Confusion and mental status changes in a medically ill child

2021 ◽  
pp. 229-234
Author(s):  
Robyn P. Thom
Keyword(s):  
Stress Reduction ◽  
Medical Condition ◽  
Signs And Symptoms ◽  
Primary Treatment ◽  
Child Life ◽  
Toxic Exposure ◽  
Supportive Psychotherapy ◽  
Medically Ill ◽  
Reduction Strategies ◽  
Underlying Medical Condition

Delirium is an acute, transient syndrome of global brain dysfunction that is the pathophysiological consequence of an underlying medical condition or toxic exposure. It affects 13% to 44% of hospitalized children. Signs and symptoms of delirium include disturbances in attention, awareness, and cognition that develop over a short period of time and fluctuate in severity. Patients with suspected delirium should undergo a physical examination and laboratory investigation to determine potential underlying medical etiologies. The primary treatment of delirium is identification and management of the underlying medical condition. Antipsychotics may be used to manage symptoms that threaten safety or impede the provision of medical care. Children with delirium may also benefit from supportive psychotherapy, involvement with child-life specialists, and other stress reduction strategies.

Dysphagia in Persons With Communication Disorders

2018 ◽  
pp. 158-183
Author(s):  
Gayathri Krishnan ◽  
S. P. Goswami
Keyword(s):  
Quality Of Life ◽  
Pharmacological Treatment ◽  
Medical Condition ◽  
Signs And Symptoms ◽  
Communication Disorders ◽  
Central Control ◽  
Transient Phase ◽  
Nutrition And Hydration ◽  
Underlying Medical Condition

Dysphagia (swallowing disorders) is any difficulty in swallowing that interferes with safe and adequate intake of nutrition and hydration requirements in an individual. It may present itself as a symptom of another underlying medical condition or as a consequence of surgical and pharmacological treatment. While in few, dysphagia resolves itself as a transient phase; in the rest, dysphagia demands immediate treatment. It may be seen as an associated dysfunction in persons with communication disorders (PsWCD) as speech and swallowing functions share many neuro-musculo-skeletal structures at the oral, pharyngeal, and laryngeal level along with their central control processes. This chapter aims at introducing the readers to the signs and symptoms of dysphagia in PsWCD. This is expected to guide the team of professionals working with PsWCDin identification and making appropriate referrals to the concerned professional for effective intervention. This further can accelerate the progress and prognosis of PsWCD towards improved health, development, and quality of life.

Rating Peripheral Neuropathy

2003 ◽  
Vol 8 (1) ◽  
pp. 1-10
Author(s):  
Christopher R. Brigham
Keyword(s):  
Nervous System ◽  
Peripheral Neuropathy ◽  
Medical Condition ◽  
Nerve Fibers ◽  
Sensory Loss ◽  
Toxic Exposure ◽  
Fourth Edition ◽  
Afferent Nerve Fibers ◽  
Discrimination Testing ◽  
Underlying Medical Condition

Abstract This article discusses the evaluation of peripheral nerve impairment and focuses on assessing peripheral polyneuropathies. Although peripheral neuropathy is a common neurological disorder, no uniform criteria exist for either evaluation or diagnosis, and 30% of cases remain idiopathic. The patient must be at maximum medical improvement (MMI) before permanent impairment is rated, but determining MMI is challenging, particularly if neuropathy is secondary to an underlying medical condition such as hypothyroid or diabetic neuropathy or toxic exposure. A table in this article directs readers to specific tables from the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) for determining maximum motor and sensory loss. Sensory dysfunction is evaluated by whether it interferes with performance of daily functions, and another table compares sensory gradings according to the AMA Guides, Fifth Edition (Tables 16-10 and 13-23) and the Fourth Edition (Table 11). When using these tables, evaluators should be aware of differences in terminology: sensation is the acceptance and activation of impulses in the afferent nerve fibers of the nervous system, and sensibility is the conscious appreciation and interpretation of the stimulus. In addition, a box discusses two-point discrimination testing and steps the examiner can take to minimize the variability of this procedure. Grading a sensory deficit requires considerable judgment and interpretation, which makes the findings less objective than findings that are independently verifiable.

scholarly journals Psychosis Without Meaning: Creating Modern Clinical Psychiatry, 1950 to 1980

