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1.
J Invest Surg ; 33(1): 79-93, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29856663

RESUMO

Purpose/Aim: Lumbar degenerative diseases (LDDs) cause pain and disability and are treated with lumbar fusion surgery. The aim of this study was to evaluate the efficacy of lumbar fusion surgery with ISOBAR devices versus posterior lumbar interbody fusion (PLIF) surgery for alleviating LDD-associated pain and disability. Materials and Methods: We performed a literature review and meta-analysis conducted in accordance with Cochrane methodology. The analysis included Group Reading Assessment and Diagnostic Evaluation assessments, Jadad Quality Score evaluations, and Risk of Bias in Non-randomized Studies of Interventions assessments. We searched PubMed, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, ProQuest, the Airiti Library, and the China Academic Journals Full-text Database for relevant randomized controlled trials and cohort studies published in English or Chinese between 1997 and 2017. Outcome measures of interest included general pain, lower back pain, and disability. Results: Of the 18 studies that met the inclusion criteria, 16 examined general pain (802 patients), 5 examined lower back pain (274 patients), and 15 examined disability (734 patients). General pain, lower back pain, and disability scores were significantly lower after lumbar fusion surgery with ISOBAR devices compared to presurgery. Moreover, lumbar fusion surgery with ISOBAR devices was more effective than PLIF for decreasing postoperative disability, although it did not provide any benefit in terms of general pain or lower back pain. Conclusions: Lumbar fusion surgery with ISOBAR devices alleviates general pain, lower back pain, and disability in LDD patients and is superior to PLIF for reducing postoperative disability. Given possible publication bias, we recommend further large-scale studies.


Assuntos
Doença , Fusão Vertebral , China , Humanos , Região Lombossacral , Pacientes
3.
Quintessence Int ; 51(1): 78-85, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31781693

RESUMO

OBJECTIVES: Video sharing sites are a popular and useful way to spread information. The aim of this study was to evaluate information about oral care for leukemia patients and quality of information related to videos available on YouTube. METHOD AND MATERIALS: In this cross-sectional study, YouTube videos were analyzed according to the information content. The search was performed in English and using the search term: leukemia/oral care. The following information was registered: date of upload, source of upload, duration, total views, number of likes, number of dislikes, number of comments, overall quality. The overall quality of videos was assessed using the following quality criteria presented in the Global Quality Scale (GQS): poor, generally poor, moderate, good, and excellent. In addition, videos were classified as useful, misleading, and patient personal experience. Videos were assessed in terms of definition, etiology, pathogenesis, symptoms, treatment, and oral care for leukemia. RESULTS: Sixty-three videos (78.8%) were classified as useful, 6 (7.5%) as misleading and 11 (13.8%) as a patient's personal experience. Thirteen videos (16.3%) discussed the definition of leukemia, 8 (10.0%) discussed etiology, 6 (7.5%) discussed pathogenesis, 7 (8.8%) discussed symptoms of leukemia, 50 (62.5%) discussed treatment choices, and 15 videos (18.8%) discussed oral care of leukemia. Thirteen videos (16.3%) were assessed as poor, 17 (21.3%) as generally poor, 39 (48.8%) as moderate, 10 (12.5%) as good quality, and 1 (1.3%) as excellent. There was a significant difference between the content of videos and the number of views, number of likes, number of dislikes, and number of comments (P < .05). There was a significant difference between the content of videos and number of views, number of likes, number of dislikes, and number of comments (P = .007, P = .006, P = .049, and P = .011 respectively). There was no significant difference between demographic parameters and quality of video. There was no significant difference between demographic parameters (except duration, P = .025) and source of information. CONCLUSIONS: YouTube is a useful source of information on leukemia. Health care professionals should take into consideration that YouTube is an effective information tool for the patient.


