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Patient Being (patient + being)
Selected AbstractsCurrent topics relating to autoimmune hepatitis diagnosis and therapyHEPATOLOGY RESEARCH, Issue 2007Hiroki Takahashi Autoimmune hepatitis (AIH) was first reported by Professor Ian R. Mackay. Environmental factors (such as viral infection), chemical substances (including some drugs) and genetic factors (such as human leukocyte antigen-DR) are believed to participate in the pathogenesis of AIH. Because satisfactory prognosis depends upon the patient being diagnosed with AIH correctly and receiving proper therapy immediately, it isvery important to make a correct diagnosis and perform the suitable therapy as soon as possible. In this review, current topics relating to AIH diagnosis and therapy are summarized. [source] Predictors of entering 24-h care for people with Alzheimer's disease: results from the LASER-AD studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2009Stephanie Habermann Abstract Objectives Many studies have investigated predictors of people with dementia entering 24-h care but this is the first to consider a comprehensive range of carer and care recipient (CR) characteristics derived from a systematic review, in a longitudinal cohort study followed up for several years. Methods We interviewed 224 people with Alzheimer's disease (AD) and their carers, recruited to be representative in terms of their severity, sex and living situation as part of the LASER-AD study; and determined whether they entered 24-h care in the subsequent 4.5,years. We tested a comprehensive range of characteristics derived from a systematic review, and used Cox proportional hazard regression to determine whether they independently predicted entering 24-h care. Results The main independent predictors of shorter time to enter 24-h care were the patient being: more cognitively or functionally impaired (hazard ratio (HR),=,1.09; 95% CI,=,1.06,1.12) and (HR,=,1.04 95% CI,=,1.03,1.05), having a paid versus a family carer (HR,=,2.22; 95% CI,=,1.39,3.57), the carer being less educated (HR,=,1.43; 95% CI,=,1.12,1.83) and spending less hours caring (HR,=,1.01; 95% CI,=,1.00,1.01). Conclusion As having a family carer who spent more time caring (taking into account illness severity) delayed entry to 24-h care, future research should investigate how to enable carers to provide this. Other interventions to improve patients' impairment may not only have benefits for patients' health but also allow them to remain longer at home. This financial benefit could more than offset the treatment cost. Copyright © 2009 John Wiley & Sons, Ltd. [source] MRSA pyomyositis complicating sickle cell anaemiaINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 5 2001C. Millar A patient being treated for sickle cell crisis developed swollen, painful, indurated, discoloured thighs after several days in hospital. Imaging revealed the presence of multiple small abscesses in the muscle and methicillin resistant Staphylococcus aureus (MRSA) was cultured from aspirated fluid. Pyomyositis usually occurs in association with damaged muscle and impaired host defences. Staphylococcus is the most frequent organism involved. It is not a common complication of sickle cell disease, although it may be under diagnosed. Availability of advanced imaging techniques facilitates early diagnosis of pyomyositis. [source] Bullying among mentally-ill patients detained in a high-secure hospital: an exploratory study of the perceptions of staff and patients into how bullying is definedAGGRESSIVE BEHAVIOR, Issue 5 2006Jane L. Ireland Abstract The present study is the first to explore patient-to-patient bullying within a secure psychiatric hospital housing mentally-ill patients. Its main aim was to provide an outline of the perceptions held by both patients and staff with regards to patient-to-patient bullying as opposed to providing an objective study of bullying. The total sample comprised 104 participants, 44 patients and 60 staff. These were sampled from wards housing male patients and wards housing female patients. All participants took part in a semi-structured interview based on that developed by Ireland and Ireland [2003] and Ireland [2005, 2004]. One quarter of participants stated they had seen a patient being bullied in the previous week, with staff perceiving a higher extent of bullying than patients. Differences between wards were minimal. It was predicted that theft-related bullying would be reported most frequently, that staff would identify a wider range of bullying behaviours than patients and that direct forms of aggression would be identified more readily as bullying than indirect forms. All predictions were supported. Problems in attempting to obtain a definition of bullying were also identified, with participants operating broader definitions than those found in the school-based literature. For example, bullying was not generally considered a repeated form of aggression, the severity of the aggression or provocative behaviour of the victim were not defining features, and it was felt bullying could be accidental. In summary, the current study highlights how patient-to-patient bullying does occur in services housing mentally-ill patients and that researching the behaviour may require the adoption of broader hospital-specific definitions of bullying. Aggr. Behav. 