scholarly journals Saved by a syncretic faith? A case from 1995

2021 ◽  
pp. 01-03
Author(s):  
Anurag Bhargava

Physicians in countries like India have to take on the care of seriously ill patients that, in a strict sense, maybe beyond their means to handle. They do so often because their patients trust them or the institutions that they may be a part of. The author reflects on his stint as a young physician in a rural medical college in Gujarat in the 1990s. He narrates the experience of dealing with a critically ill young man brought by road from a hospital in Bombay, 500 km away, to his hometown. The patient survived because the correct diagnosis was reached, and the family assisted in his intensive care with a remarkable composure which owed its origins to a faith crossing the boundaries of religion.

2012 ◽  
Vol 61 (1) ◽  
Author(s):  
José Luis Pérez Requejo ◽  
Justo Aznar Lucea

Mai prima d’ora i pazienti gravemente malati o con malattie incurabili o croniche, sono stati così esposti a organizzazioni mediche senza scrupoli, che approfittando del loro logico disagio e della loro preoccupazione promettono cure miracolose e trattamenti, facendo pagare enormi somme di denaro per procedure senza alcuna garanzia, alcun reale beneficio e, peggio ancora, con gravi rischi per la salute. Questo articolo discute alcuni casi di pazienti che hanno pagato con la loro salute, spesso irrimediabilmente, o in maniera catastrofica, gli effetti di terapie teoricamente avanzate con cellule staminali di alcuni centri. Ci si è riferiti a diversi paesi che, in tempi anche non remoti, offrono e praticano qualcuno di questi trattamenti, il più delle volte attraverso strategie di marketing dirette e aggressive per i pazienti o le loro famiglie, mostrando reale o fittizi rapporti relativi ad altri pazienti, ma senza previ studi scientifici che avvalorino i risultati dei presunti benefici. In questo articolo, discutiamo alcuni utili suggerimenti e linee guida internazionali per riconoscerli ed evitarli. Inoltre, abbiamo discusso in dettaglio le ragioni specifiche per cui la maggior parte dei medici e clinici sollevino dei dubbi sulla competenza e le ragioni etiche di questi centri e scoraggino i viaggi di questo “turismo medico”. È sempre consigliabile chiedere il consiglio del medico di famiglia o specialista, prima della decisione dei pazienti di ricevere trattamenti dubbi, con la certezza che il paziente avrà sempre la sua comprensione e il supporto emotivo e medico. ---------- Never before seriously ill patients with chronic or incurable diseases have been so exposed to unscrupulous medical organizations that, taking advantage of their logical distress and worry, promise miracle cures and treatments and charge them huge amounts of money for procedures with no guarantee, no real benefits and, even worse, with serious risks to their health. This paper discusses some cases of patients who paid with their health, often irreparably, or catastrophically, the effects of supposedly advanced therapy centers with stem cells. Several countries are mentioned, not always as remote, which offer and practice any of these treatments, most often by direct and aggressive marketing to patients or their families, showing real or fictional accounts of other patients, but without the previous studies and scientific papers that endorse their supposed beneficial results. In this article we discuss some useful hints and international guidelines to recognize and avoid them. Also, we discussed in detail the specific reasons why most doctors and clinics doubt about the competence and ethical reasons of these centers and discourage those “medical tourism” trips. It is always advisable to seek the advice of the family doctor or specialist in charge, before the patients decision to receive dubious treatments, with the assurance that, decide what the patient decide, they will have always his understanding and his emotional and medical support.


2021 ◽  
pp. 95-105
Author(s):  
L. K. Karimova ◽  
V. O. Belash

The survival rate of children who require intensive care for life-threatening diseases or injuries has recently increased significantly. In pediatric intensive care, a decrease in mortality is accompanied by an increase in morbidity. This trend has led to a shift in focus of attention from reducing mortality to optimizing outcomes in critically ill patients. A broader approach and focus on outcome in critically ill survivors has been greatly facilitated by the development of a concept that integrates post-intensive care (PIC) diseases into Post Intensive Care Syndrome (PICS). The concept of PIC syndrome implies the occurrence of disorders in patients after IC in three main areas: mental health, cognitive functions and physical health, and also takes into account the state of the family of surviving patients, in particular, parents, who often have a deterioration in mental health. Diagnosis and treatment of this condition involves the work of a multidisciplinary team, in which it is desirable to include an osteopathic doctor in order to more effectively and timely diagnose and correct reversible functional disorders.


