativ pædagogik inden for arbejdspladsrelateret undervisning i dansk som andetsprog for voksne....
Christensen, Jesper Frank; Jones, L W; Andersen, J L;
dysfunction is evident across all stages of the cancer trajectory. The causes of cancer-related muscle dysfunction are complex, but may involve a wide range of tumor-, therapy- and/or lifestyle-related factors, depending on the clinical setting of the individual patient. The main importance of muscle...... dysfunction in cancer patients lies in the correlation to vital clinical end points such as cancer-specific and all-cause mortality, therapy complications and quality of life (QoL). Such associations strongly emphasize the need for effective therapeutic countermeasures to be developed and implemented in...... powered to evaluate clinical outcomes associated with improvements in muscle function, or be promoted in advanced stage settings, aiming to reverse cancer-related muscle dysfunction, and thus potentially improve time-to-progression, treatment toxicity and survival....
Shojanoori, Reza; Juric, Radmila
We propose an automated and personalized remote patient monitoring (RPM) system, which is applied to care homes and is dependent on the manipulation of semantics describing situations during patient monitoring in ontological models. Decision making in RPM is based on reasoning performed upon ontologies, which secures the delivery of appropriate e-health services in care homes. Our working experiment shows an example of preventive e-healthcare, but it can be extended to any situation that requires either urgent action from healthcare professionals or a simple recommendation during RPM. We use Semantic Web technology and OWL/SWRL-enabled ontologies to illustrate the proposal and feasibility of implementing this RPM system as a software solution in pervasive healthcare. It will be of interest to healthcare professionals, who can directly shape and populate the proposed ontological model, and software engineers, who would consider using OWL/SWRL when creating e-health services in general. PMID:23363406
Carrick, Matthew M.; Leonard, Jan; Slone, Denetta S.; Mains, Charles W.
Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur. The randomized controlled trials examining restricted fluid resuscitation have demonstrated that aggressive fluid resuscitation in the prehospital and hospital setting leads to more complications than hypotensive resuscitation, with disparate findings on the survival benefit. Since the populations studied in each randomized controlled trial are slightly different, as is the timing of intervention and targeted vitals, there is still a need for a large, multicenter trial that can examine the benefit of hypotensive resuscitation in both blunt and penetrating trauma patients. PMID:27595109
Dahl, Poul Nørgård
I det danske sundhedsvæsen tillægges kommunikationen med patienten øget betydning, hvilket bl.a. ses i Speciallægekommissionens betænkning Fremtidens speciallæge (2000) og anbefalingerne i Patientens møde med sundhedsvæsenet (2003). Begge steder fremgår det, at god kommunikation ikke kun handler om......’, lægen ifølge Cordella (2004) kan tale med, som er forbundet med de ’stemmer’, patienten kan tale med. God kommunikation kan ses som den rette kombination af ’stemmer’ i forhold til den konkrete patient og dennes situation. En autentisk samtale med en hofteopereret patient næranalyseres ud fra sam- og...
