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1.
Support Care Cancer ; 31(8): 473, 2023 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-37462739

RESUMO

PURPOSE: This study was conducted to examine the effects of physical and psychological symptoms seen in inpatient cancer patients on spiritual well-being and emotional distress. METHOD: This descriptive and cross-sectional study was conducted with 98 cancer patients treated in oncology, haematology, and stem cell services at a university hospital between April and June 2022. Socio-demographic characteristic form, Karnofsky performance scale, Nightingale Symptom Assessment Scale, Hospital Anxiety and Depression Scale, distress thermometer and spiritual well-being scale were used to collect data. Statistical analyses were made by taking the descriptive features of the data. RESULTS: It was determined that 55.1% of the patients were diagnosed with cancer for more than one year, 53.1% receiving treatment for more than one year, 61.2% were diagnosed with haematological cancer, and 62.2% were treated only with chemotherapy. Cancer type (p<0.01), treatment (p<0.05) and Karnofsky scores (p<0.01) had an effect on the spiritual well-being and distress scores. It was determined that 39.8% of the patients were in the yellow zone of the distress thermometer, could not manage their stress well and needed psychological support. As the psychological symptoms of the patients increased, their spiritual well-being declined (r=-0.447, p<0.01), and as their physical (r=0.222, p<0.05) and psychological (r=0.311, p<0.01) symptoms increased, their distress scores increased. CONCLUSION: It is anticipated that identifying the problems that patients have and making interventions to solve those problems by oncology nurses would significantly contribute to the patient's spiritual well-being and emotional distress.


Assuntos
Neoplasias , Angústia Psicológica , Humanos , Depressão/psicologia , Pacientes Internados , Estudos Transversais , Neoplasias/terapia , Neoplasias/psicologia , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
2.
Support Care Cancer ; 31(5): 288, 2023 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-37079098

RESUMO

PURPOSE: Patients with multiple myeloma and their caregivers are financially burdened, and their quality of life is significantly affected by treatment costs and care expenses. The aim of our study is to examine the impact of financial well-being of the caregiver on the life quality of patients with multiple myeloma. METHODS: The study included 113 patients with multiple myeloma and 113 caregivers in two hospitals located in Western Turkey. This study evaluated the demographic characteristics of patients and their caregivers, financial status, financial well-being, and quality of life of caregivers. Simple linear regression analyses were used to examine the impact of financial well-being on caregiver quality of life. RESULTS: The average age of multiple myeloma patients and caregivers is 64.00 ± 11.05 and 48.02 ± 11.4, respectively. Of patients, 50.4% and 62.8% of their caregivers were female. It is determined that 51.3% of the patients were diagnosed in 1-5 years, 85% received chemotherapy, and 80.5% had an ECOG performance status between 0 and 1. Caregivers' quality of life and financial well-being were found to be low. On one hand, while caregivers' financial well-being (ß = - 1.003; t = - 3.831; p = .000) negatively affected the quality of their lives, their financial satisfaction (ß = 2.507; t = 3.820; p = .000) positively affected the quality of their lives, on the other hand. CONCLUSIONS: Caregivers' quality of life declined as their financial well-being got worse. Decreased quality of life of caregivers may affect the quality of care they provide to patients with MM. Hence, this study recommends the following. First, nurses who care for patients with MM should always assess the financial situation of patients and caregivers. Second, patient navigators, hospital billing specialists, and social workers should provide financial guidance to multiple myeloma patients and caregivers and provide help in solving their financial problems. Finally, policies that support the financial situation of patients and caregivers should be developed.


Assuntos
Mieloma Múltiplo , Qualidade de Vida , Humanos , Feminino , Masculino , Mieloma Múltiplo/terapia , Cuidadores , Análise de Regressão , Satisfação Pessoal
3.
J Relig Health ; 62(5): 3563-3578, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37516698

RESUMO

This study evaluated the Turkish version of the Nurse Spiritual Therapeutic Scale for assessing oncology patients' and caregivers' needs. It involved 200 participants from July 2022 to May 2023. The scale demonstrated high validity (content validity index = 0.97) and good internal consistency (Cronbach's alpha = 0.879). Factor analysis revealed a 20-item single-factor structure with satisfactory representation (factor loadings: 0.29-0.89). Item-total score correlations indicated moderate to strong relationships (0.236-0.761). The model showed a good fit (goodness-of-fit indices > 0.90). The Turkish version of the scale is valid and reliable for assessing oncology patients' and caregivers' spiritual care needs.


