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Other Illnesses (other + illness)
Selected AbstractsSevere mental illness across culturesACTA PSYCHIATRICA SCANDINAVICA, Issue 2006D. Bhugra Objective:, International studies have shown that the outcome of illnesses like schizophrenia vary across cultures. The good outcome in developing countries depends upon a number of factors. Method:, Using both primary and secondary sources, existing literature was reviewed. Using terms severe mental illness, culture and schizophrenia, Medline, Psychinfo and Embase were searched. Further searches were conducted using secondary searches. Results:, The impact of culture and its components on the individual and their families influences compliance, engagement with services and expectations of treatment. Cultures also impact upon identity and explanatory models of individuals. Conclusion:, Severe mental illness is as likely to be affected by culture as other illnesses. Clinicians need to use multi-model assessment and management techniques. [source] Some unusual type 2 reactions in leprosyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2010V. Ramesh MD Background, Type 2 reactions with lepromatous leprosy (LL) not occurring during multi-drug therapy (MDT) have been reported. Methods, Three patients have been described, each representing a prototype, the first presenting as bullous erythema nodosum leprosum (ENL), second with ENL erupting after treatment for co-existing pulmonary tuberculosis and resembling immune reconstitution inflammatory syndrome, and a third patient with recurrent Sweets-syndrome like presentation who had taken incomplete MDT in the past for leprosy. In all, the diagnosis was established by demonstration of acid-fast bacilli (AFB) on slit-skin smears (SSS) and histopathology. Results & Conclusion, The fact that reactions can occur in patients with clinically inapparent LL, who are more likely to present in general hospitals, has been reemphasized to enhance awareness among physicians. First presentation of leprosy as ENL is probably precipitated by common antibiotics taken for other illnesses. Since reactional episodes can occur before, during and after MDT for leprosy and the clinical picture is not specific to any of them, it is important to ascertain the status of anti-leprosy therapy during these episodes and treat them accordingly. [source] What do we know about quality of life in dementia?INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2009A review of the emerging evidence on the predictive, explanatory value of disease specific measures of health related quality of life in people with dementia Abstract Objective Given its complexity, there is growing consensus on the need to measure patient-rated broad outcomes like health-related quality of life (HRQL) as well as discrete functions like cognition and behaviour in dementia. This review brings together current data on the distribution, determinants and course of HRQL in dementia to investigate the predictive and explanatory value of measures of HRQL in people with dementia. Design A systematic review of papers in English published up to October 2007 to identify data on the use of disease-specific measures of HRQL in dementia. Results There are no clear or consistent associations between socio-demographic variables and HRQL. There is no convincing evidence that lower cognition or greater activity limitation is associated with lower HRQL. There is a strong suggestion that depression is consistently associated with decreased HRQL in dementia. However, the magnitude of the associations observed is moderate only and the proportion of variance explained is low suggesting that depression and HRQL are different constructs. We currently know almost nothing about the natural history of HRQL in dementia or what attributes or interventions promote or inhibit HRQL life for people with dementia. Conclusions While in other illnesses there may be simple association between HRQL and an easily measurable clinical variable, in dementia this is not so. There are now instruments available with which to measure disease-specific HRQL directly in clinical trials and other studies that can yield informative data. Copyright © 2008 John Wiley & Sons, Ltd. [source] Therapy of metastasized Merkel cell carcinoma with liposomal doxorubicin in combination with radiotherapyJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 6 2009Marion Wobser Summary Background: Merkel cell carcinoma is a rare skin cancer of neuroendocrine origin, which is characterized by a high rate of recurrence, metastatic spread and mortality. Because of its rarity, evidence-based therapeutic regimens are difficult to establish. Merkel cell carcinoma is known to be both radio- and chemosensitive. Toxicity is a key factor in assessing any regimen, as the patients are usually elderly and likely to have other significant medical problems. Patients and Methods: We retrospectively evaluated five patients with