Infant with a rapidly progressing rash

2021 ◽  
Vol 14 (1) ◽  
pp. e239353
Author(s):  
Rachelle Hancock ◽  
Ilene Rothman ◽  
Mary Kate Mannix ◽  
Shamim Islam
Keyword(s):  
Emergency Department ◽  
Healthcare Providers ◽  
Family Members ◽  
Sudden Onset ◽  
The Body ◽  
Leucocytoclastic Vasculitis ◽  
Benign Nature

An infant presented to the emergency department with sudden onset of rapidly progressing erythematous macules and distal oedema. The rash was striking in appearance, covering most of the body, which raised concern for pressing infectious (eg, meningococcaemia) and other serious aetiologies. Nevertheless, the infant remained playful and was overall stable and posed a diagnostic and management dilemma. After an extensive workup and multispecialty consultations, the patient was eventually diagnosed with acute haemorrhagic oedema of infancy, a benign leucocytoclastic vasculitis. The patient received no treatment and resolution of the rash occurred within 7 days of onset. Recognition of this condition and its benign nature can spare patients from an extensive workup and reduce anxiety for both family members and healthcare providers.

scholarly journals Internet of things issues related to psychiatry

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Scott Monteith ◽  
Tasha Glenn ◽  
John Geddes ◽  
Emanuel Severus ◽  
Peter C. Whybrow ◽  
...  
Keyword(s):  
Internet Of Things ◽  
Cognitive Abilities ◽  
Healthcare Providers ◽  
Emotional Reactions ◽  
The Body ◽  
Psychiatric Research ◽  
Main Body ◽  
Personal Safety ◽  
Healthcare Organizations ◽  
Iot Devices

Abstract Background Internet of Things (IoT) devices for remote monitoring, diagnosis, and treatment are widely viewed as an important future direction for medicine, including for bipolar disorder and other mental illness. The number of smart, connected devices is expanding rapidly. IoT devices are being introduced in all aspects of everyday life, including devices in the home and wearables on the body. IoT devices are increasingly used in psychiatric research, and in the future may help to detect emotional reactions, mood states, stress, and cognitive abilities. This narrative review discusses some of the important fundamental issues related to the rapid growth of IoT devices. Main body Articles were searched between December 2019 and February 2020. Topics discussed include background on the growth of IoT, the security, safety and privacy issues related to IoT devices, and the new roles in the IoT economy for manufacturers, patients, and healthcare organizations. Conclusions The use of IoT devices will increase throughout psychiatry. The scale, complexity and passive nature of data collection with IoT devices presents unique challenges related to security, privacy and personal safety. While the IoT offers many potential benefits, there are risks associated with IoT devices, and from the connectivity between patients, healthcare providers, and device makers. Security, privacy and personal safety issues related to IoT devices are changing the roles of manufacturers, patients, physicians and healthcare IT organizations. Effective and safe use of IoT devices in psychiatry requires an understanding of these changes.

Nursing Home Resident, Family, and Staff Perspectives on Hospital Transfers for End-of-Life Care

2021 ◽  
pp. 003022282199770
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Terminally Ill ◽  
South Florida ◽  
Care Planning ◽  
Life Care ◽  
Advance Care

Residents who are terminally ill often experience transfers to the emergency department resulting in hospitalizations, which may be potentially avoidable with treatment in the nursing home. This qualitative study explored the perspectives of 15 residents, 10 family members, and 20 nursing home staff regarding end-of-life care and the circumstances prompting resident transfers. Data analysis of participant interviews conducted January to May 2019 in a South Florida nursing home identified four themes related to transfer to the hospital: time left to live, when aggressive treatments would be unavailing, not knowing what the nursing home can do, and transfer decisions are situation-dependent. Study findings underscore the importance of increasing resident and family awareness of treatments available in the nursing home and person-centered advance care planning discussions. Further research should explore the reasons for residents’ and family members’ choice of aggressive therapies and their goals for care at the end of life.

scholarly journals Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected

2021 ◽  
Vol 43 (05) ◽  
pp. 414-416
Author(s):  
Daniela Alexandra Gonçalves Pereira ◽  
Eliana Patrícia Pereira Teixeira ◽  
Ana Cláudia Martins Lopes ◽  
Ricardo José Pina Sarmento ◽  
Ana Paula Calado Lopes
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Clinical Course ◽  
Malignant Tumors ◽  
Sudden Onset ◽  
Drug Reactions ◽  
Genital Ulceration ◽  
Sexually Transmitted ◽  
Inflammatory Processes ◽  
Genital Ulcers

