scholarly journals Germinal Matrix -Intraventricular Hemorrhage: Current Concepts and Future Direction

2021 ◽  
Author(s):  
Sadhika Sood ◽  
Rohit Gulati
Keyword(s):  
Nursing Care ◽  
Intraventricular Hemorrhage ◽  
Healthcare Providers ◽  
Developing Brain ◽  
Scientific Development ◽  
Germinal Matrix ◽  
Cytological Features ◽  
Future Direction ◽  
Preterm Newborns

Germinal Matrix Hemorrhage -Intraventricular hemorrhage (IVH) is a bleed of multifactorial etiology involving the highly vascular and delicate neuro-glial precursors in the developing brain. It poses a challenging complication in preterm newborns. This chapter provides a focused discussion on the current concepts in pathogenesis, management, and complications of IVH. The radiological findings at diagnosis and follow-up and the cytological features of CSF will be valuable to both frontline and diagnostic healthcare providers. The chapter also reviews the ongoing scientific development in the field. The authors believe that this chapter will be a valuable tool for all healthcare providers (students, physicians, and in nursing care) in managing this challenging condition.

scholarly journals Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6333
Author(s):  
Ching-Fang Lee ◽  
Fur-Hsing Wen ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Providers ◽  
First Trimester ◽  
Symptom Distress ◽  
Teaching Hospitals ◽  
Lower Back ◽  
Distress Symptoms ◽  
Related Symptom ◽  
Experienced Symptom

During pregnancy, a woman’s enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be “Decreased then Increased” (56.8%). Other noticeable patterns were “Continuously Increased” (28.4%), “Increased then Decreased” (10.5%) and “Continuously Decreased” (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants’ major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the “moderately distressful” level. This study provides evidence that could be used to predict women’s pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.

scholarly journals TELEMEDICINE IN IBD: GOOD TRUST FROM OUTPATIENTS DURING THE COVID-19 PANDEMIC IN MILAN (LOMBARDY)

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S51-S51
Author(s):  
Andrea Costantino ◽  
Daniele Noviello ◽  
Stefano Mazza ◽  
Roberto Berté ◽  
Maurizio Vecchi ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Assessment Tool ◽  
Healthcare Providers ◽  
Telemedicine Service ◽  
Moderate Disease ◽  
Video Consultation ◽  
K Current ◽  
Remote Assistance ◽  
Video Calling

Abstract Background and Aim During the recent COVID-19 pandemic, telemedicine has enabled many IBD patients worldwide to get access to remote assistance. Some positive reports on the use of telemedicine among patients and healthcare providers have been published1-4, but a patient’s trust perspective is not available yet. The aim of our study was to verify IBD patients’ trust in telemedicine. This study was approved by our local Ethics Committee. Material and Methods At our Gastroenterology Unit in Milan (Italy), 123 video-consultations were delivered to IBD patients with mild or moderate disease, in place of follow-up visits scheduled but not provided during the general lockdown (March-April 2020). Video-calling solutions from Google (Hangouts or Meet) or Microsoft Teams were used according to the patient’s preference. The patients’ trust in telemedicine was assessed through an adapted version of the PAtient Trust Assessment Tool (PATAT) questionnaire.5 The primary endpoint was expressed as a >75% percentage of patients giving a score of at least 4 out of 5 in a Likert Scale for three selected key statements: “I can trust video-consultation”, “I can trust that possible problems with the telemedicine service will be solved properly” and “I feel at ease when working with this website”. The questionnaire was formulated through the EUSurvey platform, widely used for clinical research questionnaires in Europe. Results One-hundred-fifteen (93.4%) video-consultations were performed out of the 123 scheduled. Among the 115 consultations, 100 questionnaires were completed (86.9%). The primary endpoint of trust in the telemedicine service was achieved in 95%, 90% and 84% of patients for the three selected key statements about the trust in the telemedicine service, its capability to solve clinical problems and its ease to use. While clinical outcomes were beyond our intentions, we reported no drugs withdrawal in this cohort nor major events. Conclusion Our results showed that during the COVID-19 pandemic most of our IBD patients accepted to receive a video-consultation in spite of the traditional in-person visit and trusted the video-consultation. References: 1. Bezzio C. et al. Gut 2020;69:1213–1217 2. George L.A., Raymond K. Current Gastroenterology Reports (2020) 22: 12 3. Lees C. W. et al. Gastroenterology 2020; 2020 May 28 4. Allocca M et al. Clin Gastroenterol Hepatol 2020;18:1882–1883 5. Velsen, L. V. et al, H. Int. J. Med. Inform 2017;97:52–58.

