Discomfort reported by patients after cardiac catheterization, performed by the Judkins technique

2010 ◽  
Vol 4 (4) ◽  
pp. 1735
Author(s):  
Claudia Russo ◽  
Karina De Oliveira Azzolin
Keyword(s):  
Neck Pain ◽  
Cardiac Catheterization ◽  
Recovery Period ◽  
Signs And Symptoms ◽  
Lumbar Pain ◽  
Systematic Observation ◽  
Health Council ◽  
Ethics In Research ◽  
Small Hematoma ◽  
Care Nursing

ABSTRACTObjective: to describe the discomfort reported by patients at rest after cardiac catheterization, performed by the Judkins technique. Methodology: this is a cohort study was conducted in a service of hemodynamics. Data collection was performed at admission in the recovery room, the 4th and 6th  hours after the procedure, using a questionnaire and systematic observation. This study follows the norms of Resolution 196/96 of the National Health Council and was approved by the Ethics in Research ISCMPA (nº 311709). Results: from the 42 patients analyzed, 52.4% were men, with mean age of 62 years. As for symptoms, the most relevant was the neck pain reported by 28.7% at the 6th hour, the urinary discomfort was mentioned by 23.8% in the early hours, remaining in the 4th and 6th hours. The presence of headache was reported by 19.2% in the initial hours and at the 4th hour. The neck pain was present in 16.7% as moderate at the 6th hour and the lumbar pain was reported by 9.5% as moderate at the 4th hour, with a low percentage of severe pain being reported by the patients. Among all described signs, a small hematoma was made by 9.5% after removal of the sheath. Conclusion: the discomfort reported by patients during the recovery period after cardiac catheterization showed no significant worsening between the 4th and 6th hours. Descriptors: cardiac catheterization; signs and symptoms; nursing care; nursing; hemodynamics.RESUMO Objetivo: descrever os desconfortos relatados pelos pacientes durante o repouso após cateterismo cardíaco, realizado através da técnica de Judkins. Metodologia: trata-se de estudo de coorte, realizado com pacientes submetidos ao cateterismo cardíaco em um serviço de hemodinâmica. A coleta de dados foi realizada no momento da admissão na sala de recuperação, na 4ª e 6ª hora pós procedimento, através da utilização de um questionário e observação sistemática. Este estudo segue as normas da Resolução 196/96 do Conselho Nacional de Saúde, sendo aprovado pelo Comitê de Ética em Pesquisa da ISCMPA (nº 311709). Resultados: dos 42 pacientes, 52,4% eram homens, com idade média de 62 anos. Quanto aos sintomas apresentados, o mais relevante foi a dor cervical relatada por 28,7% na 6ª hora, o desconforto urinário foi mencionado por 23,8% na hora inicial, permanecendo na 4ª e 6ª hora, a presença de cefaléia foi referida por 19,2% na hora inicial e 4ª hora. A dor cervical foi presente em 16,7% como moderada na 6ª hora e a dor lombar foi relatada por 9,5% como moderada na 4ª hora, sendo baixos os percentuais de dor intensa. Entre os sinais, o hematoma pequeno foi apresentado por 9,5% após a retirada da bainha. Conclusão: os desconfortos referidos pelos pacientes durante o período de repouso pós cateterismo cardíaco não demonstram piora significativa entre a 4ª e 6ª hora. Descritores: cateterismo cardíaco; sinais e sintomas; cuidados de enfermagem; enfermagem; hemodinâmica.RESUMENObjetivos: describir las molestias informadas por los pacientes durante el reposo después de la cateterización cardiaca, realizado mediante la técnica de Judkins. Metodologia: se trata de un estudio del corte, realizado en uno servicio de hemodinâmica. La captura de los datos fue hecha en el momento de la admisión el la habitación de recuperación, en la 4ª y la 6ª hora después del procedimiento, por la utilización de uno cuestionario y la observación sistemática Este estudio sigue las normas de la Resolución 196/96 del Consejo Nacional de Salud y fue aprobado por la Ética en la Investigación ISCMPA (nº 311709). Resultados: de los 42 pacientes, 52,4% eran hombres, con media de edad de 62 años. Acerca de los sintomas presentados, lo más pertinente fue el dolor cervical informada por 28,7% en la 6ª hora, la molestia urinaria fue mencionado por 23,8% en la hora del inicio restante hasta la 4ªy 6ª hora, la presencia del dolor de cabeza fue informado por 19,2% en la hora del inicio y la 4ª hora. El dolor cervical estuvo presente en 16,7% como moderado en la 6ª hora y el dolor lumbar fue informada por 9,6% como moderado en la 4ª hora, siendo baja las porcentajes del dolor intenso. Entre los señales, el hematoma pequeño fue presentado por 9,5% después de la retirada de la vaina. Conclusión: las molestias informadas por los pacientes en el período de reposo después del cateterismo cardiaco no enseñaron empeoramiento significativo entre la 4ª y la 6ª hora. Descriptores: cateterismo cardíaco; signos e síntomas; atención de enfermeira; enfermeíra; hemodinâmica. 