AbstractThe diagnosis of genital ulcers remains a challenge in clinical practice. Lipschütz ulcer is a non-sexually transmitted rare and, probably, underdiagnosed condition, characterized by the sudden onset of vulvar edema along with painful necrotic ulcerations. Despite its unknown incidence, this seems to be an uncommon entity, with sparse cases reported in the literature. We report the case of an 11-year-old girl who presented at the emergency department with vulvar ulcers. She denied any sexual intercourse. The investigation excluded sexually transmitted infections, so, knowledge of different etiologies of non-venereal ulcers became essential. The differential diagnoses are extensive and include inflammatory processes, drug reactions, trauma, and malignant tumors. Lipschütz ulcer is a diagnosis of exclusion. With the presentation of this case report, the authors aim to describe the etiology, clinical course, and outcomes of this rare disease, to allow differential diagnosis of genital ulceration.

scholarly journals Psychological Consequences of the Delay in the Silent Mentor Programme During the COVID-19 Pandemic: Perspectives From Family Members of Silent Mentors

2021 ◽  
pp. 003022282110009
Author(s):  
Li Ping Wong ◽  
Sik Loo Tan ◽  
Haridah Alias ◽  
Thiam Eng Sia ◽  
Aik Saw
Keyword(s):  
Mental Health ◽  
Qualitative Interviews ◽  
Psychological Impact ◽  
Family Members ◽  
Well Being ◽  
The Body ◽  
Functional Health ◽  
Psychological Consequences ◽  
Negative Effect ◽  
Health And Well Being

The COVID-19 pandemic has put a hold on the Silent Mentor Programme (SMP); this pause has not only caused unprecedented challenges for the delivery of medical education but has forced changes in the programme ceremony sessions. We aimed to describe the psychological impact and experiences of family members of silent mentors during the COVID-19 pandemic using qualitative interviews. Many expressed feelings of remorse and unrest about the unprecedented delay of the SMP. The delay increased negative emotions particularly among some elderly family members; however, there was no prominent negative effect on their functional health and well-being. Several participants relayed the belief that the soul cannot rest until the body receives a proper burial while some worried about the deterioration of the physical condition of the mentors. In conclusion, findings provide insights into the importance of not overlooking the mental health implications of delaying the SMP in future outbreaks or crises.

scholarly journals Healthcare pathways and resource use: mapping consequences of ambulance assessment for direct care with alternative healthcare providers

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sofi Varg ◽  
Veronica Vicente ◽  
Maaret Castren ◽  
Peter Lindgren ◽  
Clas Rehnberg
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Resource Use ◽  
Healthcare Providers ◽  
Healthcare Utilisation ◽  
Direct Care ◽  
Care Centre ◽  
Decision System ◽  
Geriatric Ward ◽  
Patient Pathways

Abstract Background A decision system in the ambulance allowing alternative pathways to alternate healthcare providers has been developed for older patients in Stockholm, Sweden. However, subsequent healthcare resource use resulting from these pathways has not yet been addressed. The aim of this study was therefore to describe patient pathways, healthcare utilisation and costs following ambulance transportation to alternative healthcare providers. Methods The design of this study was descriptive and observational. Data from a previous RCT, where a decision system in the ambulance enabled alternative healthcare pathways to alternate healthcare providers were linked to register data. The receiving providers were: primary acute care centre or secondary geriatric ward, both located at the same community hospital, or the conventional pathway to the emergency department at an acute hospital. Resource use over 10 days, subsequent to assessment with the decision system, was mapped in terms of healthcare pathways, utilisation and costs for the 98 included cases. Results Almost 90% were transported to the acute care centre or geriatric ward. The vast majority arriving to the geriatric ward stayed there until the end of follow-up or until discharged, whereas patients conveyed to the acute care centre to a large extent were admitted to hospital. The median patient had 6 hospital days, 2 outpatient visits and costed roughly 4000 euros over the 10-day period. Arrival destination geriatric ward indicated the longest hospital stay and the emergency department the shortest. However, the cost for the 10-day period was lower for cases arriving to the geriatric ward than for those arriving to the emergency department. Conclusions The findings support the appropriateness of admittance directly to secondary geriatric care for older adults. However, patients conveyed to the acute care centre ought to be studied in more detail with regards to appropriate level of care.

scholarly journals Comparison of fit factors among healthcare providers working in the Emergency Department Center before and after training with three types of N95 and higher filter respirators

Medicine ◽  
2019 ◽  
Vol 98 (6) ◽  
pp. e14250 ◽  
Author(s):  
Hongjung Kim ◽  
Juncheol Lee ◽  
Sanghyun Lee ◽  
Jaehoon Oh ◽  
Boseung Kang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Healthcare Providers ◽  
Before And After

