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Medical Issues (medical + issues)
Selected AbstractsMedical and surgical therapies for alopecias in black womenDERMATOLOGIC THERAPY, Issue 2 2004Valerie D. Callender ABSTRACT:, Hair loss is a common problem that challenges the patient and clinician with a host of cosmetic, psychological and medical issues. Alopecia occurs in both men and women, and in all racial and ethnic populations, but the etiology varies considerably from group to group. In black women, many forms of alopecia are associated with hair-care practices (e.g., traction alopecia, trichorrhexis nodosa, and central centrifugal cicatricial alopecia). The use of thermal or chemical hair straightening, and hair braiding or weaving are examples of styling techniques that place African American women at high risk for various "traumatic" alopecias. Although the exact cause of these alopecias is unknown, a multifactorial etiology including both genetic and environmental factors is suspected. A careful history and physical examination, together with an acute sensitivity to the patient's perceptions (e.g., self-esteem and social problems), are critical in determining the best therapy course. Therapeutic options for these patients range from alteration of current hair grooming practices or products, to use of specific medical treatments, to hair replacement surgery. Since early intervention is often a key to preventing irreversible alopecia, the purpose of the present article is to educate the dermatologist on all aspects of therapy for hair loss in black women,including not only a discussion of the main medical and surgical therapies but also an overview of ethnic hair cosmetics, specific suggestions for alterations of hair-care practices, and recommendations for patient education and compliance. [source] Kabuki syndrome: oral and general features seen in a 2-year-old Chinese boyINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2006M. ATAR Summary., This report describes the case of a young Chinese boy with Kabuki syndrome (KS). KS is a congenital condition characterized by multiple anomalies, especially of the face, and is usually associated with mild to moderate mental retardation. The patient presented with the characteristic facial features of KS and some skeletal and neurological anomalies including a butterfly vertebrae with scoliosis, cerebral atrophy, and irregular dentition. Dental examination revealed screwdriver-shaped incisors and a high arched maxilla, features typical of patients with KS, as well as very poor oral hygiene and early childhood caries. This report includes discussion of the aetiology of KS as well as discussion of the long-term prognosis for this particular patient, and patients with KS in general, with consideration of associated dental and medical issues. [source] Identifying and screening for psychological and comorbid medical and psychological disorders in medical settings,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2009Rodger Kessler Abstract There is increased attention to the medical and economic consequences of psychological problems comorbid with medical issues. There is also a clear awareness that most psychological problems are assessed and responded to in nonpsychiatric medical settings. This has furthered interest and attention in implementing screening procedures to better identify psychological, behavioral, and substance abuse problems in medical settings. Such interest is taking the form of recommendations from federal government task forces, and the funding of large projects to include screening in medical settings. At the same time there has been further attention to brief, valid, and reliable measures with which to capture psychological comorbidities. However, there have been multiple concerns raised about a variety of issues concerning the utility and effectiveness of such screening procedures and the identification of multiple issues to be considered in screening design. The author outlines and reviews the rationale and concerns about screening, identifies the issues that need to be considered in screening program development, and describes the efforts to develop a screening capacity in a rural family practice. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65:1,15, 2009. [source] Living with chronic illness: A phenomenological study of the health effects of the patient,provider relationshipJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 3 2008Associate Professor of Nursing), CNS (Psychiatric, Mental Health Clinical Specialist, Sylvia Fox PhD Abstract Purpose: To understand the patient,healthcare provider (HCP) relationship from the lived experience of women with chronic disease and determine how this relationship affects women's health. Data sources: Narrative accounts of 25 women's relationships with HCPs in repeated group and individual interviews were audio-taped and transcribed verbatim. Interpretive phenomenology was used to explore the data using three interconnected modes of paradigm cases, exemplars, and themes. Conclusions: Women with chronic disease believed their health was significantly affected by their relationships with HCPs. They experienced a greater sense of well-being and security in connected relationships and had more confidence and motivation to manage their illness. Implications for practice: This research suggests that for women with chronic disease, relationships with HCPs that are connected, and characterized by partnership, and personableness result in the women feeling better in many dimensions. The context of today's healthcare system often pushes the nurse practitioner (NP) to provide care more attuned to medical issues, leaving little time for the development of connected relationships. In spite of this pressure, NPs need to strive to develop relationships with patients that are intersubjective/connected. [source] Health Status of