Ashby, G Alice; O'Brien, Aileen; Bowman, Deborah; Hooper, Carwyn; Stevens, Toby; Lousada, Esther
Since its beginnings in the 1980s the internet has come to shape our everyday lives, but doctors still seem rather afraid of it. This anxiety may be explained by the fact that researchers and regulatory bodies focus less on the way that the internet can be used to enhance clinical work and more on the potential and perceived risks that this technology poses in terms of boundary violations and accidental breaches of confidentiality. Some aspects of the internet's impact on medicine have been better researched than others, for example, whether email communication, social media and teleconferencing psychotherapy could be used to improve the delivery of care. However, few authors have considered the specific issue of searching online for information about patients and much of the guidance published by regulatory organisations eludes this issue. In this article we provide clinical examples where the question 'should I Google the patient?' may arise and present questions for future research. PMID:26755985
This paper presents the estimation of dose-area product (DAP) received by 128 patients during different interventional radiological procedures in the Hospital Universitario de Salamanca, analyzing the differences between procedures classified as either vascular, non vascular, diagnostic or therapeutic. These differences can be assessed and reference dose levels can be established as a function of the variation of those parameters. Comparisons between dose-area product values obtained from this study are made with the data from nine other patient dose surveys, although explanations for some of the differences could not be obtained in some cases. The reference values in these procedures in our centre are very high due to a great number of images, so the clinical protocol should be changed to avoid this problem. (author)
Every irradiation contributes to increasing the risk and cost-benefit considerations went into radiation protection work. The stochastic effect of cancer induction is the main concern in today's work on radiation protection of the patient. In radiation therapy, doses to the target volume (tumour and nearby healthy tissues) are part of the therapy and not a matter of radiation protection; doses to distant organs need, however, to be minimised to reduce the risk of developing radiation induced cancer later in life. The present recommendations by the ICRP are gathered in three publications for patients in diagnostic radiology, radiotherapy and nuclear medicine, respectively. This article discusses some of the social and economical aspects of diagnostic radiology, reviews its biological effects and gives risk estimates according to the ICRP 60. The concepts of radiation protection are also discussed and some of the strategies for dose reduction adopted by the European Union are outlined
Arora, Shubhangi; Singh, Preet Mohinder; Trikha, Anjan
Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS) secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented. PMID:24550626
Full text: The prognosis of achieving longtime remission for disseminated cancer disease is in many cases poor. A systemic treatment is required and therefore external beam radiation therapy is less suited. Treatment with radiolabeled pharmaceuticals, so called radionuclide therapy is such a systemic treatment. In radionuclide therapy, the absorbed dose is delivered by administration of radionuclides that emit electrons or alpha particles. It is here assumed that the released kinetic energy is transferred by interactions to sensitive parts of the cells activating cell death, and thus an accurate dosimetry is important. However, absorbed dose planning for radionuclide therapy is a real challenge in that the source cannot be turned on or off (as in external beam therapy) but decays exponentially with characteristics depending on the biokinetics and the radionuclide half-life. On a small-scale, the radiopharmaceutical is also heterogeneously distributed which means that the energy deposition is generally nonuniform. The biokinetics may also change over time which means that activity measurements need to be made at several time points to estimate the total amount of released energy in an organ or tumour. Practical issues regarding the number of measurements and patient mobility may therefore limit the accuracy in this calculation. The dose-rate for radionuclide therapy is also much lower than in external beam therapy. Since the treatment is systemic, circulating activity may result in absorbed doses to normal organs and tissues. Often this poses a problem and puts a limit on the amount of activity to can be administered. This is one of the major reasons for the requirement of an accurate patient-specific dosimetry. One of the major problems is that the biokinetics varies between patients and the activity uptake and clearance should therefore be measured for each individual patient in order to estimate the total number of decays in a particular organ/tissue. The way
Full Text Available Lung injury in trauma patients can occur because of direct injury to lung or due to secondary effects of injury elsewhere for example fat embolism from a long bone fracture, or due to response to a systemic insult such as; acute respiratory distress syndrome (ARDS secondary to sepsis or transfusion related lung injury. There are certain special situations like head injury where the primary culprit is not the lung, but the brain and the ventilator strategy is aimed at preserving the brain tissue and the respiratory system takes a second place. The present article aims to delineate the strategies addressing practical problems and challenges faced by intensivists dealing with trauma patients with or without healthy lungs. The lung protective strategies along with newer trends in ventilation are discussed. Ventilatory management for specific organ system trauma are highlighted and their physiological base is presented.
La logique du choix se manifeste sous diverses formes, l’une d’elles s’articulant dans le marché. En matière de soins de santé, les patients y sont décrits comme des “clients” : ils achètent leurs soins et les paient en monnaie sonnante. De ce fait, personne n’attend d’eux de reconnaissance car il ne s’agit pas d’un cadeau bienveillant ni d’un acte gratuit. Au contraire, le langage du marché permet de dire que les patients doivent en avoir pour leur argent, et que l’offre de soins doit s’adap...
