Nocturnal Traction: Techniques Used for Hair Style Maintenance while Sleeping May Be a Risk Factor for Traction Alopecia

2021 ◽  
pp. 1-4
Author(s):  
Aman Samrao ◽  
Amy McMichael ◽  
Paradi Mirmirani
Keyword(s):  
Health Care Providers ◽  
Hair Loss ◽  
Early Recognition ◽  
Care Providers ◽  
Risk Patients ◽  
Curly Hair ◽  
Hair Care ◽  
Care Practices ◽  
High Index Of Suspicion ◽  
Chronic Use

Background: Traction alopecia (TA) is a preventable form of hair loss that most commonly affects women. It is the result of chronic use of hairstyles that put tension on hair. Public health efforts to increase awareness of this condition are critical. Early recognition by health care providers, along with counseling and cessation of offending hair care practices can impact severity of hair loss. Objectives: In a patient with patchy hair loss, having a high index of suspicion for TA and looking for clues in the history and exam, can help establish an accurate diagnosis. Methods: Patients with afro-textured or curly hair may use various techniques to maintain their hairstyles while sleeping in order to avoid time-consuming and/or expensive hair care. This behavior is not commonly recognized or addressed. Results and Conclusions: Increased awareness of “nocturnal traction” and asking patients “How do you wear your hair when you sleep?” may help identify at-risk patients.

Treating Afro hair loss: signs, symptoms and specialist interest

2021 ◽  
Vol 10 (5) ◽  
pp. 190-197
Author(s):  
Ingrid Wilson
Keyword(s):  
Black Women ◽  
Hair Loss ◽  
Factors Affecting ◽  
Different Types ◽  
Recent Developments ◽  
Hair Care ◽  
Care Practices ◽  
The Aesthetic ◽  
The Impact ◽  
Symptoms And Signs

This article explores the different types of hair loss that black women may experience more than other groups of patients. Properties of African hair and the impact of hair care practices are discussed, as well as factors affecting the presentation of other hair loss conditions. It is important for the aesthetic practitioner to be able to distinguish between the temporary forms of hair loss that they can help to treat and the permanent or scarring forms of hair loss, which need a prompt referral to a dermatologist with a specialist interest in hair. Prompt recognition and referral can help to delay the progression of hair loss. The symptoms and signs that patients and practitioners should be alerted to are explored, as well as the treatments that can help and where referrals may be necessary. Recent developments and gaps in knowledge are summarised.

scholarly journals The impact of using primaquine without prior G6PD testing: a case series describing the obstacles to the medical management of haemolysis

2019 ◽  
Vol 4 ◽  
pp. 25 ◽  
Author(s):  
Cindy S. Chu ◽  
Germana Bancone ◽  
Nay Lin Soe ◽  
Verena I. Carrara ◽  
Gornpan Gornsawun ◽  
...  
Keyword(s):  
Health Care Providers ◽  
G6pd Deficiency ◽  
Case Series ◽  
Radical Cure ◽  
Care Providers ◽  
Medical Treatments ◽  
Normal Individuals ◽  
High Index Of Suspicion ◽  
Glucose 6 Phosphate Dehydrogenase ◽  
The Impact

Radical cure of Plasmodium vivax malaria in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals employs weekly primaquine dosing. This is the only recommended regimen for this patient sub-group. If national malaria programs mandate daily primaquine dosing (the recommended regimen for G6PD normal individuals), then G6PD testing before prescription is necessary to avoid iatrogenic haemolysis in G6PD deficient individuals. In this case series, two P. vivax infected patients with unknown G6PD status from two different countries were prescribed primaquine as per national malaria program guidelines. During treatment both patients presented to the clinic with symptoms of anaemia after taking primaquine incorrectly. The clinical management of the iatrogenic severe haemolysis that occurred in these patients demonstrates the various adverse effects primaquine can cause, that other common medical treatments also have haemolytic potential, and how the diagnosis of G6PD deficiency can be elusive during acute haemolysis. Health care providers should provide careful instructions about primaquine dosing, be watchful for haemolysis, and have a high index of suspicion for G6PD deficiency in the presence of haemolysis if the G6PD status is previously unknown.