REGROWTH AND OVERGROWTH OF THE THYMUS AFTER ATROPHY INDUCED BY THE ORAL ADMINISTRATION OF ADRENOCORTICOSTEROIDS TO HUMAN INFANTS

PEDIATRICS ◽  
1960 ◽  
Vol 26 (5) ◽  
pp. 762-770
Author(s):  
John Caffey ◽  
Robert Silbey
Keyword(s):  
Oral Administration ◽  
Cardiac Catheterization ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Human Infants ◽  
Cardiac Image ◽  
Rapid Regrowth

The oral administration of adrenocorti-costeroids provokes rapid atrophy of the thymus which is followed consistently, after stoppage of the steroid, by rapid regrowth of the thymus and, in some cases, over-growth. Steroid-induced shrinkage of the thymus makes possible visualization of the true cardiac image which is often masked by the overlapping lobes of a large thymus. Such shrinkage may prevent the spurious diagnosis of cardiomegaly, and the use of more elaborate and hazardous methods such as opaque angiocardiography and cardiac catheterization. Steroid shrinkage of the thymus is indicated only in patients who have cardiac signs and symptoms combined with enlarged deformed mediastinums in which the true cardiac image cannot be seen radiographically. Steroid shrinkage is not indicated in patients who have cardiac signs and symptoms combined with small mediastinums, or in patients who have large mediastinums without cardiac signs and symptoms. Steroid shrinkage should not be tried when there are other factors which suggest greater than the probable benefits to be derived from their use. Massive rapid regrowth of the thymus following steroid-inducing atrophy was not associated with clinical signs or symptoms in any of our cases.

scholarly journals Surgical treatment of dropped head syndrome secondary to fascioscapulohumeral muscle dystrophy: a case report

2021 ◽  
Vol 6 (10) ◽  
Keyword(s):  
Conservative Treatment ◽  
Neck Pain ◽  
Signs And Symptoms ◽  
Muscle Dystrophy ◽  
Dropped Head Syndrome ◽  
Cervical Surgery ◽  
The Face ◽  
Hereditary Myopathy ◽  
Clinical And Radiological Results ◽  
Posterior Cervical Surgery

Fascioscapulohumeral muscular dystrophy is an uncommon hereditary myopathy which affects mainly the muscle of the face and upper limb girdle. We present a rare case with dropped head syndrome as the prominent manifestation of that disease and successfully treated by surgical management. It was a 25-year-old male patient with the chief complaint of neck pain and inability to maintain his horizontal gaze for long periods and as a result he had to quit his job as a shipper. His mother also had signs and symptoms of fascioscapulohumeral muscle dystrophy. Conservative treatment consisting of physical therapy and hard collar was the first attempt in order to reduce the neck pain and had limited result. We then performed a posterior cervical surgery including C2 to T2 instrumentation and kyphotic correction for the patient. The ten-month postop clinical and radiological results were satisfactory and the patient could return to his previous job. Dropped head syndrome with failed conservative treatment can be surgically treated after considering all clinical and radiographic factors.