Hrubiško, M; Špičák, V
Specific allergen immunotherapy (AIT) is the only therapeutic method with positive impact on natural course of allergic disease - affecting clinical development (including the progression of rhinitis to asthma) and new sensitisations. The actual problem is the increasing number of patients manifesting poly-sensitivity in allergy skin tests and / or in specific IgE tests. Usually, AIT is not recommended in such individuals. The objective we are facing is that in many patients tested as poly-reactive, we have to distinguish in which cases it is a true polysensitization, and when it is due to cross-reactivity of specific IgE antibodies induced by panallergens. This may really determine when AIT may be an appropriate course of action. The article focuses on this problem in more detail, applying the long time Czech and Slovak experience with allergy testing and allergen immunotherapy. PMID:27152601
Maria Isabela Sarbu
Full Text Available Psoriasis is a chronic, immune-mediated disorder with a worldwide occurrence characterized by well-defined infiltrated erythematous papules and plaques, covered by silvery white or yellowish scales. It is a physically, socially and emotionally invalidating disorder that affects 1-2% of the population. Sexual health is an important part of general health and sexual dysfunctions can negatively affect self-esteem, confidence, interpersonal relationships and the quality of life. Dermatology Life Quality Index (DLQI, Psoriasis Disability Index (PDI and the Impact of Psoriasis on Quality of Life (IPSO questionnaire are all questionnaires used to assess the quality of life of patients with psoriasis and each has one question regarding sexual dysfunction. Several scales were also designed to particularly assess sexual satisfaction in men and women. The aim of this paper is to perform an overview of the existing studies on sexual dysfunction in psoriatic patients.
Hekimsoy, Zeliha; Ozmen, Bilgin; Ulusoy, Sadik
Acromegaly is associated with a two to three-fold increase in mortality related predominantly to cardiovascular disease. The excess mortality is associated most closely with higher levels of growth hormone (GH). Survival in acromegaly may be normalized to a control age-matched rate by controlling GH levels; in particular, GH levels less than 2.5 ng/mL are associated with survival rates equal to those of the general population. Hyperhomocysteinemia has also been recognized as a risk factor for cardiovascular disease, yet there are limited data on the prevalence of hyperhomocysteinemia in patients with acromegaly. Eighteen acromegaly patients (7 male, 11 female, mean age 42.8 +/- 11.0 years) in our endocrine clinic consented to having the following tests performed: complete blood count (CBC), thyroid hormones, folic acid, vitamin B12, plasma homocysteine levels, uric acid, fibrinogen, CRP, fasting glucose, insulin, C-peptide, total serum cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, GH, insulin-like growth factor-1 (IGF-1) and GH levels after an oral glucose tolerance test (OGTT). By history, fourteen had macroadenomas and four had microadenomas; eight had hypertension; two had glucose intolerance, and four had diabetes. Fifteen had had transsphenoidal or transfrontal surgery: two had been cured, but 13 others were taking long-acting octreotide. Five patients had undergone radiotherapy and the acromegaly in two was treated primarily with long-acting octreotide. CBC, thyroid hormone, folic acid, and vit B12 levels were normal in all patients. We divided the patients into two groups according to mean GH levels after an OGTT: Group 1 (GH<2.5 ng/mL, n=10), and Group 2 (GH<2.5 ng/mL, n=8). Comparison of the two groups using Mann-Whitney U testing revealed statistically significant lower levels in Group 1 of the following parameters: GH (1.91 +/- 0.90 vs. 8.58 +/- 5.55 ng/mL, p=0.002), IGF-1 (338.30 +/- 217.90 vs. 509.60 +/- 293.58 ng/dL, p=0.06), GH after
Khalid, Usman; Gislason, Gunnar Hilmar; Hansen, Peter Riis
PURPOSE: Psoriasis is a chronic inflammatory disease characterized by a systemic immunological response which is mainly driven by activated T helper (Th) 1 and Th17 lymphocytes. Like psoriasis, sarcoidosis is a chronic inflammatory disorder with Th1/Th17-driven inflammation. Therefore, we...... investigated the risk of sarcoidosis in patients with psoriasis compared to the background population in a nationwide cohort. METHODS: The study included the entire Danish population aged ≥10 years followed from 1st January 1997 until diagnosis of sarcoidosis, death or 31st December 2011. Patients with a...... history of psoriasis and/or sarcoidosis at baseline were excluded. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. Incidence rates of sarcoidosis were calculated and adjusted hazard ratios (HRs) were estimated by multivariable...
