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Crisis Care

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https://www.readbyqxmd.com/read/27908900/democratic-therapeutic-community-treatment-for-personality-disorder-randomised-controlled-trial
#1
Steve Pearce, Lisle Scott, Gillian Attwood, Kate Saunders, Madeleine Dean, Ritz De Ridder, David Galea, Haroula Konstantinidou, Mike Crawford
BACKGROUND: Democratic therapeutic community (DTC) treatment has been used for many years in an effort to help people with personality disorder. High-quality evidence from randomised controlled trials (RCTs) is absent. AIMS: To test whether DTC treatment reduces use of in-patient services and improves the mental health of people with personality disorder. METHOD: An RCT of 70 people meeting DSM-IV criteria for personality disorder (trial registration: ISRCTN57363317)...
December 1, 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/27908485/managing-fluid-and-electrolyte-disorders-in-kidney-disease
#2
REVIEW
Cathy Langston
Because of the role of the kidneys in maintaining homeostasis in the body, kidney disease leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, and repeated and frequent reassessment of fluid and electrolyte balance. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in kidney disease and some may be life-threatening...
November 28, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#3
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906718/anesthesia-for-nonintubated-video-assisted-thoracic-surgery
#4
Hiroshi Sunaga, Justin D Blasberg, Paul M Heerdt
PURPOSE OF REVIEW: This review focuses primarily on nonintubated video-assisted thoracic surgery (NIVATS), and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. RECENT FINDINGS: Advancements in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. For thoracic operations in particular, video-assisted thoracic surgery (VATS) has largely replaced traditional thoracotomy, and continued technical development has made surgical access into the pleural space even less disruptive...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27905909/development-of-a-measure-of-model-fidelity-for-mental-health-crisis-resolution-teams
#5
Brynmor Lloyd-Evans, Gary R Bond, Torleif Ruud, Ada Ivanecka, Richard Gray, David Osborn, Fiona Nolan, Claire Henderson, Oliver Mason, Nicky Goater, Kathleen Kelly, Gareth Ambler, Nicola Morant, Steve Onyett, Danielle Lamb, Sarah Fahmy, Ellie Brown, Beth Paterson, Angela Sweeney, David Hindle, Kate Fullarton, Johanna Frerichs, Sonia Johnson
BACKGROUND: Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable. We aimed to develop and test a fidelity scale to assess adherence to a model of best practice for CRTs, based on best available evidence. METHODS: A concept mapping process was used to develop a CRT fidelity scale...
December 1, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27902153/nurse-led-medicines-monitoring-a-study-examining-the-effects-of-the-west-wales-adverse-drug-reaction-profile
#6
Richard Jones, Christopher Moyle, Sue Jordan
Aim The physical health of people with mental health conditions is often suboptimal, and in many cases this may be related to their prescription medicines. One issue is that patients are monitored inconsistently for adverse drug reactions (ADRs). The aim of this study was to explore whether the nurse-led West Wales Adverse Drug Reaction (WWADR) Profile for Mental Health Medicines could improve recognition and management of ADRs in a crisis resolution home treatment service. Method The WWADR Profile was implemented in addition to usual care, in a one-group 'before and after' comparison study (n=20)...
November 30, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27902122/fathers-can-play-central-role-in-tackling-child-health-crisis
#7
(no author information available yet)
Fathers are being denied involvement in their children's health care, with potentially devastating consequences, the RCN International Centenary Conference heard last week.
November 30, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27899384/rifampicin-induced-adrenal-crisis-in-a-patient-with-tuberculosis-a-therapeutic-challenge
#8
Nicholas Denny, Sarika Raghunath, Praveen Bhatia, Muntasir Abdelaziz
A 55-year-old Indian man presented with productive cough and a large left pleural effusion. Pleural fluid culture grew Mycobacterium tuberculosis, and he was started on antituberculosis therapy. One week later, the patient presented to hospital with drowsiness, dehydration and hypotension. He was transferred to critical care and only improved after starting hydrocortisone and stopping rifampicin. His short synACTHen test subsequently confirmed primary adrenal insufficiency, and a CT of the abdomen showed bilateral adrenal enlargement...
