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Adequate Management (adequate + management)
Selected AbstractsThe economic impact of severe asthma to low-income familiesALLERGY, Issue 3 2009R. Franco Background:, To estimate the direct and indirect costs of severe asthma and the economic impact of its management to low-income families in Salvador, Brazil. Methods:, One hundred and ninety-seven patients with severe asthma and referred to a state-funded asthma center providing free treatment were evaluated. At registration, they were asked about family cost-events in the previous year and had a baseline assessment of lung function, symptoms and quality of life. During the subsequent year, they were reassessed prospectively. Results:, One hundred-eighty patients concluded a 12-month follow-up. Eighty-four percent were female patients, and the median family income was US$ 2955/year. Forty-seven percent of family members had lost their jobs because of asthma. Total cost of asthma management took 29% of family income. After proper treatment, asthma control scores improved by 50% and quality of life by 74%. The income of the families increased by US$ 711/year, as their members went back to work. The total cost of asthma to the families was reduced by a median US$ 789/family/year. Consequently, an annual surplus of US$ 1500/family became available. Conclusions:, Family costs of severe asthma consumed over one-fourth of the family income of the underprivileged population in a middle-income country. Adequate management brings major economic benefit to individuals and families. [source] Cancer patients' expectations of experiencing treatment-related side effectsCANCER, Issue 4 2004A University of Rochester Cancer Center-Community Clinical Oncology Program study of 938 patients from community practices Abstract BACKGROUND Adequate management of treatment-related side effects is important for patients and challenging for clinicians. Side effects generated by various treatments have been characterized reasonably well. However, to the authors' knowledge, less is known regarding what patients expect to experience regarding these side effects and how patient characteristics are related to these expectations. METHODS Patients with cancer (n = 1015 patients) from 17 Community Clinical Oncology Program (CCOP) institutions affiliated with the University of Rochester Cancer Center CCOP Research Base were surveyed regarding their expectations of experiencing side effects associated with cancer treatment, with 938 patients providing evaluable data. Patients responded to the item, "Indicate your expectations of having this side effect" for 12 common side effects. Patients rated their expectations using a 5-point Likert scale, from 1 ("I definitely will not have this") to 5 ("I definitely will have this"). RESULTS The median number of symptoms expected (characterized by any value other than one) was nine. The six most expected symptoms were fatigue, nausea, sleep disturbance, weight loss, hair loss, and skin problems. Patients age > 60 years expected to have fewer symptoms than younger patients; female patients expected more side effects than male patients; and patients who had some college education expected more side effects than patients who were high school graduates or had not completed high school. CONCLUSIONS Patients with cancer clearly exhibit expectations regarding treatment-related side effects; and age, gender, and education level appear to influence these expectations. Further careful characterization of patient expectations and how expectations relate to experience may lead to earlier and more effective management of side effects. Cancer 2004. © 2004 American Cancer Society. [source] First case of immune-mediated haemolytic anaemia associated to imatinib mesylateEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2003Marcia C. Zago Novaretti Abstract: Imatinib mesylate is a specific inhibitor of protein tyrosine kinase activity secondary to bcr-abl, mostly indicated for the treatment of patients with Philadelphia chromosome positive chronic myeloid leukaemia (CML). Generally, the undesirable effects of imatinib administration observed in clinical trials were of mild-to-moderate degree, and no haemolysis has been associated with this drug. We report here a case of immune-mediated haemolytic anaemia associated to imatinib mesylate successfully treated with prednisone in a patient with CML. Laboratory investigation showed anaemia [haemoglobin (Hb) of 59 g/L], reticulocyte of 61 × 109/L and a positive direct antiglobulin test. Anti-drug in vitro studies revealed a positive result with gel microcolumn assay by an adsorption mechanism. Seventy-four days after prednisone therapy, the patient's Hb level was of 110 g/L with negative direct antiglobulin test and drug in vitro studies. This case demonstrated that patients treated with imatinib mesylate can present