Immune-related adverse events associated with immune checkpoint inhibitors in patients with cancer

2020 ◽  
pp. 030089162095346
Author(s):  
Nilay Sengul Samanci ◽  
Duygu Ilke Cikman ◽  
Kerem Oruc ◽  
Sahin Bedir ◽  
Emir Çelik ◽  
...  
Keyword(s):  
Adverse Events ◽  
Health Care Providers ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Early Recognition ◽  
Care Providers ◽  
Patients With Cancer ◽  
Combination Treatments ◽  
Grade 3

Introduction: With the widespread use of immune checkpoint inhibitors (ICIs), we are facing challenges in the management of immune-related adverse events (irAEs). We aimed to characterize the spectrum of toxicity, management, and outcomes for irAEs. Methods: Patients who were treated with at least one ICI in clinical trials, expanded access programs, or routine clinical practice were included. Clinical and laboratory parameters were collected retrospectively to determine the incidence of irAEs, methods of management, and treatment outcomes. Results: A total of 255 patients were screened retrospectively. Of these, 71 (27.8%) patients developed irAEs. More than 2 different types of irAEs were detected in 16 (6.2%) out of 255 patients. A total of 3177 doses were given to 255 patients. In 93 (2.9%) of the 3177 doses, 1 episode of irAEs was experienced. A total of 22 out of 93 (23.7%) episodes were reported as grade 1, 49 (52.7%) as grade 2, 19 (20.4%) as grade 3, and 3 (3.2%) as grade 4. The most frequently seen irAEs were pneumonitis, hepatitis, and hypothyroidism. With regard to treatment, 39 out of 93 episodes (42%) of any grade irAEs occurred after anti–programmed cell death-1 therapy, 47 (50.5%) occurred following administration of anti–programmed death-ligand 1, and 7 (7.5%) occurred after combination treatments. Conclusion: With the increased use of immunotherapeutic agents, increased awareness and early recognition are required for effective management of irAEs. Our experience as a single institution might be of use for health care providers in oncology.

scholarly journals Experiences of Young Children With Cancer and Their Parents With Nurses’ Caring Practices During the Cancer Trajectory

2019 ◽  
Vol 37 (1) ◽  
pp. 21-34 ◽  
Author(s):  
Karin Enskär ◽  
Laura Darcy ◽  
Maria Björk ◽  
Susanne Knutsson ◽  
Karina Huus
Keyword(s):  
Young Children ◽  
Health Care Providers ◽  
Care Plan ◽  
Care Providers ◽  
Children With Cancer ◽  
Nurse Care ◽  
Care Processes ◽  
Care Practices ◽  
Oncology Unit

Children with cancer require repeated hospitalizations and the family’s everyday life and routines undergo change. Concrete descriptions of how nurses act when caring for children with cancer throughout the various phases of care and treatment are sparsely highlighted in the literature. The aim of this study was to describe young children with cancer and their parents’ experiences of nurses’ caring practices over a 3-year period, from diagnosis to follow-up. This study is based on semistructured interviews with 25 children newly diagnosed with cancer, aged 1 to 6 years, and their parents, connected to a pediatric oncology unit in Sweden. Child and parent data were analyzed with a deductive content analysis using Swanson’s theory of caring. The result shows that nurse care practices directed toward young children with cancer and their parents are to some extent similar across a 3-year period from diagnosis to follow-up but also differ in some ways. Nurses’ caring practices aim to support children and parents in the transition to a “new normal.” Child- and family-friendly care processes include the following: creating hope and a trustful relationship, asking rather than assuming, providing knowledge and information, performing tasks skillfully, displaying an interest in the child’s and parents’ life outside the hospital, and helping the family to trust in the future and other health care providers. Based on these results, we recommend the development of a standardized and structured nursing care plan or clinical guideline with detailed information on how to carry out clinical nurse care practices in the different phases.

Pain Associated With Continuous Intravenous Infusion of Bumetanide: A Case Series

2021 ◽  
Vol 41 (2) ◽  
pp. 44-50
Author(s):  
Lori B. Herges ◽  
Jacob C. Jentzer ◽  
Diane D. Brighton ◽  
Joseph R. Herges ◽  
Narith N. Ou
Keyword(s):  
Health Care ◽  
Adverse Event ◽  
Continuous Infusion ◽  
Health Care Providers ◽  
Early Recognition ◽  
Case Series ◽  
Clinical Findings ◽  
Care Providers ◽  
Comfort Care ◽  
Patient Reported

