Musculoskeletal conditions

2018 ◽  
pp. 353-396
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Traumatic Injury ◽  
Summary Table ◽  
Musculoskeletal Conditions ◽  
Clinical Investigations ◽  
Increased Risk ◽  
Life Threatening ◽  
Reduce Risk ◽  
Prescribed Medicines ◽  
The Many

The skeleton, skeletal muscles, joints, tendons, and ligaments function to protect the body’s internal organs and facilitate movement and mobility. Disorders of the musculoskeletal system will often be the result of trauma or long-term degenerative conditions, which can affect people of any age, although older people are at increased risk. Many people with musculoskeletal conditions will be treated by specialist orthopaedic and rheumatology services, but general adult nurses will come into contact with many people who are suffering from a range of musculoskeletal disorders. Whether these are muscle sprains, people living with long-term arthritic conditions, or those who have suffered a potentially life-threatening traumatic injury, all will have some degree of compromised movement. It is important that general adult nurses can work with people to help restore function and reduce risk from the many complications which can arise from immobility or disability. This chapter outlines key facts about musculoskeletal conditions which are likely to be useful to the general nurse, alongside clinical investigations, and key nursing considerations. A summary table of frequently prescribed medicines is also presented.

Gastrointestinal conditions

2018 ◽  
pp. 277-312
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Health Conditions ◽  
Gastrointestinal Disorders ◽  
Summary Table ◽  
Gastrointestinal Conditions ◽  
Life Threatening ◽  
Community People ◽  
Gastrointestinal Complaints ◽  
Prescribed Medicines ◽  
Specialist Nurses

Gastrointestinal complaints range from mild and transient disorders, through to life-threatening diseases. People with disorders of the gastrointestinal system may be encountered in both hospital and community settings. In the community, people with long-term or other acute health conditions may experience disturbances in their eating patterns or bowel habits, and within the hospital, people having treatment for other diagnosed conditions may develop associated gastrointestinal disorders. People with severe gastrointestinal conditions will often be cared for by specialist nurses, but general adult nurses will encounter people with gastrointestinal disorders in all areas of clinical practice, either as a primary complaint or as a secondary complication of other illnesses or treatments. This chapter outlines key facts about gastrointestinal conditions which are likely to be useful to the general nurse and describes key nursing considerations for working with people with these disorders. An overview of frequently prescribed medicines for gastrointestinal conditions is presented in a summary table.

scholarly journals The correlation between traditional risk factors and the severity of acute coronary syndrome and long-term prognosis

2015 ◽  
Vol 6 (4) ◽  
pp. 6-10
Author(s):  
I. S Skopets ◽  
N. N Vezikova ◽  
I. M Marusenko ◽  
O. Yu Barysheva
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Family History ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Life Threatening ◽  
Traditional Risk Factors ◽  
Long Term Prognosis

A number of studies demonstrate that patients with traditional risk factors (TRF) have not only increases primary risk of atherothrombotic events, but are also associated with many complicates and poor prognosis.Purpose: assessment of TRF effect on the incidence of complications and outcomes in patients with acute coronary syndrome (ACS).Materials and methods: in 255 patients hospitalized with ACS were retrospective determined the TRF prevalence, frequency of the complications and correlation between the presence of TRF and the risk of complications and long-term prognosis (follow-up 1 year).Results: patients had TRF very often, 80% patients had more than 3 TRFs. The presence of some TRFs (smoking, abdominal obesity, family history) was associated with a significantly increased risk of complications in patients with ACS, including life-threatening. Effect of TRF on long-term prognosis was not determined.Conclusion: the findings suggest the need to evaluation TRF not only in primary preventive and also to improve the effectiveness of risk stratification in patients with ACS.

scholarly journals Long-term prognostic outcomes in patients with haemoptysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michele Mondoni ◽  
Paolo Carlucci ◽  
Giuseppe Cipolla ◽  
Matteo Pagani ◽  
Francesco Tursi ◽  
...  
Keyword(s):  
Lung Neoplasm ◽  
P Value ◽  
Recurrence Rates ◽  
Risk Of Death ◽  
Increased Risk ◽  
Anticoagulant Drugs ◽  
Life Threatening ◽  
Risk Factors For Recurrence

