Thematische Bibliographien / Incompetent patients

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Auswahl der wissenschaftlichen Literatur zum Thema „Incompetent patients“

Autor: Grafiati
Veröffentlicht am 28. Juni 2021
Zuletzt aktualisiert am 14. Februar 2022

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Zeitschriftenartikel zum Thema "Incompetent patients"

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Valentín, L. I., W. H. Valentín, S. Mercado und C. J. Rosado. „Venous Reflux Localization: Comparative Study of Venography and Duplex Scanning“. Phlebology: The Journal of Venous Disease 8, Nr. 3 (September 1993): 124–27. http://dx.doi.org/10.1177/026835559300800309.

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Objective: To compare the results obtained by duplex ultrasound imaging and ascending and descending phlebography in patients with chronic venous insufficiency. Design: Prospective comparison between venography and duplex ultrasound imaging in a single patient group with chronic venous insufficiency. Setting: Private vascular clinic in Puerto Rico. Patients: Twenty-one patients presenting with clinical evidence of venous disease of the lower limb. Main outcome measures: Presence of valvular incompetence in deep and superficial veins as indicated by duplex ultrasound imaging and ascending and descending phlebography. Results: Duplex ultrasound imaging showed twice as many patients with popliteal vein incompetence (eight veins compared with four veins) and twice as many incompetent long saphenous veins (14 detected by duplex, eight detected by venography). In the proximal venous system, 13 common femoral veins were thought incompetent on venography, but only seven on duplex scanning; in the superficial femoral vein, 11 were incompetent on venography and three on duplex scanning. Conclusion: Duplex ultrasound scanning provides greater sensitivity for detection of valvular incompetence in distal veins compared with venography. Descending phlebography is poor in demonstrating distal venous valvular incompetence.
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Belcaro, G., und B. M. Errichi. „Selective Saphenous Vein Repair: A 5-Year Follow-up Study“. Phlebology: The Journal of Venous Disease 7, Nr. 3 (September 1992): 121–24. http://dx.doi.org/10.1177/026835559200700310.

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objective: To evaluate the effect of selective saphenous vein repair (SSVR) in a 5-year follow-up study. Design: Prospective, randomized study of 44 subjects randomized to an SSVR group and a control group. Setting: University Clinic, Chieti, and Angiology and vascular Surgery Clinic, Pescara, Italy. Patients: Twenty-two patients in the SSVR group and 22 in the control group. Inclusion criteria were incompetence of the saphenofemoral junction (SFJ) with presence of valve cusps and two to five venous sites in the long saphenous vein. interventions: SFJ plication and selective interruption of the incompetent sites under general anaesthetic. Main outcome measures: Ambulatory venous pressure measurements (refilling time) and colour duplex scanning to detect the number of incompetent sites. Result: After 5 years, 18 patients in the SSVR group and 19 in the control group completed the study. SSVR increased refilling time ( p<0.02) and the number of incompetent sites was decreased ( p<0.02); in the control group, refilling time remained short and the number of incompetent sites increased ( p<0.05). Conclusion: SSVR is an effective treatment with good 5-year results on incompetence and the development of new incompetent venous sites.
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Nusrat Mahjabeen und Shaikh Zinnat Ara Nasreen. „McDonald’s suture: A successful case“. Z H Sikder Women’s Medical College Journal 3, Number 1 (01.01.2021): 38–40. http://dx.doi.org/10.47648/zhswmcj.2021.v0301.09.

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Cervical incompetence is characterized by painless dilatation of the incompetent cervix and results in miscarriages and preterm delivery during second trimester. Cervical cerclage (CC) has been utilized for the cure of loss in second trimester pregnancy. The detection of cervical incompetency is difficult. Usually patients have history of repeated second trimester demise or early preterm delivery after cervical dilatation without pain having no bleeding, contractions, or other reasons. We report a 28years old patient, 3rd gravida, para 0+2, at 11 weeks’ gestation with the diagnosis of cervical incompetence, in whom cervical cerclage (McDonald’s suture) was performed successfully. There were no operative or immediate postoperative complications. A healthy infant was delivered at 37 weeks by caesarean section. After delivery the suture was removed. Cervical cerclage during pregnancy can be safe and effective treatment for well-selected patients with cervical incompetence.
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Al Jubair, Khalid A., Abdullah Jaralla, Mohsen Fadala, Emad Bukhari, Yahya Al Faraidi, Huwaida Al Qethami und Mohamed R. Al Fagih. „Repair of the mitral valve because of pure rheumatic mitral valvar incompetence in the young“. Cardiology in the Young 8, Nr. 1 (Januar 1998): 90–93. http://dx.doi.org/10.1017/s1047951100004698.