2014 ◽  
Vol 26 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Adriana Carla Bridi ◽  
Roberto Carlos Lyra da Silva ◽  
Carolina Correa Pinto de Farias ◽  
Andrezza Serpa Franco ◽  
Viviane de Lima Quintas dos Santos

2020 ◽  
Author(s):  
Marcelo Marchesin

Abstract.In this paper I use the simple logistic mathematical model to represent the development of COVID-19 epidemic in São Paulo city under quarantine regime and I estimate the total amount of time it is necessary to decrease the number of seriously ill patients in order to reduce the demand for hospital beds of Intensive Care Units (ICU) to tolerable levels. Clearly the same reasoning and mathematical methods used in here can be used for any other city in similar conditions of social isolation.


PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 556-556
Author(s):  

Let us address ourselves to the problem of informed consent. I believe, as a physician who has had prior contact with the family, that I can persuade 99% of parents to my way of thinking if I really work at it, even if I am 100% wrong. If I tell them in such a way that I appear concerned and that I am knowledgeable and that I have their interests at heart and the interest of their foetus or their newborn baby, there is no question they will be totally agreeable to my suggestion. I think informed consent is an absolute farce, legalistically, morally and ethically. The information is what I want it to be. Certainly, the physician must try to involve the parents in decision making. He should do so to the maximum extent feasible, but we are fooling ourselves if we believe that the parent or the physician can make all the decisions.—Director of a Neonatal Intensive Care Unit.


1991 ◽  
Vol 2 (2) ◽  
pp. 316-320
Author(s):  
Thomas Allen Frelchels

The needs of family members with a critically ill relative present a significant challenge to nursing professionals in the intensive care unit. Initially, interventions aimed at providing focused information and relieving anxiety take precedence. As the crisis period passes, however, the family may need to reestablish familiar patterns of functioning. Thus, family assessment and intervention is vital throughout the course of the patient’s hospitalization. This article examines how a medical-respiratory intensive care unit has applied family need research in designing and implementing an ongoing family-based plan of care


1999 ◽  
Vol 43 (5) ◽  
pp. 1277-1280 ◽  
Author(s):  
Douglas N. Fish ◽  
Edward Abraham

ABSTRACT The pharmacokinetics of clarithromycin and its 14-(R)-hydroxylated metabolite were studied on two separate occasions after nasogastric administration of 500 mg of a clarithromycin suspension to 16 seriously ill adults in an intensive care unit. The clarithromycin suspension appeared to be adequately absorbed, and the pharmacokinetics of neither clarithromycin nor 14-(R)-hydroxyclarithromycin differed significantly between the two dosing periods. No substantial differences in pharmacokinetics were observed compared to previously published studies of other adult populations. Minimal intrapatient variability of pharmacokinetic parameters was observed in these seriously ill patients.


2017 ◽  
Vol 06 (04) ◽  
pp. 240-244 ◽  
Author(s):  
Kyle Galbraith ◽  
Kyle Brothers ◽  
Trevor Bibler

AbstractWho decides when a child is dead? The story of Jahi McMath has brought this question into focus for pediatric intensivists, ethicists, and the American public. In this article, we address this question by arguing that medical professionals do not have an obligation to acquiesce when families insist upon postmortem therapies. To do so may harm the dignity of the child by subjecting him or her to procedures that objectify the body, damage the child's reputation, and violate his or her privacy. Applying this answer to the real world of pediatric intensive care, we suggest practices meant to preserve the dignity of the child while accepting that the family is struggling to understand the tragedy. Muddled communication or an unyielding attitude will fail to help the family understand and cope with the death of their young loved one. Clear and honest communication—in conjunction with an empathetic disposition—can improve pre- and postmortem care for both patient and family.


1995 ◽  
Vol 109 (7) ◽  
pp. 640-643 ◽  
Author(s):  
V. Nandapalan ◽  
J. C. McIlwain ◽  
J. Hamilton

AbstractThis study was undertaken to assess any salivary aspiration in seriously ill patients with tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheobronchial secretions of 15 such patients were analysed to evaluate the incidence of salivary aspiration. None of the patients had clinical or radiological evidence of lung disorder at the time of the commencement of the study. Six out of 15 patients showed very high levels of alpha-amylase activity in their tracheobronchial secretions on Day 3 and all six subsequently developed severe chest infections. The other nine patients showed a low level of amylase activity in their secretions. Two patients in the latter group developed severe pulmonary disease. This study demonstrates that a high level of alpha-amylase activity in the tracheobronchial secretions of tracheotomized, ventilated patients indicates that salivary aspiration may be taking place, and further suggests that progressively increasing levels may indicate the likelihood of a major pulmonary complication developing.


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