2021 ◽  
Author(s):  
Joel T. Braslow
Keyword(s):  
Clinical Psychiatry ◽  
Life Histories ◽  
Psychotic Disorders ◽  
Clinical Care ◽  
Signs And Symptoms ◽  
Primary Treatment ◽  
Social Contexts ◽  
Clinical Practices ◽  
State Hospitals ◽  
1960S And 1970S

AbstractOver the last fifty years, American psychiatrists have embraced psychotropic drugs as their primary treatment intervention. This has especially been the case in their treatment of patients suffering from psychotic disorders such as schizophrenia. This focus has led to an increasing disregard for patients’ subjective lived-experiences, life histories, and social contexts. This transformation of American psychiatry occurred abruptly beginning in the late 1960s and 1970s. My essay looks the ways these major transformations played themselves out in everyday clinical practices of state hospital psychiatrists from 1950 to 1980. Using clinical case records from California state hospitals, I chronicle the ways institutional and ideological forces shaped the clinical care of patients with psychotic disorders. I show there was an abrupt rupture in the late 1960s, where psychiatrists’ concerns about the subjective and social were replaced by a clinical vision focused on a narrow set of drug-responsive signs and symptoms. Major political, economic, and ideological shifts occurred in American life and social policy that provided the context for this increasingly pharmacocentric clinical psychiatry, a clinical perspective that has largely blinded psychiatrists to their patients’ social and psychological suffering.

Documented Evidence of Depression in Medical and Nursing Case-Notes and Its Implications in Acutely Ill Geriatric Inpatients

1998 ◽  
Vol 10 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Ajit Shah ◽  
Tamal De
Keyword(s):  
Geriatric Medicine ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Signs And Symptoms ◽  
Screening Procedure ◽  
Medically Ill ◽  
Brief Assessment ◽  
Medical Inpatients ◽  
Elderly Inpatients ◽  
The Impact

Depression is common among acutely ill elderly medical inpatients. Identification of such depression by the geriatric medicine staff would allow early treatment. The impact of a depression screening procedure on documentation of depressive signs and symptoms in the medical and nursing case-notes was examined. Thirty-five sets of medical and nursing case-notes of medically ill elderly inpatients, for whom data from the Brief Assessment Schedule and the short Geriatric Depression Scale (GDS) were also available, were examined for documentation of signs and symptoms of depression, prescription of antidepressants, and referred to the psychogeriatric service. Depressive signs and symptoms were documented in only a few medical (29%) and nursing (11%) case-notes. Only a small number of depressed patients were prescribed antidepressants (20%) or were referred to the psychogeriatric service (13%). The frequency of documentation of depressive signs and symptoms after the screening procedure with the short GDS was associated with subsequent prescription of antidepressants and referral to the psychogeriatric service. The screening procedure itself may increase the general awareness of depressive signs and symptoms and affect its management. These results require replication.

scholarly journals A CASE STUDY ON AYURVEDIC MANAGEMENT OF VATAHATA VARTMA (PTOSIS)

2021 ◽  
Vol p5 (4) ◽  
pp. 2955-2959
Author(s):  
Sangeeta Neelannavar ◽  
Vijayamahantesh Hugar ◽  
Varsha Kulkarni
Keyword(s):  
Surgical Intervention ◽  
Medical Condition ◽  
Medical Science ◽  
Signs And Symptoms ◽  
Treatment Modalities ◽  
Upper Eyelid ◽  
Contemporary Science ◽  
Functional Deterioration

Vatahata Vartma is a condition of Vartma where in the Vartma-Shuklagata Sandhi is afflicted by vitiated Vata leading to Vimukta Sandhi (functional deterioration of the Shuklavartmagata Sandhi which facilitates the movement of eyelids), Nischeshta (no or reduced eyelids activity), Nimilayati (unable to close the eyelids). The signs and symptoms of Vatahata Vartma can be corelated to Ptosis in modern medical science. Ptosis is a medical condition in which there will be drooping or falling of upper eyelid. The condition worsens when there is exhaustion of the extra ocular muscles. This condition can be either uni-ocular or binocular. If the condition is left untreated, it can lead to complications. Surgical intervention is the only line of treatment mentioned for ptosis in contemporary science. Ayurveda has mentioned different treatment modalities for similar conditions. This paper highlights a case study of Vatahata Vartma (ptosis) managed with Ayurvedic line of treatment with Mukhabhyanga, Sweda, Nasya, Akshipindi and Akshi Tarpana. Keywords: Vatahata Vartma, Ptosis, Nasya, Akshitarpana, Akshipindi

scholarly journals Medical mimics: Differential diagnostic considerations for psychiatric symptoms