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AbstractBetween January 1985 and April 1994, 42 children aged between 7 and 14 years (mean 11.3 years) underwent repair of severely incompetent rheumatic mitral valves with no accompanying mitral stenosis. In 19 patients the tricuspid valve was severely incompetent, while 8 patients had severe aortic incompetence. Overall, the repair incorporated shortening of elongated tendinous cords and insertion of a Duran or Carpentier prosthetic ring. The repair was the sole procedure in 15 patients, whilst 19 patients also had a De Vega tricuspid valvar annuloplasty and 8 had repair or replacement of the aortic valve. There were no hospital deaths. Postoperative transthoracic echocardiographic studies revealed trivial residual mitral valvar regurgitation in 6 patients, mild regurgitation in 18, moderate in 15, and regurgitation severe enough to warrant replacement of the mitral valve in 3 patients. The mean follow-up period was 37 months (maximum 120 months, minimum 1 month). 0139 patients followed-up, 28 attended for more than 5 years. Of these, 7 underwent replacement of the mitral valve for severe regurgitation within 4 years of the repair. Severe mitral regurgitation in 3 patients was controlled by medical therapy. One was eventu ally lost to follow-up, and one patient died of causes unrelated to surgery. The remaining 16 patients had absent to moderate mitral valvar regurgitation. These results contrast with 10 repairs of congenital mitral incompetence, where no patients required re-operation in the immediate 5 years period of follow-up. Every effort should be made in children with rheumatic mitral incompetence to preserve the natural valve by con servative repair, despite the fact that repair of the incompetent rheumatic mitral valve is not so durable as repair of congenitally incompetent valves.
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Zaniewski, M., T. Urbanek, A. Dorobisz, E. Majewski, U. Skotnicka-Graca und J. Kostecki. „Haemodynamic changes of the deep vein system of the leg after surgery of the incompetent great saphenous vein“. Phlebologie 39, Nr. 01 (2010): 18–23. http://dx.doi.org/10.1055/s-0037-1622288.

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SummarySurgical treatment of chronic venous disease primarily aims to restore the normal haemodynamic conditions in the venous system. The objective of the study was an assessment of the influence of incompetent saphenous vein removal on the haemodynamical changes within the venous and arterial system of the operated extremity. Patients, materials, methods: The study utilised a group of 50 patients presenting with varicose veins (C2 according to CEAP classification) and great saphenous vein incompetence selected for saphenous vein stripping. In all patients, duplex Doppler examination of femoral and popliteal veins as well as femoral and popliteal arteries was performed before surgery, on the first postoperative day and 30 days after surgery. Results: After the removal of an incompetent great saphenous vein, a statistically significant increase in the minute volume flow in the femoral (p = 0.0004) and popliteal veins (p = 0.0011) was observed. Following saphenous vein stripping, a statistically significant reduction of the venous reflux time in the deep vein system was also observed in the common femoral, femoral and popliteal veins, as compared to a pre-operative examination. Postoperatively, normalisation of the venous reflux time was achieved in 36–40% of patients from the group with concomitant deep vein system incompetence. As far as the arterial system is concerned, an increase in the volume flow in the femoral (p = 0.0463) and popliteal arteries was observed, but statistical significance was not achieved in the latter (p = 0.2912). Conclusion: The flow in the deep vein system increases after the removal of the incompetent great saphenous vein. In some patients with an incompetent deep vein system, venous reflux time returns to normal after the incompetent saphenous vein has been removed.
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Kerridge, Ian. „Competent Patients, Incompetent Decisions“. Annals of Internal Medicine 123, Nr. 11 (01.12.1995): 878. http://dx.doi.org/10.7326/0003-4819-123-11-199512010-00011.