Assuntos
Cuidadores , Neoplasias , Humanos , Psicometria , Inquéritos e Questionários , Reprodutibilidade dos Testes
4.
Support Care Cancer ; 30(10): 8323-8332, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35854156

RESUMO

INTRODUCTION: Caregivers have to manage tasks at home such as providing management of the patient's follow-up. Social support is known to have protective effects, especially for caregivers for cancer patients. The aim of this study is to examine the effect of home care practices and perceived social support level of caregivers of cancer patients on the burden of care. METHODS: A descriptive and cross-sectional study. A total of 222 caregivers were included in the study. In this study, Caregiver and Patient Identification Form, Caregiver's Home Care Practices Questionnaire Form, Zarit Caregiver Burden Scale, Multidimensional Scale of Perceived Social Support, and Karnofsky Performance Scales were used. RESULTS: Of the caregivers included in the study, it was found that 47.3% were in the 40-61 age group, and 64.4% were women. The total score of caregivers from MSPSS was 61.29 ± 17.27, the total score they received from the Home Care Practices Questionnaire was 28.88 ± 7.72, and the total score they got from the ZBI was 29.11 ± 14.58. It was found that there was a weak and negative correlation between the perceived social support total scores and caregiver burden scores of caregivers (p < .01). In particular, in the regression analysis, a significant correlation was found between the total score of home care practices and personal sub-dimension scores (r: .91, p < .001, tolerance value: .158, VIF: 6.311). CONCLUSIONS: It has been determined that the increase in home care practices of caregivers of cancer patients and the low level of perceived social support increase the burden of care.


Assuntos
Serviços de Assistência Domiciliar , Neoplasias , Sobrecarga do Cuidador , Cuidadores , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Masculino , Neoplasias/terapia , Apoio Social
5.
J Pak Med Assoc ; 72(4): 634-638, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35614592

RESUMO

OBJECTIVE: To examine the relationship between the symptom experience of lung cancer patients and their illness perception of the disease. METHODS: The descriptive and cross-sectional study was conducted from April to September 2015 at the Chemotherapy Treatment Centre of the Medicine Chest Diseases Clinic at the Ege University, Izmir, Turkey, and comprised lung cancer patients of either gender aged >18 years. Data was collected using a predesigned Patient Questionnaire as well as the standard Lung Cancer Symptom Scale, Illness Perception Questionnaire and Karnofsky Performance Scale. The patients' sociodemographic characteristics and data on their illness, the symptoms they experienced and the numerical and percentage distribution of the items on the illness perception scale, mean and standard deviation values were examined. Pearson Correlation analysis was used to examine the correlation between illness perception and Karnofsky Performance Scale scores and other variables. RESULTS: Of the 105 patients, 86(81.9%) were males, 86(81.9%) were married, 49(46.7%) were elementary school graduates, 101(96.2%) were unemployed, and 95(90.5%) were receiving chemotherapy. The overall mean age of the sample was 61.43±8.24 years, the period since diagnosis was 11.38±17.84 months, and the duration of chemotherapy was 4.28±2.37 months. The mean symptom burden score was 22.75±10.85 and the Lung Cancer Symptom Scale score was 22.75±10.85. The mean score of the type of illness domain was 5.53±2.12. The overall mean global quality of life score was 64.30±12.60. CONCLUSIONS: As the symptom burden experienced by the lung cancer patients increased, their perception of the illness became more negative, and the longer the cyclical periods and the period of diagnosis, the patients' control over their illness decreased.


Assuntos
Neoplasias Pulmonares , Qualidade de Vida , Idoso , Estudos Transversais , Feminino , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Percepção , Inquéritos e Questionários
6.
Eur J Cancer Care (Engl) ; 29(6): e13310, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32881155

RESUMO

OBJECTIVE: This is a descriptive, cross-sectional and observational study that determines the factors affecting the knowledge levels of oncology nurses for skin cancer and sun protection. MATERIALS & METHODS: This study was performed on the members of the Turkish Oncology Nursing Association and oncology nurses working in hospitals in Turkey between November 2019 and March 2020. Data were collected by using the Nurse Information Form and Skin Cancer and Sun Knowledge (SCSK) scale. For data analysis, average and percentage calculations and multiple linear regression analyses were used. The significance level was set at p < .05. RESULTS: We found those female nurses who were above 40 years of age and having darker skin tone due to excessive sun exposure, with a family history of skin cancer, and educated on skin cancer, performed better on the SCSK scale. We found a statistically significant difference between the mean scores of skin cancer and sun exposure. Using multiple regression analysis, a model was created based on the relationship between variables. In this model, the personality traits of oncology nurses are responsible for higher (91.1%) knowledge levels on skin cancer and sun exposure. CONCLUSION: In conclusion, it is important to consider factors that will influence an individual's behaviour while developing skin cancer and sun protection programmes.