Abstract Background Haemoptysis is a challenging symptom that can be associated with potentially life-threatening medical conditions. Follow-up is key in these patients to promptly detect new or misdiagnosed pathologic findings. Few prospective studies have evaluated long-term prognostic outcomes in patients with haemoptysis. Furthermore, the role played by antiplatelet and anticoagulant drugs on mortality and recurrence rates is unclear. The aim of this study was to assess mortality after 18 months of follow-up. Furthermore, the incidence of recurrence and the risk factors for recurrence and death were evaluated (including the role played by anticoagulant and antiplatelet drugs). Methods Observational, prospective, multicentre, Italian study. Results 451/606 (74.4%) recruited patients with haemoptysis completed the 18 months follow-up. 22/604 (3.6%) diagnoses changed from baseline to the end of the follow-up. 83/604 (13.7%) patients died. In 52/83 (62.7%) patients, death was the outcome of the disease which caused haemoptysis at baseline. Only the diagnosis of lung neoplasm was associated with death (OR (95%CI): 38.2 (4.2–347.5); p-value: 0.0001). 166 recurrences were recorded in 103/604 (17%) patients. The diagnosis of bronchiectasis was significantly associated with the occurrence of a recurrence (OR (95% CI): 2.6 (1.5–4.3)); p-value < 0.0001). Anticoagulant, antiaggregant, and anticoagulant plus antiaggregant drugs were not associated with an increased risk of death and recurrence. Conclusions Our study showed a low mortality rate in patients with haemoptysis followed-up for 18 months. Pulmonary malignancy was the main aetiology and the main predictor of death, whereas bronchiectasis was the most frequent diagnosis associated with recurrence. Antiplatelet and/or anticoagulant therapy did not change the risk of death or recurrence. Follow-up is recommended in patients initially diagnosed with lower airways infections and idiopathic bleeding. Trial registration: NCT02045394

Respiratory conditions

2018 ◽  
pp. 165-194
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Respiratory Disease ◽  
Adult Population ◽  
Health Condition ◽  
Summary Table ◽  
Surgical Interventions ◽  
Clinical Investigations ◽  
Specialist Nurses ◽  
Respiratory Conditions ◽  
Short Section

Respiratory conditions can be an acute health problem or a long-term and debilitating health condition. They are common in the adult population, and many aspects of respiratory care are carried out by advanced practitioners and specialist nurses. General adult nurses are likely to encounter people with respiratory disease across all care settings. This chapter outlines key facts about respiratory disease which are likely to be useful to the general nurse. These include an overview of acute and chronic respiratory conditions and a summary of associated clinical investigations and treatment approaches, including a section on oxygen therapy. The chapter also has a short section on key facts related to surgical interventions. Key nursing considerations for working with people with respiratory disease, in hospital and at home, are outlined, and an overview of frequently prescribed medicines is presented in a summary table.

X-linked thrombocytopenia (XLT) due to WAS mutations: clinical characteristics, long-term outcome, and treatment options

Blood ◽  
2010 ◽  
Vol 115 (16) ◽  
pp. 3231-3238 ◽  
Author(s):  
Michael H. Albert ◽  
Tanja C. Bittner ◽  
Shigeaki Nonoyama ◽  
Lucia Dora Notarangelo ◽  
Siobhan Burns ◽  
...  
Keyword(s):  
Severe Disease ◽  
Treatment Options ◽  
Gene Mutations ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Increased Risk ◽  
Life Threatening ◽  
Severe Infections

Abstract A large proportion of patients with mutations in the Wiskott-Aldrich syndrome (WAS) protein gene exhibit the milder phenotype termed X-linked thrombocytopenia (XLT). Whereas stem cell transplantation at an early age is the treatment of choice for patients with WAS, therapeutic options for patients with XLT are controversial. In a retrospective multicenter study we defined the clinical phenotype of XLT and determined the probability of severe disease-related complications in patients older than 2 years with documented WAS gene mutations and mild-to-moderate eczema or mild, infrequent infections. Enrolled were 173 patients (median age, 11.5 years) from 12 countries spanning 2830 patient-years. Serious bleeding episodes occurred in 13.9%, life-threatening infections in 6.9%, autoimmunity in 12.1%, and malignancy in 5.2% of patients. Overall and event-free survival probabilities were not significantly influenced by the type of mutation or intravenous immunoglobulin or antibiotic prophylaxis. Splenectomy resulted in increased risk of severe infections. This analysis of the clinical outcome and molecular basis of patients with XLT shows excellent long-term survival but also a high probability of severe disease-related complications. These observations will allow better decision making when considering treatment options for individual patients with XLT.

scholarly journals Ultra-trail: Ultra-Health?