scholarly journals A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure

2021 ◽  
Vol 18 (1) ◽  
pp. 278
Author(s):  
Jahyung Kim ◽  
Sanghyeon Lee ◽  
Jeong Seok Lee ◽  
Sung Hun Won ◽  
Dong Il Chun ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Simple Procedure ◽  
Wedge Resection ◽  
Operation Time ◽  
University Hospital ◽  
Wound Infections ◽  
Germinal Matrix ◽  
One Year ◽  
Ingrown Toenails

(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the nail fold and complete ablation of the germinal matrix. We evaluated the outcomes of original Winograd procedure without wedge resection with electrocautery-aided matrixectomy. (2) Methods: We retrospectively analyzed the outcomes of patients who underwent surgery for ingrown toenails at a university hospital for two years from November 2015 to October 2017. Surgery was performed in 76 feet with a mean operation time of 9.34 min. (3) Results: The minimal interval from surgery to return to regular activities was 13.26 (range 7 to 22) days. Recurrence and postoperative wound infections were found in 3 (3.95%) and 2 (2.63%) patients, respectively. Evaluation of patient satisfaction at one-year follow-up showed that 40 (52.63%) patients were very satisfied, 33 (43.42%) were satisfied, 3 (3.95%) were dissatisfied, and none of them were very dissatisfied. The average follow-up duration was 14.66 (range 12 to 25) months. (4) Conclusions: Therefore, it is believed that this less-invasive and simple procedure could be easily performed by clinicians, with satisfactory patient outcomes.

Satisfaction of tuberculosis patients with health services in Ghana

2017 ◽  
Vol 30 (6) ◽  
pp. 545-553 ◽  
Author(s):  
Frank Bonsu ◽  
Felix Afutu ◽  
Nii Nortey Hanson-Nortey ◽  
Mary-Anne Ahiabu ◽  
Joshua Amo-Adjei
Keyword(s):  
Client Satisfaction ◽  
Service Providers ◽  
Healthcare Providers ◽  
Large Body ◽  
Service Users ◽  
Content Type ◽  
Sputum Production ◽  
Interview Guide

Purpose Within human services, client satisfaction is highly prioritised and considered a mark of responsiveness in service delivery. A large body of research has examined the concept of satisfaction from the perspective of service users. However, not much is known about how service providers construct client satisfaction. The purpose of this paper is to throw light on healthcare professionals’ perspectives on patient satisfaction, using tuberculosis (TB) clinics as a case study. Design/methodology/approach In-depth interviews were conducted with 35 TB clinic supervisors purposively sampled from six out of the ten regions of Ghana. An unstructured interview guide was employed. The recorded IDIs were transcribed, edited and entered into QSR NVivo 10.0 and analysed inductively. Findings Respondents defined service satisfaction as involving education/counselling (on drugs, nature of condition, sputum production, caregivers and contacts of patients), patient follow-up, assignment of reliable treatment supporters as well as being attentive and receptive to patients, service availability (e.g. punctuality at work, availability of commodities), positive assurances about disease prognosis and respect for patients. Practical implications Complementing opinions of health service users with those of providers can offer key performance improvement areas for health managers. Originality/value To the best of the authors’ knowledge, this is a first study that has examined healthcare providers’ views on what makes their clients satisfied with the services they provide.

