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Sample records for prelingually deafened patients

  1. Cochlear implantation in late-implanted prelingually deafened adults: changes in quality of life.

    NARCIS (Netherlands)

    Straatman, L.V.; Huinck, W.J.; Langereis, M.C.; Snik, A.F.M.; Mulder, J.J.S.

    2014-01-01

    BACKGROUND: With expanding inclusion criteria for cochlear implantation, the number of prelingually deafened persons who are implanted as adults increases. Compared with postlingually deafened adults, this group shows limited improvement in speech recognition. In this study, the changes in health-re

  2. Acoustic properties of vocal singing in prelingually-deafened children with cochlear implants or hearing aids.

    Science.gov (United States)

    Mao, Yitao; Zhang, Mengchao; Nutter, Heather; Zhang, Yijing; Zhou, Qixin; Liu, Qiaoyun; Wu, Weijing; Xie, Dinghua; Xu, Li

    2013-11-01

    The purpose of the present study was to investigate vocal singing performance of hearing-impaired children with cochlear implants (CI) and hearing aids (HA) as well as to evaluate the relationship between demographic factors of those hearing-impaired children and their singing ability. Thirty-seven prelingually-deafened children with CIs and 31 prelingually-deafened children with HAs, and 37 normal-hearing (NH) children participated in the study. The fundamental frequencies (F0) of each note in the recorded songs were extracted and the duration of each sung note was measured. Five metrics were used to evaluate the pitch-related and rhythm-based aspects of singing accuracy. Children with CIs and HAs showed significantly poorer performance in either the pitch-based assessments or the rhythm-based measure than the NH children. No significant differences were seen between the CI and HA groups in all of these measures except for the mean deviation of the pitch intervals. For both hearing-impaired groups, length of device use was significantly correlated with singing accuracy. There is a marked deficit in vocal singing ability either in pitch or rhythm accuracy in a majority of prelingually-deafened children who have received CIs or fitted with HAs. Although an increased length of device use might facilitate singing performance to some extent, the chance for the hearing-impaired children fitted with either HAs or CIs to reach high proficiency in singing is quite slim. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Acoustic properties of vowel production in prelingually deafened Mandarin-speaking children with cochlear implants

    OpenAIRE

    YANG, Jing; Brown, Emily; Fox, Robert A.; Xu, Li

    2015-01-01

    The present study examined the acoustic features of vowel production in Mandarin-speaking children with cochlear implants (CIs). The subjects included 14 native Mandarin-speaking, prelingually deafened children with CIs (2.9–8.3 yr old) and 60 age-matched, normal-hearing (NH) children (3.1–9.0 years old). Each subject produced a list of monosyllables containing seven Mandarin vowels: [i, a, u, y, ɤ, ʅ, ɿ]. Midpoint F1 and F2 of each vowel token were extracted and normalized to eliminate the e...

  4. Acoustic properties of vowel production in prelingually deafened Mandarin-speaking children with cochlear implants.

    Science.gov (United States)

    Yang, Jing; Brown, Emily; Fox, Robert A; Xu, Li

    2015-11-01

    The present study examined the acoustic features of vowel production in Mandarin-speaking children with cochlear implants (CIs). The subjects included 14 native Mandarin-speaking, prelingually deafened children with CIs (2.9-8.3 yr old) and 60 age-matched, normal-hearing (NH) children (3.1-9.0 years old). Each subject produced a list of monosyllables containing seven Mandarin vowels: [i, a, u, y, ɤ, ʅ, ɿ]. Midpoint F1 and F2 of each vowel token were extracted and normalized to eliminate the effects of different vocal tract sizes. Results showed that the CI children produced significantly longer vowels and less compact vowel categories than the NH children did. The CI children's acoustic vowel space was reduced due to a retracted production of the vowel [i]. The vowel space area showed a strong negative correlation with age at implantation (r = -0.80). The analysis of acoustic distance showed that the CI children produced corner vowels [a, u] similarly to the NH children, but other vowels (e.g., [ʅ, ɿ]) differently from the NH children, which suggests that CI children generally follow a similar developmental path of vowel acquisition as NH children. These findings highlight the importance of early implantation and have implications in clinical aural habilitation in young children with CIs.

  5. Cochear implantion for prelingually deafened children with leukoencephalopathy%脑白质病语前聋儿童人工耳蜗植入疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴莎; 华清泉; 曹永茂; 杨琨; 张志敏

    2014-01-01

    目的:通过对脑白质病语前聋儿童人工耳蜗植入术疗效的观察,探讨人工耳蜗植入术在脑白质病语前聋儿童中的临床应用。方法经术前常规听力学、影像学、智力、心理等评估,筛选30例脑白质病语前聋儿童(脑白质病组)实施人工耳蜗植入术,并与同期30例接受人工耳蜗植入未伴脑白质病等中枢神经系统疾病的语前聋儿童(对照组)进行术后听觉语言康复情况疗效比较。结果(1)术后半年行声场测试,脑白质病组声场听阈为39.67±5.28dBHL,对照组为37.67±3.84dBHL,差异无统计学意义(P>0.05);(2)术后1年行听觉语言能力评估,听觉能力评估显示脑白质病组言语识别率为83.48±7.63%,对照组为85.03±9.43%;语言能力评估显示脑白质病组语言年龄为2.63±0.69岁,对照组语言年龄为2.71±0.74岁,两组患儿听觉能力及语言能力均无统计学差异(P>0.05)。结论脑白质病语前聋儿童在经过术前充分评估及观察筛选后实施人工耳蜗植入术与单纯语前聋儿童疗效相当,说明脑白质病聋儿实施人工耳蜗植入术是可行的。%Objective To observe the effects of cochear implantion for prelingually deafened children with leukoence-phalopathy. Methods 30 prelingually deafend children with leukoencephalopathy were screened in this study as leukoencephalopathy group by preoperative audiology, imaging data, intelligence and psychology assessment , and another 30 prelingually deafend children without central nervous diseases and accepted cochlear implantation at the same period were chosen as control group. The postoperative outcomes of the two groups were compared. Results (1)Half a year after cochlear implication, the field hearing threshold of leukoencephalopathy group was 39.67±5.28dBHL, the control group was 37.67±3.84dBHL, there was no significant difference in the two groups(P>0.05);(2)All children were

  6. Do Profoundly Prelingually Deaf Patients with Psychosis Really Hear Voices?

    Science.gov (United States)

    Paijmans, R.; Cromwell, J.; Austen, S.

    2006-01-01

    The psychiatric literature has described profoundly prelingually deaf people with psychosis who report hearing voices. The present study proposes that such reports in fact reflect the beliefs of professionals in mental health and deafness and not the hallucinatory experience of psychotic deaf people. The study demonstrates that it is functionally…

  7. Behavioral Assessment of Prelingually Deaf Children Before Cochlear Implantation

    Science.gov (United States)

    Horn, David L.; Pisoni, David B.; Sanders, Mary; Miyamoto, Richard T.

    2011-01-01

    Objectives/Hypothesis To determine whether scores from a behavioral assessment of prelingually deafened children who present for cochlear implant surgery are predictive of audiological outcomes Study Design Retrospective review of longitudinal data collected from 42 children with prelingual hearing loss who presented for a cochlear implant before age 5 years. Methods The Vineland Adaptive Behavioral Scales (VABS) was administered during the preimplant workup. Standardized scores reflect daily living skills, socialization, and motor development compared with a normative sample. Regression analyses were conducted to determine whether any subject variables were related to VABS scores. Mixed-model analyses were computed to determine whether preimplant VABS scores were predictive of longitudinal spoken-language data obtained after cochlear implant surgery. Results Motor scores tended to be higher than nonmotor scores. Nonmotor scores were significantly lower than the normative mean and decreased with testing age. Children with acquired deafness demonstrated lower motor scores than children with congenital causes. Children with higher motor scores demonstrated significantly higher performance on language, vocabulary, and word recognition tests than children with lower motor scores. Nonmotor domains were not as robustly related to spoken-language measures, although similar trends were observed Conclusion Profound deafness and language delay may confound the assessment of daily living skills and socialization in the population studied. Motor development appears to proceed normally in prelingually deafened children and is a preimplant predictor of spoken-language outcome in young infants and children with cochlear implants, a finding consistent with the large body of work establishing links between perceptual-motor and language development. PMID:16148703

  8. Aphasia in a prelingually deaf woman.

    Science.gov (United States)

    Chiarello, C; Knight, R; Mandel, M

    1982-03-01

    A left parietal infarct in a prelingually deaf person resulted in an aphasia for both American Sign Language (ASL) and written and finger-spelled English. Originally the patient had a nearly global aphasia affecting all language systems. By five to seven weeks post-onset her symptoms resembled those of hearing aphasics with posterior lesions: fluent but paraphasic signing, anomia, impaired comprehension and repetition, alexia, and agraphia with elements of neologistic jargon. In addition, there was a pronounced sequential movement copying disorder, reduced short-term verbal memory and acalculia. In general, the patient's sign errors showed a consistent disruption in the structure of ASL signs which parallels the speech errors of oral aphasic patients. We conclude that most aphasic symptoms are not modality-dependent, but rather reflect a disruption of linguistic processes common to all human languages. This case confirms the importance of the left hemisphere in the processing of sign language. Furthermore, the results indicate that the left supramarginal and angular gyri are necessary substrates for the comprehension of visual/gestural languages.

  9. Auditory pathway functioning in prelingual deafness : The clinical consequences for cochlear implantation

    NARCIS (Netherlands)

    Lammers, M.J.W.

    2015-01-01

    Cochlear implantation has proven itself as a very successful treatment for both children and adults with severe to profound hearing loss. Although most patients obtain a high level of speech perception, performance is more variable in prelingually deaf patients, i.e., patients with an onset of sever

  10. Prelingual deafness: Benefits from cochlear implants versus conventional hearing aids

    Science.gov (United States)

    Bittencourt, Aline Gomes; Torre, Ana Adelina Giantomassi Della; Bento, Ricardo Ferreira; Tsuji, Robinson Koji; Brito, Rubens de

    2012-01-01

    Summary Introduction: The majority of patients with hearing loss, including those with severe hearing loss, benefits from the use of hearing aids. The cochlear implant is believed to achieve better results in a child with hearing loss in cases where the severity of disability renders hearing aids incapable of providing adequate sound information, as they require sufficient cochlear reserve so that acoustic detention occurs. Objective: To assess if cochlear implants provide more benefit than conventional hearing aids in prelingually deaf patients. Summary of the findings: The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies. Conclusion: Based on several studies, cochlear implants were demonstrated to be the best current alternative for bilateral severe or profound hearing loss, achieving better results in speech perception and development in prelingual children when compared to conventional hearing aids. PMID:25991962

  11. Functional Reorganizations of Brain Network in Prelingually Deaf Adolescents

    OpenAIRE

    Wenjing Li; Jianhong Li; Jieqiong Wang; Peng Zhou; Zhenchang Wang; Junfang Xian; Huiguang He

    2016-01-01

    Previous neuroimaging studies suggested structural or functional brain reorganizations occurred in prelingually deaf subjects. However, little is known about the reorganizations of brain network architectures in prelingually deaf adolescents. The present study aims to investigate alterations of whole-brain functional network using resting-state fMRI and graph theory analysis. We recruited 16 prelingually deaf adolescents (10~18 years) and 16 normal controls matched in age and gender. Brain ne...

  12. [Societal cost of pre-lingual deafness].

    Science.gov (United States)

    Bubbico, L; Bartolucci, M A; Broglio, D; Boner, A

    2007-01-01

    Congenital hearing loss still remain an important medical and social problem for the delayed language development. Object of this study is to provide an updated and close estimate of the economic burden involved in pre-lingual hearing loss. Data were provided by the Ministry of Health data bank, the Ministry of Education national data bank, the National Institute of Social Insurance national data bank and the Italian Central Statistics Institute. The information was collected by means of a specially provided Societal Cost Questionnaire (SCQ). Direct medical costs, direct non-medical costs and indirect welfare costs involved in deafness were included in the cost estimate. Was enrolled in the study a sample of subjects with pre-lingual deafness, with a mean bilateral neuro-sensorial hearing impairment equal to 60 dB or more for 500, 1,000 and 2,000 Hz frequency tones in the better ear detected in neonatal age, had prevented speech from developing. The statistical assessment was performed according to an actuarial approach, considering the estimated life expectancy at birth, based on updated population data from census 2001. Based on life expectancy, the lifetime mean cost assessed for a subject affected by profound pre-lingual deafness turned out to be equal to Euro 737,994.76 for a male and Euro 755,404.02 for a female. Unlike other disabling affections, deafness weighs significantly more on the social system than on the health system. As a matter of fact, the direct medical costs, such as audiological diagnosis, hearing aids, etc., only account for 3.8% of the societal cost, whereas education, rehabilitation and welfare costs reach 96.2% of the total. Finally, our results suggest that societal costs can only be reduced by zeroing in on promotion and broadening of effective prevention strategies. The appropriate public health measures (such as the universal newborn hearing screening) set up and implemented in several European and non-European countries proved

  13. Scar formation in mice deafened with kanamycin and furosemide.

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    Żak, Magdalena; van der Linden, Cynthia A; Bezdjian, Aren; Hendriksen, Ferry G; Klis, Sjaak F L; Grolman, Wilko

    2016-08-01

    In mammals, hair cell loss is irreversible and leads to hearing loss. To develop and test the functioning of different strategies aiming at hair cell regeneration, animal models of sensorineural hearing loss are essential. Although cochleae of these animals should lack hair cells, supporting cells should be preserved forming an environment for the regenerated hair cells. In this study, we investigated how ototoxic treatment with kanamycin and furosemide changes the structure of cochlear sensory epithelium in mice. The study also compared different tissue preparation protocols for scanning electron microscopy (SEM). Cochleae were collected from deafened and nondeafened mice and further processed for plastic mid modiolar sections and SEM. For comparing SEM protocols, cochleae from nondeafened mice were processed using three protocols: osmium-thiocarbohydrazide-osmium (OTO), tannic acid-arginine-osmium, and the conventional method with gold-coating. The OTO method demonstrated optimal cochlear tissue preservation. Histological investigation of cochleae of deafened mice revealed that the supporting cells enlarged and ultimately replaced the lost hair cells forming types 1 and 2 phalangeal scars in a base towards apex gradient. The type 3 epithelial scar, flattened epithelium, has not been seen in analysed cochleae. The study concluded that mice deafened with kanamycin and furosemide formed scars containing supporting cells, which renders this mouse model suitable for testing various hair cell regeneration approaches. Microsc. Res. Tech. 79:766-772, 2016. © 2016 Wiley Periodicals, Inc.

  14. Preoperative cerebral metabolic difference related to the outcome of cochlear implantation in prelingually deaf children

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    Lee, J. H.; Lim, G. C.; Ahn, J. H.; Lee, K. S.; Jeong, J. W.; Kim, J. S. [Asan Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    The outcome of cochlear implantation (CI) has known to be variable. The aim of this study was to evaluate the preoperative regional glucose metabolism difference related to the speech perception outcome after CI in prelingually deaf children. Forty-one prelingually deaf children who underwent CI at age 2{approx}10 years were included. All patients underwent F-18 FDG brain PET within one month before CI and measured speech perception using the institute version of the CID at 2 years after CI. Patients were classified into younger (2{approx}6 years) and older (7{approx}10 years) groups. Each group was also divided into a GOOD (CID scores>80) and a BAD (CID scores<60) subgroup. We assessed regional metabolic difference according to CID scores and age by voxel based analysis (SPM2) comparing normal controls (n =8, 20{approx}30 years). Speech perception was good in 19 (68%) of 28 younger patients and 5 (38%) of 13 older patients after CI. Regional metabolism of both younger and older GOOD subgroup was significantly decreased in right temporal, left cerebellar and right frontal regions compared to normal controls (uncorrected p<0.001). In younger GOOD subgroup, left frontotemporal and both parietal regions showed decreased metabolism and right frontal, left temporal and anterior cingulate regions showed increased metabolism compared to BAD subgroup (uncorrected p<0.005). In younger group, regional metabolism in left superior frontal, right temporal and right occipital regions showed a significant negative correlation with CID scores (uncorrected p<0.005). In older group, the pattern of regional metabolic difference correlated with CID score was not similar to that of younger group. Preoperative regional cerebral metabolism is decreased in several brain regions related to the language in preligually deaf patients and the neuralplasty of younger patients are different according to the outcome of speech perception after CI.

  15. When Hearing Is Tricky: Speech Processing Strategies in Prelingually Deafened Children and Adolescents with Cochlear Implants Having Good and Poor Speech Performance

    Science.gov (United States)

    Ortmann, Magdalene; Zwitserlood, Pienie; Knief, Arne; Baare, Johanna; Brinkheetker, Stephanie; am Zehnhoff-Dinnesen, Antoinette; Dobel, Christian

    2017-01-01

    Cochlear implants provide individuals who are deaf with access to speech. Although substantial advancements have been made by novel technologies, there still is high variability in language development during childhood, depending on adaptation and neural plasticity. These factors have often been investigated in the auditory domain, with the mismatch negativity as an index for sensory and phonological processing. Several studies have demonstrated that the MMN is an electrophysiological correlate for hearing improvement with cochlear implants. In this study, two groups of cochlear implant users, both with very good basic hearing abilities but with non-overlapping speech performance (very good or very poor speech performance), were matched according to device experience and age at implantation. We tested the perception of phonemes in the context of specific other phonemes from which they were very hard to discriminate (e.g., the vowels in /bu/ vs. /bo/). The most difficult pair was individually determined for each participant. Using behavioral measures, both cochlear implants groups performed worse than matched controls, and the good performers performed better than the poor performers. Cochlear implant groups and controls did not differ during time intervals typically used for the mismatch negativity, but earlier: source analyses revealed increased activity in the region of the right supramarginal gyrus (220–260 ms) in good performers. Poor performers showed increased activity in the left occipital cortex (220–290 ms), which may be an index for cross-modal perception. The time course and the neural generators differ from data from our earlier studies, in which the same phonemes were assessed in an easy-to-discriminate context. The results demonstrate that the groups used different language processing strategies, depending on the success of language development and the particular language context. Overall, our data emphasize the role of neural plasticity and use of adaptive strategies for successful language development with cochlear implants. PMID:28056017

  16. Music and Quality of Life in Early-Deafened Late-Implanted Adult Cochlear Implant Users

    NARCIS (Netherlands)

    Fuller, Christina; Mallinckrodt, Lisa; Maat, Bert; Başkent, Deniz; Free, Rolien

    2013-01-01

    Hypothesis and Background: The early-deafened, late-implanted (EDLI) CI users constitute a relatively new and understudied clinical population. To contribute to a better understanding of the implantation outcome, this study evaluated this population for self-reported enjoyment and perception of musi

  17. Effect of the loss of auditory feedback on segmental parameters of vowels of postlingually deafened speakers.

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    Schenk, Barbara S; Baumgartner, Wolf Dieter; Hamzavi, Jafar Sasan

    2003-12-01

    The most obvious and best documented changes in speech of postlingually deafened speakers are the rate, fundamental frequency, and volume (energy). These changes are due to the lack of auditory feedback. But auditory feedback affects not only the suprasegmental parameters of speech. The aim of this study was to determine the change at the segmental level of speech in terms of vowel formants. Twenty-three postlingually deafened and 18 normally hearing speakers were recorded reading a German text. The frequencies of the first and second formants and the vowel spaces of selected vowels in word-in-context condition were compared. All first formant frequencies (F1) of the postlingually deafened speakers were significantly different from those of the normally hearing people. The values of F1 were higher for the vowels /e/ (418+/-61 Hz compared with 359+/-52 Hz, P=0.006) and /o/ (459+/-58 compared with 390+/-45 Hz, P=0.0003) and lower for /a/ (765+/-115 Hz compared with 851+/-146 Hz, P=0.038). The second formant frequency (F2) only showed a significant increase for the vowel/e/(2016+/-347 Hz compared with 2279+/-250 Hz, P=0.012). The postlingually deafened people were divided into two subgroups according to duration of deafness (shorter/longer than 10 years of deafness). There was no significant difference in formant changes between the two groups. Our report demonstrated an effect of auditory feedback also on segmental features of speech of postlingually deafened people.

  18. Improved Auditory Nerve Survival with Nanoengineered Supraparticles for Neurotrophin Delivery into the Deafened Cochlea

    Science.gov (United States)

    Tan, Justin; Wang, Yajun; Caruso, Frank; Shepherd, Robert K.

    2016-01-01

    Cochlear implants electrically stimulate spiral ganglion neurons (SGNs) in order to provide speech cues to severe-profoundly deaf patients. In normal hearing cochleae the SGNs depend on endogenous neurotrophins secreted by sensory cells in the organ of Corti for survival. SGNs gradually degenerate following deafness and consequently there is considerable interest in developing clinically relevant strategies to provide exogenous neurotrophins to preserve SGN survival. The present study investigated the safety and efficacy of a drug delivery system for the cochlea using nanoengineered silica supraparticles. In the present study we delivered Brain-derived neurotrophic factor (BDNF) over a period of four weeks and evaluated SGN survival as a measure of efficacy. Supraparticles were bilaterally implanted into the basal turn of cochleae in profoundly deafened guinea pigs. One ear received BDNF-loaded supraparticles and the other ear control (unloaded) supraparticles. After one month of treatment the cochleae were examined histologically. There was significantly greater survival of SGNs in cochleae that received BDNF supraparticles compared to the contralateral control cochleae (repeated measures ANOVA, p = 0.009). SGN survival was observed over a wide extent of the cochlea. The supraparticles were well tolerated within the cochlea with a tissue response that was localised to the site of implantation in the cochlear base. Although mild, the tissue response was significantly greater in cochleae treated with BDNF supraparticles compared to the controls (repeated measures ANOVA, p = 0.003). These data support the clinical potential of this technology particularly as the supraparticles can be loaded with a variety of therapeutic drugs. PMID:27788219

  19. Vowel acquisition by prelingually deaf children with cochlear implants

    Science.gov (United States)

    Bouchard, Marie-Eve; Le Normand, Marie-Thérèse; Ménard, Lucie; Goud, Marilyne; Cohen, Henri

    2004-05-01

    Phonetic transcriptions (study 1) and acoustic analysis (study 2) were used to clarify the nature and rhythm of vowel acquisition following the cochlear implantation of prelingually deaf children. In the first study, seven children were divided according to their degree of hearing loss (DHL): DHL I: 90-100 dB of hearing loss, 1 children; DHL II: 100-110 dB, 3 children; and DHL III: over 110 dB, 3 children. Spontaneous speech productions were recorded and videotaped 6 and 12 months postsurgery and vowel inventories were obtained by listing all vowels that occurred at least twice in the child's repertoire at the time of recording. Results showed that degree of hearing loss and age at implantation have a significant impact on vowel acquisition. Indeed, DHL I and II children demonstrated more diversified as well as more typical pattern of acquisition. In the second study, the values of the first and second formants were extracted. The results suggest evolving use of the acoustic space, reflecting the use of auditory feedback to produce the three phonological features exploited to contrast French vowels (height, place of articulation, and rounding). The possible influence of visual feedback before cochlear implant is discussed.

  20. Age effect of deafening on stereotyped song maintenance in adult male bengalese finches Lonchura striata domestica

    Institute of Scientific and Technical Information of China (English)

    Yingyu SUN; Rui WANG; Shuli SHAO; Shaoju ZENG; Mingxue ZUO

    2009-01-01

    Birdsong is a complex learned vocal behavior that relies on auditory experience for development. However, it appears that among different species of close-ended songbirds, there are some variations in the necessity of auditory feedback for maintaining stereotyped aduh song. In zebra finches, the deterioration of adult songs following deafness depends on the birds' age. It is unknown whether this age effect is a general ride in other avian species as well. Therefore, we chose Bengalese finches, whose songs show more complexity and have much heavier dependency on auditory feedback than that of zebra finches, to compare the degree of song degradation after heating loss in old (over 18 months old) and young adult birds (5-6 months old). We found that beth syllable sequence and syllable phonology were much leas severely affected by deafening in old adults than that in young ones. Moreover, young adults almost lost their capability to sing trills over 6 months following deafening, while old birds continued to sing plenty of trills and trilled syllables after the same period of deafening. Our results suggest that age plays an important role in affecting the dependency of adult song maintenance on auditory feedback in Bengalese finches. Furthermore, the age dependency may be a general phenomenon in different species of close-ended songbirds.

  1. Perception of environmental sounds by experienced cochlear implant patients.

    Science.gov (United States)

    Shafiro, Valeriy; Gygi, Brian; Cheng, Min-Yu; Vachhani, Jay; Mulvey, Megan

    2011-01-01

    moderately correlated with the temporal order for tones. However, the correlation between speech and environmental sounds changed little after partialling out the variance due to other variables. Present findings indicate that environmental sound identification is difficult for CI patients. They further suggest that speech and environmental sounds may overlap considerably in their perceptual processing. Certain spectrotemproral processing abilities are separately associated with speech and environmental sound performance. However, they do not appear to mediate the relationship between speech and environmental sounds in CI patients. Environmental sound rehabilitation may be beneficial to some patients. Environmental sound testing may have potential diagnostic applications, especially with difficult-to-test populations and might also be predictive of speech performance for prelingually deafened patients with cochlear implants.

  2. Pediatric cochlear implants in prelingual deafness: medium and long-term outcomes.

    Science.gov (United States)

    Kaplan, Daniel M; Puterman, Moshe

    2010-02-01

    Unfortunately, no large-scale, well-designed, comprehensive studies on medium and long-term effect of cochlear implants in prelingual children exist. Furthermore, the few studies listed have addressed different aspects of this issue, in a non-standardized manner. With the question of outcomes becoming so important in modern medicine, standardized reporting methods are essential. This would enable a fair comparison between the different commercial devices and between rehabilitation-education methods. The studies presented above were published between 1999 and 2008. Due to the long follow-up period required for reporting medium and long-term outcomes, they actually represent patients implanted one and two decades ago. At present and in the near future, we may expect better results from patients who were implanted in the last few years for several reasons: a) superior cochlear implants with better coding strategies; b) developments in rehabilitation and higher awareness among parents and staff; c) better health care and universal screening programs, leading to implants being performed in an earlier age; and d) a high rate of performing bilateral cochlear implants (either simultaneously or sequentially) in the last decade, which accomplishes even better results compared to unilateral implants. From the studies reviewed above, mainstreaming the child who has auditory-verbal and oral communication is the preferred educational setting for maximizing the medium and long-term benefit from a cochlear implant. Hearing and speech skills continue to improve many years after the implant. Non-use and failure rates (as reported by the authors from the medical centers and not solely by the cochlear implant manufacturers) are low, ranging from 1% to 2.7% per year. Overall, patients have a high rate of employment, close to that of the general population. However, they may be less satisfied, as the individual and the parents may feel compromised by their communication skills.

  3. Behavioral responses of deafened guinea pigs to intracochlear electrical stimulation: a new rapid psychophysical procedure.

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    Agterberg, Martijn J H; Versnel, Huib

    2014-07-01

    In auditory research the guinea pig is often preferred above rats and mice because of the easily accessible cochlea and because the frequency range of its hearing is more comparable to that of humans. Studies of the guinea-pig auditory system primarily apply histological and electrophysiological measures. Behavioral animal paradigms, in particular in combination with these histological and electrophysiological methods, are necessary in the development of new therapeutic interventions. However, the guinea pig is not considered an attractive animal for behavioral experiments. Therefore, the purpose of this study was to develop a behavioral task suitable for guinea pigs, that can be utilized in cochlear-implant related research. Guinea pigs were trained in a modified shuttle-box in which a stream of air was used as unconditioned stimulus (UCS). A stream of air was preferred over conventionally used methods as electric foot-shocks since it produces less stress, which is a confounding factor in behavioral experiments. Hearing guinea pigs were trained to respond to acoustic stimuli. They responded correctly within only five sessions of ten minutes. The animals maintained their performance four weeks after the right cochlea was implanted with an electrode array. After systemic deafening, the animals responded in the first session immediately to intracochlear electrical stimulation. These responses were not affected by daily chronic electrical stimulation (CES). In conclusion, the present study demonstrates that guinea pigs can be trained relatively fast to respond to acoustic stimuli, and that the training has a lasting effect, which generalizes to intracochlear electrical stimulation after deafening. Furthermore, it demonstrates that bilaterally deafened guinea pigs with substantial (∼50%) loss of spiral ganglion cells (SGCs), detect intracochlear electrical stimulation.

  4. 语前聋患者人工耳蜗植入术后听觉言语康复相关影响因素的研究%Research on the Influencing Factors of Auditory and Speech Rehabilitation Outcomes of Prelingually Deaf Patients with Cochlear Implants

    Institute of Scientific and Technical Information of China (English)

    张斯斯; 林有辉; 张榕; 叶胜难

    2013-01-01

    目的探讨语前聋人工耳蜗植入患者的听觉言语康复效果及其相关影响因素。方法对159例人工耳蜗植入患者家长和康复教师进行调查随访。根据听觉行为分级标准(Categories of Auditory Performance,CAP)和言语可懂度分级标准(Speech Intelligibility Rating,SIR),对患者的听觉能力和言语能力进行分级评估。用组内单因素秩和检验和多因素Logistic回归分析CAP和SIR分级结果与性别、惯用手、内耳发育、颅脑影像学情况、术前助听器使用、术前语训、植入耳侧、植入电极类型、植入年龄、植入后时间、术后语言环境、术后康复模式、家庭经济状况等13个因素的关系。结果单因素分析结果显示,不同的术前助听器使用情况、术前语训、植入后时间、家庭经济状况组间CAP分级结果有显著性差异(P值均<0.05);不同的植入耳侧、植入后时间、家庭经济状况组间SIR分级结果有显著性差异(P值均<0.05)。多因素Logistic回归分析结果显示,植入后时间、家庭经济状况与CAP、SIR分级结果均有显著相关。结论植入后时间、家庭经济状况对人工耳蜗植入术后患者的听觉言语康复效果起决定性的作用。%Objective To explore the auditory and speech rehabilitation outcomes of prelingually hearing-impaired patients with cochlear implants and the related influencing factors. Methods One hundred fifty-nine cochlear implantees were recruited in this study.The parents or teachers were interviewed to assess the auditory and speech abilities of the subjects using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). The relationships were investigated between auditory and speech rehabilitation outcomes represented by CAP/SIR results and 13 possible influencing factors including gender, handedness, inner ear malformations, brain abnormalities, hearing aid use, language training before

  5. Behavioral training enhances cortical temporal processing in neonatally deafened juvenile cats.

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    Beitel, Ralph E; Vollmer, Maike; Raggio, Marcia W; Schreiner, Christoph E

    2011-08-01

    Deaf humans implanted with a cochlear prosthesis depend largely on temporal cues for speech recognition because spectral information processing is severely impaired. Training with a cochlear prosthesis is typically required before speech perception shows improvement, suggesting that relevant experience modifies temporal processing in the central auditory system. We tested this hypothesis in neonatally deafened cats by comparing temporal processing in the primary auditory cortex (AI) of cats that received only chronic passive intracochlear electric stimulation (ICES) with cats that were also trained with ICES to detect temporally challenging trains of electric pulses. After months of chronic passive stimulation and several weeks of detection training in behaviorally trained cats, multineuronal AI responses evoked by temporally modulated ICES were recorded in anesthetized animals. The stimulus repetition rates that produced the maximum number of phase-locked spikes (best repetition rate) and 50% cutoff rate were significantly higher in behaviorally trained cats than the corresponding rates in cats that received only chronic passive ICES. Behavioral training restored neuronal temporal following ability to levels comparable with those recorded in naïve prior normal-hearing adult deafened animals. Importantly, best repetitition rates and cutoff rates were highest for neuronal clusters activated by the electrode configuration used in behavioral training. These results suggest that neuroplasticity in the AI is induced by behavioral training and perceptual learning in animals deprived of ordinary auditory experience during development and indicate that behavioral training can ameliorate or restore temporal processing in the AI of profoundly deaf animals.

  6. Enhancing Parent-Child Communication and Parental Self-Esteem with a Video-Feedback Intervention: Outcomes with Prelingual Deaf and Hard-of-Hearing Children

    Science.gov (United States)

    Lam-Cassettari, Christa; Wadnerkar-Kamble, Meghana B.; James, Deborah M.

    2015-01-01

    Evidence on best practice for optimizing communication with prelingual deaf and hard-of-hearing (DHH) children is lacking. This study examined the effect of a family-focused psychosocial video intervention program on parent-child communication in the context of childhood hearing loss. Fourteen hearing parents with a prelingual DHH child…

  7. Enhancing Parent-Child Communication and Parental Self-Esteem with a Video-Feedback Intervention: Outcomes with Prelingual Deaf and Hard-of-Hearing Children

    Science.gov (United States)

    Lam-Cassettari, Christa; Wadnerkar-Kamble, Meghana B.; James, Deborah M.

    2015-01-01

    Evidence on best practice for optimizing communication with prelingual deaf and hard-of-hearing (DHH) children is lacking. This study examined the effect of a family-focused psychosocial video intervention program on parent-child communication in the context of childhood hearing loss. Fourteen hearing parents with a prelingual DHH child…

  8. Recovery characteristics of the electrically stimulated auditory nerve in deafened guinea pigs: relation to neuronal status.

    Science.gov (United States)

    Ramekers, Dyan; Versnel, Huib; Strahl, Stefan B; Klis, Sjaak F L; Grolman, Wilko

    2015-03-01

    Successful cochlear implant performance requires adequate responsiveness of the auditory nerve to prolonged pulsatile electrical stimulation. Degeneration of the auditory nerve as a result of severe hair cell loss could considerably compromise this ability. The main objective of this study was to characterize the recovery of the electrically stimulated auditory nerve, as well as to evaluate possible changes caused by deafness-induced degeneration. To this end we studied temporal responsiveness of the auditory nerve in a guinea pig model of sensorineural hearing loss. Using masker-probe and pulse train paradigms we compared electrically evoked compound action potentials (eCAPs) in normal-hearing animals with those in animals with moderate (two weeks after ototoxic treatment) and severe (six weeks after ototoxic treatment) loss of spiral ganglion cells (SGCs). Masker-probe interval and pulse train inter-pulse interval was varied from 0.3 to 16 ms. Whereas recovery assessed with masker-probe was roughly similar for normal-hearing and both groups of deafened animals, it was considerably faster for six weeks deaf animals (τ ≈ 1.2 ms) than for two weeks deaf or normal-hearing animals (τ ≈ 3-4 ms) when 100-ms pulse trains were applied. Latency increased with decreasing inter-pulse intervals, and this was more pronounced with pulse trains than with masker-probe stimulation. With high frequency pulse train stimulation eCAP amplitudes were modulated for deafened animals, meaning that amplitudes for odd pulse numbers were larger than for even pulses. The relative refractory period (τ) and the modulation depth of the eCAP amplitude for pulse trains, as well as the latency increase for both paradigms significantly correlated with quantified measures of auditory nerve degeneration (size and packing density of SGCs). In addition to these findings, separate masker-probe recovery functions for the eCAP N1 and N2 peaks displayed a robust non-monotonic or shoulder

  9. Maximal vowel space method in analysis of vowels in prelingual speech phase

    Directory of Open Access Journals (Sweden)

    Vojnović Milan

    2014-01-01

    Full Text Available The main problems in the analysis of vowels which occur in prelingual speech phase are centralization of utterance and unknown dimension of vocal tract. Most researches in this field are based on the analysis of maximal vowel space (MVS because discrimination of vowels is very difficult in this early period. MVS analysis includes the estimation of vocal tract (VT physical dimensions. The aim of this research was to estimate and define changes in vowel pronunciation during prelingual speech phase. The analysis and voice recording were performed in a two month old child until he turned one. The recording was performed in 42 sessions, on average 4 sessions every month. Sound segments that look like vowel pronunciation were extracted from the recordings and were used for the formant frequencies estimation by PRAAT software. The Burg method was used for formant frequency estimation. Research results showed that MVS can be used in diagnostic procedure from a child's earliest age. MVS analysis is appropriate for a child's earliest age as a child needs to pronounce individual phonemes, and does not need to respond to speech stimuli. These results need to be confirmed on a larger sample when extended analysis should define criteria for discrimination of typical and atypical formant frequencies.

  10. Dendrogenin A and B two new steroidal alkaloides increasing neural responsiveness in deafened guinea pig

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    Anette Elisabeth Fransson

    2015-07-01

    Full Text Available Aim: To investigate the therapeutic potential for treating inner ear damage of two new steroidal alkaloid compounds, Dendrogenin A and Dendrogenin B, previously shown to be potent inductors of cell differentiation. Methods: Guinea pigs, unilaterally deafened by neomycin infusion, received a cochlear implant followed by immediate or a two-week delayed treatment with Dendrogenin A, Dendrogenin B, and, as comparison artificial perilymph and glial cell-line derived neurotrophic factor. After a 4-week treatment period the animals were sacrificed and the cochleae processed for morphological analysis. Electrically-evoked auditory brainstem responses were measured weekly throughout the experiment. Results: Following immediate or delayed Dendrogenin treatment the electrical responsiveness was significantly maintained, in a similar extent as has been shown using neurotrophic factors. Histological analysis showed that the spiral ganglion neurons density was only slightly higher than the untreated group. Conclusions: Our results suggest that Dendrogenins constitute a new class of drugs with strong potential to improve cochlear implant efficacy and to treat neuropathy/synaptopathy related hearing loss. That electrical responsiveness was maintained despite a significantly reduced neural population suggests that the efficacy of cochlear implants is more related to the functional state of the spiral ganglion neurons than merely their number.

  11. Similarities and Differences in the Processing of Written Text by Skilled and Less Skilled Readers with Prelingual Deafness

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    Miller, Paul

    2013-01-01

    This study focuses on similarities and differences in the processing of written text by individuals with prelingual deafness from different reading levels that used Hebrew as their first spoken language and Israeli Sign Language as their primary manual communication mode. Data were gathered from three sources, including (a) a sentence…

  12. Phenotype and genotype analysis of a Chinese family with prelingual X-linked hereditary hearing impairment

    Institute of Scientific and Technical Information of China (English)

    HAN Bing; CHENG Jing; YANG Shu-zhi; CAO Ju-yang; SHEN Wei-dong; JI Fei; KANG Dong-yang; ZHANG Xin; DAI Pu; YUAN Hui-jun

    2009-01-01

    Background X-linked hearing impairment is clinically and genetically a heterogeneous disease.Although many disorders manifest with hearing loss,a limited number of sex-linked loci and only one gene (POU3F4) have been shown to be implicated in X-linked non-syndromic hearing impairment.In the present study,we have performed a clinical and genetic analysis of a Chinese family with X-linked non-syndromic hearing loss,with emphasis on audiological findings and genomic mapping.Methods The clinical features of Family JX01 were evaluated by physical and audiometric examination in eighteen family members.Mutation screening of POU3F4 was identified by polymerase chain reaction (PCR) amplification and sequencing.Molecular evaluation consisted of X-chromosome wide genotyping by microsatellite makers (STR),followed by analyzing using MLINK computer program.Results Five affected males demonstrated bilateral,symmetrical sensorineural and profound hearing loss.The hearing impairment started prelingual.The female carriers did not have any complain of hearing loss,however,two of them were tested with milder loss with high frequency.No causative mutations in POU3F4 gene were detected by DNA sequencing.Linkage analysis indicated that the responsible gene was linked to locus DXS1227 (maximum lod score=2.04 at θ=0).Conclusions The affected males in Family JX01 have profound prelingual sensorineural hearing impairment,In addition,two female carriers showed mild to moderate hearing losses.However,none of females complained of any hearing loss.Analysis of hereditary deafness in this family mapped most compatibly to the Xq27.2.

  13. Prelingual auditory-perceptual skills as indicators of initial oral language development in deaf children with cochlear implants.

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    Pianesi, Federica; Scorpecci, Alessandro; Giannantonio, Sara; Micardi, Mariella; Resca, Alessandra; Marsella, Pasquale

    2016-03-01

    To assess when prelingually deaf children with a cochlear implant (CI) achieve the First Milestone of Oral Language, to study the progression of their prelingual auditory skills in the first year after CI and to investigate a possible correlation between such skills and the timing of initial oral language development. The sample included 44 prelingually deaf children (23 M and 21 F) from the same tertiary care institution, who received unilateral or bilateral cochlear implants. Achievement of the First Milestone of Oral Language (FMOL) was defined as speech comprehension of at least 50 words and speech production of a minimum of 10 words, as established by administration of a validated Italian test for the assessment of initial language competence in infants. Prelingual auditory-perceptual skills were assessed over time by means of a test battery consisting of: the Infant Toddler Meaningful Integration Scale (IT-MAIS); the Infant Listening Progress Profile (ILiP) and the Categories of Auditory Performance (CAP). On average, the 44 children received their CI at 24±9 months and experienced FMOL after 8±4 months of continuous CI use. The IT-MAIS, ILiP and CAP scores increased significantly over time, the greatest improvement occurring between baseline and six months of CI use. On multivariate regression analysis, age at diagnosis and age at CI did not appear to bear correlation with FMOL timing; instead, the only variables contributing to its variance were IT-MAIS and ILiP scores after six months of CI use, accounting for 43% and 55%, respectively. Prelingual auditory skills of implanted children assessed via a test battery six months after CI treatment, can act as indicators of the timing of initial oral language development. Accordingly, the period from CI switch-on to six months can be considered as a window of opportunity for appropriate intervention in children failing to show the expected progression of their auditory skills and who would have higher risk of

  14. [Suprasegmental speech in prelingual hearing-impaired children with cochlear implants, hearing-impaired children without implants and normal hearing children].

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    Ligthelm, A; Groenewald, E

    1999-01-01

    A review of the relevant literature indicates a lack of knowledge regarding suprasegmental speech characteristics in prelingual hearing impaired children with cochlear implants. This study is aimed at examining certain suprasegmental features in the speech of prelingual hearing impaired children with cochlear implants by perceptual ratings and acoustic analyses, comparing these results to that of prelingual hearing impaired children without implants, and normal hearing children of the same age. Twelve Afrikaansspeaking children between the ages of six and ten years were included in three groups. An integrated view of the perceptual and acoustic results shows that the cochlear implanted children's suprasegmental speech characteristics bear closer resemblance to those of the normal hearing group than those of the hearing impaired group.

  15. Effects of brain-derived neurotrophic factor (BDNF) and electrical stimulation on survival and function of cochlear spiral ganglion neurons in deafened, developing cats.

    Science.gov (United States)

    Leake, Patricia A; Stakhovskaya, Olga; Hetherington, Alexander; Rebscher, Stephen J; Bonham, Ben

    2013-04-01

    Both neurotrophic support and neural activity are required for normal postnatal development and survival of cochlear spiral ganglion (SG) neurons. Previous studies in neonatally deafened cats demonstrated that electrical stimulation (ES) from a cochlear implant can promote improved SG survival but does not completely prevent progressive neural degeneration. Neurotrophic agents combined with an implant may further improve neural survival. Short-term studies in rodents have shown that brain-derived neurotrophic factor (BDNF) promotes SG survival after deafness and may be additive to trophic effects of stimulation. Our recent study in neonatally deafened cats provided the first evidence of BDNF neurotrophic effects in the developing auditory system over a prolonged duration Leake et al. (J Comp Neurol 519:1526-1545, 2011). Ten weeks of intracochlear BDNF infusion starting at 4 weeks of age elicited significant improvement in SG survival and larger soma size compared to contralateral. In the present study, the same deafening and BDNF infusion procedures were combined with several months of ES from an implant. After combined BDNF + ES, a highly significant increase in SG numerical density (>50 % improvement re: contralateral) was observed, which was significantly greater than the neurotrophic effect seen with ES-only over comparable durations. Combined BDNF + ES also resulted in a higher density of myelinated radial nerve fibers within the osseous spiral lamina. However, substantial ectopic and disorganized sprouting of these fibers into the scala tympani also occurred, which may be deleterious to implant function. EABR thresholds improved (re: initial thresholds at time of implantation) on the chronically stimulated channels of the implant. Terminal electrophysiological studies recording in the inferior colliculus (IC) revealed that the basic cochleotopic organization was intact in the midbrain in all studied groups. In deafened controls or after ES-only, lower IC

  16. The effects of early bilateral deafening on calretinin expression in the dorsal cochlear nucleus of aged CBA/CaJ mice.

    Science.gov (United States)

    Zettel, Martha L; O'Neill, William E; Trang, Tung T; Frisina, Robert D

    2003-09-01

    The aim of this study was to test the hypothesis that calretinin (CR) levels in the aged mouse auditory brainstem depend upon hearing ability. Old animals with good hearing, and thus higher sound-evoked activity levels, were predicted to have higher levels of CR immunoreactivity than old animals with hearing loss. CR immunoreactivity was analyzed in the deep layer (layer III) of the dorsal cochlear nucleus (DCN) in CBA/CaJ mice that were bilaterally deafened at 3 months of age with kanamycin, and then aged until 24 months. This manipulation partially mimics the lack of sound-evoked auditory activity experienced by old C57BL/6J mice, who are deaf at 24 months of age (but show residual hearing at 15 months) and have lower levels of CR immunoreactivity than old CBA mice with normal hearing [Hear. Res. 158 (2001) 131]. Cell counts revealed that the density of CR+ cells in DCN layer III of the deafened CBA mice was statistically different from old intact CBA mice raised under identical conditions. Old deafened CBAs showed a decline of 47% in the mean density of CR+ cells compared to old hearing CBAs, thus supporting the hypothesis. Interestingly, while there tended to be fewer CR+ cells in the old deaf C57s as compared to young C57s and young and old CBAs with normal hearing, the difference was not statistically significant. It is possible that the residual hearing of C57 mice at 15 months may provide sufficient auditory input to maintain CR at levels higher than CBA mice that are deafened completely at 3 months of age, and are profoundly deaf for a much longer time (21 months).

  17. Enhancing Parent–Child Communication and Parental Self-Esteem With a Video-Feedback Intervention: Outcomes With Prelingual Deaf and Hard-of-Hearing Children

    Science.gov (United States)

    Wadnerkar-Kamble, Meghana B.; James, Deborah M.

    2015-01-01

    Evidence on best practice for optimizing communication with prelingual deaf and hard-of-hearing (DHH) children is lacking. This study examined the effect of a family-focused psychosocial video intervention program on parent–child communication in the context of childhood hearing loss. Fourteen hearing parents with a prelingual DHH child (Mage = 2 years 8 months) completed three sessions of video interaction guidance intervention. Families were assessed in spontaneous free play interactions at pre and postintervention using the Emotional Availability (EA) Scales. The Rosenberg Self-esteem Scale was also used to assess parental report of self-esteem. Compared with nontreatment baselines, increases were shown in the EA subscales: parental sensitivity, parental structuring, parental nonhostility, child responsiveness, and child involvement, and in reported self-esteem at postintervention. Video-feedback enhances communication in families with prelingual DHH children and encourages more connected parent–child interaction. The results raise implications regarding the focus of early intervention strategies for prelingual DHH children. PMID:25819293

  18. Background and educational characteristics of prelingually deaf children implanted by five years of age.

    Science.gov (United States)

    Geers, Ann; Brenner, Chris

    2003-02-01

    This study documents child, family and educational characteristics of a large representative sample of 8- to 9-yr-old prelingually deaf children who received a cochlear implant by 5 yr of age. Because pre-existing factors such as the child's gender, family characteristics, additional handicaps, age at onset of deafness and at implant, may affect postimplant outcomes, these variables must be accounted for before the impact of educational factors on performance with an implant can be adequately determined. Classroom variables that may affect postimplant outcomes include placement in public or private, mainstream or special education, oral or total communication environments. Other intervention variables include type and amount of individual therapy, experience of the therapist and parent participation in therapy. Documenting these characteristics for a large representative sample of implanted children can provide clinicians and researchers with insight regarding the types of families who sought early cochlear implantation for their children and the types of educational programs in which they placed their children after implantation. It is important to undertake studies that control for as many of these factors as possible so that the relative benefits of specific educational approaches for helping children to get the most benefit from their cochlear implant can be identified. Over a 4-yr period, 181 children from across the US and Canada, accompanied by a parent, attended a cochlear implant research camp. Parents completed questionnaires in which they reported the child's medical and educational history, characteristics of the family, and their participation in the child's therapy. The parent listed names and addresses of clinicians who had provided individual speech/language therapy to the child and signed permission for these clinicians to complete questionnaires describing this therapy. To the extent that this sample is representative of those families seeking a

  19. [Development of early auditory and speech perception skills within one year after cochlear implantion in prelingual deaf children].