November 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27899338/high-touch-and-high-tech-ht2-proposal-transforming-patient-engagement-throughout-the-continuum-of-care-by-engaging-patients-with-portal-technology-at-the-bedside
#9
Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Alison M Aldrich, Daniel M Walker, Milisa K Rizer, Susan D Moffatt-Bruce, Timothy R Huerta
BACKGROUND: For patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge...
November 29, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27898147/existentiell-kris-i-livets-slutskede-f%C3%A3-rst%C3%A3-rker-de-fysiska-symtomen-minskad-%C3%A3-ngest-och-k%C3%A3-nsla-av-gemenskap-kan-minska-upplevelsen-av-sm%C3%A3-rta
#10
Peter Strang
Existential anxiety might reinforce bodily symptoms All crises have existential elements, but the crisis will transform to a predominantly existential crisis, when the dying person is no longer shielded from stressful thoughts about death, meaninglessness, existential loneliness and unsolved guilt issues. The suffering is not merely on an existential level, as the connection between body and mind is strong and existential anxiety might reinforce bodily symptoms, e.g. pain. In this article, the influence of death anxiety and loneliness is discussed in relation to pain treatment in palliative care...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27896755/the-application-of-multiplex-biomarker-techniques-for-improved-stratification-and-treatment-of-schizophrenia-patients
#11
Johann Steiner, Paul C Guest, Hassan Rahmoune, Daniel Martins-de-Souza
In the case of major psychiatric disorders such as schizophrenia, shortcomings in the conversion of scientific discoveries into newer and safer treatment options has led to a loss of confidence and precipitated a crisis for large pharmaceutical companies. This chapter describes how incorporation of multiplex biomarker approaches into the clinical pipeline can lead to better patient characterization, delivery of novel treatment approaches and help to renew efforts in this important area. The development of specific biomarker test panels for disease prediction should facilitate early intervention strategies, which may help to slow disease development or progression...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27893185/women-s-pathways-to-abortion-care-in-south-carolina-a-qualitative-study-of-obstacles-and-supports
#12
Judy Margo, Lois McCloskey, Gouri Gupte, Melanie Zurek, Seema Bhakta, Emily Feinberg
CONTEXT: Women seeking timely and affordable abortion care may face myriad challenges, including high out-of-pocket costs, transportation demands, scheduling difficulties and stigma. State-level regulations may exacerbate these burdens and impede women's access to a full range of care. Women's reports of their experiences can inform efforts to improve pathways to abortion care. METHODS: In 2014, semistructured qualitative interviews were conducted with 45 women obtaining abortions in South Carolina, which has a restrictive abortion environment...
November 28, 2016: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/27890272/-my-stomach-the-monster-under-my-bed
#13
Claire Liné, Joanne Rietsch, Jonathan Lachal, Marie Rose Moro
Care for patients with eating disorders is complex and plurimodal. Care plans need to be adapted in order to take into account the body in crisis. A series of hospital admissions combined with specific psychomotor approaches, can contribute to the patient being reappropriated with their own body.
November 2016: Soins. Psychiatrie
https://www.readbyqxmd.com/read/27890073/switching-to-nilotinib-versus-imatinib-dose-escalation-in-patients-with-chronic-myeloid-leukaemia-in-chronic-phase-with-suboptimal-response-to-imatinib-lasor-a-randomised-open-label-trial
#14
Jorge E Cortes, Carmino Antonio De Souza, Manuel Ayala, Jose Luis Lopez, Eduardo Bullorsky, Sandip Shah, Xiaojun Huang, K Govind Babu, Kudrat Abdulkadyrov, José Salvador Rodrigues de Oliveira, Zhi-Xiang Shen, Tomasz Sacha, Israel Bendit, Zhizhou Liang, Tina Owugah, Tomasz Szczudlo, Sadhvi Khanna, Rafik Fellague-Chebra, Philipp D le Coutre
BACKGROUND: Optimal management of patients with chronic myeloid leukaemia in chronic phase with suboptimal cytogenetic response remains undetermined. This study aimed to investigate the safety and efficacy of switching to nilotinib vs imatinib dose escalation for patients with suboptimal cytogenetic response on imatinib. METHODS: We did a phase 3, open-label, randomised trial in patients with chronic myeloid leukaemia in chronic phase with suboptimal cytogenetic response to imatinib according to the 2009 European LeukemiaNet criteria, in Latin America, Europe, and Asia (59 hospitals and care centres in 12 countries)...