Assuntos
Enfermeiras e Enfermeiros , Neoplasias Cutâneas , Queimadura Solar , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Neoplasias Cutâneas/prevenção & controle , Queimadura Solar/prevenção & controle , Luz Solar/efeitos adversos , Protetores Solares , Inquéritos e Questionários
7.
Mol Pharmacol ; 95(4): 442-450, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30737253

RESUMO

The ligand-gated ion channel P2X7 receptor attracts special attention due to its widespread presence as well as its unusual responses. Besides relatively well-understood mechanisms such as intracellular Ca2+ increase and K+ depletion, the P2X7 receptor activates other peculiar responses whose mechanisms are not fully understood. The best known among these is the permeabilization of the cell membrane to large molecules. This permeabilization has been explained by the activation of a nonselective permeation pathway by the P2X7 receptor, a phenomenon called "pore formation." However, with the emergence of new data, it became apparent that large molecules enter the cell directly through the pore of the ion channel, similar to the smaller ions. This explanation seems to be true for cationic large molecules. On the other hand, there is still convincing evidence indicating that the P2X7 receptor activates a separate pathway that permeates anionic large molecules in some cell types. Furthermore, there exist functional data suggesting that the P2X7 receptor may also activate other intracellular signaling molecules or other ion channels. Interestingly and contrary to what is expected from a ligand-gated channel, these activations occur in a seemingly direct manner. Somewhat overshadowed by the pore formation hypothesis, these action mechanisms may lead to a better understanding of not only the P2X7 receptor itself but also some important physiologic functions such as the release of anionic autocoids/neurotransmitters in the central nervous system. This review discusses, assesses, and draws attention to the data concerning these neglected but potentially important points in the P2X7 receptor field.


Assuntos
Receptores Purinérgicos P2X7/metabolismo , Cálcio/metabolismo , Cátions/metabolismo , Membrana Celular/metabolismo , Humanos , Permeabilidade , Potássio/metabolismo , Transdução de Sinais/fisiologia
8.
J Relig Health ; 58(1): 303-316, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29926322

RESUMO

The aim of this study was to determine the attitudes of nurses working in two university hospitals located in the west and east of Turkey toward care of dying individual as well as religious and cultural factors that influence their attitudes. The descriptive and comparative study was conducted with a total of 189 nurses who were working in adult inpatient clinics of two university hospitals in western (101 nurses) and eastern (88 nurses) Turkey between July and November 2016. The data were obtained by using the questionnaire and Frommelt Attitudes Toward Care of the Dying Scale. As a result of this study, it was determined that in terms of the status of receiving training the end-of-life care the majority of nurses received this training; however, this rate was higher (51.0%) in nurses working in the eastern hospital (p = 0.025). The nurses working in the east (51.6%) were determined to have more problems during caregiving due to their religious and cultural beliefs, the most frequent problem they experienced was "being uncomfortable due to privacy when giving care to patients from opposite gender" (57.1%). The emotions felt mostly by nurses during the care of dying patient were grief (nurses in the east = 48.5%, nurses in the west = 51.5%) and despair (nurses in the east = 40.4%, nurses in the west = 59.6%). Nurses working both in the east (98.27 ± 7.71) and in the west (97.19 ± 8.99) were determined to have positive attitude toward death, and there was no statistically significant difference between both groups in terms of the mean scores of the Attitudes Toward Care of the Dying Scale (p = 0.373). In accordance with these results, it is recommended to focus on death issues in end-of-life care during the nursing education and to support nurses with in-service trainings regularly after the graduation.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Morte , Enfermeiras e Enfermeiros , Religião e Medicina , Humanos , Inquéritos e Questionários , Assistência Terminal/psicologia , Turquia
9.
Eur Arch Otorhinolaryngol ; 273(2): 419-24, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26335288

