Relieving pain and distress symptoms in outpatient burn clinic: The contribution of a medical clown

Burns ◽  
2021 ◽  
Author(s):  
Yuval Krieger ◽  
Michelle Pachevsky ◽  
Yaron Shoham ◽  
Ron Biederko ◽  
Lena Novack ◽  
...  
Keyword(s):  
Distress Symptoms ◽  
Medical Clown

scholarly journals Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6333
Author(s):  
Ching-Fang Lee ◽  
Fur-Hsing Wen ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Providers ◽  
First Trimester ◽  
Symptom Distress ◽  
Teaching Hospitals ◽  
Lower Back ◽  
Distress Symptoms ◽  
Related Symptom ◽  
Experienced Symptom

During pregnancy, a woman’s enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be “Decreased then Increased” (56.8%). Other noticeable patterns were “Continuously Increased” (28.4%), “Increased then Decreased” (10.5%) and “Continuously Decreased” (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants’ major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the “moderately distressful” level. This study provides evidence that could be used to predict women’s pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.

scholarly journals Stress-related emotional and behavioural impact following the first COVID-19 outbreak peak

2021 ◽  
Author(s):  
Asaf Benjamin ◽  
Yael Kuperman ◽  
Noa Eren ◽  
Ron Rotkopf ◽  
Maya Amitai ◽  
...  
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Health Impact ◽  
Anxiety And Depression ◽  
Distress Symptoms ◽  
Increased Risk ◽  
Physiological Symptoms ◽  
Individual Ability ◽  
And Coping

AbstractThe COVID-19 pandemic poses multiple psychologically stressful challenges and is associated with an increased risk for mental illness. Previous studies have focused on the psychopathological symptoms associated with the outbreak peak. Here, we examined the behavioural and mental-health impact of the pandemic in Israel using an online survey, during the six weeks encompassing the end of the first outbreak and the beginning of the second. We used clinically validated instruments to assess anxiety- and depression-related emotional distress, symptoms, and coping strategies, as well as questions designed to specifically assess COVID-19-related concerns. Higher emotional burden was associated with being female, younger, unemployed, living in high socioeconomic status localities, having prior medical conditions, encountering more people, and experiencing physiological symptoms. Our findings highlight the environmental context and its importance in understanding individual ability to cope with the long-term stressful challenges of the pandemic.

Social Stressors, Arboviral Infection, and Immune Dysregulation in the Coastal Lowland Region of Ecuador: A Mixed Methods Approach in Ecological Perspective

2021 ◽  
Author(s):  
Denisse Vega Ocasio ◽  
Anna M. Stewart-Ibarra ◽  
Rachel Sippy ◽  
Christina Li ◽  
Kaitlyn McCue ◽  
...  
Keyword(s):  
At Risk ◽  
Immune Responses ◽  
Inflammatory Responses ◽  
Social Stressors ◽  
Biological Responses ◽  
Distress Symptoms ◽  
Tnf Α ◽  
Hair Samples ◽  
Arboviral Diseases

Aedes aegypti, the mosquito that transmits arboviral diseases such as dengue (DENV), chikungunya (CHIKV), and Zika viruses (ZIKV), is present in tropical and subtropical regions of the world. Individuals at risk of mosquito-borne disease (MBD) in the urban tropics face daily challenges linked to their socio-environment conditions, such as poor infrastructure, poverty, crowding, and limited access to adequate healthcare. These daily demands induce chronic stress events and dysregulated immune responses. We sought to investigate the role of socio-ecologic risk factors in distress symptoms and their impact on biological responses to MBD in Machala, Ecuador. Between 2017 and 2019, individuals (≥ 18 years) with suspected arbovirus illness (DENV, ZIKV, and CHIKV) from sentinel clinics were enrolled (index cases, N = 28). Cluster investigations of the index case households and people from four houses within a 200-m radius of index home (associate cases, N = 144) were conducted (total N = 172). Hair samples were collected to measure hair cortisol concentration (HCC) as a stress biomarker. Blood samples were collected to measure serum cytokines concentrations of IL-10, IL-8, TNF-α, and TGF-β. Univariate analyses were used to determine the association of socio-health metrics related to perceived stress scores (PSS), HCC, and immune responses. We found that housing conditions influence PSS and HCC levels in individuals at risk of MBD. Inflammatory cytokine distribution was associated with the restorative phase of immune responses in individuals with low-moderate HCC. These data suggest that cortisol may dampen pro-inflammatory responses and influence activation of the restorative phase of immune responses to arboviral infections.

scholarly journals Randomized Clinical Trial of Telephone-Administered Cognitive-Behavioral Therapy to Reduce Post-Traumatic Stress Disorder and Distress Symptoms After Hematopoietic Stem-Cell Transplantation

2010 ◽  
Vol 28 (23) ◽  
pp. 3754-3761 ◽  
Author(s):  
Katherine N. DuHamel ◽  
Catherine E. Mosher ◽  
Gary Winkel ◽  
Larissa E. Labay ◽  
Christine Rini ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Behavioral Therapy ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Hematopoietic Stem ◽  
General Distress ◽  
Distress Symptoms ◽  
Post Traumatic