    Science.gov (United States)

    Fu, Ying; Chen, Yuan; Xi, Xin; Hong, Mengdi; Chen, Aiting; Wang, Qian; Wong, Lena

    2015-04-01

    To investigate the development of early auditory capability and speech perception in the prelingual deaf children after cochlear implantation, and to study the feasibility of currently available Chinese assessment instruments for the evaluation of early auditory skill and speech perception in hearing-impaired children. A total of 83 children with severe-to-profound prelingual hearing impairment participated in this study. Participants were divided into four groups according to the age for surgery: A (1-2 years), B (2-3 years), C (3-4 years) and D (4-5 years). The auditory skill and speech perception ability of CI children were evaluated by trained audiologists using the infant-toddler/meaningful auditory integration scale (IT-MAIS/MAIS) questionnaire, the Mandarin Early Speech Perception (MESP) test and the Mandarin Pediatric Speech Intelligibility (MPSI) test. The questionnaires were used in face to face interviews with the parents or guardians. Each child was assessed before the operation and 3 months, 6 months, 12 months after switch-on. After cochlear implantation, early postoperative auditory development and speech perception gradually improved. All MAIS/IT-MAIS scores showed a similar increasing trend with the rehabilitation duration (F=5.743, P=0.007). Preoperative and post operative MAIS/IT-MAIS scores of children in age group C (3-4 years) was higher than that of other groups. Children who had longer hearing aid experience before operation demonstrated higher MAIS/IT-MAIS scores than those with little or no hearing aid experience (F=4.947, P=0.000). The MESP test showed that, children were not able to perceive speech as well as detecting speech signals. However as the duration of CI use increased, speech perception ability also improved substantially. However, only about 40% of the subjects could be evaluated using the most difficult subtest on the MPSI in quiet at 12 months after switch-on. As MCR decreased, the proportion of children who could be tested

  20. The Music Experiences and Attitudes Of A First Cohort of Prelingually-Deaf Adolescents and Young Adults CI Recipients

    Science.gov (United States)

    Gfeller, Kate; Driscoll, Virginia; Smith, Rachel See; Scheperle, Christina

    2012-01-01

    The purpose of this study was to examine the musical engagement (participation and attitude) of pediatric CI recipients who were implanted during early childhood and who have reached age 15 or older. A questionnaire was administered to a group of 31 prelingually deaf CI users who receive annual follow up services and assessment in a clinical research center. The questionnaire was used to examine involvement in and attitudes toward music in school, the community, and in the home; social affiliation (hearing, Deaf, both) and mode of communication (oral, manual, both) were also examined. Despite the technical limitations of cochlear implants in transmitting pitch, melody, and tone quality, over two thirds of this sample described music as being important or very important in their lives. A high level of past and present familial involvement in music was associated with higher levels of current involvement and importance of music in the lives of adolescent and young adult CI users. Comparisons were noted with data from prior studies of persons with hearing loss who were non-CI users. PMID:23565029

  1. Postural responses applied in a control model in cochlear implant users with pre-lingual hearing loss.

    Science.gov (United States)

    Suarez, Hamlet; Ferreira, Enrique; Alonso, Rafael; Arocena, Sofia; San Roman, Cecilia; Herrera, Tamara; Lapilover, Valeria

    2016-01-01

    Conclusions The assessment of postural responses (PR) based in a feedback control system model shows selective gains in different bands of frequencies adaptable with child development. Objective PR characterization of pre-lingual cochlear implant users (CIU) in different sensory conditions. Methods Total energy consumption of the body's center of pressure signal (ECCOP) and its distribution in three bands of frequencies: band 1 (0-0.1 Hz), band 2 (0.1-0.7 Hz), and band 3 (0.7-20 Hz) was measured in a sample of 18 CIU (8-16 years old) and in a control group (CG) (8-15 years old). They were assessed in a standing position on a force platform in two sensory conditions: 1 = Eyes open. 2 = Eyes closed and standing on foam. Results In condition 1, total ECCOP of PR and its proportion of energy consumption in the three bands of frequencies were similar between CIU and CG (p > 0.05). In condition 2, CIU have significantly higher ECCOP, mainly in high frequencies (bands 2 and 3) (p < 0.05). ECCOP values decreased with age also, mainly in bands 2 and 3. This behavior is interpreted in the control system model proposed as an adaptation process related with child development.

  2. [Permanent hearing loss in the prelingual phase in children with a non-aberrant neonatal hearing screening result].

    Science.gov (United States)

    Korver, A M H; Meuwese-Jongejeugd, J; Briaire, J J; Frijns, J H M; Oudesluys-Murphy, A M

    2008-02-23

    --Neonatal hearing screening is fully implemented in the Netherlands since June 2006 using otoacoustic emissions (OAE) and automated auditory brainstem response (AABR) technology. --A normal neonatal hearing screening result unfortunately does not guarantee childhood normal hearing. Hearing loss may not become manifest until after the neonatal period. --Hearing loss at a later stage may be classified in three categories: (a) delayed onset hearing loss which occurs when the cause of the hearing loss is present at birth but the hearing loss itself becomes detectable at a later stage; (b) progressive hearing loss in which a very slight hearing loss may be present at birth but is not yet detectable and the hearing loss becomes progressively more severe; and (c) acquired hearing loss that results from a number of external factors, such as meningitis, ototoxic drugs, neonatal hyperbilirubinaemia necessitating an exchange transfusion, and trauma. --Neonatal hearing screening can result in detection of moderate to profound permanent hearing loss at an early age when therapeutic options may have maximum effect. However, even after this period, constant vigilance is necessary to detect permanent hearing loss in young children, especially during the prelingual period.

  3. Epidemiology of prelingual sensorineural hearing impairment at a children’s center in Bogotá, Colombia between 1997 and 2008

    Directory of Open Access Journals (Sweden)

    Claudia Talero-Gutiérrez

    2011-06-01

    Full Text Available Introduction: Hearing loss is a frequent problem in childhood with an incidence of about one case per 1000 births. Control of deafness should be aimed at prevention and early diagnosis in efforts to provide appropriate treatment and stimulate adequate communication in children affected. The objective of this study was to determine the prevalence of different etiologies among deaf children with a diagnosis of prelingual sensorineural hearing loss referred to the Fundación CINDA in Bogotá, Colombia, between 1997 and 2008.Materials and methods: The medical records were selected from those with prelingual hearing loss. Information was gathered in a format containing variables related to the risk factors suggested by the Joint Committee of Infant Hearing.Results: We studied 254 children; boys and girls were equally distributed. The most common etiological diagnosis was «unknown cause», followed by genetic causes (31 cases, and 38 cases from TORCH infections (toxoplasmosis, others – syphilis, rubella, cytomegalovirus, herpes, with rubella as the most common cause.Conclusions: Review of prenatal, perinatal, and postnatal history often reveals the cause of the deafness in children; therefore, appropriate evaluation of pregnant mothers could result in decreased frequency of deafness in children in our country.

  4. Long-term language levels and reading skills in mandarin-speaking prelingually deaf children with cochlear implants.

    Science.gov (United States)

    Wu, Che-Ming; Chen, Yen-An; Chan, Kai-Chieh; Lee, Li-Ang; Hsu, Kuang-Hung; Lin, Bao-Guey; Liu, Tien-Chen

    2011-01-01

    The aim of this study was to document receptive and expressive language levels and reading skills achieved by Mandarin-speaking children who had received cochlear implants (CIs) and used them for 4.75-7.42 years. The effects of possible associated factors were also analyzed. Standardized Mandarin language and reading tests were administered to 39 prelingually deaf children with Nucleus 24 devices. The Mandarin Chinese version of the Peabody Picture Vocabulary Test was used to assess their receptive vocabulary knowledge and the Revised Primary School Language Assessment Test for their receptive and expressive language skills. The Graded Chinese Character Recognition Test was used to test their written word recognition ability and the Reading Comprehension Test for their reading comprehension ability. Raw scores from both language and reading measurements were compared to normative data of nor- mal-hearing children to obtain standard scores. The results showed that the mean standard score for receptive vocabulary measurement and the mean T scores for the receptive language, expressive language and total language measurement were all in the low-average range in comparison to the normative sample. In contrast, the mean T scores for word and text reading comprehension were almost the same as for their age-matched hearing counterparts. Among all children with CIs, 75.7% scored within or above the normal range of their age-matched hearing peers on receptive vocabulary measurement. For total language, Chinese word recognition and reading scores, 71.8, 77 and 82% of children with CIs were age appropriate, respectively. A strong correlation was found between language and reading skills. Age at implantation and sentence perception scores account for 37% of variance for total language outcome. Sentence perception scores and preimplantation residual hearing were revealed to be associated with the outcome of reading comprehension. We concluded that by using standard tests, the

  5. Cross-Modal and Intra-Modal Characteristics of Visual Function and Speech Perception Performance in Postlingually Deafened, Cochlear Implant Users.

    Directory of Open Access Journals (Sweden)

    Min-Beom Kim

    Full Text Available Evidence of visual-auditory cross-modal plasticity in deaf individuals has been widely reported. Superior visual abilities of deaf individuals have been shown to result in enhanced reactivity to visual events and/or enhanced peripheral spatial attention. The goal of this study was to investigate the association between visual-auditory cross-modal plasticity and speech perception in post-lingually deafened, adult cochlear implant (CI users. Post-lingually deafened adults with CIs (N = 14 and a group of normal hearing, adult controls (N = 12 participated in this study. The CI participants were divided into a good performer group (good CI, N = 7 and a poor performer group (poor CI, N = 7 based on word recognition scores. Visual evoked potentials (VEP were recorded from the temporal and occipital cortex to assess reactivity. Visual field (VF testing was used to assess spatial attention and Goldmann perimetry measures were analyzed to identify differences across groups in the VF. The association of the amplitude of the P1 VEP response over the right temporal or occipital cortex among three groups (control, good CI, poor CI was analyzed. In addition, the association between VF by different stimuli and word perception score was evaluated. The P1 VEP amplitude recorded from the right temporal cortex was larger in the group of poorly performing CI users than the group of good performers. The P1 amplitude recorded from electrodes near the occipital cortex was smaller for the poor performing group. P1 VEP amplitude in right temporal lobe was negatively correlated with speech perception outcomes for the CI participants (r = -0.736, P = 0.003. However, P1 VEP amplitude measures recorded from near the occipital cortex had a positive correlation with speech perception outcome in the CI participants (r = 0.775, P = 0.001. In VF analysis, CI users showed narrowed central VF (VF to low intensity stimuli. However, their far peripheral VF (VF to high intensity

  6. Non-syndromic sensorineural prelingual deafness: the importance of genetic counseling in demystifying parents' beliefs about the cause of their children's deafness.

    Science.gov (United States)

    Rodrigues, Fidjy; Paneque, Milena; Reis, Cláudia; Venâncio, Margarida; Sequeiros, Jorge; Saraiva, Jorge

    2013-08-01

    Recent advances in molecular genetics have allowed the determination of the genetic cause of some childhood non-syndromic deafness. In Portugal only a small proportion of families are referred to a clinical genetics service in order to clarify the etiology of the deafness and to provide genetic counseling. Consequently, there are no published studies of the prior beliefs of parents about the causes of hereditary deafness of their children and their genetic knowledge after receipt of genetic counseling. In order to evaluate the impact of genetic counseling, 44 parents of 24 children with the diagnosis of non-syndromic sensorineural prelingual deafness due to mutations in the GJB2 (connexin 26), completed surveys before and after genetic counseling. Before counseling 13.6 % of the parents knew the cause of deafness; at a post-counseling setting this percentage was significantly higher, with 84.1 % of the parents accurately identifying the etiology. No significant differences were found between the answers of mothers and fathers either before or after genetic counseling. Parents' level of education was a significant factor in pre-test knowledge. After genetic counseling 95.5 % of the parents stated that the consultation had met their expectations, 70.5 % remembered correctly the inheritance pattern, and 93.2 % correctly recalled the chance of risk of deafness. These results underline the importance of genetic counseling in demystifying parents' beliefs about the etiology of their children's deafness.

  7. Effect Analysis of Inner Ear Malformations Pre-lingual Deaf Children after Cochlear Implantation*%内耳畸形语前聋患儿人工耳蜗植入术后效果分析*

    Institute of Scientific and Technical Information of China (English)

    钟润兰; 冯永; 管志伟

    2013-01-01

    Objective:To investigate the feasibility of cochlear implantation for inner ear malformations pre-lingual deaf children, and evaluates the rehabilitation effect on hearing and speech after the surgery. Methods:Used cochlear implantation to inner ear mal-formations pre-lingual deaf children, compared with pre-lingual deaf children of normal inner ear structure, recorded the transfer ma-chine T value after the surgery in 1 year, then evaluated and analyzed the rehabilitation effect of hearing and speech, and investigated the satisfaction about the effect of surgery of the patents. Results:There was no significant differences on the test results of hearing and speech and T value between the inner ear in pre-lingual deaf children and those of normal inner ear structure (P>0.05), and most of parents were satisfied with the effect of surgery. Conclusion:After the cochlear implantation, the rehabilitation effect on the hear-ing of inner ear malformation pre-lingual deaf children is great, and no differences from that of pre-lingual deaf children of normal inner ear structure, which is worth promotion.%  目的:探讨内耳畸形语前聋患儿人工耳蜗植入术的可行性,并对其术后听觉言语康复效果进行评估。方法:对内耳畸形的语前聋患儿进行人工耳蜗植入术,并与内耳结构正常的语前聋患儿比较,记录术后1年的调机T值,评估和分析其术后听觉言语康复效果,并调查患儿家长对术后效果的满意度。结果:内耳畸形的语前聋患儿的术后听力及言语测试结果、调机T值等与内耳结构正常的患儿比较无显著性差异(P>0.05),且多数患儿家长对手术效果感到满意。结论:内耳畸形语前聋患儿行人工耳蜗植入术后,听觉康复效果显著,与内耳结构正常的语前聋患儿无明显差别,值得临床推广。

  8. Epidemiología de la pérdida auditiva neurosensorial pre-lingual en un centro de atención a niños de Bogotá, Colombia entre 1997 y 2008

    Directory of Open Access Journals (Sweden)

    Claudia Talero-Gutiérrez

    2011-06-01

    Full Text Available Introduction: Hearing loss is a frequent problem in childhood with an incidence of about one case per 1000 births. Control of deafness should be aimed at prevention and early diagnosis in efforts to provide appropriate treatment and stimulate adequate communication in children affected. The objective of this study was to determine the prevalence of different etiologies among deaf children with a diagnosis of prelingual sensorineural hearing loss referred to the Fundación CINDA in Bogotá, Colombia, between 1997 and 2008. Materials and methods: The medical records were selected from those with prelingual hearing loss. Information was gathered in a format containing variables related to the risk factors suggested by the Joint Committee of Infant Hearing. Results: We studied 254 children; boys and girls were equally distributed. The most common etiological diagnosis was «unknown cause», followed by genetic causes (31 cases, and 38 cases from TORCH infections (toxoplasmosis, others – syphilis, rubella, cytomegalovirus, herpes, with rubella as the most common cause. Conclusions: Review of prenatal, perinatal, and postnatal history often reveals the cause of the deafness in children; therefore, appropriate evaluation of pregnant mothers could result in decreased frequency of deafness in children in our country.

  9. Speech perception in adolescents with pre-lingual hearing impairment with cochlear implants Percepção de fala em adolescentes com surdez pré-lingual usuários de implante coclear

    Directory of Open Access Journals (Sweden)

    Izi Patricia Souza de Souza

    2011-04-01

    Full Text Available Profound hearing loss is a disability that affects personality and when it involves teenagers before language acquisition, these bio-psychosocial conflicts can be exacerbated, requiring careful evaluation and choice of them for cochlear implant. AIM: To evaluate speech perception by adolescents with profound hearing loss, users of cochlear implants. STUDY DESIGN: Prospective. MATERIALS AND METHODS: Twenty-five individuals with severe or profound pre-lingual hearing loss who underwent cochlear implantation during adolescence, between 10 to 17 years and 11 months, who went through speech perception tests before the implant and 2 years after device activation. For comparison and analysis we used the results from tests of four choice, recognition of vowels and recognition of sentences in a closed setting and the open environment. RESULTS: The average percentage of correct answers in the four choice test before the implant was 46.9% and after 24 months of device use, this value went up to 86.1% in the vowels recognition test, the average difference was 45.13% to 83.13% and the sentences recognition test together in closed and open settings was 19.3% to 60.6% and 1.08% to 20.47% respectively. CONCLUSION: All patients, although with mixed results, achieved statistical improvement in all speech tests that were employed.A surdez profunda é uma deficiência que afeta a personalidade e quando se trata de adolescentes com surdez profunda pré-lingual, esses conflitos biopsicossociais são exacerbados, necessitando de cautela na avaliação e escolha destes candidatos ao implante coclear. OBJETIVO: Avaliar a percepção de fala em adolescentes portadores de surdez pré-lingual do tipo neurossensorial grave a profunda bilateral com implante coclear. FORMA DE ESTUDO: Prospectivo. CASUÍSTICA E MÉTODO: Vinte e cinco indivíduos com surdez pré-lingual, sensório-neural, de grau severo ou profundo, que foram submetidos ao implante coclear na adolesc

  10. Individual Differences in Effectiveness of Cochlear Implants in Children Who Are Prelingually Deaf: New Process Measures of Performance.

    Science.gov (United States)

    Pisoni, David B; Cleary, Miranda; Geers, Ann E; Tobey, Emily A

    1999-01-01

    The efficacy of cochlear implants in children who are deaf has been firmly established in the literature. However, the effectiveness of cochlear implants varies widely and is influenced by demographic and experiential factors. Several key findings suggest new directions for research on central auditory factors that underlie the effectiveness of cochlear implants. First, enormous individual differences have been observed in both adults and children on a wide range of audiological outcome measures. Some patients show large increases in speech perception scores after implantation, whereas others display only modest gains on standardized tests. Second, age of implantation and length of deafness affect all outcome measures. Children implanted at younger ages do better than children implanted at older ages, and children who have been deaf for shorter periods do better than children who have been deaf for longer periods. Third, communication mode affects outcome measures. Children from "oral-only" environments do much better on standardized tests that assess phonological processing skills than children who use Total Communication. Fourth, at the present time there are no preimplant predictors of outcome performance in young children. The underlying perceptual, cognitive, and linguistic abilities and skills emerge after implantation and improve over time. Finally, there are no significant differences in audiological outcome measures among current implant devices or processing strategies. This finding suggests that the major source of variance in outcome measures lies in the neural and cognitive information processing operations that the user applies to the signal provided by the implant. Taken together, this overall pattern of results suggests that higher-level central processes such as perception, attention, learning, and memory may play important roles in explaining the large individual differences observed among users of cochlear implants. Investigations of the content

  11. 语前聋儿童康复训练后听觉能力的动态评估%The Dynamic Assessment of Hearing of Prelingually Deaf Children after Rehabilitation Training

    Institute of Scientific and Technical Information of China (English)

    李郁明; 梁勇; 谭少珍

    2013-01-01

    目的 分析和总结语前聋患儿佩戴助听器并经康复训练后听觉能力提高的规律和效果以及评估方法.方法语前聋且双耳佩戴助听器的儿童135例(女57例,男78例)为研究对象,根据初次接受康复训练时的年龄分为三组:>5岁组(42例),4~5岁组(44例)和中的听觉能力评估方法,分别在训练前、训练后6个月和12个月对各组儿童进行听觉能力评估,对结果进行比较分析.10项评估内容总计100分,总分70分以上为有效,得分越高,听觉能力越好.结果 135例患儿经过康复训练6、12个月后,听觉能力均明显提高,训练前、训练后6、12个月评估得分的均值分别为51.33±9.44、70.19±9.43及87.55±6.15分,训练后评估得分明显高于训练前的评估得分(P<0.01);不同性别、年龄、听力损失程度组聋儿康复训练12个月后听觉能力评估得分均较训练前明显提高,差异有极显著统计学意义(P<0.01),有效率达100%.结论规范的康复训练对提高语前聋儿童听觉能力可取得良好的效果,定期评估其听觉能力,有利于为针对性个性化康复训练提供参考.%Objective To dynamically assess the effects of the hearing under rehabilitation training in 135 prelingually deaf children. To analyze and summarize the methods of hearing assessment, regularity and experience of prelingually deaf children under rehabilitation training. Methods 135 prelingually deaf children (57 girls and 78 boys) were included, classified into three groups according to the ages when receiving the first training(grcatcr than 5 years old, 4- 5 years old and less than 4 years old). According to the hearing loss they were classified into two groups of severe and profound hearing loss. The hearing of the prelingually deaf children before training, after six months and after twelve months was evaluated by using the Hearing and Language assessment of hearing - impaired children. The results were analyzed by SPSS 16. 0

  12. Effect of rehabilitation for prelingual deaf children who use cochlear implants in conjunction with hearing aids in the opposite ears%语前聋患儿一侧人工耳蜗对侧助听器效果分析

    Institute of Scientific and Technical Information of China (English)

    田彦静; 周慧芳; 张静; 杨东; 许轶; 郭玉玺

    2012-01-01

    目的:通过对人工耳蜗植入对侧耳不同听力损失的患儿联合使用助听器与人工耳蜗语前聋患儿的听觉、语言及学习能力进行评估和比较,探索对患儿更为有效的助听方法,帮助患儿获得最大限度的言语交流。方法:将30例3~6岁语前聋患儿按照植入人工耳蜗对侧耳听力损失程度及是否佩戴助听器,分为一侧人工耳蜗+对侧重度听力损失助听器组(CI+SHA组)、一侧人工耳蜗+对侧极重度听力损失助听器组(CI+PHA组)、单耳人工耳蜗组(CI组).评估各组在康复3、6、9、12、15、18个月时听觉、语言及学习能力,并记录结果。结果:随着术后康复时间的延长,聋儿听觉、语言及学习能力逐渐提高(P<0.05),CI+SHA组听觉能力优于CI+PHA组及CI组(均P<0.05),语言能力及学习能力无明显差异(P>0.05)。结论:语前聋患儿单耳人工耳蜗植入后,若对侧耳尚有残余听力,佩戴助听器后听觉能力效果显著,长期佩戴有助于患儿的康复。%Objective; To compare the effect of rehabilitation of prelingual deaf children who used a cochlear implant(CI) in one ear and a hearing aids in the opposite ear while the hearing level of the opposite ears are different. Hearing ability,language ability and learning ability was included in the content. The aim of this research is to investigate better style of rehabilitation,and to offer the best help to the prelingual deaf children. Method: According to the hearing level of the ear opposite to the one wearing a cochlear implant and whether the opposite ear wear a hearing aid or not,30 prelingual deaf children were divided into three groups, including cochlear implant with opposite severe hearing loss and hearing aid ear(CH-SHA), cochlear implant with opposite profound hearing loss and hearing aid ear(CI+PHA) ,cochlear implant only(CI). The effect of rehabilitation was assessed in six different times(3,6, 9,12,15 and 18 months after the cochlear

  13. Large deletion of the GJB6 gene in deaf patients heterozygous for the GJB2 gene mutation: genotypic and phenotypic analysis.

    Science.gov (United States)

    Feldmann, Delphine; Denoyelle, Françoise; Chauvin, Pierre; Garabédian, Eréa-Noël; Couderc, Rémy; Odent, Sylvie; Joannard, Alain; Schmerber, Sébastien; Delobel, Bruno; Leman, Jacques; Journel, Hubert; Catros, Hélène; Le Maréchal, Cédric; Dollfus, Hélène; Eliot, Marie-Madeleine; Delaunoy, Jean-Pierre; David, Albert; Calais, Catherine; Drouin-Garraud, Valérie; Obstoy, Marie-Françoise; Bouccara, Didier; Sterkers, Olivier; Huy, Patrice Tran Ba; Goizet, Cyril; Duriez, Françoise; Fellmann, Florence; Hélias, Jocelyne; Vigneron, Jacqueline; Montaut, Bétina; Lewin, Patricia; Petit, Christine; Marlin, Sandrine

    2004-06-15

    Recent investigations identified a large deletion of the GJB6 gene in trans to a mutation of GJB2 in deaf patients. We looked for GJB2 mutations and GJB6 deletions in 255 French patients presenting with a phenotype compatible with DFNB1. 32% of the patients had biallelic GJB2 mutations and 6% were a heterozygous for a GJB2 mutation and a GJB6 deletion. Biallelic GJB2 mutations and combined GJB2/GJB6 anomalies were more frequent in profoundly deaf children. Based on these results, we are now assessing GJB6 deletion status in cases of prelingual hearing loss. Copyright 2004 Wiley-Liss, Inc.

  14. 语前聋儿童人工耳蜗植入术后元音声调发声状况分析%Characteristics of Tones in Vowels in Prelingual Hearing-impaired Children after Cochlear Implant

    Institute of Scientific and Technical Information of China (English)

    沈晓丽; 管燕平; 蒋功达; 俞鲁婷; 周静

    2013-01-01

    Objective To observe the pronunciation characteristics of vowels' tone in prelingual hearing-impaired children accepted co-chlear implant (CI). Methods 8 prelingual hearing-impaired children accepted CI aged 3~4 years (group CI) and 8 normal-hearing children (group NH) with the same age were asked to pronounce the vowels of/a/,/o/,/e/,/i/,/u/, and/ü/ in four tones with the direction of speech training teacher. The sounds were recorded and analyzed with Praat software extract Formants (F1, F2) and duration of the sounds. Results The error of vowels in four tones was more in group CI than in group NH, but difficult level was almost the same between groups. There was significant difference in the F1 of/e/, F2 of/i/and/u/in tone 2, F2 of/e/and duration of/o/,/e/, and/ü/in tone 3 between groups (P<0.05). Conclusion Pronouncing the four tones of vowels is more difficult for the hearing-impaired children. For vowels articulation training, it is important to focus on the mouth and breath training.%  目的探讨语前聋儿童人工耳蜗植入术后元音声调的发声特点。方法8例语前聋人工耳蜗植入儿童(聋儿组)和8例同年龄组(3~4岁)听力正常儿童(正常组),在语训教师(音量控制在60~70 dBSPL)带领下朗读四声状态下的元音/a/、/o/、/e/、/i/、/u/、/ü/。对语音录音采样,采用Praat语音分析软件提取共振峰(F1、F2)及音长。结果聋儿组元音四声错误率高于正常组,但两组儿童四声发音的难易程度一致。与正常组比较,聋儿组阳平/e/的F1,/i/和/u/的F2存在显著性差异(P<0.05);上声/e/的F2存在显著性差异(P<0.05);上声/o/、/e/和/ü/的音长存在显著性差异(P<0.05)。结论人工耳蜗植入儿童声调习得难度更大。共振峰、音长测试可为口型和舌位的训练提供参考。

  15. Evaluation of glucose metabolic abnormality in postlingually deaf patients using F-18-FDG positron emission tomography and statistical parametric mapping

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Sung; Lee, Dong Soo; Oh, Seung Ha; Kim, Chong Sun; Park, Kwang Suk; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2000-07-01

    We have previously reported the prognostic relevance of cross-modal cortical plasticity in prelingual deaf patients revealed by F-18-FDG PET and SPM analysis. In this study, we investigated metabolic abnormality in postlingual deaf patients, whose clinical features are different from prelingual deafness. Nine postlingual deaf patients (age: 30.5 {+-}14.0) were performed on F-18-FDG brain PET. We compared their PET images with those of age-matched 20 normal controls (age: 27.1 {+-}8.6), and performed correlation analysis to investigate the relationship between glucose metabolism and deaf duration using SPM99. Glucose metabolism of deaf patients was significantly (p<0.05, corrected) decreased in both anterior cingulate, inferior frontal cortices, and superior temporal cortices, and left hippocampus. Metabolism in both superior temporal cortices and association area in inferior parietal cortices showed significant (p<0.01, uncorrected) positive correlation with deaf duration. Decreased metabolism in hippocampus accompanied with hypometabolism in auditory related areas can be explained by recent finding of anatomical connectivity between them, and may be the evidence indicating their functional connectivity. Metabolism recovery in auditory cortex after long deaf duration suggests that cortical plasticity takes place also in postlingual deafness.

  16. 语前聋患儿人工耳蜗植入术后听觉言语功能发育的观察%Development of Auditory and Speech Ability in Prelingual Deafness Children after Cochlear Implantation

    Institute of Scientific and Technical Information of China (English)

    张宏征; 钱宇虹; 郭梦和

    2013-01-01

    目的研究语前聋患儿植入人工耳蜗后听觉言语能力的发育情况及相关因素。方法34例接受人工耳蜗植入的极重度语前聋儿童手术时年龄为1岁2个月~5岁10个月,平均3岁2.15个月,按照植入手术时年龄分为幼龄组(A组,<3岁,17例)、大龄组(B组,≥3岁,17例),在植入手术前和开机后3、6、12个月四个时间点采用有意义听觉整合量表(meaningful auditory integration scale ,MAIS)和婴幼儿有意义听觉整合量表(the infant-toddler meaningful auditory integration scale ,IT -MAIS)对患儿进行听觉能力评估。结果全体患儿植入人工耳蜗后量表总分及三组问题的得分均明显高于植入前,并且随着开机时间的延长其得分逐步上升(P<0.05),其中评价患儿对声音感知能力的Q3~6在开机后的3个月内进展最为迅速。B组植入术前与听觉辅具有关的问题Q1~2和开机后3个月Q3~6得分高于A组(P<0.05),其余各项得分两组间差异无统计学意义。总体上男性和女性患儿各项得分无差异(P>0.05),A组女性患者术前Q1~2得分高于男性(P<0.05),其余各时间点男女间得分差异无统计学意义(P>0.05)。结论随着使用人工耳蜗时间的延长,人工耳蜗植入患儿总体听觉能力呈逐步上升的趋势,进步最快的时间为开机后的3个月内,这个阶段较大龄的患儿对声音的察觉能力优于婴幼儿患者,但随着植入时间的延长两组听觉能力的发育无差异;不同性别患儿植入人工耳蜗后的听觉发育无差异。%Objective To evaluate auditory and speech development longitudinally over the first year after co-chlear implantation in prelingual deaf pediatric cochlear implant (CI) recipients .Methods Meaningful auditory inte-gration scale (MAIS) and infant-toddler meaningful auditory integration scale (ITMAIS) were used to evaluate 34

  17. Prelingual auditory verbal agnosia, A rare condition

    National Research Council Canada - National Science Library

    Violeta Necula; Cristina Mirela Stamate; Krishna Luchoo; Marcel Cosgarea

    2017-01-01

    Auditory agnosia, agnosia for speech is a rare condition, caused mostly by stroke, in adults, while in children it is often a sequel of herpes simplex encephalitis or is associated with epilepsy, in Landau–Kleffner syndrome...

  18. Language Practices in the Ci-Classroom

    DEFF Research Database (Denmark)

    Mourtou, Eleni

    2014-01-01

    Prelingually deafened children are nowadays likely to receive a cochlear implant (ci). As these children do their language acquisition with a cochlear implant they require a constant rehabilitation and support. Educational staff is instructed on how to work with children with ci in form...... of guidelines and workshops. This paper discusses language practices used in the setting of a school for cochlear-implanted children. These children encounter language and pronunciation problems that accompany prelingual deafness and hearing with a cochlear implant. I examine two practices, which are used...

  19. Assessment of Early Prelingual Auditory Development for 0-9-month-old Infants after Early Hearing Aid Fitting%9月龄内听力损失婴儿助听器干预后的早期语前听能发育规律初步研究

    Institute of Scientific and Technical Information of China (English)

    张圆; 郑芸; 李刚; Sigfrid D. Soli

    2015-01-01

    Objective To study the early prelingual auditory development of 0-9-month-old infants after early hearing aid fitting.Methods The design of this study was longitudinal and prospective. The infant-toddler meaningful auditory integration scale (IT-MAIS) was used to evaluate 43 infants diagnosed with moderate, severe, and profound sensorineural hearing loss (SNHL) and fitted with hearing aids bilaterally before 9 months old. The early prelingual auditory development of all subjects was evaluated with IT-MAIS before hearing aid fitting, and 1, 3, 6, 12 months after fitting.Results The mean IT-MAIS scores showed significant improvements as time of hearing aid use increased for all three groups (P0.05). The multiple comparisons indicated that there was no significant difference between the moderate and severe group before and 1,3 and 6 months after fitting(P>0.05),but were significant differences between the moderate and profound group at each assessment interval(P0.05), but were significant differences before fitting and 3 and 6 months after fitting(P0.05)。对配戴前及配戴后1、3、6个月的IT-MAIS得分分别进行两两比较显示,中度组与重度组在6个月前均无显著性差异(P>0.05);中度组与极重度组在6个月前均具有显著性差异(P0.05)外,其余均有显著性差异(P<0.05)。结论听力损失婴儿助听后的早期语前听觉能力随助听器配戴时间延长而提高,早期语前听能发育主要受助听器配戴时间的影响。IT-MAIS可提供常规测听方法不能反映的重要听能发育信息,应作为听力损失患儿康复效果评估的常规测试方法在临床上应用。

  20. Connexin 26 (GJB2) mutation in an Argentinean patient with keratitis-ichthyosis-deafness (KID) syndrome: a case report.

    Science.gov (United States)

    Dalamón, Viviana Karina; Buonfiglio, Paula; Larralde, Margarita; Craig, Patricio; Lotersztein, Vanesa; Choate, Keith; Pallares, Norma; Diamante, Vicente; Elgoyhen, Ana Belén

    2016-05-04

    Keratitis-Ichthyosis-Deafness (KID) syndrome is a rare condition characterized by pre-lingual sensorineural deafness with skin hyperkeratinization. The primary cause of the disease is a loss-of-function mutation in the GJB2 gene. Mutations in Argentinean patients have not been described. We studied a 2 year-old boy with bilateral congenital sensorineural deafness with dry skin over the entire body, hypotrichosis of the scalp, thin and light-blond hair. Analysis of the GJB2 gene nucleotide sequence revealed the substitution of guanine-148 by adenine predicted to result in an Asp50Asn amino acid substitution. This is the first KID report in a patient from Argentina. This de novo mutation proved to be the cause of keratitis-ichthyosis-deafness syndrome (KID-syndrome) in the patient, and has implications in medical genetic practice.

  1. Scar formation in mice deafened with kanamycin and furosemide

    NARCIS (Netherlands)

    Zak, Magdalena; van der Linden, Cynthia A; Bezdjian, Aren; Hendriksen, Ferry G; Klis, Sjaak F L; Grolman, Wilko

    2016-01-01

    In mammals, hair cell loss is irreversible and leads to hearing loss. To develop and test the functioning of different strategies aiming at hair cell regeneration, animal models of sensorineural hearing loss are essential. Although cochleae of these animals should lack hair cells, supporting cells s

  2. Scar formation in mice deafened with kanamycin and furosemide

    NARCIS (Netherlands)

    Zak, Magdalena; van der Linden, Cynthia A; Bezdjian, Aren; Hendriksen, Ferry G; Klis, Sjaak F L; Grolman, Wilko

    In mammals, hair cell loss is irreversible and leads to hearing loss. To develop and test the functioning of different strategies aiming at hair cell regeneration, animal models of sensorineural hearing loss are essential. Although cochleae of these animals should lack hair cells, supporting cells

  3. Speech feature discrimination in deaf children following cochlear implantation

    Science.gov (United States)

    Bergeson, Tonya R.; Pisoni, David B.; Kirk, Karen Iler

    2002-05-01

    Speech feature discrimination is a fundamental perceptual skill that is often assumed to underlie word recognition and sentence comprehension performance. To investigate the development of speech feature discrimination in deaf children with cochlear implants, we conducted a retrospective analysis of results from the Minimal Pairs Test (Robbins et al., 1988) selected from patients enrolled in a longitudinal study of speech perception and language development. The MP test uses a 2AFC procedure in which children hear a word and select one of two pictures (bat-pat). All 43 children were prelingually deafened, received a cochlear implant before 6 years of age or between ages 6 and 9, and used either oral or total communication. Children were tested once every 6 months to 1 year for 7 years; not all children were tested at each interval. By 2 years postimplant, the majority of these children achieved near-ceiling levels of discrimination performance for vowel height, vowel place, and consonant manner. Most of the children also achieved plateaus but did not reach ceiling performance for consonant place and voicing. The relationship between speech feature discrimination, spoken word recognition, and sentence comprehension will be discussed. [Work supported by NIH/NIDCD Research Grant No. R01DC00064 and NIH/NIDCD Training Grant No. T32DC00012.

  4. 语前聋儿童人工耳蜗植入术后一年内的听觉发展和言语识别%Development of early auditory and speech perception skills within one year after cochlear implantion in prelingual deaf children

    Institute of Scientific and Technical Information of China (English)

    傅莹; 陈源; 郗昕; 洪梦迪; 陈艾婷; 王倩; 黄丽娜

    2015-01-01

    后儿童早期听觉、言语识别的可用工具.%Objective To investigate the development of early auditory capability and speech perception in the prelingual deaf children after cochlear implantation,and to study the feasibility of currently available Chinese assessment instruments for the evaluation of early auditory skill and speech perception in hearing-impaired children.Methods A total of 83 children with severe-to-profound prelingual hearing impairment participated in this study.Participants were divided into four groups according to the age for surgery:A (1-2 years),B (2-3 years),C (3-4 years) and D (4-5years).The auditory skill and speech perception ability of CI children were evaluated by trained audiologists using the infant-toddler/ meaningful auditory integration scale (IT-MAIS/MAIS) questionnaire,the Mandarin Early Speech Perception (MESP)test and the Mandarin Pediatric Speech Intelligibility (MPSI) test.The questionnaires were used in face to face interviews with the parents or guardians.Each child was assessed before the operation and 3 months,6 months,12 months after switch-on.Results After cochlear implantation,early postoperative auditory development and speech perception gradually improved.All MAIS/IT-MAIS scores showed a similar increasing trend with the rehabilitation duration (F =5.743,P =0.007).Preoperative and post operative MAIS/IT-MAIS scores of children in age group C (3-4 years) was higher than that of other groups.Children who had longer hearing aid experience before operation demonstrated higher MAIS/IT-MAIS scores than those with little or no hearing aid experience(F =4.947,P =0.000).The MESP test showed that,children were not able to perceive speech as well as detecting speech signals.However as the duration of CI use increased,speech perception ability also improved substantially.However,only about 40% of the subjects could be evaluated using the most difficult subtest on the MPSI in quiet at 12 months after switch-on.As MCR

  5. Phenotypic characterization of DFNA24: prelingual progressive sensorineural hearing impairment.

    NARCIS (Netherlands)

    Santos, R.L.; Hafner, F.M.; Huygen, P.L.M.; Linder, T.E.; Schinzel, A.; Spillmann, T.; Leal, S.M.

    2006-01-01

    This article describes the hearing impairment (HI) phenotype which segregates in a large multi-generation Swiss-German family with autosomal dominant nonsyndromic HI. The locus segregating within this pedigree is located on chromosome 4q35-qter and is designated as DFNA24. For this pedigree, audiome

  6. Patients

    African Journals Online (AJOL)

    Items 1 - 7 ... Results: The mean age for patient group is 65.6 years while for controls it is 30.3 years. ... result in large number of population in old ages ... Originally the American Urological Asso- .... age distribution and study results in this study.

  7. Visual Temporal Acuity Is Related to Auditory Speech Perception Abilities in Cochlear Implant Users.

    Science.gov (United States)

    Jahn, Kelly N; Stevenson, Ryan A; Wallace, Mark T

    Despite significant improvements in speech perception abilities following cochlear implantation, many prelingually deafened cochlear implant (CI) recipients continue to rely heavily on visual information to develop speech and language. Increased reliance on visual cues for understanding spoken language could lead to the development of unique audiovisual integration and visual-only processing abilities in these individuals. Brain imaging studies have demonstrated that good CI performers, as indexed by auditory-only speech perception abilities, have different patterns of visual cortex activation in response to visual and auditory stimuli as compared with poor CI performers. However, no studies have examined whether speech perception performance is related to any type of visual processing abilities following cochlear implantation. The purpose of the present study was to provide a preliminary examination of the relationship between clinical, auditory-only speech perception tests, and visual temporal acuity in prelingually deafened adult CI users. It was hypothesized that prelingually deafened CI users, who exhibit better (i.e., more acute) visual temporal processing abilities would demonstrate better auditory-only speech perception performance than those with poorer visual temporal acuity. Ten prelingually deafened adult CI users were recruited for this study. Participants completed a visual temporal order judgment task to quantify visual temporal acuity. To assess auditory-only speech perception abilities, participants completed the consonant-nucleus-consonant word recognition test and the AzBio sentence recognition test. Results were analyzed using two-tailed partial Pearson correlations, Spearman's rho correlations, and independent samples t tests. Visual temporal acuity was significantly correlated with auditory-only word and sentence recognition abilities. In addition, proficient CI users, as assessed via auditory-only speech perception performance, demonstrated

  8. Language Practices in the Ci-Classroom

    DEFF Research Database (Denmark)

    Mourtou, Eleni

    2014-01-01

    Prelingually deafened children are nowadays likely to receive a cochlear implant (ci). As these children do their language acquisition with a cochlear implant they require a constant rehabilitation and support. Educational staff is instructed on how to work with children with ci in form...... during the storytelling activity: repeat requests and questions. Whereas repeat requests are used in ci-therapy, questions have been shown to be instrumentalized for educational purposes in the setting of a school. I will reveal the educational/rehabilitational issues that are linked to these practices....

  9. Magnet dislocation: an increasing and serious complication following MRI in patients with cochlear implants.

    Science.gov (United States)

    Hassepass, F; Stabenau, V; Arndt, S; Beck, R; Bulla, S; Grauvogel, T; Aschendorff, A

    2014-07-01

    Cochlear implantation (CI) represents the gold standard in the treatment of children born deaf and postlingually deafened adults. Initial magnetic resonance imaging (MRI) was contraindicated in CI users. Meanwhile, there are specific recommendations concerning MRI compatibility depending on the type of CI system and the device manufacturer. Some CI systems are even approved for MRI with the internal magnet left in place. The aim of this study was to analyze all magnet revision surgeries in CI patients at one CI center and the relationship to MRI scans over time. Between 2000 and 2013, a total of 2027 CIs were implanted. The number of magnet dislocation (MD) surgeries and their causes was assessed retrospectively. In total 12 cases of MD resulting from an MRI scan (0.59 %) were observed, accounting for 52.2 % of all magnetic revision surgeries. As per the labeling, it was considered safe to leave the internal magnet in place during MRI while following specific manufacturer recommendations: MRI intensity of 1.5 Tesla (T) and compression head bandage during examination. A compression head bandage in a 1.5 T MRI unit does not safely prevent MD and the related serious complications in CI recipients. We recommend a Stenvers view radiograph after MRI with the internal magnet in place for early identification of MD, at least in the case of pain during or after MRI examination. MRI in CI patients should be indicated with restraint and patients should be explicitly informed about the possible risks. Recommendations regarding MRI compatibility and the handling of CI patients issued with MRI for the most common CI systems are summarized. © Georg Thieme Verlag KG Stuttgart · New York.

  10. ASSESSMENT OF IMPROVEMENT IN SPEECH PERCEPTION AND LANGUAGE DEVELOPMENT IN COCHLEAR IMPLANT SURGERY : AN INTERESTING STUDY FROM A TERTIARY CARE HOSPITAL OF CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Sunil

    2015-10-01

    Full Text Available Severe to profound prelingual deafness that is either congenital or acquired is estimated to occur in 0.5 to 3 per 1000 live births. This is often associated with early delays in language development, speech perception, socialization and results in lower academic achievement. These de velopmental and behavioral problems are severe as 90 % of children are born to normal patients whereas with deaf parents it is less as they have a mutual communication. After much research in this field the first 22 channel cochlear implant surgery was don e in 1982. The number of prelingually deafened adults seeking cochlear implant is increasing as these individuals can derive substantial benefit, although their performance is poorer than adults with post - lingual deafness. MATERIAL AND METHODS : The present prospective study was conducted in the Department of ENT, Pt. J.N.M. Medical College and Dr. B. R.A.M. Hospital, Raipur (C.G. The subject selected were prelingually deafened individuals who were undergoing post cochlear implant speech therapy in the Depar tment. This study included individuals, who underwent cochlear implant surgery in this Department during the period of July, 2008 to September, 2010 and the age was within 10 years at the time of surgery. The study was designed as a prospective longitudina l analysis to asses functioning of patients, who underwent cochlear implantation. A total 37 cochlear implant surgeries were carried out in Department. Of these 3 cases were outside the age criteria of the present study and another 2 cases were lost in fol low up. Pre - operatively, detailed information of subject including the age, sex and address as well as contact number was collected. Then a General Examination was followed with reference to Built, Nutrition, Pulse, and Blood pressure, Oedema, Cyanosis, Cl ubbing and Citrus. A systemic examination was also performed. A Local Examination with special emphasis to tympanic membrane and any middle ear

  11. Development of a home-based auditory training to improve speech recognition on the telephone for patients with cochlear implants: A randomised trial.

    Science.gov (United States)

    Ihler, F; Blum, J; Steinmetz, G; Weiss, B G; Zirn, S; Canis, M

    2017-03-20

    Speech recognition on the telephone poses a challenge for patients with cochlear implants (CIs) due to a reduced bandwidth of transmission. This trial evaluates a home-based auditory training with telephone-specific filtered speech material to improve sentence recognition. Randomised controlled parallel double-blind. One tertiary referral centre. A total of 20 postlingually deafened patients with CIs. Primary outcome measure was sentence recognition assessed by a modified version of the Oldenburg Sentence Test filtered to the telephone bandwidth of 0.3-3.4 kHz. Additionally, pure tone thresholds, recognition of monosyllables and subjective hearing benefit were acquired at two separate visits before and after a home-based training period of 10-14 weeks. For training, patients received a CD with speech material, either unmodified for the unfiltered training group or filtered to the telephone bandwidth in the filtered group. Patients in the unfiltered training group achieved an average sentence recognition score of 70.0%±13.6% (mean±SD) before and 73.6%±16.5% after training. Patients in the filtered training group achieved 70.7%±13.8% and 78.9%±7.0%, a statistically significant difference (P=.034, t10 =2.292; two-way RM ANOVA/Bonferroni). An increase in the recognition of monosyllabic words was noted in both groups. The subjective benefit was positive for filtered and negative for unfiltered training. Auditory training with specifically filtered speech material provided an improvement in sentence recognition on the telephone compared to training with unfiltered material. © 2017 John Wiley & Sons Ltd.

  12. REZ-Ⅰ型人工耳蜗植入对成人残余听力的影响%Effect of REZ-Ⅰ cochlear implantation on residual hearing in adult patients

    Institute of Scientific and Technical Information of China (English)

    陶朵朵; 陈兵; 王正敏; 迟放鲁; 李华伟

    2010-01-01

    Objective To evaluate the effect of cochlear implantation with REZ-Ⅰ straight electrodes on residual hearing of postlingually deafened adults, and to explore the audiologically safety and injury characteristics of cochlear implantation. Methods Sixteen unilateral REZ-Ⅰ (22 channels) cochlear implantation recipients from September 2009 to December 2009 were picked out. Their pre-and postimplantation audiometry data including pure-tone audiometry (PTA), auditory steady-state responses (ASSR), auditory brainstem responses(ABR) and distortion product otoacoustic emissions(DPOAE) were retrospectively analyzed, in order to compare the change between pre- and post-implantation residual hearing. Results Among the 12 recipients who had some measurable residual hearing before implantation,5 (41.6%) patients had conserved some measurable hearing but the other 7 (58.4%) recipients had lost all measurable hearing after implantation on the implanted side. The implanted ears had an average PTA threshold drop of 9.5 dB HL and a statistically significant difference between pre- and post-implantation (P0.05).结论 REZ-Ⅰ型人工耳蜗植入会对植入侧残余听力造成一定程度的损伤.

  13. Deafening silence? Time to reconsider whether organisations are silent or deaf when things go wrong.

    Science.gov (United States)

    Jones, Aled; Kelly, Daniel

    2014-09-01

    Several public inquiries into healthcare failings in the UK have noted that employees of failing organizations attempt to raise concerns about shortcomings in care, often over a prolonged period of time, only for those concerns to be ignored. However, healthcare literature has largely focused on how organizations and their employees are silent in the face of such failings, positioning employees as daring not to speak in response to serious workplace problems or issues. We argue that only focussing on organizational silence is a critical mistake which misrepresents actual events and overly-simplifies the complexities of workplace culture. The disregard shown by academics, practitioners and policy makers to employee voice strategies, which do not amount to whistle-blowing, but equally cannot either be defined as "silence", results in signals being ignored that can be effective in preventing and ending wrongdoing by others. In addition to understanding silence we suggest therefore that better understanding of why organizations are deaf to, or disregard, employee concerns are needed. We propose that a virtuous cycle is possible, whereby the introduction of systems that result in better listening and valuing of employee concerns reinforces a culture of speaking up and, in turn, organizational learning. Similarly, organizations that disregard employees concerns are destined not to learn, ultimately falling silent and failing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Neurotrophic treatment of the degenerating auditory nerve; cochlear implants in deafened guinea pigs

    NARCIS (Netherlands)

    Agterberg, M.J.H.