Introduction Bumetanide can induce generalized musculoskeletal pain when administered as a continuous infusion, an effect that may be underrecognized. The purpose of this case series is to educate health care providers about the incidence and presentation of pain associated with bumetanide infusions, adding to the existing literature describing this adverse event. Clinical Findings Of 40 critically ill patients, 15 (38%) had increased pain scores after initiation of a continuous infusion of bumetanide, with symptoms commonly occurring 12 to 24 hours after initiation of the infusion. Reported descriptions of the pain included generalized aching, soreness, burning, allodynia, headaches, and exacerbation of underlying pain in localized areas. Increases in patient-reported pain correlated directly with initiation of the continuous infusion of bumetanide. Diagnosis Four of the 15 bumetanide-associated pain events (27%) were recognized as such by the health care team. Interventions Bumetanide was promptly discontinued in the 4 identified cases. The 11 patients (73%) whose pain was not recognized as related to bumetanide remained on a continuous infusion of bumetanide and received pain medications including opioids. Infusions were stopped when patients transitioned to dialysis (n = 8 [53%]), began receiving comfort care (n = 5 [33%]), or completed diuresis therapy (n = 2 [13%]). Outcomes For all patients, pain symptoms resolved within 24 to 48 hours after discontinuation of bumetanide infusion with no significant electrolyte abnormalities. Conclusion Bumetanide-induced pain is more common than previously described. Early recognition of this adverse event can prevent patient discomfort and escalation of treatment.

scholarly journals Leveraging an Ambulatory Patient and Family Advisory Council to Improve Patient Experience Scores

2021 ◽  
Vol 8 ◽  
pp. 237437352110393
Author(s):  
Susan Y. Lee
Keyword(s):  
Quality Improvement ◽  
Patient Experience ◽  
Health Care Providers ◽  
Advisory Council ◽  
Care Providers ◽  
Ambulatory Patient ◽  
Care Practices ◽  
Primary Care Practices ◽  
Consumer Assessment ◽  
Improve Patient

Reports have shown that ambulatory primary care practices that include patients and families in their quality improvement efforts have many benefits including better relationships and interactions with patients. In this paper, we describe our experience of involving our patients, family, and staff who are members of or Patient and Family Advisory Council (PFAC) in our quality improvement efforts related to patient experience. For a year, members of the PFAC suggested creative implementations to our office policies and workflow to improve satisfaction scores on the Clinician and Group Consumer Assessment of Health care Providers and Systems survey in key areas: information about delays, wait times in clinic, and convenience of appointments.

scholarly journals AWARENESS OF MOTHER WITH BABY PACIFIER

2021 ◽  
Vol 9 (07) ◽  
pp. 516-525
Author(s):  
Yasmine Tarek ◽  
Shymah AlMubarak ◽  
Zahraa Aljassem ◽  
Sajidah Al_Aliwi ◽  
Maryam Albagshi
Keyword(s):  
Breast Feeding ◽  
Health Care Providers ◽  
Hospital Setting ◽  
First Year ◽  
Care Providers ◽  
Nutritive Sucking ◽  
Care Practices ◽  
Calming Effect ◽  
Breast Fed ◽  
Pacifier Use

Introduction: Pacifiers consist of a latex or silicone nipple with a firm plastic shield and handle and are available in different forms and sizes. This is used in infant for colling and calming effect on infant however, it is related to many disadvantage and side effect on teeth of the infants. In this study we aimed to a Assess the interrelation between different on-nutritive sucking habits, pacifier use and thumb/digit sucking. Besides, Investigate the relationships between various non-nutritive sucking habits and occlusion in the primary dentition. Methodology: Following a comprehensive literature review, the questionnaire was designed and used for data collection. Then, a cross‐sectional survey was distributed throughout the internet for two months (October - November 2019) to 200 mothers in Riyadh, Saudi Arabia. The mothers answered 16 questions, where 5 of them were self-administered, while the others followed the pacifier and their effect on Breastfeeding and teeth. Initially, the participants have answered inquiries about the demographic information. Results: The results of our study include 202 mothers in which 55.9 % were between 18 -30 years old while 88.6 % of married while 6.4 % were widowed and the rest were divorced. Moreover, 67.3 % of mothers in this study started breast feeding but stopped it, while 15.3 % still breast feeding partially, 12.9 % still breasting feeding exclusively and 4.5 % never breast fed during the process of the survey. 58.9 % of mothers agree about the use of pacifier with their infants where younger mothers were more intended to agree about using of pacifier. Considering the reason behind using of pacifier, mothers reported that 74.3 % of mothers using pacifier because of its comfort or soothing effect. Moreover, 47.1 % of the sample thought that best time to start using pacifiers is from first week of birth and 49 % of mothers in this study thought that pacifier should be used for 4 hours per day. Finally, most of mother thought that the ideal time of pacifier cessation before the first year (45%). Conclusion: As with all infant care practices, there may be multiple factors influencing the parental decision to use or not use a pacifier for the infant. Some of these factors (e.g., concerns about nipple confusion, dental concerns) may be the result of misinformation. As pacifier use has been associated with a reduced risk for SIDS, it is important for health care providers to understand and be able to address the concerns that parents may have about pacifier use. In the hospital setting, providers should be aware that parents may have strong preferences about getting educated regarding pacifier use and its consequences.