Purpose A significant number of survivors of hematopoietic stem-cell transplantation (HSCT) report enduring adverse effects of treatment, including illness-related post-traumatic stress disorder (PTSD) symptoms and general distress. We report results of a randomized clinical trial that tested the effects of a 10-session, telephone-administered cognitive-behavioral therapy (CBT) intervention on PTSD, depression, and distress symptoms. Methods Survivors who had undergone HSCT 1 to 3 years earlier (N = 408) were assessed for study eligibility. Those who met study eligibility criteria (n = 89) completed a baseline assessment that included a clinical interview and self-report measures of PTSD symptoms (the primary outcome) and depression and general distress (the secondary outcomes). Next, they were randomly assigned to CBT or an assessment-only condition. Survivors in the CBT group completed 10 individual telephone-based CBT sessions (T-CBT) that included strategies to reduce PTSD symptoms, depression, and general distress. Follow-up assessments occurred at 6, 9, and 12 months after the baseline assessment. Results Linear mixed-model analyses revealed that, compared with HSCT survivors in the assessment-only condition, survivors who completed T-CBT reported fewer illness-related PTSD symptoms, including less avoidance (P < .001) and fewer intrusive thoughts (P < .05) as well as less general distress and fewer depressive symptoms (P < .05) even after controlling for potential demographic and medical covariates. These results were consistent across the three follow-up assessments. Conclusion A brief, telephone-administered CBT intervention developed for HSCT survivors is an efficacious treatment for reducing illness-related PTSD symptoms and general distress.

scholarly journals Ceramide Levels and Covid-19 Respiratory Distress, a Causal Relationship

2021 ◽  
Author(s):  
Mehran Khodadoust
Keyword(s):  
Respiratory Distress ◽  
Causal Relationship ◽  
Fold Increase ◽  
Plasma Samples ◽  
Total Plasma ◽  
Lipidomic Analysis ◽  
Distress Symptoms ◽  
Concentration Dependency ◽  
Ceramide Synthesis ◽  
Total Plasma Concentration

Abstract A causal relationship between plasma ceramide concentration and Covid-19 patients with respiratory distress symptoms is presented. In this study, plasma samples of 52 individuals infected with Covid-19 were utilized in a lipidomic analysis. Lipids belonging to ceramide class exhibited a 400-fold increase in total plasma concentration in infected patients. Further analysis lead to demonstration of concentration dependency, for severe Covid-19 respiratory symptoms, in a subclass of ceramides. The subclasses Cer(d18:0/24:1), Cer(d18:1/24:1), and Cer(d18:1/22:0) are shown to be increased by 48, 40, and 33–folds respectively in infected plasma samples, and to 116, 91 and 50-folds in plasma samples with respiratory distress. Hence, monitoring of plasma ceramide concentration, targeting ceramide synthesis, its salvage and its regulatory mechanisms, are validated approach towards enhancing survival from Covid-19 respiratory distress.

scholarly journals ACUTE PULMONARY EMBOLISM BY AMNIOTIC FLUID – A RARE COMPLICATION OF PERINATAL PERIOD THAT SHOULD NOT BE FORGOTTEN

2021 ◽  
Vol 74 (8) ◽  
pp. 2011-2015
Author(s):  
Mateusz Jermakow ◽  
Agnieszka Palus ◽  
Michał Ciurzyński ◽  
Bronisława Pietrzak ◽  
Katarzyna Kurnicka ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Amniotic Fluid ◽  
Rare Complication ◽  
Perinatal Period ◽  
Developed Countries ◽  
Medical Emergency ◽  
Maternal Circulation ◽  
Excessive Bleeding ◽  
Distress Symptoms ◽  
Emergency Cesarean

Amniotic fluid embolism (AFE) is a diagnostically challenging type of pulmonary embolism that occurs when amniotic fluid enters maternal circulation during delivery or postpartum. This obstetric complication is very rare but characterized by high mortality rate. The main symptoms are dyspnea, cardiovascular collapse, disseminated intravascular coagulation (DIC) and even sudden cardiac death. The aim of the article is to draw attention to AFE as a rare but possible and catastrophic complication of perinatal period. The authors present a 28-year-old woman who was admitted to obstetric ward during the first stage of labour. The patient developed sudden deterioration of her medical state with acute respiratory distress symptoms. An emergency cesarean section was performed, complicated by excessive bleeding. After a detailed assessment of the patient’s condition and evaluation of the results of additional tests, we diagnosed AFE as the cause of the patient’s deterioration. Conclusions: The case study shows how unpredictable, unpreventable and dangerous is AFE. It is still one of the main causes of maternal deaths in developed countries. Four diagnostic criteria proposed by the Society for Maternal-Fetal Medicine (SMFM) may accelerate diagnosis. AFE as a medical emergency, requires immediate multidisciplinary response and aggressive treatment. The initial medical care may be facilitated by the application of the general guidelines recommended by SMFM. The case report also emphasizes the need for further research on this disease, in particular on early detection and prevention.

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