32:1,13, 2006. © 2006 Wiley-Liss, Inc. [source] Nature, extent, and causes of bullying among personality-disordered patients in a high-secure hospitalAGGRESSIVE BEHAVIOR, Issue 3 2004Jane L. Ireland Abstract The present study explored the perceptions and experiences of the nature, extent and causes of bullying among personality-disordered patients, with a subsidiary aim of exploring differences in perceptions between staff and patients. The sample was selected from the Personality Disorder Unit of a high secure hospital. The total sample consisted of 60 participants, 30 patients and 30 staff. Participants engaged in a semi-structured interview based on that developed by Brookes [1993] and modified by Ireland and Archer [1996] and Ireland [2002a]. The interview assessed their perceptions and experiences of patient-to-patient bullying. One fifth of patients and staff reported that they had seen a patient being bullied in the previous week. One-fifth of patients reported that they had been bullied in the previous week and less than one tenth reported that they had bullied others. The most frequent types of bullying reported were theft-related, verbal abuse, being made to do chores, physical assaults and intimidation. One fifth of the sample reported that sexual abuse took place. Victims were generally perceived to be ,easy targets' that were vulnerable, either physically or emotionally. Staff identified a wider range of victim types than patients. The results highlight how patient-to-patient bullying does occur and is an important issue worthy of further research. A number of similarities were found between the current findings and those of prison-based research suggesting that both hospitals and prisons share a number of environmental similarities that help to explain why bullying takes placed in secure forensic settings. Aggr. Behav. 30:229,242, 2004. © 2004 Wiley-Liss, Inc. [source] Clinic in the Air?JOURNAL OF TRAVEL MEDICINE, Issue 6 2008A Retrospective Study of Medical Emergency Calls From A Major International Airline Background There is a high likelihood of a medical professional being onboard the aircraft at the time of emergency. Therefore, a health-care professional should be familiar with in-flight medical events and how to deal with them. Methods I present a 12-month retrospective study of medical distress calls from a major Asian international airline for which International SOS provided in-flight telemedical assistance. All the calls from the airplane to our center were analyzed from January 1, 2006, to January 1, 2007. The number of recommended diversions, availability of a medical professional, the range of medical problems, and used medications were considered. Results Overall, there were 191 in-flight air-to-ground consultations. Twenty-three (12.04%) calls were made for pediatric problems, with the youngest patient being 9 months old. Gastrointestinal complaints and simple faints comprised 50.2% of all calls. Most of the in-flight problems were successfully treated symptomatically with the initial recommendation to lie the patient down and administer oxygen. Metoclopramide, stemetil, loperamide, and buscopan were the most often administered drugs. A doctor was onboard in 45.5% of all calls. A recommendation to divert the aircraft was made in six (3.1%) cases. Conclusions Although developments in telemedical assistance and the content of a medical kit make the management of potential in-flight medical emergency much easier, they will never turn a commercial aircraft into a flying clinic. Preflight check-in screening by airlines and encouraging future air travelers with health concerns to seek medical help before flying should be recommended. [source] Perplexity: an effect of social traumaPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 1 2003Julia Braun Abstract This paper faces the challenge of building hypotheses that contain referents about social subjectivity and the effects of mental inscription of traumatic social events. The authors' starting