Search results for "access"
showing 10 items of 1232 documents
Rare diseases and orphan drugs: Latvian story
2014
Background Ten years have passed since Latvia became a Member State of the EU in 2004. As a result European regulations, including those related to rare diseases and orphan drugs, have been applied to Latvian legislative system. Orphan diseases have been recognized as a priority area for action in the public health system, though there are significant differences in the national healthcare services for rare diseases among the EU States. This study aims to determine situation in the field of rare diseases in Latvia and compare it with other European countries. Methods We used the national plan for rare diseases, EUCERD reports, Orphanet data, Latvian and European regulations, publicly availa…
The Infanticide: Some Forensic and Ethical Issues
2013
Forensic investigation and clinical treatment of infanticide mother is occasion to reflect about this crime, related to social stigma. The forensic-psychiatric assessment must be anchored on authentic and meaningful clinical relationship to criminal mother, without misinterpretation and controtransferal dynamics, such as emotional reactions of mistrust and stigmatization toward the offender, which prevent the evaluator from a correct psychological and psychopathological comprehension. Otherwise, diachronic, multidisciplinary diagnostic evaluation may lead to strategies for treatment and rehabilitation, which can bring the patient to regain his dignity, his working capacities and social role…
Retained pieces of wood in the retromaxillary space: a case report.
1995
Detection and operative removal of wood as a foreign body in the cranio-maxillary area has received frequent attention in the literature. However, as a rule, most of the cases described are related to the orbit or the orbito-neurocranial space. Almost no literature exists on the detection and treatment of wooden foreign bodies in the retromaxillary space. The authors present an unusual case of long-term retained wood in this area in a child. The case inspires discussion of the general problem of detecting retained retromaxillary wood, even using modern diagnostic tools in this area and the question of the operative therapy, especially the most favourable surgical access.
Lipoprotein apheresis in Germany - Still more commonly indicated than implemented. How can patients in need access therapy?
2019
Abstract Background Although lipid-lowering drugs, especially statins, and recently also PCSK9 inhibitors can reduce LDL cholesterol (LDL-C) and decrease the risk for cardiovascular disease (CVD) including coronary artery disease (CAD) events most efficiently, only 5–10% of high-risk cardiovascular patients reach the target values recommended by international guidelines. In patients who cannot be treated adequately by drugs it is possible to reduce increased LDL-C and/or lipoprotein(a) (Lp(a)) values by the use of lipoprotein apheresis (LA) with the potential to decrease severe CVD events in the range of 70%->80%. Even in Germany, a country with well-established reimbursement guidelines for…
Frequency and Characterization of Benign Lesions in Pancreatic Specimens of Patients Operated for the Suspicion of Pancreatic Cancer
2012
Context A final diagnosis of benign lesions is reported in up to 21% of patients who underwent duodenocephalopancreatectomy for neoplasia, whereas no data have yet been published for resection of the body-tail. Objective To investigate the frequency and to characterize the benign lesions mimicking a neoplasia in the head and in the body-tail of the pancreas. Methods We retrospectively reviewed all the pancreatic specimens collected from 2005 to 2011 in the database of the Institute of Pathology of Mainz. Patients with a final diagnosis excluding malignancy were analyzed by histological, clinical and imaging findings. Results Three-hundreds and 73 patients were identified. A final diagnosis …
A multicenter survey on access to care in Multiple Sclerosis-related trigeminal neuralgia
2021
The prevalence of trigeminal neuralgia (TN) in patients with Multiple Sclerosis (MS) is higher than in the general population and its management can be particularly challenging due to a number of reasons including high recurrence rates, lack of MS-specific treatment guidelines and uncertainties about pain pathophysiology. Aim of this cross-sectional, multicentre survey was to gather information on the current treatment modalities and options of MS-related TN across 23 Italian MS centres. Initial medical management (carbamazepine or oxcarbazepine) of MS-related TN was fairly homogeneous throughout Italian centres. The most commonly available surgical procedure was microvascular decompression…
Phrenic nerve displacement by intrapericardial balloon inflation during epicardial ablation of ventricular tachycardia: Four case reports
2020
BACKGROUND Phrenic nerve (PN) injury is one of the recognized possible complications following epicardial ablation of ventricular tachycardia (VT). High-output pacing is a widely used maneuver to establish a relationship between the PN and the ablation catheter tip. An absence of PN capture is usually considered an indication that it is safe to ablate, and that successful ablation may be performed at adjacent sites. However, PN capture may impact the procedural outcome. Only a few cases have been reported in the literature that avoid PN injury by using different techniques. CASE SUMMARY Three patients with a previous history of myocarditis and one patient with ischemic cardiomyopathy underw…
Nutrition care of cancer patients-A survey among physicians and nurses
2018
In order to quantify gaps in the provision of medical nutrition care in Germany and pinpoint specific areas of need, we collected data from patients, nurses and physicians. The results from the patient survey were published separately. A total of 506 participants from 69 certified centers answered the questions developed in cooperation with representatives from different professional groups (physicians, nurses and dietitians). Only about a third of participants reported that their institution provides structured pathways to nutritional counseling. 70.1% of those physicians reported that there was a specialist in nutrition available at their center while only 55.8% of nurses agreed. Only a q…
Percutaneous puncture of an aorto‐bifemoral bypass graft and successful closure with MANTA ® device in transfemoral TAVR
2021
Transfemoral aortic valve replacement (TAVR) has become a standard therapeutic option for patients with symptomatic severe aortic stenosis. Special anatomies can pose distinct challenges for vascular access and later closure of the access site, for example, in preoperated patients. Here, we elucidate a case of transfemoral TAVR with vascular access by direct puncture of an aorto-bifemoral bypass graft and illustrate the feasibility of vascular closure by an anchored collagen-plug vascular closure device (Teleflex MANTA® ).
Needle Insertion Difficulty Algorithm (NIDA): A novel pilot study to predict Huber needle insertion difficulty in totally implanted devices.
2021
Safeguarding of venous assets in cancer patients provides for positioning vascular devices. In totally implanted central venous access devices, hereinafter referred as TIVADs, it’s necessary introducing Huber needle, into subcutaneous port, to use it. This procedure is not easy for all implanted devices. The procedural difficulty is to be attributed both to the type of the implanted port and to the skill of the clinician. The degree of patient satisfaction is variable and related with the clinician performing the maneuver. It follows a professional dissatisfaction of the clinician and a hesitation of the patient. Moreover, the incorrect positioning of the Huber needle into the port, could …