RESUMO

This study which is a retrospective chart review aims to characterize the comorbidities associated with adult laryngotracheal stenosis and evaluate the relationship of these with stenosis grade, length, surgical interventions, and surgical intervals. Patients' demographics, medical and surgical comorbidities, grade of stenosis, quantity and degree of balloon dilations, dilation intervals, open airway procedures, and tracheotomy status were recorded from 2002 to 2012, at a tertiary voice and airway center. Surgical outcomes were evaluated in relation to patient comorbidities, stenosis quality, and surgical procedures. A total of 101 patients with laryngotracheal stenosis were examined with female patients comprising 71 % of the population. Seventeen patients (16.8 %) had idiopathic stenosis. Number of balloon dilations ranged from 0 to 24 (mean = 3.3). The average time between dilations was 38.4 weeks (range = 1.14-215.8 weeks). The patients with idiopathic stenosis were found to have a lower grade (p = 0.0066). Fifty-two patients (51.5 %) received a tracheotomy at one point during their management. The 14 patients (13.9 %) who remained tracheotomy dependent had a body mass index (BMI) of >30. No statistically significant correlation was found when the patients' age, BMI and comorbidites were compared with the grade of stenosis, number of balloon dilatations needed and other surgical interventions. On the other hand, interval in between surgeries was found to be longer in patients without an intubation history, and in idiopathic SGS (p = 0.004, p = 0.015, respectively). There was no significant relationship between surgical interval and gender, BMI, length of stenosis, grade (p = 0.059, p = 0.47, p = 0.97, p = 0.36, respectively). Airway stenosis in adults is complicated by the presence of multiple comorbidities. Better understanding of the etiology could aid in the prevention of the injury before it forms.


Assuntos
Dilatação/métodos , Endoscopia/métodos , Laringoestenose/epidemiologia , Medição de Risco/métodos , Estenose Traqueal/epidemiologia , Traqueotomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Laringoestenose/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Estenose Traqueal/cirurgia , Resultado do Tratamento , Estados Unidos/epidemiologia
11.
Kulak Burun Bogaz Ihtis Derg ; 24(5): 271-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25513870

RESUMO

OBJECTIVES: This study aims to evaluate our injection laryngoplasty experience in patients with unilateral vocal fold paralysis. PATIENTS AND METHODS: Sixty-eight patients (32 males, 36 females; mean age 59.5 years; range 27 to 86 years) who were diagnosed with unilateral vocal fold paralysis at our clinic and who underwent injection laryngoplasty using calcium hydroxylapatite between January 2005 and June 2012 were included in this study. RESULTS: Mean follow-up period was 36 weeks (range 0-340.4 weeks). Data of 29 patients with post-injection Voice Handicap Index (VHI) scores were retrospectively analyzed. Of these patients, 16 (55%) were female, and the mean patient age was 60 (range 27 to 86 years). Seventeen patients underwent suspension laryngoscopy in the operating room, 12 patients underwent in-office percutaneous injection. Post-injection mean VHI score was 36.7 (range 4 to 87). Percutaneous injection laryngoplasty was performed to half of the 20 patients with pre- and post-injection VHI data. Mean VHI scores of these 20 patients improved by 27.9 points. Mean VHI score improved by 35.1 points in the percutaneous group, and by 20.7 points in the suspension group (p=0.29). Post-injection VHI score of one patient with lung cancer decreased, as his general health deteriorated. CONCLUSION: This study supports injection laryngoplasty in vocal fold paralysis. Calcium hydroxylapatite is a safe and effective treatment method in both percutaneous and operating room procedures.


Assuntos
Durapatita/administração & dosagem , Paralisia das Pregas Vocais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Injeções Intralesionais , Laringoplastia/métodos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
12.
Otolaryngol Clin North Am ; 57(4): 685-693, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38806319

RESUMO

Older adults are projected to outnumber children aged under 18 years for the first time in United States history by 2034, according to Census Bureau projections. This will lead to significant increase in age-related disorders. One of the most important disorders that will increase in prevalence is dysphagia, as it leads to malnutrition, dehydration, aspiration pneumonia, and death. In this article, the physiology of dysphagia in the elderly, as well as the management options is discussed.