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Francis, R. „Treating temporarily incompetent patients“. BMJ 311, Nr. 7009 (30.09.1995): 876–77. http://dx.doi.org/10.1136/bmj.311.7009.876b.

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Chaudhri, K. „Treating temporarily incompetent patients“. BMJ 311, Nr. 7010 (07.10.1995): 948–49. http://dx.doi.org/10.1136/bmj.311.7010.948c.

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van Gent, WB, und CHA Wittens. „Influence of perforating vein surgery in patients with venous ulceration“. Phlebology: The Journal of Venous Disease 30, Nr. 2 (19.12.2013): 127–32. http://dx.doi.org/10.1177/0268355513517685.

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Objectives The exact role of perforating vein surgery is still unclear. The aim of this study is to analyze the influence of perforating vein surgery in patients with venous ulceration. Methods This study was part of a randomized controlled trial in which conservative and surgical treatment of venous ulceration was compared. It is a secondary analysis of prospectively gathered data. Ninety-seven active leg ulcers were surgically treated with a subfascial endoscopic perforating vein surgery (SEPS) procedure. Concomitant superficial venous incompetence was treated with flush saphenopopliteal ligation and/or saphenofemoral ligation and limited stripping of the great saphenous vein. All patients were also treated with ambulatory compression therapy. Ulcer healing and recurrences are described in detail. To measure the completeness of the SEPS procedure duplex ultrasonography was performed on each patient before and 6 weeks and 12 months after surgery. Also newly formed perforators after surgery were scored and their influence was analyzed. Results Analyses were performed on 94 ulcerated legs with a mean follow-up of 29 months. In all treated legs, only 45% all perforators were treated. In 55% one (29%) or more (26%) perforators were missed. Healing was not significantly influenced by the number of remaining incompetent perforating veins, but recurrence was significantly higher in patients who had incomplete SEPS procedure ( p = 0.007 log-rank). New incompetent perforating veins did not affect ulcer healing or recurrence. The plotted location of new perforators did not show a pattern. Deep vein incompetence and treatment of superficial venous incompetence had no significant influence on healing or recurrence rates in a complete or incomplete SEPS procedure. Conclusion In this series a well-performed SEPS procedure lowers the venous ulcer recurrence rate significantly, indicating the clinical importance of incompetent perforating veins in patients with an active venous ulcer.
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Conrad, P. „Endoscopic Exploration of the Subfascial Space of the Lower Leg with Perforator Vein Interruption Using Laparoscopic Equipment: A Preliminary Report“. Phlebology: The Journal of Venous Disease 9, Nr. 4 (Dezember 1994): 154–57. http://dx.doi.org/10.1177/026835559400900405.

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Objective: To describe a method of endoscopic exploration of the medial subfascial space of the lower leg using laparoscopic equipment and dividing incompetent perforating veins crossing this space with diathermy. Design: Prospective study in seven patients with significant perforating vein incompetence in the medial lower leg. Setting: Department of Surgery, Nepean Hospital, New South Wales, Australia. Intervention: Laparoscopic equipment is used to explore endoscopically the medial subfascial space of the lower leg. Incompetent perforating veins preoperatively marked by duplex examination are identified and divided by endoscopic diathermy. Main outcome measures: The endoscopic division close to their source from the deep veins of incompetent perforating veins of the medial compartment of the lower leg. Results: Endoscopic interruption of incompetent perforators in the medial compartments of seven legs achieved with minimal morbidity. Conclusions: Endoscopic diathermy interruption of incompetent perforators in the medial compartment of the lower leg using laparoscopic equipment is a rapid and accurate procedure with minimal morbidity, as shown in a small series of seven legs.
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Dissertationen zum Thema "Incompetent patients"

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Cockram, Cheryl Anne. „Level of demoralization as a predictor of stage of change in patients with gastrointestinal and colorectal cancer“. [Tampa, Fla.] : University of South Florida, 2004. http://purl.fcla.edu/fcla/etd/SFE0000269.