2016 ◽  
Vol 6 (6) ◽  
pp. 289-296 ◽  
Author(s):  
Jerry McKee ◽  
Nancy Brahm
Keyword(s):  
Psychiatric Symptoms ◽  
Age Of Onset ◽  
Medical Condition ◽  
Clinical Situation ◽  
Symptom Presentation ◽  
Psychiatric Symptomatology ◽  
Statistical Manual ◽  
Diagnostic Categories ◽  
Diagnostic And Statistical Manual ◽  
Underlying Medical Condition

Abstract Patients with underlying medical disease can present to the health care system with psychiatric symptoms predominating. Identification of an underlying medical condition masquerading as a psychiatric disorder can be challenging for clinicians, especially in patients with an existing psychiatric condition. The term medical mimic or secondary psychosis has been used to describe this clinical situation. Diagnostic categories from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, that may encompass medical mimics include substance-induced disorders, which includes medications, and unspecified mental disorder due to another medical condition in situations where the clinician may lack needed information for a complete diagnosis. At this time, there is no single diagnostic test or procedure available to differentiate primary versus secondary psychosis on the basis of psychopathology presentation alone. When considering a diagnosis, clinicians should evaluate for the presence of atypical features uncharacteristic of the psychiatric symptoms observed; this may include changes in functionality and/or age of onset and symptom presentation severity. The purpose of this work is to provide a structured clinical framework for evaluation for medical mimics, identify groups considered to be at highest risk for medical mimics, and present common syndromic features suggestive of a medical mimic. Selected case scenarios are used to illustrate key concepts for evaluating and assessing a patient presenting with acute psychiatric symptomatology to improve judgment in ruling out potential medical causality.

Coping Against Weight-Related Teasing among Adolescents Perceived to be Overweight or Obese in Urban Physical Education

2012 ◽  
Vol 31 (2) ◽  
pp. 182-199 ◽  
Author(s):  
Weidong Li ◽  
Paul Rukavina ◽  
Paul Wright
Keyword(s):  
Social Support ◽  
Physical Education ◽  
Stress Reduction ◽  
Focus Group Interview ◽  
Research Process ◽  
Urban School District ◽  
Multiple Strategies ◽  
Reduction Strategies ◽  
Checking Procedure ◽  
Self Protection

The purpose of this study was to examine coping against weight-related teasing among adolescents perceived to be overweight or obese in urban physical education. Forty-seven students perceived to be overweight or obese from a large urban school district were interviewed. Trustworthiness of data analysis was established by using a member-checking procedure, focus group interview, and peer debriefing throughout the research process. The results indicated that adolescents perceived to be overweight or obese used self-protection, compensation, confrontation, seeking social support, avoidance/psychological disengagement, losing weight and stress reduction strategies to cope against weight-related teasing. Adolescents used multiple strategies under different mechanisms to cope, and the strategies they chose were dependent on the situation.

scholarly journals Temporoparietal Fascia Free Flap for a Large Nasal Septal Perforation

2019 ◽  
Vol 04 (01) ◽  
pp. e42-e46
Author(s):  
Nicholas G. Cuccolo ◽  
Ryan P. Cauley ◽  
Brady A. Sieber ◽  
Syed M.D. Hussain ◽  
Laurel K. Chandler ◽  
...  
Keyword(s):  
Medical Condition ◽  
Donor Site ◽  
Free Tissue Transfer ◽  
Donor Site Morbidity ◽  
Nasal Septal Perforation ◽  
Temporoparietal Fascia ◽  
Versatile Tool ◽  
Underlying Medical Condition