    2009-01-01

    To date, the cochlear implant is the most successful sensorineural prosthesis. The device consists of a small array with a number of electrodes implanted in the cochlea of profoundly hearing impaired people. Some people with an implant are able to use the telephone. Unfortunately, others hardly bene

  15. Recovery characteristics of the electrically stimulated auditory nerve in deafened guinea pigs : Relation to neuronal status

    NARCIS (Netherlands)

    Ramekers, Dyan; Versnel, Huib; Strahl, Stefan B.; Klis, Sjaak F L; Grolman, Wilko

    2015-01-01

    Successful cochlear implant performance requires adequate responsiveness of the auditory nerve to prolonged pulsatile electrical stimulation. Degeneration of the auditory nerve as a result of severe hair cell loss could considerably compromise this ability. The main objective of this study was to ch

  16. Assessment and Preservation of Auditory Nerve Integrity in the Deafened Guinea Pig

    NARCIS (Netherlands)

    Ramekers, D.

    2014-01-01

    Profound hearing loss is often caused by cochlear hair cell loss. Cochlear implants (CIs) essentially replace hair cells by encoding sound and conveying the signal by means of pulsatile electrical stimulation to the spiral ganglion cells (SGCs) which form the auditory nerve. SGCs progressively degen

  17. Behavioral responses of deafened guinea pigs to intracochlear electrical stimulation: a new rapid psychophysical procedure

    NARCIS (Netherlands)

    Agterberg, M.J.H.; Versnel, H.

    2014-01-01

    In auditory research the guinea pig is often preferred above rats and mice because of the easily accessible cochlea and because the frequency range of its hearing is more comparable to that of humans. Studies of the guinea-pig auditory system primarily apply histological and electrophysiological mea

  18. Magnet discolation - An increasing and serious complication following MRI in patients with chochlear implants; Magnetdiskolation - eine zunehmende und folgenreiche Komplikation nach MRT bei Patienten mit Cochlea Implantat

    Energy Technology Data Exchange (ETDEWEB)

    Hassepass, F.; Staubenau, V.; Arndt, S.; Beck, R.; Grauvogel, T.; Aschendorff, A. [Univ. Medical Center Freiburg (Germany). Dept. of Otorhinolaryngology-Head and Neck Surgery; Bulla, S. [Univ. Medical Center Freiburg (Germany). Dept. of Diagnostic Radiology

    2014-07-15

    Cochlear implantation (CI) represents the gold standard in the treatment of children born deaf and postlingually deafened adults. Initial magnetic resonance imaging (MRI) was contraindicated in CI users. Meanwhile, there are specific recommendations concerning MRI compatibility depending on the type of CI system and the device manufacturer. Some CI systems are even approved for MRI with the internal magnet left in place. The aim of this study was to analyze all magnet revision surgeries in CI patients at one CI center and the relationship to MRI scans over time. Between 2000 and 2013, a total of 2027 CIs were implanted. The number of magnet dislocation (MD) surgeries and their causes was assessed retrospectively. In total 12 cases of MD resulting from an MRI scan (0.59 %) were observed, accounting for 52.2 % of all magnetic revision surgeries. As per the labeling, it was considered safe to leave the internal magnet in place during MRI while following specific manufacturer recommendations: MRI intensity of 1.5 Tesla (T) and compression head bandage during examination. A compression head bandage in a 1.5 T MRI unit does not safely prevent MD and the related serious complications in CI recipients. We recommend a Stenvers view radiograph after MRI with the internal magnet in place for early identification of MD, at least in the case of pain during or after MRI examination. MRI in CI patients should be indicated with restraint and patients should be explicitly informed about the possible risks. Recommendations regarding MRI compatibility and the handling of CI patients issued with MRI for the most common CI systems are summarized.

  19. Health-related quality of life and mental distress in patients with partial deafness: preliminary findings.

    Science.gov (United States)

    Cieśla, Katarzyna; Lewandowska, Monika; Skarżyński, Henryk

    2016-03-01

    The aim of the study was to evaluate mental distress and health-related quality of life in patients with bilateral partial deafness (high-frequency sensorineural hearing loss) before cochlear implantation, with respect to their audiological performance and time of onset of the hearing impairment. Thirty-one patients and 31 normal-hearing individuals were administered the Beck Depression Inventory (BDI), the State-Trait-Anxiety-Inventory (STAI) and the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). Patients also completed the Nijmegen-Cochlear-Implant-Questionnaire (NCIQ), a tool for evaluation of quality of life related to hearing loss. Patients revealed increased depressive and anxiety symptoms, as well as decreased health-related quality of life (psychological health, physical health), in comparison with their healthy counterparts (t tests, p patients with a prelingual onset of hearing loss enhanced self-evaluated social interactions and activity (NCIQ), when their outcomes were contrasted with those obtained in individuals with postlingual partial deafness (p Patients not using hearing aids had better audiological performance and, therefore, better sound perception and speech production, as measured with NCIQ. There was no effect of hearing aid use with respect to mental distress. Additional statistically significant correlations seen in patients included those between a steeper slope hearing loss configuration (averaged pure-tone thresholds at 1 and 2 kHz with subtracted threshold at 0.5 kHz) and better audiometric speech detection, between audiometric thresholds and the subjectively rated sound perception (NCIQ), as well as left-ear audiometric word recognition scores and the subjectively perceived ability to recognize advanced sounds (NCIQ). In addition, a longer duration of postlingual deafness, as well as a younger age at the onset were both related to worse speech detection thresholds. The results of the study provide evidence

  20. MUSIC AND COCHLEAR IMPLANTS

    Institute of Scientific and Technical Information of China (English)

    Mao Yitao; Xu Li

    2013-01-01

    Currently, most people with modern multichannel cochlear implant systems can understand speech in qui-et environment very well. However, studies in recent decades reported a lack of satisfaction in music percep-tion with cochlear implants. This article reviews the literature on music ability of cochlear implant users by presenting a systematic outline of the capabilities and limitations of cochlear implant recipients with regard to their music perception as well as production. The review also evaluates the similarities and differences be-tween electric hearing and acoustic hearing regarding music perception. We summarize the research results in terms of the individual components of music (e.g., rhythm, pitch, and timbre). Finally, we briefly intro-duce the vocal singing of prelingually-deafened children with cochlear implants as evaluated by acoustic measures.

  1. Sarcasm and Advanced Theory of Mind Understanding in Children and Adults with Prelingual Deafness

    Science.gov (United States)

    O'Reilly, Karin; Peterson, Candida C.; Wellman, Henry M.

    2014-01-01

    Two studies addressed key theoretical debates in theory of mind (ToM) development by comparing (a) deaf native signers (n = 18), (b) deaf late signers (n = 59), and (c) age-matched hearing persons (n = 74) in childhood (Study 1: n = 81) and adulthood (Study 2: n = 70) on tests of first- and second-order false belief and conversational sarcasm.…

  2. Sentence Production after Listener and Echoic Training by Prelingual Deaf Children with Cochlear Implants

    Science.gov (United States)

    Golfeto, Raquel M.; de Souza, Deisy G.

    2015-01-01

    Three children with neurosensory deafness who used cochlear implants were taught to match video clips to dictated sentences. We used matrix training with overlapping components and tested for recombinative generalization. Two 3?×?3 matrices generated 18 sentences. For each matrix, we taught 6 sentences and evaluated generalization with the…

  3. Effects of a Wearable, Tactile Aid on Language Comprehension of Prelingual Profoundly Deaf Children.

    Science.gov (United States)

    Proctor, Adele

    Factors influencing the use of nonacoustic aids (such as visual displays and tactile devices) with the hearing impaired are reviewed. The benefits of tactile devices in improving speech reading/lipreading and speech are pointed out. Tactile aids which provide information on rhythm, rate, intensity, and duration of speech increase lipreading and…

  4. Benefits of simultaneous bilateral cochlear implantation on verbal reasoning skills in prelingually deaf children

    NARCIS (Netherlands)

    Jacobs, Evi; Langereis, Margreet C.; Frijns, Johan H. M.; Free, Rolien H.; Goedegebure, Andre; Smits, Cas; Stokroos, Robert J.; Ariens-Meijer, Saskia A. M.; Mylanus, Emmanuel A. M.; Vermeulen, Anneke M.

    2016-01-01

    Background: Impaired auditory speech perception abilities in deaf children with hearing aids compromised their verbal intelligence enormously. The availability of unilateral cochlear implantation (Cl) auditory speech perception and spoken vocabulary enabled them to reach near ageappropriate levels.

  5. Benefits of simultaneous bilateral cochlear implantation on verbal reasoning skills in prelingually deaf children.

    Science.gov (United States)

    Jacobs, Evi; Langereis, Margreet C; Frijns, Johan H M; Free, Rolien H; Goedegebure, Andre; Smits, Cas; Stokroos, Robert J; Ariens-Meijer, Saskia A M; Mylanus, Emmanuel A M; Vermeulen, Anneke M

    2016-11-01

    Impaired auditory speech perception abilities in deaf children with hearing aids compromised their verbal intelligence enormously. The availability of unilateral cochlear implantation (CI) auditory speech perception and spoken vocabulary enabled them to reach near ageappropriate levels. This holds especially for children in spoken language environments. However, speech perception in complex listening situations and the acquisition of complex verbal skills remains difficult. Bilateral CI was expected to enhance the acquisition of verbal intelligence by improved understanding of speech in noise. This study examined the effect of bilateral CI on verbal intelligence of 49 deaf children (3;5-8;0 years). Relations between speech perception in noise, auditory short-term memory and verbal intelligence were analysed with multiple linear regressions. In addition, the interaction of educational setting, mainstream or special, on these relations was analysed. Children with bilateral CI obtained higher scores on verbal intelligence. Significant associations were present between speech perception in noise, auditory short-term memory and verbal intelligence. Children with simultaneous bilateral CIs showed better speech perception in noise than children with unilateral CIs, which mediated by the auditory short-term memory capacity, enhanced the ability to acquire more complex verbal skills for BICI children in mainstream education. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Intelligence development of pre-lingual deaf children with unilateral cochlear implantation.

    Science.gov (United States)

    Chen, Mo; Wang, Zhaoyan; Zhang, Zhiwen; Li, Xun; Wu, Weijing; Xie, Dinghua; Xiao, Zi-An

    2016-11-01

    The present study aims to test whether deaf children with unilateral cochlear implantation (CI) have higher intelligence quotients (IQ). We also try to find out the predictive factors of intelligence development in deaf children with CI. Totally, 186 children were enrolled into this study. They were divided into 3 groups: CI group (N = 66), hearing loss group (N = 54) and normal hearing group (N = 66). All children took the Hiskey-Nebraska Test of Learning Aptitude to assess the IQ. After that, we used Deafness gene chip, Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) methods to evaluate the genotype, auditory and speech performance, respectively. At baseline, the average IQ of hearing loss group (HL), CI group, normal hearing (NH) group were 98.3 ± 9.23, 100.03 ± 12.13 and 109.89 ± 10.56, while NH group scored higher significantly than HL and CI groups (p  0.05). The growth of SIR was positive correlated with the growth of IQ (r = 0.247, p = 0.046), while no significant correlation were found between IQ growth and other possible factors, i.e. gender, age of CI, use of hearing aid, genotype, implant device type, inner ear malformation and CAP growth (p > 0.05). Our study suggests that CI potentially improves the intelligence development in deaf children. Speech performance growth is significantly correlated with IQ growth of CI children. Deaf children accepted CI before 6 years can achieve a satisfying and undifferentiated short-term (12 months) development of intelligence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Benefits of simultaneous bilateral cochlear implantation on verbal reasoning skills in prelingually deaf children

    NARCIS (Netherlands)

    Jacobs, E.; Langereis, M.C.; Frijns, J.H.; Free, R.H.; Goedegebure, A.; Smits, C.; Stokroos, R.J.; Ariens-Meijer, S.A.; Mylanus, E.A.M.; Vermeulen, A.M.J.

    2016-01-01

    BACKGROUND: Impaired auditory speech perception abilities in deaf children with hearing aids compromised their verbal intelligence enormously. The availability of unilateral cochlear implantation (CI) auditory speech perception and spoken vocabulary enabled them to reach near ageappropriate levels.

  8. Benefits of simultaneous bilateral cochlear implantation on verbal reasoning skills in prelingually deaf children

    NARCIS (Netherlands)

    Jacobs, Evi; Langereis, Margreet C.; Frijns, Johan H. M.; Free, Rolien H.; Goedegebure, Andre; Smits, Cas; Stokroos, Robert J.; Ariens-Meijer, Saskia A. M.; Mylanus, Emmanuel A. M.; Vermeulen, Anneke M.

    2016-01-01

    Background: Impaired auditory speech perception abilities in deaf children with hearing aids compromised their verbal intelligence enormously. The availability of unilateral cochlear implantation (Cl) auditory speech perception and spoken vocabulary enabled them to reach near ageappropriate levels.

  9. Identification of vowel length, word stress and compound words and phrases by postlingually-deafened cochlear implant listeners

    DEFF Research Database (Denmark)

    Morris, David Jackson; Magnusson, Lennart; Faulkner, Andrew

    2013-01-01

    Background: The accurate perception of prosody assists a listener in deriving meaning from natural speech. Few studies have addressed the ability of cochlear implant (CI) listeners to perceive the brief duration prosodic cues involved in contrastive vowel length, word stress, and compound word...... word stress, vowel length, and compound words or phrases all of which were presented with minimal-pair response choices. Tests were performed in quiet and in speech-spectrum shaped noise at a 10 dB signal- to-noise ratio. Also, discrimination thresholds for four acoustic properties of a synthetic vowel...

  10. Releases of surgically deafened homing pigeons indicate that aural cues play a significant role in their navigational system.

    Science.gov (United States)

    Hagstrum, Jonathan T; Manley, Geoffrey A

    2015-10-01

    Experienced homing pigeons with extirpated cochleae and lagenae were released from six sites in upstate New York and western Pennsylvania on 17 days between 1973 and 1975 by William T. Keeton and his co-workers at Cornell University. The previously unpublished data indicate that departure directions of the operated birds were significantly different from those of sham-operated control birds (314 total), indicating that aural cues play an important part in the pigeon's navigational system. Moreover, propagation modeling of infrasonic waves using meteorological data for the release days supports the possibility that control birds used infrasonic signals to determine their homeward direction. Local acoustic 'shadow' zones, therefore, could have caused initial disorientation of control birds at release sites where they were normally well oriented. Experimental birds plausibly employed an alternate 'route-reversal' strategy to return home perhaps using their ocular-based magnetic compass. We suggest, based on Keeton's results from another site of long-term disorientation, that experienced pigeons depend predominantly on infrasonic cues for initial orientation, and that surgical removal of their aural sense compelled them to switch to a secondary navigational strategy.

  11. Patient - patient interaction

    DEFF Research Database (Denmark)

    Birkelund, Regner; Søndergaard Larsen, Lene

    2013-01-01

    Aim:  The aim of this study is to provide an understanding of the significance of hospitalized patients’ interpersonal interaction with fellow patients in an infectious disease ward in a large Danish hospital. Method:  A qualitative approach was selected using participant observation and semi...... 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...

  12. Patient Empowerment

    Science.gov (United States)

    ... ONS Journals Research Medical Advisors Young Investigator Award Patient Empowerment What’s Empowerment? Patients and families have rights, ... organizations for your type of cancer. Contact Your Patient Organization The Kidney Cancer Association (KCA) serves kidney ...

  13. Patient Rights

    Science.gov (United States)

    As a patient, you have certain rights. Some are guaranteed by federal law, such as the right to get a copy ... them private. Many states have additional laws protecting patients, and healthcare facilities often have a patient bill ...

  14. Speech Experience Shapes the Speechreading Network and Subsequent Deafness Facilitates It

    Science.gov (United States)

    Suh, Myung-Whan; Lee, Hyo-Jeong; Kim, June Sic; Chung, Chun Kee; Oh, Seung-Ha

    2009-01-01

    Speechreading is a visual communicative skill for perceiving speech. In this study, we tested the effects of speech experience and deafness on the speechreading neural network in normal hearing controls and in two groups of deaf patients who became deaf either before (prelingual deafness) or after (postlingual deafness) auditory language…

  15. Patient satisfaction

    Directory of Open Access Journals (Sweden)

    Bhanu Prakash

    2010-01-01

    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.

  16. The Importance of Vowel Diacritics for Reading in Hebrew: What Can Be Learned from Readers with Prelingual Deafness?

    Science.gov (United States)

    Miller, Paul

    2004-01-01

    This study investigates the importance of vowel diacritics for the reading of Hebrew in individuals with different levels of phonological control. A paradigm calling for written ordered-recall of 12 lists of 8 consecutively displayed Hebrew nouns was used as a test tool. Item presentation and between-item interval were computer-controlled. Half of…

  17. Patient opinion

    DEFF Research Database (Denmark)

    Zurita, Laura; Nøhr, Christian

    2004-01-01

    The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system.......The paper is based upon a case study and aims to provide information abouit patients values and communication that will be useful in the design of more patient friendly health system....

  18. Novel Mutations and Mutation Combinations of TMPRSS3 Cause Various Phenotypes in One Chinese Family with Autosomal Recessive Hearing Impairment

    Science.gov (United States)

    Wang, Guo-Jian; Xu, Jin-Cao; Su, Yu

    2017-01-01

    Autosomal recessive hearing impairment with postlingual onset is rare. Exceptions are caused by mutations in the TMPRSS3 gene, which can lead to prelingual (DFNB10) as well as postlingual deafness (DFNB8). TMPRSS3 mutations can be classified as mild or severe, and the phenotype is dependent on the combination of TMPRSS3 mutations. The combination of two severe mutations leads to profound hearing impairment with a prelingual onset, whereas severe mutations in combination with milder TMPRSS3 mutations lead to a milder phenotype with postlingual onset. We characterized a Chinese family (number FH1523) with not only prelingual but also postlingual hearing impairment. Three mutations in TMPRSS3, one novel mutation c.36delC [p.(Phe13Serfs⁎12)], and two previously reported pathogenic mutations, c.916G>A (p.Ala306Thr) and c.316C>T (p.Arg106Cys), were identified. Compound heterozygous mutations of p.(Phe13Serfs⁎12) and p.Ala306Thr manifest as prelingual, profound hearing impairment in the patient (IV: 1), whereas the combination of p.Arg106Cys and p.Ala306Thr manifests as postlingual, milder hearing impairment in the patient (II: 2, II: 3, II: 5), suggesting that p.Arg106Cys mutation has a milder effect than p.(Phe13Serfs⁎12). We concluded that different combinations of TMPRSS3 mutations led to different hearing impairment phenotypes (DFNB8/DFNB10) in this family. PMID:28246597

  19. Patient life

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    2004-01-01

    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 ...... knowledge and better understanding about patients' lives would give nurses and other professionals more scope to identify and oblige patient needs and preferences during hospitalisation and in planning nursing care....

  20. The use of German aha in the classroom: Teachers’ demonstration and instrumentalization of aha as a response to the storytelling of children with cochlear implants

    DEFF Research Database (Denmark)

    Mourtou, Eleni

    2016-01-01

    informed. In this paper I investigate one specific type of response particle, the German change-of-state token ‘aha’ and how it is used by a teacher in the classroom with prelingually deafened and cochlear-implanted children. ‘Aha’ has been documented to display surprise, thus indicating that an utterance...... has informed the speaker and marking an epistemic shift from that of –K (not knowing) to + K (knowing) of the producer. Based on 60 storytellings of children with cochlear-implants I show that the teacher in fact uses ‘aha’ for two purposes: firstly, as a demonstration of news receipt after unknown...... information within the story and secondly, as a tool to acknowledge the child’s effort to improve his/her language production. I conclude with a summary of the findings, discussing the implications the teacher’s differentiated use of ‘aha’ may have for the children and their acquisition of interactional...

  1. Mandarin Chinese Tone Recognition with an Artificial Neural Network

    Institute of Scientific and Technical Information of China (English)

    XU Li; ZHANG Wenle; ZHOU Ning; LEE Chaoyang; LI Yongxin; CHEN Xiuwu; ZHAO Xiaoyan

    2006-01-01

    Mandarin Chinese tone patterns vary in one of the four ways, i.e, (1) high level; (2) rising; (3) low falling and rising; and (4) high falling. The present study is to examine the efficacy of an artificial neural network in recognizing these tone patterns. Speech data were recorded from 12 children (3-6 years of age) and 15 adults. All subjects were native Mandarin Chinese speakers. The fundamental frequencies (FO) of each monosyllabic word of the speech data were extracted with an autocorrelation method. The pitch data(i.e., the FO contours) were the inputs to a feed-forward backpropagation artificial neural network. The number of inputs to the neural network varied from 1 to 16 and the hidden layer of the network contained neurons that varied from 1 to 16 in number. The output of the network consisted of four neurons representing the four tone patterns of Mandarin Chinese. After being trained with the Levenberg-Marquardt optimization, the neural network was able to successfully classify the tone patterns with an accuracy of about 90% correct for speech samples from both adults and children. The artificial neural network may provide an objective and effective way of assessing tone production in prelingually-deafened children who have received cochlear implants.

  2. Patient empowerment

    DEFF Research Database (Denmark)

    Eskildsen, Nanna Bjerg; Joergensen, Clara Ruebner; Thomsen, Thora Grothe

    2017-01-01

    assessing empowerment from the user perspective. The aim of this review was to identify questionnaires and subscales measuring empowerment and manifestations of empowerment among cancer patients. MATERIALS AND METHODS: We conducted a systematic search of the PubMed, PsycINFO and CINAHL databases......BACKGROUND: There is an increased attention to and demand for patient empowerment in cancer treatment and follow-up programs. Patient empowerment has been defined as feeling in control of or having mastery in relation to cancer and cancer care. This calls for properly developed questionnaires....... Empowerment and multiple search terms associated with empowerment were included. We included peer-reviewed articles published in English, which described questionnaires measuring empowerment or manifestations of empowerment in a cancer setting. In addition, the questionnaire had to be a patient...

  3. chemotherapy patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Augustyniuk

    2016-02-01

    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.

  4. chemotherapy patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Augustyniuk

    2016-02-01

    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.

  5. "To silence the deafening silence": Survivor's needs and experiences of the impact of disaster radio for their recovery after a natural disaster.

    Science.gov (United States)

    Hugelius, Karin; Gifford, Mervyn; Ortenwall, Per; Adolfsson, Annsofie

    2016-09-01

    In the aftermath of the Haiyan typhoon, disaster radio was used to spread information and music to the affected population. The study described survivors' experiences of being in the immediate aftermath of a natural disaster and the impact disaster radio made on recovery from the perspective of the individuals affected. Twenty eight survivors were interviewed in focus groups and individual interviews analyzed with phenomenological-hermeneutic method. Being in disaster mode included physical and psychosocial dimensions of being in the immediate aftermath of the disaster. Several needs among the survivors were expressed. Disaster radio contributed to recovery by providing facts and information that helped the survivor to understand and adapt. The music played contributed to emotional endurance and reduced feelings of loneliness. To re-establish social contacts, other interventions are needed. Disaster radio is a positive contribution to the promotion of survivors' recovery after disasters involving a large number of affected people and severely damaged infrastructure. Further studies on the use and impact of disaster radio are needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. 语后聋Nucleus人工耳蜗使用者的声调识别%Tone recognition in post-lingual deafened Nucleus cochlear recipients

    Institute of Scientific and Technical Information of China (English)

    郑振宇; 曹克利; 魏朝刚; 邢奋丽; 王轶; 金昕

    2004-01-01

    目的评估语后聋Nucleus人工耳蜗使用者的普通话声调识别水平,探讨其影响因素.方法应用材料及北京协和医院耳蜗中心自编材料,评估14例语后聋Nucleus人工耳蜗使用者的普通话声调识别能力,其中使用Nucleus 24型Sprint产品ACE方案者11例,Nucleus 2 2型MSP产品MPEAK方案者3例.结果所有植入者的普通话声调识别率均高于机会水平,其中2例Nucleus 24型Sprint产品使用者可达到100%.结论Nucleus人工耳蜗语后聋使用者可以获得较好的普通话声调识别,Nucleus 24型Sprint产品可为部分植入者提供充分的声调信息.

  7. Screening of GJB2 mutations in Chinese population

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The GJB2 gene (connexin 26) has been shown to be responsible for DFNB1 and DFNA3. We screened the GJB2 gene in 488 patients with prelingual deafness (Group 1 ), 124 with postlingual deafness(Group 2), and 117 normal hearing subjects (Group 3). We found that, in Group 1, 65 patients (13.32%) were homozygotes or compound heterozygotes and 51 patients (10.45%) carried a single pathogenic mutation. The 235delC mutation was the most frequent mutation, accounting for 73.22% of the known pathogenic alleles in Group 1. No homozygotes or compound heterozygotes were detected in Group 2 or Group 3. Some postlingual deaf patients (2.42%) and normal hearing subjects (4.27%) were 235delC carriers. Our preliminary data indicate that 235delC, the most frequent mutation identified in this study, is a major cause for prelingual deafness.

  8. [Long-latency auditory evoked potentials in cochlear implants].

    Science.gov (United States)

    Mata, J J; Jiménez, J M; Pérez, J; Postigo, A; Roldán, B

    1999-01-01

    Cortical evoked potentials were evaluated in patients with cochlear implants. In a group of 8 adults of different ages, the lingual state before implantation and during rehabilitation were evaluated. Using cortical evoked potentials, the results of the P300 wave in response to two tones, one frequent (1,000 Hz) and the other infrequent (2,000 Hz), presented at 70 and 80 dB HL were studied. Results were analyzed and compared in relation to locutive state, rehabilitation stage, and intensity of stimulus. Absolute latencies did not differ significantly. However, latency values in relation to reaction time were significantly longer in prelingual than in postlingual patients (p test). The results confirmed the normality of central cognitive processes in patients with cochlear implants in objective assessment of P300 latency. The results suggest differences between prelingual and postlingual patients in relation to central signal processing.

  9. Patient life

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    2004-01-01

    , treatment, and staff members will be attended to. A specific focus on contrasting experiences is made in order to enhance a better understanding of patients' interactions. Methods: I explore patients' social interactions in their day-to-day lives in two adult surgical units at a University Hospital......-interviews. The material will consist of field-notes, interviews, and audio-video recordings of interactions between patients. The material will be analysed with inspiration from Mattingly's ideas of narrative, drawing on the work of Ricoeur's term of emplotment developed through considering the narrative structures...... of fiction and history. Especially her way of bringing the term emplotment directly into the area of social action, I find inspiring. Conclusions:The study is ongoing. Yet it is not clear in what perspectives the findings will be interpreted, but age, body, gender, time and space might be relevant. More...

  10. Patient safety

    African Journals Online (AJOL)

    406 CME Nov/Dec 2012 Vol. 30 No. 11 ... The message remains the same: around 10% of all patients ... error rates in healthcare in South Africa, no real data exist. ... so as technology progresses. The medical .... top priority and they will include it in planning and .... Reason J. Managing the risks of organisational accidents.

  11. diabetic patients

    Directory of Open Access Journals (Sweden)

    Mehraban Falahati

    2016-09-01

    candiduria and female gender, high FBS and urine glucose, uncontrolled diabetes (HbA1c ≥8, and acidic urine pH (P<0.05. Conclusion: Considering the high incidence rate of candiduria in diabetic patients, control of diabetes, predisposing factors, and causal relationships between diabetes and candiduria should be highlighted.

  12. [Patient advice].

    Science.gov (United States)

    Lucio-Villegas Menéndez, M Eulalia; González, Laura López; Gutiérrez Pérez, M Isabel; Lluch, Natalia Aresté; Morató Agustí, M Luisa; Cachafeiro, Santiago Pérez

    2014-05-01

    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. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  13. Deafness: Cross-modal plasticity and cochlear implants

    Science.gov (United States)

    Lee, Dong Soo; Lee, Jae Sung; Oh, Seung Ha; Kim, Seok-Ki; Kim, Jeung-Whoon; Chung, June-Key; Lee, Myung Chul; Kim, Chong Sun

    2001-01-01

    Hearing in profoundly deaf people can be helped by inserting an implant into the inner ear to stimulate the cochlear nerve. This also boosts the low metabolic activity of the auditory cortex, the region of the brain normally used for hearing. Other sensory modalities, such as sign language, can also activate the auditory cortex, a phenomenon known as cross-modal plasticity. Here we show that when metabolism in the auditory cortex of prelingually deaf children (whose hearing was lost before they learned to talk) has been restored by cross-modal plasticity, the auditory cortex can no longer respond to signals from a cochlear implant installed afterwards. Neural substrates in the auditory cortex might therefore be routed permanently to other cognitive processes in prelingually deaf patients.

  14. Patients' preferences for patient-centered communication

    DEFF Research Database (Denmark)

    Lau, Sofie Rosenlund; Christensen, Søren Troels; Andreasen T., Jesper

    2013-01-01

    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....

  15. First Language Acquisition Differs from Second Language Acquisition in Prelingually Deaf Signers: Evidence from Sensitivity to Grammaticality Judgement in British Sign Language

    Science.gov (United States)

    Cormier, Kearsy; Schembri, Adam; Vinson, David; Orfanidou, Eleni

    2012-01-01

    Age of acquisition (AoA) effects have been used to support the notion of a critical period for first language acquisition. In this study, we examine AoA effects in deaf British Sign Language (BSL) users via a grammaticality judgment task. When English reading performance and nonverbal IQ are factored out, results show that accuracy of…

  16. First language acquisition differs from second language acquisition in prelingually deaf signers: Evidence from sensitivity to grammaticality judgement in British Sign Language

    Science.gov (United States)

    Cormier, Kearsy; Schembri, Adam; Vinson, David; Orfanidou, Eleni

    2012-01-01

    Age of acquisition (AoA) effects have been used to support the notion of a critical period for first language acquisition. In this study, we examine AoA effects in deaf British Sign Language (BSL) users via a grammaticality judgment task. When English reading performance and nonverbal IQ are factored out, results show that accuracy of grammaticality judgement decreases as AoA increases, until around age 8, thus showing the unique effect of AoA on grammatical judgement in early learners. No such effects were found in those who acquired BSL after age 8. These late learners appear to have first language proficiency in English instead, which may have been used to scaffold learning of BSL as a second language later in life. PMID:22578601

  17. Cochlear implantation (CI) for prelingual deafness: the relevance of studies of brain organization and the role of first language acquisition in considering outcome success.

    Science.gov (United States)

    Campbell, Ruth; MacSweeney, Mairéad; Woll, Bencie

    2014-01-01

    Cochlear implantation (CI) for profound congenital hearing impairment, while often successful in restoring hearing to the deaf child, does not always result in effective speech processing. Exposure to non-auditory signals during the pre-implantation period is widely held to be responsible for such failures. Here, we question the inference that such exposure irreparably distorts the function of auditory cortex, negatively impacting the efficacy of CI. Animal studies suggest that in congenital early deafness there is a disconnection between (disordered) activation in primary auditory cortex (A1) and activation in secondary auditory cortex (A2). In humans, one factor contributing to this functional decoupling is assumed to be abnormal activation of A1 by visual projections-including exposure to sign language. In this paper we show that that this abnormal activation of A1 does not routinely occur, while A2 functions effectively supramodally and multimodally to deliver spoken language irrespective of hearing status. What, then, is responsible for poor outcomes for some individuals with CI and for apparent abnormalities in cortical organization in these people? Since infancy is a critical period for the acquisition of language, deaf children born to hearing parents are at risk of developing inefficient neural structures to support skilled language processing. A sign language, acquired by a deaf child as a first language in a signing environment, is cortically organized like a heard spoken language in terms of specialization of the dominant perisylvian system. However, very few deaf children are exposed to sign language in early infancy. Moreover, no studies to date have examined sign language proficiency in relation to cortical organization in individuals with CI. Given the paucity of such relevant findings, we suggest that the best guarantee of good language outcome after CI is the establishment of a secure first language pre-implant-however that may be achieved, and whatever the success of auditory restoration.

  18. First language acquisition differs from second language acquisition in prelingually deaf signers: evidence from sensitivity to grammaticality judgement in British Sign Language.

    Science.gov (United States)

    Cormier, Kearsy; Schembri, Adam; Vinson, David; Orfanidou, Eleni

    2012-07-01

    Age of acquisition (AoA) effects have been used to support the notion of a critical period for first language acquisition. In this study, we examine AoA effects in deaf British Sign Language (BSL) users via a grammaticality judgment task. When English reading performance and nonverbal IQ are factored out, results show that accuracy of grammaticality judgement decreases as AoA increases, until around age 8, thus showing the unique effect of AoA on grammatical judgement in early learners. No such effects were found in those who acquired BSL after age 8. These late learners appear to have first language proficiency in English instead, which may have been used to scaffold learning of BSL as a second language later in life. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Cochlear Implantation (CI for prelingual deafness: the relevance of studies of brain organization and the role of first language acquisition in considering outcome success.

    Directory of Open Access Journals (Sweden)

    Ruth eCampbell

    2014-10-01

    Full Text Available Cochlear implantation (CI for profound congenital hearing impairment, while often successful in restoring hearing to the deaf child, does not always result in effective speech processing. Exposure to non-auditory signals during the pre-implantation period is widely held to be responsible for such failures. Here, we question the inference that such exposure irreparably distorts the function of auditory cortex, negatively impacting the efficacy of cochlear implantation. Animal studies suggest that in congenital early deafness there is a disconnection between (disordered activation in primary auditory cortex (A1 and activation in secondary auditory cortex (A2. In humans, one factor contributing to this functional decoupling is assumed to be abnormal activation of A1 by visual projections – including exposure to sign language. In this paper we show that that this abnormal activation of A1 does not routinely occur, while A2 functions effectively supramodally and multimodally to deliver spoken language irrespective of hearing status. What, then, is responsible for poor outcomes for some individuals with CI and for apparent abnormalities in cortical organization in these people? Since infancy is a critical period for the acquisition of language, deaf children born to hearing parents are at risk of developing inefficient neural structures to support skilled language processing. A sign language, acquired by a deaf child as a first language in a signing environment, is cortically organized like a heard spoken language in terms of specialization of the dominant perisylvian system. However, very few deaf children are exposed to sign language in early infancy. Moreover, no studies to date have examined sign language proficiency in relation to cortical organization in individuals with CI. Given the paucity of such relevant findings, we suggest that the best guarantee of good language outcome after CI is the establishment of a secure first language pre-implant – however tha

  20. First Language Acquisition Differs from Second Language Acquisition in Prelingually Deaf Signers: Evidence from Sensitivity to Grammaticality Judgement in British Sign Language

    Science.gov (United States)

    Cormier, Kearsy; Schembri, Adam; Vinson, David; Orfanidou, Eleni

    2012-01-01

    Age of acquisition (AoA) effects have been used to support the notion of a critical period for first language acquisition. In this study, we examine AoA effects in deaf British Sign Language (BSL) users via a grammaticality judgment task. When English reading performance and nonverbal IQ are factored out, results show that accuracy of…

  1. A comparison of vowel productions in prelingually deaf children using cochlear implants, severe hearing-impaired children using conventional hearing aids and normal-hearing children.

    Science.gov (United States)

    Baudonck, Nele; Van Lierde, K; Dhooge, I; Corthals, P

    2011-01-01

    The purpose of this study was to compare vowel productions by deaf cochlear implant (CI) children, hearing-impaired hearing aid (HA) children and normal-hearing (NH) children. 73 children [mean age: 9;14 years (years;months)] participated: 40 deaf CI children, 34 moderately to profoundly hearing-impaired HA children and 42 NH children. For the 3 corner vowels [a], [i] and [u], F(1), F(2) and the intrasubject SD were measured using the Praat software. Spectral separation between these vowel formants and vowel space were calculated. The significant effects in the CI group all pertain to a higher intrasubject variability in formant values, whereas the significant effects in the HA group all pertain to lower formant values. Both hearing-impaired subgroups showed a tendency toward greater intervowel distances and vowel space. Several subtle deviations in the vowel production of deaf CI children and hearing-impaired HA children could be established, using a well-defined acoustic analysis. CI children as well as HA children in this study tended to overarticulate, which hypothetically can be explained by a lack of auditory feedback and an attempt to compensate it by proprioceptive feedback during articulatory maneuvers. Copyright © 2010 S. Karger AG, Basel.

  2. Patient notes

    Directory of Open Access Journals (Sweden)

    Pádraig Ó Tuama

    2017-05-01

    Full Text Available Here’s the thing. While I have my asthma under control and my sleeping is no worse than usual, I am still near the uaigh. That’s the word for grave in Irish, and it’s also part of the word for loneliness. I’m near one or the other, or both. There was a time when my health was the only thing I talked about, and my friends from that time ask me now, and I remember that that was the person I was; when health was a fear, because pain was my first language. But what’s really bothering me is the way I use the possessive when it comes to my asthma, my insomnia, my thinning hair, my symptoms. It makes me think I think I am these things. Am I? I wilt therefore I am? If they are me, where will I go if I lose them? I remember when I learned the word ontology – the study of the nature of being. If I am sad, is sad me? If sad is me then what happens when someone treats my sadness? If we were all speaking Irish we would say that sadness is on me. But we’re not. Because when I was five I asked where English came from and my parents introduced me to stair. If we all spoke Irish we would say stair instead of history. But we speak English, mostly, and so stair is relegated to something we use to get up or down, never a story. Did you know that I carry my people’s history in my bones? People didn’t believe me when I said that but then scientists wrote about it, and discovered what was already there — inherited in the blood, the bones, the DNA, the genomes, the chromosomes, like thinning curly hair, like weak lungs, like poetry, like insomnia — and it’s all the rage now, that codified stairstory inside us. Once when I was waiting on a trolley I kept on trying to get up even though I knew I’d fall down. So they put an orderly to mind me. Well, he was there to restrain me, but I didn’t mind. He was young and eager to be seen to be good with patients. I asked him how long his shift had been and he said it was his first. After a bit of this

  3. Achieving patient satisfaction: resolving patient complaints.

    Science.gov (United States)

    Oxler, K F

    1997-07-01

    Patients demand to be active participants on and partners with the health care team to design their care regimen. Patients bring unique perceptions and expectations and use these to evaluate service quality and satisfaction. If customer satisfaction is not achieved and a patient complaint results, staff must have the skills to respond and launch a service recovery program. Service recovery, when done with style and panache, can retain loyal customers. Achieving patient satisfaction and resolving patient complaints require commitment from top leadership and commitment from providers to dedicate the time to understand their patients' needs.

  4. Spatial channel interactions in cochlear implants

    Science.gov (United States)

    Tang, Qing; Benítez, Raul; Zeng, Fan-Gang

    2011-08-01

    The modern multi-channel cochlear implant is widely considered to be the most successful neural prosthesis owing to its ability to restore partial hearing to post-lingually deafened adults and to allow essentially normal language development in pre-lingually deafened children. However, the implant performance varies greatly in individuals and is still limited in background noise, tonal language understanding, and music perception. One main cause for the individual variability and the limited performance in cochlear implants is spatial channel interaction from the stimulating electrodes to the auditory nerve and brain. Here we systematically examined spatial channel interactions at the physical, physiological, and perceptual levels in the same five modern cochlear implant subjects. The physical interaction was examined using an electric field imaging technique, which measured the voltage distribution as a function of the electrode position in the cochlea in response to the stimulation of a single electrode. The physiological interaction was examined by recording electrically evoked compound action potentials as a function of the electrode position in response to the stimulation of the same single electrode position. The perceptual interactions were characterized by changes in detection threshold as well as loudness summation in response to in-phase or out-of-phase dual-electrode stimulation. To minimize potentially confounding effects of temporal factors on spatial channel interactions, stimulus rates were limited to 100 Hz or less in all measurements. Several quantitative channel interaction indexes were developed to define and compare the width, slope and symmetry of the spatial excitation patterns derived from these physical, physiological and perceptual measures. The electric field imaging data revealed a broad but uniformly asymmetrical intracochlear electric field pattern, with the apical side producing a wider half-width and shallower slope than the basal

  5. Pharmacist-Patient Interaction and Patient Expectations

    Science.gov (United States)

    DeSimone, Edward M.; And Others

    1977-01-01

    The nature of the professional interaction between the pharmacist and the patient was explored, with data collected from 3,743 questions asked of 16 pharmacists during an 8-week period. Factors that might affect the nature of the pharmacist-patient interaction are identified along with a cognitive-based profile of patient wants. (LBH)

  6. Patient Treatment Tracking Chart

    Science.gov (United States)

    ... ZIP code here Hepatitis C Treatment Tracking Chart Patient Treatment Tracking Chart Patient Treatment Tracking Chart Sample Chart This chart is ... this website Submit Share this page Related Resource Patient Treatment Tutorial return to top CONNECT Veterans Crisis ...

  7. Patient Assessment File (PAF)

    Data.gov (United States)

    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...

  8. [Patient education in France].

    Science.gov (United States)

    Bertrand, Dominique

    2011-10-01

    Patient education is an increasingly important component of therapeutic strategies, especially for chronic illnesses, which currently affect about 12% of the French population and will undoubtedly increase in coming years. Patient education aims to enhance patients' personal responsibility and participation in their therapeutic management and quality of life. Article 84 of French health legislation passed in 2009 inscribes patient education in the Public Health Code for the first time. It distinguishes personalized therapeutic education, patient accompaniment, and learning programs. Direct links between patients and drug companies are prohibited. However, the notion of patient accompaniment remains to be defined, along with the evaluation of patient education, funding sources and practical modalities.

  9. Transfer Out Patient Not Abandon The Patient

    Directory of Open Access Journals (Sweden)

    Deepak Gupta

    2015-12-01

    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

  10. 'Patient satisfaction' in hospitalized cancer patients.

    Science.gov (United States)

    Skarstein, Jon; Dahl, Alv A; Laading, Jacob; Fosså, Sophie D

    2002-01-01

    Predictors of 'patient satisfaction' with hospitalization at a specialized cancer hospital in Norway are examined in this study. Two weeks after their last hospitalization, 2021 consecutive cancer patients were invited to rate their satisfaction with hospitalization, quality of life, anxiety and depression. Compliance rate was 72% (n = 1453). Cut-off levels separating dissatisfied from satisfied patients were defined. It was found that 92% of the patients were satisfied with their stay in hospital, independent of cancer type and number of previous admissions. Performance of nurses and physicians, level of information perceived, outcome of health status, reception at the hospital and anxiety independently predicted 'patient satisfaction'. The model explained 35% of the variance with an area under the curve of 0.76 of the Receiver Operator Curve. Cancer patients' satisfaction with their hospital stay was high, and predicted by four independently predictive variables related to the performance of caregivers. These suggest areas for further improvement in the healthcare service.

  11. Patient hand hygiene practices in surgical patients.

    Science.gov (United States)

    Ardizzone, Laura L; Smolowitz, Janice; Kline, Nancy; Thom, Bridgette; Larson, Elaine L

    2013-06-01

    Little is known about the hand hygiene practices of surgical patients. Most of the research has been directed at the health care worker, and this may discount the role that hand hygiene of the surgical patient might play in surgical site infections. A quasiexperimental, pretest/post-test study was conducted in which patients (n = 72) and nurses (n = 42) were interviewed to examine perceptions and knowledge about patient hand hygiene. Concurrently, observations were conducted to determine whether surgical patients were offered assistance by the nursing staff. Following an initial observation period, nursing staff received an educational session regarding general hand hygiene information and observation results. One month after the education session, patient/nurse dyads were observed for an additional 6 weeks to determine the impact of the educational intervention. Eighty observations, 72 patient interviews, and 42 nurse interviews were completed preintervention, and 83 observations were completed postintervention. In response to the survey, more than half of patients (n = 41, 55%) reported that they were not offered the opportunity to clean their hands, but a majority of the nursing staff reported (n = 25, 60%) that they offered patients the opportunity to clean their hands. Prior to the educational intervention, nursing staff assisted patients in 14 of 81 hand hygiene opportunities. Following the intervention, nursing staff assisted patients 37 out of 83 opportunities (17.3% vs 44.6%, respectively, [χ(2)1 = 13.008, P = .0003]). This study suggests that efforts to increase hand hygiene should be directed toward patients as well as health care workers. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  12. Dentist-Patient Relationship

    Directory of Open Access Journals (Sweden)

    Gheorghe Raftu

    2016-01-01

    In the dentist-patient relationship confidence comes from the assurance that personal information(belonging to the patient will remain confidential; this is in the interest of the patient and the patient'sautonomy is recognized. There were presented several behavioral types which can lead to a physicianpatientrelationship, based on trust.

  13. Displacing the Patient

    DEFF Research Database (Denmark)

    Pors, Anja Svejgaard

    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...

  14. Patient-centred Prevention among PAD Patients

    DEFF Research Database (Denmark)

    Pii, Kathrine Hoffmann

    2014-01-01

    -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 patient-centred approach does not ensure patient autonomy, but continues to be organized according to biomedical regimes and thereby carry on a paternalistic approach. In this paper, I present findings from a PhD project, which investigates how the ideal of patient-centredness is practiced in the case...... as a relational property/entity, which implies that professionals intervene in the development of patients’ autonomy by expanding their capacity to make and actualize choices. The dilemma regarding the concern to ensure patient autonomy and still wanting patients to make the “right” choices is not one...

  15. Mucormycosis in trauma patients.

    Science.gov (United States)

    Cocanour, C S; Miller-Crotchett, P; Reed, R L; Johnson, P C; Fischer, R P

    1992-01-01

    Cutaneous mucormycosis is a rare but often fatal infection in trauma patients. We retrospectively reviewed a 9-year experience with mucormycosis among injured patients. Eleven patients had biopsy- or culture-proven mucormycosis. Nine patients were victims of blunt trauma, two patients had burns measuring greater than 50% TBSA. No patient was at increased risk because of underlying disease or immunosuppression prior to injury. All 11 patients had open wounds on admission. Four patients died of mucormycosis. All nonsurvivors had phycomycotic gangrenous cellulitis of the head, the trunk, or both. In contrast, survivors had involvement of only the extremities. Because of underlying disease, contaminating wounds, antibiotic use, or immunocompromise secondary to shock and sepsis, trauma patients are at risk of developing mucormycosis. To successfully treat mucormycosis, diagnosis must be prompt and accompanied by aggressive debridement and parenteral administration of amphotericin B.

  16. Comparison of speech perception performance between Sprint/Esprit 3G and Freedom processors in children implanted with nucleus cochlear implants.

