scholarly journals A 54-Year-Old Female With Fever and Ataxia

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Marie-Lie Cadieux-Simard MD ◽  
Laurence Green MD
Keyword(s):  
Emergency Department ◽  
Urinary Incontinence ◽  
Family Member ◽  
Family Members ◽  
Gait Disturbance ◽  
Medical Attention ◽  
Shortness Of Breath ◽  
Her Family ◽  
Level Of Consciousness ◽  
New Onset

We present the case of a 54-year-old female known for hypertension, alcoholism and occasional cocaine intake. She was brought to the emergency department because of new onset confusion and decreased level of consciousness. The history was taken from a family member. The patient had increased shortness of breath with a cough that started 48 hours prior to her visit. The night prior to presentation, she was intoxicated with cocaine and alcohol and was then found to have slurred speech, gait disturbance and urinary incontinence. The next morning, she was found obtunded, which prompted her family members to seek medical attention.

Wernicke encephalopathy in a caregiver: A serious physical issue resulting from stress in a family member caring for an advanced cancer patient

2021 ◽  
pp. 1-3
Author(s):  
Mayumi Ishida ◽  
Nozomu Uchida ◽  
Akira Yoshioka ◽  
Izumi Sato ◽  
Tetsuya Hamaguchi ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Family Member ◽  
Advanced Cancer ◽  
Family Members ◽  
The Body ◽  
Mental Condition ◽  
Wernicke Encephalopathy ◽  
Level Of Consciousness ◽  
Loss Of Appetite ◽  
Burden Of Caring

Abstract Objective It is well known that the burden on the families of cancer patient extends across many aspects, but there have been no reports of family members developing delirium due to the burden of caring for a cancer patient. Methods We reported a caregiver who developed Wernicke encephalopathy (WE) while caring for a family member with advanced cancer. Results The subject was a 71-year-old woman who had been caring for her husband, diagnosed with gastric cancer and liver metastases, for 5 months. She visited the “caregivers’ clinic” after referral by an oncologist who was worried about a deterioration in her mental condition that had appeared several weeks previously. The woman had a history of diabetes mellitus. Some giddiness was observed and, based on her inability to answer questions, her level of consciousness was checked and some disorientation was observed. She was diagnosed with delirium. A blood sample was collected to investigate the cause of the delirium, but the test data showed no hypoglycemia. Her appetite had declined since her husband was diagnosed with cancer. Thiamine deficiency was suspected as thiamine stores in the body are depleted within about 18 days and her loss of appetite had continued for 5 months. On intravenous injection of 100 mg of thiamine, her consciousness level was returned to normal in 1 h. A diagnosis of WE was supported by the patient's abnormally low serum thiamine level. Significance of the results The family members of cancer patients may develop a loss of appetite due to the burden of caring, resulting in WE. When providing care for signs of distress in family members, it is necessary to pay attention not only to the psychological aspects but also to their level of consciousness and physical aspects, particularly the possibility of serious illness resulting from reduced nutritional status.

scholarly journals Predictive factors of hospitalization related to the caregiver burden in older adults presenting to the emergency department

2017 ◽  
Vol 41 (S1) ◽  
pp. S174-S175
Author(s):  
G. Mattei ◽  
I. Goldoni ◽  
F. Mariani ◽  
G. Casu ◽  
L. Boccaletti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Caregiver Burden ◽  
Psychological Health ◽  
Family Members ◽  
The Elderly ◽  
Medical Attention ◽  
Term Care ◽  
Old Patients ◽  
Emotional Burden ◽  
Frequent Event