December 2016: Lancet Haematology
https://www.readbyqxmd.com/read/27889623/training-needs-of-clinical-nurses-at-an-university-hospital-in-turkey
#15
Emine Kol, Emine İlaslan, Mehtap Turkay
The learning needs of clinical nurses should be determined and evaluated at regular intervals for evaluate the continuity and the efficiency of education. The descriptive study was conducted to determine the training needs of nurses working in an educational hospital between February 1st 2012 and May 1st 2012. It was determined that, among the training topics related to patient care, those demanded the most were cardio-pulmonary resuscitation, fluid-electrolyte balance, safe drug administration and wound Care...
November 16, 2016: Nurse Education in Practice
https://www.readbyqxmd.com/read/27880008/head-and-neck-surgical-subspecialty-training-in-africa-sustainable-models-to-improve-cancer-care-in-developing-countries
#16
Johannes J Fagan, Mark Zafereo, Joyce Aswani, James L Netterville, Wayne Koch
BACKGROUND: Cancer poses a health crisis in the developing world where surgery is the mainstay of treatment for head and neck cancers. However, a shortage of surgeons with appropriate skills exists. How do we train head and neck surgeons in developing countries and avoid a brain drain? The ideal model provides appropriate affordable training leading to establishment of head and neck cancer centers that teach and train others. METHODS: Different head and neck surgery training models are presented based on the personal experiences of the authors...
November 23, 2016: Head & Neck
https://www.readbyqxmd.com/read/27878605/-special-medical-problems-in-end-of-life-care-crisis-at-the-end-of-life-which-therapy-is-adequate-and-when-is-redefining-treatment-goals-appropriate
#17
Gesine Benze, Bernd Alt-Epping, Friedemann Nauck
Crisis at the end of life are exceptional challenges for patients, relatives and therapists. With respect to the individual treatment goals and the patients' autonomy, therapeutic action should be commenced in an adequate manner in order to preserve the patients' quality of life as much as possible. Advance care planning for specific critical scenarios may be helpful in order to treat patients according to their wishes and values even if they are not capable to express themselves. Furthermore, a crisis plan can define the scope of action for therapists in emergency situations...
November 23, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27877063/copd-patients-medical-care-and-support-in-greece-during-financial-crisis
#18
George Mitonas, Alexia Juvana, Zoe Daniil, Chryssa Hatzoglou, Konstantinos Gourgoulianis
BACKGROUND: The need to follow a multidisciplinary strategy in chronic obstructive pulmonary disease (COPD) management and rehabilitation in community settings in Greece raises significant questions, given the severe austerity measures being imposed at present. The aim of this study was to investigate the clinical profile of patients with COPD along with the care provided in rural community settings in Greece. METHODS: Two primary health care centers and 200 newly diagnosed patients over a 12-month period were involved in the study...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/27876595/behavioral-mental-and-physical-health-characteristics-and-opioid-medication-misuse-among-community-pharmacy-patients-a-latent-class-analysis
#19
Gerald Cochran, Valerie Hruschak, Jennifer L Bacci, Kenneth C Hohmeier, Ralph Tarter
BACKGROUND: Community pharmacists are well-positioned to address the US opioid medication crisis, which has created a need to detect misuse risk in order to provide optimal patient care. OBJECTIVES: This study sought to identify community pharmacy patient subgroups at risk for opioid medication misuse. METHODS: This study was a cross-sectional survey that examined behavioral, mental, and physical health characteristics among patients filling opioid pain medications...
November 15, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27873121/challenges-to-treatment-of-chronic-pain-and-addiction-during-the-opioid-crisis
#20
REVIEW
Daniel Krashin, Natalia Murinova, Mark Sullivan
Health care in the USA faces a double challenge, the crisis of chronic pain and the crisis of opioid misuse and overdose. Patients have been prescribed opioids at high doses with unclear indications for long periods of time, putting them at high risk for morbidity and mortality. A significant proportion of these patients have comorbid psychiatric or substance use disorders complicating their pain conditions. The challenges to treating these patients adequately are discussed, along with potential solutions to these issues at the level of the individual provider, healthcare systems, and society...
December 2016: Current Pain and Headache Reports
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