Caring for Medically Complex Children in the Outpatient Setting

2021 ◽  
Vol 68 ◽  
pp. 89-102
Author(s):  
Michelle A. Blanco ◽  
Carol M. Lilly ◽  
Brooke C. Bavinger ◽  
Sara Garcia ◽  
Michelle P. Hojnicki
Keyword(s):  
Outpatient Setting

Lingual Strengthening: Success in an Outpatient Setting

2015 ◽  
Vol 24 (2) ◽  
pp. 71-74
Author(s):  
Ali Meier
Keyword(s):  
Oropharyngeal Dysphagia ◽  
Patient Discharge ◽  
Outpatient Setting ◽  
Oral Performance ◽  
Exercise Protocol ◽  
Anterior Position ◽  
Tongue Position ◽  
Bolus Propulsion ◽  
Posterior Position

In the last decade or more, dysphagia research has investigated the effect of lingual strengthening on oropharyngeal dysphagia with promising results. Much of this research has utilized strengthening devices such as the Iowa Oral Performance Instrument (IOPI) or the Madison Oral Strengthening Therapeutic (MOST) Device. Patients are often given a device to use, and are able to complete an exercise protocol daily or multiple times per day. This case study was completed to determine the effectiveness of using the IOPI in an outpatient clinic where therapy was conducted two to three times per week. The patient was seen post tongue resection due to oropharyngeal cancer. From initiation of IOPI use to patient discharge, the patient demonstrated a 71% increase in lingual strength at the anterior position, a 61% increase at the posterior position, and a 314% increase at the base of tongue position. His diet advanced from NPO to general based on gains in lingual strength and bolus propulsion.

Abstract #1142: Improving Diabetes Management By Residents in an Outpatient Setting

2017 ◽  
Vol 23 ◽  
pp. 312-313
Author(s):  
Jahnavi Sagi ◽  
Lavanya Vuppu ◽  
Medha Joshi
Keyword(s):  
Diabetes Management ◽  
Outpatient Setting

Tonsillar Inflammation, a Rare Cause of Bradycardia and Hypotension

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Streptococcus Pyogenes ◽  
Fusobacterium Necrophorum ◽  
Outpatient Setting ◽  
Peritonsillar Abscess ◽  
The Other ◽  
Streptococcus Group ◽  
Other Hand ◽  
Group A

Tonsillitis is a frequently encountered pathology in the outpatient setting, usually caused by viruses [1]. When bacterial, the most common causatory microbe is streptococcus group A [1]. Tonsillar and peritonsillar abscess (PTA) on the other hand are never viral, and are usually caused by streptococcus pyogenes, Streptococcus melleri, fusobacterium necrophorum and staphylococci [1,2]. The overall incidence of PTA is suggested to be 37/100,000 patients, with the highest incidence between ages 14-21 at 124/100,000 [3].

Natriuretic Peptides – Addressing the Dilemma of Heart Failure Management

2011 ◽  
Vol 7 (2) ◽  
pp. 104
Author(s):  
Kenneth McDonald ◽  
Ulf Dahlström ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Physical Examination ◽  
Natriuretic Peptides ◽  
Normal Values ◽  
Outpatient Setting ◽  
Heart Failure Management ◽  
Effective Screening ◽  
Specific Symptoms ◽  
Objective Marker

Heart failure (HF) is characterised by non-specific symptoms and unremarkable physical examination; therefore, the need exists for an available objective marker of HF status. Natriuretic peptides (NPs) are a marker that can aid the dilemmas in present-day HF management. More effective screening for clinical deterioration would include changes in brain natriuretic peptide (BNP) levels. Normal values for BNP, <50–100 pg/ml, have excellent negative predictive value (NPV) in excluding HF as a diagnosis. BNP values that are significantly elevated, e.g. >500 pg/ml, make the diagnosis of HF more likely. There are now established and emerging uses for NPs in managing HF in the community. These include the role of NPs at the time of possible new presentation of HF, its role in prognostication and, finally, the increasing interest in using NPs to guide therapy in the outpatient setting.

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