BackgroundLong-term care for the elderly by their family members represents a serious burden in Italy. The physical and psychological health of informal caregivers is a growing public health issue. Old patients often seek urgent medical attention in the Emergency Department (ED) and hospitalisation is frequent event among the elderly.AimAim of the study was (1) to investigate the burden of care among the caregivers of old patients; (2) to examine the influence of the burden experienced by the caregivers on ED and hospital admissions of the elderly.MethodsWe conducted a descriptive study of patients aged 75 years or older and their caregiver admitted to the ED from 10/1/15 to 6/10/15 (77 patient-caregiver pairs). The caregivers were evaluated using the Caregiver Burden Inventory (CBI). A case manager collected the patient's data.ResultsCBI score is the highest among patients seeking ED evaluation due to caregiver's concern. The majority of the elderly admitted to the ED whose caregiver shows elevated emotional burden at the CBI do not present with serious or urgent medical condition and are not hospitalised. Emotional burden is the highest among the caregivers of demented subjects who share the same house.ConclusionOur findings indicate that the burden experienced by caregiving family members plays a role in elderly people avoidable ED visits.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Hiccups and Psychosis: Two atypical presentations of COVID -19

2020 ◽  
Author(s):  
Teresa Alvarez-Cisneros ◽  
Aldo Lara-Reyes ◽  
Stephanie Sansón-Tinoco
Keyword(s):  
Emergency Department ◽  
Mexico City ◽  
Private Hospital ◽  
The Other ◽  
Shortness Of Breath ◽  
Healthy Men ◽  
Neurological Signs ◽  
The World ◽  
Atypical Presentations ◽  
New Onset

Abstract The WHO defines a possible case of COVID-19 as a person experiencing fever, cough, shortness of breath and neurological signs including anosmia, ageusia or dysgeusia. However, experiences from hospitals all over the world have shown that presentations vary widely. In our emergency department in a private hospital in Mexico City, we received two patients with very different symptoms on the same shift. Two previously healthy men in their 40 s presented, one with 3 days of hiccups and the other with a new onset psychotic event.

Family health evaluated by family members of older patients and nurses in emergency departments

2017 ◽  
Vol 38 (1) ◽  
pp. 38-47
Author(s):  
Jekaterina Demidenko ◽  
Pirkko Routasalo ◽  
Mika Helminen ◽  
Päivi Åstedt-Kurki ◽  
Eija Paavilainen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Family Member ◽  
Emergency Departments ◽  
Older Patients ◽  
Family Members ◽  
Family Health ◽  
Moderate Level ◽  
The Family ◽  
Health Related ◽  
Over Time

Older patients quite often arrive in an emergency department (ED) with a family member, but little is known about the family member’s health evaluated in ED. The aim of this study was to describe family health in EDs evaluated by family members and nurses. Data were collected from Estonian hospital EDs from 111 family members of older patients and from 93 nurses. Family health in EDs was evaluated as being at a moderate level. Family members reported that family health was better when older patients lived with the family. The more time the family spent in the ED, the worse the health-related activities were. Nurses reported that cardiovascular problems in older patients who presented in EDs disturbed the values of family health. We conclude that ED nurses should recognize the level of family health, in order to ensure that the family will be able to cope at home. Family health in EDs should be reviewed over time to help nurses meet the required needs of the family.

scholarly journals Valproic Acid Induced Pancreatitis Presenting With Decreased Level of Consciousness in a Child With Tuberous Sclerosis Complex

2020 ◽  
Vol 25 (3) ◽  
pp. 256-260 ◽  
Author(s):  
Pierre-Charles Deschenes ◽  
Julie Autmizguine ◽  
Philippe Major ◽  
Niina Kleiber
Keyword(s):  
Emergency Department ◽  
Valproic Acid ◽  
Tuberous Sclerosis ◽  
Tuberous Sclerosis Complex ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Drug Reactions ◽  
Multiple Organs ◽  
Level Of Consciousness ◽  
New Onset

A 2-year-old Caucasian boy with tuberous sclerosis complex presented to the emergency department with lethargy and new onset myoclonias. Pancreatitis, thrombocytopenia, and coagulopathy associated to a decreased level of consciousness were diagnosed. Valproic acid had been initiated 13 months before and had been slowly increased to a dose of approximately 38 mg/kg/day. All the symptoms resolved after discontinuation of the medication. The clinical presentation of this child highlights that valproic acid-related pancreatitis can present with decreased level of consciousness without associated gastrointestinal symptoms. Adverse drug reactions associated with valproic acid can lead to damage of multiple organs and may prove fatal if not promptly recognized and managed.