AbstractReconstruction of large nasal septal perforations can be a considerable challenge for surgeons. Reconstructive modalities are often determined by the size of the defect and the quality of local tissue and vasculature. Local and regional flaps may not provide enough tissue to achieve successful closure in patients with large perforations and those with baseline compromise of the nasal mucosa and blood supply from prior intervention or underlying medical condition. Microvascular free tissue transfer is a possible approach to reconstruction in these patients. We report a case of a 30-year-old man who presented with a large, symptomatic, 4 × 3.5 cm perforation as a result of prior functional septoplasty at an outside hospital. Reconstruction of the defect was accomplished in this setting with a free temporoparietal fascia (TPF) flap anastomosed to the columellar branch of the labial artery and the angular vein. Postoperative follow-up visits showed successful closure of the perforation without complications. As illustrated by this case, TPF flap is a versatile tool for complex nasal reconstructions. With minimal donor-site morbidity and rich vascularity capable of promoting remucosalization without the need for prelamination, the TPF flap may be suited for the repair of large nasoseptal perforations.

Pandemic (H1N1) 2009 influenza in the UK: clinical and epidemiological findings from the first few hundred (FF100) cases

2010 ◽  
Vol 138 (11) ◽  
pp. 1531-1541 ◽  
Author(s):  
E. McLEAN ◽  
R. G. PEBODY ◽  
C. CAMPBELL ◽  
M. CHAMBERLAND ◽  
C. HAWKINS ◽  
...  
Keyword(s):  
Seasonal Influenza ◽  
Medical Condition ◽  
Pandemic H1n1 ◽  
Duration Of Illness ◽  
Gastrointestinal Complaints ◽  
Novel Virus ◽  
Pandemic H1n1 2009 ◽  
The Uk ◽  
Epidemiological Characteristics ◽  
Underlying Medical Condition

SUMMARYThe UK was one of few European countries to document a substantial wave of pandemic (H1N1) 2009 influenza in summer 2009. The First Few Hundred (FF100) project ran from April–June 2009 gathering information on early laboratory-confirmed cases across the UK. In total, 392 confirmed cases were followed up. Children were predominantly affected (median age 15 years, IQR 10–27). Symptoms were mild and similar to seasonal influenza, with the exception of diarrhoea, which was reported by 27%. Eleven per cent of all cases had an underlying medical condition, similar to the general population. The majority (92%) were treated with antiviral drugs with 12% reporting adverse effects, mainly nausea and other gastrointestinal complaints. Duration of illness was significantly shorter when antivirals were given within 48 h of onset (median 5 vs. 9 days, P=0·01). No patients died, although 14 were hospitalized, of whom three required mechanical ventilation. The FF100 identified key clinical and epidemiological characteristics of infection with this novel virus in near real-time.

Performance of endovenous foam sclerotherapy in the USA for the treatment of venous disorders: ACP/SVM/AVF/SIR quality improvement guidelines

2013 ◽  
Vol 29 (2) ◽  
pp. 76-82 ◽  
Author(s):  
S Rathbun ◽  
A Norris ◽  
N Morrison ◽  
K Gibson ◽  
P Raymond-Martimbeau ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Varicose Veins ◽  
Meta Analysis ◽  
Previous Treatment ◽  
Signs And Symptoms ◽  
Primary Treatment ◽  
Consensus Panel ◽  
Foam Sclerotherapy ◽  
The Usa ◽  
Venous Disorders

Objective This report summarizes the findings of the consensus panel based on the results of the comprehensive questionnaire of US American College of Phlebology annual congress attendees and results of the systematic meta-analysis of the literature and provides quality improvement guidelines for the use of endovenous foam sclerotherapy (EFS) for the treatment of venous disorders, as well as identifies areas of needed research. Methods Based on the above data, quality improvement guidelines were developed and reviewed by the ten US consensus panel members and approved by their respective societies. Results EFS is effective for the treatment of truncal and tributary varicose veins, both as primary treatment and for treatment of recurrence. It may improve the signs and symptoms associated with varicose veins including pain and swelling. EFS is contraindicated in patients who have experienced an allergic reaction to previous treatment with foam or liquid sclerosant, and in patients with acute venous thrombosis events secondary to EFS. Conclusion These guidelines for the use of EFS in the treatment of venous disorders provide an initial framework for the safe and efficacious use of this therapy, and the impetus to promote the evaluation of the questions remaining regarding the use of EFS through well-designed randomized and cohort studies.

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