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Medical Status (medical + status)
Selected AbstractsSixteen years of prenatal consultations for the N370S/N370S Gaucher disease genotype: What have we learned?PRENATAL DIAGNOSIS, Issue 10 2010Yael Eitan Abstract Objective Although prenatal diagnosis and genotyping are available for Gaucher disease, genetic counseling for an affected child's parents reflects the inability to predict disease course with certainty. The purpose of this survey is to ascertain disease status of children identified by prenatal screening. Methods All carrier couples for glucocerebrosidase mutations who were counseled at our large Gaucher Clinic were included; none had genotyped the fetus. Medical status of children was assessed by questionnaires and data were collected from clinic charts and/or telephone contact with the parents. Results Of 34 children born, 1 died in utero, 5 fetuses (N370S/N370S) aborted. Of 21 genotyped N370S/N370S, 7 children had Gaucher-like symptoms/signs but for only one child (two symptoms) were these ascribable to Gaucher disease; four children had non-Gaucher symptoms/signs. Conclusion Of 21 children whose parents pursued prenatal counseling for Gaucher disease and were found to have the N370S/N370S genotype, none has presented with severe disease with follow-up of 15 years. The Israeli experience shows that Gaucher disease N370S screening does not identify children requiring treatment, but rather leads to termination of asymptomatic fetuses; this may lead to reconsideration of guidelines regarding Gaucher screening. Copyright © 2010 John Wiley & Sons, Ltd. [source] Oral disease experience of older adults seeking oral health servicesGERODONTOLOGY, Issue 2 2010Kavita P. Ahluwalia doi:10.1111/j.1741-2358.2009.00311.x Oral disease experience of older adults seeking oral health services Objective:, The objective of this investigation was to describe the dental disease (dental caries and alveolar bone loss) experience in a sample of community-dwelling older adults who regularly utilize dental services in New York City. Background:, Public financing for dental care directed at older adults in the United States is minimal. Improved preventive methods, primarily the use of fluorides, have resulted in declines in tooth loss, and concomitant increase in risk for dental diseases among older adults. While the oral disease burden in institutionalized elderly and those unable to access services is well-documented, the dental care needs of older adults who access dental services are not well documented. Materials and Methods:, Radiographic and record review were used to determine prevalence of dental caries, alveolar bone loss, frequency of service utilization, and medical status in this cross-sectional investigation of a sample of older adults (N = 200) using dental services at Columbia University College of Dental Medicine. Results:, Only 9% of the sample was completely edentulous, the mean DMFT was 19.9 and mean alveolar bone loss was 3.6 mm. Missing and Decayed Teeth accounted for 57.8% and 6.5% of the total caries burden respectively. Missing Teeth and alveolar bone loss increased with increasing age, but there was no increase in Decayed Teeth. Conclusions:, While access to and utilization of dental services may result in improved tooth retention, older adults who use dental services continue to have dental care needs, especially periodontal care needs. [source] The role of maternal responsiveness in predicting infant affect during the still face paradigm with infants born very low birth weightINFANT MENTAL HEALTH JOURNAL, Issue 2 2008Sarah J. Erickson There is limited empirical literature addressing infants' response to a standardized stressor with infants born very low birth weight (VLBW). The purpose of this study was to assess the relative strength of maternal responsiveness in predicting infant affect in response to the Still Face (SF) paradigm in a cross-sectional cohort of ethnically diverse infants born VLBW and their mothers (N = 50; infants 6,8 months old). Infant affect and maternal responsiveness were coded in 1-s intervals while dyads participated in the SF. In addition, perinatal medical status, developmental status, and infant temperament were assessed. Findings revealed that positive infant affect during and after the SF stressor were strongly associated with baseline infant positive affect and maternal responsiveness at the reunion episode, respectively. In contrast, when predicting negative infant affect during and after the SF stressor, prior infant negative affect was strongly and uniquely significant. Infant positive affect, negative affect, and maternal responsiveness were not significantly associated with gender, infant perinatal medical history, developmental status, or temperament. Future research is warranted to determine how these findings relate to infants' stress reactions in naturalistic settings and if relationship-focused interventions may reverse infant negative emotionality, enhance positive emotionality, and thereby improve self-regulation and longer term social and cognitive developmental outcomes in medically at-risk infants. [source] Dental treatment of children referred to general anaesthesia , association with country of origin and medical statusINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2006D. HAUBEK Summary., Background., A small proportion of children and adolescents need dental treatment with general anaesthesia (DGA). The aim of this retrospective cross-sectional study was to analyse how country of origin