    Science.gov (United States)

    Santarelli, Rosamaria; Magnavita, Vincenzo; De Filippi, Roberta; Ventura, Laura; Genovese, Elisabetta; Arslan, Edoardo

    2009-04-01

    To compare speech perception performance in children fitted with previous generation Nucleus sound processor, Sprint or Esprit 3G, and the Freedom, the most recently released system from the Cochlear Corporation that features a larger input dynamic range. Prospective intrasubject comparative study. University Medical Center. Seventeen prelingually deafened children who had received the Nucleus 24 cochlear implant and used the Sprint or Esprit 3G sound processor. Cochlear implantation with Cochlear device. Speech perception was evaluated at baseline (Sprint, n = 11; Esprit 3G, n = 6) and after 1 month's experience with the Freedom sound processor. Identification and recognition of disyllabic words and identification of vowels were performed via recorded voice in quiet (70 dB [A]), in the presence of background noise at various levels of signal-to-noise ratio (+10, +5, 0, -5) and at a soft presentation level (60 dB [A]). Consonant identification and recognition of disyllabic words, trisyllabic words, and sentences were evaluated in live voice. Frequency discrimination was measured in a subset of subjects (n = 5) by using an adaptive, 3-interval, 3-alternative, forced-choice procedure. Identification of disyllabic words administered at a soft presentation level showed a significant increase when switching to the Freedom compared with the previously worn processor in children using the Sprint or Esprit 3G. Identification and recognition of disyllabic words in the presence of background noise as well as consonant identification and sentence recognition increased significantly for the Freedom compared with the previously worn device only in children fitted with the Sprint. Frequency discrimination was significantly better when switching to the Freedom compared with the previously worn processor. Serial comparisons revealed that that speech perception performance evaluated in children aged 5 to 15 years was superior with the Freedom than previous generations of Nucleus

  17. Environmental sounds recognition in children with cochlear implants.

    Directory of Open Access Journals (Sweden)

    Shu-Yu Liu

    Full Text Available The aims of this study were (1 to document the recognition performance of environmental sounds (ESs in Mandarin-speaking children with cochlear implants (CIs and to analyze the possible associated factors with the ESs recognition; (2 to examine the relationship between perception of ESs and receptive vocabulary level; and (3 to explore the acoustic factors relevant to perceptual outcomes of daily ESs in pediatric CI users. Forty-seven prelingually deafened children between ages 4 to 10 years participated in this study. They were divided into pre-school (group A: age 4-6 and school-age (group B: age 7 to 10 groups. Sound Effects Recognition Test (SERT and the Chinese version of the revised Peabody Picture Vocabulary Test (PPVT-R were used to assess the auditory perception ability. The average correct percentage of SERT was 61.2% in the preschool group and 72.3% in the older group. There was no significant difference between the two groups. The ESs recognition performance of children with CIs was poorer than that of their hearing peers (90% in average. No correlation existed between ESs recognition and receptive vocabulary comprehension. Two predictive factors: pre-implantation residual hearing and duration of CI usage were found to be associated with recognition performance of daily-encountered ESs. Acoustically, sounds with distinct temporal patterning were easier to identify for children with CIs. In conclusion, we have demonstrated that ESs recognition is not easy for children with CIs and a low correlation existed between linguistic sounds and ESs recognition in these subjects. Recognition ability of ESs in children with CIs can only be achieved by natural exposure to daily-encountered auditory stimuli if sounds other than speech stimuli were less emphasized in routine verbal/oral habilitation program. Therefore, task-specific measures other than speech materials can be helpful to capture the full profile of auditory perceptual progress after

  18. Neuroplasticity of sign language: implications from structural and functional brain imaging.

    Science.gov (United States)

    Meyer, Martin; Toepel, Ulrike; Keller, Joerg; Nussbaumer, Daniela; Zysset, Stefan; Friederici, Angela D

    2007-01-01

    The present study was designed to investigate the neural correlates of German Sign Language (Deutsche Gebärdensprache; DGS) processing. In particular, was expected the impact of the visuo-spatial mode in sign language on underlying neural networks compared to the impact of the interpretation of linguistic information. For this purpose, two groups of participants took part in a functional MRI study at 3 Tesla. One group consisted of prelingually deafened users of DGS, the other group of hearing non-signers naïve to sign language. The two groups were presented with identical video sequences comprising DGS sentences in form of dialoges. To account for substantial interindividual anatomical variability observed in the group of deaf participants, the brain responses in the two groups of subjects were analyzed with two different procedures. Results from a multi-subject averaging approach were contrasted with an analysis, which can account for the considerable inter-individual variability of gross anatomical landmarks. The anatomy-based approach indicated that individuals' responses to proper DGS processing was tied up with a leftward asymmetry in the dorsolateral prefrontal cortex, anterior and middle temporal gyrus, and visual association cortices. In contrast, standard multi-subject averaging of deaf individuals during DGS perception revealed a less lateralized peri- and extrasylvian network. Furthermore, voxel-based analyses of the brains' morphometry evidenced a white-matter deficit in the left posterior longitudinal and inferior uncinate fasciculi and a steeper slope of the posterior part of the left Sylvian Fissure (SF) in the deaf individuals. These findings may imply that the cerebral anatomy of deaf individuals has undergone structural changes as a function of monomodal visual sign language perception during childhood and adolescence.

  19. [The application of artificial neural network on the assessment of lexical tone production of pediatric cochlear implant users].

    Science.gov (United States)

    Mao, Y T; Chen, Z M; Xu, L

    2017-08-07

    Objective: The present study was carried out to explore the tone production ability of the Mandarin-speaking children with cochlear implants (CI) by using an artificial neural network model and to examine the potential contributing factors underlining their tone production performance. The results of this study might provide useful guidelines for post-operative rehabilitation processes of pediatric CI users. Methods: Two hundred and seventy-eight prelingually deafened children who received unilateral CI participated in this study. As controls, 170 similarly-aged children with normal hearing (NH) were recruited. A total of 36 Chinese monosyllabic words were selected as the tone production targets. Vocal production samples were recorded and the fundamental frequency (F0) contour of each syllable was extracted using an auto-correlation algorithm followed by manual correction. An artificial neural network was created in MATLAB to classify the tone production. The relationships between tone production and several demographic factors were evaluated. Results: Pediatric CI users produced Mandarin tones much less accurately than did the NH children (58.8% vs. 91.5% correct). Tremendous variability in tone production performance existed among the CI children. Tones 2 and 3 were produced less accurately than tones 1 and 4 for both groups. For the CI group, all tones when in error tended to be judged as tone 1. The tone production accuracy was negatively correlated with age at implantation and positively correlated with CI use duration with correlation coefficients (r) of -0.215 (P=0.003) and 0.203 (P=0.005), respectively. Age was one of the determinants of tonal ability for NH children. Conclusions: For children with severe to profound hearing loss, early implantation and persistent use of CI are beneficial to their tone production development. Artificial neural network is a convenient and reliable assessment tool for the development of tonal ability of hearing

  20. The participatory patient

    DEFF Research Database (Denmark)

    Andersen, Tariq Osman

    2010-01-01

    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...... between a patient¿s work on the project as a co-designer and his work of being a patient using a prototype. I conclude by arguing for the importance of being aware of the ways in which patients inscribe patient work and non-work and thinking of what kind of working or non-working patients it implies....

  1. Displacing the patient

    DEFF Research Database (Denmark)

    Pors, Anja Svejgaard

    2012-01-01

    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...

  2. Patient Safety Culture

    DEFF Research Database (Denmark)

    Kristensen, Solvejg

    of health care professional’s behaviour, habits, norms, values, and basic assumptions related to patient care; it is the way things are done. The patient safety culture guides the motivation, commitment to and know-how of the safety management, and how all members of a work place interact. This thesis......Patient safety is highly prioritised in the Danish health care system, never the less, patients are still exposed to risk and harmed every day. Implementation of a patient safety culture has been suggested an effective mean to protect patients against adverse events. Working strategically...... with assessment and development of the patient safety culture is in early days in Denmark. It depends upon valid, reliable and effective methods. The patient safety culture represents a wide range of social phenomena permeating the way of life in a health care. In essence, the safety culture is an aggregation...

  3. National Patient Safety Foundation

    Science.gov (United States)

    ... Donate Help Contact Home Creating a world where patients and those who care for them are free ... News Member Testimonials Lifetime Members Stand Up for Patient Safety Welcome Stand Up Members Stand Up e- ...

  4. Patient life in hospital

    DEFF Research Database (Denmark)

    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....... 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...

  5. Can "patient keeper" help in-patients?

    Science.gov (United States)

    Al-Hinnawi, M F

    2009-06-01

    The aim of this paper is to present our "Patient Keeper" application, which is a client-server medical application. "Patient Keeper" is designed to run on a mobile phone for the client application and on a PC for the server application using J2ME and JAVA2, respectively. This application can help doctors during visits to their patients in hospitals. The client application allows doctors to store on their mobile phones the results of their diagnoses and findings such as temperature, blood pressure, medications, analysis, etc., and send this information to the server via short message service (SMS) for storage in a database. The server can also respond to any request from the client and send the result via Bluetooth, infrared, or over the air. Experimental results showed a significant improvement of the healthcare delivery and reduction for in-patient stay.

  6. A good patient?

    DEFF Research Database (Denmark)

    Campbell, Catherine; Scott, Kerry; Skovdal, Morten

    2015-01-01

    Background: While patient-provider interactions are commonly understood as mutually constructed relationships,the role of patient behaviour, participation in interactions, and characteristics, particularly ideals surrounding notionsof ‘good’ and ‘bad’ patients, are under-examined. This article ex...

  7. Learning from patients

    DEFF Research Database (Denmark)

    Henriksen, Ann-Helen; Ringsted, Charlotte

    2011-01-01

    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...

  8. HYPERTENSION IN PSYCHIATRIC PATIENTS

    OpenAIRE

    Chaturvedi, Santosh K.; Michael, Albert

    1986-01-01

    SUMMARY Known cases of hypertension and those fulfilling WHO criteria for diagnosis of hypertension were identified in psychiatric patients and compared with non - hypertensive psychiatric patients. Hypertension was detected in 141 (9.98%) cases, and was significantly more associated with elder age, married status, urban background and neurotic illness. The implications are in early detection and effective management of hypertension in psychiatric patients.

  9. Learning from patients

    DEFF Research Database (Denmark)

    Henriksen, Ann-Helen; Ringsted, Charlotte

    2011-01-01

    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...

  10. Patient Delay in Colorectal Cancer Patients

    DEFF Research Database (Denmark)

    Pedersen, Anette Fischer; Hansen, Rikke P; Vedsted, Peter

    2013-01-01

    , at patienter med kolorektal¬kræft, som har oplevet blødning fra endetarmen, har længere forsinkelser i forløbet (39 dage) end patienter, som ikke har haft dette symptom (15 dage). Tidligere studier har tolket det som et tegn på, at patienter med rektal blødning regner med, at blødningen skyldes godartede...... lidelser. Dette studie finder som noget nyt, at mange patienter med rektal blødning har tænkt mere over kræft i perioden op til første lægebesøg end patienter uden dette symptom. En forkert tolkning af symptomet er altså ikke den eneste forklaring på forsinkelserne i forløbet for denne patientgruppe....... Fundene i studiet åbner for den mulighed, at forsinkelserne hos nogle patienter kan skyldes bekymring for, hvad lægen vil finde, og at de derfor tøver med at konsultere lægen. Denne tøven kan hænge sammen med følelses¬mæssige barrierer, fx at patienten er flov over symptomerne eller frygter forestående...

  11. Patient blood management equals patient safety.

    Science.gov (United States)

    Zacharowski, Kai; Spahn, Donat R

    2016-06-01

    Patient blood management (PBM) can be defined in many ways and may consist of hundreds of single measures to improve patient safety. Traditionally, PBM is based on three pillars and defined as (i) optimization of the endogenous red blood cell (RBC) mass through the targeted stimulation of erythropoiesis and the treatment of modifiable underlying disorders; (ii) minimization of diagnostic, interventional, and surgical blood loss to preserve the patient's RBC mass; and (iii) optimization of the patient-specific tolerance to anemia through strict adherence to physiological transfusion thresholds [1-4]. However, for this review, we have chosen the following three peri-interventional parts: (1) diagnosis and therapy of anemia, (2) optimal hemotherapy, and (3) minimization of hospital-acquired anemia. PBM is an evidence-based, multidisciplinary preventive, and therapeutic approach focusing each patient. The PBM concept involves the use of safe and effective medical and surgical methods and techniques designed to prevent peri-interventional anemia, rationalize use of blood products, and set good blood management measures in an effort to improve patient safety and outcome.

  12. Does patient satisfaction affect patient loyalty?

    Science.gov (United States)

    Kessler, Daniel P; Mylod, Deirdre

    2011-01-01

    This paper aims to investigate how patient satisfaction affects propensity to return, i.e. loyalty. Data from 678 hospitals were matched using three sources. Patient satisfaction data were obtained from Press Ganey Associates, a leading survey firm; process-based quality measures and hospital characteristics (such as ownership and teaching status) and geographic areas were obtained from the Centers for Medicare and Medicaid Services. The frequency with which end-of-life patients return to seek treatment at the same hospital was obtained from the Dartmouth Atlas. The study uses regression analysis to estimate satisfaction's effects on patient loyalty, while holding process-based quality measures and hospital and market characteristics constant. There is a statistically significant link between satisfaction and loyalty. Although satisfaction's effect overall is relatively small, contentment with certain hospitalization experience may be important. The link between satisfaction and loyalty is weaker for high-satisfaction hospitals, consistent with other studies in the marketing literature. RESEARCH LIMITATION/IMPLICATIONS: The US hospitals analyzed are not a random sample; the results are most applicable to large, non-profit teaching hospitals in competitive markets. Satisfaction ratings have business implications for healthcare providers and may be useful as a management tool for private and public purchasers. The paper is the first to show that patient satisfaction affects actual hospital choices in a large sample. Because patient satisfaction ratings are also correlated with other quality measures, the findings suggest a pathway through which individuals naturally gravitate toward higher-quality care.

  13. Patient-centered Care.

    Science.gov (United States)

    Reynolds, April

    2009-01-01

    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).

  14. Patient-centered professionalism

    Directory of Open Access Journals (Sweden)

    Rapport F

    2012-03-01

    Full Text Available Hayley A Hutchings, Frances RapportCollege of Medicine, Swansea University, Swansea, Wales, United KingdomIntroduction: Although the concept of patient-centered professionalism has been defined in the literature and adopted to some extent by key health care regulatory bodies, there has been little research that has identified what the concept means to professionals and patients.Aim: The purpose of this paper is to identify the key concepts of patient-centered professionalism as identified in the literature and to discuss these within the context of existing research across a variety of health care settings.Findings: Key documents have been identified from within nursing, medicine, and pharmacy, which outline what is expected of professionals within these professional groups according to their working practices. Although not defined as patient-centered professionalism, the principles outlined in these documents mirror the definitions of patient-centered professional care defined by Irvine and the Picker Institute and are remarkably similar across the three professions. While patients are identified as being at the heart of health care and professional working practice, research within the fields of community nursing and community pharmacy suggests that patient and professional views diverge as regards what is important, according to different group agendas. In addition, the delivery of patient-centered professional care is often difficult to achieve, due to numerous challenges to the provision of patient-centric care.Conclusion: According to the literature, patient-centered professionalism means putting the patient at the heart of care delivery and working in partnership with the patient to ensure patients are well informed and their care choices are respected. However, limited research has examined what the concept means to patients and health care professionals working with patients and how this fits with literature definitions. Further work is

  15. Depression in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Beyhan Bag

    2014-06-01

    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

  16. Prehospital transported patients

    DEFF Research Database (Denmark)

    Bech, Camilla Louise Nørgaard; Brabrand, M.; Lassen, Annmarie Touborg

    2015-01-01

    Introduction The survival of patients transported by ambulance to the emergency department (ED) depends on clinical conditions, patient-related factors and organisational prehospital set up. Data and information concerning patients in the prehospital system could form a valuable resource for asse......Introduction The survival of patients transported by ambulance to the emergency department (ED) depends on clinical conditions, patient-related factors and organisational prehospital set up. Data and information concerning patients in the prehospital system could form a valuable resource......-time ambulance transport to the ED at Odense University Hospital in the period 1 April 2012 to 30 September 2013. Ambulance personnel recorded vital signs and other clinical findings on a structured form on paper during the ambulance transport. Each contact was linked to information from population...

  17. Music for Hemodialysis patients

    DEFF Research Database (Denmark)

    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...

  18. Music for Hemodialysis patients

    DEFF Research Database (Denmark)

    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...

  19. Patient-doctor communication.

    Science.gov (United States)

    Teutsch, Carol

    2003-09-01

    Communication is an important component of patient care. Traditionally, communication in medical school curricula was incorporated informally as part of rounds and faculty feedback, but without a specific or intense focus on skills of communicating per se. The reliability and consistency of this teaching method left gaps, which are currently getting increased attention from medical schools and accreditation organizations. There is also increased interest in researching patient-doctor communication and recognizing the need to teach and measure this specific clinical skill. In 1999, the Accreditation of Council for Graduate Medical Education implemented a requirement for accreditation for residency programs that focuses on "interpersonal and communications skills that result in effective information exchange and teaming with patients, their families, and other health professionals." The National Board of Medical Examiners, Federation of State Medical Boards. and the Educational Commission for Foreign Medical Graduates have proposed an examination between the. third and fourth year of medical school that "requires students to demonstrate they can gather information from patients, perform a physical examination, and communicate their findings to patients and colleagues" using standardized patients. One's efficiency and effectiveness in communication can be improved through training, but it is unlikely that any future advances will negate the need and value of compassionate and empathetic two-way communication between clinician and patient. The published literature also expresses belief in the essential role of communication. "It has long been recognized that difficulties in the effective delivery of health care can arise from problems in communication between patient and provider rather than from any failing in the technical aspects of medical care. Improvements in provider-patient communication can have beneficial effects on health outcomes". A systematic review of

  20. Displacing the patient

    DEFF Research Database (Denmark)

    Pors, Anja Svejgaard

    2014-01-01

    Over the past decade, patient communication has become a strategic priority in Danish public hospitals: communication is a focal point of policies, plans and daily work practices. Hospitals today create communication strategies and build communication departments to improve communication with pat...... conditions. Care and market appear to be intertwined in political patient figures through which the hospital is trying to manage the patient as well as to transform itself from within.......Over the past decade, patient communication has become a strategic priority in Danish public hospitals: communication is a focal point of policies, plans and daily work practices. Hospitals today create communication strategies and build communication departments to improve communication...... with patients. However, in the existing studies of strategic communication in the hospital sector, the patient’s role in the organizational work has yet to be explored. This paper draws on a major case study of a communication programme entitled 'The Perspective of the Patient', conducted at a public hospital...

  1. Den moderne patient

    DEFF Research Database (Denmark)

    Lassen, Trine

    2012-01-01

    Kapitlet indkredser, hvordan vi som sundhedsprofessionelle kan forklare den moderne patient. I særdeleshed lægges vægt på definerende faktorer i skabelsen af den patient vi møder i sundhedsvæsnet i dag. Kapitlet giver forskellige teoretiske bud på, hvordan man som sundhedsprofessionel kan anskue...... den moderne, nutidige patienter samt en kortere beskrivelse af, hvordan patienten tidligere er blev anskuet....

  2. [Therapeutic patient education revisited].

    Science.gov (United States)

    Ruiz, Juan

    2014-06-04

    The therapeutic patient education is an absolute necessity in the management of chronic diseases including diabetes. This discipline promotes personal autonomy to live optimally, to achieve personal and professional projects, despite the constraints of the disease and treatments. The DAWN2 study demonstrates the systemic effects of this disease that goes beyond simple glycemic control. The biopsychosocial dimension needs to be better explored. Other assessment tools should be used to better manage these patients. Exploring the health literacy and numeracy are other tools that can explore the problems for socially disadvantaged patients. The main goal is development of patient capabilities and his environment for the development of the human person.

  3. [Impressibility of schizophrenic patients].

    Science.gov (United States)

    Bazhin, E F; Korneva, T V; Lomachenkov, A S

    1978-01-01

    The authors studied the abilities to identify emotional states according to the acustico-phonetical symptoms of speech in 160 schizophrenic patients and 80 normals. These studies were performed with the aid of a specially elaborated tape recorder test. It was established that difficulties in accomplishing these tasks were found in schizophrenic patients with paranoid symptomatology. Patients with other clinical states, including sufficiently expressed specific disturbances in the emotional sphere, extremely subtly differentiated the emotional state of the announcers. These data are considered as proof of preserved impressive abilities in the majority of schizophrenic patients. The significance of these factors for the organization of psychosocial influences are discussed.

  4. Anesthesia for geriatric patients.

    Science.gov (United States)

    Deiner, S; Silverstein, J H

    2011-02-01

    The number of elderly surgical patients will be increasing in Italy. Slowly, anesthesiologists are developing the expertise to care for these patients. The information available to apply to these cases is now the topic of a number of anesthesia textbooks dedicated to the elderly. In this article, we review some of the more recent findings and provide some tips to help guide the care of elderly patients. It is hoped that practitioners will use this information to improve the care of these patients and conduct additional research to further improve care in the future.

  5. Withholding truth from patients.

    LENUS (Irish Health Repository)

    O'Sullivan, Elizabeth

    2012-01-31

    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.

  6. Patient life in hospital

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    basic tool for emplotting the encounters between patients with the message that we are in an awaiting position and obliged to stay here for a while is a specific set of behaviours that patients perform. The emplotment of waiting is communicated as a frame within which minor plots appear. These plots...

  7. Excluding the typical patient

    DEFF Research Database (Denmark)

    Odlaug, Brian Lawrence; Weinhandl, Eric; Mancebo, Maria C

    2014-01-01

    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...

  8. Effective communication with patients.

    Science.gov (United States)

    Klein, Evelyn R

    2005-09-01

    This brief article aims at heightening awareness about communication with various patients, including strategies to assist in improving communicative effectiveness. It assists us as health care professionals to go back to basics and reflect on how we communicate. Several researchers have provided insight into ways that communication may be enhanced. Walter, Bundy, and Donan (2005) suggested personally greeting the patient, introducing oneself, engaging in talk about clinical concerns, and then discussing next steps toward healthcare solutions. Schillinger (2003) implored that health related jargon be avoided and that all messages be clear and simple. Illustrations in the form of black-white line drawn pictures also tend to assist in patient comprehension. Lawton and Carroll (2005) suggested that effective communication requires assessing what the patient knows about their illness. Seidel's model (2004) stated that healthcare providers listen to the patient's story and elicit information through questioning with sufficient time allotted to provide answers. He also discussed the importance of providing a short summary of what the patient conveyed and giving additional information so they learn more about what is happening to them and can become an active participant in making decisions. It is important that patients understand what we as healthcare professionals say to them. Wisner (1999) further conveyed that it is not words alone that communicate. Body language, facial expressions, and tone of voice often provide additional clues influencing communicative effectiveness. Without a doubt, communication, directly impacts service delivery and quality of care in healthcare today. Listen to your patients, they have much to say.

  9. Lejringsskader hos rygopererede patienter

    DEFF Research Database (Denmark)

    Sestoft, Bodil; Larsen, Birgit; Erlandsen, Mogens;

    2009-01-01

    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 par...

  10. Excluding the typical patient

    DEFF Research Database (Denmark)

    Odlaug, Brian Lawrence; Weinhandl, Eric; Mancebo, Maria C

    2014-01-01

    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...

  11. [Anesthesiologist: the patient's perception].

    Science.gov (United States)

    Ribeiro, Carolina Sobrinho; Mourão, Joana Irene de Barros

    2015-01-01

    Anesthesia is still a major concern for patients, although the anesthetic complications have decreased significantly. Additionally, the role assigned to the anesthesiologist remains inaccurate. The aim of this study was to evaluate the concerns with anesthesia and assess the patient's knowledge about the anesthesiologist's duties. Prospective study conducted over three months with patients in the preoperative anesthetic visit in a university hospital. Demographic information about the level of education and prior anesthesia was obtained. The knowledge of patients regarding the anesthesiologists' education was evaluated. Patients' concerns and anesthesiologist and surgeon responsibilities were classified with a 5-point scale. The analysis was performed with SPSS 21, and pAnestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Anesthesiologist: the patient's perception.

    Science.gov (United States)

    Ribeiro, Carolina Sobrinho; Mourão, Joana Irene de Barros

    2015-01-01

    Anesthesia is still a major concern for patients, although the anesthetic complications have decreased significantly. Additionally, the role assigned to the anesthesiologist remains inaccurate. The aim of this study was to evaluate the concerns with anesthesia and assess the patient's knowledge about the anesthesiologist's duties. Prospective study conducted over three months with patients in the preoperative anesthetic visit in a university hospital. Demographic information about the level of education and prior anesthesia was obtained. The knowledge of patients regarding the anesthesiologists' education was evaluated. Patients' concerns and anesthesiologist and surgeon responsibilities were classified with a 5-point scale. The analysis was performed with SPSS 21, and pAnestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  13. A good patient?

    DEFF Research Database (Denmark)

    Campbell, Catherine; Scott, Kerry; Skovdal, Morten;

    2015-01-01

    Background: While patient-provider interactions are commonly understood as mutually constructed relationships,the role of patient behaviour, participation in interactions, and characteristics, particularly ideals surrounding notionsof ‘good’ and ‘bad’ patients, are under-examined. This article...... examines social representations of ‘a good patient’and how these representations affect patient-healthcare provider relationships and antiretroviral treatment (ART) forpeople living with HIV. Methods: Using thematic network analysis, we examined interview and focus group transcripts involving 25healthcare...... staff, 48 ART users, and 31 carers of HIV positive children, as well as field notes from over 100 h ofethnographic observation at health centres in rural Zimbabwe. Results: Characteristics of a good patient include obedience, patience, politeness, listening, enthusiasm fortreatment, intelligence...

  14. The right patient.

    Science.gov (United States)

    Howrigon, Ron

    2012-01-01

    This article offers professional opinions and advice on how physicians should prepare in order to protect themselves and their practices during this turbulent time in healthcare reform. This article presents real-life scenarios to help physicians understand what they may face and what actions they should take in anticipation of the future in healthcare. The article focuses on the concept of "the right patient," defining the characteristics of patients that benefit the financial aspect of a practice and those who do not. Its purpose is not to encourage physicians to deny care to patients who are poorly insured or uninsured, but to guide in the establishment of a smart and safe balance between the two. Strategies are discussed on how to attract the right patient and what these patients mean to the practice. The importance of practice marketing is also highlighted, along with an emphasis on the necessity of change in order to survive in the future healthcare environment.

  15. [Physiotherapy of cancer patients].

    Science.gov (United States)

    Gomez, Izabella; Szekanecz, Éva; Szekanecz, Zoltán; Bender, Tamás

    2016-07-01

    Physiotherapy of cancer patients is one of the most controversial issues in our country. Malignant diseases are firstly mentioned as a contraindication of physiotherapy. Until now, physiotherapy was not suggested (or only in limited accessibility) for those patients who had malignant disease in medical history. International medical practice was less restrictive in managing this topic. The development of imaging techniques put this question in a new light. On the basis of evidence, the majority of articles have reported beneficial effects of physiotherapy in cancer patients, and only few articles mentioned it as harmful. Of course, each patient requires an individual assessment, however, if we exclude the possibility of tumor recurrence and metastasis, most of physiotherapy procedures can be used safely. One of the aims of this review is to support the physicians' decisions when to prescribe treatments, in such a way, that more patients could receive physiotherapy. Orv. Hetil., 2016, 157(31), 1224-1231.

  16. Nutrition of burned patients.

    Science.gov (United States)

    Gudaviciene, Daiva; Rimdeika, Rytis; Adamonis, Kestutis

    2004-01-01

    Burns form 5-12% of all traumas. About 2,200 of patients are annually hospitalized in Lithuania. In most cases people of the employable age get burned. The treatment is often long-lasting, and afterwards recovered patients often have invalidity from burn sequels. The mortality of hospitalized burned patients is about 10%. The most common causes of death are pulmonary edema, pneumonia, sepsis and multiorgan failure. All these complications are related with insufficient nutrition. These complications are extremely frequent and dangerous for patients with more than 20% of body burned. The nutritional support of burned patient gives a possibility to increase the survival probability, to decrease complication rate and hospitalization time. Currently in Lithuania there are no standards for burned patient nutrition. More attention is given to strategy of surgical strategy and techniques, as well as antibiotic therapy. This article is the review of the different aspects of artificial nutrition of burned patient: indications, modes of nutrition, mixtures and terms of nutritional support.

  17. Anesthesiologist: the patient's perception

    Directory of Open Access Journals (Sweden)

    Carolina Sobrinho Ribeiro

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES: Anesthesia is still a major concern for patients, although the anesthetic complications have decreased significantly. Additionally, the role assigned to the anesthesiologist remains inaccurate. The aim of this study was to evaluate the concerns with anesthesia and assess the patient's knowledge about the anesthesiologist's duties. METHODS: Prospective study conducted over three months with patients in the preoperative anesthetic visit in a university hospital. Demographic information about the level of education and prior anesthesia was obtained. The knowledge of patients regarding the anesthesiologists' education was evaluated. Patients' concerns and anesthesiologist and surgeon responsibilities were classified with a 5-point scale. The analysis was performed with SPSS 21, and p < 0.05 was considered statistically significant. RESULTS: We included 204 patients, and 135 (66.2% recognized the anesthesiologist as a specialist physician. Not waking up after surgery and postoperative infection were the main concerns compared to all others (p < 0.05. Women expressed more concern than men about not waking up after surgery, nausea and postoperative vomiting, medical problems, and waking up during surgery (p < 0.05. Ensure that patients do not wake up during surgery was the anesthesiologist task most recognized, compared to all other (p < 0.05. The surgeon was more recognized (p < 0.05 than the anesthesiologist in post-operative, antibiotics administration, and blood transfusions pain management. CONCLUSIONS: Patients need to be informed about the current safety of anesthesia and the anesthesiologist's functions. The patient involvement will demystify some fears and reassure the confidence in the health system.

  18. Constructions of the patient in healthcare communications: six patient figures.

    Science.gov (United States)

    Pors, Anja Svejgaard

    2016-01-01

    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. 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. 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. 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.

  19. The patient with ataxia.

    Science.gov (United States)

    Maggs, F G

    2014-01-01

    In this article we look at the causes of ataxia, and how the patient presenting with ataxia should be managed. One of the difficulties in managing the patient with ataxia is that acute ataxia has many causes, but usually these can be teased out by means of a careful history and examination. Investigations can then be targeted at confirming or disproving the differential diagnosis. Some patients with ataxia need to be managed in hospital, but many can be investigated, and receive therapy, as an outpatient.

  20. Acknowledging the back patient

    DEFF Research Database (Denmark)

    Damsgaard, Janne Brammer; Bastrup Jørgensen, Lene; Norlyk, Annelise

    #296 Acknowledging The Back Patient. A Thematic Synthesis Of Qualitative Research. A Systematic Literature Review. Janne Brammer Damsgaard1, Lene Bastrup Jørgensen1, Annelise Norlyk2, Regner Birkelund3 1. Health, Section for Nursing, Aarhus University & Research Unit, Elective Surgery Centre......, Silkeborg Regional Hospital, Regional Hospital Central Jutland, Silkeborg, Denmark 2. Health, Section for Nursing, Aarhus University, Aarhus, Denmark 3. University of Southern Denmark & Vejle Sygehus, Vejle, Denmark keywords:Back Patient, Narrative, Biomedical, Marginalisation, Self-Identity, Ethical...... to gain a better idea of the most ideal treatment process, it is important to first investigate what it feels like to be a back patient and what patients consider important when dealing with the healthcare system. It is the aim of this qualitative literature review based on thematic synthesis to shed more...

  1. Nurse-patient collaboration

    DEFF Research Database (Denmark)

    Sørensen, Dorthe; Frederiksen, Kirsten; Groefte, Thorbjoern

    2013-01-01

    at three intensive care units and one general respiratory ward in Denmark. Results: Succeeding emerged as the nurses’ main concern in the nurse-patient collaboration during non-invasive ventilation treatment. Four collaborative typologies emerged as processing their main concern: (1) twofold oriented......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...

  2. Nigerian obstetric patients

    African Journals Online (AJOL)

    combination of Mallampati and Thyro-mental distance had values of ... difficult tracheal intubation is not precisely known but failed ... predictive values in a sample of Nigeria Obstetric Patients. ... the mentum to the thyroid notch was measured.

  3. The patient's perspective

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Backer, Vibeke; Søes-Petersen, Ulrik

    2006-01-01

    Adherence with controller therapy poses a major challenge to the effective management of persistent asthma. The aim of this study was to explore the patient-related aspects of adherence among adult asthmatics....

  4. USU Patient Simulation Center

    Data.gov (United States)

    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.,...

  5. Patient survey (HCAHPS) - State

    Data.gov (United States)

    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...

  6. IMPROVING PATIENT SAFETY:

    DEFF Research Database (Denmark)

    Bagger, Bettan; Taylor Kelly, Hélène; Hørdam, Britta

    2013-01-01

    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...... errors. An interesting finding though is that despite the legal requirements concerning the mandatory reporting of all clinical errors, 37% of the students participating in this study report that they perhaps would be reluctant to report an eventual clinical error. Further initiatives are thus necessary...

  7. Nurse–patient collaboration

    DEFF Research Database (Denmark)

    Sørensen, Dorthe; Frederiksen, Kirsten; Grøfte, Thorbjørn;

    2013-01-01

    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...... at three intensive care units and one general respiratory ward in Denmark. Results: Succeeding emerged as the nurses’ main concern in the nurse-patient collaboration during non-invasive ventilation treatment. Four collaborative typologies emerged as processing their main concern: (1) twofold oriented...

  8. Patient Advocate Foundation

    Science.gov (United States)

    ... Resources CoPay Resources Healthcare Reform Prevention View Resource Click here to submit a resource Subscribe Copyright © 2012 Patient Advocate Foundation Headquarters: 421 Butler Farm Road, Hampton, VA 23666 Phone: (800) 532-5274 - ...

  9. Optimizing patient nutrition

    DEFF Research Database (Denmark)

    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...

  10. Cirrhosis: A Patient's Guide

    Science.gov (United States)

    ... A Patient's Guide Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For Veterans and the Public Veterans and the Public Home Hepatitis A Hepatitis B Hepatitis C Hepatitis C Home Getting ...

  11. Doctors and patients.

    Science.gov (United States)

    Gillon, R

    1986-02-15

    Gillon outlines some prima facie moral duties of physicians to patients that have emerged from his previous articles in a series on philosophical medical ethics. These duties follow from four general ethical principles--respect for autonomy, beneficence, non-maleficence, and justice--plus the self-imposed supererogatory duty of medical beneficence. From these principles the author derives such duties as providing adequate information and advice on treatment options, encouraging patient participation leading to informed decisions, maintaining competence and exposing incompetence, admitting errors, disclosing personal medico-moral standards, and acknowledging that other interests may occasionally supersede those of the individual patient. Gillon concludes that, where self interest conflicts with medical beneficence, the claim of medicine as a profession requires that the patient's interests take priority.

  12. Woe patient is purple

    Directory of Open Access Journals (Sweden)

    Hatice Dogan

    2014-08-01

    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

  13. Sygepleje til trakeostomerede patienter

    DEFF Research Database (Denmark)

    Christensen, Dorthe Wiinholdt; Richard, René; Rydahl Hansen, Susan

    2016-01-01

    Der er ikke enighed om principperne bag plejen af trakeostomerede patienter, når de er i risiko for dysfagi og silent aspiration. Uenigheden har ført til udarbejdelse af en klinisk retningslinje med evidensbaserede anbefalinger....

  14. Inappropriate requests from patients

    African Journals Online (AJOL)

    injury. Some of these patients were vege- tative or severely neurologically damaged. Others were children — anencephalic infants, for example, or infants with anox- ic brain injury. On some ... represented an odd twist on the older debates ...

  15. Patient survey (ICH CAHPS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — In-Center Hemodialysis Facilites Patient evaluations from the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) Survey. The...

  16. Patient Treatment File (PTF)

    Data.gov (United States)

    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...

  17. Patient satisfaction constructs.

    Science.gov (United States)

    Rahman, Muhammad Sabbir; Osmangani, Aahad M

    2015-01-01

    The purpose of this paper is to examine the five-factor structure of patients' satisfaction constructs toward private healthcare service providers. This research is a cross-sectional study. A questionnaire-based survey was conducted with previous and current Bangladeshi patients. Exploratory factor analysis was employed to extract the underlying constructs. Five underlying dimensions that play a significant role in structuring the satisfaction perceived by Bangladeshi private healthcare patients are identified in this study. Practical implications - The main contribution of this study is identifying the dimensions of satisfaction perceived by Bangladeshi patients regarding private healthcare service providers. Healthcare managers adopt the five identified underlying construct items in their business practices to improve their respective healthcare efficiency while ensuring overall customer satisfaction.

  18. Optimizing patient nutrition

    DEFF Research Database (Denmark)

    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...

  19. Patient survey (HCAHPS) - National

    Data.gov (United States)

    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...

  20. Leadership for patient care.

    Science.gov (United States)

    Nackel, J G; Shelley, S R

    1991-01-01

    In an era of change in health-care delivery and, particularly, change in patient care, leadership is the cornerstone of change management. The environment of the 1990s will challenge even the most sophisticated and capable health-care executives. This paper discusses key aspects of leadership and models them to the patient-care setting. Leadership will be the differentiating factor as organizations seek competitive advantage.

  1. UAVs and Patient Movement

    Science.gov (United States)

    2016-04-01

    to mitigate hemorrhage, to optimize airway management , and to reduce the time interval between the point of injury and surgical intervention.72...depth look at the evolution of patient movement and the utilization of advanced technologies from to ultimately decrease the time to care. Future...with its employment for Class VII resupply (i.e., blood) and easily evolves toward full scale patient movement using advanced remote tele-monitoring

  2. The patient's perspective

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Backer, Vibeke; Søes-Petersen, Ulrik

    2006-01-01

    Adherence with controller therapy poses a major challenge to the effective management of persistent asthma. The aim of this study was to explore the patient-related aspects of adherence among adult asthmatics.......Adherence with controller therapy poses a major challenge to the effective management of persistent asthma. The aim of this study was to explore the patient-related aspects of adherence among adult asthmatics....

  3. Medical Services: Patient Administration

    Science.gov (United States)

    2007-11-02

    Family planning services a. Family planning services (for example, counseling, prescription of oral contraceptive pills , and prescription of other methods...of contraception ) may be furnished to eligible persons requesting such care at Army MTFs. They will be provided to the extent that professional...table 2–2, table 2–3 Comfort items for patients, 4–3 Commercial transportation or travel, 2–6, 9–9 Consent by nonmilitary patient, 2–12 Contraception , 2

  4. Keeping the patient happy.

    Science.gov (United States)

    Bomar, F

    1992-01-01

    Customer service is the catch word for the 90s and hospitals are constantly looking for ways to make their customer--the patient--happier. In a section of the country where fried chicken, grits and gravy are home-cooking staples, an unlikely marriage between Southern hospitals and a European food preparation process may be the key to many hospitals' ability to cater to the patient by offering gourmet meals on a regular basis.

  5. The effect of patient qualifications and number of patient accompanist on patient's satisfaction

    OpenAIRE

    Korkmaz, Tanzer; Balaban, Burcin; Onder, Husnu; Saricil, Fusun

    2016-01-01

    Objectives Patient satisfaction surveys are important information sources for the evaluation of the quality and continuity of medical care. In this study, it is aimed to investigate the impact of patient's qualifications and the number of patient accompanists on the patient satisfaction and to find out whether there is a relationship between the number of patient accompanist and discharge status of patient. Methods All patients over 18 years old who have applied to emergency department within...

  6. Tuberculosis in HIV Patient

    Directory of Open Access Journals (Sweden)

    Bidhan Nidhi Paudel

    2013-09-01

    Full Text Available Introduction: Strict monitoring of anti tuberculosis therapy (ATT and antiretroviral therapy (ART is crucial for proper management of TB/HIV co-infected patients. Methods: Between December 2006 and December 2008 a prospective observational study was conducted among 135 TB/HIV co-infected patients visiting antiretroviral therapy in Seti Zonal Hospital, Dhangadi. The diagnosed TB patients were subjected to ATT through directly observed treatment short-course (DOTS and its response was evaluated as per WHO guidelines. Results: Among 135 studied subjects, 71.9% were males and over 88 % of the patients were in the age group 21 to 50. Of the Total TB cases 68.1% presented pulmonary TB (PTB and 37.20% of the Extra-pulmonary Tuberculosis (EPTB cases were lymph node TB. 75.5% of them had completed ATT, 8.2% transfer out and 12.6% were default. Conclusions: Majority of the patients presented PTB, and lymph node TB was found to be the most common EPTB. Comparatively, high efficacy of ATT was found in HIV patients visiting this resource poor setting. Key words: antiretroviral therapy; anti TB therapy; Dhangadi; lymph node T; treatment response.

  7. [Nutrition and cancer patients].

    Science.gov (United States)

    Katsuramaki, T; Hirata, K; Isobe, M

    1998-03-01

    Nutritional therapy for cancer patients includes various objectives such as improvement of cachexia, elucidation of the mechanism of malnutrition, development of therapy for anorexia, nutrition support during chemotherapy or radiotherapy, and inhibition of tumor growth under controlled caloric intake. This review describes recent remarkable developments in nutritional therapy for cancer patients. Cytokines such as interleukin (IL)-1, IL-6, and tumor necrosis factor which induce proteolysis and lipolysis are involved in the cause of malnutrition and cachexia in cancer patients. IL-1 also plays a significant role in the development of cancer anorexia via direct action in the brain. For anorexia therapy, progestogens have been shown to improve appetite and food intake in cancer patients. Moreover, glutamine supplementation improves the host protein metabolism without enhancement of tumor growth during chemotherapy. Among the effects of caloric intake on anticancer therapy, AO-90, a methionine-free intravenous amino acid solution, has been shown to increase the antitumor effect of 5-fluorouracil in clinical studies. From these observations, recent progress in nutritional therapy for cancer patients has been remarkable. Further study of nutritional therapy is required in order to maintain or improve the quality of life of cancer patients in the future.

  8. Evaluation of Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Ioana GĂDĂLEAN

    2011-12-01

    Full Text Available Introduction: Patient satisfaction is an element of psychological health which influence the results of the medical care and their impact. Patient experience can be quantified from their questioning or direct observation. Objectives: The purpose of this paper is to analyze and evaluate the satisfaction of nursing activities closely related to the patients admitted in ICU ward Institute of Oncology Prof. Dr. Ion Chiricuţă Cluj-Napoca. Materials and Methods: This paper describes a prospective study conducted on a sample of 106 patients hospitalized in the intensive care unit of the Institute of Oncology Prof. Dr. Ion Chiricuţă Cluj-Napoca in June 2011 - August 2011. The results were obtained using descriptive and analytical statistical technique of SPSS software. To detect relationships / associations between qualitative variables the Chi-Square test was used (statistically significant association if p ≤ 0.05. Patients received an anonymous questionnaire applied at 24 hours after discharge from the IT department so that the responses would be most sincerely. Results: Patients selected only two degrees of satisfaction, 53.8% very satisfied, respectively 46.2% satisfied. Dissatisfaction factors that may affect satisfaction were communication, accommodation facilities, factors arising from the lack of personal, pain and lack of sleep. Conclusions: Satisfaction “score” is influenced by education level and diagnosis. Resumption of the questionnaire is required periodically to assess the results of our section. It is also necessary to continue to compare results with other departments in the country.

  9. Patient loyalty model.

    Science.gov (United States)

    Sumaedi, Sik; Bakti, I Gede Mahatma Yuda; Rakhmawati, Tri; Astrini, Nidya Judhi; Yarmen, Medi; Widianti, Tri

    2015-07-06

    This study aims to investigate the simultaneous effect of subjective norm, perceived behavioral control and trust on patient loyalty. The empirical data were collected through survey. The respondents of the survey are 157 patients of a health-care service institution in Bogor, Indonesia. Multiple regressions analysis was performed to test the conceptual model and the proposed hypotheses. The findings showed that subjective norm and trust influence patient loyalty positively. However, this research also found that perceived behavioral control does not influence patient loyalty significantly. The survey was only conducted at one health-care service institution in Bogor, Indonesia. In addition, convenience sampling method was used. These conditions may cause that the research results can not be generalized to the other contexts. Therefore, replication research is needed to test the stability of the findings in the other contexts. Health-care service institutions need to pay attention to trust and subjective norm to establish patient loyalty. This study is believed to be the first to develop and test patient loyalty model that includes subjective norm, perceived behavioral control and trust.

  10. [Urosepsis in Geriatric Patients].

    Science.gov (United States)

    Heppner, H J; Yapan, F; Wiedemann, A

    2016-02-01

    Due to the demographic shift, increasing numbers of geriatric patients are admitted to acute care hospitals of all levels of care. This means that special challenges must be met in the medical care and management of these patients.Immunosenescence and multimorbidity make elderly patients vulnerable to infectious diseases. Urinary tract infections range from "simple" cystitis to pyelonephritis and urosepsis and, at 25%, are the second most common form of infection in geriatric patients. It is often difficult to make a diagnosis because typical symptoms do not always occur. Urosepsis, a hyperactive and uncontrolled immune response of the organism due to exogenous damage, is based on bacterial infection of the urogenital tract. Urinary retention, immunosuppressive medication, malignancy, diabetes mellitus and renal or prostatic processes promote the risk for urosepsis. Complicated urosepsis additionally comprises a structural or functional abnormality, including ureteral obstruction. Risk factors for urosepsis are urinary incontinence, an indwelling urinary catheter, hydronephrosis or ureteral calculi. Patients suffering from diabetes mellitus are also at a higher risk for urosepsis. When diagnosing elderly patients, one has to consider that the classic symptoms can be masked by multimorbidity, or septic encephalopathy and acute confusion (delirium) may be the only symptoms. Body temperature is lower in elderly patients and does not necessarily rise to 38°C or more in the acute phase. In patients older than 75 years who are suspicious for sepsis, temperatures as low as 37.4°C should be rated as fever. Treatment of urosepsis basically includes clearing the focus, antimicrobial treatment, stabilisation of circulation and replacement of failed organ functions. Initial empiric antibiotic treatment, depending on local resistance, should be done with acylaminopenicilline and beta-lactamase inhibitors (e. g. piperacillin/combactam or tazobactam or group 3 cephalosporins

  11. Pain in patients with cancer

    NARCIS (Netherlands)

    Vissers, K.C.P.; Besse, K.; Wagemans, M.; Zuurmond, W.; Giezeman, M.J.; Lataster, A.; Mekhail, N.; Burton, A.W.; Kleef, M. van; Huygen, F.

    2011-01-01

    Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients' quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate

  12. Preventing Infections in Cancer Patients

    Science.gov (United States)

    ... Caregivers Flu Treatment for Cancer Patients and Survivors Flu Publications Stay Informed Cancer Home Information for Patients and Caregivers Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Cancer patients ...

  13. Den digitale patient

    DEFF Research Database (Denmark)

    Dahl, Mads Ronald; birkler, jacob

    Den digitale patient tager afsæt i en ny verden: Patienten er blevet digitaliseret! Men hvem og hvad er den digitale patient, og hvornår og hvordan bliver den enkelte borger til en digital patient? Bogen indkredser patientens nye digitale identitet, som kan skabe grobund for en fælles forståelse og...... tværfagligt samarbejde mellem forskellige faggrupper. Bogens målgruppe er alle, som arbejder professionelt med sundhed og sundhedsvæsenet i Danmark. Det gælder på grunduddannelsesniveau, i forhold til efter- og videreuddannelse samt i klinisk praksis og blandt praktikere. Den digitale patient er skrevet ud...... fra et patientperspektiv, og ideen er at synliggørelse de mange udfordringer og konsekvenser, sundhedsinformatikken er svanger med. Bogen beskriver ikke blot den digitale patients fremtid, men fokuserer især på en række forhold og forbehold, der bør medtænkes, når nye elektroniske kommunikationsveje...

  14. The "Permanent" Patient Problem.

    Science.gov (United States)

    Bruce, Courtenay R; Majumder, Mary A

    2014-01-01

    Patients who enter the health care system for acute care may become "permanent" patients of the hospital when a lack of resources precludes discharge to the next level of post-acute care. Legal, professional, and ethical norms prohibit physician and acute care hospital "dumping" of these patients. However, limitless use of hospital resources for indefinite stays is untenable. In the absence of hospital policy addressing this specific issue, the availability of financial support will be determined by health care professionals' willingness to advocate for the patient and negotiate with hospital administrators and the ability and willingness of administrators to authorize the use of hospital resources. We propose five mid-level ethical principles to guide advocacy and administrative decision-making about provision of financial support for post-acute care for those patients who cannot afford it. We use two actual, de-identified cases to illustrate how these principles can be used to make reasoned, consistent decisions about the provision of post-acute financial support.

  15. Effect of auditory feedback on speech production after cochlear implantation

    Directory of Open Access Journals (Sweden)

    Sheikh Zadeh H

    2001-10-01

    Full Text Available The main goal of this study is to determine the auditory feedback effects in improvement of speech production process in prelingual totally deaf children who used cochlear implant prosthesis. For this reason, we recorded speech of four prelingual cochlear implant children pre and post of operation. Then we extract some static features of vowels-such as fundamental frequency, formant frequencies, vowel duration and vowel energy-from their stable mid-section and analyze them using a longitudinal prosthesis-on/off analysis. These patients-where are in the range of 7-13 years old-were operated in the cochlear implant clinic of Amiralam hospital. At each session, patients read the sentences once in device-on condition and then after 30 minutes stay in device-off condition. Quantitative results show that at least for the features under study, the patient's reliance on the auditory feedback decreased consistently by time (about 65%-averaged on all three vowels under study and all patients. So we concluded that after a sufficient time of operation, the speech motor patterns of patients will be trained for the correct production of static features of vowels and the relation of patients to auditory feedback for the production of such features considerably decreased by time.

