Similar Long-Term Outcomes in Children Presenting With Abscess vs Phlegmon at Diagnosis of Crohn Disease.

Background: Limited data are available for long-term outcomes of pediatric patients with abdominal abscess or phlegmon at diagnosis of Crohn disease. Methods: We performed a retrospective chart review of such children over a recent 6-year period at 5 pediatric inflammatory bowel diseases. Results: Fifty-two patients (mean age 15.9 ± 1.8 years) were reviewed. Thirty-six had an abscess and 27 (75%) required resectional therapy compared to 16 with phlegmon which 10 (63%) requiring surgery. Overall (37/52) 71% had surgery which was performed within 6 months in 32 (86%). Conclusions: A similar high surgical rate exists whether pediatric patients with Crohn disease present with abscess or phlegmon.

CPAP devices: encouraging patients with sleep apnea.

Continuous positive airway pressure devices (CPAP) used at night prevent apnea, hypoxia, and sleep disturbance. Although CPAP is more effective than placebo in improving sleepiness and quality of life measures in people with obstructive sleep apnea, patients often prefer a less-effective oral appliance. This article examines help-seeking experiences in support groups of individuals with sleep apnea who use CPAP devices. To understand patients' experiences and difficulties using CPAP, an urban medical center and a rural hospital shared data collected from 17 individuals with sleep apnea who use CPAP for treatment and attend a support group. Four related themes emerged including (a) becoming motivated to persist with help from the group, (b) accommodating to the device, (c) listening and telling stories to gain practical knowledge, and (d) implementing a support group as a caring community. Healthcare providers could recommend support groups on CPAP use while nurses guide discussion, provide technical information, and promote empowerment.

A CNS-facilitated ICD support group: a clinical project evaluation.

PURPOSE: The purpose of this article is to describe and evaluate a clinical nurse specialist (CNS)-facilitated support group for recipients of implantable cardioverter defibrillator. Specific evaluation aims were as follows: (1) How do demographic and clinical factors differ between those who attended the support group and those who did not? (2) Is there a difference in the quality of life index (QLI) of individuals with an implantable cardioverter defibrillator who attended the CNS-facilitated support group and those who did not? (3) What demographic and clinical factors are related to QLI? DESIGN AND METHOD: Clinical project theory-based objectives were described. Implementation of the project was evaluated by retrospective survey of all implantable cardioverter defibrillator recipients during a 10-year time frame using the Ferrans and Powers' Quality of Life Index: Cardiac Version and demographic questionnaire. Attendance sheets defined who attended so comparisons could be made. EVALUATION RESULTS: One hundred and twelve surveys were returned (34% return rate). A positive relationship between CNS visit during hospitalization, number of and value of supports, years of education, and ejection fraction was noted with attendance at the support group. No between-group differences on total QLI, or on any subscales, were found. Comorbidity was the only clinical factor correlated with QLI. CONCLUSION: CNS-facilitated support groups can be offered as an additional support. Evaluation design issues limited the measuring outcomes of existing interventions. Future prospective studies are recommended to determine the affect of the support group on quality of life.