scholarly journals PHEOCHROMOCYTOMA CONCEALED BY CHRONIC METHAMPHETAMINE ABUSE

2020 ◽  
Vol 6 (5) ◽  
pp. e212-e216
Author(s):  
Georgiana Constantinescu ◽  
Steffen Leike ◽  
Matthias Gruber ◽  
Katharina Langton ◽  
Carola Kunath ◽  
...  
Keyword(s):  
Illicit Drugs ◽  
Single Photon ◽  
Plasma Concentrations ◽  
Photon Emission ◽  
Signs And Symptoms ◽  
Panic Attacks ◽  
Lumbar Pain ◽  
Emission Computed Tomography ◽  
Methamphetamine Abuse ◽  
History Of

Objective: Both clinical suspicion and diagnosis of pheochromocytoma (PCC) can be challenging in patients where the presentation can be confused with the pharmacophysiological effects of illicit drugs known to activate the sympathetic nervous system. We report on such a patient and outline considerations that can impact diagnostic decision making. Methods: Clinical examination, measurement of plasma metanephrines, followed by magnetic resonance imaging, iodine 123-metaiodobenzylguanidine single-photon emission computed tomography, and histopathology of the resected tumor. Results: A 35-year-old male patient was referred to our center because of a right-sided adrenal mass, incidentally found during an abdominal ultrasound performed due to nausea, vomiting, and lumbar pain. Although he had no history of hypertension, he had complained for over 6 years of severe episodic headache, panic attacks, and profuse sweating. He also had a longer history of methamphetamine abuse. Plasma concentrations of metanephrine (10.7 pmol/L) and normetanephrine (3.83 pmol/L) were 25-fold and 5.6-fold above respective upper limits of reference intervals (0.42 and 0.69 pmol/L). This indicated a PCC, which was confirmed after adrenalectomy. Failure to recognize the patient’s signs and symptoms as attributable to a PCC was unsurprising given that methamphetamine abuse can result in many of the same signs and symptoms as a catecholamine-producing tumor. Conclusion: The abuse of drugs such as methamphetamine can obscure an underlying PCC due to the similarity of several symptoms associated with both conditions. Recognition of a PCC in patients using illicit drugs such as methamphetamine remains challenging.

scholarly journals Sinais, sintomas e complicações do infarto agudo do miocárdio

2018 ◽  
Vol 12 (1) ◽  
pp. 247 ◽  
Author(s):  
Renata Soares Passinho ◽  
Cândida Caniçali Primo ◽  
Walckiria Garcia Romero Sipolatti ◽  
Mirian Fioresi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Nursing Care ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Nursing Diagnosis ◽  
Affected Person ◽  
Insuficiencia Cardiaca ◽  
Care Nursing