Ionizing radiation used in treating the head and neck area produces oral side effects such as mucositis, salivary changes, trismus and radiation caries. Sequelae of cancer chemotherapy often include oral stomatitis, myelosuppression and immunosuppression. Infections of dental origin in compromised patients are potentially lethal. Specific programs to eliminate dental pathology before radiation and chemotherapy, and to maintain oral hygiene during and after therapy, will minimize these complications
Evgeni, Brotfain; Akiva, Leibowitz; Yoav, Bihovsky; Yoram, Shapira; Andrey, Shwartz; Serik, Akshulakov2; Moti, Klein; Alexander, Zlotnik
Thermoregulation during anesthesia – general or regional – is often significantly impaired. Any shifts from a body core temperature of 36.6°c±0.2°c results in either hyperthermia or hypothermia, causing pathophysiologic reactions. Hyperthermic disorders are very dangerously and critical for patients. Hyperthermia is caused by a variety of clinical states. It is important to differentiate controlled and uncontrolled hyperthermia and evaluate the underlying cause. In this paper we discuss most ...
Orhan Çizmeci; Samet Vasfi Kuvat
Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are generea...
Duišin, Dragana; NIkolić-Balkoski, Gordana; Batinić, Borjanka
Background: Gender identity disorder is a rare entity in psychiatry which affects deep instincts and personal identity. A review of the recent literature has shown that research of socio-demographic characteristics of transsexual patients is sporadic. There are very few investigations which consider the socio-demographic characteristics in individuals with disharmonized sex and gender identity. This kind of research has not been done in Serbia until now. The objective of this research was ...
Dragotoiu, A; Checheriţă, AI; Ciocâlteu, A; Rizeanu, S
The stress a patient is subjected to during dialysis treatment can be reduced by using a synergetic approach by the medical team. The integration into therapy of the positive psychical resources such as: active positive coping mechanisms, individual or family mental resilience, improvement of the image and self-esteem, better tolerance to frustration can represent an important part in the improvement of the patient’s quality of life, determination of a positive approach of the situations both...
Objective: To determine the usefulness of perspective-filet view for polypoid lesions in paediatric patients in comparison with conventional virtual colonoscopy (VC) analysis and optical colonoscopy. Methods: Sixty-one patients (mean age 5 years old) with a previous episode of rectal bleeding were studied using a 16 slices CT scanner. All patients underwent a colonic preparation. Two acquisitions were done in supine and prone positions with slices of 2 mm thickness; increment 1 mm, 30-50 mA; 90-120 kV. In a workstation an experienced radiologist reviewed images twice. The first read was done using the conventional virtual colonoscopy technique with the evaluation of two-dimensional (2D), three-dimensional (3D) and endoscopical images. Later, in a second session, perspective-filet view was used. It shows a 360 deg. unrolled visualization of the inner colon. The presence, size and location of the lesions were determined. A record of the reading time was made. Results: At per patient evaluation the conventional virtual colonoscopy analysis obtained a sensitivity of 86% and a specificity of 98%. The perspective-filet view obtained a sensitivity of 91% and a specificity of 99%. In the evaluation on a per lesion basis the conventional analysis had a sensitivity of 81% and a specificity of 88%. Perspective-filet view, had a sensitivity of 82% and specificity of 90%. The average total reading time using conventional colonoscopy technique was 18 ± 3 min, versus 4 ± 1 min using the perspective-filet view. Conclusion: Virtual colon dissection with perspective-filet view is more time-efficient than conventional virtual colonoscopy evaluation with correct correlation in results.