Assuntos
Transtornos de Deglutição , Humanos , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Idoso , Estados Unidos/epidemiologia , Envelhecimento/fisiologia , Prevalência , Idoso de 80 Anos ou mais
13.
Ear Nose Throat J ; : 1455613241258646, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38855826

RESUMO

Introduction: During the COVID-19 pandemic, our institution adopted telemedicine for voice therapy (VT) as an alternative to in-person sessions, which has been integrated into our routine practice following the pandemic. This study aims to explore factors influencing completion rates among the 2 methods. Method: A retrospective chart review at a single tertiary care institution between 2019 and 2021 was conducted. Patient zip codes were used to determine Neighborhood Atlas® Area Deprivation Index (ADI) scores and travel distance to our institution. Demographic data, Voice Handicap Index (VHI) scores, and completion status were extracted. Results: Between 2019 and 2021, 521 patients were referred to VT at our institution, with 29% opting for telemedicine VT (TVT) sessions and 71% choosing in-person sessions. Seventy-four percent was female, and average age was 57.1 years (range:10-89 years old). No statistically significant differences were observed between the 2 groups regarding sex, age, employment status, or insurance type. Participants in the TVT group demonstrated notably higher completion rates compared to the in-person group [70.0% vs 31.6% (P < .001)]. The TVT group also comprised of a higher percentage of white patients, reported longer travel distances and times to reach therapy, but had comparable ADI scores to the in-person group. Moreover, there were no significant differences in pretreatment VHI scores between the 2 groups or between those who completed therapy versus those who did not (P = .501). Conclusion: Our findings indicate that patients utilizing the telemedicine platform had significantly higher VT completion rates compared to patients appearing in person. These results highlight the importance of being able to offer telemedicine-based options in the management of voice patients.

14.
J Biol Chem ; 287(9): 6362-74, 2012 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-22241475

RESUMO

Activation of ß(2)-adrenegic receptor (ß(2)-AR) leads to an increase in intracellular cAMP and activation of ERK. These two signals are activated by the interaction of the receptor with different transducer partners. We showed that the intrinsic activities of ß(2)-AR ligands for stimulating cAMP production and ERK phosphorylation responses in HEK-293 cells were not correlated. The lack of correlation resulted mainly from the discrepancy between the intrinsic activities of two groups of ligands for these two responses: The first group consisted of clenbuterol, cimaterol, procaterol, and terbutaline which acted as full agonists for cAMP production but displayed very weak effect on ERK phosphorylation. The second group comprised adrenaline and noradrenaline which displayed higher intrinsic activity for the ERK phosphorylation than for the cAMP response. Thus, both groups behaved as functionally selective ligands. The functional selectivity of the first group was observable only in adherent cells when confluence was approximately 100%. When cell-cell contact was minimized either by decreasing the density of the adherent cells or by bringing the cells into suspension, the first group of ligands gained the ability to stimulate ERK phosphorylation without a change in their effect on cAMP production. In contrast, selectivity of the second group was independent of the adherence state of the cells. Our results show that the inherent "bias" of ligands in coupling a G protein-coupled receptor to different transducers may not always be revealed as functional selectivity when there is a "cross-talk" between the signaling pathways activated by the same receptor.


Assuntos
Adesão Celular/fisiologia , AMP Cíclico/metabolismo , Sistema de Sinalização das MAP Quinases/fisiologia , Receptores Adrenérgicos beta 2/metabolismo , Adenilil Ciclases/metabolismo , Arrestinas/metabolismo , Proteínas Quinases Dependentes de AMP Cíclico/antagonistas & inibidores , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Proteínas de Ligação ao GTP/metabolismo , Células HEK293 , Humanos , Isoquinolinas/farmacologia , Ligantes , Fosforilação/fisiologia , Inibidores de Proteínas Quinases/farmacologia , RNA Interferente Pequeno/farmacologia , Receptor Cross-Talk/fisiologia , Receptores Adrenérgicos beta 2/genética , Sulfonamidas/farmacologia , beta-Arrestinas
15.
J Commun Disord ; 101: 106290, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36502668