  16. 人工耳蜗植入者对侧耳佩戴助听器的效果评价%Effectiveness evaluation of contralateral hearing aid for cochlear implant users

    Institute of Scientific and Technical Information of China (English)

    钱宇虹; 郭梦和

    2004-01-01

    背景:双耳聆听能够更好地进行声源定位,感受立体声,提高听阈5~10dB及增强噪声环境中的言语辨别能力.目的:探讨人工耳蜗植入者对侧耳佩戴助听器的意义和作用.设计:自身和相互对照研究.地点和对象:实验在第一军医大学珠江医院耳鼻咽喉科全军听力中心完成,对象为本科收治的语前聋患者6例,男4例,女2例,年龄7~18岁.方法:均为单耳使用Nucleus24人工耳蜗系统,采用ACE编码策略.于术后开机半年时在不同助听方式下(人工耳蜗+助听器和单独使用人工耳蜗)分别进行声场(啭音)测听、言语功能评估和问卷调查,将结果进行统计分析.主要观察指标:①两种助听方式下测试125,250,500,1 000,2 000,4 000和8 000 Hz的啭音听阈.②言语功能评估.③问卷调查.结果:人工耳蜗+助听器各频率听阈均值(18.89 Hz)较单独使用人工耳蜗声场(啭音)测试的各频率听阈均值(24.17 Hz)为低(t=4.647,P<0.01),频率特性好.50个常用词汇及音节复述得分,人工耳蜗+助听器平均86分,单用人工耳蜗平均84分,说明患者利用两种助听方式均能获得较好的聆听效果.问卷调查显示使用人工耳蜗+助听器比单独使用人工耳蜗在辨别方向,噪声环境中聆听具有更好的效果,但在安静环境下聆听,两者无明显差异.结论:使用人工耳蜗者对侧耳佩戴助听器有助于更好地聆听.%BACKGROUND: Binaural hearing can localize sound, perceive stereo,and help to improve auditory threshold by 5 - 10 dB and the ability to distinguish sounds in noisy environment.OBJECTIVE: To investigate the effects of contralateral hearing aid for cochlear implant users.DESIGN: Auto-control and mutual control study.SETTING and PARTICIPANTS: The experiment was conducted at the PLA Hlearing Center of Department of Otorhinolarynagology, Zhujiang Hospital, First Military Medical University. The subjects were 6 prelingually deafened patients (4 males

  17. Participating in patient education

    DEFF Research Database (Denmark)

    Kristiansen, Tine Mechlenborg; Antoft, Rasmus

    2015-01-01

    The paper builds on previous ethnographic research in Denmark focusing on the significance of participating in a locally developed patient education programme for everyday life (Kristiansen et.al. 2015). It presents a secondary analysis. Group based patient education can be understood as a health...... point is applied in order to illustrate two central status passages taking place at the locally developed patient education programme: 1) The status passage from novice to an experienced person with chronic illness, and 2) The transformation from adolescence to adulthood living with a chronic illness....... Related to both status passages we analyse how the central properties of status passage are at play and how they are shaped by the social interactions among the different agents: participants, lay experts and health professionals. We discuss how the theory of status passage might further enrich empirical...

  18. Patient Belief in Miracles

    DEFF Research Database (Denmark)

    Hvidt, Niels Christian

    2011-01-01

    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...... medical treatment on the basis of their belief in Divine intervention. On the other hand, faith in miracles forms an important part of a well-integrated religiosity by inspiring hope and so helping patients to find meaning and initiative in situations in which they might otherwise be tempted to give up....... Against the backdrop of such considerations, the chapter provides recommendations for health professionals and relatives as how to handle patient belief in miracles in practice....

  19. [Toxoplasmosis in immunocompromised patients].

    Science.gov (United States)

    Machala, L; Kodym, P; Malý, M; Geleneky, M; Beran, O; Jilich, D

    2015-06-01

    In humans, toxoplasmosis mostly occurs as a latent infection, but in immunocompromised individuals, the agent may reactivate and cause severe to life-threatening disease. HIV positive individuals and transplant recipients, in particular hematopoietic stem cell transplant and heart transplant recipients, are at highest risk. The disease most often affects the central nervous system but can involve any organ. Because of the alteration of the immune response in these patients, the serodiagnosis is not reliable and direct detection of the causative agent is needed--namely by microscopy and DNA PCR. If inadequately treated or left untreated, toxoplasmosis generally has a fatal prognosis in immunocompromised patients and therefore, the treatment must be started as early and energetically as possible. The gold standard both in the treatment of reactivation and secondary prophylaxis is the pyrimethamine-sulfadiazine combination while co-trimoxazole can be used in the primary prophylaxis for high-risk patients.

  20. IMPROVING PATIENT SAFETY:

    DEFF Research Database (Denmark)

    Bagger, Bettan; Taylor Kelly, Hélène; Hørdam, Britta

    2013-01-01

    , 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......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...... it possible for the students to train and test their knowledge and understanding independent of time and place. Data accumulated from the e-learning program will be used to further develop digital learning initiatives....

  1. Robotherapy with Dementia Patients

    Directory of Open Access Journals (Sweden)

    Francisco Martín

    2013-01-01

    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 application's impact on the patient's 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.

  2. The elderly patients' dignity

    DEFF Research Database (Denmark)

    Høy, Bente; Hall, E.O.C.; Wagner, L.

    2007-01-01

    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...

  3. Robotherapy with Dementia Patients

    Directory of Open Access Journals (Sweden)

    Francisco Martín

    2013-01-01

    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.

  4. Patient Belief in Miracles

    DEFF Research Database (Denmark)

    Hvidt, Niels Christian

    2011-01-01

    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...... medical treatment on the basis of their belief in Divine intervention. On the other hand, faith in miracles forms an important part of a well-integrated religiosity by inspiring hope and so helping patients to find meaning and initiative in situations in which they might otherwise be tempted to give up....... Against the backdrop of such considerations, the chapter provides recommendations for health professionals and relatives as how to handle patient belief in miracles in practice....

  5. Participating in patient education

    DEFF Research Database (Denmark)

    Kristiansen, Tine Mechlenborg; Antoft, Rasmus

    2015-01-01

    The paper builds on previous ethnographic research in Denmark focusing on the significance of participating in a locally developed patient education programme for everyday life (Kristiansen et.al. 2015). It presents a secondary analysis. Group based patient education can be understood as a health...... promoting initiative. It is set up to regularize and help people manage the status passage from being a normal person to becoming a person living with chronic illness and to support them in accepting and learning to live with this identity transition. The theory of status passage and the concept of turning...... point is applied in order to illustrate two central status passages taking place at the locally developed patient education programme: 1) The status passage from novice to an experienced person with chronic illness, and 2) The transformation from adolescence to adulthood living with a chronic illness...

  6. [Anesthesia for ambulatory patients].

    Science.gov (United States)

    Landauer, B

    1975-11-13

    The specific problems of outpatient anesthesia are discussed with respect to the patient's condition, the anesthesist's qualification and pharmacological properties of anesthetics used. Methohexitone seems to be the best choice for induction. Problems may arise from the use of Propanidid, Ketamin and Diazepam. Nitrousoxide and Enflurane are a suitable completion. Endotracheal intubation, if needed, is facilitated by Suxamethonium, which is rapidly eliminated. Practical aspects of timing, premedication, induction, maintenance and ending of anesthesia are pointed out. After 1-2 hours the patient can be allowed to leave the hospital accompanied by a responsible person. Driving a car is not recommended before 24 hours have elapsed since anesthesia.

  7. [Patients and the Web].

    Science.gov (United States)

    Cluzeau, T; Mounier, N

    2010-10-01

    In recent years, Internet has become an indispensable tool for all types of information. Its importance has increased in medicine and particularly in human malignancies. The data issued by the Internet are many and varied sources ranging from official websites to patient's blogs. HIV infection is an infection highly publicized in recent years, we take the case of Hodgkin's disease associated with HIV to compare data from the Internet and scientific articles. The information from the Internet is mostly good but not updated and erroneous data are regularly found. This confirms that the consultation by a specialist doctor referral should remain the main source of information for the patient.

  8. Practical Patient Safety

    CERN Document Server

    Reynard, John; Stevenson, Peter

    2009-01-01

    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

  9. Do patients initiate therapy?

    DEFF Research Database (Denmark)

    Thengilsdóttir, G; Pottegård, Anton; Linnet, K

    2015-01-01

    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 6.3% and 8...... 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...

  10. Sarcopenia in Cancer Patients.

    Science.gov (United States)

    Chindapasirt, Jarin

    2015-01-01

    Sarcopenia, characterized by a decline of skeletal muscle plus low muscle strength and/or physical performance, has emerged to be an important prognostic factor for advanced cancer patients. It is associated with poor performance status, toxicity from chemotherapy, and shorter time of tumor control. There is limited data about sarcopenia in cancer patients and associated factors. Moreover, the knowledge about the changes of muscle mass during chemotherapy and its impact to response and toxicity to chemotherapy is still lacking. This review aimed to provide understanding about sarcopenia and to emphasize its importance to cancer treatment.

  11. Patient Participation: Current Knowledge and Applicability to Patient Safety

    OpenAIRE

    Longtin, Yves; Sax, Hugo; Leape, Lucian L; Sheridan, Susan E.; Donaldson, Liam; Pittet, Didier

    2010-01-01

    Patient participation is increasingly recognized as a key component in the redesign of health care processes and is advocated as a means to improve patient safety. The concept has been successfully applied to various areas of patient care, such as decision making and the management of chronic diseases. We review the origins of patient participation, discuss the published evidence on its efficacy, and summarize the factors influencing its implementation. Patient-related factors, such as accept...

  12. Acknowledging the back patient

    DEFF Research Database (Denmark)

    Damsgaard, Janne Brammer; Bastrup, Lene; Norlyk, Annelise

    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...

  13. Fra Person til Patient

    DEFF Research Database (Denmark)

    Worsøe, Line Brink; Tordsson, Emma Mathilde

    2008-01-01

    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 special...

  14. [Healthcare patient loyalty].

    Science.gov (United States)

    Ameri, Cinzia; Fiorini, Fulvio

    2016-01-01

    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.

  15. Patient Telmonitoring at Home

    Science.gov (United States)

    2007-11-02

    dealing with cardiovascular variables . This is the case, as we have already pointed out, of diabetic patients during periods of dialysis. Another...1999. [2] J.P. Silva Cunha, M. Baptista, A. Ribeiro and A. Sousa Pereira. “Telecardio: especificação técnica e funcional do demonstrador de

  16. Acknowledging the back patient

    DEFF Research Database (Denmark)

    Damsgaard, Janne Brammer; Bastrup, Lene; Norlyk, Annelise;

    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...

  17. Patient management in dermoscopy

    Directory of Open Access Journals (Sweden)

    Işıl Kılınç Karaarslan

    2014-03-01

    Full Text Available Considering the work load in daily practice, it’s necessary to establish a cost-effective approach in the dermoscopic evaluation for early diagnose of melanoma, which is the primary goal of dermoscopy. In this article, the basic characteristics of “patient management strategy in dermoscopy”, which are necessary for such an approach, are discussed.

  18. Patient's Bill of Rights

    Science.gov (United States)

    ... in medical writing. Along with the American Cancer Society, other sources of information and support include: US Department of Health and Human Services Website: www.healthcare.gov/how-does-the-health-care-law-protect-me This site explains patient rights with ...

  19. Assemblages of Patient Safety

    DEFF Research Database (Denmark)

    Balatsas Lekkas, Angelos

    2016-01-01

    This thesis identifies how design processes emerge during the use of devices in healthcare, by attending to assemblages where contingencies of risk and harm co-exist with the contribution of healthcare professionals to the safe care of patients. With support from the field of Science and Technology...

  20. Cancer patients' evaluation of communication

    DEFF Research Database (Denmark)

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit

    2013-01-01

    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.......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....

  1. Improving patient education for patients with low literacy skills.

    Science.gov (United States)

    Mayeaux, E J; Murphy, P W; Arnold, C; Davis, T C; Jackson, R H; Sentell, T

    1996-01-01

    Patients who misunderstand their diagnosis and treatment plans usually exhibit poor compliance. The 90 million adult Americans with low literacy skills struggle to understand such essential health information as discharge instructions, consent forms, oral instructions and drug labels. The Joint Commission on Accreditation of Health Organizations (JCAHO) now requires that instructions be given on a level understandable to the patient. Most physicians tend to give too much information on too high a level for many patients to understand. Physicians who speak in simpler language, repeat their instructions and demonstrate key points, while avoiding too many directives, enhance their patients' understanding. Combining easy-to-read written patient education materials with oral instructions has been shown to greatly enhance patient understanding. To be effective with patients whose literacy skills are low, patient education materials should be short and simple, contain culturally sensitive graphics and encourage desired behavior. Compliance with therapy also may be improved by including family members in the patient education process.

  2. Activities Patients and Nurses Undertake to Promote Patient Participation.

    Science.gov (United States)

    Tobiano, Georgia; Marshall, Andrea; Bucknall, Tracey; Chaboyer, Wendy

    2016-07-01

    To describe and understand activities patients and nurses undertake to enact patient participation in nursing care. This observational study was conducted on two medical units at a public hospital in Australia. Twenty-eight nurse-patient dyads were observed for at least 4 hr. Data were collected from November 2013 to February 2014. Field notes were collected and were analyzed both inductively and deductively. Nurse-patient interactions promoted patient participation through dialogue and knowledge sharing. Less evident was patient involvement in planning or self-care. Nurses exerted control over patient care, which influenced the extent of patient participation. Patient participation appears to be difficult to enact. Nurses' controlling approach, influenced by organizational issues, was in conflict with a patient-centered approach to care. Nurse-patient communication is one aspect of patient-centered care enacted more frequently. Nurses may benefit from strategies at the individual and organizational level to enhance their patient-centered practices. Fostering nurses' communication may enhance patient-centered practices in hospitals. © 2016 Sigma Theta Tau International.

  3. Trauma patients: I can't get no (patient) satisfaction?

    Science.gov (United States)

    Bentley-Kumar, Karalyn; Jackson, Theresa; Holland, Danny; LeBlanc, Brian; Agrawal, Vaidehi; Truitt, Michael S

    2016-12-01

    The Centers for Medicare and Medicaid Services (CMS) provides financial incentives to hospitals based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey. This data is made publicly available on their website to be utilized by patients and insurers. Hospitals are profoundly interested in identifying patient populations that negatively contribute to overall patient satisfaction scores. Hospitals consider trauma patients "high risk" from a HCAHPS perspective, but there is no data to inform this opinion. The purpose of this study is to evaluate trauma patient satisfaction scores and their impact on overall patient satisfaction. Three different analyses were performed. Group 1 was composed of ALL patients admitted to our hospital over a 7-month period who were administered a validated patient satisfaction survey by a 3rd party and compared patient satisfaction of trauma vs. non-trauma patients (ALL). Group 2 compared admitted patients with a specific ICD-9 procedure code to non-trauma patients who underwent a procedure with the same ICD-9 code (ICD). Group 3 examines patient satisfaction between three Level I Trauma Centers within our geographic area (TC). Patient satisfaction data of trauma vs non-trauma patients (ALL), those with a specific ICD-9 procedure code (ICD), and the 3 Level I Trauma Centers in our area (TC) were analyzed with the appropriate statistical test. In the ALL group, no difference in satisfaction was noted in 18/21 questions for trauma patients when compared to non-trauma patients at our hospital. In the ICD group, 57 ICD-9 procedure codes were analyzed. Of these, only patients who required spinal fusion secondary to trauma reported lower overall patient satisfaction. No meaningful difference was found in HCAHPS associated satisfaction between the Level I Trauma Centers in our area (TC). In contrast to commonly held opinion, trauma patients do not negatively contribute to overall patient

  4. "Patient care in radiology"

    DEFF Research Database (Denmark)

    Bro Brask, Kirsten; Birkelund, Regner

    2014-01-01

    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...

  5. Handover of patients

    DEFF Research Database (Denmark)

    Jensen, S M; Lippert, A; Ostergaard, D

    2013-01-01

    Handover has major implications for patient care. The handover process between ambulance and emergency department (ED) staff has been sparsely investigated. The purpose of this paper is, based on a literature review, to identify and elaborate on the major factors influencing the ambulance to ED...... that implementing a structured handover format holds the possibilities for improving the process. Electronic equipment could play a part in reducing problems. Cultural and organizational factors impact the process in different ways. The professions perceive the value and quality of information given differently....... 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...

  6. Visualising patient flow.

    Science.gov (United States)

    Jensen, Andrew; Boyle, Justin; Khanna, Sankalp

    2012-01-01

    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.

  7. [Postoperative patient. Treatment plan].

    Science.gov (United States)

    López Medina, I M; Sánchez Criado, V

    2001-03-01

    In order to prevent problems and complications which patients who have undergone surgery tend to suffer, it is fundamental to utilize a generic standardized treatment plan due to the preventive dimension which nursing care may then acquire. So that this treatment plan provide greater effectiveness, it should include standardized nursing interventions such as those listed in the Classification of Nursing Interventions since by this method, a common terminology is built up among professionals which provides continuity to treatment and facilitates the selection of adequate interventions for each situation. This report establishes the most frequent nursing diagnoses among post-surgical patients and adapts these to the nursing treatments in the Classification of Nursing Interventions.

  8. "Patient care in radiology"

    DEFF Research Database (Denmark)

    Bro Brask, Kirsten; Birkelund, Regner

    2014-01-01

    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...... was electronically forwarded. And, care expressed in between was perceived as care in the traditional sense and termed as “patient care in radiology.”...

  9. Communicating with Latino patients.

    Science.gov (United States)

    de Pheils, Pilar Bernal; Saul, Naledi Marie

    2009-09-01

    This article describes the efforts of the University of California, San Francisco, School of Nursing to develop the Spanish language and cultural competency skills of advanced practice nursing students by establishing an elective course, Communicating with the Latino Patient. The need for this training is reflected in the literature, which has shown that language barriers decrease patient satisfaction and quality of care and increase the likelihood of medical error. Fifty-seven first-year master's students participated in this course. The effectiveness of the training was monitored during and after each course by self-assessment surveys of the participants' language acquisition. The data suggest that the most successful outcomes result from limiting class size, emphasizing high interactivity, and incorporating clinical experiences in the instruction, as well as focusing exclusively on intermediate-level speakers when resources are limited. Training can be time consuming and costly, yet graduates agreed that the training was imperative and valuable.

  10. Mucormycosis in immunochallenged patients

    Directory of Open Access Journals (Sweden)

    Pak Jane

    2008-01-01

    Full Text Available Mucorales species are deadly opportunistic fungi with a rapidly invasive nature. A rare disease, mucormycosis is most commonly reported in patients with diabetes mellitus, because the favorable carbohydrate-rich environment allows the Mucorales fungi to flourish, especially in the setting of ketoacidosis. However, case reports over the past 20 years show that a growing number of cases of mucormycosis are occurring during treatment following bone marrow transplants (BMT and hematological malignancies (HM such as leukemia and lymphoma. This is due to the prolonged treatment of these patients with steroids and immunosuppressive agents. Liposomal amphotericin B treatment and posaconazole are two pharmacologic agents that seem to be effective against mucormycosis, but the inherently rapid onset and course of the disease, in conjunction with the difficulty in correctly identifying it, hinder prompt institution of appropriate antifungal therapy. This review of the literature discusses the clinical presentation, diagnosis, and treatment of mucormycosis among the BMT and HM populations.

  11. Mucormycosis in immunochallenged patients.

    Science.gov (United States)

    Pak, Jane; Tucci, Veronica T; Vincent, Albert L; Sandin, Ramon L; Greene, John N

    2008-07-01

    Mucorales species are deadly opportunistic fungi with a rapidly invasive nature. A rare disease, mucormycosis is most commonly reported in patients with diabetes mellitus, because the favorable carbohydrate-rich environment allows the Mucorales fungi to flourish, especially in the setting of ketoacidosis. However, case reports over the past 20 years show that a growing number of cases of mucormycosis are occurring during treatment following bone marrow transplants (BMT) and hematological malignancies (HM) such as leukemia and lymphoma. This is due to the prolonged treatment of these patients with steroids and immunosuppressive agents. Liposomal amphotericin B treatment and posaconazole are two pharmacologic agents that seem to be effective against mucormycosis, but the inherently rapid onset and course of the disease, in conjunction with the difficulty in correctly identifying it, hinder prompt institution of appropriate antifungal therapy. This review of the literature discusses the clinical presentation, diagnosis, and treatment of mucormycosis among the BMT and HM populations.

  12. COPD: the patient perspective

    Directory of Open Access Journals (Sweden)

    Jones PW

    2016-02-01

    Full Text Available Paul W Jones,1 Henrik Watz,2 Emiel FM Wouters,3 Mario Cazzola4 1Division of Clinical Science, St George’s, University of London, London, UK; 2Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North (ARCN, Member of the German Center for Lung Research (DZL, Grosshansdorf, Germany; 3CIRO+, Department of Respiratory Medicine, Maastricht University, Maastricht, the Netherlands; 4Unit of Respiratory Clinical Pharmacology, Department of Systemic Medicine, University of Rome ‘Tor Vergata,’ Rome, Italy Abstract: Chronic obstructive pulmonary disease (COPD is a highly prevalent disease characterized by nonreversible airway obstruction. Well-characterized symptoms such as exertional dyspnea and fatigue have a negative impact on patients’ quality of life (QoL and restrict physical activity in daily life. The impact of COPD symptoms on QoL is often underestimated; for example, 36% of patients who describe their symptoms as being mild-to-moderate also admit to being too breathless to leave the house. Additionally, early morning and nighttime symptoms are a particular problem. Methods are available to allow clinicians to accurately assess COPD symptoms, including patient questionnaires. Integrated approaches to COPD management, particularly pulmonary rehabilitation, are effective strategies for addressing symptoms, improving exercise capacity and, potentially, also increasing physical activity. Inhaled bronchodilators continue to be the mainstay of drug therapy in COPD, where options can be tailored to meet patients’ needs with careful selection of the inhaled medication and the device used for its delivery. Overall, an integrated approach to disease management should be considered for improving QoL and subsequent patient outcomes in COPD. Keywords: COPD, patients, physical actiity levels, pulmonary rehabilitation

  13. Thromboprophylaxis with dalteparin in medical patients: which patients benefit?

    Science.gov (United States)

    Cohen, Alexander T; Turpie, Alexander G G; Leizorovicz, Alain; Olsson, Carl-Gustav; Vaitkus, Paul T; Goldhaber, Samuel Z

    2007-05-01

    It is unclear whether thromboprophylaxis produces a consistent risk reduction in different subgroups of medical patients at risk from venous thromboembolism. We performed a retrospective, post hoc analysis of 3706 patients enrolled in the PREVENT study. Patients were at least 40 years old with an acute medical condition requiring hospitalization for at least 4 days and had no more than 3 days of immobilization prior to enrolment. Patients received either subcutaneous dalteparin (5000 IU) or placebo once daily. The primary end point was the composite of symptomatic deep vein thrombosis (DVT), pulmonary embolism, asymptomatic proximal DVT, or sudden death. Primary diagnosis subgroups were acute congestive heart failure, acute respiratory failure, infectious disease, rheumatological disorders, or inflammatory bowel disease. All patients, except those with congestive heart or respiratory failure, had at least one additional risk factor for venous thromboembolism. A risk reduction was shown in patients receiving dalteparin versus placebo. The relative risk (RR) was 0.73 in patients with congestive heart failure, 0.72 for respiratory failure, 0.46 for infectious disease, and 0.97 for rheumatological disorders. The RR was 0.52 in patients aged > or = 75 years, 0.64 in obese patients, 0.34 for patients with varicose veins, and 0.71 in patients with chronic heart failure. No subgroup had a significantly different response from any other. Importantly, multivariate analysis showed that all patient groups benefited from thromboprophylaxis with dalteparin. Our findings, therefore, support the broad application of thromboprophylaxis in acutely ill hospitalized medical patients.

  14. Pain in burn patients.

    Science.gov (United States)

    Latarjet, J; Choinère, M

    1995-08-01

    While severe pain is a constant component of the burn injury, inadequate pain management has been shown to be detrimental to burn patients. Pain-generating mechanisms in burns include nociception, primary and secondary hyperalgesia and neuropathy. The clinical studies of burn pain characteristics reveal very clear-cut differences between continuous pain and pain due to therapeutic procedures which have to be treated separately. Some of the main features of burn pain are: (1) its long-lasting course, often exceeding healing time, (2) the repetition of highly nociceptive procedures which can lead to severe psychological disturbances if pain control is inappropriate. Pharmaco-therapy with opioids is the mainstay for analgesia in burned patients, but non-pharmacological techniques may be useful adjuncts. Routine pain evaluation is mandatory for efficient and safe analgesia. Special attention must be given to pain in burned children which remains too often underestimated and undertreated. More educational efforts from physicians and nursing staff are necessary to improve pain management in burned patients.

  15. Humidification for intubated patients

    Directory of Open Access Journals (Sweden)

    Fotoula Babatsikou

    2008-10-01

    Full Text Available Artificial airways bypass the physiological mechanism of humidification and filtration of the inspired air, increasing, therefore, the possibilities of copious secretions production. Copious secretions increase the danger for atelektasis and respiratory infections. Moreover, clots can be shaped in the interior of the endotracheal tube or thracheostomy, resulting in increased work of breathing (WOB and reduced odds of successful extubation. It is also possible to lead progressively to complete obstruction of the endotracheal tube.Thus, the choice of a suitable humidification device during mechanical ventilation is of distinguished importance. There are various types of humidifiers. However, hydroscopic Heat and Moisture Exchangers (HMEs with filter and Heated Humidifiers (HHs, which provide humidity in form of water vapors, are currently used. When they are used correctly, and not in the cases where they are contraindicated, HMEs’ do not have complications and they decrease the cost of hospitalization as well as the staff workload. HMEs are better choice for short duration of intubation (<96 hours and during transports. HHs are preferred for patients with persisting hypercapnia, chronic respiratory failure and difficulty in ventilator weaning. HHs should be used for patients with prolonged duration of mechanical ventilation or patients that HMEs are contraindicated for. Neither HMEs nor HHs have been accused for increased incidences of ventilator associated pneumonia (VAP.

  16. Patient health questionnaire. Using a patient-focused assessment tool.

    OpenAIRE

    Mitchell, J. D.

    1996-01-01

    A patient health questionnaire was developed for use in family practice to help identify lifestyle risk factors, assess health care needs, and better understand patients. This article discusses the questionnaire's development and practical application.

  17. Communication with patients and colleagues

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte

    2011-01-01

    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......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...

  18. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Shah U

    2015-04-01

    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

  19. Physician-Patient Communication and Patient Compliance: A Theoretical Orientation.

    Science.gov (United States)

    Clampitt, Phillip G.; Williams, M. Lee

    This paper synthesizes much of the literature concerning physician/patient communication as it relates to patient compliance. Using the theoretical perspective that deals with belief, attitude, intention, and behavior (a perspective generated by Martin Fishbein and Icek Ajzen), a new theoretical orientation for predicting patient compliance is…

  20. Patient delay in patients with ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, Christel Ga; Laut, Kristina G; Jensen, Lisette O

    2016-01-01

    BACKGROUND AND AIMS: To improve treatment success of ST-elevation myocardial infarction, a minimal delay from symptom onset to reperfusion therapy is crucial. The patient's response to initial symptoms (patient delay) substantially affects the delay. We investigated time patterns of patient delay...

  1. Vancomycin dosing in neutropenic patients

    NARCIS (Netherlands)

    M.B. Haeseker (Michiel); S. Croes (Ser); C. Neef (Cees); C.A. Bruggeman (Cathrien); L. Stolk (Lisette); A. Verbon (Annelies)

    2014-01-01

    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

  2. Bathing a patient in bed

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000427.htm Bathing a patient in bed To use the sharing features on this page, please enable JavaScript. Some patients cannot safely leave their beds to bathe. For ...

  3. Medical and Dental Patient Issues

    Science.gov (United States)

    ... A RadiationAnswers.org Ask the Experts Medical and Dental Patient Issues What's My Risk? The risks of ... developed by our topic editors for this category: Dental-Patient Issues Medical CT Reference Books and Articles ...

  4. Semi-customizing patient surveys

    DEFF Research Database (Denmark)

    Riiskjær, Erik; Ammentorp, Jette; Nielsen, Jørn Flohr

    2011-01-01

    . 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...

  5. PATIENTS — THE CLINICAL IMPLICATIONS

    African Journals Online (AJOL)

    bin (HbA,¢) levels of diabetes mellitus patients as an index of glycaetnlc control. ... diabetic patients, attending a Diabetic Clinic at the Komfo Anokye Teaching ..... complications like nephropathy and retinopathy. ... technology and knowledge.

  6. Podcasting: contemporary patient education.

    Science.gov (United States)

    Abreu, Daniel V; Tamura, Thomas K; Sipp, J Andrew; Keamy, Donald G; Eavey, Roland D

    2008-04-01

    Portable video technology is a widely available new tool with potential to be used by pediatric otolaryngology practices for patient and family education. Podcasts are media broadcasts that employ this new technology. They can be accessed via the Internet and viewed either on a personal computer or on a handheld device, such as an iPod or an MP3 player. We wished to examine the feasibility of establishing a podcast-hosting Web site. We digitally recorded pediatric otologic procedures in the operating room and saved the digital files to DVDs. We then edited the DVDs at home with video-editing software on a personal computer. Next, spoken narrative was recorded with audio-recording software and combined with the edited video clips. The final products were converted into the M4V file format, and the final versions were uploaded onto our hospital's Web site. We then downloaded the podcasts onto a high-quality portable media player so that we could evaluate their quality. All of the podcasts are now on the hospital Web site, where they can be downloaded by patients and families at no cost. The site includes instructions on how to download the appropriate free software for viewing the podcasts on a portable media player or on a computer. Using this technology for patient education expands the audience and permits portability of information. We conclude that a home computer can be used to inexpensively create informative surgery demonstrations that can be accessed via a Web site and transferred to portable viewing devices with excellent quality.

  7. Polypharmacy in Osteoporosis Patients

    Directory of Open Access Journals (Sweden)

    Yavuz Ali Karahan

    2015-04-01

    Full Text Available Objective: In this study, it was aimed to determine the rates of multiple drug use in the patients with osteoporosis as well as the use of drugs affecting bone metabolism and balance. Materials and Methods: We included outpatients from Physical Medicine and Rehabilitation Policlinics diagnosed with primary or secondary osteoporosis between January 2014 and May 2014. Written consent of the participants was obtained. Data of the first 1000 patients who agreed to participate in the study were evaluated. Data regarding age, history, drugs currently being used and newly initiated were recorded. The drugs that affect bone metabolism were determined. The drugs that heva side effects including dizziness, somnolence, distractibility, decrease in the visual acuity, orthostatic hypotension and ototoxicity and were recorded because these can cause a balance disorder. Results: In this study, 64% of the participants were on five or more drugs. The most commonly used drugs were analgesics (65.4%, antihypertensives (52.6%, and drugs for digestive system (37.3%. We found that 65.5% of the participants were using drugs that may have side effects on bone metabolism and 93.7% were using drugs that may have side effects on balance. Conclusion: Multi-drug use and drug interactions should be considered during the treatment of osteoporosis and the drugs used should be recorded. Drugs that affect bone metabolism should only be used over the short term. Also, patients should be informed about side effects that might affect visuality, somatosensorial system and vestibular system and their daily activities should be regulated. (Turkish Journal of Osteoporosis 2015;21: 5-9

  8. Leptospirosis in elderly patients.

    Science.gov (United States)

    Gancheva, Galya Ivanova

    2013-01-01

    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 by microscopic agglutination test. Twelve cases (80%) presented with the severe form of leptospirosis. Co-morbidity (hypertonic diseases, chronic pulmonary diseases, chronic alcohol abuse, and diabetes) was registered in 13 cases. All cases had fever, oliguria, conjunctival suffusions, hepatosplenomegaly. Jaundice (14/93%), hemorrhagic diathesis (13/87%), vomiting (11/73%), abdominal pain (10/67%), myalgia (7/47%) and hypotension (7/47%) also were observed. Renal dysfunction was expressed by increased blood urea nitrogen (mean 38.1±24.1mmol/L) and serum creatinine (mean 347.6±179.8μmol/L). Hepatic dysfunction was expressed by increased total serum bilirubin level (mean 274.6±210.7μmol/L) and slightly elevated aminotransferases (ASAT mean 125.8±61.6IU/L; ALAT mean 131.3±126.5IU/L). Five cases (33%) had a lethal outcome. In conclusion, leptospirosis in elderly patients is associated with severe course and higher risk for death, and requires prompt intensive treatment.

  9. Leptospirosis in elderly patients

    Directory of Open Access Journals (Sweden)

    Galya Ivanova Gancheva

    2013-10-01

    Full Text Available 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 by microscopic agglutination test. Twelve cases (80% presented with the severe form of leptospirosis. Co-morbidity (hypertonic diseases, chronic pulmonary diseases, chronic alcohol abuse, and diabetes was registered in 13 cases. All cases had fever, oliguria, conjunctival suffusions, hepatosplenomegaly. Jaundice (14/93%, hemorrhagic diathesis (13/87%, vomiting (11/73%, abdominal pain (10/67%, myalgia (7/47% and hypotension (7/47% also were observed. Renal dysfunction was expressed by increased blood urea nitrogen (mean 38.1 ± 24.1 mmol/L and serum creatinine (mean 347.6 ± 179.8 µmol/L. Hepatic dysfunction was expressed by increased total serum bilirubin level (mean 274.6 ± 210.7 µmol/L and slightly elevated aminotransferases (ASAT mean 125.8 ± 61.6 IU/L; ALAT mean 131.3 ± 126.5 IU/L. Five cases (33% had a lethal outcome. In conclusion, leptospirosis in elderly patients is associated with severe course and higher risk for death, and requires prompt intensive treatment.

  10. Readmissions of medical patients

    DEFF Research Database (Denmark)

    Cooksley, T.; Nanayakkara, P. W. B.; Nickel, C. H.

    2016-01-01

    of 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...... 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 health...

  11. Sepsis in frail patient

    Directory of Open Access Journals (Sweden)

    Andrea Beltrame

    2016-12-01

    Full Text Available Frailty is defined as a clinical syndrome in which three or more of the following criteria are present: unintentional weight loss, self-reported exhaustion, weakness (grip strength, slow walking speed and low physical activity. Sepsis is defined as an inflammatory response to infection, with severe sepsis and septic shock being the most severe forms. The incidence of severe sepsis increases with older age and several studies have shown that there are many risk factors that predispose the elderly to a higher incidence of sepsis. Pre-existing co-morbidities such as cancer, diabetes, obesity, human immunodeficiency virus, and renal or pulmonary disease can cause sepsis, but other factors including poor lifestyle habits (i.e., smoking, drug or alcohol abuse, malnutrition, and endocrine deficiencies, which are frequent in the elderly, may also predispose to severe infections. Other risk factors for sepsis include recurrent hospitalization, especially in the Intensive Care Unit, and nursing home residence, where interventions such as urinary catheterization or multiple drug use are quite frequent and many studies reported that people above 65 years of age are three times more likely to be admitted to hospital than those aged 16-64 years, and have a higher risk of prolonged hospital stays, institutionalization and death. Clinical evaluation of the frail patient with sepsis poses some challenges. The immune response becomes progressively less efficient with increasing age thereby causing an altered response to infection and it is important to know that the clinical evaluation of the so-called fragile patient with severe infection should take into account the sometimes unusual signs and symptoms that, if identified, can lead to early diagnosis. Laboratory diagnostics can also be of great help in this setting. The treatment of sepsis in the fragile patient can be empirical or based on microbiological culture. Moreover, frail patient population presents

  12. Rehabilitation of cancer patients.

    Directory of Open Access Journals (Sweden)

    Pandey M

    2001-01-01

    Full Text Available 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 natural calamities, puts rehabilitation movements in the back seat. Treatment and prevention of disability and its rehabilitation requires comprehensive and multidisciplinary approach. There is an urgent need to promote physical and psychological rehabilitation.

  13. Labeling of Patient Specimens

    Science.gov (United States)

    2011-01-26

    noted during the event that the actu.al number of near miss incidmts reported monthly was low due to laboratory personnel performing rounds each...specimens never leaves label and if moved it is labeled), All orders in system and all near misses and errors reported to patient safety Purchase/Install...Meeting 14 Aug 09, 1400 in lab break room thru out Develop TICK sheet to track near misses .JDI Ms. Clark Clinics will provide toPS 1st working day of

  14. Patient Safety Center Organization

    Science.gov (United States)

    2006-06-01

    Dr. Karen Horvath R3 Inguinal & Ventral Hernia Repair 2/22/06 4 hours/course (36 hours/year) Surgery R 9 Dr. Karen Horvath R4 Lap Entero...separate rooms for skills and computer-based simulators, group work areas and conferencing, and a dedicated Human Patient Anesthesia simulator (METI...2/15/06, 3/1/06, 3/15/06 (12 classes per year) 4 hours/class (288hours/year) Anesthesia R 6 students/month = 72 students

  15. Patient caries risk assessment

    DEFF Research Database (Denmark)

    Twetman, Svante; Fontana, Margherita

    2009-01-01

    Risk assessment is an essential component in the decision-making process for the correct prevention and management of dental caries. Multiple risk factors and indicators have been proposed as targets in the assessment of risk of future disease, varying sometimes based on the age group at which...... for prediction purposes, as measured until now in the literature, is at best questionable in schoolchildren, adolescents and adults. That is not to say these additional factors should not be assessed to help understand the strength of their associations with the disease experience in a particular patient......, and aid in the development of an individualized and targeted preventive and management plan....

  16. The patient-friendly practice.

    Science.gov (United States)

    Dooley, Sharon Kay

    2006-01-01

    In today's medical marketplace, patients see themselves as consumers of healthcare with certain customer-service expectations. The medical practice that is indifferent or resistant to these changes is at risk. Having a good understanding of patient-friendly changes can help a practice survive in a changing environment. A patient-friendly office will continue to meet the needs of the patient by adopting this new practice style.

  17. [Organizing patient education in cardiology].

    Science.gov (United States)

    Fischer, Eric; Thieffry, Eliane

    2014-02-01

    A central element of the care management of patients with heart failure, therapeutic patient education mobilises caregivers into forming a multi-disciplinary team. In this article, a hospital team shares the different stages in the construction and implementation of a programme for use with hospitalised patients and in consultations. To do this, the nurses undertook training to acquire new educational skills.

  18. Dental problems in epileptic patients.

    Science.gov (United States)

    Zioło, Anna; Mielnik-Błaszczak, Maria

    2004-01-01

    On the grounds of literature and own clinical experience, pathological changes in epilepitic patients have been described. Dental management procedures in these patients have also been presented. The unquestionable importance of prophylaxis, which may markedly minimize the impact of epilepsy on the incidence of mouth diseases, has been emphasised. It has also been stated that epileptic patients should receive specialised and integrated dental treatment.

  19. Communication with patients and colleagues

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte

    2011-01-01

    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 healt...

  20. Dyspepsia in chronic psychiatric patients

    NARCIS (Netherlands)

    Mookhoek, E.J.; Meijs, V.M.M.; Loonen, A.J.M.; Leufkens, H.G.M.

    2005-01-01

    Introduction: We report on dyspeptic complaints among patients hospitalized in the long-stay ward of a general psychiatric hospital. Methods: A representative sample of the patients was interviewed using a structured questionnaire. Results: Eighty percent of the patients reported one or more symptom

  1. Sleep in obese patients

    Directory of Open Access Journals (Sweden)

    Natalya Victorova Strueva

    2014-08-01

    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.

  2. Diseases of Elderly Patient

    Directory of Open Access Journals (Sweden)

    Eulália Maria Martins da SILVA

    2007-03-01

    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.

  3. The Patient Who Falls

    Science.gov (United States)

    Tinetti, Mary E.; Kumar, Chandrika

    2013-01-01

    Falls are common health events that cause discomfort and disability for older adults and stress for caregivers. Using the case of an older man who has experienced multiple falls and a hip fracture, this article, which focuses on community-living older adults, addresses the consequences and etiology of falls; summarizes the evidence on predisposing factors and effective interventions; and discusses how to translate this evidence into patient care. Previous falls; strength, gait, and balance impairments; and medications are the strongest risk factors for falling. Effective single interventions include exercise and physical therapy, cataract surgery, and medication reduction. Evidence suggests that the most effective strategy for reducing the rate of falling in community-living older adults may be intervening on multiple risk factors. Vitamin D has the strongest clinical trial evidence of benefit for preventing fractures among older men at risk. Issues involved in incorporating these evidence-based fall prevention interventions into outpatient practice are discussed, as are the trade-offs inherent in managing older patients at risk of falling. While challenges and barriers exist, fall prevention strategies can be incorporated into clinical practice. PMID:20085954

  4. Caring for Latino patients.

    Science.gov (United States)

    Juckett, Gregory

    2013-01-01

    Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. Barriers to care have resulted in striking disparities in quality of health care for these patients. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Other health problems include stress, neurocysticercosis, and tuberculosis. It is important to explore the use of alternative therapies and belief in traditional folk illnesses, recognizing that health beliefs are dependent on education, socioeconomic status, and degree of acculturation. Many-but not all-folk and herbal treatments can be safely accommodated with conventional therapy. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). The LEARN technique can facilitate cross-cultural interviews. Some cultural barriers may be overcome by using the "teach back" technique to ensure that directions are correctly understood and by creating a welcoming health care environment for Latino patients.

  5. Depression in geriatric patients.

    Science.gov (United States)

    Abbas Asghar-Ali, A; Braun, U K

    2009-02-01

    While the most serious of depressive illnesses in the elderly is major depressive disorder, patients' quality of life can be significantly impacted by dysthmic disorder, sub-threshold depression (minor depression), or a depressive disorder due to a general medical condition, all of which have been shown to be more prevalent than major depression in the community dwelling population of older adults. Older adults are also more likely to develop grief reaction and frequently deal with issues of bereavement. This review will discuss the diagnoses of all relevant depressive diagnoses that primary care physicians are likely to encounter. Among the many different assessment tools that screen for depression the briefest instruments are a two-question screening tool recommended by the U.S. Preventive Services Task Force and, specifically developed for older adults, the Geriatric Depression Scale (GDS) that is available in a short 15- Yes/No-question version. Many medical illnesses are associated with depressive symptoms. The focus in this review is on dementing illnesses/cerebrovascular disease, dementia of the Alzheimer's type, and Parkinson disease. First-line pharmacological therapy of depression includes selective serotonin inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs). Side effects of particular drugs can often be geared towards achieving additional benefits, e.g. weight gain associated with the use of some SSRISs may be helpful for patients with dementia.

  6. Pulmonary metastasectomy in pediatric patients.

    Science.gov (United States)

    Erginel, Basak; Gun Soysal, Feryal; Keskin, Erbug; Kebudi, Rejin; Celik, Alaaddin; Salman, Tansu

    2016-02-02

    This study aims to evaluate the outcomes of pulmonary metastasectomy resections in pediatric patients. We retrospectively reviewed the medical records of 43 children who were operated on in the Pediatric Surgery Clinic between January 1988 and 2014. Forty-three children (26 boys; 17 girls; mean age 10±4.24 years, range 6 months-18 years) who underwent pulmonary metastasectomy resection were included in the study. The patients were evaluated based on age, gender, history of disease, surgical procedures, complications, duration of hospitalization, duration of chest tube placement, and procedure outcome. Indications for pediatric resections were oncological. Metastasis was secondary to Wilms' tumor in 14 patients, osteosarcoma in 7 patients, Ewing's sarcoma in 5 patients, rhabdomyosarcoma in 5 patients, lymphoma in 3 patients, hepatoblastoma in 2 patients, and other tumors in 7 patients. A total of 59 thoracotomies were performed. Approaches utilized included unilateral posterolateral thoracotomy (n=33), bilateral posterolateral thoracotomy (n=8), and sternotomy (n=2). Wedge resection was the procedure of choice (n=44). In selected cases, 11 segmentectomies, 3 lobectomies, and 1 pneumonectomy were performed. There was no perioperative mortality. One patient suffered prolonged air leak and three patients from fever. All patients received chemotherapy. Radiotherapy was administered to 16 patients (37.2%). Of those 16 patients, 7 had Wilms' tumor, 6 had Ewing's sarcoma/PNET, and 3 were rhabdomyosarcoma patients. During a median follow-up of 3 years, the overall survival was 74.4%. Multidisciplinary treatment involving pediatric oncologists, surgeons, and radiation oncologists is necessary to obtain positive results in children who have pulmonary metastases of oncological diseases. Wedge resection is a suitable option for children because less lung tissue is resected.

  7. Delirium hos kritisk syge patienter

    DEFF Research Database (Denmark)

    Strøm, Thomas; Pande-Rolfsen, Guri; Hagen, Christine

    2009-01-01

    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...

  8. Delirium hos kritisk syge patienter

    DEFF Research Database (Denmark)

    Strøm, Thomas; Pande-Rolfsen, Guri; Hagen, Christine;

    2009-01-01

    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...

  9. Effective communication with the patient

    Directory of Open Access Journals (Sweden)

    R. Booker

    2005-12-01

    Full Text Available The chronic and slowly progressive nature of chronic obstructive pulmonary disease (COPD can create difficulties in effective communication between healthcare provider and patient. Such barriers, which include the personal beliefs of both caregiver and patient, need to be understood and addressed if the aims of the consultation are to be met. Patients with COPD may feel guilty, depressed and angry about their condition. Many patients with COPD are elderly and/or from lower socio-economic groups, both of which pose challenges to the caregiver, as does the stigma the disease carries, which stems from its strong link with smoking. Humanity, respect and people orientation are vital to good communication with COPD patients. Physicians and nurses should try to avoid patient misunderstanding and uncertainty, involve the patient in decision-making and achieve a shared understanding (concordance, as well as encourage the patient to accept responsibility for the actions agreed. This should improve management decisions made by healthcare professionals and ensure a more satisfied patient. Greater patient satisfaction may improve concordance and so bring about better patient outcomes.

  10. Obstructive Uropathy in Sudanese Patients

    Directory of Open Access Journals (Sweden)

    El Imam M

    2006-01-01

    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%.

  11. Patienters vurdering af medicinpakningernes indlaegssedler

    DEFF Research Database (Denmark)

    Horwitz, Anna; Reuther, Lene; Andersen, Stig Ejdrup

    2009-01-01

    effects had made them stop taking their medicine. Future studies should bring into focus the reason for medication adherence, how written information can be made easier to read, comprehensive and correct without contributing to anxiety and non-adherence. Udgivelsesdato: 2009-Feb......INTRODUCTION: The objective was to investigate patients' perception of patient information leaflets, including their readability, comprehensibility and their impact on adherence. MATERIAL AND METHODS: A 14-item questionnaire was prepared and answered by unselected patients in a general practice...... 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...

  12. Design of a 'smart' patient record system for mammography patients.

    Science.gov (United States)

    Frigas, Antonis; Spyrou, George; Antaraki, Argyro; Patiraki, Elisabeth; Koufopoulos, Konstantinos; Mantas, John; Ligomenides, Panos

    2009-01-01

    One of the most common cancer types among women is breast cancer. Regular mammographic examinations increase the possibility for early diagnosis and treatment and significantly improve the chance of survival for patients with breast cancer. Keeping an informed and complete patient record is of great importance as the doctor needs this information for every patient examination. The proposed implementation is a patient record system that includes 'smart' algorithms in order to automatically use data from the patient's record to calculate well established epidemiological breast cancer models. A computer-aided diagnosis system is also used in order to analyze each mammogram and obtain a certain risk percentage concerning whether the patient has to undergo biopsy or not. The aforementioned system has been implemented to support a large set of patient data (1,178 patients) which included detailed personal patient data, medical history and examination details per date and is used in the daily clinical practice of a breast cancer diagnostic center facilitating patient record retrieval, storage and supporting the doctor's decisions.

  13. Critically ill obstetric patients

    Directory of Open Access Journals (Sweden)

    Kirti Rajesh Bendre

    2015-04-01

    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

  14. [Management of splenectomized patients].

    Science.gov (United States)

    Chambon, J P; Vallet, B; Caiazzo, R; Zerbib, P

    2003-09-06

    PARTIAL SPLENECTOMY: Partial resection is possible in certain indications for splenectomy. Partial splenectomy is the best way to prevent postsplenectomy infections, even though vaccination and antibiotic prophylaxis must be prescribed. This association is also necessary when the patient undergoes an autograft to reimplant splenic tissue or develops splenosis, i.e. fortuitous autotransplantation of splenic parenchyma. GUIDELINES FOR PLANNED SPLENECTOMY: Prophylactic vaccination should be performed 15 days, or 6 weeks, before surgery. Antibiotic prophylaxis includes a preoperative injection of cefazolin followed by intravenous amoxicillin, then Oracilline (Penicilline V) with resumption of oral intake. SURGICAL ASPECTS: Indications for laparoscopic surgery have broadened, laparotomy being reserved for the most difficult cases. Special care is recommended concerning complications, particularly respiratory disorders (pleural effusion, atelectasia) and acute pancreatitis.

  15. Thrombolysis in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Santiago Herrero; Jose Antonio Lapuerta-Irigoyen

    2007-01-01

    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.

  16. The Berlin Patient

    Institute of Scientific and Technical Information of China (English)

    Maya; Reid

    2011-01-01

    LAST December,the science journal Blood published a paper claiming a cure for HIV had been found.While the announcement breathes new life into the AIDS research community,it’s not without caveats. The paper’s authors’ evidence came in the form of a 44-year-old man referred to as "The Berlin Patient." An American living in Germany,the man,whose real name is Timothy Ray Brown, was diagnosed with HIV around age 30.He spent a decade following a traditional drug regimen for the disease with success; he was healthy and had a high T-cell count.Then,in 2006, Brown was diagnosed with acute leukemia.His doctor,Gero H(u|¨)tter,decided to use the cancer as an opportunity to also rid Brown of his HIV.