Incarcerated Adolescents: Implications for Juvenile Justice Decision MakingJUVENILE AND FAMILY COURT JOURNAL, Issue 1 2004ROBERT E. MORRIS ABSTRACT Adolescents arriving in detention often bring with them significant medical, dental, and psychological problems. These issues have important implications for courts that must decide the best disposition for offending youths. Appropriate treatment benefits the individual by enhancing his/her well-being and improving his/her chances of successful rehabilitation. Society also benefits by avoiding the higher cost of caring for neglected conditions later in life. A comprehensive health care program for detention facilities involves establishing standardized procedures that address both common adolescent problems plus those more peculiar to detainees. Health care professionals working in a correctional setting have unique duties such as clearing youths for boot camp, monitoring injuries, dealing with resistant patients, monitoring for safe activities, and planning aftercare for youths who may face impediments to accessing care such as poor motivation and poverty. Research concerning issues specific to the needs of incarcerated youths remains infrequent and should be undertaken by health care providers. This article provides an overview of medical issues confronting juvenile offenders that should be considered when a juvenile becomes involved in the juvenile justice system. [source] Essential medical facts for mental health practitionersNEW DIRECTIONS FOR YOUTH DEVELOPMENT, Issue 87 2000Milton L. Wainberg M.D. New information about the life cycle of HIV, new HIV-specific laboratory tests, and newer antiretroviral medications have transformed the management of HIV illness. Knowledge about these changes will help mental health providers better understand the latest medical issues affecting their HIV-infected patients, which will assist them in providing better care. [source] Historical Review of Penile Prosthesis Design and Surgical Techniques: Part 1 of a Three-Part Review Series on Penile Prosthetic SurgeryTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2009Gerard D. Henry MD ABSTRACT Introduction., Throughout history, many attempts to cure complete impotence have been recorded. Early attempts at a surgical approach involved the placement of rigid devices to support the natural process of erection formation. However, these early attempts placed the devices outside of the corpora cavernosa, with high rates of erosion and infection. Today, most urologists in the United States now place an inflatable penile prosthesis (IPP) with an antibiotic coating inside the tunica albuginea. Aim., The article describes the key historical landmarks in penile prosthesis design and surgical techniques. Methods., The article reviews and evaluates the published literature for important contributions to penile prosthesis design and surgical techniques. Main Outcome Measures., The article reviews and evaluates the historical landmarks in penile prosthesis design and surgical techniques that appear to improve outcomes and advance the field of prosthetic urology for the treatment of erectile dysfunction. Results., The current review demonstrates the stepwise progression starting with the use of stenting for achieving rigidity in the impotent patient. Modern advances were first used in war-injured patients which led to early implantation with foreign material. The design and techniques of penile prostheses placement have advanced such that now, more complications are linked to medical issues than failure of the implant. Conclusions., Today's IPPs have high patient satisfaction rates with low mechanical failure rates. Gerard D. Henry. Historical review of penile prosthesis design and surgical techniques: Part 1 of a three-part review series on penile prosthetic surgery. J Sex Med 2009;6:675,681. [source] Service delivery in older patients with bipolar disorder: a review and development of a medical care modelBIPOLAR DISORDERS, Issue 6 2008Amy M Kilbourne Objectives:, Medical comorbidities, especially cardiovascular disease (CVD), occur disproportionately in older patients with bipolar disorder. We describe the development, implementation, and feasibility/tolerability results of a manual-based medical care model (BCM) designed to improve medical outcomes in older patients with bipolar disorder. Methods:, The BCM consisted of (i) self-management sessions focused on bipolar disorder symptom control, healthy habits, and provider engagement, (ii) telephone care management to coordinate care and reinforce self-management goals, and (iii) guideline dissemination focused on medical issues in bipolar disorder. Older patients with bipolar disorder and a CVD-related risk factor (n = 58) were consented, enrolled, and randomized to receive BCM or usual care. Results:, Baseline assessment (mean age = 55, 9% female, 9% African American) revealed a vulnerable population: 21% were substance users, 31% relied on public transportation, and 22% reported problems accessing medical care. Evaluation of BCM feasibility revealed high overall patient satisfaction with the intervention, high fidelity (e.g., majority of self-management sessions and follow-up contacts completed), and good tolerability (dropout rate <5%). Use of telephone contacts may have mitigated barriers to medical care (e.g., transportation). Conclusions:, The BCM is a feasible model for older, medically ill patients with bipolar disorder, and could be an alternative to more costly treatment models that involve co-location and/or additional hiring of medical providers in mental health clinics. Future research directions pertinent to the development of the BCM and other medical care models for older patients with bipolar disorder include assessment of their long-term effects on physical health and their cost-effectiveness across different treatment settings. [source] | |||||||||||||