RESUMO

OBJECTIVE: The purpose of the study was to investigate the effects of flow phonation voice therapy on laryngeal physiology and vocal quality in persons with primary Muscle Tension Dysphonia (MTD1). METHODS: Seventeen participants with a diagnosis of MTD1 completed the study. Participants were randomized to two groups. Group 1 (9 participants) received flow phonation treatment and individualized vocal hygiene education for 12 sessions over six weeks. Group 2 (8 participants) received vocal hygiene education only for three weeks (6 sessions), followed by another three weeks (6 sessions) of both vocal hygiene instruction and flow phonation therapy. Treatment consisted of cup-bubble blowing, gargling, and stretch and flow exercises. Visual-perceptual. auditory-perceptual, acoustic, aerodynamic and voice-related quality-of-life measures were obtained at three time points: before treatment, three weeks after initiation of treatment and after completion of treatment. RESULTS: Voice quality was perceived to be significantly improved in both groups. Voice related quality-of-life trended toward improvement for both groups across time points. Changes in aerodynamic and acoustic measures did not reach statistical significance compared to baseline for both groups. Visual comparisons of laryngeal closure patterns demonstrated comparably better outcomes for Group 1. CONCLUSIONS: Results of this study indicate flow phonation exercises can potentially be favorably employed for individuals with MTD1. In particular, it appears that the exercises aid in alleviating vocal hyperfunction, as evidenced by visual perceptual stroboscopic analysis, and clinically improved auditory-perceptual measures.


Assuntos
Disfonia , Humanos , Disfonia/terapia , Tono Muscular , Treinamento da Voz , Resultado do Tratamento , Fonação/fisiologia
16.
Laryngoscope Investig Otolaryngol ; 8(1): 156-161, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36846406

RESUMO

Introduction: Tracheotomy is one of the most commonly performed procedure by otolaryngologists, but no consensus exists on the effect of suturing techniques on postoperative complications. Stay sutures and Bjork flaps are utilized frequently for securing the tracheal incision to the neck skin in order to create a tract for recannulation. Methods: Retrospective cohort study of tracheotomies performed by Otolaryngology-Head and Neck Surgery providers (May 2014 to August 2020) was conducted to determine the effect of suturing technique on postoperative complications and patient outcomes. Patient demographics, medical comorbidities, indication for tracheostomy, and postoperative complications were analyzed with a statistical alpha set of .05. Results: Out of 1395 total tracheostomies performed at our institution during the study period, 518 met inclusion criteria for this study. Three hundred and seventeen tracheostomies were secured by utilizing a Bjork flap, while 201 were secured with up and down stay sutures. Neither technique was noted to be more commonly associated with tracheal bleeding, infection, mucus plugging, pneumothorax, or false passage of the tracheostomy tube. One mortality was noted following decannulation during the study period. Conclusion: Though various techniques exist; adverse outcomes are not associated with the manner in which a new tracheostomy stoma is secured. Medical comorbidities and the indications for tracheostomy likely play a more significant role in postoperative outcomes and complications. Level of evidence: Level 3.

17.
Biochim Biophys Acta ; 1813(8): 1511-24, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21621562

RESUMO

Local movements of receptors in the plasma membrane have been extensively studied, as it is generally believed that the dynamics of membrane distribution of receptors regulate their functions. However, the properties of large-scale (>5µm) receptor movements in the membrane are relatively obscure. In the present study, we addressed the question as to whether the large-scale movement of receptor in the plasma membrane at the whole cell level can be explained quantitatively by its local diffusive properties. We used HEK 293 cells transfected with human ß2-adrenoceptor fused to photoconvertible fluorescent protein dendra2 as a model system; and found that 1) functional integrity of the dendra2-tagged receptor remains apparently intact; 2) in a mesoscopic scale (~4µm), ~90% of the receptors are mobile on average, and receptor influx to, and out-flux from a membrane area can be symmetrically explained by a diffusion-like process with an effective diffusion coefficient of ~0.1µm(2)/s; 3) these mobility parameters are not affected by the activity state of the receptor (assessed by using constitutively active receptor mutants); 4) in the macroscopic scale (4-40µm), although a slowly diffusing fraction of receptors (with D<0.01µm(2)/s) is identifiable in some cases, the movement of the predominant fraction is perfectly explained by the same effective diffusion process observed in the mesoscopic scale, suggesting that the large scale structure of the cell membrane as felt by the receptor is apparently homogeneous in terms of its mesoscopic properties. We also showed that intracellular compartments and plasma membrane are kinetically connected even at steady-state.