  17. EUS in pediatric patients.

    Science.gov (United States)

    Attila, Tan; Adler, Douglas G; Hilden, Kristen; Faigel, Douglas O

    2009-11-01

    The knowledge of EUS use in children is limited. We investigated the indications, feasibility, safety, and clinical utility of EUS in the management of pediatric GI, pancreatobiliary, and mediastinal diseases. Retrospective study. Two tertiary referral university hospitals. Consecutive children age younger than 18 years referred over a 7-year period for EUS evaluation. Forty EUS scans were performed in 38 children with a mean age of 13.5 years. The indications for pancreatobiliary endosonography were pancreatitis (n = 10), solid pancreatic mass (n = 7), cystic pancreatic mass (n = 1), cyst in the setting of chronic pancreatitis (n = 1), suspected annular pancreas (n = 1), celiac plexus block (n = 1), suspected common bile duct stone (n = 1), abdominal pain and atrophic pancreas (n = 1), ampullary adenoma (n = 1), and abnormal MRCP in a patient with jaundice (n = 1). The indications for gastric EUS were mucosal lesions (n = 2) and subepithelial lesions (n = 4). The indications for mediastinal endosonography were mediastinal masses/lymph nodes (n = 5). The remaining evaluations were performed for esophageal stricture (n = 1), unexplained abdominal pain (n = 1), unexplained abdominal pain with celiac axis block (n = 1), and perirectal fluid collection (n = 1). EUS-guided FNA (EUS-FNA) was performed in 12 (30%) cases and established the correct diagnosis in 9 (75%). EUS-guided fine-needle injections for celiac axis block were performed in 2 (5%) cases. The procedure was successful in all patients, and no complications related to sedation, EUS, or EUS-FNA were encountered. Retrospective study. EUS and EUS-FNA are feasible and safe and have a significant impact on the management of pediatric GI, pancreatobiliary, and mediastinal diseases.

  18. Venous thromboembolism in cancer patients

    Directory of Open Access Journals (Sweden)

    Mehmet Fuat Eren

    2013-09-01

    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.

  19. [Electroconvulsive therapy in nonconsenting patients].

    Science.gov (United States)

    Besse, M; Methfessel, I; Wiltfang, J; Zilles, D

    2017-01-01

    Electroconvulsive therapy (ECT) is a potent and successful method for the treatment of severe psychiatric disorders. Severe depressive and psychotic disorders may lead to legal incapacity and inability to consent. In Germany, administration of ECT against the patient's will is feasible under certain constellations and is regulated under the terms of the guardianship law. This article outlines the prevalence, effectiveness and tolerability of ECT when applied in nonconsenting patients. Case report and literature review. The literature on ECT as a treatment in nonconsenting patients is relatively sparse. In 2008 the prevalence in Germany was less than 0.5 % of all patients receiving ECT. Case reports and case series suggest a good and equal level of effectiveness when compared to consenting patients. In the course of treatment the majority of patients consented to receive further ECT and retrospectively judged ECT as helpful. The use of ECT is a highly effective treatment in severe psychiatric disorders even when administered as treatment in nonconsenting patients. It can be lifesaving and lead to a rapid improvement of symptoms and relief from severe suffering also from the patients' perspective. Thus, it seems unethical not to consider ECT as a treatment against the nonautonomous will of legally incompetent patients in individual cases. Nevertheless, physicians should always seek to obtain the patients' consent as soon as possible for both legal and ethical reasons.

  20. Hallux ulceration in diabetic patients.

    Science.gov (United States)

    ElMakki Ahmed, Mohamed; Tamimi, Abdulhakim O; Mahadi, Seif I; Widatalla, Abubakr H; Shawer, Mohamed A

    2010-01-01

    We undertook a prospective cohort study to assess risk factors associated with hallux ulceration, and to determine the incidence of healing or amputation, in consecutive patients with diabetes mellitus who were treated over the observation period extending from September 2004 to March 2005, at the Jabir Abu Eliz Diabetic Centre, Khartoum City, Sudan. There were 122 diabetic patients in the cohort (92 males and 30 females) with an overall mean age of 58 +/- 9 years. Fifty-three percent of patients had complete healing within 8 weeks and 43% healed within 20 weeks. The overall mean time to healing was 16 +/- 8 weeks. In 32 (26.2%) patients, osteomyelitic bone was removed, leaving a healed and boneless hallux. The hallux was amputated in 17 (13.9%) patients; in 2 (1.6%) patients it was followed by forefoot amputation and in 7 (5.7%) patients by below-the-knee amputation. In 90 (73.8%) patients the initial lesion was a blister. In conclusion, hallux ulceration is common in patients with diabetes mellitus and is usually preceded by a blister. Neuropathy, foot deformity, and wearing new shoes are common causative factors; and ischemia, osteomyelitis, any form of wound infection, and the size of the ulcer are main outcome determinants. Complete healing occurred in 103 (85%) of diabetic patients with a hallux ulcer. Vascular intervention is important relative to limb salvage when ischemia is the main cause of the ulcer.

  1. Improving emergency department patient flow.

    Science.gov (United States)

    Jarvis, Paul Richard Edwin

    2016-06-01

    Emergency departments (ED) face significant challenges in delivering high quality and timely patient care on an ever-present background of increasing patient numbers and limited hospital resources. A mismatch between patient demand and the ED's capacity to deliver care often leads to poor patient flow and departmental crowding. These are associated with reduction in the quality of the care delivered and poor patient outcomes. A literature review was performed to identify evidence-based strategies to reduce the amount of time patients spend in the ED in order to improve patient flow and reduce crowding in the ED. The use of doctor triage, rapid assessment, streaming and the co-location of a primary care clinician in the ED have all been shown to improve patient flow. In addition, when used effectively point of care testing has been shown to reduce patient time in the ED. Patient flow and departmental crowding can be improved by implementing new patterns of working and introducing new technologies such as point of care testing in the ED.

  2. Creating the ideal patient experience.

    Science.gov (United States)

    Purcărea, Th.V

    2016-01-01

    Healthcare industry continues to evolve under conditions of intense competition in approaching health prevention, protection, and promotion. Therefore, healthcare providers are challenged to always ensure better patient experience, winning patients' satisfaction, and loyalty and remain competitive on today's healthcare market. Healthcare markets bring together professionals and their patients into real collaborative relationships, which empower patients to contribute to the healthcare improvement. Within this competitive landscape, which is also characterized by digital health tools boosting patients' awareness and controlling their own health, medical providers need to be perceived as skilled and trustworthy in relying on patients' needs, expectations, and sacrifices are required in order to obtain the promised benefits. Moreover, while constantly providing a holistic assessment of the healthcare services' and experience attributes, acting on feedback and reaching healthcare service excellence, providing a better understanding of all the touch points with their patients and improving the quality and consistency of all these touch points, all these are achieved by employees, who are truly connected to the healthcare business. Today, patients are systematically becoming aware of the diversity of their choices, being increasingly involved in making better healthcare choices, and, so, more and more innovative products are introduced, targeting new patient segments. Findings from the last three years have shown that patients may achieve better outcomes due to the stakeholders' commitment to innovation within the context of the big-data revolution, by building new values.

  3. Patient's rights charter in Iran.

    Directory of Open Access Journals (Sweden)

    Alireza Parsapoor

    2014-01-01

    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.

  4. Burn Patient Expectations from Nurses

    Directory of Open Access Journals (Sweden)

    Sibel Yilmaz sahin

    2014-02-01

    Full Text Available AIM: Burn is a kind of painful trauma that requires a long period of treatment and also changes patients body image. For this reason, nursing care of burn patients is very important. In this study in order to provide qualified care to the burned patients, patient and #8217;s expectations from nurses were aimed to be established. METHODS: Patients and #8217; expectations were evaluated on 101 patients with burn in Ministry of Health Ankara Numune Education and Research Hospital Burn Service and Gulhane Military Medical Academy Education and Research Hospital Burn Center. A questionnaire which was developed by the researchers was used for collecting data. The questions on the questionnaire were classified into four groups to evaluate the patients and #8217; expectations about communication, information, care and discharge. Data was evaluated by using SPSS 12 package software. RESULTS: In this study, 48.5% of patients were at 18-28 age group, 79.2% were male and 51.5% of patients were employed. Almost all of patients expect nurses to give them confidence (98% and to give them information about latest developments with the disease. Patients prior expectation from nurses about care was to do their treatments regularly (100% and to take the necessary precautions in order to prevent infection (100%. 97% of patient expect nurses to give them information about the drugs, materials and equipment that they are going to use while discharge. CONCLUSION: As a result we found that burn patient expectations from nurses about communication, information, care and discharge were high. [TAF Prev Med Bull 2014; 13(1.000: 37-46

  5. Febrile neutropaenia in cancer patients.

    Science.gov (United States)

    Walwyn, M; Nicholson, A; Lee, M G; Wharfe, G; Frankson, M A

    2010-03-01

    Febrile neutropaenia is a common complication of chemotherapy in cancer patients. Empirical antibiotic regimes are based on the epidemiological characteristics of bacterial isolates globally and locally. This study retrospectively reviewed all cases of febrile neutropaenia in patients with confirmed cancer admitted at the University Hospital of the West Indies in the four-year period between, January 1, 2003 and December 31, 2006 and who received chemotherapy. Cases were identified from blood culture records and hospital charts which were reviewed to determine the aetiological agents causing bacteraemia, their antimicrobial susceptibilities and clinicalfeatures. These cases were compared with non-neutropaenic cancer patients admitted with fever. A total of 197 febrile episodes in cancer patients were reviewed. Thirty-seven per cent had febrile neutropaenia while 62% were non-neutropaenic. Acute myeloid leukaemia was the most common haematological malignancy and the most common solid tumour was breast cancer. Twenty-six per cent of patients had a positive blood culture. In febrile neutropaenic patients, Escherichia coli was the most common organism isolated followed by coagulase-negative staphylococci while in non-neutropaenic patients, coagulase-negative staphylococci was most common. Acinetobacter infections was prominent in non-neutropaenic patients but absent in neutropaenic patients. More than one organism was cultured in 9 neutropaenic and 18 non-neutropaenic patients. Mortality was 10.8% in neutropaenic and 24.4% in non-neutropaenic patients. Gram-negative organisms are the predominant isolates in febrile neutropaenic episodes in this cohort of patients. Non-neutropaenic patients had an increased mortality with an increase in Acinetobacter infections and multiple isolates.

  6. Evaluation of intra-operative EABR characteristics and rehabilitation effects of cochlear implantation in patients with internal auditory canal stenosis%内耳道狭窄患者人工耳蜗术中EABR特点及术后疗效评估

    Institute of Scientific and Technical Information of China (English)

    金毅; 曹克利; 魏朝刚; 王斌

    2013-01-01

    目的:探讨内耳道狭窄患者电刺激听觉脑干诱发电位(EABR)的特点及与人工耳蜗植入术后听力言语康复效果的关系.方法:回顾性分析内耳道狭窄(IACS)的语前聋人工耳蜗植入患者16例(IACS组),筛选条件相近的16例内耳道解剖结构正常的语前聋人工耳蜗植入者配对(对照组),术中人工耳蜗植入前采用EABR评估听觉传导通路,记录EABR波形、阈值和动态范围;对患者家长和康复教师进行调查随访,根据听觉行为分级标准(CAP)和言语可懂度分级标准(SIR)对患者听力言语康复效果分级评估.采用配对样本T检验比较术前和术后1年患者CAP和SIR评分,Spearman检验对术中EABR分级和术后CAP评分进行相关性分析.结果:IACS组2例患者术中未记录到典型EABR波形,术后开机无反应.IACS组EABR波形分化差于对照组,其EABR阈值(192.5±11.73)高于对照组(168.75±6.94),动态范围(32.50±19.69)小于对照组(80.63±9.04).术后1年IACS的听觉言语康复效果的CAP和SIR值分别为3.47±1.09、1.62±0.50,得分均低于对照组(分别为5.06±0.79、2.59±0.58),差异有统计学意义(均P<0.05).术中EABR分级和术后CAP评分具有明显相关性(r=0.78,P<0.05).结论:EABR能够较准确地反映听觉传导通路功能的完整性,有利于判断内耳道狭窄患者人工耳蜗植入后能否获得听觉反应.EABR辅助人工耳蜗植入前的全面评估,内耳道狭窄患者的听觉言语能力可得到不同程度的康复.%Objective:To investigate the intra-operative electrical evoked auditory brain stem response(EABR) characteristics and the hearing and speech rehabilitation effects of cochlear implantation(CI) in patients with internal auditory canal stenosis(IACS).Method:A retrospective study was performed on 16 patients with IACS (IACS group) matched with 16 implantees without IACS(control group),who received multi-channel CI because of prelingual sensorineural hearing loss

  7. How Communication Disharmonies between Patients and Nurses Can Affect Patients

    DEFF Research Database (Denmark)

    Thygesen, Marianne Kirstine; D. Pedersen, Birthe

    2017-01-01

    and drained of energy. The Broaden and Build theory and the Sense of Coherence theory might support our findings. True presence of the nurse is important in order to meet the patient where she is and communicate from there. More evidence based suggestions for future clinical foci are given. Female cancer......Patient-provider interaction is important for cancer patients’ wellbeing and further coping and it might be beneficial to further investigate this in the fast track trajectories. Cancer patients experience themselves as liminal and we aimed to investigate how patients experience healthcare...

  8. Respiratory failure in elderly patients.

    Science.gov (United States)

    Sevransky, Jonathan E; Haponik, Edward F

    2003-02-01

    Elderly individuals comprise an increasing proportion of the population and represent a progressively expanding number of patients admitted to the ICU. Because of underlying pulmonary disease, loss of muscle mass, and other comorbid conditions, older persons are at increased risk of developing respiratory failure. Recognition of this vulnerability and the adoption of proactive measures to prevent decompensation requiring intrusive support are major priorities together with clear delineation of patients' wishes regarding the extent of support desired should clinical deterioration occur. Further, the development of coordinated approaches to identify patients at risk for respiratory failure and strategies to prevent the need for intubation, such as the use of NIV in appropriate patients, are crucial. As soon as endotracheal intubation and mechanical ventilation are implemented strategies that facilitate the liberation of elderly patients from the ventilator are especially important. The emphasis on a team approach, which characterizes geriatric medicine, is essential in coordinating the skills of multiple health care professionals in this setting. Respiratory failure can neither be effectively diagnosed nor managed in isolation. Integration with all other aspects of care is essential. Patient vulnerability to nosocomial complications and the "cascade effect" of these problems such as the effects of medications and invasive supportive procedures all impact on respiratory care of elderly patients. For example, prolonged mechanical ventilation may be required long after resolution of the underlying cause of respiratory failure because of unrecognized and untreated delirium or residual effects of small doses of sedative and/or analgesic agents or other medications in elderly patients with altered drug metabolism. The deleterious impact of the foreign and sometimes threatening ICU environment and/or sleep deprivation on the patient's course are too often overlooked because

  9. Neurotrophin gene therapy for sustained neural preservation after deafness.

    Directory of Open Access Journals (Sweden)

    Patrick J Atkinson

    Full Text Available The cochlear implant provides auditory cues to profoundly deaf patients by electrically stimulating the residual spiral ganglion neurons. These neurons, however, undergo progressive degeneration after hearing loss, marked initially by peripheral fibre retraction and ultimately culminating in cell death. This research aims to use gene therapy techniques to both hold and reverse this degeneration by providing a sustained and localised source of neurotrophins to the deafened cochlea. Adenoviral vectors containing green fluorescent protein, with or without neurotrophin-3 and brain derived neurotrophic factor, were injected into the lower basal turn of scala media of guinea pigs ototoxically deafened one week prior to intervention. This single injection resulted in localised and sustained gene expression, principally in the supporting cells within the organ of Corti. Guinea pigs treated with adenoviral neurotrophin-gene therapy had greater neuronal survival compared to contralateral non-treated cochleae when examined at 7 and 11 weeks post injection. Moreover; there was evidence of directed peripheral fibre regrowth towards cells expressing neurotrophin genes after both treatment periods. These data suggest that neurotrophin-gene therapy can provide sustained protection of spiral ganglion neurons and peripheral fibres after hearing loss.

  10. Anemia in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Laušević Mirjana

    2006-01-01

    Full Text Available A normocytic normochromic anemia is one of the first signs of renal failure. Since anemia increases morbidity and mortality, its elimination is one of the essential objectives of the treatment. Human recombinant erythropoietin (rHuEPO has changed the therapeutical approach to anemia. The aim of the present study was to compare efficacy of anemia correction in peritoneal dialysis patients depending on treatment and dialysis modality. The study is the retrospective analysis of 64 patients who presented to our Clinic in 2003. Eighteen (28.13% patients were treated with rHuEPO, 14 (28% underwent continuous ambulatory peritoneal dialysis (CAPD, 2 (100% - automated peritoneal dialysis (APD and 2 (33.3% - intermittent peritoneal dialysis (IPD. Mean hemoglobin level was 98.6±17.82 g/l in patients treated with rHuEPO versus 98.81±15.14 g/I in patients without rHuEPO treatment. Erythropoietin requirements were 3392.85±1211.77 IU/week. AII patients received iron supplementation during rHuEPO therapy. Mean serum ferritin levels were 463.41 ±360 μg/l. Transferrin saturation (TSAT was 0.35±0.16%. No difference of serum iron and TSAT levels was found between CAPD and IPD patients. The degree of anemia significantly differed between CAPD and IPD patients. A total of 17.11% of PD patients were given blood transfusions, most frequently during the first three months after the onset of dialysis. Our conclusion is that the number of patients receiving rHuEPO should be increased, as 50% of our patients should be substituted, while only 28% are being treated. As 50% of patients receiving rHuEPO failed to reach target Hgb levels, higher EPO doses should be considered. Iron stores should be continuously monitored, particularly in patients receiving rHuEPO, since iron deficiency is an important problem for patients undergoing peritoneal dialysis, especially during erythropoietin therapy. Oral iron supplementation is satisfactory in the majority of patients, and

  11. A Porsche for patient accrual.

    Science.gov (United States)

    Steinberg, David

    2005-01-01

    A $1,000 lottery ticket for a Porsche Boxster automobile was offered to the investigator who accrued the most patients to a Southwest Oncology Group prostate cancer protocol. This was done with the admirable intention of increasing patient accrual and improving the outlook for men with high risk prostate cancer. However, the offer of this prize also makes the statement that it is permissible to reward a doctor with an expensive automobile for putting patients on an oncology research protocol. Awarding an expensive prize for patient accrual risks eroding public confidence by creating the perception that clinical investigators, swayed by the allure of an expensive automobile, were motivated by material self-interest rather than the welfare of their patients and the advancement of medical science. I suspect that if the practice of expensive rewards for patient accrual became widespread the cumulative damage would ultimately outweigh the benefits.

  12. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  13. Web Applications for Patient Communication.

    Science.gov (United States)

    Lewis, Kristopher; Reicher, Murray A

    2016-12-01

    Communication between imaging professionals and patients can help achieve many goals, including improved patient understanding of imaging-related diagnostic and treatment options, better compliance with appropriate imaging screening procedures, and improved efficiency of service. The explosive growth of out-of-pocket consumer spending on health care has heightened health care shopping, thus making patient communication an important goal of any imaging practice or health care organization. Furthermore, the Merit-Based Incentive Payment System introduced by CMS will publicly disclose physicians' quality ratings, which are in part dependent on patient engagement. The authors summarize the rationale for web communication with patients, the range of content that should be considered, and the technology options. The aim is to help imaging providers develop organized patient communication strategic and implementation plans. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  15. Conversations with chronic schizophrenic patients.

    Science.gov (United States)

    Morgan, R

    1979-02-01

    An account is given of some of the topics discussed during a small informal weekly open group meeting of chronic schizophrenic patients, based on occasional notes compiled over eleven years. The main feature of the patients' condition as displayed was poverty--clinical, social, behavioural, material and financial--and certain features suggested an organic aetiology. Reasons are given for considering that the patients' condition was predominantly caused by schizophrenia rather than by institutionalism.

  16. Genital reconstruction in exstrophy patients

    OpenAIRE

    2012-01-01

    Introduction: Surgery for bladder exstrophy has been evolving over the last four to five decades. Because survival has become almost universal, the focus has changed in the exstrophy-epispadias complex to improving quality of life. The most prevalent problem in the long-term function of exstrophy patients is the sexual activity of the adolescent and adult males. The penis in exstrophy patients appears short because of marked congenital deficiency of anterior corporal tissue. Many patients app...

  17. Thromboprophylaxis in immobilized medical patients.

    Science.gov (United States)

    Vaitkus, Paul T

    2004-03-30

    Venous thromboembolism accounts for a large number of preventable deaths. The majority of these events occur in medical patients, but medical thromboprophylaxis remains underutilised in this population. The purpose of this review is to examine the results of recent clinical trials of low molecular weight heparins in the prevention of venous thromboembolic disease in medical patients. The available data make a compelling case in favor of widespread use of low molecular weight heparin in medical patients.

  18. Phaeohyphomycosis in Transplant Patients

    Directory of Open Access Journals (Sweden)

    Sanjay G. Revankar

    2015-12-01

    Full Text Available Phaeohyphomycosis is caused by a large, heterogenous group of darkly pigmented fungi. The presence of melanin in their cell walls is characteristic, and is likely an important virulence factor. These infections are being increasingly seen in a variety of clinical syndromes in both immunocompromised and normal individuals. Transplant patients are especially at risk due their prolonged immunosuppression. There are no specific diagnostic tests for these fungi, though the Fontana-Masson stain is relatively specific in tissue. They are generally seen in a worldwide distribution, though a few species are only found in specific geographic regions. Management of these infections is not standardized due to lack of clinical trials, though recommendations are available based on clinical experience from case reports and series and animal models. Superficial infections may be treated without systemic therapy. Central nervous system infections are unique in that they often affect otherwise normal individuals, and are difficult to treat. Disseminated infections carry a high mortality despite aggressive therapy, usually with multiple antifungal drugs. Considerable work is needed to determine optimal diagnostic and treatment strategies for these infections.

  19. Psychotherapy patient transfer: secondhand rose.

    Science.gov (United States)

    Sederer, L

    1975-10-01

    The author uses the analogy of the marketplace to examine the dynamics of the transfer of psychotherapy patients in university clinic settings. The outgoing therapist is the seller, the prospective therapist the buyer, and the patient the commodity--the secondhand Rose. Marketing techniques that are used in this buyers' market allow no active patient participation and are therefore antithetical to the tenets of psychotherapy. The author suggests early clarification of therapeutic goals, assignment of therapists on the basis of patient choice, and explanation of time frames and limits as means for ameliorating the problems he describes.

  20. Engaging patients through your website.

    Science.gov (United States)

    Snyder, Kimberlee; Ornes, Lynne L; Paulson, Pat

    2014-01-01

    Legislation requires the healthcare industry to directly engage patients through technology. This paper proposes a model that can be used to review hospital websites for features that engage patients in their healthcare. The model describes four levels of patient engagement in website design. The sample consisted of 130 hospital websites from hospitals listed on 2010 and 2011 Most Wired Hospitals. Hospital websites were analyzed for features that encouraged patient interaction with their healthcare according to the levels in the model. Of the four levels identified in the model, websites ranged from "informing" to "collaborative" in website design. There was great variation of features offered on hospital websites with few being engaging and interactive.

  1. Fungal laryngitis in immunocompetent patients.

    Science.gov (United States)

    Ravikumar, A; Prasanna Kumar, S; Somu, L; Sudhir, B

    2014-01-01

    The diagnosis of fungal laryngitis is often overlooked in immunocompetent patients because it is commonly considered a disease of the immunocompromised. Further confusion is caused by clinical and histological similarity to more common conditions like Leukoplakia. Demonstration of hyperkeratosis particularly if associated with intraepithelial neutrophils on biopsy should trigger a search for fungus using specialized stains. These patients usually present with hoarseness of voice. Pain is present inconsistently along with dysphagia and odynophagia. We present three cases of fungal laryngitis in immunocompetent patients out of which one underwent microlaryngeal surgery with excision biopsy. All these patients responded well with oral antifungal therapy.

  2. Psychological distress and patient satisfaction.

    Science.gov (United States)

    Greenley, J R; Young, T B; Schoenherr, R A

    1982-04-01

    Psychologically distressed patients and clients of health care and social service organizations are found to report somewhat more dissatisfaction with services than do the nondistressed. Four explanations for this relationship are examined: 1) the psychologically distressed are generally dissatisfied; 2) service providers react negatively to the psychologically distressed; 3) psychologically distressed patients are dissatisfied when service providers do not respond to their psychological needs; and 4) patients who deny their psychological distress tend to be dissatisfied. The results show that the psychologically distressed report more dissatisfaction because of the very high levels of dissatisfaction found among patients who deny having personal problems.

  3. Patient Transport via Commercial Airlines

    Science.gov (United States)

    Macnab, Andrew John

    1992-01-01

    Because the frequency of patient transport from one hospital to another is increasing and the popularity of air travel continues to rise, physicians should be aware of the procedures for patient transport by commercial airlines. Major airlines in Canada have experienced personnel and established procedures that facilitate the transportation of patients with special medical needs. By working with the airline medical health officers and using up-to-date equipment, physicians can achieve safe, cost-effective transport of appropriate patients via commercial aircraft. PMID:21221401

  4. Nutrition in the hospitalized patient.

    Science.gov (United States)

    Kirkland, Lisa L; Kashiwagi, Deanne T; Brantley, Susan; Scheurer, Danielle; Varkey, Prathibha

    2013-01-01

    Almost 50% of patients are malnourished on admission; many others develop malnutrition during admission. Malnutrition contributes to hospital morbidity, mortality, costs, and readmissions. The Joint Commission requires malnutrition risk screening on admission. If screening identifies malnutrition risk, a nutrition assessment is required to create a nutrition care plan. The plan should be initiated early in the hospital course, as even patients with normal nutrition become malnourished quickly when acutely ill. While the Harris-Benedict equation is the most commonly used method to estimate calories, its accuracy may not be optimal in all patients. Calculating the caloric needs of acutely ill obese patients is particularly problematic. In general, a patient's caloric intake should be slightly less than calculated needs to avoid the metabolic risks of overfeeding. However, most patients do not receive their goal calories or receive parenteral nutrition due to erroneous practices of awaiting return of bowel sounds or holding feeding for gastric residual volumes. Patients with inadequate intake over time may develop potentially fatal refeeding syndrome. The hospitalist must be able to recognize the risk factors for malnutrition, patients at risk of refeeding syndrome, and the optimal route for nutrition support. Finally, education of patients and their caregivers about nutrition support must begin before discharge, and include coordination of care with outpatient facilities. As with all other aspects of discharge, it is the hospitalist's role to assure smooth transition of the nutrition care plan to an outpatient setting.

  5. Patients with multiple contact allergies

    DEFF Research Database (Denmark)

    Carlsen, Berit Christina; Andersen, Klaus Ejner; Menné, Torkil;

    2008-01-01

    Patients with multiple contact allergies, also referred to as polysensitized, are more frequent than predicted from prevalence of single sensitivities. The understanding of why some people develop multiple contact allergies, and characterization of patients with multiple contact allergies...... 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 patients with multiple contact allergies. We suggest that contact allergy to 3 or more allergens are defined as multiple contact allergies....

  6. Orthodontic treatment in oncological patients.

    Science.gov (United States)

    Mituś-Kenig, Maria; Łoboda, Magdalena; Marcinkowska-Mituś, Agata; Durka-Zajac, Magdalena; Pawłowska, Elzbieta

    2015-01-01

    The progress in oncological treatment has led to the current increase of childhood cancer survival rate to 80%. That is why orthodontists more and more frequently consult patients who had completed a successful anti-cancer therapy in childhood. Oncological treatments such as chemotherapy, radiotherapy or supportive immunosuppressive therapy cause numerous side effects in growing patients, connected i.a. with growth, the development of teeth or the viscerocranium. This is a special group of patients that needs an optimised plan of orthodontic treatment and often has to accept a compromise result. The purpose of the current work is to discuss the results of orthodontic treatment in patients after an anti-cancer therapy. Time of treatment was 12,5 months. In 6 patients (from 40 undergoing orthodontic therapy) we haven't reached a normocclusion, in 9 patients we should have stopped the therapy because of the recurrence. In 11 patients we found mucosa inflammation and in 1 patient the therapy stopped before the end because of very low oral hygiene level. Bearing in mind the limited number of original works on the above topic in Polish medical literature, the study has been carried out in order to make Polish orthodontists more acquainted with the topic and the standards of dealing with an oncological patient.

  7. Mandibulotomy in the irradiated patient

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J.; Freeman, J.; Birt, D.

    1989-04-01

    Though the mandibular swing, as an approach to certain upper aerodigestive tract malignancies, has been gaining popularity in recent years, there has been little reported as to the feasibility of this procedure in subjects who have received radical preoperative radiotherapy. We have recently reported the results of 23 such patients, and we now present an update. The results presented are of a retrospective analysis of 44 patients, 50% of whom received radical preoperative radiotherapy to fields including the osteotomy site. As in the previous study, there were no statistically significant differences between the complication rates in the irradiated and nonirradiated patient populations. All the patients were orally rehabilitated.

  8. Erectile dysfunction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Imen Gorsane

    2016-01-01

    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.

  9. Hospitalized Older Adults’ Patient Satisfaction

    Directory of Open Access Journals (Sweden)

    Neale R. Chumbler

    2016-04-01

    Full Text Available This article examines the extent to which older adult patients’ perceptions of inpatient dimensions of care experiences are associated with their overall satisfaction. A secondary objective is to determine if these specific care experiences differed between elderly female and male patients. Patient satisfaction data from 6,021 older patients (65 years of age and older were collected by using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS Survey through telephone interviews of older patients who were recently discharged. Multiple linear regression analyses with older patients’ HCAHPS dimensions (Communication With Nurses, Communication With Doctors, Responsiveness of Hospital Staff, Communication About Medicines, Cleanliness of the Hospital Environment, and Quietness of Hospital Environment and gender were conducted while controlling for self-rated health status, age, race, and education. Multiple linear regression analysis showed that all of the HCAHPS dimensions were significantly associated with overall satisfaction. Older female patients reported substantially more positive global evaluations than their male counterparts. However, for older male patients, Communication With Doctors was more influential in their ratings of overall satisfaction than for older female patients. For older female patients, Communication With Nurses was more influential in their ratings of overall satisfaction than for older male patients.

  10. Observation af kritisk syge patienter

    DEFF Research Database (Denmark)

    Fuhrmann, Lone; Hesselfeldt, Rasmus; Lippert, Anne

    2009-01-01

    . 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...... vital signs measured by study personnel. A total of 77% of patients had vital signs documented in their records on the day of the observation. The previous day, vital signs were documented in 70% of records and on the day after in 66%. The documentation of vital signs was significantly higher when staff...

  11. Patient bill of rights 2001.

    Science.gov (United States)

    Benjamin, G C

    2001-01-01

    Breaking gridlock on managed care reform, a bipartisan coalition in Congress introduced the newest version of a patient bill of rights. Unlike last year's ill-fated Norwood-Dingell bill, the Bipartisan Patient Protection Act of 2001 has strong bipartisan support; concern remains, however, on the provisions that allow patients to sue their managed care plan. The debate now focuses on the type of liability reform that Congress and the White House can agree on. If they are able to agree, a patient bill of rights may soon become law.

  12. Thyroid Disease in the Older Patient

    Science.gov (United States)

    ... a brother, sister or child of the patient. HYPERTHYROIDISM IN THE OLDER PATIENT As in all hyperthyroid ... and family. TREATMENT OF THE OLDER PATIENT WITH HYPERTHYROIDISM As with younger patients, treatment of hyperthyroidism in ...

  13. Controlling Hypertension in Diabetic Patients | Familoni | Nigerian ...

    African Journals Online (AJOL)

    Controlling Hypertension in Diabetic Patients. ... risk factor for both macrovascular and microvascular complications in patients with diabetes. ... about 22.4% of patients with type 1 and 58.9% of patients with type 2 diabetes mellitus in Nigeria.

  14. Patient safety risks and patients treated by multiple specialties.

    NARCIS (Netherlands)

    Baines, R.; Bruijne, M. de; Langelaan, M.; Wagner, C.

    2013-01-01

    Objectives: To determine if the number of medical specialties treating a patient is associated with the risk of experiencing harm during hospital admission. Methods: We performed structured retrospective patient record review study by trained nurses and physicians. We included 20 hospitals in the N

  15. Individual patient information to select patients for different radiation techniques

    NARCIS (Netherlands)

    Quik, E. H.; Feenstra, T. L.; Postmus, D.; Slotman, B. J.; Leemans, C. R.; Krabbe, P. F. M.; Langendijk, J. A.

    2016-01-01

    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

  16. [Patient information in radiooncology Information seeking behaviour and patient characteristics].

    Science.gov (United States)

    Pour-Haring, Herta Farassati; Volleritsch, Christa; Roth, Roswith

    2009-01-01

    Provision of relevant and accurate information is an important factor for patient-satisfaction. This study investigated the self-assessed level of information, information needs and sources of information of patients undergoing radiotherapy in correlation between socio-demographic, medical and psychological variables. A self-ministered questionnaire designed to measure the self-assessed level of information and information needs was distributed to 133 cancer patients before (t(1)) and 14 days after the first medical consultation (t(2)). "Anxiety" and "Social desirability" were assessed at t(1) and four groups of coping methods (repressive, sensitive, anxious, non-defensive/non-anxious) were derived. Sources of information were elicited at t(2). The self-assessed level of information increased, while the demand for information declined. Female patients felt better informed than males. Older patients had a lower self-assessed level of information than younger patients. Among the four groups using different methods of coping, the repressive group wanted the least information. Generally medical consultations were preferred and other sources of information rarely were used. Where there are a large number of older patients with a low educational background, the use of computers is not appropriate at the moment. It can, however, be assumed that the next generation of patients will have a more practical knowledge of computers, and will thus make better use of this method of communication.

  17. Importance of patient centred care for various patient groups.

    NARCIS (Netherlands)

    Rademakers, J.J.D.J.M.; Delnoij, D.M.J.; Boer, D. de

    2010-01-01

    Background: Though patient centred care is a somewhat ‘fuzzy’ concept, in general it is considered as something to strive for. However, preliminary evidence suggests that the importance of elements of patient-centred care (PCC), such as communication, information and shared decision making, may vary

  18. Identifying Patients at Risk and Patients in Need

    DEFF Research Database (Denmark)

    Schmidt, Thomas

    2015-01-01

    En væsentlig andel af patienter oplever forværring under indlæggelse på Fælles Akutmodtagelsen (FAM). At identificere disse forværringer før de bliver alvorlige er vanskeligt for klinikere eftersom de behandler meget forskellige patienter under et stort pres for at bevare overblik og årvågenhed. ...

  19. Emerging versions of patient involvement with Patient Reported Outcomes

    DEFF Research Database (Denmark)

    Langstrup, Henriette

    It is a central argument in the growing Danish PRO-arena, that a large-scale collection of PRO from patients in the Danish Healthcare system will pave the way for more genuine patient involvement in clinical decision-making, quality management and governance of the health services. In this paper I...... discuss how patient involvement is being (re)configured when increasingly connected to national visions of participatory healthcare. A central discussion centers on ‘meaningful use’ of patient-generated data promoting patients’ expectations and experiences as a criterion for how to proceed...... involvement with PRO, I want to point to the need for further empirical exploration of how patients and professionals engage with PRO in specific daily practices and to stimulate a general discussion of all too simple normativities of the so-called ‘participatory turn’ in healthcare. I draw onempirical...

  20. Patient safety: Safety culture and patient safety ethics

    DEFF Research Database (Denmark)

    Madsen, Marlene Dyrløv

    2006-01-01

    and interviews with staff and management in four hospital departments. The appendix contains the Patient Safety Culture Questionnaire tool that I have developed, tested and revised for use in theDanish hospital setting based on the research projects on safety culture described in papers 3, 4 and 5. Paper 6......Patient safety - the prevention of medical error and adverse events - and the initiative of developing safety cultures to assure patients from harm have become one of the central concerns in quality improvement in healthcare both nationally andinternationally. This subject raises numerous...... the problems, and suggest possible solutions for improving patient safety through the promotion of safety culture and ethics. I seek to illuminate theissues of patient safety from several perspectives; the organizational healthcare system, in particular the healthcare workers perspectives and experiences...

  1. Can patient safety be measured by surveys of patient experiences?

    Science.gov (United States)

    Solberg, Leif I; Asche, Stephen E; Averbeck, Beth M; Hayek, Anita M; Schmitt, Kay G; Lindquist, Tim C; Carlson, Richard R

    2008-05-01

    A study was conducted to test whether patient reports of medical errors via surveys could produce sufficiently accurate information to be used as a measure of patient safety. A survey mailed regularly by a large multispecialty medical group to recent patients to assess their satisfaction and error experiences was expanded to collect more details about the patient-perceived errors. Following an initial mailing to 3,109 patients and parents of child patients soon after they had office visits in June 2005, usable mailed or phone follow-up responses were obtained from 1,998 respondents (65.1% adjusted). Responses were reviewed through a two-stage process that included chart audits and implicit physician reviewer judgments. The analysis categorized the review results and compared patient-reported errors with satisfaction. Of the 1,998 respondents, 219 (11.0%) reported 247 separate incidents, for a rate of 12.4 errors per 100 patients. After complete review, only 5 (2.0%) of these incidents were judged to be real clinician errors. Most appeared to represent misunderstandings or behavior/communication problems, but 15.4% lacked sufficient information to categorize. Women, Hispanics, and those aged 41-60 years were most likely to report errors. Those respondents making error reports were much more likely to report visit dissatisfaction than those not reporting them (odds ratio [OR] = 13.8, p technical medical errors and patient safety reliably without added evaluation. This study's findings need to be replicated elsewhere before generalizing from one metropolitan region and a patient population that is about two-thirds members of one health plan.

  2. Patient safety culture among nurses.

    Science.gov (United States)

    Ammouri, A A; Tailakh, A K; Muliira, J K; Geethakrishnan, R; Al Kindi, S N

    2015-03-01

    Patient safety is considered to be crucial to healthcare quality and is one of the major parameters monitored by all healthcare organizations around the world. Nurses play a vital role in maintaining and promoting patient safety due to the nature of their work. The purpose of this study was to investigate nurses' perceptions about patient safety culture and to identify the factors that need to be emphasized in order to develop and maintain the culture of safety among nurses in Oman. A descriptive and cross-sectional design was used. Patient safety culture was assessed by using the Hospital Survey on Patient Safety Culture among 414 registered nurses working in four major governmental hospitals in Oman. Descriptive statistics and general linear regression were employed to assess the association between patient safety culture and demographic variables. Nurses who perceived more supervisor or manager expectations, feedback and communications about errors, teamwork across hospital units, and hospital handoffs and transitions had more overall perception of patient safety. Nurses who perceived more teamwork within units and more feedback and communications about errors had more frequency of events reported. Furthermore, nurses who had more years of experience and were working in teaching hospitals had more perception of patient safety culture. Learning and continuous improvement, hospital management support, supervisor/manager expectations, feedback and communications about error, teamwork, hospital handoffs and transitions were found to be major patient safety culture predictors. Investing in practices and systems that focus on improving these aspects is likely to enhance the culture of patient safety in Omani hospitals and others like them. Strategies to nurture patient safety culture in Omani hospitals should focus upon building leadership capacity that support open communication, blame free, team work and continuous organizational learning. © 2014 International

  3. Patient Satisfaction After Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    V. Tari

    2008-02-01

    Full Text Available Background:Patient satisfaction with the cosmetic result of spinal fusion surgery was studied in 40 cases of adolescent idiopathic scoliosis.Neutral or dissatisfied patients were compared with satisfied patients in several physical and psychological characteristics. The aim of the study was to determine whether adolescents generally report satisfaction with the postoperative appearance of their back after the correction of severe curves and whether preoperative medical and/or psychological factors could distinguish between patients who report satisfaction with the cosmetic surgical result from those who report neutrality or dissatisfaction. Previous reports emphasize the need for medical outcome research that evaluates both patient satisfaction and technical success. Patient satisfaction with spinal surgery has largely been evaluated in retrospective studies and most consistently is related to postoperative cosmesis and degree of curve correction. Methods: 40 adolescents with idiopathic scoliosis without any comorbidity who were 10 years of age or older were studied preoperatively by physical and psychological measurements. Results: Of patients undergoing surgical correction of severe curves, 50% reported satisfaction with the cosmetic result. Neutral or dissatisfied patients were more likely to have a King II or King IV curve types and less correction than satisfied patients. Preoperative psychological difficulties (P< 0.05 and unmet expectations regarding postoperative cosmesis (P<0.05 were more common among neutral or dissatisfied patients. Conclusion: Most adolescents with idiopathic scoliosis expressed satisfaction with the cosmetic surgical result. Preoperative physical characteristics, psychological difficulties, and unrealistic expectations regarding postoperative cosmesis are associated with patient neutrality or dissatisfaction.

  4. Patient error: a preliminary taxonomy.

    NARCIS (Netherlands)

    Buetow, S.; Kiata, L.; Liew, T.; Kenealy, T.; Dovey, S.; Elwyn, G.

    2009-01-01

    PURPOSE: Current research on errors in health care focuses almost exclusively on system and clinician error. It tends to exclude how patients may create errors that influence their health. We aimed to identify the types of errors that patients can contribute and help manage, especially in primary ca

  5. Venous thrombosis : a patient's view

    NARCIS (Netherlands)

    Korlaar, Inez van

    2006-01-01

    The studies described in this thesis had two main aims: 1) To study the quality of life of patients with venous thrombosis and to examine the role of illness perceptions in explaining the quality of life of these patients. 2) To assess the psychological consequences of genetic testing for thrombop

  6. Communicating effectively with deaf patients.

    Science.gov (United States)

    McAleer, Monica

    This article explores the communication needs of deaf patients who use British Sign Language as their first or preferred language. It would appear that these needs are not being met, particularly in acute hospital settings. Practical advice is provided for nurses to improve the quality of care that deaf patients receive.

  7. Asthma control: Patient and environment

    NARCIS (Netherlands)

    Rijssenbeek-Nouwens, L.H.M.

    2015-01-01

    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

  8. Patient Disclosure of Medical Misdeeds

    Science.gov (United States)

    Bergen, Clara; Stivers, Tanya

    2013-01-01

    Modern patients walk a tightrope between respecting medical authority and acting as knowledgeable advocates regarding health issues, with the agency and responsibilities that come with this. This article uses conversation analysis to explore this balance in relation to patient disclosures of medical misdeeds in video-recorded primary care medical…

  9. Corneal Protection for Burn Patients

    Science.gov (United States)

    2013-10-01

    Houston, TX Purpose:Patients with severe facial burns often suffer indirect damage to their eyes. Burn wound contracture of the periocular skin...periocular muscles , are injured and the protective blink reflex is lost. With loss of the blink reflex the patient quickly develops exposure keratitis

  10. Empowering Patients: PD in Healthcare

    DEFF Research Database (Denmark)

    Kensing, Finn; Strand, Dixi Louise; Bansler, Jørgen P.

    2004-01-01

    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 empowe...

  11. Psychodynamics in medically ill patients.

    Science.gov (United States)

    Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

    2009-01-01

    This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

  12. Industrial Robots for Patient Support

    Science.gov (United States)

    Sommer, Andres

    Flexibility, precision, and capability to support the clinical workflow make robots the ideal choice for ion beam therapy (IBT) facilities for use in patient positioning. To fulfill the clinical needs in IBT, an industrial robot patient positioner needs to be carefully designed regarding applications and safety issues as well as precision and handling.

  13. Nursing professional facing patient privacy

    Directory of Open Access Journals (Sweden)

    Fidel López Espuela

    2010-05-01

    Full Text Available Privacy of patients admitted to the hospital is played down in favour of other needs considered more basic by the healthcare system and more related to the disease than to patients themselves. Situations and factors where privacy is damaged are frequent, but it is known that when these are avoided by professionals’ attitude, through strategies and different mechanisms, it becomes one of the most satisfactory elements to patients.Objectives: To identify and analyze situations and factors which affect privacy in hospital environment as well as the adaptation capacity of patients to them.Methodology: Phenomenological, qualitative research. By means of discussion groups with professionals, the following questions where answered: ‘What do professionals understand by privacy? Which situations and factors jeopardize it during the hospital stay? How do they think patients get adapted?Results: The concept of privacy is complex, personal and non-transferable. Situations in which it is jeopardized were divided in 5 main areas. Numerous behaviors regarding adaptation of patients to these were collected.Discussion: Although there is little nursery research referring to privacy and its defense in the professional-patient relationship field, concern about this aspect always shown by nursery staff stands out.As a conclussion, we observe the need to complement this research with the perception patients have about these same questions, establishing the importance they give to privacy.

  14. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    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...

  15. Hypokalemia in acute medical patients

    DEFF Research Database (Denmark)

    Jensen, Helene Christine Kildegaard; Brabrand, Mikkel; Vinholt, Pernille Just

    2015-01-01

    . 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...... or betagonist use. CONCLUSIONS: In a mixed population of hospitalized medical patients, hypokalemia is common and plasma [K(+)

  16. Monitoring of stable glaucoma patients

    NARCIS (Netherlands)

    K.M. Holtzer-Goor (Kim); N.S. Klazinga (Niek); M.A. Koopmanschap (Marc); H.G. Lemij (Hans); T. Plochg; E. van Sprundel (Esther)

    2010-01-01

    textabstractA high workload for ophthalmologists and long waiting lists for patients challenge the organization of ophthalmic care. Tasks that require less specialized skills, like the monitoring of stable (well controlled) glaucoma patients could be substituted from ophthalmologists to other profes

  17. Metabolic alterations in dialysis patients

    NARCIS (Netherlands)

    Drechsler, Christiane

    2010-01-01

    Assessing metabolic risk in dialysis patients, three main aspects are important: a) the pathophysiologic effects of metabolic disturbances as known from the general population are unlikely to completely reverse once patients reach dialysis. b) Specific additional problems related to chronic kidney d

  18. Perioperative nutrition in cancer patients.

    Science.gov (United States)

    Daly, J M; Redmond, H P; Gallagher, H

    1992-01-01

    Cancer patients have the highest incidence of protein-calorie malnutrition seen in hospitalized patients, with significant malnutrition occurring in more than 30% of cancer patients undergoing major upper gastrointestinal procedures. Clinically significant malnutrition occurs as a result of diminished nutrient intake, increased nutrient losses, and tumor-induced derangements in host metabolism. In the absence of adequate exogenous nutrients, the body utilizes endogenous substrates to satisfy the ongoing requirements of both host and tumor for energy and protein. In those patients with malignant obstruction of the gastrointestinal tract, the tumor itself may induce diminished nutrient intake. Present day treatment modalities including gastrointestinal resection, chemotherapy, and radiotherapy compound these metabolic derangements, further increasing the risk of postoperative morbidity and death. The presence of malnutrition in cancer patients has prognostic importance. In a review of more than 3000 cancer patients, DeWys and colleagues identified significantly improved survival in those patients without weight loss compared with those had lost 6% of their body weight (Am J Med 69:491-497, 1980). Other investigators have noted increased postoperative morbidity and mortality associated with malnutrition. Early hypotheses suggested that reversal of weight loss would improve survival. The development and refinements of enteral and parenteral nutrition have provided the opportunity for studying the relationship between nutritional supplementation and postoperative prognosis. Nutrition support is therefore often instituted to improve nutritional status and thereby reduce the risks of postoperative complications. This article addresses the beneficial role of preoperative nutrition therapy in cancer patients.

  19. Preventing pitfalls in patient surveys.

    Science.gov (United States)

    Steiber, S R

    1989-05-01

    Properly conceived, customer satisfaction surveys can yield the quantitative data needed to gauge patient satisfaction. But, as the author notes, these surveys can be "a veritable mine field of surprises for the uninitiated." This article, the last in a three-part series on measuring patient satisfaction, describes potential pitfalls and discusses the merits of in-person, mail and telephone surveys.