RESUMOObjetivo: analisar as produções científicas a respeito da frequência dos sinais, sintomas e complicações do infarto agudo do miocárdio. Método: revisão integrativa, com busca publicações entre 2010 a 2014 nas bases de dados LILACS, MEDLINE e CINAHL. O processo de análise dos 122 artigos selecionados deu-se por meio da leitura exploratória e crítica dos títulos, resumos e dos resultados das pesquisas, onde se buscaram os fenômenos relacionados ao IAM (sinais, sintomas e complicações). Resultados: A dor no peito (N = 75), a insuficiência cardíaca (N = 52), a dispneia (N= 24) e a arritmia (N= 20) foram os sinais e sintomas mais encontrados. Conclusão: a dor no peito é o sintoma mais frequente da doença. O reconhecimento precoce desses fenômenos irá contribuir para a melhoria do prognóstico da pessoa acometida. Descritores: Cuidados de Enfermagem; Diagnóstico de Enfermagem; Infarto Agudo do Miocárdio; Classificação; Enfermeiras e Enfermeiros; Cardiologia.ABSTRACTObjective: to analyze the scientific productions regarding the frequency of signs, symptoms and complications of acute myocardial infarction. Method: integrative review, with search publications between 2010 to 2014, in the databases LILACS, MEDLINE and CINAHL. The process of analysis of the 122 articles selected was based on the exploratory and critical reading of the titles, abstracts and results of the research, in which the AMI-related phenomena (signs, symptoms and complications) were searched. Results: chest pain (N = 75), heart failure (N = 52), dyspnea (N = 24) and arrhythmia (N = 20) were the most common signs and symptoms. Conclusion: chest pain is the most frequent symptom of the disease. The early recognition of these phenomena will contribute to the improvement of the prognosis of the affected person. Descriptors: Nursing Care; Nursing diagnosis; Acute Myocardial Infarction; Classification; Nurses and Nurses; Cardiology.RESUMENObjetivo: analizar las producciones científicas acerca de la frecuencia de los signos, síntomas y complicaciones del infarto agudo de miocardio. Método: revisión integrativa, con búsqueda publicaciones entre 2010 a 2014, en las bases de datos LILACS, MEDLINE y CINAHL. El proceso de análisis de los 122 artículos seleccionados se dio por medio de la lectura exploratoria y crítica de los títulos, resúmenes y de los resultados de las investigaciones, donde se buscaron los fenómenos relacionados al IAM (signos, síntomas y complicaciones). Resultados: el dolor en el pecho (N = 75), la insuficiencia cardiaca (N = 52), la disnea (N = 24) y la arritmia (N = 20) fueron los signos y síntomas más encontrados. Conclusión: el dolor en el pecho es el síntoma más frecuente de la enfermedad. El reconocimiento precoz de estos fenómenos contribuirá a la mejora del pronóstico de la persona acometida. Descriptores: Cuidados de Enfermería; Diagnóstico de Enfermería; Infarto Agudo de Miocardio; Clasificación; Enfermeras y Enfermeras; Cardiología.

scholarly journals Machine Learning Methods for Classification Multiple Sclerosis with different stages

2021 ◽  
Author(s):  
Atrin Barzegar ◽  
Yas Barzegar
Keyword(s):  
Machine Learning ◽  
Multiple Sclerosis ◽  
Recovery Period ◽  
Fuzzy Optimization ◽  
Signs And Symptoms ◽  
Nerve Fibers ◽  
Nerve Damage ◽  
The Body ◽  
Communication Problems ◽  
The Brain

Multiple sclerosis (MS) is a debilitating disease of the brain and spinal cord (central nervous system). In MS, the immune system attacks the protective sheath (myelin) that covers the nerve fibers, causing communication problems between the brain and the rest of the body. Eventually the disease can cause permanent damage or nerve damage. The signs and symptoms of MS are very different and depend on the extent of the nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or completely, while others may experience a long recovery period without any new symptoms. Most people with MS have a relapsing-remitting illness. They experience periods of new symptoms or recurrences that occur over days or weeks and usually improve somewhat or completely. Following these recurrences, there are periods of recovery that can last for months or even years. In this Project, we used some methods of machine learning in order to evaluate the precision and accuracy of Methods to Predict and classification of Multiple Sclerosis with different stages. In order to calculate accuracy, precision, recall Fscore we used some different method such as Art Fuzzy, SVM, Decision tree to compare the classes two by two. To improve the results we used the method of Adaptive fuzzy optimization. we used two options Genetic algorithm and particle swarm optimization.