Assuntos
Membrana Celular/metabolismo , Receptores Adrenérgicos beta 2/metabolismo , Transporte Biológico Ativo , AMP Cíclico/metabolismo , Difusão , Recuperação de Fluorescência Após Fotodegradação , Células HEK293 , Humanos , Espaço Intracelular/metabolismo , Cinética , Proteínas Luminescentes/metabolismo , Microscopia Confocal , Modelos Biológicos , Proteínas Recombinantes de Fusão/metabolismo
18.
J Voice ; 36(1): 146.e5-146.e16, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32451253

RESUMO

OBJECTIVES/HYPOTHESIS: The purpose of this study was to (1) investigate the percent change in communicative participation in individuals with spasmodic dysphonia (SD) pre- and post-BOTOX® treatment; and (2) to investigate if percent change in communicative participation is predicted by change in self-esteem, coping, and/or Voice-Related Quality of Life (V-RQOL) pre- and post-BOTOX® treatment. STUDY DESIGN/METHODS: A cross-sectional study of 49 patients was conducted across three clinics, with each participant completing the Rosenberg Self-Esteem Scale, the Voice Disability Coping Questionnaire (VDCQ), the V-RQOL instrument, and the Communication Participation Item Bank (CPIB) before BOTOX® treatment and 10-14 days following BOTOX® treatment. DATA ANALYSIS: For Research Question 1, a paired t test was applied to test the equality of means for CPIB and to test the pre-post changes among other composite measurements before and after the BOTOX® treatment. For Research Question 2, a multivariable linear regression model was applied with percent change in CPIB as a main outcome, and change in Rosenberg Self-Esteem Scale, VDCQ, and the V-RQOL as independent variables (or covariates) in order to test the associations. RESULTS: The results indicated that pre- and post-BOTOX® measures of communicative participation are not statistically significantly different among the participants with SD. There was a strong positive correlation between change in coping and voice-related QOL. CONCLUSIONS: A better understanding of the relationship between communicative participation and voice-related QOL is warranted. Item analysis of the V-RQOL and the VDCQ may illustrate coping strategies and functional impairments and provide further information regarding highly variable communicative participation among individuals with SD.


Assuntos
Toxinas Botulínicas Tipo A , Disfonia , Adaptação Psicológica , Comunicação , Estudos Transversais , Disfonia/diagnóstico , Disfonia/tratamento farmacológico , Humanos , Qualidade de Vida
19.
Med Phys ; 38(7): 4372-85, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21859038

RESUMO

PURPOSE: To evaluate the feasibility of line-focused ultrasound for thermal ablation of superficially located tumors. METHODS: A SonoKnife is a cylindrical-section ultrasound transducer designed to radiate from its concave surface. This geometry generates a line-focus or acoustic edge. The motivation for this approach was the noninvasive thermal ablation of advanced head and neck tumors and positive neck nodes in reasonable treatment times. Line-focusing may offer advantages over the common point-focusing of spherically curved radiators such as faster coverage of a target volume by scanning of the acoustic edge. In this paper, The authors report studies using numerical models and phantom and ex vivo experiments using a SonoKnife prototype. RESULTS: Acoustic edges were generated by cylindrical-section single-element ultrasound transducers numerically, and by the prototype experimentally. Numerically, simulations were performed to characterize the acoustic edge for basic design parameters: transducer dimensions, line-focus depth, frequency, and coupling thickness. The dimensions of the acoustic edge as a function of these parameters were determined. In addition, a step-scanning simulation produced a large thermal lesion in a reasonable treatment time. Experimentally, pressure distributions measured in degassed water agreed well with acoustic simulations, and sonication experiments in gel phantoms and ex vivo porcine liver samples produced lesions similar to those predicted with acoustic and thermal models. CONCLUSIONS: Results support the feasibility of noninvasive thermal ablation with a SonoKnife.


Assuntos
Ablação por Ultrassom Focalizado de Alta Intensidade/instrumentação , Modelos Biológicos , Simulação por Computador , Desenho Assistido por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Estudos de Viabilidade , Humanos
20.
Clin Nurs Res ; 30(6): 790-798, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33764220

RESUMO

This study aims to provide a closer examination of the problems experienced by individuals with pemphigus vulgaris with their eyes and experiences. This is a phenomenological study. The study population was completed with eight people with pemphigus vulgaris who applied to the dermatology clinic of a university hospital in a metropolis between September 2019 and March 2020. The interviews were transcribed and analyzed using phenomenological methods. Three main themes emerged and nine supporting sub-themes were identified. The main themes are (a) the physical problems they are experiencing now, (b) the psychological difficulties they are feeling now, and (c) intense future anxiety about the process and the future. This study will increase the understanding of the lived experiences of pemphigus vulgaris patients, increase the awareness of each nurse about these patients and will be able to provide better quality care to individuals with pemphigus vulgaris.


Assuntos
Pênfigo , Ansiedade , Humanos , Pesquisa Qualitativa
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