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Joussain, Charles. „Construction and validation of HSV-1 vectors with selective and long-term expression in bladder afferent neurons for gene therapy of neurogenic detrusor overactivity. : A translational approach Botulinum Neurotoxin Light Chains Expressed by Defective Herpes Simplex Virus Type-1 Vectors Cleave SNARE Proteins and Inhibit CGRP Release in Rat Sensory Neurons Development and assessment of herpes simplex virus type 1 (HSV-1) amplicon vectors with expression from sensory neuron-selective promoters. Construction and properties of replication-incompetent HSV-1 recombinant vectors expressing transgenic botulinum toxins in primary cultures of human sensory neurons and displaying long-term expression in vivo. Therapeutic escalation for the neurogenic bladder in SCI patients : A bicentric study real life experience Long-term outcomes and risks factors for failure of intradetrusor onabotulinumtoxin A injections for the treatment of refractory neurogenic detrusor overactivity“. Thesis, Université Paris-Saclay (ComUE), 2019. http://www.theses.fr/2019SACLV057.

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Cinquante à 80% des patients atteints d'une lésion médullaire traumatique (LM) présente des d'épisodes d'incontinence urinaire liés à une hyperactivité détrusorienne neurogène (HDN). L’HDN est caractérisée par des contractions non inhibées du détrusor pendant la phase de remplissage vésical, qui conduit à une augmentation des pressions détrusoriennes, particulièrement lorsque l’HDN est associée à une dyssynergie vésico-sphinctérienne. L'objectif principal de la prise en charge de l’HDN est d'obtenir une vidange vésicale régulière, complète et à basse pression, ainsi que de maintenir la continence urinaire, afin d'améliorer la qualité de vie des patients et de prévenir les complications uro-néphrologiques dont l’insuffisance rénale. La prise en charge actuelle repose sur une pharmacothérapie agissant principalement au niveau de la branche efférente, motrice, du réflexe mictionnel, permettant ainsi un remplissage vésical à basse pression. Le traitement de première intention repose sur des antimuscariniques oraux, le plus souvent associés à la réalisation d’autosondages pluriquotidiens. En cas d’échec de cette thérapeutique, l’injection intradétrusorienne de toxine botulique A est proposée. Cependant, malgré leur efficacité, ces traitements induisent des effets secondaires et souffrent d’un échappement thérapeutique, conduisant à un traitement chirurgical de troisième ligne. La technique de Brindley, qui consiste en une désafférentation des racines postérieures sacrées innervant la vessie associée à une stimulation électrique, à la demande, des racines antérieures est une alternative prometteuse, mais reste peu proposée en raison de la complexité de la procédure chirurgicale requise. L'HDN résulte de l'émergence d'un réflexe spinal anormal médié par une plasticité des afférences vésicales de type-C dans les suites de la LM. Le projet de mon équipe est de réaliser une déafférentation vésicale par thérapie génique afin d'abolir le réflexe de miction spinale altérée. Dans un second temps, la miction sera déclenchée par une stimulation électrique à la demande, des neurones efférents de la vessie. Mon travail de thèse consistait à développer les outils nécessaires à une telle désafférentation moléculaire. En conséquence, j'ai construit des vecteurs défectifs HSV-1 délivrant comme transgène thérapeutique la chaine légère d’un toxine botulique (BoNT-LC), sous le contrôle du promoteur du gène codant pour la protéine liée au gène de la calcitonine (hCGRP), permettant une expression sélective au sein des neurones sensoriels. La cassette de transcription a été insérée dans le locus LAT du génome HSV-1, la seule région du génome du virus qui reste active sur le plan transcriptionnel pendant une infection latente. Ces vecteurs ont été évalués (i) in vitro, sur des lignées cellulaires d'origine neurale et sur des cultures primaires de neurones sensoriels embryonnaires et adultes de rats, ainsi que sur des cultures primaires de neurones sensoriels et sympathiques humains adultes, (ii) ex vivo, sur des cultures organotypiques de ganglions sensoriels, sympathiques et parasympathiques de rats adultes, et (iii) in vivo, post inoculation au niveau du coussinet plantaire de rats adultes. Nos résultats indiquent que (i) les vecteurs expriment des BoNT-LC fonctionnelles, clivant ainsi les protéines SNARE post infection de cultures primaires de neurones sensoriels de rats et d’être humain, et inhibant la libération du neuromédiateur CGRP dans les neurones sensoriels de rat, (ii) la sélectivité d’expression de ces vecteurs dans des neurones sensoriels humains, par rapport aux neurones sympathiques humains, et (iii) une expression transgénique prolongée in-vivo au sein de ganglions sensoriels (DRG), au moins pour trois mois, après injection. Par conséquent, ces vecteurs semblent présenter les trois principales spécifications requises pour le développement d’une future stratégie de thérapie génique visant à traiter l’HDN