point is the hypothesis that every link involves a subjectivizing potential. Also the ,unconscious principle of uncertainty' holds that every encounter exposes the individual to unforeseeable effects that cause emotional states bound to the uncertainty that underlies the construction of every link. This principle remains unconscious because the individual defensively implements the ,illusion of predictability', but a violent and unexpected attack may activate it, causing a state of disorganization whose clinical indicator is the feeling of perplexity. The paper discusses thinking disorders within the context of violent actions. Finally, clinical material about a patient being assaulted and held as hostage is discussed. Copyright © 2003 Whurr Publishers Ltd [source] Profound hypocalcaemia in a patient being anticoagulated with citrate for continuous renal replacement therapyANAESTHESIA, Issue 12 2009D. J. R. Morgan Summary Citrate, as an anticoagulant for continuous renal replacement therapy in critically ill patients, has some potential advantages over heparin, including a prolonged dialysis filter life and reduced risk of bleeding. The key parameter involved in monitoring the adequacy and safety of citrate anticoagulation during continuous renal replacement therapy pertains to the ionised and total plasma calcium levels. We report a case of severe systemic hypocalcaemia during continuous renal replacement therapy with citrate anticoagulation resulting from relentless sequestration of calcium due to undiagnosed evolving rhabdomyolysis. Although excessive systemic citrate accumulation can also cause hypocalcaemia, this complication was not observed in our patient. While an acceptable lower limit of ionised calcium remains unknown, severe rhabdomyolysis needs to be considered when a patient's ionised calcium levels are not responsive to standard calcium replacement therapy during continuous renal replacement therapy using citrate anticoagulation in critically ill patients. [source] Acceptance of tamoxifen chemoprevention by physicians and women at riskCANCER, Issue 9 2004Julia Tchou M.D., Ph.D. Abstract BACKGROUND In the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 trial, tamoxifen was shown to reduce breast carcinoma risk by 49% in high-risk women. The purpose of the current study was to identify factors associated with being offered, and accepting, tamoxifen chemoprevention. METHODS The records of 219 women who sought risk evaluation after the publication of the NSABP P-1 trial between September 1998 and October 2002 were reviewed. Risk was calculated using the model of either Gail et al. or Claus et al. The impact of individual risk factors on the offering and acceptance of tamoxifen was compared using the Fisher exact test and logistic regression analysis. RESULTS Tamoxifen was offered to 137 women (63%) in the current study. The magnitude of Gail risk, age, menopausal status, hysterectomy, and history of lobular carcinoma in situ (LCIS) or atypical hyperplasia (AH) were all found to be significant predictors of a patient being offered tamoxifen. On multivariate analysis, only a history of AH or LCIS and hysterectomy were found to be significant, with odds ratios of 20.3 and 3.4, respectively. Fifty-seven of the women who were offered tamoxifen (42%) took the drug. Only a history of LCIS or AH and older age were found to be predictive of tamoxifen acceptance. CONCLUSIONS In the current study, risk due to AH or LCIS was found to be the main predictor of being offered and accepting tamoxifen chemoprevention. Cancer 2004. © 2004 American Cancer Society. [source] Laparoscopic treatment of primary omental torsion: Case report and literature reviewASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2010GR. Portillo Abstract Omental torsion is a rare cause of acute abdominal pain. The diagnosis is rarely made preoperatively. The treatment has been classically open. We present a case of omental torsion laparoscopically. A 63-year-old man was admitted to the emergency department. The patient had a right upper quadrant pain that started 3 d before his admission. The omentum was freed in a blunt fashion by identifying a point of torsion in the base of the mass. Partial omentectomy was performed with the assistance of a harmonic scalpel. The specimen was retrieved in a bag through a 3 cm left flank incision extended from a 10 mm port site. The pathology evaluation revealed an infarcted omentum. The patient had instant relief of pain, and the recovery was uneventful, with the patient beings discharged 2 d postoperative. The laparoscopic treatment of omental torsion is a safe, feasible and effective alternative. [source] | |||||||||||||