metastatic Merkel cell carcinoma to see if liposomal doxorubicin (Caelyx® or Myocet®) in combination with radiotherapy exhibited clinical anti-tumoral effects accompanied by acceptable side effects. Results: The outpatient chemotherapy regimen was tolerated without major side effects and produced good response rates. All patients achieved at least tumor stabilization; four of five had a partial remission. Effects of therapy were usually seen in the first cycle of therapy but the responses were of short duration with an average interval of two months until progression. Conclusions: As combined radiochemotherapy with liposomal doxorubicin is well tolerated even in older patients with other illnesses and can be given on an outpatient basis, it is an attractive option for metastatic Merkel cell carcinoma. Based on response rate or overall survival, it offers no advantages compared to polychemotherapy. [source] Fatigue in multiple sclerosis patientsJOURNAL OF CLINICAL NURSING, Issue 9 2009Mukadder Mollao Aim., This study aimed to describe fatigue and the factors that affect fatigue in people with multiple sclerosis. Background., Fatigue is the most common symptom and has the greatest effect on multiple sclerosis patients' activities of daily living. There is limited understanding of the level of fatigue experienced by people with multiple sclerosis, with research currently limited to other symptoms and problems related to multiple sclerosis. Design., This research was conducted as a descriptive survey. Methods., The study involved 120 people with multiple sclerosis. The data were collected with a Patient Questionnaire and a Visual Analogue Scale for Fatigue (VAS-F). Variance analysis, Mann,Whitney U -test and Kruskal,Wallis test were used in the data analysis. Results., All of the individuals in the sample experienced fatigue. Their fatigue was also affected by factors such as age, gender, education, marital status, number of children, occupation and duration of illness. In addition, the situations with the greatest effect on their fatigue were taking a hot bath/shower, hot/humid weather, stress, infection and other illnesses causing fever, disturbance in sleep pattern, increase in daily activities and exercise. Conclusions., Fatigue is a symptom that has a significant effect on the daily lives of people with multiple sclerosis. Accordingly, it is recommended that factors affecting fatigue in people with multiple sclerosis be evaluated and that education programmes directed at how to control these factors. Relevance to clinical practice., The determination of factors affecting fatigue is important for multiple sclerosis individuals' ability to cope with fatigue and keep it under control. To be able to accomplish this it is necessary for health care personnel, the family and friends to work together. [source] Exploring the quality of dying of patients with chronic obstructive pulmonary disease in the intensive care unit: a mixed methods studyNURSING IN CRITICAL CARE, Issue 2 2009Donna Goodridge Abstract Rationale for the study:, Improving the quality of end-of-life (EOL) care in critical care settings is a high priority. Patients with advanced chronic obstructive pulmonary disease (COPD) are frequently admitted to and die in critical care units. To date, there has been little research examining the quality of EOL care for this unique subpopulation of critical care patients. Aims:, The aims of this study were (a) to examine critical care clinician perspectives on the quality of dying of patients with COPD and (b) to compare nurse ratings of the quality of dying and death between patients with COPD with those who died from other illnesses in critical care settings. Design and sample:, A sequential mixed method design was used. Three focus groups provided data describing the EOL care provided to patients with COPD dying in the intensive care unit (ICU). Nurses caring for patients who died in the ICU completed a previously validated, cross-sectional survey (Quality of Dying and Death) rating the quality of dying for 103 patients. Data analysis:, Thematic analysis was used to analyse the focus group data. Total and item scores for 34 patients who had died in the ICU with COPD were compared with those for 69 patients who died from other causes. Results:, Three primary themes emerged from the qualitative data are as follows: managing difficult symptoms, questioning the appropriateness of care and establishing care priorities. Ratings for the quality of dying were significantly lower for patients with COPD than for those who died from other causes on several survey items, including dyspnoea, anxiety and the belief that the patient had been kept alive too long. The qualitative data allowed for in-depth explication of the survey results. Conclusions:, Attention to the management of dyspnoea, anxiety and treatment decision-making are priority concerns when providing EOL care in the ICU to patients with COPD. [source] | ||||||||||||||||||||||