and medical status were related to age at treatment, waiting times in the system, and dental treatment provided in general anaesthesia. Methods., A total of 786 patients received DGA at the University Hospital of Aarhus, Denmark in the period from 1990 to 2001. Information on the date of referral, the date of examination, the date of treatment, country of origin (Danish or non-Danish), medical status (non-special needs or special needs), and dental treatment performed was collected from patient records. Results., Patients with special needs were older when treated than non-special needs patients, whereas patients with a non-Danish origin were younger than those with a Danish origin when treated. There were no differences between non-special needs and special needs patients in waiting times from referral to examination and from examination to dental treatment. In contrast, patients from a non-Danish origin waited longer from examination to treatment than patients of Danish origin, whereas no difference was found in waiting time from referral to examination. Patients with special needs had fewer teeth treated than non-special needs patients, whereas patients with non-Danish origin had more teeth treated than those of a Danish origin. Conclusion., Age at treatment, waiting times in the system, and dental treatment received under general anaesthesia vary according to medical status and country of origin of the patients in Denmark. These findings should be considered in the organization and the funding of this type of service. [source] Dietary habits and health status of African-Caribbean adultsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 3 2010J. Earland Abstract Background:, Although African-Caribbeans in the UK are more likely to suffer from a number of diet-related health conditions, including obesity, hypertension and type II diabetes, there have been few dietary studies on this group. The present study is based on a small survey of food and nutrient intakes and traditional dietary habits of African-Caribbean adults living in Staffordshire. Methods:, A questionnaire, designed to collect demographic data and information on medical status, physical activities, dietary, cooking and food shopping habits was administered to a convenience sample of 39 adults. Detailed information on food intakes was gathered using a modified existing Food Frequency Questionnaire with 169 items. Height and weight were measured for the calculation of body mass index. Results:, The average age of the subjects was 47 years (range 19,65 years). The prevalence of obesity was 39% and one-third of subjects reported having at least one health condition. Physical activities, outside of work, were undertaken by 95% of the sample. Traditional foods were used by 92% of respondents, including fruit and vegetables purchased at markets outside of their local area. A wide variety of foods were consumed and the percentages of energy provided by fats and carbohydrates (30% and 53%, respectively) appeared to be meeting government recommendations. However, absolute energy intakes were high and salt consumption, often in the form of commercial seasonings, exceeded government recommendations. Conclusions:, The positive aspects of the diets of this population need to be encouraged. Interventions need to focus on ways of reducing total energy intakes, as well as levels of salt consumption. [source] Nurses' Views of Factors That Help and Hinder Their Intrapartum CareJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2007Martha Sleutel Objective:, To explore labor and delivery nurses' views of intrapartum care, particularly factors that help or hinder their efforts to provide professional labor support. Design:, Content analysis of narrative comments that nurses wrote on questionnaires during a two-part research study on professional labor support in 2001. Participants:, Intrapartum registered nurses. Results:, Six themes emerged under the category of factors that hinder nurses' intrapartum care: (a) hastening, controlling, and mechanizing birth; (b) facility culture and resources; (c) mothers' knowledge, language, and medical status; (d) outdated practices; (e) conflict; and (f) professional/ethical decline. Under the category of factors that help nurses' intrapartum care, four themes emerged: (a) teamwork and collaboration, (b) philosophy of birth as a natural process, (c) facility culture and resources, and (d) nursing impact, experience, and autonomy. Conclusions:, Nurses conveyed a spectrum of feelings from intense pride and pleasure to disillusionment, dissatisfaction, and distress based on barriers and facilitators to their ability to provide effective optimal care. They felt strongly that medical interventions often hindered their care and prevented them from providing labor support. Nurses offered blunt, often scathing criticism and also glowing praise for their colleagues in nursing, nurse-midwifery, and medicine regarding the quality of their care. JOGNN, 36, 203-211; 2007. DOI: 10.1111/J.1552-6909.2007.00146.x [source] Pre-ICD Illness Beliefs Affect Postimplant Perceptions of Control and Patient Quality of LifePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2010CLAIRE N. HALLAS Ph.D. Background: The implantable cardioverter defibrillator (ICD) is a device used in the treatment of ventricular arrhythmias and the prevention of sudden cardiac death. However, the ICD has been associated with negative psychological outcomes such as anxiety, depression, panic, and poor quality of life (QoL). Recent studies suggest that the