Mucormycosis in diabetes

1997 ◽  
Vol 6 (5) ◽  
pp. 363-367 ◽  
Author(s):  
MA Hopkins ◽  
DM Treloar
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Infection ◽  
Signs And Symptoms ◽  
Diabetic Woman ◽  
Critical Care Nursing ◽  
Appropriate Treatment ◽  
The Central Nervous System ◽  
The Brain ◽  
Care Nursing

Mucormycosis is a rare opportunistic infection caused by ubiquitous fungi typically found in soil, spoiled foods, bread, and dust. The acute infection most commonly is rhinocerebral and is associated with metabolic acidosis. Mucormycosis spreads quickly and can progress from the paranasal area to the brain in a few days. In the case presented, a young diabetic woman had diabetic ketoacidosis and classic signs and symptoms of mucormycosis. Even after aggressive and appropriate treatment with surgical debridement and IV administration of amphotericin B, the fungus invaded the central nervous system. This article discusses current methods of treating mucormycosis and important critical care nursing considerations for patients who have the infection.

scholarly journals Use of the Fonseca's questionnaire to assess the prevalence and severity of temporomandibular disorders in brazilian dental undergraduates

2007 ◽  
Vol 18 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Kariny Nomura ◽  
Mathias Vitti ◽  
Anamaria Siriani de Oliveira ◽  
Thaís Cristina Chaves ◽  
Marisa Semprini ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Neck Pain ◽  
Temporomandibular Joint ◽  
Temporomandibular Disorders ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Public University ◽  
Men Students ◽  
Young Population ◽  
Clinical Signs And Symptoms

This study to assessed the prevalence of signs and symptoms of temporomandibular disorders (TMD) by means of the frequency distribution of data for 218 dentistry students from a Brazilian public university using the Fonseca's questionnaire. The group consisted of 96 men and 122 women, with an average age of 20 years. Of the students, 53.21% showed some level of TMD: 35.78% mild TMD 11.93% moderate and 5.5% severe. Women were the most affected group, with 63.11% showing some level of TMD, against 40.62% of men. When considering only severe TMD, women are approximately 9 times more affected than men. Students with any level of TMD showed marked characteristics: 76.72% considered themselves tense people; 71.55% reported to clench or grind their teeth; 65.52% reported clicking of the temporomandibular joint; 64.66% reported frequent headache and 61.21% neck pain. In conclusion, clinical signs and symptoms of TMD can occur in young population and this information is of great importance for the early diagnosis of the dysfunction.

scholarly journals Therapeutic listening in clinical mental health care nursing

2015 ◽  
Vol 24 (1) ◽  
pp. 154-160 ◽  
Author(s):  
Deivson Wendell da Costa Lima ◽  
Alcivan Nunes Vieira ◽  
Lia Carneiro Silveira
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Therapeutic Potential ◽  
Signs And Symptoms ◽  
Care Process ◽  
Structured Interviews ◽  
Therapeutic Listening ◽  
The Subject ◽  
Care Nursing

Research with the aim to understand the conception of therapeutic listening in clinical mental health care nursing. Qualitative study carried out with nine nurses inserted into mental health services. Data were generated by semi-structured interviews and assessed by Michel Pechêux's discourse analysis. The research identified that the listening process is devoid of its therapeutic potential. It is only conceived as a means to obtain information on the subject in psychological distress, a practice that, in summary, is specifically correlated to objectified signs and symptoms at the patient's body. Occasionally, such practice is guided by a psychosocial framework. The listening practice is not in harmony with the principles of the psychiatric reform, as it does not allow for the inclusion of the subject in the care process, and even disregards the patient's speech as an expression of his existence-suffering. Although it contains elements of the psychosocial framework, the listening practice is actually limited to addressing the mental suffering, with no recognition whatsoever of the suffering individual.

scholarly journals Nursing faults in the recovery period of surgical patients

2006 ◽  
Vol 14 (6) ◽  
pp. 879-886 ◽  
Author(s):  
Tânia Couto Machado Chianca
Keyword(s):  
Continuing Education ◽  
Nursing Care ◽  
Human Error ◽  
Recovery Period ◽  
Organizational Factors ◽  
Descriptive Study ◽  
Structured Interview ◽  
Surgical Patients ◽  
Systematic Observation ◽  
Nursing Errors