Fifty to 80% of patients with traumatic spinal cord injury (SCI) undergo urinary incontinence episodes, mostly related to neurogenic detrusor overactivity (NDO). NDO is characterized by uninhibited detrusor contractions during the bladder-filling phase which could lead to a significant increase in bladder pressures, especially when associated to sphincter-destrusor-dyssynergia, leading to uro-nephrological complications. The main goal of NDO management following SCI is to achieve regular and complete bladder emptying, avoiding high intra-detrusor pressure and maintaining continence, in order to improve patients’ quality of life and to prevent renal failure. The current management is well characterized and relies on pharmacotherapy acting primarily at the level of efferent motor micturition reflex branch, thus allowing bladder filling at low pressure. First line treatment relies on oral antimuscarinics, often associated to clean intermittent bladder self-catheterization. When patients are refractory to antimuscarinics, injection of botulinum toxin A into the detrusor is proposed. However, despite their efficacy, these treatments fail to persist in the long term, leading to a third-line surgical treatment, which consists in cystoplasty augmentation or sacral neuromodulation. The Brindley technique, which consist in a sacral deafferentation of bladder posterior roots associated to an electrical stimulation, on demand, of anterior roots is a promising alternative, but remains seldom performed because of the complex surgical procedure required. NDO results from the emergence, secondary to neuronal plasticity following SCI, of an abnormal micturition reflex mediated by bladder afferent C-fibers, conveying aberrant sensory information to the spinal cord. The aim of the team where I developed my work is to silence these bladder afferent C-fibers in order to abolish the impaired spinal micturition reflex after SCI. In a second time, micturition would be fired, on demand, by electric stimulation of the bladder efferent neurons. My work consisted in developing the tools and methods required for such molecular deafferentation. Accordingly, I constructed replication-incompetent HSV-1 vectors conceived to deliver a therapeutic transcription cassette, consisting in the light chains of botulinum toxin (BoNT-LC) driven by the human version of the promoter of the gene encoding calcitonin gene-related protein (hCGRP), to achieve sensory neuron-selective transgenic expression. The transcription cassette was inserted into the LAT locus of the HSV-1 genome, the only region of the virus genome that remains transcriptionally active during latent infection. These vectors have been assessed (i) in vitro, on cell lines of neural origin and on primary cultures of rat embryonic and adult sensory neurons, and on primary cultures of adult human sensory and sympathetic neurons, (ii) ex vivo, on organotypic cultures of sensory, sympathetic and parasympathetic ganglia from adult rats, and (iii) in vivo, in sensory ganglia following infection at the hind footpad of adult rats.Our results indicate that (i) the vectors express functional BoNT-LC, thereby cleaving proteins of the SNARE complex in rat and human sensory neurons and inhibiting release of the neuromediator CGRP in rat sensory neurons, (ii) the transcription cassette delivered by the vectors display highly selectively expression towards human sensory neurons, as compared to human sympathetic neurons, and (iii) the vectors induced long-term transgenic expression in sensory (DRG) ganglia (at least for three months) following footpad injection. Therefore, the vectors seem to accomplish the three main specifications required for a future gene therapy strategy, allowing to restore urinary continence and micturition without catheterization and without any major surgery. This approach will represent a major breakthrough in the management of NDO in SCI patients with complete and incomplete lesion
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Ficken, Carl Theodore. „Using demographic and clinical variables to predict the length of stay of "incompetent to stand trial" patients“. Thesis, 2003. http://hdl.handle.net/1957/31823.