FAKTOR – FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN PNEUMONIA PADA BALITA DI WILAYAH KERJA PUSKESMAS WONOREJO SAMARINDA TAHUN 2017

2018 ◽  
Vol 3 (2) ◽  
pp. 76
Author(s):  
Novi Anggun Pusvitasary
Keyword(s):  
Environmental Factors ◽  
Family Member ◽  
Cause Of Death ◽  
Family Members ◽  
Smoking Behavior ◽  
Smoking Habits ◽  
P Value ◽  
Behavioral Factors ◽  
The World ◽  
Health Standards

Pneumonia disease is the leading cause of death of babies in the world. The prevalence of pneumonia in infants is 18.5 / mil. Data from Samarinda City Health Office during the last 1 year there are 91 cases of pneumonia in Karang Anyar Village and 63 cases in Teluk Lerong Ulu Village. Factors causing pneumonia are toddler factors, behavioral factors, and environmental factors. The results show there is a relationship between house humidity (p value = 0,013; OR = 0,192), house dwelling density (p value = 0,024; OR = 0,214), and family member smoking behavior (p value = 0,006; OR = 10,450) with incidence of pneumonia in toddlers in the Working Area of Puskesmas Wonorejo Samarinda. There was no correlation between house temperature (p value = 0,214; OR = 0,337), house lighting (p value = 0,095; OR = 3,188) and family disease history (p value = 0,707; OR = 0,753) with Pneumonia occurrence in infant in region Work Puskesmas Wonorejo Samarinda. It was concluded that there was a relationship between house humidity, home dwelling density, and smoking behavior of family members with the incidence of pneumonia in infants. It is recommended to be able to apply housing health requirements that meet health standards to reduce the incidence of pneumonia in infants and change smoking habits.

“The Pain Of Protagonists” Inselected Novels Of Anita Nair

Think India ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 434-438
Author(s):  
R. CELIN DIANA
Keyword(s):  
Family Members ◽  
Central Theme ◽  
Social Convention ◽  
Indian Women ◽  
Her Family ◽  
Modern Times ◽  
Female Protagonists ◽  
The Social ◽  
Pain And Suffering ◽  
Simple Life

MRS. R. CELIN DIANA A female is God's lovable creature to balance man. She is mentally and physically weak through creation itself, but she express her feelings unexpectedly in the battle against her. She is even spoiled for that. A women’s picture is a central theme to literature writings around the globe. The writings of Anita Nair is concerned with man, females, nature, true life, and social convention. She explores the existential struggle of her protagonists in most of her novels. Nair describes particularly, how Indian women are exploited, abused, marginalized even in the modern times both by individuals and by the society. Apart from the society women are tossed even by her family members. Anita Nair emphasizes the need for creating awareness in women. Her female protagonists are conscious of the injustice in marriage brought to them.Probably, the protagonists of Nair’s novels denies to flow along the current.  They seem to be adamant or aggressive, but the fact is that they underwent much pain and suffering. Apart from the pain the protagonists are the losers of life, respect, family, dignity and everything. This paper is an effort to bring to light the pathetic conditions of the protagonists,and to study the social, family and economic picture of women's suffering in life. Though the protagonist characters are brave, they seem pathetic and losers of a common simple life, they dream to live. Anita Nair defines circumstances or occurrences that harm or kill characters due to the aggressive nature of characters in her novels.

scholarly journals Does regular strength training cause urinary incontinence in overweight inactive women? A randomized controlled trial