  20. Venous thrombosis : a patient's view

    NARCIS (Netherlands)

    Korlaar, Inez van

    2006-01-01

    The studies described in this thesis had two main aims: 1) To study the quality of life of patients with venous thrombosis and to examine the role of illness perceptions in explaining the quality of life of these patients. 2) To assess the psychological consequences of genetic testing for

  1. Gadobutrol in Renally Impaired Patients

    Science.gov (United States)

    Michaely, Henrik J.; Aschauer, Manuela; Deutschmann, Hannes; Bongartz, Georg; Gutberlet, Matthias; Woitek, Ramona; Ertl-Wagner, Birgit; Kucharczyk, Walter; Hammerstingl, Renate; De Cobelli, Francesco; Rosenberg, Martin; Balzer, Thomas; Endrikat, Jan

    2017-01-01

    Objective The aim of this study was to assess the potential risk of gadobutrol-enhanced magnetic resonance imaging (MRI) in patients with moderate to severe renal impairment for the development of nephrogenic systemic fibrosis (NSF). Materials and Methods We performed a prospective, international, multicenter, open-label study in 55 centers. Patients with moderate to severe renal impairment scheduled for any gadobutrol-enhanced MRI were included. All patients received a single intravenous bolus injection of gadobutrol at a dose of 0.1 mmol/kg body weight. The primary target variable was the number of patients who develop NSF within a 2-year follow-up period. Results A total of 908 patients were enrolled, including 586 with moderate and 284 with severe renal impairment who are at highest risk for developing NSF. The mean time since renal disease diagnosis was 1.83 and 5.49 years in the moderate and severe renal impairment cohort, respectively. Overall, 184 patients (20.3%) underwent further contrast-enhanced MRI with other gadolinium-based contrast agents within the 2-year follow-up. No patient developed symptoms conclusive of NSF. Conclusions No safety concerns with gadobutrol in patients with moderate to severe renal impairment were identified. There were no NSF cases. PMID:27529464

  2. Metabolic alterations in dialysis patients

    NARCIS (Netherlands)

    Drechsler, Christiane

    2010-01-01

    Assessing metabolic risk in dialysis patients, three main aspects are important: a) the pathophysiologic effects of metabolic disturbances as known from the general population are unlikely to completely reverse once patients reach dialysis. b) Specific additional problems related to chronic kidney

  3. Preoperative anxiety in neurosurgical patients.

    Science.gov (United States)

    Perks, Anna; Chakravarti, Sucharita; Manninen, Pirjo

    2009-04-01

    Anxiety is common in surgical patients, with an incidence of 60% to 92%. There is little information on the incidence and severity of preoperative anxiety in patients scheduled for neurosurgery. The aim of this study was to measure the level of preoperative anxiety in neurosurgical patients and to assess any influencing factors. After the Institutional Review Board approval and informed written consent, 100 patients booked for neurosurgery were interviewed preoperatively. Each patient was asked to grade their preoperative anxiety level on a verbal analog scale, Amsterdam Preoperative Anxiety and Information Scale, and a set of specific anxiety-related questions. The anxiety scores and the responses to the questions were compared between the sex, age, weight, diagnosis, and history of previous surgery. The mean age (+/-SD) was 50+/-13 years. The preoperative diagnosis was tumor (n=64), aneurysm (n=14), and other (n=22). Overall verbal analog scale was 5.2+/-2.7; the score was higher for female (5.8+/-2.8) than male patients (4.6+/-2.5) (PAmsterdam Preoperative Anxiety and Information Scale anxiety and knowledge scores were greater for surgery than for anesthesia. Questionnaire results showed that the most common anxieties were waiting for surgery, physical/mental harm, and results of the operation. In conclusion, our study showed that neurosurgical patients have high levels of anxiety, with a higher incidence in females. There was a moderately high need for information, particularly in patients with a high level of preoperative anxiety.

  4. ECG changes in epilepsy patients

    DEFF Research Database (Denmark)

    Tigaran, S; Rasmussen, V; Dam, M

    1997-01-01

    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...

  5. Dentinal candidiasis in cancer patients.

    Science.gov (United States)

    Damm, D D; Neville, B W; Geissler, R H; White, D K; Drummond, J F; Ferretti, G A

    1988-01-01

    Two examples of an unusual presentation of oropharyngeal candidiasis in cancer patients are offered. The light and scanning electron microscopic appearances of candidiasis involving the dentin of teeth are described. The potential significance of recognition of this form of candidiasis in cancer patients is discussed.

  6. Observation af kritisk syge patienter

    DEFF Research Database (Denmark)

    Fuhrmann, Lone; Hesselfeldt, Rasmus; Lippert, Anne

    2009-01-01

    The aim of this study was to estimate to which extent patients with abnormal vital signs on general wards had their vital signs monitored and documented and to establish if staff concern for patients influenced the level of monitoring and was predictive of increased mortality....

  7. Thromboembolic Complications in Fontan Patients

    DEFF Research Database (Denmark)

    Idorn, L; Jensen, A S; Juul, K

    2013-01-01

    patients and plasma was analyzed in 76 patients for biomarkers reflecting endothelial-, glycocalyx-, platelet-, and fibrinolysis function (histone-complexed DNA fragments, Protein C, soluble CD40 ligand, soluble thrombomodulin, syndecan-1, tissue-type plasminogen activator). The results were compared...

  8. The Danish National Patient Register

    DEFF Research Database (Denmark)

    Lynge, Elsebeth; Sandegaard, Jakob Lynge; Rebolj, Matejka

    2011-01-01

    The Danish National Patient Register (NPR) was established in 1977, and it is considered to be the finest of its kind internationally.......The Danish National Patient Register (NPR) was established in 1977, and it is considered to be the finest of its kind internationally....

  9. Blood transfusion: patient identification and empowerment.

    Science.gov (United States)

    Stout, Lynn; Joseph, Sundari

    Positive patient identification is pivotal to several steps of the transfusion process; it is integral to ensuring that the correct blood is given to the correct patient. If patient misidentification occurs, this has potentially fatal consequences for patients. Historically patient involvement in healthcare has focused on clinical decision making, where the patient, having been provided with medical information, is encouraged to become involved in the decisions related to their individualised treatment. This article explores the aspects of patient contribution to patient safety relating to positive patient identification in transfusion. When involving patients in their care, however, clinicians must recognise the diversity of patients and the capacity of the patient to be involved. It must not be assumed that all patients will be willing or indeed able to participate. Additionally, clinicians' attitudes to patient involvement in patient safety can determine whether cultural change is successful.

  10. Colonoscopic polypectomy in anticoagulated patients

    Institute of Scientific and Technical Information of China (English)

    Shai Friedland; Daniel Sedehi; Roy Soetikno

    2009-01-01

    AIM: To review our experience performing polypectomy in anticoagulated patients without interruption of anticoagulation.METHODS: Retrospective chart review at the Veterans Affairs Palo Alto Health Care System. Two hundred and twenty five polypectomies were performed in 123 patients. Patients followed a standardized protocol that included stopping warfarin for 36 h to avoid supratherapeutic anticoagulation from the bowel preparation. Patients with lesions larger than 1 cm were generally rescheduled for polypectomy off warfarin. Endoscopic clips were routinely applied prophylactically.RESULTS: One patient (0.8%, 95% CI: 0.1%-4.5%)developed major post-polypectomy bleeding that required transfusion. Two others (1.6%, 95% CI:0.5%-5.7%) had self-limited hematochezia at home and did not seek medical attention. The average polyp size was 5.1 ± 2.2 mm.

  11. Mirroring patients – or not

    DEFF Research Database (Denmark)

    Davidsen, Annette Sofie; Fosgerau, Christina Fogtmann

    2015-01-01

    on studies of imitative behaviour within linguistics and psychology, we argue that interactional mirroring is an important aspect of displaying implicit mentalization. We aimed to explore if, and in that case how, mirroring is displayed by general practitioners (GPs) and psychiatrists in 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 and verbal...... and acoustic features of speech. GPs mirrored their patients more than psychiatrists in all modalities and were more flexible in their interactional behaviour. Psychiatrists seemed more static, regardless of the emotionality displayed by patients. Implicitly mirroring and attuning to patients could signify...

  12. Endodontics and the ageing patient.

    Science.gov (United States)

    Johnstone, M; Parashos, P

    2015-03-01

    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. © 2015 Australian Dental Association.

  13. Patients' attitudes towards animal testing

    DEFF Research Database (Denmark)

    Masterton, Malin; Renberg, Tobias; Kälvemark Sporrong, Sofia

    2014-01-01

    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...... of the Swedish Rheumatism Association (n=1195) and to all scientific experts serving on Ethical Review Boards in Sweden (n=364), with response rates of 65 per cent and 60 per cent, respectively. Results show that patients hold a positive stance towards animal testing, but with many caveats, and the level...

  14. Oocyte cryopreservation in oncological patients.

    Science.gov (United States)

    Porcu, Eleonora; Fabbri, Raffaella; Damiano, Giuseppe; Fratto, Rosita; Giunchi, Susanna; Venturoli, Stefano

    2004-04-05

    The use of chemotherapy and radiotherapy in oncological patients may reduce their reproductive potential. Sperm cryopreservation has been already used in men affected by neoplastic disease. Oocyte cryopreservation might be an important solution for these patients at risk of losing ovarian function. A program of oocyte cryopreservation for oncological patients is also present in our center. From June 1996 to January 2000, 18 patients awaiting chemotherapy and radiotherapy for neoplastic disease were included in our oocyte cryopreservation program. Our experience documents that oocyte storage may be a concrete and pragmatic alternative for oncological patients. The duration of oocyte storage does not seem to interfere with oocyte survival as pregnancies occurred even after several years of gamete cryopreservation in liquid nitrogen.

  15. Developing patient safety in dentistry.

    Science.gov (United States)

    Pemberton, M N

    2014-10-01

    Patient safety has always been important and is a source of public concern. Recent high profile scandals and subsequent reports, such as the Francis report into the failings at Mid Staffordshire, have raised those concerns even higher. Mortality and significant morbidity associated with the practice of medicine has led to many strategies to help improve patient safety, however, with its lack of associated mortality and lower associated morbidity, dentistry has been slower at systematically considering how patient safety can be improved. Recently, several organisations, researchers and clinicians have discussed the need for a patient safety culture in dentistry. Strategies are available to help improve patient safety in healthcare and deserve further consideration in dentistry.

  16. Psychological aspects of cancer patients

    Directory of Open Access Journals (Sweden)

    Graça Cardoso

    2014-06-01

    Full Text Available Cancer is accompanied by important psychological distress experienced by both patient and family. From the moment of the diagnosis on, the patient has to develop a great number of mechanisms and tasks of adjustment to the illness and its circumstances. The high prevalence of anxiety and depressive disorders during the course of cancer increases in the end stage disea‐ se. Therefore, a global plan of intervention integrating somatic and psychological/ psychiatric care throughout all the phases of the illness is crucial in the treatment of these patients. Health professionals working on this field can also experience emotional reactions to their patients’ suffering. They should be aware of the emotional aspects involved and develop training to help them intervene adequately with the patient and the family. The articulation between oncologists, palliative care professionals, and mental health care teams can be of great help in providing good quality of care to cancer patients.

  17. Pulmonary complications in neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Randeep Guleria

    2012-01-01

    Full Text Available Pulmonary complications are a major cause of morbidity and mortality in neurosurgical patients. The common pulmonary complications in neurosurgical patients include pneumonia, postoperative atelectasis, respiratory failure, pulmonary embolism, and neurogenic pulmonary edema. Postoperative lung expansion strategies have been shown to be useful in prevention of the postoperative complications in surgical patients. Low tidal volume ventilation should be used in patients who develop acute respiratory distress syndrome. An antibiotic use policy should be put in practice depending on the local patterns of antimicrobial resistance in the hospital. Thromboprophylactic strategies should be used in nonambulatory patients. Meticulous attention should be paid to infection control with a special emphasis on hand-washing practices. Prevention and timely management of these complications can help to decrease the morbidity and mortality associated with pulmonary complications.

  18. Patient discomfort following periapical surgery.

    Science.gov (United States)

    Christiansen, René; Kirkevang, Lise-Lotte; Hørsted-Bindslev, Preben; Wenzel, Ann

    2008-02-01

    The aim of the study was to assess patient discomfort following periapical surgery. Forty-two patients with apical periodontitis were allocated to apicectomy with either smoothening of the gutta-percha root filling or a retrograde root filling with mineral trioxide aggregate (MTA). Pooling all patients, VAS score for pain peaked 3 hours postoperatively (mean VAS = 29). The VAS score for swelling peaked 1 day postoperatively (mean VAS = 41). Patients' overall perception of postoperative discomfort was induced by (questions asked at the day for suture removal): Oral awareness (36 yes, 6 no); swelling (30 yes, 12 no); compromised chewing ability (18 yes, 24 no); pain (15 yes, 27 no). There was no correlation between the operating time and VAS scores for pain and swelling (r .11). Patients experienced little pain and moderate swelling after periapical surgery. Oral awareness was the most reported reason for postoperative discomfort. The operating time was not a decisive factor in relation to postoperative discomfort.

  19. Hormone therapy for transgender patients

    Science.gov (United States)

    2016-01-01

    Many transgender men and women seek hormone therapy as part of the transition process. Exogenous testosterone is used in transgender men to induce virilization and suppress feminizing characteristics. In transgender women, exogenous estrogen is used to help feminize patients, and anti-androgens are used as adjuncts to help suppress masculinizing features. Guidelines exist to help providers choose appropriate candidates for hormone therapy, and act as a framework for choosing treatment regimens and managing surveillance in these patients. Cross-sex hormone therapy has been shown to have positive physical and psychological effects on the transitioning individual and is considered a mainstay treatment for many patients. Bone and cardiovascular health are important considerations in transgender patients on long-term hormones, and care should be taken to monitor certain metabolic indices while patients are on cross-sex hormone therapy. PMID:28078219

  20. Patients experience of source isolation

    DEFF Research Database (Denmark)

    Johansen, Kamilla; Pedersen, Didde; Kragbak, Nina

    2013-01-01

    Patients´ experience of source isolation - a literature review Title: Patients experience of source isolation – a literature review Authors: Nina Kragbak*, Didde Pedersen*, Kamilla Johansen* and Peter E. Jensen** *students, **lecturer, bachelor in science and Ph.D., at VIA University College......, 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...... of the patients perspectives of being isolated to identify areas of potential interest for developing new caring strategies to minimize the negative side effects of isolation. Methods: Literature was systematically searched in CINAHL, Nursing Reference Center, Social Care Online, SveMed+, The Cochrane Library...

  1. Endodontics and the irradiated patient

    Energy Technology Data Exchange (ETDEWEB)

    Cox, F.L.

    1976-11-01

    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.

  2. Protect the Patient from Whom?

    DEFF Research Database (Denmark)

    Pii, Kathrine Hoffmann; Villadsen, Kaspar

    2013-01-01

    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 studies...... of discipline and biopolitics in preventive practices, this study eschews an interpretation that views the powers of the professional health system as invasive and one-directional. Perhaps surprisingly, the study demonstrates how patients in various ways defy a ‘patient-centered’ and empowering approach...... and demand to be treated medically and disciplined in a more traditional sense. The blurring of the public/private boundary, then, cannot be straightforwardly described as a result of a professional health system that, more or less subtly, reaches into the private lives of patients. A more complex picture...

  3. [Longitudinal effects of structured patient education programs for vasculitis patients].

    Science.gov (United States)

    Herlyn, K; Gross, W L; Reinhold-Keller, E

    2008-05-01

    According to the literature it is known that structured standardized patient education represents an effective additional treatment in patients with chronic diseases. Positive effects in the reduction of disease activity and depression have been shown for rheumatoid arthritis, systemic lupus erythematodes, and diabetes mellitus. An interdisciplinary approach for providing information was developed for patients with primary systemic vasculitides (PSV) in the vasculitis center in Bad Bramstedt. The contents of the seminars were revised and condensed into five modules. To evaluate the new form of the program a documentation system was designed. Patients were trained in closed groups (n=10-15) and completed the questionnaires at baseline, 4 weeks, 6 and 12 months following participation. A total of 102 patients in 10 closed groups showed a statistically significant increase in their knowledge in the three aspects of medicine, therapy and side effects, nutrition and physiotherapy. Health-related quality of life in all dimensions increased considerably. Both self-efficacy and the patient-assessed health status improved. The standardized structured education program for vasculitis patients provides an additional treatment in the interdisciplinary care of vasculitis.

  4. Patients' feelings about hand washing, MRSA status and patient information.

    Science.gov (United States)

    Duncan, Christopher Paul; Dealey, Carol

    The purpose of this study was to explore patient opinion about asking healthcare professionals to wash their hands before a clinical procedure and to explore if methicillin-resistant Staphylococcus aureus (MRSA) status and access to patient information about infection control would influence the patients' anxiety about asking. A descriptive survey was undertaken using a semi-structured questionnaire. The questionnaire was distributed to a randomized convenience sample of 185 inpatients across all departments of an acute NHS Trust hospital (response rate 58.9%). Spearman's rank order and Kendall Tau-b tests were used to analyse specific correlations. Respondents were more confident than anxious about being involved in a campaign that empowered patients to ask staff to wash their hands. Patients were more anxious to ask if their previous admission episodes were fewer, if their knowledge of MRSA was high and if there was less information about infection control available. Patients who had contracted MRSA in the past were less anxious, as they had a better understanding of the disease. In addition, more patients felt less anxious about asking staff to wash their hands if staff wore a badge saying 'It's OK to ask'.

  5. Patients as educators: interprofessional learning for patient-centred care.

    Science.gov (United States)

    Towle, Angela; Godolphin, William

    2013-01-01

    Patients with chronic conditions have unique expertise that enhances interprofessional education. Although their active involvement in education is increasing, patients have minimal roles in key educational tasks. A model that brings patients and students together for patient-centred learning, with faculty playing a supportive role, has been described in theory but not yet implemented. To identify issues involved in creating an educational intervention designed and delivered by patients and document outcomes. An advisory group of community members, students and faculty guided development of the intervention (interprofessional workshops). Community educators (CEs) were recruited through community organizations with a healthcare mandate. Workshops were planned by teams of key stakeholders, delivered by CEs, and evaluated by post-workshop student questionnaires. Workshops were delivered by CEs with epilepsy, arthritis, HIV/AIDS and two groups with mental health problems. Roles and responsibilities of planning team members that facilitated control by CEs were identified. Ten workshops attended by 142 students from 15 different disciplines were all highly rated. Workshop objectives defined by CEs and student learning both closely matched dimensions of patient-centredness. Our work demonstrates feasibility and impact of an educational intervention led by patient educators facilitated but not controlled by faculty.

  6. Pulmonary embolism in cancer patients

    Directory of Open Access Journals (Sweden)

    S P Sawant

    2012-01-01

    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.

  7. Patient satisfaction with medical care

    Directory of Open Access Journals (Sweden)

    M. A. Sadovoy

    2017-01-01

    Full Text Available Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federation 

  8. Patient Admission Preferences and Perceptions

    Science.gov (United States)

    Wu, Clayton; Melnikow, Joy; Dinh, Tu; Holmes, James F.; Gaona, Samuel D.; Bottyan, Thomas; Paterniti, Debora; Nishijima, Daniel K.

    2015-01-01

    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

  9. Patient-Centered Care Transition for Patients Admitted through the ED: Improving Patient and Employee Experience

    Directory of Open Access Journals (Sweden)

    Andrea Algauer BSN, RN

    2015-05-01

    Full Text Available With increasing wait times in emergency departments (ED across America, there is a need to streamline the inpatient admission process in order to decrease wait times and more important, to increase patient and employee satisfaction. One inpatient unit at New York-Presbyterian Weill Cornell Medical Center initiated a program to help expedite the inpatient admission process from the ED. The goal of the ED Bridge program is to ease the patient's transition from the ED to an inpatient unit by visiting the patient in the ED and introducing and setting expectations for the inpatient environment (i.e. telemetry alarms, roommates, hourly comfort rounds. Along with improving the patient experience, this program intends to improve the collaboration between ED nurses and inpatient nurses. With the continued support of our nurse management, hospital administrators and most important, our staff, this concept is aimed to increase patient satisfaction scores and subsequently employee satisfaction.

  10. Patient satisfaction: focusing on "excellent".

    Science.gov (United States)

    Otani, Koichiro; Waterman, Brian; Faulkner, Kelly M; Boslaugh, Sarah; Burroughs, Thomas E; Dunagan, W Claiborne

    2009-01-01

    In an emerging competitive market such as healthcare, managers should focus on achieving excellent ratings to distinguish their organization from others. When it comes to customer loyalty, "excellent" has a different meaning. Customers who are merely satisfied often do not come back. The purpose of this study was to find out what influences adult patients to rate their overall experience as "excellent." The study used patient satisfaction data collected from one major academic hospital and four community hospitals. After conducting a multiple logistic regression analysis, certain attributes were shown to be more likely than others to influence patients to rate their experiences as excellent. The study revealed that staff care is the most influential attribute, followed by nursing care. These two attributes are distinctively stronger drivers of overall satisfaction than are the other attributes studied (i.e., physician care, admission process, room, and food). Staff care and nursing care are under the control of healthcare managers. If improvements are needed, they can be accomplished through training programs such as total quality management or continuous quality improvement, through which staff employees and nurses learn to be sensitive to patients' needs. Satisfying patients' needs is the first step toward having loyal patients, so hospitals that strive to ensure their patients are completely satisfied are more likely to prosper.

  11. Dermatophytosis in special patient populations

    Institute of Scientific and Technical Information of China (English)

    Salama A Ouf; Tarek A Moussa; Alshimaa M Abd-Elmegeed; Samar R Eltahlawy

    2016-01-01

    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.

  12. HPV Carcinomas in Immunocompromised Patients

    Directory of Open Access Journals (Sweden)

    Nicole M. Reusser

    2015-01-01

    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.

  13. [Treatment of patients with osteoarthritis].

    Science.gov (United States)

    Vargas Negrín, Francisco; Medina Abellán, María D; Hermosa Hernán, Juan Carlos; de Felipe Medina, Ricardo

    2014-01-01

    The therapeutic management of patients with osteoarthritis aims to decrease pain and inflammation, improve physical function, and to apply safe and effective treatments. A patient-centered approach implies the active participation of the patient in the design of the treatment plan and in timely and informed decision-making at all stages of the disease. The nucleus of treatment is patient education, physical activity and therapeutic exercise, together with weight control in overweight or obese patients. Self-care by the individual and by the family is fundamental in day-to-day patient management. The use of physical therapies, technical aids (walking sticks, etc.) and simple analgesics, opium alkaloids, and antiinflammatory drugs have demonstrated effectiveness in controlling pain, improving physical function and quality of life and their use is clearly indicated in the treatment of osteoarthritis. Conservative surgery and joint replacement is indicated when treatment goals are not achieved in specific patients. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  14. Creating the ideal patient experience

    Science.gov (United States)

    Purcărea, Th.V

    2016-01-01

    Healthcare industry continues to evolve under conditions of intense competition in approaching health prevention, protection, and promotion. Therefore, healthcare providers are challenged to always ensure better patient experience, winning patients’ satisfaction, and loyalty and remain competitive on today’s healthcare market. Healthcare markets bring together professionals and their patients into real collaborative relationships, which empower patients to contribute to the healthcare improvement. Within this competitive landscape, which is also characterized by digital health tools boosting patients’ awareness and controlling their own health, medical providers need to be perceived as skilled and trustworthy in relying on patients’ needs, expectations, and sacrifices are required in order to obtain the promised benefits. Moreover, while constantly providing a holistic assessment of the healthcare services’ and experience attributes, acting on feedback and reaching healthcare service excellence, providing a better understanding of all the touch points with their patients and improving the quality and consistency of all these touch points, all these are achieved by employees, who are truly connected to the healthcare business. Today, patients are systematically becoming aware of the diversity of their choices, being increasingly involved in making better healthcare choices, and, so, more and more innovative products are introduced, targeting new patient segments. Findings from the last three years have shown that patients may achieve better outcomes due to the stakeholders’ commitment to innovation within the context of the big-data revolution, by building new values. PMID:27928442

  15. Neurological disorders in hypertensive patients

    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina

    2015-01-01

    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.

  16. Patients with narcolepsy in Slovenia

    Directory of Open Access Journals (Sweden)

    Leja Dolenc Grošelj

    2014-12-01

    Full Text Available Abstract Background: To determine the number of patients with narcolepsy in Slovenia, describe their typical clinical features and the diagnostic criteria they met on polysomnography (PSG, the mean sleep latency test (MSLT and HLA typing.Methods: Retrospective study of all narcolepsy patients referred to the National Sleep Disorder Centre at the Institute of Clinical Neurophysiology, University Medical Centre Ljubljana in the period from May 1994 to September 2013.Results: There are currently only 38 patients with narcolepsy in Slovenia. The average time lapse from onset to diagnosis is 17 years. The time lapse is much longer for older patients. The prevalence of narcolepsy in Slovenia is 1.85 to 100,000 inhabitants. All patients had EDS, 89% cataplexy, 66% hallucinations and 37% sleep paralysis at the time of diagnosis. Characteristic changes on PSG and MSLT were present in 97% of all tested patients. HLA DQB1*0602 is present in 88% of all tested patients. The most common differential diagnoses found were OSAS and hypersomnia.Conclusion: With a prevalence of 1.85/100,000 narcolepsy in Slovenia, it is seriously underdiagnosed and not recognized by general practitioners and neurologists alike. Both should be more aware of the disease and think about the possibility of it in patients with excessive daytime sleepiness and unexplained attacks, with additional symptoms such as hallucinations and paralysis during sleep. Such patients should be sent to the Sleep Disorder Centre, where the diagnosis can be confirmed and treatment started as soon as possible, thereby reducing the patient’s pathological symptoms and improve their quality of life.  

  17. Regional anesthesia for the trauma patient: improving patient outcomes

    OpenAIRE

    Gadsden J; Warlick A

    2015-01-01

    Jeff Gadsden, Alicia Warlick Department of Anesthesiology, Duke University, Durham, NC, USA Abstract: Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. In contrast, regional...

  18. Emergency department team communication with the patient: the patient's perspective.

    Science.gov (United States)

    McCarthy, Danielle M; Ellison, Emily P; Venkatesh, Arjun K; Engel, Kirsten G; Cameron, Kenzie A; Makoul, Gregory; Adams, James G

    2013-08-01

    Effective communication is important for the delivery of quality care. The Emergency Department (ED) environment poses significant challenges to effective communication. The objective of this study was to determine patients' perceptions of their ED team's communication skills. This was a cross-sectional study in an urban, academic ED. Patients completed the Communication Assessment Tool for Teams (CAT-T) survey upon ED exit. The CAT-T was adapted from the psychometrically validated Communication Assessment Tool (CAT) to measure patient perceptions of communication with a medical team. The 14 core CAT-T items are associated with a 5-point scale (5 = excellent); results are reported as the percent of participants who responded "excellent." Responses were analyzed for differences based on age, sex, race, and operational metrics (wait time, ED daily census). There were 346 patients identified; the final sample for analysis was 226 patients (53.5% female, 48.2% Caucasian), representing a response rate of 65.3%. The scores on CAT-T items (reported as % "excellent") ranged from 50.0% to 76.1%. The highest-scoring items were "let me talk without interruptions" (76.1%), "talked in terms I could understand" (75.2%), and "treated me with respect" (74.3%). The lowest-scoring item was "encouraged me to ask questions" (50.0%). No differences were noted based on patient sex, race, age, wait time, or daily census of the ED. The patients in this study perceived that the ED teams were respectful and allowed them to talk without interruptions; however, lower ratings were given for items related to actively engaging the patient in decision-making and asking questions. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Respiratory Emergencies in Geriatric Patients.

    Science.gov (United States)

    Tyler, Katren; Stevenson, Dane

    2016-02-01

    Acute dyspnea in older patients is a common presentation to the emergency department. Acute dyspnea in older adults is often the consequence of multiple overlapping disorders, such as pneumonia precipitating acute heart failure. Emergency physicians must be comfortable managing patients with acute dyspnea of uncertain cause and varying goals of care. In addition to the important role noninvasive ventilation (NIV) plays in full resuscitation, NIV can be useful as a method of providing supportive or nearly fully supportive care while more information is gathered from the patients and their loved ones.

  20. Healthcare IT and Patient Empowerment

    DEFF Research Database (Denmark)

    Danholt, Peter; Bødker, Keld; Hertzum, Morten

    2004-01-01

    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...... of type II diabetes at the clinic is characterized by team treatment, a diabetes school, standard treatment plans, and an electronic patient record system. By studying work at the clinic as well as the patients’ ‘work’ with their disease, we aim to come to grips with the complexity of treating type II...

  1. Improving oral hygiene for patients.

    Science.gov (United States)

    Bonetti, Debbie; Hampson, Victoria; Queen, Kerry; Kirk, Donna; Clarkson, Jan; Young, Linda

    2015-01-13

    Systematic reviews and patient safety initiatives recommend that oral hygiene should be part of routine patient care. However, evidence suggests it is often neglected in hospitals and care homes. Research recommends encouraging beliefs that support oral hygiene, and teaching nurses appropriate skills, as necessary prerequisites to implementing best practice in hospital wards. This article describes a pilot study of an educational workshop on oral hygiene. Results from the pilot study suggest that this workshop is a feasible intervention for a service-wide trial. The literature suggests that other interventions are required to complement this approach if nurses are to make oral hygiene a priority in daily patient care.

  2. Diarrhea in the immunocompromised patient.

    Science.gov (United States)

    Krones, Elisabeth; Högenauer, Christoph

    2012-09-01

    Diarrhea is a common problem in patients with immunocompromising conditions. The etiologic spectrum differs from patients with diarrhea who have a normal immune system. This article reviews the most important causes of diarrhea in immunocompromised patients, ranging from infectious causes to noninfectious causes of diarrhea in the setting of HIV infection as a model for other conditions of immunosuppression. It also deals with diarrhea in specific situations, eg, after hematopoietic stem cell or solid organ transplantation, diarrhea induced by immunosuppressive drugs, and diarrhea in congenital immunodeficiency syndromes.

  3. With patient satisfaction under increasing scrutiny, consider patient callbacks.

    Science.gov (United States)

    2011-07-01

    Under the final rules for Medicare's value-based purchasing program, one-third of the funding that is set aside to reward quality will be based on how patients rate their hospital experience. However, some EDs are already working to maximize patient satisfaction by implementing programs or policies whereby patients who have been discharged are routinely called to make sure their recovery is going well, as well as to intervene if there is an opportunity for service recovery. There are benefits to having ED clinicians make the follow-up calls themselves, but some health care organizations are also reaping benefits by having non-clinicians collect feedback on individual clinicians as well as specific facilities. In addition to potentially boosting quality and customer service, experts say callbacks are useful in curbing malpractice litigation. To avoid pushback among staff, consider beginning a program of patient callbacks by asking clinicians to call back just two patients per shift worked, and to share their experiences with colleagues. For maximum value, experts recommend that patient callbacks be made within one to four days of discharge.

  4. ANEMIA IN HEMODIALYSIS PATIENTS: DIABETIC VS NON DIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    SH SHAHIDI

    2002-12-01

    Full Text Available Introduction. One of the characteristic signs of uremic syndrome is anemia. One of major factors that affects on severity of anemia in ESRD is underlying diseas. The porpuse of this study is to compaire anemia between diabetic and non diabetic ESRD patients. Methods. In a case control study we compared the mean valuse of Hb, Het, MCV, MCH, MCHC, BUN, Cr and duration of dialysis between diabetic and nondiabetic patients on chronic hemodialyis. some variables (such as age, sex, use of erythropoietin, nonderolone decaonats, folic acid, ferrous sulfate, transfusion and blood loss in recent three months and acquired kidney cysts were matched between cases and controls. Results. Means of Hb were 9±1.3 and 8 ± 1.7 in diabetic and non diabetic patients (P<0.05. Mean corposcular volume in diabetic patients (91±3.1 fl was more higher than non diabetic ones (87.1 ± 8.9 (P < 0.05. Other indices had no differences between two groups (P > 0.05. Discussion. Severity of anemia in patients with diabetic nephropathy is milder that other patients with ESRD. So, Anemia as an indicator of chronocity of renal disease in diabetics is missleading.

  5. Quality of Doctor-Patient Communication through the Eyes of the Patient: Variation According to the Patient's Educational Level

    Science.gov (United States)

    Aelbrecht, Karolien; Rimondini, Michela; Bensing, Jozien; Moretti, Francesca; Willems, Sara; Mazzi, Mariangela; Fletcher, Ian; Deveugele, Myriam

    2015-01-01

    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…

  6. Quality of Doctor-Patient Communication through the Eyes of the Patient: Variation According to the Patient's Educational Level

    Science.gov (United States)

    Aelbrecht, Karolien; Rimondini, Michela; Bensing, Jozien; Moretti, Francesca; Willems, Sara; Mazzi, Mariangela; Fletcher, Ian; Deveugele, Myriam

    2015-01-01

    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…

  7. Learning from patients: students' perceptions of patient-instructors.

    Science.gov (United States)

    Henriksen, Ann-Helen; Ringsted, Charlotte

    2011-09-01

    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 explore whether there is added value in using patients as instructors in health professions education and, if there is, to examine how it is constituted. Group interviews were conducted with physiotherapy and occupational therapy students who had attended a 3-hour optional class entitled 'Thoughtful joint examination and respectful patient contact'. This class was delivered by patient-instructors (PIs), who were patients with rheumatism certified to teach. A semi-structured interview guide was used. Interviews continued until data saturation occurred (seven interviews). The interviews were recorded and transcribed verbatim. Data were analysed using content analysis. The main finding of this study is that PI sessions facilitate a learning environment in which the content matter is complemented by the provision of realism and individual perspectives on rheumatism, the pedagogical format is characterised by authenticity and intimacy in the style of instruction and feedback, and the PI-student relationship is characterised by balanced teacher-student power relations that support the legitimacy of learning and make space for the asking of questions and the making of mistakes. This study indicates that, in terms of power relations, the PI-student relationship differs from those between faculty teachers and students, and students and patients in the clinic. The formation of a professional identity by students may clash with the fulfilment of their learning tasks in the clinical environment. The study indicates that patient-centredness can be fostered in the PI-student relationship. This is probably supported by the absence of faculty staff involvement in PI teaching sessions

  8. Developing patient-centered teams: The role of sharing stories about patients and patient care.

    Science.gov (United States)

    Bennett, Ariana H; Hassinger, Jane A; Martin, Lisa A; Harris, Lisa H; Gold, Marji

    2015-09-01

    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. (c) 2015 APA, all rights reserved).

  9. Implant rehabilitation in bruxism patient

    Science.gov (United States)

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas

    2014-01-01

    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

  10. Muscle dysfunction in cancer patients

    DEFF Research Database (Denmark)

    Christensen, Jesper Frank; Jones, L W; Andersen, J L

    2014-01-01

    implications of muscle dysfunction in cancer patients. The efficacy of exercise training to prevent and/or mitigate cancer-related muscle dysfunction is also discussed. DESIGN: We identified 194 studies examining muscular outcomes in cancer patients by searching PubMed and EMBASE databases. RESULTS: Muscle...... 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...

  11. Vaccines for Patients with COPD.

    Science.gov (United States)

    Moreno, Dolores; Barroso, Judith; Garcia, Alexis

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow limitation. This disease is currently the fourth higher cause of death in the world, and it is predicted to be the third by the year 2020. Patients with COPD are frequently exposed to Human Rhinovirus, Respiratory Syncytial and Influenza Virus, as well as to Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. These infectious agents are responsible for exacerbations increasing morbidity and mortality in COPD patients. Prevention of infectious exacerbations by vaccination would improve quality of life and patient survival. A literature search: "vaccination of COPD patients" was performed using Medline, the Cochrane Library and other Non-Indexed Citations for this review. This article presents a brief overview of the different studies found, on the new patents, and the future strategies on the field.

  12. Fluconazole Pharmacokinetics in Burn Patients

    Science.gov (United States)

    Boucher, Bradley A.; King, Stephen R.; Wandschneider, Heidi L.; Hickerson, William L.; Hanes, Scott D.; Herring, Vanessa L.; Canada, Todd W.; Hess, Mary M.

    1998-01-01

    The pharmacokinetics of fluconazole in nine adult patients with severe (30 to 95% total body surface area) burns were studied. There was no significant difference in half-life (t1/2), clearance (CL), or volume of distribution (V) over time in five patients on days 3 and 8 of the study (P > 0.05). Combined parameter estimates (means ± standard deviations) for all nine patients for the two study periods were as follows: t1/2, 24.4 ± 5.8 h; CL, 0.36 ± 0.09 ml/min/kg; and V, 0.72 ± 0.12 liters/kg. These estimates of t1/2 and CL in burn patients were approximately 13% shorter and 30% more rapid, respectively, than the most extreme estimates reported for other populations. PMID:9559811

  13. CCCT - Patient Advocate Steering Committee

    Science.gov (United States)

    The Patient Advocate Steering Committee (PASC) works to ensure advocates involved with the Scientific Steering Committees (SSCs) are completely integrated in the development, implementation, and monitoring of clinical trials within those groups.

  14. National Patient Care Database (NPCD)

    Data.gov (United States)

    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...

  15. Music for untying restrained patients.

    Science.gov (United States)

    Janelli, L M; Kanski, G

    1998-03-01

    The purpose of this descriptive pilot study was two-fold: (a) to test psychometrically an observational instrument designed to measure patient behaviors displayed while unrestrained and receiving a musical intervention; and (b) to determine the effect of a musical intervention on the behavioral reactions of physically restrained patients. The Restraint-Music Response Instrument (RMRI) is a 40-item observational checklist consisting of 22 positive and 18 negative responses developed by the researchers. Content validity was assessed by a panel of experts. The RMRI was tested for interrater reliability using three simulated and 10 actual patients. Results suggest that the RMRI is a valid and reliable measure of patients' responses to music but requires additional study with a control group not receiving the intervention.

  16. Writing of Patient Case History

    Institute of Scientific and Technical Information of China (English)

    Tian Junying

    2016-01-01

    This paper introduces the language features, structure and contents of case history. Good patient case history contributes to correct diagnosis and formulation of a treatment plan, therefore, it is important for physicians to learn how to write case history.

  17. [Perioperative Management of PD Patients].

    Science.gov (United States)

    Reichmann, H

    2016-07-01

    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. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Pineal calcification among black patients.

    Science.gov (United States)

    Fan, K J

    1983-08-01

    A postmortem histopathological study was done in 233 pineal glands of black patients. Among them, 70 percent showed microscopic evidence of calcification in the pineal parenchyma. The frequency of calcification increased with age. However, the severity of calcification reached the peak in the 60 to 69 year old age group and then gradually declined. As compared to males, females had slightly higher frequency and reached the peak of severity in younger age groups. When pineal calcification was compared among patients with various malignancies, a higher frequency and more severe calcification were observed in patients with carcinoma of the prostate and the pancreas. A lower frequency and less severe calcification were observed in patients with carcinoma of the breast and the cervix. The results of this study emphasize the important role of sex hormone in genesis of pineal calcification.

  19. A comparison of patient satisfaction

    African Journals Online (AJOL)

    2014-09-11

    Sep 11, 2014 ... antenatal care: A comparison of patient satisfaction. Author: ... Methods: A quantitative comparative descriptive design with a Likert-scale measure was used. ..... Qualitative exploratory studies can permit one to ascertain.

  20. The patient with daily headaches.

    Science.gov (United States)

    Maizels, Morris

    2004-12-15

    The term "chronic daily headache" (CDH) describes a variety of headache types, of which chronic migraine is the most common. Daily headaches often are disabling and may be challenging to diagnose and treat. Medication overuse, or drug rebound headache, is the most treatable cause of refractory daily headache. A pathologic underlying cause should be considered in patients with recent-onset daily headache, a change from a previous headache pattern, or associated neurologic or systemic symptoms. Treatment of CDH focuses on reduction of headache triggers and use of preventive medication, most commonly anti-depressants, antiepileptic drugs, and beta blockers. Medication overuse must be treated with discontinuation of symptomatic medicines, a transitional therapy, and long-term prophylaxis. Anxiety and depression are common in patients with CDH and should be identified and treated. Although the condition is challenging, appropriate treatment of patients with CDH can bring about significant improvement in the patient's quality-of-life.

  1. Anaesthesia for a "Scalped" Patient.

    Science.gov (United States)

    Rizvi, M M; Singh, Raj Bahadur; Sarkar, Arindam; Choubey, Sanjay

    2015-06-01

    Trichilemmal carcinoma of scalp is a rare malignant tumour of scalp. A 52-year-old female presented with an extensive ulcerative lesion of the scalp. As the location of the tumour was in the occipital region and there was loss of bony skull in the region, this case became challenging. This patient was managed in the left lateral which was a difficult situation for even the experienced Anaesthesiologist. Intravenous access was acquired, central venous catheter (CVC) was placed in the right internal jugular vein under ultrasonography (USG) guidance and intubation was carried out in the lateral position. After the procedure, patient was again returned to the left lateral position. The trachea was extubated in the lateral position once the patient was awake, after thorough reversal of neuromuscular blockade. Patient had an uneventful postoperative period. This case report highlights the management of an unusual case of Trichilemmal carcinoma of the scalp.

  2. Framework for Patient Flow Improvement

    Directory of Open Access Journals (Sweden)

    S.V. Medina-León

    2014-07-01

    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.

  3. Patients Bill of Rights Data

    Data.gov (United States)

    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...

  4. Noma in an immunocompromised patient.

    Science.gov (United States)

    Silva, Igor Henrique Morais; Faria, Andreza Barkokebas S de; Fonseca, Deborah Daniela Diniz; Aguiar, Carlos Menezes; Carvalho, Alessandra Tavares; Gueiros, Luiz Alcino; Leao, Jair Carneiro

    2013-01-01

    Noma (also known as cancrum oris) is classified by the World Health Organization as a necrotizing ulcerative stomatitis, an invasive acute infection which affects the orofacial tissues. Patients who are subject to such risk factors as severe malnutrition or alteration of the immune system are predominantly affected. This article presents a case of noma in a 62-year-old immunocompromised patient with pain and tooth mobility in the mandibular region, ulceration, bleeding, gingival inflammatory secretion, and oral malodor. The signs and symptoms were controlled only after the intravenous administration of 500 mg tid of imipenem/cilastatin sodium and 2 g qd of vancomycin. After infection control was maintained, the patient was directed to surgery for removal of bone sequestration and curettage of the maxillary sinus. The patient was prescribed 1 g qd of oral clindamycin for 3 months postsurgery.

  5. Psychotherapists' dreams about their patients.

    Science.gov (United States)

    Kron, Tamar; Avny, Nadav

    2003-06-01

    This study examines therapists' dreams about their patients from the Jungian and the relational perspectives. Few clinical and empirical references to this subject are to be found in the literature. In the present study 31 dreams were collected from 22 therapists. Dreams were collected using anonymous self-report inventory. The research focused on three theoretical research questions: 1. What themes appear in the manifest content of therapists' dreams about their patients? 2. What contributions are made by Jungian interpretation of therapists' dreams about their patients? 3. To what extent are masochistic contents present in the manifest content of therapists' dreams about their patients? The first question was addressed using categorical content analysis of a) themes common to different dreams and b) pre-determined themes for all dreams. The third research question was addressed using Beck's (1967) 'Masochistic Dream' measure. Among the themes common to different dreams were: therapist-patient role reversal; therapist and/or patient attends and remains in meeting, departs/doesn't depart; cancellation of therapy session; sexuality between therapist and patient; aggression; presence vs. absence; non-verbal relationship and communication; time; driving vs. stopping. With regard to pre-determined themes it was found that in 20 of the 31 dreams, the therapist had a negative experience and was characterized as vulnerable. Likewise it was found that 26 out of 31 dreams took place in either a) a street, a road, a route, a corridor; b) en route to somewhere; c) a therapy room and/or building; d) a house. With regard to the contribution of Jungian interpretations of the dreams it was found that 17 of the dreams had diagnostic and prognostic elements, 4 of which were initial dreams, 9 of them were compensatory dreams and in 14 it was found that the patient represents the shadow of the therapist. With regard to the third question it was found that 18 of the 31 dreams met Beck

  6. Rehabilitative Games for Stroke Patients

    Directory of Open Access Journals (Sweden)

    A. Pyae

    2015-07-01

    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.

  7. Implant rehabilitation in bruxism patient

    OpenAIRE

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline [UNESP; da Silva, Emily Vivianne Freitas

    2014-01-01

    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 protocol...

  8. Enteral nutrition in critical patients

    OpenAIRE

    Botello Jaimes, Jhon Jairo; Medico Cuidado Intensivo Clínica San Marcel / Jefe de Urgencias y Unidad de Cuidado Especial Clínica San Marcel / Docente Medicina Interna y Cuidado Intensivo Universidad de Manizales / Docente Internado de Urgencias y de PROFUNDIZACION Urgencias, Cuidado Intermedio e Intensivo Universidad de Caldas / Docente del programa de enfermería Universidad Católica de Manizales / Instructor Internacional / Director Fundación Versalles / Candidato a Magíster en Educación Docencia. Envío co rrespondencia:. Avenida Alberto Mendoza No 93-25 - Clínica San Marcel.; González Rincón, Alejandra; Enfermería Universidad Católica de Manizales. Miembro directivo Fundación Versalles. Miembro Correspondiente Asociación Colombiana de Trauma y Miembro Activo de la Sociedad Panamericana de Trauma. Envío correspondencia: alejita_gonzalez12@ hotmail.com . Calle 50 No 24-14 – Fundación Versalles.

    2010-01-01

    Nutritional support in critically ill patients is of vital importance for its impact on morbidity, hospital stay and preservation of tissue mass among others. It must ensure nutritional support to all critically ill patients enterally ideally by reduced bacterial translocationand stimulation of the function of the intestinal villi. In recent years we have studied immunonutrients as glutamine, arginine, fatty acids and nucleotides with promising effects (Immune response, Intestinal barrier or ...

  9. [Childhood of the schizophrenic patient].

    Science.gov (United States)

    Da Fonseca, D

    2009-01-01

    We are able to identify the different risk factors involved in the development of the disorder from a study of the childhood of a schizophrenic patient. More specifically, we will define the perinatal risk factors: season and place of birth, viral exposure during pregnancy and obstetric complications. Developmental factors will also be discussed. Socialisation, language, psychomotor and cognitive development disorders are all developmental difficulties seen during the childhood of the schizophrenic patient. Finally we will finish by discussing a few psychosocial risk factors.

  10. Cultural competence and simulated patients.

    Science.gov (United States)

    Paroz, Sophie; Daele, Amaury; Viret, Francine; Vadot, Sara; Bonvin, Raphaël; Bodenmann, Patrick

    2016-10-01

    Cultural competence education is central in addressing the socio-cultural factors that affect health care; however, there is little agreement over the best teaching approach. Although simulated patients are widely used in medical education, little is known about their application to cultural competence education. At the Department of Ambulatory Care and Community Medicine, University of Lausanne, the content of a cultural competence education module for resident doctors was recently restructured, with a final session emphasising previous principles through a simulated patient-doctor encounter. We tested the feasibility of cultural competence training with simulated patients. We created two complementary case scenarios based on real clinical practice and focused on specific clinical skills. An interdisciplinary team trained two simulated patients, and a 90-minute pilot session took place. General satisfaction was high and the increased opportunity for interaction was greatly appreciated. According to the learners, the simulated case setting was relevant for improving self-reflection and cultural sensitivity: applying skills in the session enhanced perceived impact for 'real-world' practice. We tested the feasibility of cultural competence training with simulated patients The use of patient-centred simulated clinical practice as a teaching approach seems to be advantageous in increasing providers' self-reflection about cultural competence and intensifying the impact of cultural competence education in clinical practice, and hopefully will improve the quality of care for every patient. Case scenarios based on a diversity of socio-cultural factors and oriented towards a broad skills set would seem preferable to avoid cultural drift and to enhance the learning of cultural approaches that are adaptable to every patient. © 2016 John Wiley & Sons Ltd.

  11. Pulmonary metastasectomy in pediatric patients

    OpenAIRE

    Erginel, Basak; Gun Soysal, Feryal; Keskin, Erbug; Kebudi, Rejin; Celik, Alaaddin; SALMAN, Tansu

    2016-01-01

    Background This study aims to evaluate the outcomes of pulmonary metastasectomy resections in pediatric patients. Methods We retrospectively reviewed the medical records of 43 children who were operated on in the Pediatric Surgery Clinic between January 1988 and 2014. Forty-three children (26 boys; 17 girls; mean age 10???4.24?years, range 6?months?18?years) who underwent pulmonary metastasectomy resection were included in the study. The patients were evaluated based on age, gender, history o...

  12. Hypogonadism in thalassemia major patients

    Directory of Open Access Journals (Sweden)

    Sasima Srisukh

    2016-09-01

    Full Text Available Despite recent advances in iron chelation therapy, excess iron deposition in pituitary gonadotropic cells remains one of the major problems in thalassemic patients. Hypogonadism, mostly hypogonadotropic hypogonadism, is usually detected during puberty. Early diagnosis and treatment are crucial for normal pubertal development and to reduce the complications of hypogonadism. The risks and benefits of hormonal replacement therapy, especially regarding the thromboembolic event, remain a challenge for providers caring for thalassemic patients.

  13. [Orthodontic treatment in periodontal patients].

    Science.gov (United States)

    Krausz, E; Einy, S; Aizenbud, D; Levin, L

    2011-07-01

    Orthodontic treatment poses a significant challenge in patients suffering from periodontal disease. Providing orthodontic treatment to periodontal patients should be carefully planned and performed in a tight collaboration between the orthodontist and periodontist. Resolution and stabilization of the periodontal condition is a pre-requisite for orthodontic treatment initiation. Careful oral hygiene performance and highly frequent recall periodontal visits are also crucial. Pre- or post- orthodontic periodontal surgery might help providing better treatment outcomes.