immune-mediated haemolysis and adequate management of this event can be done maintaining the drug and associating corticosteroids. [source] External commercialization of knowledge: Review and research agendaINTERNATIONAL JOURNAL OF MANAGEMENT REVIEWS, Issue 4 2005Ulrich Lichtenthaler Companies increasingly make use of external knowledge exploitation, i.e. the commercialization of knowledge assets, although they often perceive considerable difficulties in managing external commercialization tasks. These difficulties are partly due to the imperfections in the markets for knowledge, which may be mastered by adequate management, as examples of various well-known companies show. In combination, these facts point to the need for research into external knowledge exploitation. A thorough analysis of past research confirms this need and shows that the existing literature is highly fragmented. By integrating the main findings of the different research streams, a detailed overview of the literature on external knowledge exploitation is established. The key characteristics of externally leveraging knowledge assets are presented, and a research agenda is set up. [source] Successful renal transplantation in the right iliac fossa 2 years after serious deep venous thrombosis in a patient with systemic lupus erythematosusINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2005NORIHIKO TSUCHIYA Abstract Deep venous thrombosis (DVT) possibly occurs in the perioperative period, and induces serious complications such as a pulmonary embolism. On the other hand, allograft renal vein thrombosis leads to a high incidence of graft loss. We experienced a case in which a serious DVT occurred prior to renal transplantation; however, a successful renal transplantation in the right iliac fossa was performed after 2 years of anticoagulant therapy. It is suggested that the external iliac vein even after suffering from DVT can be anastomosed to an allograft vein successfully, when enough blood ,ow or a lower venous pressure is con,rmed. However, one should be aware of the risk factors and the adequate management of thrombosis in renal transplantation because of the serious complications of DVT and the poor prognosis of allograft vein thrombosis. [source] Relationship between the length of hospital stay after hip fracture surgery and ambulatory ability or mortality after discharge in JapanJAPAN JOURNAL OF NURSING SCIENCE, Issue 1 2010Akiko KONDO Abstract Aim:, To examine whether the length of hospital stay after hip fracture surgery is related to patients' ambulatory ability or mortality after discharge. Methods:, This is a retrospective observational study of patients who had undergone hip fracture surgery at one of three hospitals in Japan. The medical records of patients who were ,65 years and who had hip fracture surgery within the past 2.5 years were reviewed regarding the demographics, treatments, and health outcomes during the hospital stay. A mail survey, asking about health outcomes after discharge, was sent to the study participants and/or their family members. The response rate of the survey was 70% (n = 149). Results:, The patients who were discharged between 30 and 39 days after surgery had significantly lower current ambulatory ability, compared to the patients who stayed for ,40 days, after adjusting for patient characteristics, treatments, and hospital. The patients who were discharged within 2 weeks after surgery and the patients who were discharged between 30 and 39 days after surgery had a significantly higher risk of mortality, compared to the patients who stayed in the hospital for ,40 days, after adjustments were made. Conclusions:, If patients are discharged to a rehabilitation hospital before they are totally recovered from surgery, the emphasis might be on their rehabilitation without adequate management of their comorbidities. Additional prospective studies are needed to determine the effects of a shorter length of hospital stay after hip fracture surgery on patient outcomes. [source] Unipolar or bipolar depression?JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 4 2007Improving diagnostic confidence with the adult patient Abstract Purpose: The purpose of this article is to inform advanced practice nurses in primary care about the differential diagnosis of bipolar disorder (BD), when depression is identified in the adult patient. Data sources: Selected research and clinical articles. Conclusions: Adult patients with BD are much more likely to seek treatment for depression than for mania or hypomania. Recognition of BD is improved when the primary care clinician is alerted to the factors indicating bipolarity and utilizes available screening tools. Implications for practice: Misdiagnosis of a bipolar spectrum disorder delays proper treatment and precludes adequate management both pharmacologically and psychotherapeutically. [source] | ||||||||||