Search results for "Outpatient"
showing 10 items of 205 documents
Psychosis, Need Adapted treatment, and psychiatrists' agency
2013
Background: In the Need-Adapted approach (NAA) therapy meetings are a deliberate effort to bring all meaningful parties and views to a common discussion prior to decisions; this constitutes a challenge for psychiatrists’ agency. Aims: To describe how psychiatrists see their agency in NAA. Methods: Using videos of co-research interviews, stimulated-recall interviews of 10 interviewees were conducted and transcribed verbatim. The material was analyzed via an adapted dialogical-narrative analytical method. Results: Institutional forces were experienced as having an enormous impact on psychiatrists’ agency, especially in the inpatient setting, reducing professional creativity. In the outpatient…
G.P.232
2014
Spinal muscular atrophy (SMA) and Pompe disease (PD) are common neuromuscular disorders during childhood causing progressive weakness of proximal muscles with gait disturbances, loss of ambulation and breathing difficulties. Whereas SMA is the result of a neurogenic atrophy caused by mutations in the SMN1 gene, PD is a lysosomal glycogen storage disease (type II) due to mutations of the GAA gene responsible for the enzyme activity of acid alpha-1,4-glucosidase. PD is treatable by enzyme replacement therapy, but in SMA there is no established curable therapy. We report on a child with genetically proven SMA type III and PD caused by mutations in the SMN1 and GAA genes. A 3 years old girl pre…
Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre …
2017
Objective:\ud \ud High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1).\ud Methods:\ud \ud 117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records. Follow up was for a mean of 23 months.\ud Results:\ud \ud Fifty five females and 62 males (mean age 47.7 years) were included. Complete data were available for ECG in 107…
Dental treatment for handicapped patients: sedation vs general anesthesia and update of dental treatment in patients with different diseases
2013
Dental treatment on Handicapped Patients is often difficult because many people with a wide range of ages (from children to the elderly) with different pathologies that can affect the oral cavity and differ widely are included in this group. This situation creates some controversy, because according to pathology, each patient will be treated differently depending on collaboration, general health status, age or medication used to treat this pathologies. Ac - cording to this situation we can opt for an outpatient treatment without any kind of previous medication, a treat - ment under conscious or deep sedation or a under general anesthesia treatment. With this systematic review is intended to…
Water and Sodium in Heart Failure: A Spotlight on Congestion.
2014
Despite all available therapies, the rates of hospitalization and death from heart failure (HF) remain unacceptably high. The most common reasons for hospital admission are symptoms related to congestion. During hospitalization, most patients respond well to standard therapy and are discharged with significantly improved symptoms. Post-discharge, many patients receive diligent and frequent follow-up. However, rehospitalization rates remain high. One potential explanation is a persistent failure by clinicians to adequately manage congestion in the outpatient setting. The failure to successfully manage these patients post-discharge may represent an unmet need to improve the way congestion is …
[Early duodenal adenocarcinoma arising in gastric metaplasia treated by endoscopic resection].
2006
Duodenale Fruhkarzinome sind eine Seltenheit. Die meisten duodenalen Karzinome werden in einem fortgeschrittenen Stadium diagnostiziert. Wir berichten den Fall einer 59-jahrigen Patientin, welche zur weiteren Diagnostik und Therapie eines auswarts diagnostizierten duodenalen Fruhkarzinoms zu uns uberwiesen wurde. Die Osophagogastroduodenoskopie bei Aufnahme ergab eine Typ IIa+c-Lasion im proximalen Duodenum (10 - 12 mm grose zentral diskret eingesenkte Lasion). Mittels Chromo- und Magnifikationsendoskopie konnte die Lasion gut demarkiert und Veranderungen der Zottenarchitektur im Sinne einer Neoplasie gesehen werden. Nach Unterspritzung mit einer verdunnten Adrenalin-Losung konnte die Lasio…
Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care
2017
In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and …
Telemedicine during Covid-19 pandemic: Advantage or critical issue?
2020
Telemedicine offers a support to traditional medicine, delivering clinical services when distance is a critical factor. Although this tool does not replace a medical examination, during Covid-19 pandemic, it reduces the spread of infection and avoids the need for a patient’s visit. It is useful in the management of chronic disorders or for patients undergoing palliative treatment. The University Hospital of Palermo has applied this in cases of chronic illness caring for patients who cannot stop their treatment, such as Department of Onco-Haematology, Internal Medicine, Dermatology, etc. The Department of Legal Medicine of Palermo, in particular, is also using telemedicine to manage medico-…
Telemedicine Online Visits in Urology During the COVID-19 Pandemic-Potential, Risk Factors, and Patients' Perspective.
2020
The current coronavirus disease 2019 (COVID-19) pandemic has placed considerable strain on hospital resources. We explored whether telemedicine (defined as a videoconference) might help. We undertook prospective structured phone interviews of urological patients (n = 399). We evaluated their suitability for telemedicine (judged by a panel of four physicians) and their risks from COVID-19 (10 factors for a poor outcome), and collected willingness for telemedicine and demographic data. Risk factors for an adverse outcome from COVID-19 infection were common (94.5% had one or more) and most patients (63.2%) were judged suitable for telemedicine. When asked, 84.7% of patients wished for a teleme…
Abdominal obesity, insulin resistance, and metabolic syndrome in a southern European population.
2003
Background: Our objective was to investigate the relationship between abdominal obesity (AO), as measured by waist circumference (WC), insulin resistance (IR), and components of the metabolic syndrome (MS). Methods: A cross-sectional study was carried out with 283 subjects (130 males and 153 females aged 25–65 years) from a primary care outpatient clinic in Valencia (Spain) over a period of 1 year. Body mass index (BMI), waist circumference (WC), blood pressure (BP), total cholesterol, triglycerides, HDL-C, glucose, and insulin were measured by standard methods. IR was defined as HOMA-IR equal to or greater than 3.8. Results: The prevalence of IR was 39.6%. Subjects were divided into groups…