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In Oregon, "Incompetent to Stand Trial (1ST) Patients" were observed to be increasing in number, remaining in the hospital longer, and costing more to treat. A study was designed to investigate variables that could be used to predict their length of stay at Oregon State Hospital. Data for thirteen independent variables (gender, age, having an Axis I psychosis level diagnosis, having an Axis I substance-related diagnosis, having an Axis II personality disorder diagnosis, evidence of involuntary medications, being on atypical medications at discharge, number of seclusion and restraint events, number of felony charges, number of misdemeanor charges, and number of inter-ward transfers) and one dependent variable (length of stay) were analyzed for 198 1ST patients discharged from Oregon State Hospital between January, 1999 and December, 2001. Bivariate correlations for all variables, and length of stay (LOS) means for all levels of each variable were examined and discussed. A standard multiple regression analysis was performed. The regression model accounted for 36.5% (32.7% adjusted) of the variability in (log) LOS. R for regression was found to be significantly different from zero. Five variables were found to be significant contributors to explaining the variability in (log) LOS: (square root) number of inter-ward transfers (16%), gender (5.8%), evidence of involuntary medications (5.2%), (square root) number of felony charges (2.8%), and (square root) number of seclusion and restraint events (1.6%). Despite accounting for more variability in LOS than several previous studies with psychiatric patients, 67.3% of the variability was unaccounted for by the regression model. Unstandardized regression coefficients for untransformed variables were interpreted, revealing that gender, number of inter-ward transfers, and evidence of involuntary medications significantly predicted the largest increases in LOS. Recommendations were made for further research related to LOS of 1ST patients.
Graduation date: 2003
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Francová, Terezie. „Rozhodování za pacienta neschopného vyslovit souhlas s poskytováním zdravotních služeb“. Master's thesis, 2021. http://www.nusl.cz/ntk/nusl-446634.

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1 Proxy decision making for incompetent patients Abstract The author of this thesis discusses the applicable Czech legislation on the proxy decision making for incompetent patients and the provision of medical care without informed consent. The thesis is divided into six parts, while the first part is devoted to the definition of the basic terms that are directly related to this topic and which are repeatedly used herein. These basic terms are the following: health services and healthcare, informed consent and the patient. The second chapter is devoted to sources of law, which are divided into three levels - international sources, European Union law and national sources. Within the national regulation, attention is focused mainly on Act No. 372/2011 Coll., On health services and conditions of their provision, as amended. It also outlines the issue of the duality of legal regulation, that was caused by the adoption of Act No. 89/2012 Coll., Civil Code. The third chapter deals with surrogate consent, attention is paid mainly to resolving conflicts of opinions and to the best interests pricniple, as to the key factor when granting the proxy consent. The fourth chapter is devoted to the institute of previously expressed wishes. The fifth chapter analyses the issue of providing health services to vulnerable...
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Huang, I.-lin, und 黃依琳. „The Study of Patient’s Autonomy in Criminal Law─Incompetent Patient as the Center for Discussion“. Thesis, 2009. http://ndltd.ncl.edu.tw/handle/02775587458595888909.