Het medisch aansprakelijkheidssysteem en defensief gedrag in België

2021 ◽  
Author(s):  
K. DANIELS ◽  
T. VANDERSTEEGEN ◽  
W. MARNEFFE ◽  
L. DE WILDE
Keyword(s):  
Health Care Providers ◽  
Healthcare Providers ◽  
Defensive Medicine ◽  
The Other ◽  
Medical Liability ◽  
Care Providers ◽  
Defensive Behaviour ◽  
Risk Patients ◽  
Malpractice Liability ◽  
The One

The medical liability system and defensive behaviour in Belgium The aim of the medical liability system is, on the one hand, providing adequate compensation to victims of medical incidents and, on the other hand, incentivising health care providers to adopt sufficient care. However, the fear of healthcare providers for being involved in a liability procedure in case of a medical incident may cause them to practice defensive medicine. Defensive medicine is defined as the ordering of more tests, procedures and visits (assurance behaviour) or the avoidance of high-risk patients or procedures (avoidance behaviour), primarily (but not necessarily solely) to reduce the exposure to malpractice liability. Although various foreign studies assess the prevalence of defensive medicine, it is not yet sufficiently clear to what extent Belgian physicians act defensively in practice. A survey conducted in 2015 among 90 specialist physicians indicates that the medical liability system in Belgium may have an influence on their clinical practice and decision-making. However, additional research is necessary to inform policymakers about the real prevalence of defensive behaviour and its potential drivers and consequences.

Gas Embolism: Part II. Arterial Gas Embolism and Decompression Sickness

1996 ◽  
Vol 11 (5) ◽  
pp. 261-283 ◽  
Author(s):  
Mark M. Wilson ◽  
Frederick J. Curley
Keyword(s):  
Health Care Providers ◽  
Decompression Sickness ◽  
Tissue Injury ◽  
Clinical Manifestations ◽  
The Body ◽  
Care Providers ◽  
Gas Embolism ◽  
Treatment Regimens ◽  
Organ Systems ◽  
High Index Of Suspicion

Gas emboli syndromes are known to occur in many different settings, and they may result in life-threatening emergencies. Venous gas embolization was discussed previously in Part I of this review. Gas emboli that gain access to the arterial circulation or that result from exposures to decreased ambient pressures in the environment are discussed in Part II. The prevalence of arterial gas emboli and decompression sickness are likely not as high as for venous gas emboli. Most cases are preventable, and prompt treatment is frequently effective. Once present, gas bubbles generally distribute themselves throughout the body based on the relative blood flow at the time, thus making the nervous system, heart, lung, and skin the primary organ systems involved. Both mechanical and biophysical effects lead to intravascular and extracellular alterations that result in tissue injury. The clinical manifestations of these disorders are varied, and a high index of suspicion in the appropriate settings will aid health care providers in prompt recognition of these problems and allow timely intervention with specific therapy. Management of arterial gas emboli and decompression sickness is similar, with a focus on hyberbaric chamber therapy and intermittent hyperoxygenation. Recompression schedules in current use have withstood the test of time. Research continues to refine our understanding of these diseases and to optimize the treatment regimens available.

Genetic Counseling and Testing in a Community Setting: Quality, Access, and Efficiency

2019 ◽  
pp. e34-e44 ◽  
Author(s):  
Stephanie A. Cohen ◽  
Angela Bradbury ◽  
Vida Henderson ◽  
Kent Hoskins ◽  
Erica Bednar ◽  
...  
Keyword(s):  
Genetic Counseling ◽  
Health Care Providers ◽  
Community Setting ◽  
Care Providers ◽  
Counseling And Testing ◽  
Risk Patients ◽  
Diagnosis Of Cancer ◽  
Prevention Of Cancer ◽  
Improve Access ◽  
Early Detection And Prevention

There is an increasing need for genetic counseling and testing for individuals diagnosed with cancer, as treatment may be affected by the results. In addition, the identification of individuals before a diagnosis of cancer allows for optimal surveillance and early detection and prevention of cancer. With the recognition that as much as 10% of all cancers are hereditary, there is a growing need to improve access to genetic counseling and genetic testing, both before and at the time of diagnosis. This article focuses on models of identifying at-risk patients, including underserved communities; providing genetic counseling and testing in community practices; using telehealth; and collaborating with nongenetics health care providers and technological solutions to maximize efficiency and access.

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