2019 ◽  
Vol 67 (3) ◽  
Keyword(s):  
Grey Literature ◽  
Traumatic Injury ◽  
Exercise Duration ◽  
Health Issues ◽  
Long Term Effects ◽  
Increased Risk ◽  
Inflammatory State ◽  
Enzyme Elevation ◽  
Psychological Dimensions

Background: The development of Mountain Ultra Marathon (MUM) raises several questions to health professionals, regarding the short or long-term consequences on the health of participants. Objective: to present the main acute and long-term effects of MUM on the main health issues usually studied among runners. Methods: Pragmatic review of the literature, including grey literature from the medical staff of the races, notably the Ultra-trail du Mont Blanc. Results: Concerning the acute effects, many studies show a severe transient inflammatory state, in particular related to eccentric loads encountered in downhill running, sometimes leading to an extracellular accumulation of water and to a muscular or even renal functional alteration, worsened when NSAIDs are used during the race. Structured and specific training seems to reduce this risk. Transient impairment of cardiac function and cardiac enzyme elevation are often discussed, but not related to symptoms in healthy subjects. In the long term, osteoarticular symptoms appear to be primarily related to a previous traumatic injury, such as ACL tear, rather than to the training load. Cardiac adaptations are similar to those of the “athlete’s heart” described in endurance athletes, which can lead to an increased risk of arrhythmias, usually benign, when training planning is too intensive. This point seems crucial to avoid over-training, and sometimes addiction to sport, whose prevalence seems worrying in this environment. Discussion: MUM is characterized by a long exercise duration but low intensity, which limits the duration of acute damage. The effects of the inflammation state that could become chronic in case of accumulation of races remain uncertain for health. New longitudinal studies are therefore needed, including behavioural and psychological dimensions.

scholarly journals Long-term Prognostic Outcomes in Patients With Hemoptysis

2021 ◽  
Author(s):  
Michele Mondoni ◽  
Paolo Carlucci ◽  
Giuseppe Cipolla ◽  
Matteo Pagani ◽  
Francesco Tursi ◽  
...  
Keyword(s):  
Lung Neoplasm ◽  
P Value ◽  
Recurrence Rates ◽  
Factors Associated ◽  
Risk Of Death ◽  
Increased Risk ◽  
Anticoagulant Drugs ◽  
Life Threatening

Abstract Background: Hemoptysis is a challenging symptom which can be associated with potentially life-threatening medical conditions. Follow-up is key in these patients to early detect new or misdiagnosed pathologic findings. Few prospective studies evaluated long-term prognostic outcomes. Furthermore, the role played by antiplatelet and anticoagulant drugs on mortality and recurrence rates is unclear.The aim of the study was to assess the mortality after 18 months of follow-up; furthermore, it was evaluated the incidence of recurrences and the factors associated with both recurrence and death (including the role played by anticoagulant and antiplatelet drugs).Methods: Observational, prospective, multicentre, Italian study.Results: 451/606 (74.4%) recruited patients with hemoptysis completed the 18 months follow-up.22/604 (3.6%) diagnoses changed from baseline to the end of the follow-up. 83/604 (13.7%) patients died. In 52/83 (62.7%) patients, death was the outcome of the disease which caused hemoptysis at baseline. Only the diagnosis of lung neoplasm was associated with death (OR (95%CI): 38.2 (4.2-347.5); p-value: 0.0001).166 recurrences were recorded in 103/604 (17%) patients. The diagnosis of bronchiectasis was significantly associated with the occurrence of a recurrence (OR (95% CI): 2.6 (1.5-4.3)); p-value <0.0001).Anticoagulant, antiaggregant, and anticoagulant plus antiaggregant drugs were not associated with an increased risk of death and recurrence.Conclusions: Our study showed a low mortality rate in patients with hemoptysis followed-up for 18 months. Pulmonary malignancy is the main etiology and the main predictor of death, whereas bronchiectasis is the most frequent diagnosis associated with recurrence. Antiplatelet and/or anticoagulant therapy do not change the risk of death or recurrence. Follow-up is recommended in patients initially diagnosed with lower airways infections and idiopathic bleedings.Clinical trial registration: NCT02045394.

scholarly journals Risk Factors for Invasive Aspergillosis in Patients Admitted to the Intensive Care Unit With Coronavirus Disease 2019: A Multicenter Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiqian Xu ◽  
Xiaobo Yang ◽  
Zheng Lv ◽  
Ting Zhou ◽  
Hong Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Invasive Mechanical Ventilation ◽  
Invasive Pulmonary Aspergillosis ◽  
Corticosteroid Treatment ◽  
Clinical Criteria ◽  
Increased Risk ◽  
Life Threatening ◽  
Vasopressor Use