preimplantation psychology of patients, combined with their postimplantation perceptions about their cardiac condition, are greater contributory factors than their medical status to a poor outcome. Method: Our study employed an interview-based qualitative grounded theory methodology to explore whether medical history hetereogeneity and illness beliefs impact on the QoL of 13 ICD patients. Results: Perceived control emerged as the core category related to QoL with three subsystem themes related to control: (1) illness beliefs, attributions, and appraisals; (2) coping resources and strategies; and (3) the social world. Patients at risk for the poorest adaptation were younger (<45), unemployed, and with an acute onset cardiac history. These patients interpreted their illness as severe, utilized emotion-focused coping (e.g., avoidance of situations), and believed themselves to be socially excluded. Adjusted patients used proactive problem-focused coping (e.g., normalizing) and minimized consequences of the device. Conclusions: The data developed a theoretical model of QoL, which identified perceived control, illness beliefs, and coping impacting on adjustment. From our study, we have a wider understanding of the combination psychological issues relevant to ICD patients and are able to treat those at risk with interventions to promote adjustment in the context of a society that values health and well-being. (PACE 2010; 33:256,265) [source] An Updated Interdisciplinary Clinical Pathway for CRPS: Report of an Expert PanelPAIN PRACTICE, Issue 1 2002Dr. med, Michael D. Stanton-Hicks MB Abstract: The goal of treatment in patients with complex regional pain syndrome (CRPS) is to improve function, relieve pain, and achieve remission. Current guidelines recommend interdisciplinary management, emphasizing 3 core treatment elements: pain management, rehabilitation, and psychological therapy. Although the best therapeutic regimen or the ideal progression through these modalities has not yet been established, increasing evidence suggests that some cases are refractory to conservative measures and require flexible application of the various treatments as well as earlier consideration of interventions such as spinal cord stimulation (SCS). While existing treatment guidelines have attempted to address the comprehensive management of CRPS, all fail to provide guidance for contingent management in response to a sudden change in the patient's medical status. This paper reviews the current pathophysiology as it is known, reviews the purported treatments, and provides a modified clinical pathway (guideline) that attempts to expand the scope of previous guidelines. [source] Acoustic cry characteristics of infants exposed to methadone during pregnancyACTA PAEDIATRICA, Issue 1 2009Zoe L Quick Abstract Objective: Infant cry characteristics reflect the neurological and medical status of the infant. This study compared the acoustic cry characteristics of infants born to mothers maintained on methadone during pregnancy with those of infants not exposed to methadone during pregnancy. Methods: At 42 weeks of post-menstrual age, 89 crying episodes ranging in duration from 1.15 to 1.97 sec were collected from 10 methadone-exposed (ME) and 10 non-methadone-exposed (NE) infants. Cry utterances were analysed acoustically using spectrographic displays and measures of cry utterance duration and fine-grained analyses of the fundamental frequency calculated for each cry. Results: No between-group differences were found on measures of cry duration or fundamental frequency. However, analyses of frequency perturbation showed that the cry utterances of ME infants were characterized by significantly higher levels of frequency perturbation than the cries of infants not exposed to methadone. These effects largely persisted after statistical control for the confounding effects of other maternal drug use during pregnancy. Conclusion: The crying behaviour of infants exposed prenatally to the synthetic opiate, methadone, is characterized by higher levels of vocal fold vibratory perturbation than NE infants. These findings suggest the possibility of early, subtle neurological vulnerability in this high-risk group of infants. [source] Endolaryngeal cysts presenting with acute respiratory distress,CLINICAL OTOLARYNGOLOGY, Issue 5 2004M. Shandilya This is a retrospective review of benign cysts of the adult endolarynx that presented as airway emergencies in four teaching hospitals of Dublin, Ireland, over 2 years. During that period nine patients with endolaryngeal cysts necessitating emergency airway intervention were managed. All cases were treated by endoscopic microlaryngeal marsupialization after securing the airway either at the same time or as a staged procedure. Four of these patients required tracheostomies, one performed under local anaesthesia and the others after initial endotracheal intubation. Definitive treatment was carried out in six cases at initial endoscopic diagnosis. Three of the tracheostomized patients had a staged management, two because of their medical status and one for further investigations. On the basis of our findings we suggest that all benign cysts around the endolarynx should simply be called ,endolaryngeal cysts' instead of the current practice of trying to classify them into various histological and morphological types with no prognostic or management differences. Benign cysts of the endolarynx presenting with airway obstruction would appear to be more frequent than is generally maintained in the literature. [source] | ||||||||||