This is a descriptive study based on the theory of human error, in order to analyze and classify nursing errors during the nursing care of surgical patients at recovery. Twenty-five (25) fault reports were collected through a semi-structured interview. Those reports were submitted to 15 nurse experts to evaluate the risk of seriousness; human, equipment and organizational factors involved; members interaction; information and reversibility of the accident. Faults were directly attributed to psychosocial and organizational aspects, equipment and seriousness. A multidimensional scaling test (MDS) was applied and a graph was obtained. It showed four groups of faults, due to problems related to sensory-motor, procedure, abstraction and supervision control. In conclusion, the faults were caused by non-defined personnel roles, continuing education deficiency, non-systematic observation, inadequate space and equipment.

scholarly journals SAT-181 Pheochromocytoma Masquerading as Acute Coronary Syndrome. To Cath or Not to Cath?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Krish Khatri ◽  
Richard Allen Haas
Keyword(s):  
Blood Pressure ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Cardiac Catheterization ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Significant Risk ◽  
Signs And Symptoms ◽  
Serum Free ◽  
Coronary Syndrome

Abstract Background Pheochromocytoma had been known as the “Great Mimic” as it can present with signs and symptoms consistent with numerous differentials [1]. Cardiac ischemia is one in particular which creates a diagnostic dilemma and poses significant risk for misdiagnosis. Clinical Case 62-year-old female with recent onset hypertension and type II diabetes(HbA1C of 6.9%) presented to the ER with new episodes of nausea, vomiting, and substernal chest pain. During the preceding four months she also experienced episodic headaches, palpitations, and flushing. Initial vital signs were significant for blood pressure 157/81 mm Hg. Physical exam was unremarkable. An Electrocardiogram showed normal sinus rhythm with right axis deviation and ST segment depressions in the inferior leads II, III and aVF. Labs revealed a troponin peak at 2.95 (<0.04 ng/mL) and d-dimer of 403 (<400 ng/mL). Serum chemistry, TSH, and complete blood count were within normal limits. A CT Chest with angiography was negative for pulmonary emboli. However, it did note a heterogenous 7.6 cm right adrenal mass. At this juncture there was clinical concern for pheochromocytoma and serum free metanephrines was ordered. Prior to receiving medical treatment for her pheochromocytoma, she underwent cardiac catheterization which showed no evidence of coronary artery disease. The procedure was uncomplicated. However, post-procedurally she did develop worsening paroxysms and severe hypertensive episodes with heart rate up to 140 beats per minute and systolic blood pressure up to 220 mm Hg. She was subsequently started on alpha blockage with phenoxybenzamine 10mg twice daily to which she responded favorably. Her initial serum free metanephrine was 6087(< 57 pg/mL) and free normetanephrine 2489 (<148 pg/mL). Conclusions This case highlights the importance of maintaining a high index of suspicion for pheochromocytoma for all patients with acute chest pain and hypertension. Her untreated pheochromocytoma could have been fatal during or immediately after the cardiac catheterization. Given the suspicion for pheochromocytoma in this case, it would have been most appropriate to have begun alpha blockade after blood was drawn for metanephrines and before attempting any invasive procedures. Pheochromocytoma should be included in the differential diagnosis of acute coronary syndrome because it can mimic an ischemic episode. References: 1. Soltani A, Pourian M, Davani BM. Does this patient have Pheochromocytoma? a systematic review of clinical signs and symptoms. J Diabetes Metab Disord. 2016 Mar 17;15:6. doi: 10.1186/s40200-016-0226-x. Erratum in: J Diabetes Metab Disord. 2017 Oct 16;16:42. PMID: 26998444; PMCID: PMC4797176.

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