Background: Invasive pulmonary aspergillosis (IPA) is a life-threatening complication in coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs), but risk factors for COVID-19-associated IPA (CAPA) have not been fully characterized. The aim of the current study was to identify factors associated with CAPA, and assess long-term mortality.Methods: A retrospective cohort study of adult COVID-19 patients admitted to ICUs from six hospitals was conducted in Hubei, China. CAPA was diagnosed via composite clinical criteria. Demographic information, clinical variables, and 180-day outcomes after the diagnosis of CAPA were analyzed.Results: Of 335 critically ill patients with COVID-19, 78 (23.3%) developed CAPA within a median of 20.5 days (range 13.0–42.0 days) after symptom onset. Compared to those without CAPA, CAPA patients were more likely to have thrombocytopenia (50 vs. 19.5%, p &lt; 0.001) and secondary bacterial infection prior to being diagnosed with CAPA (15.4 vs. 6.2%, p = 0.013), and to receive vasopressors (37.2 vs. 8.6%, p &lt; 0.001), higher steroid dosages (53.9 vs. 34.2%, p = 0.002), renal replacement therapy (37.2 vs. 13.6%, p &lt; 0.001), and invasive mechanical ventilation (57.7 vs. 35.8%, p &lt; 0.001). In multivariate analysis incorporating hazard ratios (HRs) and confidence intervals (CIs), thrombocytopenia (HR 1.98, 95% CI 1.16–3.37, p = 0.012), vasopressor use (HR 3.57, 95% CI 1.80–7.06, p &lt; 0.001), and methylprednisolone use at a daily dose ≥ 40 mg (HR 1.69, 95% CI 1.02–2.79, p = 1.02–2.79) before CAPA diagnosis were independently associated with CAPA. Patients with CAPA had longer median ICU stays (17 days vs. 12 days, p = 0.007), and higher 180-day mortality (65.4 vs. 33.5%, p &lt; 0.001) than those without CAPA.Conclusions: Thrombocytopenia, vasopressor use, and corticosteroid treatment were significantly associated with increased risk of incident IPA in COVID-19 patients admitted to ICUs. The occurrence of CAPA may increase the likelihood of long-term COVID-19 mortality.

Physical Activity and Colon Cancer

2012 ◽  
Vol 6 (3) ◽  
pp. 204-215 ◽  
Author(s):  
Terry Boyle
Keyword(s):  
Physical Activity ◽  
Colon Cancer ◽  
Risk Factor ◽  
Sedentary Behavior ◽  
Convincing Evidence ◽  
Increased Risk ◽  
Reduce Risk ◽  
Intense Activity ◽  
Reduced Risk

Despite the convincing evidence that physical activity reduces the risk of colon cancer, there are some aspects of the association that remain unclear. These include the appropriate timeframe of exposure, whether the intensity of physical activity matters, and whether sedentary behavior is a distinct risk factor. This review summarized the research that has investigated these issues. In terms of timing, physical activity at any age (with the exception of physical activity performed up to and including the late teens) has been shown to be associated with a significantly reduced risk of colon cancer. Physical activity performed between 30 and 50 years of age, as well as long-term or lifetime physical activity, has been most consistently shown to reduce risk. For intensity, research to date suggests that more intense activity (particularly vigorous activity) may be associated with a greater reduction in the risk of colon cancer for males but not for females. Finally, most of the studies that have investigated the effect of sedentary behavior on the risk of colon or colorectal cancer have shown an increased risk, suggesting that sedentary behavior may be a distinct risk factor for colon cancer.

scholarly journals On Nurses, Mental Health & Caring for the Carers

2020 ◽  
Vol 13 (3) ◽  
Author(s):  
Pardina Samson-Fessale
Keyword(s):  
Healthcare Workers ◽  
Healthcare Systems ◽  
Daily Basis ◽  
Allied Health Professionals ◽  
The Public ◽  
Increased Risk ◽  
Personal Experiences ◽  
The Many ◽  
The Uk

The COVID-19 pandemic has stretched the resources of healthcare systems across the world, as professionals work to treat the public with the scant evidence available. This has resulted in the loss of many essential workers' lives, with the loss of over 119 healthcare workers' lives in the UK as of April of this year. Adding the loss of colleagues to the many difficulties associated with working in healthcare, and the increased risk to their lives and the lives of their loved ones will undoubtedly compound the burnout already felt by nurses on a daily basis The author uses her own personal experiences to explore the themes brought up in current research, as well as looking at suggestions of how to support nurses and allied health professionals both in the immediacy and in the long term.

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