Assuntos
Leucemia , Mídias Sociais , Estudos Transversais , Humanos , Pacientes , Gravação em Vídeo
7.
Quintessence Int ; 51(1): 64-76, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31813941

RESUMO

OBJECTIVES: Although health care practitioners have become more cognizant of the hazards of opioid use, opioid misuse has emerged as a leading public health problem in the United States, accounting for 20% of all deaths among older adolescents and young adults. Opioid analgesics are an important component of dental pain management following dental procedures. The aim of this study was to assess the status of literature on dental opioid prescriptions, their misuse, and relevant prevention strategies in the US. DATA SOURCES: A keyword search of MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL (EBSCO), and Web of Science was conducted in July 2018. The search criteria were carefully selected to include all practitioners treating patients presenting with dental issues and was not restricted to dentists. All peer-reviewed publications in the US written in English about patients with dental problems were included. RESULTS: The initial search led to 267 publications; after removing duplicates, the set consolidated to 196. After an appraisal of the title and abstract for relatedness, 82 publications were selected. Three major themes were identified: epidemiology of dental opioid prescriptions; recognition of the dental providers' contribution to opioid prescription practice; pain management protocols and guidelines in dentistry. CONCLUSIONS: There is moderate recognition of the contribution of dental prescriptions to the opioid epidemic. Several tools are available to increase patient education and practitioner knowledge about the safe use of opioids with a focus on patients at greatest risk.


Assuntos
Analgésicos Opioides , Transtornos Relacionados ao Uso de Opioides , Adolescente , Odontólogos , Humanos , Pacientes , Padrões de Prática Médica , Estados Unidos , Adulto Jovem
8.
Rev. bras. cir. plást ; 34(4): 571-575, oct.-dec. 2019. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-1047934

RESUMO

O presente estudo objetiva relatar a técnica do retalho toracoabdominal pós-mastectomia por tumor localmente avançado em paciente com mutação de BRCA1. Foi realizada a mastectomia com ressecção de quase todo o músculo peitoral maior à esquerda, com linfonodectomia axilar homolateral e reconstrução do grande defeito da parede torácica com retalho toracoabdominal fasciocutâneo, baseado nas artérias intercostais posteriores.


This case report describes the application of the thoracoabdominal flap technique after locally advanced tumor mastectomy in a patient with breast cancer 1 (BRCA1) mutation. The mastectomy included resection of nearly the entire left pectoralis major muscle, with homolateral axillary lymphadenectomy and reconstruction of the large chest wall defect with a fasciocutaneous thoracoabdominal flap based on the posterior intercostal arteries.


Assuntos
Humanos , Feminino , Adulto , História do Século XXI , Pacientes , Retalhos Cirúrgicos , Mama , Neoplasias da Mama , Procedimentos Cirúrgicos Reconstrutivos , Oncologia Cirúrgica , Mutação , Retalhos Cirúrgicos/transplante , Mama/cirurgia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/complicações , Neoplasias da Mama/terapia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Oncologia Cirúrgica/métodos , Mutação/ética
9.
Soins ; 64(840): 11-16, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31847962

RESUMO

In surgery and anaesthesia safety rules and criteria must be respected. Checks need to be made by caregivers at certain stages. The patient should also be involved in these checks. The surgical patient self-check list is the tool used in this approach.


Assuntos
Lista de Checagem , Segurança do Paciente , Cuidadores , Humanos , Pacientes
10.
Rev Infirm ; 68(256): 43-44, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31870481

RESUMO

ICU services are a source of anxiety and stress. There are many barriers to well-being for the patients who are admitted. From this observation was born the surgical intensive care project of the Pellegrin Hospital in Bordeaux, which aims to create a wellness trolley. Its objective is to improve hospital conditions and the patient's experience.


Assuntos
Ansiedade , Cuidados Críticos , Unidades de Terapia Intensiva , Humanos , Pacientes/psicologia
11.
Niger Postgrad Med J ; 26(4): 211-215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621660

RESUMO

Introduction: Recent evidence suggests that rates of drug use and abuse in Nigeria exceed the global average. There is a strong treatment demand for psychoactive drug use disorders in Nigeria; however, it is not known whether available treatment facilities are attending to the array of treatment needs. This audit compares the pattern of presentations at a tertiary facility with a community-based survey. Methods: A review of cases (n = 212) seen at a regional drug treatment facility over a 4-year period, using local data retrieved from the Nigerian Epidemiological Network of Drug Use (NENDU) and comparison with data from the recently published national drug use survey. Results: Nine out of ten clients seen were male (93.4%). About half (49.5%) of the clients used psychoactive substances for the first time between ages 10 and 19 years. Cannabis was the primary drug of use overall and also among males, while females were more likely to present with opiate abuse. Over half had a co-occurring physical or mental disorder, and a minority had received testing for hepatitis C in the past 12 months. Conclusion: Although patterns of drug abuse presentations were consistent with findings from a national community-based survey, there was an under-representation of females in treatment. Implications for policy development and practice are discussed.