Abstract WP404: Stroke Cognitive Recovery Model

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Susan Alderman
Keyword(s):  
Cognitive Deficits ◽  
Cognitive Abilities ◽  
Belief Systems ◽  
Healthcare Providers ◽  
The Body ◽  
Patient Needs ◽  
Coordinated Care ◽  
Recovery Model ◽  
Cognitive Recovery ◽  
Transitional State

Background: After an acute stroke, 90% of patients have cognitive deficits; 50% remain impaired and 30% develop dementia within one year. Cognitive recovery may not occur without early and coordinated care. Many cognitive deficits, i.e. memory and neglect, are not addressed early, care is not coordinated, and depends on each institution’s guidelines. Nurses must consider all patient needs yet no holistic cognitive recovery model exists to guide them. Purpose: To create a holistic, post-stroke, patient-centered cognitive recovery model capable of guiding care. Methods: Concept synthesis is a new way of grouping or ordering information when relevant data is unclear or unknown. A concept synthesis was performed due to limitations in prior biomedical models, specifically in psychology and rehabilitation, which resulted in ill-defined terms and bias. Results: Cognitive recovery is defined as a transitional state in which a person’s cognitive abilities can be modified to approach pre-injury levels, by the interactions of personal capabilities and four encompassing Environments. Personal capabilities (acceptance, agency and congruence) are internally oriented forces which control self-care behavior. The Environments (resources or forces interacting to help/hinder recovery) are depicted as the Physical (the body), External (social support, therapists, etc.), Internal (psychiatric or emotional forces), and Created (belief systems, attitudes, etc.). Conclusions: When interactions between personal capabilities and Environments are adequate cognitive recovery will progress. Recovery should be comprehensive and nurses are uniquely qualified to ensure all aspects of the person are addressed. This model promotes collaboration among healthcare providers and guidance in identifying and addressing patient needs.

A CLINICOEPIDEMIOLOGICAL STUDY ON PAEDERUS DERMATITIS IN A TERTIARY CARE CENTRE, CHENNAI

2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sudden Onset ◽  
The Body ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Tertiary Care Centre ◽  
Linear Lesions ◽  
Paederus Dermatitis

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.

Subjects of Technology: An Auto-Archeology of Attention Deficit Disorder in Neoliberal Time(s)

2018 ◽  
Vol 19 (2) ◽  
pp. 105-115
Author(s):  
Joshua S. Hanan
Keyword(s):  
Learning Disability ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Family Members ◽  
The Body ◽  
The Self ◽  
Psychiatric Diagnoses ◽  
Critical Perspective ◽  
Close Family

This essay (re)presents my own experiences living with attention deficit disorder (ADD) as a child and adult to provide a radically historical, contextual, and critical autoethnographic conceptualization of this “learning disability.” Specifically, by building upon Ragan Fox’s “auto-archeological” method, a critical perspective that “unite[s] autoethnography and Foucault’s theories of discourse,” I draw upon institutional artifacts, psychiatric diagnoses, and interviews with close family members to show that ADD is a “technology of the self” that economizes the body in accordance with a distinctly neoliberal temporality. This temporalizing process, I show, is reinforced by a range of other neoliberal technologies of selfhood and ultimately cultivates the very “deficit framework” that ADD diagnoses are aimed at healing. The conclusion questions the legitimacy of ADD outside of the various technological interfaces that make the disability visible as a public problem and considers the intimate connections between neoliberalism, ableism, and the contemporary university.

scholarly journals Hemoperitoneum due to Splenic Laceration Caused by Colonoscopy: A Rare and Catastrophic Complication

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Shiao-Han Chen ◽  
Jiann-Ruey Ong ◽  
Hon-Ping Ma ◽  
Po-Shen Chen
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Splenic Flexure ◽  
Splenic Injury ◽  
Underlying Disease ◽  
Sudden Onset ◽  
Health Examination ◽  
Asymptomatic Patients ◽  
Grade Ii

Numerous studies suggest that in asymptomatic patients, routine follow-up CT is not indicated due to the insignificant findings found on these patients. A 53-year-old man, who denied any underlying disease before, underwent colonoscopy for routine health examination. Sudden onset of abdominal pain around left upper quarter was mentioned at our emergency department. Grade II spleen laceration was found on CT scan. Splenic injury was found few hours later on the day of colonoscopy. It might result from the extra tension between the spleen and splenic flexure which varies from different positions of patients.

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