  14. Mechanical ventilation in neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Keshav Goyal

    2013-01-01

    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.

  15. Platelet matching for alloimmunized patients

    Institute of Scientific and Technical Information of China (English)

    S H.Hsu

    2010-01-01

    @@ Platelets play an essential role in blood coagulation,hemostasis and maintenance of vascular integrity.Platelets are utilized primarily to prevent or treat bleeding in thrombocytopenic patients and patients with impaired platelet production in the bone marrow and/or with dysfunctional platelets.In current practice,platelet transfusion begins with randomly selected platelet products:either pooled platelets prepared from whole blood derived platelets; or single donor platelets prepared by apheresis procedures.

  16. Patient-empowerment interactive technologies.

    Science.gov (United States)

    Bruggers, Carol S; Altizer, Roger A; Kessler, Robert R; Caldwell, Craig B; Coppersmith, Kurt; Warner, Laura; Davies, Brandon; Paterson, Wade; Wilcken, Jordan; D'Ambrosio, Troy A; German, Massiell L; Hanson, Glen R; Gershan, Lynn A; Korenberg, Julie R; Bulaj, Grzegorz

    2012-09-19

    Video games capture the rapt attention of an individual player's mind and body, providing new opportunities for personalized health care. An example of therapeutic interactive technologies is an incentive-based video game that translates physical exercise into mental empowerment via motivational metaphoric visualization in order to help patients psychologically overcome cancer. Such nonpharmacological interventions may enhance patients' resilience toward various chronic disorders via neuronal mechanisms that activate positive emotions and the reward system.

  17. Patient Simulators Train Emergency Caregivers

    Science.gov (United States)

    2014-01-01

    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.

  18. Talking with eye injury patients

    Directory of Open Access Journals (Sweden)

    Helen Roberts

    2016-01-01

    Full Text Available Patients with an eye injury are usually in pain and very frightened. They need a gentle, reassuring approach. Your first task is to assess the general state of your patient. If they are alert and orientated and their general health is good, you can continue to examine them in the eye department. If their immediate general health is at risk, you will have to address this first.

  19. Information technology for patient empowerment in healthcare

    CERN Document Server

    Grando, Maria Adela; Bates, David

    2015-01-01

    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.

  20. [GASTRIC CANCER IN YOUNG PATIENTS

    Science.gov (United States)

    Quispe, Dolly; Ruiz, Eloy; Celis, Juan; Berrospi, Francisco; Payet, Eduardo

    2000-01-01

    OBJECTIVE: In order to determine a the clinicopatological features in young patients with gastric cancer and compare them with aged patients.PATIENTS AND METHODS: For this study, we selected the clinical charts from the total of patients with histological proved diagnosis of gastric adenocarcinoma admitted at the INEN between 1980 and 1996 whose age was less than 31 year (Young group, n =92). As a comparison group (Average Group) we chose of the same universe, a random sample of 184 patients between 50 to 70 years of age. Epidemiological, clinical and histological features, operability and resecability, TNM stage, type of surgery and follow-up of both groups were analyzed.RESULTS: In the Young Group in compared with Average Group, females were more frequent (73.9% vs. 50.5% p0.001). The mean survival time in the Young Group was 74.9 months and in the Average Group was 36.03 months (p=0.26), there were no significant differences in the survival between resecability and sex (p=0.10 and p=0.41).CONCLUSION: The females and undifferentiated carcinoma was the most frequent features in the young patients with gastric cancer. The survival in this group is better than the average group but this was a no significant difference because the diagnosis was made in late stages.

  1. [Delusion in the critical patient].

    Science.gov (United States)

    Palencia-Herrejón, E; Romera, M A; Silva, J A

    2008-02-01

    Delirium, the acute confusional syndrome, is a common although infradiagnosed problem in the critically ill patient, especially the hypoactive subtype. Risk factors for delirium are previous cognitive disturbances, some comorbidities, ambiental factors and the acute organic alterations of critical illness. Delirium is associated to an increase in short and long term mortality, prolongation of mechanical ventilation, increased Intensive Care Unit (ICU) and hospital length of stay, and cognitive impairment after hospital discharge. In the last years several tools have been developed to detect delirium in critically ill patients. The Intensive Care Delirium Screening Checklist (ICDSC) and the Confusion Assessment Method for ICU patients (CAM-ICU) have been validated and are useful even in patients receiving mechanical ventilation. Some interventions on specific risk factors can decrease the incidence of delirium in hospitalized patients. Treatment of delirium is based on the identification and correction of contributing factors, the introduction of support measures, and pharmacological therapy for symptomatic control. Halloperidol is the first line therapy of delirium in the critically ill patient, while experience with atypical neuroleptics and other drugs is limited, precluding to do recommendations about its use. Neuroleptic drugs can produce severe side effects and need careful dosage and monitoring. When agitation is important, can be necessary the simultaneous use of benzodiazepines or propofol, and some times, the temporal and protocolized application of physical restraints.

  2. Social anxiety in orthognathic patients.

    Science.gov (United States)

    Ryan, F S; Moles, D R; Shute, J T; Clarke, A; Cunningham, S J

    2016-01-01

    There is evidence that patients seeking orthognathic treatment may be motivated by social anxiety disorder (SAD). The aim of this study was to investigate SAD in orthognathic patients using the Brief Fear of Negative Evaluation Scale (BFNES) and to compare these findings with those of the general population. This was a cross-sectional, questionnaire study conducted in two parts. Firstly, a national survey was conducted to yield data for the BFNES from a large, random sample of the UK general population. Secondly, orthognathic patients completed the BFNES. The BFNES scores are reported in two formats: the original 12-item scale (O-BFNES) and a shorter eight-item version (S-BFNES). With regards to the national survey, 1196 individuals participated. The mean O-BFNES score was 29.72 (standard deviation (SD) 9.39) and S-BFNES score was 15.59 (SD 7.67). With regards to the orthognathic sample, 61 patients participated. The mean O-BFNES score was 39.56 (SD 10.35) and the mean S-BFNES score was 24.21 (SD 8.41). Orthognathic patients had significantly higher scores than the general UK population (Porthognathic patients experience significantly higher levels of social anxiety than the general population.

  3. Caring for visually impaired patients.

    Science.gov (United States)

    Orrico, Kathleen B

    2013-01-01

    To raise pharmacist awareness about the needs and concerns of our patients with visual impairment and to review useful strategies to foster medication adherence. As patient-centered pharmacists, we need to understand the challenges faced by our patients with low vision and tailor pharmaceutical care to best fit their needs. Evidence-based best practices in labeling and written communication have been developed by the American Foundation for the Blind in partnership with the American Society of Consultant Pharmacists. These recommendations include the use of specific font styles, minimum font size, and other standards known to enhance usability for those with limited vision. Recent advances in assistive technologies such as audio output and object recognition software can be used to ease the medication-taking process and effectively communicate important drug and safety information in a manner that can be understood by those with low vision. In July 2012, the Prescription Accessible Drug Labeling Promotion Act of 2012 (HR 4087) was signed into law. This new legislation is an addition to the Food and Drug Administration Safety and Innovation Act, which required the development and ultimate implementation by pharmacies of national best practices intended to improve the accessibility of prescription drug labeling for the visually impaired. As a patient-centered profession, we need to advocate for our patients with special needs by partnering with government and patient groups to support and enact legislation intended to enhance people's ability to adhere to drug therapy.

  4. Stroke Care in Young Patients

    Directory of Open Access Journals (Sweden)

    L. Tancredi

    2013-01-01

    Full Text Available The aims of this study were (i to evaluate the clinical features of a consecutive series of young patients with ischemic stroke and (ii to assess the changes in the clinical management of these patients over the study period. All consecutive cases of young adults aged 16 to 44 years, with ischemic stroke, that were admitted between 2000 and 2005 in 10 Italian hospitals were included. We retrospectively identified 324 patients. One or more vascular risk factors were present in 71.5% of the patients. With respect to the diagnostic process, an increase in the frequency of cerebral noninvasive angiographic studies and a decrease in the use of digital subtraction angiography were observed ( and , resp.. Undetermined causes decreased over 5-year period of study (. The diagnosis of cardioembolism increased. Thrombolysis was performed for 7.7% of the patients. PFO closure (8% was the most frequently employed surgical procedure. In conclusion, the clinical care that is given to young patients with ischemic stroke changed over the study period. In particular, we detected an evolution in the diagnostic process and a reduction in the number of undetermined cases.

  5. Hepatitis C in hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    Smaragdi Marinaki; John N Boletis; Stratigoula Sakellariou; Ioanna K Delladetsima

    2015-01-01

    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.

  6. Regional anesthesia for the trauma patient: improving patient outcomes.

    Science.gov (United States)

    Gadsden, Jeff; Warlick, Alicia

    2015-01-01

    Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement in trauma patients, and is safe and easy to perform. Specific populations that have shown benefits (including morbidity and mortality advantages) with regional analgesic techniques include those with fractured ribs, femur and hip fractures, and patients undergoing digital replantation. Acute compartment syndrome is a potentially devastating sequela of soft-tissue injury that complicates high-energy injuries such as proximal tibia fractures. The use of regional anesthesia in patients at risk for compartment syndrome is controversial; although the data is sparse, there is no evidence that peripheral nerve blocks delay the diagnosis, and these techniques may in fact facilitate the recognition of pathologic breakthrough pain. The benefits of regional analgesia are likely most influential when it is initiated as early as possible, and the performance of nerve blocks both in the emergency room and in the field has been shown to provide quality pain relief with an excellent safety profile.

  7. Patients assessing students' assignments; making the patient experience real.

    Science.gov (United States)

    Munro, Jane; Whyte, Fiona; Stewart, Jim; Letters, Andrew

    2012-02-01

    The care of patients with inflammatory bowel disease (IBD) frequently falls short of the highest standards. This is noted in several publications, including national standards, despite nursing students being taught the importance of listening to and understanding patients. Teaching staff at the University of Glasgow primarily responsible for teaching third year undergraduate nursing students undertook a radical rethink of the planning, delivery and assessment of lectures on IBD. The subject had previously been delivered in a modified lecture format. Although the topic could be included in the end-of-year exams, there was little evidence to show whether this traditional teaching method had any effect on students' clinical practice. In a novel approach to learning and assessment, students were invited to research and produce an information leaflet for newly diagnosed patients with IBD. The leaflets were then assessed and grades awarded by an expert panel of patients and carers. Such enquiry based learning (EBL) intended to demonstrate in practice, the key role patients can play in both undergraduate nurse education and in service planning and delivery in the National Health Service (NHS). The panel found the exercise both interesting and insightful, while the students reported being invigorated and felt the expert assessment meant they were forced to achieve a higher level of work. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. [Nutritional support in stroke patients].

    Science.gov (United States)

    Burgos Peláez, Rosa; Segurola Gurrutxaga, Hegoi; Bretón Lesmes, Irene

    2014-01-01

    Stroke is a public health problem of the first order. In developed countries is one of the leading causes of death, along with cardiovascular disease and cancer. In addition, stroke is the leading cause of permanent disability in adulthood. Many of the patients who survive do so with significant sequelae that limit them in their activities of daily living. Most strokes (80-85%) are due to ischemia, while the rest are hemorrhagic. We have identified many modifiable risk factors, some with an important relationship with dietary factors or comorbidities in wich the diet has a significant impact. The incidence of malnutrition in stroke patients is not well known, but most likely impacts on patient prognosis. Furthermore, the nutritional status of patients admitted for stroke often deteriorates during hospitalization. It is necessary to perform a nutritional assessment of the patient in the early hours of admission, to determine both the nutritional status and the presence of dysphagia. Dysphagia, through alteration of the safety and efficacy of swallowing, is a complication that has an implication for nutritional support, and must be treated to prevent aspiration pneumonia, which is the leading cause of mortality in the stroke patient. Nutritional support should begin in the early hours. In patients with no or mild dysphagia that can be controlled by modifying the texture of the diet, they will start oral diet and oral nutritional supplementation will be used if the patient does not meet their nutritional requirements. There is no evidence to support the use of nutritional supplements routinely. Patients with severe dysphagia, or decreased level of consciousness will require enteral nutrition. Current evidence indicates that early nutrition should be initiated through a nasogastric tube, with any advantages of early feeding gastrostomy. Gastrostomy will be planned when the enteral nutrition support will be expected for long-term (4 weeks). Much evidence points to the

  9. [Enteral nutrition in burn patients].

    Science.gov (United States)

    Pereira, J L; Garrido, M; Gómez-Cía, T; Serrera, J L; Franco, A; Pumar, A; Relimpio, F; Astorga, R; García-Luna, P P

    1992-01-01

    Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p diet was very good, and only mild complications such as diarrhoea developed in two patients. Enteral nutrition is a suitable nutritional support method for patients with

  10. NUTRITIONAL ASSESSMENT OF CAPD PATIENTS

    Directory of Open Access Journals (Sweden)

    Hong Ren

    2012-06-01

    Full Text Available Appearance and progressive development of malnutrition significantly influence the efficacy and treatment outcome in chronic renal failure (CRF patients receiving continuous ambulatory peritoneal dialysis (CAPD therapy. The aim of the present investigation was estimation of incidence and risk factors of the malnutrition development in CRF patients treated with CAPD. Nutritional status was studied in 244 PD patients (97 women, 146 men; age 59.58±16.55 years being under CAPD during 1-104 (median 30 months. Anthropometric (body mass index, dermato-fatty fold over 3-headed muscle, Subjective Global Assessment SGA, normalized protein catabolic rate nPCR and biochemical indices (hemoglobin Hb, serum albumin SALB, serum pre-albumin Spre-ALB, serum cholesterol SChol were used for nutritional status estimation. The overall mean body mass index was 28.18±47.11. The mean level of hemoglobin was 101.30±23.81 g/L, Scr was 857.28±336.17 umol/L, KT/V was 2.25±0.73. The overall mean SALB was 30.67±5.58 g/L, 74.2% patients on low SALB (SALB <35 g/L. The mean level of Spre-ALB was 331.63±91.43 mg/L, 35.66% patients on low Spre-ALB (Spre-ALB <300 mg/L. The mean level of PCR was 0.93±0.24 g/kg.d, 59.01% patients on low level PCR (PCR <1 g/kg.d. The mean dermato-fatty fold over 3-headed muscle was 13.42 mm. 25% patients had a SGA score of 1-4(malnutrition range. The prevalence of malnutrition was 18.03%. The main cause (44.6% of death is infection in our study, and the majority of these patients were complicated with different level of malnutrition. In conclusion, the results indicate that malnutrition is quite common and plays an important role in mortality in CAPD patients independent of dialysis efficacy and prevention or treatment of malnutrition by suitable means is necessary to improve clinical outcomes in CAPD patients.

  11. Communication during gynecological out-patient encounters.

    NARCIS (Netherlands)

    Dulmen, A.M. van

    1999-01-01

    The intimate nature of women's health problems presented during gynecological encounters places great demands on gynecologists' communicative behavior. The present study examined what patients expect from their gynecologist, how gynecologists and patients actually communicate during out-patient

  12. 'PROSTHETIC MANAGEMENT OF AN IEPILEPTIC PATIENT

    African Journals Online (AJOL)

    This case report illustrates the problems of tooth loss in an epileptic patient. The patient presented with .... Fig. lb fully dentate lower arch with no clinically obvious gingival ... For this patient who is partially edentulous: the ideal treatment option.

  13. Masticatory performance in patients with myasthenia gravis

    NARCIS (Netherlands)

    Weijnen, FG; Kuks, JBM; van der Glas, HW; Oudenaarde, [No Value; Bosman, F

    2002-01-01

    Masticatory muscle electromyograms (EMGs) were recorded while patients with bulbar myasthenia gravis chewed artificial food and compared with those of patients with ocular myasthenia gravis, patients in clinical remission who had previously suffered from bulbar myasthenia gravis and healthy individu

  14. Development of acromegaly in patients with prolactinomas

    DEFF Research Database (Denmark)

    Andersen, Marianne; Hagen, Casper; Frystyk, Jan

    2003-01-01

    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 hyperprolactina......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...

  15. Development of acromegaly in patients with prolactinomas

    DEFF Research Database (Denmark)

    Andersen, Marianne; Hagen, Casper; Frystyk, Jan

    2003-01-01

    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 hyperprolactina......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...

  16. Mycoses in the transplanted patient.

    Science.gov (United States)

    Dictar, M O; Maiolo, E; Alexander, B; Jacob, N; Verón, M T

    2000-01-01

    The incidence of invasive fungal infection (IFI) has increased considerably over the past 20 years, and transplant recipients are at especially high risk for fungal infections owing to their overall immunosuppressed condition. Organ transplantation procedures were incorporated as a therapeutic option for many patients who lacked the normal functions of organs such as the heart, liver, kidney, lung, pancreas and small bowel. The prevalence of IFI in solid organ transplant (SOTR) patients ranges from 5 to 50% in kidney and liver transplants, respectively. In bone marrow transplant (BMT) patients, IFI are major causes of morbidity and mortality due to the protracted neutropenic period and graft-versus-host disease. Candida spp. and Aspergillus spp. account for >80% of fungal episodes in both SOTR and BMT. The development of new immunosuppressive agents, new prophylaxis strategies (as pre-emptive therapy) and the improvement in surgical techniques led to increase survival of transplant recipients. In this session, a clear and concise update of the recent advances in the laboratory diagnosis of candidiasis and aspergillosis in this kind of patients was presented. However, we still need to establish more rapid, sensitive and specific methods for IFI diagnosis. Representatives of the 'Subcomision de Infecciones en el Paciente Neutropenico y Transplantado (SIPNYT)' de la Sociedad Argentina de Infectologia (SADI), presented the results of an unusual multicenter study both retrospective and descriptive studies of IFI in SOTR and BMT patients in Argentina. In addition, a study of IFI in 1,861 SOTR patients from four centers and the analysis of IFI in 2,066 BMT patients from all 12 BMT centers from Argentina was presented. From these studies it can be concluded that 'all transplant recipients are not the same' and that they should be stratified according to their different risk degrees in order to determine the best prophylaxis and treatment strategies.

  17. Autoantibodies in Patients with Fasciolosis

    Directory of Open Access Journals (Sweden)

    M Korkmaz

    2009-07-01

    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.

  18. Anxiety disorders in dialysis patients

    Directory of Open Access Journals (Sweden)

    Novaković Milan

    2007-01-01

    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. .

  19. Treating statin-intolerant patients

    Directory of Open Access Journals (Sweden)

    Pigna G

    2011-04-01

    Full Text Available Marcello Arca, Giovanni PignaAtherosclerosis Unit, Department of Internal Medicine and Allied Medical Specialities, Sapienza University of Rome, Rome, ItalyAbstract: Statins are effective in reducing cardiovascular events and are safe for almost all patients. Nevertheless, intolerance to statins is frequently faced in clinical practice. This is mostly due to muscular symptoms (myalgia with or without increase of plasma creatinine kinase and/or elevation of hepatic aminotransferases, which overall constitutes approximately two-thirds of reported adverse events during statin therapy. These side effects raise concerns in patients as well as in doctors and are likely to reduce patients' adherence and, as a consequence, the cardiovascular benefit. Therefore, it is mandatory that clinicians improve their knowledge on the clinical aspects of muscular and hepatic side effects of statin therapy as well as their ability to manage patients with statin intolerance. Besides briefly examining the clinical aspects and the mechanisms that are proposed to be responsible for the most common statin-associated side effects, the main purpose of this article is to review the available approaches to manage statin-intolerant patients. The first step is to determine whether the adverse events are indeed related to statin therapy. If so, lowering the dosage or changing statin, alternate dosing options, or the use of nonstatin compounds may be practical strategies. The cholesterol-lowering potency as well as the usefulness of these different approaches in treating statin-intolerant patients will be examined based on currently available data. However, the cardiovascular benefit of these strategies has not been well established, so their use has to be guided by a careful clinical assessment of each patient.Keywords: statin therapy, atorvastatin, rosuvastatin, aminotransferase levels, myopathy

  20. Patient representatives' views on patient information in clinical cancer trials

    DEFF Research Database (Denmark)

    Dellson, Pia; Nilbert, Mef; Carlsson, Christina

    2016-01-01

    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......BACKGROUND: Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed......-III trials, randomized and non-randomized trials that evaluated chemotherapy/targeted therapy in the neoadjuvant, adjuvant and palliative settings. Data were collected through focus groups and were analysed using inductive content analysis. RESULTS: Two major themes emerged: emotional responses and cognitive...

  1. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety...

    Science.gov (United States)

    2011-11-17

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety Foundation AGENCY: Agency for Healthcare Research and... relinquishment from Emergency Medicine Patient Safety Foundation of its status as a Patient Safety...

  2. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    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....

  3. Reconstruction of alveolar defects in patients with cleft lip and palate - 111 consecutive patients

    DEFF Research Database (Denmark)

    Andersen, Kristian

    2012-01-01

    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...

  4. The patient health questionnaire-9: validation among patients with glaucoma.

    Directory of Open Access Journals (Sweden)

    Vijaya K Gothwal

    Full Text Available BACKGROUND: Depression and anxiety are two common normal responses to a chronic disease such as glaucoma. This study analysed the measurement properties of the depression screening instrument - Patient Health Questionnaire-9 (PHQ-9 using Rasch analysis to determine if it can be used as a measure. METHODS: In this hospital-based cross-sectional study, the PHQ-9 was administered to primary glaucoma adults attending a glaucoma clinic of a tertiary eye care centre, South India. All patients underwent a comprehensive clinical evaluation. Patient demographics and sub-type of glaucoma were abstracted from the medical record. Rasch analysis was used to investigate the following properties of the PHQ-9: behaviour of the response categories, measurement precision (assessed using person separation reliability, PSR; minimum recommended value 0.80, unidimensionality (assessed using item fit [0.7-1.3] and principal components analysis of residuals, and targeting. RESULTS: 198 patients (mean age ± standard deviation  = 59.83±12.34 years; 67% male were included. The native PHQ-9 did not fit the Rasch model. The response categories showed disordered thresholds which became ordered after category reorganization. Measurement precision was below acceptable limits (0.62 and targeting was sub-optimal (-1.27 logits. Four items misfit that were deleted iteratively following which a set of five items fit the Rasch model. However measurement precision failed to improve and targeting worsened further (-1.62 logits. CONCLUSIONS: The PHQ-9, in its present form, provides suboptimal assessment of depression in patients with glaucoma in India. Therefore, there is a need to develop a new depression instrument for our glaucoma population. A superior strategy would be to use the item bank for depression but this will also need to be validated in glaucoma patients before deciding its utility.

  5. Lymphoscintigraphy evaluation of paracoccidioidomycosis patients

    Energy Technology Data Exchange (ETDEWEB)

    Griva, B.L. E-mail: bgriva@fmb.unesp.br

    2005-07-01

    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

  6. [Patients' decision for aesthetic surgery].

    Science.gov (United States)

    Fansa, H; Haller, S

    2011-12-01

    Aesthetic surgery is a service which entails a high degree of trust. Service evaluation prior to provision is difficult for the patient. This leads to the question of how to manage the service successfully while still focusing on the medical needs. The decision to undergo an operation is not influenced by the operation itself, but by preoperative events which induce the patient to have the operation done. According to "buying decisions" for products or in service management, the decision for an aesthetic operation is extensive; the patient is highly involved and actively searching for information using different directed sources of information. The real "buying decision" consists of 5 phases: problem recognition, gathering of information, alternative education, purchase decision, and post purchase behaviour. A retrospective survey of 40 female patients who have already undergone an aesthetic operation assessed for problem recognition, which types of information were collected prior to the appointment with the surgeon, and why the patients have had the operation at our hospital. They were also asked how many alternative surgeons they had been seen before. Most of the patients had been thinking about undergoing an operation for several years. They mainly used the web for their research and were informed by other (non-aesthetic) physicians/general practitioners. Requested information was about the aesthetic results and possible problems and complications. Patients came based on web information and because of recommendations from other physicians. 60% of all interviewees did not see another surgeon and decided to have the operation because of positive patient-doctor communication and the surgeon's good reputation. Competence was considered to be the most important quality of the surgeon. However, the attribute was judged on subjective parameters. Environment, office rooms and staff were assessed as important but not very important. Costs of surgery were ranked second

  7. IMMUNOTHERAPY EFFICIENCY IN RHINOSINUSITIS PATIENTS

    Directory of Open Access Journals (Sweden)

    I. V. Stagnieva

    2015-01-01

    Full Text Available Latent rhinosinusitis proceeds without facial pain symptoms. Immune deficiency plays a leading role in pathogenesis of the disease latency. Substance P seems to be a universal mediator of painful irritation and inflammation. The objective of our study was to determine effectiveness of therapies in patients with latent rhinosinusitis, in terms of substance P levels.We treated 148 patients with rhinosinusitis, being free of local pains. All the patients underwent clinical and laboratory examination, including immune profile assessment, measurements of serum cytokines IL-1β, IL-4, IL-6, IL-8, IL-10, TNFα, IFNγ, and substance P. To correct a secondary immunodeficiency, the standard treatment of rhinosinusitis in a subgroup of the patients was accomplished by immunomodulatory drugs from the first day of therapy. The latter drugs were avoided for the rest of study group. Efficacy of treatment was evaluated by clinical signs and laboratory parameters on day 7 of the medication. Pre-treatment levels of substance P were determined in all the patients with latent clinical course and lack of pain symptoms. Low substance P levels (< 100 pg /ml were considered as indications for immunomodulatory therapy, due to immune deficiency confirmed by the cytokine imbalance. Choice of a specific drug was dependent on immunopathogenesis, i.e., for catarrhal rhinosinusitis and deficiency of cellular immunity, we administered IFN-ES-lipint; in cases of purulent rhinosinusitis, Likopid was applied. The patients treated with immunomodulatory drugs showed improvement of immune indexes by the 7th day of treatment, along with return of substance P levels to control values typical to healthy persons. Among patients with low substance P levels and immune deficiency (without immunomodulatory treatment, the immune parameters and substance P levels did not exhibit any sufficient changes over time.Low contents of substance P (SP ≤ 100 pg /ml in blood serum in pain

  8. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  9. [Multifocal tuberculosis in immunocompetent patients].

    Science.gov (United States)

    Rezgui, Amel; Fredj, Fatma Ben; Mzabi, Anis; Karmani, Monia; Laouani, Chadia

    2016-01-01

    Multifocal tuberculosis is defined as the presence of lesions affecting at least two extrapulmonary sites, with or without pulmonary involvement. This retrospective study of 10 cases aims to investigate the clinical and evolutionary characteristics of multifocal tuberculosis. It included 41 cases with tuberculosis collected between 1999 and 2013. Ten patients had multifocal tuberculosis (24%): 9 women and 1 man, the average age was 50 years (30-68 years). Our patients were correctly BCG vaccinated. The evaluation of immunodepression was negative in all patients. 7 cases had lymph node tuberculosis, 3 cases digestive tuberculosis, 2 cases pericardial tuberculosis, 2 cases osteoarticular tuberculosis, 1 case brain tuberculosis, 2 cases urinary tuberculosis, 4 cases urogenital tuberculosis, 1 case adrenal tuberculosis, 1 case cutaneous and 1 case muscle tuberculosis. All patients received anti-tuberculosis treatment for a mean duration of 10 months, with good evolution. Multifocal tuberculosis is difficult to diagnose. It can affect immunocompetent patients but often has good prognosis. Anti-tuberculosis therapy must be initiated as soon as possible to avoid sequelae.

  10. Hemodynamic changes in depressive patients

    Institute of Scientific and Technical Information of China (English)

    MA Ying; LI Hui-chun; ZHENG Lei-lei; YU Hua-liang

    2006-01-01

    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.

  11. in Patients with Mustard Lung

    Directory of Open Access Journals (Sweden)

    ShahrzadM Lari

    2013-05-01

    Full Text Available   Introduction: Chronic Obstructive Pulmonary Disease (COPD secondary to sulfur mustard exposure, known as mustard lung, is an important late pulmonary complication. The BODE (Body mass index, Obstruction, Dyspnea, and Exercise index has been established as a valuable tool for determining the adverse consequences of COPD. The aim of this study was to evaluate the role of the BODE index in patients with mustard lung.   Materials and Methods: Eighty-two consecutively stable patients with mustard lung with all levels of severity were entered this study. The following parameters were recorded in all patients: standard spirometry, pulse oximetry, health-related quality of life, the BODE index. Additionally, the severity of COPD was determined by GOLD (Global initiative for chronic Obstructive Lung Disease staging. The correlation of the BODE index with pulmonary parameters was determined. Results: The mean age of the patients was 47.30±7.08 SD years. The mean BODE index was 3.16±2.25 SD. There was a statistically significant inverse correlation between the BODE index and oxygen saturation (r=-0.30, p=0.007. Also a statistically significant correlation was found between the BODE index and quality of life (r=0.80, p=0.001. The BODE index was not correlated with age of the patients and duration of disease. Conclusions: The results of this study showed that the BODE index is correlated with important clinical parameters and can be used in clinical practice

  12. Audiological Manifestations in Vitiligo Patients

    Directory of Open Access Journals (Sweden)

    Parvane Mahdi

    2012-01-01

    Full Text Available Introduction: The hallmark of vitiligo is the disappearance of melanocytes from the skin due to an as yet unidentified mechanism. The presence of melanocytes in the auditory apparatus suggests that this system could possibly be affected by vitiligo, which targets the melanocytes of the whole body and not just the skin.The purpose of this study was to assess the incidence of auditory alterations in patients with vitiligo Materials and Methods: A total of 21 patients diagnosed with vitiligo were enrolled in this study. A group of 20 healthy subjects served as a control group. Pure tone audiometry (PTA and measurements of auditory brain stem responses (ABR were carried out in all participants. Results: High frequency sensory neural hearing loss was detected in 8 patients (38.09%. Analysis of ABR revealed that 10 patients (47.61% had an abnormal increase in the latency of Wave III and 6 (28.57% had an abnormal prolongation of the inter peak latency between Wave I and III. There was no correlation between age, duration of disease, and any of the recorded parameters. Conclusion: This study highlights the involvement of the auditory system in patients with vitiligo, suggesting that vitiligo is a systemic disease rather than a purely cutaneous problem.

  13. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  14. Patient adherence to allergy immunotherapy.

    Science.gov (United States)

    Reisacher, William R; Visaya, Jiovani M

    2013-06-01

    This article reviews the literature on patient adherence to two different approaches to allergen-specific immunotherapy for allergic disease. Factors related to adherence in general, as well as the various methods used to measure adherence, will be discussed. Although a complex interaction of factors related to both the physician and the patient influence the adherence to a particular therapeutic regimen, effective communication between these two parties and the simplicity of the regimen are frequently noted to be of primary importance. Variability with respect to the definition of adherence, the method of measuring adherence, and the length of the measuring period has resulted in a wide range of adherence rates to allergy immunotherapy reported in the literature. Patients most often site inconvenience, side-effects, and poor efficacy as reasons for discontinuing allergy immunotherapy. Adherence to therapy not only improves individual patient outcomes, but also helps determine the best treatment modalities and reduces the burden of disease on society. As new methods of delivering immunotherapy are being developed, such as allergy immunotherapy tablets and oral mucosal immunotherapy, the factors associated with patient adherence should be carefully considered.

  15. Buccal health in asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Nora Sexto Delgado

    2003-04-01

    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.

  16. Psychoneuroimmunology in critically ill patients.

    Science.gov (United States)

    DeKeyser, Freda

    2003-02-01

    Psychoneuroimmunology is the study of the interactions among behavior, neural, and endocrine functions and the immune system. The purpose of this review is to briefly summarize the evidence concerning interactions among behavior, the neuroendocrine system, and the immune system, and to show how this evidence relates to critical care patients. It has been shown that the immune function of many patients in the intensive care unit is suppressed as a result of trauma, sepsis, or profound physiologic and psychological stress. Three of the most common stressors among patients in the intensive care unit are pain, sleep deprivation, and fear or anxiety. Findings have shown each of these stressors to be associated with decreased immune functioning. Nurses have an important responsibility to protect their patients from infection and promote their ability to heal. Several actions are suggested that can help the nurse achieve these goals. It is hoped that nurses would keep these interactions in mind while caring for their patients in the intensive care unit.

  17. Falls in elderly hemodialysis patients.

    Science.gov (United States)

    Abdel-Rahman, E M; Turgut, F; Turkmen, K; Balogun, R A

    2011-10-01

    The elderly, (age ≥ 65 years) hemodialysis (HD) patient population is growing rapidly across the world. The risk of accidental falls is very high in this patient population due to multiple factors which include aging, underlying renal disease and adverse events associated with HD treatments. Falls, the most common cause of fatal injury among elderly, not only increase morbidity and mortality, but also increase costs to the health system. Prediction of falls and interventions to prevent or minimize fall risk and associated complications will be a major step in helping these patients as well as decreasing financial and social burdens. Thus, it is vital to learn how to approach this important problem. In this review, we will summarize the epidemiology, risk factors, pathophysiology and complications of falls in elderly HD patients. We will also focus on available methods to assess and predict the patients at higher risk of falling and will provide recommendations for interventions to reduce the occurrence of falls in this population.

  18. MyUMC Patient Portal: patient and professional perspectives

    Science.gov (United States)

    Ros, Wynand J.G

    2012-01-01

    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 use, their experiences and to detect factors that influence use and appreciation of the portal. Method One hundred and nine patients were followed during seven months. They completed a digital questionnaire at baseline, and at 2 and 7 months. The questionnaire contains items with fixed response categories on personal characteristics (including internet use and computer skills), actual use of the portal (frequency and modules), total websites’ ease-of-use (attractiveness, controllability, efficiency, helpfulness and learnability with WAMMI), patients’ experiences with the modules and overall appreciation of the portal (10-point scale). Two open questions were add on specific positive and specific negative experiences. Results Most respondents were regular (almost daily) users of the internet and considered themselves competent computer users. Over 80% of the patients used the portal at least once. More than half of them used the portal recently, i.e. the last month. Reasons for not using the portal were lack of actual health problems, problems with login procedures, too busy with other things. Related to regular care, most patients used the portal complementary to regular care for the same questions. However, about half of the patients stated that they used the portal as a substitution for regular consultations (face to face or telephone). On the other hand, one-third stated that they used the portal in addition to regular care. The users find the

  19. Identifying patient risks during hospitalization

    Directory of Open Access Journals (Sweden)

    Lucélia Ferreira Lima

    2008-12-01

    Full Text Available Objective: To identify the risks reported at a public institution andto know the main patient risks from the nursing staff point of view.Methods: A retrospective, descriptive and exploratory study. Thesurvey was developed at a hospital in the city of Taboão da Serra, SãoPaulo, Brazil. The study included all nurses working in care areas whoagreed to participate in the study. At the same time, sentinel eventsoccurring in the period from July 2006 to July 2007 were identified.Results: There were 440 sentinel events reported, and the main risksincluded patient falls, medication errors and pressure ulcers. Sixty-fivenurses were interviewed. They also reported patient falls, medicationerrors and pressure ulcers as the main risks. Conclusions: Riskassessment and implementation of effective preventive actions arenecessary to ensure patient’s safety. Involvement of a multidisciplinaryteam is one of the steps for a successful process.

  20. PATIENT REGISTRIES FOR RARE DISEASES

    Directory of Open Access Journals (Sweden)

    Mariela Deliverska

    2016-06-01

    Full Text Available Rare diseases are diseases with a particularly low prevalence. The specificities of rare diseases - limited number of patients and scarcity of relevant knowledge and expertise - single them out as a distinctive domain of very high added value. The international reference for classification of diseases and conditions is the International Classification of Diseases (ICD, coordinated by the World Health Organization (WHO. Patient registries and databases constitute key instruments for the development of clinical research in the field of rare diseases. Rare disease registries include not only diseases that are inherently rare, but also common diseases that are rare in specific populations, especially those defined by demographics. Disease registries create the possibility of assessing the long-term safety and benefit of different treatments, perhaps leading to treatment algorithms that allow more choices for patients and clinicians.

  1. Zinc supplementation in burn patients.

    Science.gov (United States)

    Caldis-Coutris, Nancy; Gawaziuk, Justin P; Logsetty, Sarvesh

    2012-01-01

    Micronutrient supplementation is a common practice throughout many burn centers across North America; however, uncertainty pertaining to dose, duration, and side effects of such supplements persists. The authors prospectively collected data from 23 hospitalized patients with burn sizes ranging from 10 to 93% TBSA. Each patient received a daily multivitamin and mineral supplement, 50 mg zinc (Zn) daily, and 500 mg vitamin C twice daily. Supplements were administered orally or enterally. Albumin, prealbumin, C-reactive protein, serum Zn, and serum copper were measured weekly during hospital admission until levels were within normal reference range. Our study concluded that 50 mg daily dose of Zn resulted in normal serum levels in 19 of 23 patients at discharge; 50 mg Zn supplementation did not interfere with serum copper levels; and Zn supplements, regardless of administration route, did not result in gastrointestinal side effects.

  2. Patient advocacy: the technologist's role.

    Science.gov (United States)

    Church, Elizabeth J

    2004-01-01

    This article provides an overview of the various ways in which imaging professionals can demonstrate patient advocacy on a day-to-day basis and throughout their careers. Advocacy encompasses a wide range of attitudes and activities, and implementing its principles can bring new enthusiasm to the workplace and increase job satisfaction. After completing this article, readers will: Describe the fundamental aspects of advocacy. Know how to handle conflict and explain why conflict is necessary. Understand the challenges to advocacy. Apply patient advocacy in the context of diagnostic imaging. Recognize the radiologic technologist's important role in ensuring patient safety. Identify how professional codes and standards, as well as federal and state laws, encourage advocacy efforts.

  3. Antibiotic resistance in cancer patients.

    Science.gov (United States)

    Gudiol, Carlota; Carratalà, Jordi

    2014-08-01

    Bacterial infection is one of the most frequent complications in cancer patients and hematopoietic stem cell transplant recipients. In recent years, the emergence of antimicrobial resistance has become a significant problem worldwide, and cancer patients are among those affected. Treatment of infections due to multidrug-resistant (MDR) bacteria represents a clinical challenge, especially in the case of Gram-negative bacilli, since the therapeutic options are often very limited. As the antibiotics active against MDR bacteria present several disadvantages (limited clinical experience, higher incidence of adverse effects, and less knowledge of the pharmacokinetics of the drug), a thorough acquaintance with the main characteristics of these drugs is mandatory in order to provide safe treatment to cancer patients with MDR bacterial infections. Nevertheless, the implementation of antibiotic stewardship programs and infection control measures is the cornerstone for controlling the development and spread of these MDR pathogens.

  4. Adenovirus infection in immunocompromised patients

    Directory of Open Access Journals (Sweden)

    Sylwia Rynans

    2013-09-01

    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.

  5. The diabetic patient in Ramadan.

    Science.gov (United States)

    Chamsi-Pasha, Hassan; Aljabri, Khalid S

    2014-04-01

    During the month of Ramadan, all healthy, adult Muslims are required to fast from dawn to sunset. Fasting during Ramadan involves abstaining from food, water, beverages, smoking, oral drugs, and sexual intercourse. Although the Quran exempts chronically ill from fasting, many Muslims with diabetes still fast during Ramadan. Patients with diabetes who fast during the month of Ramadan can have acute complications. The risk of complications in fasting individuals with diabetes increases with longer periods of fasting. All patients with diabetes who wish to fast during Ramadan should be prepared by undergoing a medical assessment and engaging in a structured education program to undertake the fast as safely as possible. Although some guidelines do exist, there is an overwhelming need for better designed clinical trials which could provide us with evidence-based information and guidance in the management of patients with diabetes fasting Ramadan.

  6. Cancer Patients Versus Cancer Survivors

    Science.gov (United States)

    Mosher, Catherine E.; Danoff-Burg, Sharon

    2013-01-01

    Two studies examined the social and emotional implications of different linguistic classifications of individuals with cancer. Undergraduates were randomly assigned to rate their reactions to either cancer patients or cancer survivors. Across studies, participants held more favorable perceptions of the character of cancer survivors relative to cancer patients and displayed more positive attitudes toward the former group. In addition, participants in Study 1 reported greater willingness to interact with cancer survivors compared with cancer patients. Positive perceptions of prognosis did not appear to account for favorable attitudes toward cancer survivors; most participants in Study 2 did not assume that cancer survivors were beyond the treatment phase of their illness or cured of their disease. Findings point to a potentially powerful effect of word choice on reactions to individuals with cancer. PMID:24371366

  7. ANTIFUNGAL PROPHYLAXIS IN IMMUNOCOMPROMISED PATIENTS

    Directory of Open Access Journals (Sweden)

    Lourdes Vazquez

    2016-09-01

    Full Text Available Invasive fungal infections (IFIs represent significant complications in patients with hematological malignancies. Chemoprevention of IFIs may be important in this setting, but most antifungal drugs have demonstrated poor efficacy, particularly in the prevention of invasive aspergillosis. Antifungal prophylaxis in hematological patients is currently regarded as the gold standard in situations with a high risk of infection, such as acute leukemia, myelodysplastic syndromes, and autologous or allogeneic hematopoietic stem cell transplantation. Over the years, various scientific societies have established a series of recommendations for antifungal prophylaxis based on prospective studies performed with different drugs. However, the prescription of each agent must be personalized, adapting its administration to the characteristics of individual patients and taking into account possible interactions with concomitant medication.

  8. Thromboembolism in Patients with Cancer.

    Science.gov (United States)

    Büyükçelik, Abdullah; Akbulut, Hakan

    2004-03-01

    One hundred and forty years ago, Armand Trousseau described phlegmasia alba dolens as a sign of internal malignancy. Nowadays, it is commonly believed that the presence malignant tumaor increases the risk of venous thromboembolism (i.e deep vein thrombosis and pulmonary embolism) However, cancer is usually associated with other factors such as old age, extensive surgery,immobility, etc., which may predispose to thromboembolism. The majority of thrombotic events occur in the venous system; the incidence of arterial thrombosis is much lower.Recurrent thromboembolism in cancer patients frequently and diminishes the quality of life of the patients.Furthermore, if the thromboembolism is massive, destipte of early and aggressive treatment, it may result in death. In this article, we review thromboembolic complications in cancer patients.

  9. Candidemia in major burns patients.

    Science.gov (United States)

    Renau Escrig, Ana I; Salavert, Miguel; Vivó, Carmen; Cantón, Emilia; Pérez Del Caz, M Dolores; Pemán, Javier

    2016-06-01

    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. © 2016 Blackwell Verlag GmbH.

  10. Chronic constipation in hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    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.

  11. "In patient" medical abortion versus surgical abortion: patient's satisfaction.

    Science.gov (United States)

    Di Carlo, Costantino; Savoia, Fabiana; Ferrara, Cinzia; Sglavo, Gabriella; Tommaselli, Giovanni Antonio; Giampaolino, Pierluigi; Cagnacci, Angelo; Nappi, Carmine

    2016-08-01

    To compare patients' satisfaction with medical and surgical abortion, implementing the Italian guidelines on medical abortion entailing an "in patient" procedure. A total of 1832 pregnant chose between surgical (vacuum aspiration) or medical abortion (mifepristone p.o. followed after 3 days by sublingual misoprostol) and expressed their expected satisfaction on a visual analog scale (VAS). A total of 885 women chose surgical and 947 medical abortion. The primary end-point was satisfaction VAS score 20 days after the procedure. Secondary end-points were: difference between pre- and post-abortion VAS score; difference in satisfaction VAS scores according to parity and previous abortion; incidence of side effects. VAS score was high in each group but significantly higher for the 1-day surgical than for the 3-day medical abortion procedure (7.9 ± 1.0 versus 7.2 ± 1.2; p after the treatment (6.9 ± 1.6 versus 7.9 ± 1.0, p abortion; women with a previous abortion preferred surgical abortion. Both procedures are considered satisfactory by the patients. Performing medical abortion as a 3-day "in patient" procedure, decreased women's satisfaction scores from their baseline expectations.

  12. Diabetes in patients with HIV: patient characteristics, management and screening

    NARCIS (Netherlands)

    Roerink, M.E.; Meijering, R.; Bosch, M.; Galan, B.E. de; Crevel, R. van

    2015-01-01

    BACKGROUND: As HIV management has become more successful during the past years, non-communicable diseases have become more prevalent among HIV-infected individuals. As a result, more HIV-infected patients die of cardiovascular diseases, with diabetes being one of the main risk factors. This study ev

  13. [Hilarein, a patient education game for kidney transplant patients].

    Science.gov (United States)

    Césarini, Carole; Callens, Cécile

    2013-03-01

    At Nice university hospital, an educational board game has been designed by the kidney transplant team for patients suffering from kidney failure. Hilarein is a tool to support therapeutic education which demonstrates that it is possible to learn while having fun.

  14. Analysis of patient falls among hospitalised patients in Makkah region.

    Science.gov (United States)

    Flimban, Mohammed Abdulwahab; Abduljabar, Dalal Fouad; Dhafar, Khalid Obaid; Deiab, Basma Abdulhameed; Gazzaz, Zohair Jamil; Bansuan, Abasra Usman; Balbed, Abeer Ahmad; Al-Shaikhi, Ahmad Mohammed; Al-Motari, Sultan Saad; Suliman, Muhammad Imran

    2016-08-01

    To assess the frequency and its correlation of patient fall with preventing or precipitating factors among inpatients. The observational study was conducted in Makkah Region, Saudi Arabia from October 15 2012 to November 4, 2013. Data was collected using a questionnaire from 16 hospitals in four districts of Makkah province. The material was sampled through systematic randomisation from inpatient files and data was collected for those who had fallen inside the hospital. The questionnaire, validated through a pilot study run under the Directorate of Quality and Patient Safety in Makkah, was used to see whether the hospitals had adopted and applied international standards for assessment of adult and paediatric patients for falls as well as effectiveness of these applications. Of 4,799 beds, occupancy rates ranged from 1680(35%) to 4,799(100%). Out of 291 falls in all, 144(49.48%) were in Jeddah. Besides, 116(40%) of the falls occurred in the last quarter of the Islamic calendar. Statistically significant difference was found in fall episodes in different months (p=0.007). Statistical analysis indicated that the factors that significantly raised the number of patient falls were increase in hospital beds and their occupancy rate (Spearman's correlation: 0.621 and 0.579 respectively). The frequency of falls varied from hospital to hospital and factors like higher number of bed capacity and occupancy rate increased the falls.

  15. THYMOMA -A Review of Fourteen Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, S. K.; Lee, H. S.; Cho, K. H.; Suh, C. O.; Kim, G. E. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1985-06-15

    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)

  16. Patient-Specific Computational Modeling

    CERN Document Server

    Peña, Estefanía

    2012-01-01

    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.

  17. The patient as skilled practitioner

    DEFF Research Database (Denmark)

    Kilbourn, Kyle

    2012-01-01

    and create duties for patients. For the patient at home, it is not just about applying bandages to a wound. They now configure dialysis machines, inject insulin and stock medical supplies. Information technology produces data to be transformed into meaningful knowledge about one’s own body. However, with all...... of these changes, basic and fundamental questions are left unanswered. Who is this person? How do they get through everyday life? What tactics do they use as part of—and distancing themselves from—the medical regime?...

  18. Sporotrichosis in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Paulo Gewehr

    2013-01-01

    Full Text Available The current report describes two renal transplant recipients who presented with sporotrichosis. In addition, the authors review the general aspects of sporotrichosis in renal transplant recipients reported in the literature. Sporotrichosis is a rare fungal infection in transplant patients and has been reported primarily in renal transplant recipients not treated with antifungal prophylaxis. Extracutaneous forms of sporotrichosis without skin manifestations and no previous history of traumatic injuries have been described in such patients and are difficult to diagnose. Renal transplant recipients with sporotrichosis described in the present report were successfully treated with antifungal therapy including amphotericin B deoxycholate, lipid amphotericin B formulations, fluconazole and itraconazole.

  19. Patient diaries: charting the course.

    Science.gov (United States)

    Zanni, Guido R

    2007-06-01

    Clinical diaries are a way for patients to assess their own health status without clinician bias or interpretation. Diaries are especially useful in understanding symptoms' temporal dynamics, including triggers that exacerbate symptoms; they also help individuals to evaluate the impact of their treatment. Diary format should be patient-specific, with thoughtful consideration given to rating scales, symptom descriptors, number of daily entries required, and the duration of diary recording. While compliance, recall biases, and diary fatigue affect data quality, a diary's potential for individualizing treatment strategies is tremendous.

  20. Bone health in cancer patients

    DEFF Research Database (Denmark)

    Coleman, R; Body, J J; Aapro, M

    2014-01-01

    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...... in the metastatic processes required for cancer dissemination, and there are emerging data showing that, at least in some clinical situations, the use of bone-targeted treatments can reduce metastasis to bone and has potential impact on patient survival....