Assuntos
/efeitos adversos , Transtornos Mentais/epidemiologia , Pacientes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Distribuição por Idade , Alcoolismo/epidemiologia , Alcoolismo/reabilitação , Criança , Comorbidade/tendências , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/tendências , Masculino , Abuso de Maconha/epidemiologia , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pacientes/psicologia , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto Jovem
12.
Pol Arch Intern Med ; 129(9): 572-573, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31566586
13.
Rev Med Suisse ; 15(669): 1982-1986, 2019 Oct 30.
Artigo em Francês | MEDLINE | ID: mdl-31663698

RESUMO

Economists traditionally describe individuals as well-informed and rational decision-makers. Recent developments in behavioural economics, which lies at the intersection between psychology and economics, challenge these assumptions and describe the common cognitive biases that affect us all. The resulting decision errors are particularly frequent in health and health care given the predominance of uncertainty and the complexity of choices. Interventions aiming at correcting, or exploiting, these biases to improve decisions of citizens, patients, and health professionals have recently emerged. We present here a critical synthesis of findings and discuss potential applications in our health system.


Assuntos
Tomada de Decisões , Economia Comportamental , Educação em Saúde , Pessoal de Saúde/psicologia , Medicina/métodos , Pacientes/psicologia , Assistência à Saúde , Humanos
14.
Prensa méd. argent ; 105(9 especial): 501-508, oct 2019. tab
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1046263

RESUMO

The aim of the study is to increase the effectiveness of diseases treatment in elderly patients. The work is based on the study of the nature and the role of compliance disorders, optimizing the effectiveness with the use of therapeutic complex of pharmacotherapy associated with psychotherapeutic component. As a result of the analysis of morbidity in elderly age and the nature of compliance in elderly patients, an optimal therapeutic complex was proposed, which consists of rational pharmacological load and psychotherapeutic intervention, aimed at informing a patient about the disease, methods of its treatment, as well as at creating an effective therapeutic alliance which provides proper medical care and prevents self-treatment in such patients.


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Pacientes , Terapêutica , Saúde do Idoso , Inquéritos de Morbidade , Resultado do Tratamento , Tratamento Farmacológico , Múltiplas Afecções Crônicas/tratamento farmacológico , Geriatria
16.
Ann Agric Environ Med ; 26(3): 469-503, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559810

RESUMO

OBJECTIVES: The aim of the study is to determine the scale of interregional migrating patients' hospitalizations in Poland in 2013-2017, as well as their demographic and medical factors, total costs and time changes. MATERIAL AND METHODS: Data from the NHF (National Health Fund) regarding hospitalizations in a given province of patients registered in another province in Poland in 2013-2017 were statistically analyzed. Times series analyses as well as coefficients of correlation, determination and variation were used. RESULTS: The number of patients hospitalized outside their regional registration and the cost of their hospitalization increased from year-to-year during 2013-2017. There was a large variation in provinces in terms of inflow of patients and costs of their hospitalization, while there was only a small variation in terms of outflow of patients and costs of their hospitalization in the analyzed years. Among the patients hospitalized outside the province where they were registered, there were more women then men, while the age group was dominated by 60-year-olds and their share in the subsequent years increased, while the share of other age groups remained unchanged or decreased. The most and increasingly more from year-to-year hospitalizations outside the regional registration were due to neoplasms and diseases of the circulatory system. CONCLUSIONS: The results of the study may significantly contribute to the proper planning of securing the health needs of the inhabitants of particular regions, and to improving the quality and economic efficiency of health services in individual NHF branches.


Assuntos
Hospitalização/economia , Pacientes/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Comportamento de Escolha , Feminino , Custos Hospitalares , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pacientes/estatística & dados numéricos , Polônia , Fatores de Tempo , Adulto Jovem
17.
Z Psychosom Med Psychother ; 65(3): 239-256, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476991

RESUMO

Development and validation of a questionnaire for patient competence in coping with cancer (PCQ) Objectives: The aim of the study was the development and evaluation of the psychometric properties of a self-assessment questionnaire for resource-orientated coping with cancer (Patient Competence Questionnaire, PCQ). Methods: In 420 patients and members of cancer support-groups item selection and evaluation of item properties, reliability (Cronbach's Alpha), validity (convergent and divergent) and factorial structure were performed in two studies. Results: The final version of the PCQ (18 items) demonstrated a Cronbach's Alpha between 0.71 and 0.91 for five subscales identified with exploratory factor analysis (religious/spiritual coping, coping competence, healthy lifestyle, information seeking, adaptability) and 0.85 for the total score. The PCQ shows a high convergent validity (r = 0.46) with the Freiburg Questionnaire on Coping with Illness (FKV) and significant correlations with depression (r = -0.23), posttraumatic growth (r = 0.65) and religiosity (r = 0.59). Conclusions: First analyses underline that the PCQ can be regarded as a valid and reliable instrument for assessing patients' resources in dealing with cancer.