2021 ◽  
Author(s):  
Kari Bø ◽  
Lene Anette H. Haakstad ◽  
Gøran Paulsen ◽  
Anne Mette Rustaden
Keyword(s):  
Randomized Controlled Trial ◽  
Urinary Incontinence ◽  
Strength Training ◽  
Short Form ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
Randomized Controlled ◽  
Sum Score ◽  
New Onset

Abstract Introduction and hypothesis Urinary incontinence (UI) is common in women who exercise. We aimed to investigate new onset UI in formerly inactive, overweight or obese women (BMI > 25) participating in three different strength training modalities compared with a non-exercising control group. Methods This was a secondary analysis of an assessor blinded randomized controlled trial investigating the effect of 12 weeks of three strength training concepts for women on muscle strength and body composition. None of the programs included pelvic floor muscle training. International Consensus on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF) was used to investigate primary outcome; new onset UI, and secondary outcome; ICIQ-UI-SF sum score. Suissa and Shuster’s exact unconditional test was used to analyze difference in new onset UI. Difference in ICIQ-UI-SF sum score is presented as mean with 95% CI. Results At baseline 40 out of 128 (31.2%) participants reported UI. Three out of 27, 2 out of 17, 2 out of 23, and 0 out of 21 women in the three training and control groups respectively had new onset UI. There were no statistically significant differences in new onset UI across the groups or when collapsing new onset UI in the intervention groups compared with the controls (7 out of 67 vs 0 out of 21), p = 0.124. After the intervention the control group reported worse ICIQ-UI-SF sum score than any of the training groups; mean difference − 6.6 (95% CI: −11.9, −1.27), p = 0.012, but there was no difference in change from baseline to 12 weeks between the groups p = 0.145). Conclusions There was no statistically significant change in UI after strength training.

scholarly journals Diagnosis of gestational diabetes in Uganda: The reactions of women, family members and health workers

2021 ◽  
Vol 17 ◽  
pp. 174550652110137
Author(s):  
Flavia Zalwango ◽  
Janet Seeley ◽  
Arthur Namara ◽  
Sanjay Kinra ◽  
Moffat Nyirenda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Workers ◽  
Family Members ◽  
Medical Attention ◽  
Middle Income ◽  
Diabetes Mellitus Diagnosis ◽  
Life Threatening ◽  
Fear And Anxiety

Objectives: In Uganda, as in many other low- and middle-income countries, screening for gestational diabetes mellitus is suboptimal and is rarely embedded in routine antenatal care. We describe the experiences of women in Uganda who underwent screening for gestational diabetes mellitus and were diagnosed with the condition as they navigate both the reaction of family members and their interaction with health workers. Methods: Pregnant women aged 18 years or older and between 24 and 28 weeks of gestation were enrolled from the antenatal clinics at one of the five hospitals between 13 June 2018 and 31 October 2019. Ten women with gestational diabetes mellitus, ten family members and six health workers were purposively selected to take part. Interviews and focus group discussions were used to collect data on the socio-cultural and health system factors that influence timely screening and effective management of gestational diabetes mellitus in Uganda. Data were analysed thematically. Results: Women generally reflected on the importance of gestational diabetes mellitus screening and felt that an early diagnosis helped them to get timely medical attention, and most reported a positive experience of the care provided by health workers. However, women who were diagnosed with gestational diabetes mellitus reported feeling fearful and anxious, and some were worried that the condition might be life-threatening. Many women reported that they were upset and largely unprepared to receive a gestational diabetes mellitus diagnosis. A gestational diabetes mellitus diagnosis not only stirred intense feelings of fear and anxiety in women but also affected their spouses and other family members. Many male partners were sympathetic and willing to provide support. Conclusion: Our findings highlight the need to understand the perceptions and emotions that accompany a gestational diabetes mellitus diagnosis to best support women and their family members. An improved recognition of these factors can inform the development of effective gestational diabetes mellitus screening and management programmes.

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