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碩士
東吳大學
法律學系
97
“Every human being of adult years and sound mind has a right to determine what shall be done with his own body…” is a well-known saying about the right of patient’s self-determination (autonomy) said by American Justice Benjamin Cardozo. Regarding this, when patients are minor or lacking ability of consent if means doctors or family members can make medical treatment decision for them at will. It is worthy of discussing. The research purpose of this article lies in discussing the right of patient’s self- determination and it’s foundation in the constitution, then distinguishing the orientation of “Victim's consent” in system of criminal law to explain the law effect of arbitrary medical treatment behavior. Finally, from the view of “patient’s self-determination” and “protect life right and body right” to explain how can a doctor make proper medical treatment decision for patients who have no consent ability, and suggest some amendments to medical treatment- related laws in the last part of article. In the conclusion, first, this article thinks that protecting “the right of patient’s self-determination” by criminal law is necessary, however balancing between “the right of patient’s self- determination” and the other rights (such as life right, healthy right etc.) which are pursued by criminal law is also very important. For this reason, while we talk about the law effect of arbitrary medical treatment behavior, we can't only emphasize on protecting the right of patient’s self- determination, but have to give attention to other law values which are pursued by Criminal Law, particularly the pursuit of law profits, such as life right and healthy right. Second, at the part about law effect of arbitrary medical treatment behavior, this article thinks that a medical treatment behavior with patient's consent is not equal to a lawful act and“patient’s consent”is a essential condition for doctors to claim “reasonable act In service” to eliminate the illegality of their conduct, no matter doctors apply medical treatment behavior without obtaining patients’ consent, or obtaining patients’ consent but their consent is not based on enough information providing fully by doctors, doctors can’t claim “reasonable act in service” to eliminate the illegality of their conduct. According to this, the law effect of arbitrary medical treatment behavior is probably adjudged intentionally assault. Moreover, when doctors mistake the validity of patients’ consent and apply medical treatment behavior, this situation will concern the subject “mistakes of allowable criminal-component”, according to the majority, doctor’s conduct may be adjudged negligent. Finally, regarding the law effect of patient’s decision-making ability, this article thinks that lots of medical treatment-related laws are inappropriate, for example, giving family members too much power to participate in making medical treatment decision, without respecting patients’ self-determination right fully, using the standard “have ability to conclude a treaty or not” or “become adult or not” to decide the validity of consent, and the eugenics health care law forbids young girls having abortion surgery without parents’ consent may force teenage girls turning to use insecure way to terminate pregnancy. For this reason, these laws must be revised.
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Lin, Yen-Chun, und 林妍君. „The Influence of Beta-blocker on Exercise Physiological Profile in Acute Myocardial Infarction Patients with Chronotropic Incompetence“. Thesis, 2017. http://ndltd.ncl.edu.tw/handle/48933047246595210752.

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碩士
國立中興大學
運動與健康管理研究所
105
Background & Purpose : Chronotropic incompetence (CI) , broadly defined as the inability of the heart to increase its rate commensurate with increased activity or demand. It has been used to be an important predictor of autonomic nervous system. Traditionally, it has been using the predicted maximal heart rate formula (220-age) as an indicator for rehab exercise intensity prescription in clinical practice. However, it may not be suitable to apply in the patients with acute myocardial infarction (AMI) who accompanied with CI. Therefore, the current study was to investigate the influence of beta-blockers on exercise physiological profile of patients with AMI and CI. The current predict maximal heart rate formulas were also evaluated in the AMI patients with/without beta-blockers medication. Methods : One hundred and four AMI patients were recruited in this study. Patients were assigned to beta-blocker group (n=79) or non beta-blocker group (n=25) according their medical history. The exercise physiology profile was collected by Cardiopulmonary Exercise Testing, includes resting cardiac output, maximal cardiac output, resting stroke volume, maximal stroke volume, predict maximal heart rate, resting heart rate, maximal heart rate, maximal heart rate/ predict maximal heart rate, maximal oxygen uptake, metabolic equivalent, maximal workload. The maximal heart rate predictive formula was evaluated by comparing the effect of beta-blockers uses. Results：The beta- blockers group in AMI patients with CI showed the lower resting cardiac output (p=0.03), resting heart rate (p=0.04), maximal heart rate (p<0.001), maximal heart rate/predict maximal heart rate (p<0.001), maximal oxygen uptake (p=0.01) and metabolic equivalent (p=0.02) than the non beta-blocker group. Using the new predictive formula (164-0.72*age) to calculate the maximum heart rate, showed more closed to the actual maximum heart rate. The beta-blockers group demonstrated lower in actual maximum heart rate than non beta-blockers group (p<0.001). Conclusion : The current study demonstrated the influence of beta-blockers on exercise physiological profile in AMI patients with CI. The new forecast formula for maximal heart rate was closer to the actual maximum heart rate among these patients. The patients under beta-blockers medication showed a stronger CI effect. In the clinical practice, it is suggested to be carefully using maximal heart predictive formula for exercise prescription in particular for the CI patients under beta-blockers medication.
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7

Ayliffe, Brett William. „Evaluation of the Toronto Palatal Lift Prosthesis for Patients with Hypernasal Resonance Disorders“. Thesis, 2013. http://hdl.handle.net/1807/35582.