Assuntos
Adaptação Psicológica , Neoplasias/psicologia , Pacientes/psicologia , Inquéritos e Questionários/normas , Humanos , Psicometria , Reprodutibilidade dos Testes
18.
Psychiatr Danub ; 31(Suppl 3): 416-417, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488763

RESUMO

OBJECTIVES: We wanted to investigate the patient's expectations on the general practitioner's (GP) responsibilities in screening and follow up of disturbed eating behaviour. Then, we looked for remediation for some of the mentioned shortcomings in family medicine. We also examined if online aid (offered by the non-profit organisation "Eetexpert.be") is already known and used. SUBJECTS AND METHODS: Anonymous patient questionnaires were gathered at 4 treatment centres for eating disorders or were collected with help of the Flemish patients organisation for eating disorders (Vlaamse Vereniging Anorexia Nervosa en Boulimia Nervosa). Later, online enquiries were sent to Flemish GPs. RESULTS: Out of 123 patients responding to the questionnaire, 44 found their GP to have had an important supportive role in their healing process. Active listening and targeted referral were among the most appreciated interventions by those patients. 71 GPs replied the online enquiry. Only 1 out of 5 knew about the free online assistance of "Eetexpert.be". Responders suggested several additional barriers to care. CONCLUSIONS: In Flanders there is a contrast between expectations and needs of patients on one hand compared to the services provided by GPs on the other. Reassuringly, all responding physicians were open to more education and support regarding eating disorder treatment.


Assuntos
Atitude do Pessoal de Saúde , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Clínicos Gerais/psicologia , Preferência do Paciente , Pacientes/psicologia , Inquéritos e Questionários , Bélgica , Clínicos Gerais/educação , Humanos , Encaminhamento e Consulta
19.
Psychiatr Danub ; 31(Suppl 3): 427-433, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488766

RESUMO

BACKGROUND: Our previous research demonstrated that mild depression (MD) is characterized by patterns of atypical language use such as inverted word order, greater repetition, increased use of reflexive/personal (e.g. myself) or negative/ indefinite (e.g. nobody) pronouns, verbs in past tense, and other lexico-grammatical, stylistic and syntactic indicators (how the patient speaks). We now investigate the role of semantic features (what the patient speaks about) in diagnosing (why it is important to listen) affective states. SUBJECTS AND METHODS: 201 written narratives from 124 patients with MD and 77 healthy controls (HC), including 35 cases of normal sadness (NS), were studied using principle component lexis analysis. Statistical data evaluation was performed with SPSS-25 (p<0.05, significant) and included the Cohen's kappa for inter-rater reliability, nonparametric methods to measure between-group differences (Mann-Whitney U-test, Pearson Chi-square test, Kruskal-Wallis, one-way ANOVA), and discriminant analysis for modeling of semantic variables related to affective diagnostic types. RESULTS: Component lexis analysis revealed an exaggerated usage of semantic categories describing existential and family values in the texts of MD patients compared to HC. However, there were fewer cognitive and altruistic categories presented in patients' self-reports. The most substantial between-group difference was the lesser semantics of self-realization in MD patients, as well as their significantly lower ranking of social status' priorities. Communicative and hedonic values in MD speech displaced and predominated in ranking over the values of social status, versus the opposite relationship in HC speech. The discriminant model revealed a set of semantic indicators significantly distinguishing the MD, HC and NS groups (96.3%; Wilks' λ=0.001, p<0.001, r=0.996). CONCLUSIONS: Linguistic structure and content of patients' verbalizations may serve as diagnostic markers of MD. Evaluation of psychosocial themes within the content of narratives should enable a better understanding of MD pathogenesis and emphasize the importance of monitoring social difficulties during treatment.


Assuntos
Depressão/diagnóstico , Depressão/psicologia , Pacientes/psicologia , Semântica , Estudos de Casos e Controles , Audição , Humanos , Relações Profissional-Paciente , Reprodutibilidade dos Testes
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