Abstract P538: A Detailed Analysis of Intracranial Hemorrhage After Endovascular Treatment in Acute Ischemic Stroke Due to Large Vessel Occlusion in the Escape-NA1 Trial

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Johanna Ospel ◽  
Michael D Hill ◽  
Nima Kashani ◽  
Arnuv Mayank ◽  
Nishita Singh ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Intracranial Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Infarct Volume ◽  
Prognostic Impact ◽  
Vessel Occlusion ◽  
Good Outcome

Purpose: We investigated the prevalence and prognostic impact on outcome of any intracranial hemorrhage, hemorrhage morphology, type and volume in acute ischemic stroke patients undergoing mechanical thrombectomy. Methods: Prevalence of intracranial hemorrhage, hemorrhage type, morphology and volume was determined on 24h follow-up imaging (non contrast head CT or gradient-echo/susceptibility-weighted MRI). Proportions of good outcome (mRS 0-2 at 90 days) were reported for patients with vs. without any intracranial hemorrhage. Multivariable logistic regression with adjustment for key minimization variables and total infarct volume was performed to obtain adjusted effect size estimates for hemorrhage type and volume on good outcome. Results: Hemorrhage on follow up-imaging was seen in 372/1097 (33.9%) patients, among them 126 (33.9%) with hemorrhagic infarction (HI) type 1, 108 (29.0%) with HI-2, 72 /19.4%) with parenchymal hematoma (PH) type 1, 37 (10.0) with PH2, 8 (2.2%) with remote PH and 21 (5.7%) with extra-parenchymal/intraventricular hemorrhage. Good outcomes were less often achieved by patients with hemorrhage on follow-up imaging (164/369 [44.4%] vs. 500/720 [69.4%]). Any type of intracranial hemorrhage was strongly associated with decreased chances of good outcome ( adj OR 0.62 [CI 95 0.44 - 0.87]). The effect of hemorrhage was driven by both PH hemorrhage sub-type [PH-1 ( adj OR 0.39 [CI 95 0.21 - 0.72]), PH-2 ( adj OR 0.15 [CI 95 0.05 - 0.50])] and extra-parenchymal/intraventricular hemorrhage ( adj OR 0.60 (0.20-1.78) Petechial hemorrhages (HI-1 and HI-2) were not associated with poorer outcomes. Hemorrhage volume ( adj OR 0.97 [CI 95 0.05 - 0.99] per ml increase) was significantly associated with decreased chances of good outcome. Conclusion: Presence of any hemorrhage on follow-up imaging was seen in one third of patients and strongly associated with decreased chances of good outcome.

Neurologic Sequelae in the Survivors of Neonatal Intraventricular Hemorrhage

PEDIATRICS ◽  
1979 ◽  
Vol 64 (2) ◽  
pp. 233-237
Author(s):  
K. S. Krishnamoorthy ◽  
D. C. Shannon ◽  
G. R. DeLong ◽  
I. D. Todres ◽  
K. R. Davis
Keyword(s):  
Intraventricular Hemorrhage ◽  
The Other ◽  
Neurologic Outcome ◽  
Ct Scans ◽  
Brain Scan ◽  
Neurologic Sequelae ◽  
Ct Brain

We report our experience with the neurologic sequelae (at a mean follow-up of 24 months) among the 15 surviving infants who have had neonatal intraventricular hemorrhage (IVH) documented by computerized tomographic (CT) brain scan. Neurologically six infants (40%) are normal, six infants (40%) mildly impaired, and three infants (20%) moderate to severely impaired. The neurologic outcome correlated to the degree of hemorrhage seen in the CT scans when IVH was classified into four grades. None of the other neonatal factors examined showed significant correlation with the outcome.

The Flash Technique in a Low-Intensity Group Trauma Intervention for Healthcare Providers Impacted by COVID-19 Patients

2021 ◽  
pp. EMDR-D-20-00053
Author(s):  
Philip E. Manfield ◽  
Lewis Engel ◽  
Ricky Greenwald ◽  
David G. Bullard
Keyword(s):  
Group Intervention ◽  
Healthcare Providers ◽  
Preliminary Evidence ◽  
Effect Sizes ◽  
Traumatic Memories ◽  
Low Intensity ◽  
Before And After ◽  
Flash Technique ◽  
Rapid Relief

The flash technique (FT) is a low-intensity individual or group intervention that appears to rapidly lessen the distress of disturbing and traumatic memories. This paper reports on the safety and effectiveness of group FT with 77 healthcare providers and 98 psychotherapists impacted by working with COVID-19 patients. One-hour webinars included 30 minutes of psychoeducation and two guided 15-minute FT interventions, focused on participants’ most distressing pandemic-related memory. Before and after each 15-minute FT intervention, they rated that memory using the 11-point zero-to-ten subjective units of disturbance (SUD) scale. Results from both interventions were highly significant with large effect sizes (p < .001, Hedges’ g = 2.01, Hedges’ g = 2.39). No adverse reactions were reported. For 35 participants who processed the same memory in both interventions, the pre–post SUD scores from the beginning of intervention #1 to the end of intervention #2 showed a significant reduction with a large effect size (p < .001, Hedges’ g = 3.80). For this group, both intervention #1 and intervention #2 showed significant reductions with large effect sizes (p < .001, Hedges’ g = 2.00) (p < .001, Hedges’ g = 1.18). Follow-up SUD scores were obtained from 58 participants, with the mean disturbance level showing a significant further decrease. These findings provide preliminary evidence that group FT appears to safely provide rapid relief from disturbing memories. FT merits further research.

scholarly journals Verpleging van die geestesvertraagde kind in die gemeenskap

Curationis ◽  
1985 ◽  
Vol 8 (2) ◽  
Author(s):  
S.J. Moolman
Keyword(s):  
Motor Skills ◽  
Nursing Care ◽  
Self Care ◽  
Retarded Child ◽  
Mentally Retarded ◽  
Care Plan ◽  
Personal Hygiene ◽  
Multi Disciplinary Team

There is a shift in emphasis in nursing care of the mentally retarded child in the community. Firstly, the child must be identified and then his condition is evaluated, usually by a multi-disciplinary team. A decision must then be made whether the child will be cared for in the community. The nurse assists the parent or guardian in training for independence which includes self-care, use of toilet, personal hygiene, and dressing. Training in various perceptual and motor skills are also included in the nursing care plan. The nurse makes follow-up visits to evaluate progress and adapts the nursing care plan as necessary. She also has an important role in encouraging and guiding the parents. Nursing the mentally retarded child in the community requires specialised knowledge — and a lot of love.

scholarly journals Reasons patients leave their nearest healthcare service to attend Karen Park Clinic, Pretoria North

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Agnes T. Masango- Makgobela ◽  
Indiran Govender ◽  
John V. Ndimande
Keyword(s):  
Healthcare Provider ◽  
Waiting Time ◽  
Healthcare Service ◽  
Waiting Times ◽  
Healthcare Providers ◽  
Descriptive Study ◽  
Staff Attitudes ◽  
Quality Service ◽  
Cross Sectional

Background: Many patients move from one healthcare provider or facility to another, disturbing the continuity that enhances holistic patient care.Objectives: To investigate the reasons given by patients for attending Karen Park Clinic rather than the clinic nearest to their homes.Methods: A cross-sectional descriptive study was conducted during 2010. Three hundred and fifty patients attending Karen Park Clinic were given questionnaires to complete, with the following variables: place of residence; previous attendance at the clinic nearest their home; services available at their nearest clinic; and their willingness to attend their nearest clinic in future.Results: Respondents were from Soshanguve (153; 43.7%), Mabopane (92; 26.3%), Garankuwa (29; 8.3%) and Hebron (20; 5.7%) and most were women (271; 77.4%) aged 26–45 (177; 50.6%). Eighty per cent (281) of the patients had visited their nearest clinic previously and 54 of these (19.2%) said they would not return. The reasons for this were: long waiting time (88; 25.1%); long queues (84; 24%); rude staff (60; 17%); and no medication (39; 11.1%).Conclusion: The majority of patients who had attended their nearest clinic were adamant that they would not return. It is necessary to reduce waiting times, thus reducing long queues. This can be achieved by having adequate, satisfied healthcare providers to render a quality service and by organising training for management. Patients can thus be redirected to their nearest clinic and the health centre’s capacity can be increased by procuring adequate drugs. There is a need to follow up on patients’ complaints about staff attitudes.

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