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Statement of the problem. Hypernasality resulting from velopharyngeal insufficiency or incompetency is a resonance disorder that has negative consequences for speech production and intelligibility of afflicted individuals. Purpose. The purpose of this prospective study is to ascertain if a palatal lift prosthesis with a generic silicon velar lamina, termed the Toronto Palatal Lift Prosthesis (TPLP), can assist velopharyngeal valve function to reduce hypernasality in patients. Methods. A prospective study of six patients treated with the TPLP was compared by the outcome measures of nasalance scores, perceptual evaluations, and patient satisfaction to those obtained using a contemporary acrylic palatal lift prosthesis. Results. The six patients had varying degrees of reduction in hypernasality and acceptance of the TPLP. Conclusion. On the basis of this preliminary study on the TPLP it is possible to fabricate a palatal lift prosthesis with a generic silicon velar lamina that reduces hypernasality in select patients.
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Bücher zum Thema "Incompetent patients"

1

Franceschi, Claude. Conservative haemodynamic cure of incompetent and varicose veins in ambulatory patients. Précy-sous-Thil: Éditions de l'Armançon, 1993.

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2

Buchanan, Allen E. Surrogate decisionmaking for elderly individuals who are incompetent or of questionable competence. [Washington, D.C.?: The Office, 1985.

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3

Annas, George J. Withholding and withdrawing of life-sustaining treatment for elderly incompetent patients: A review of court decisions and legislative approaches. [Washington, D.C.?: The Office, 1985.

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4

Advance treatment directives and autonomy for incompetent patients: An international comparative survey of law and practice, with special attention to the Netherlands. Lewiston: Edwin Mellen Press, 2008.

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5

Carroll, Paula. Life wish: One woman's struggle against medical incompetence. Alameda, Calif: Medical Consumers Pub. Co., 1986.

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6

Robertson, Edward D. Personal autonomy and substituted judgment: Legal issues in medical decisions for incompetent patients. Diocesan Press, 1991.

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Ekundayo, Adedayo Adekemisola. THE LIVED EXPERIENCE OF SURROGATE DECISION MAKER AND REQUEST FOR DNR ORDERS ON BEHALF OF INCOMPETENT PATIENTS. 1995.

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Hertogh, Cees, und Jenny van der Steen. Ethics of living and dying with dementia. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0057.

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The gradual progression of dementia means there has to be a constant search for a reasonable balance between supporting autonomy and ensuring proper representation. ∙ Good end of life care for people with dementia depends on adequate advance care planning, startling early in the disease process ∙ Where possible, it involves striving for joint decision-making with the patient and next-of-kin about (future) medical treatment and (future) care. ∙ Written advance directives may support representatives of incompetent patients in their role of surrogate decision maker, but the contents of the directive require interpretation in the context of advance care planning. ∙ The concept of “palliative care” offers a (policy) framework for advance care planning as well as moral guideline for dealing with written advance directives of patients with dementia.
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9

Veatch, Robert M., Amy Haddad und E. J. Last. Consent and the Right to Refuse Treatment. Herausgegeben von Robert M. Veatch, Amy Haddad und E. J. Last. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190277000.003.0017.

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This chapter is concerned with one of the major ethical issues in contemporary health care practice: informed or valid consent. The chapter defines the elements of informed consent—that is, the types of information that need to be transmitted for consent to be adequately informed. The second section looks at cases involving questions of the standards of consent, referring to the question of what standard of reference should be used in determining whether a sufficient amount of a particular type of information has been transmitted: the professional standard, the reasonable person standard, or the subjective standard. The third section examines questions of whether the information transmitted is comprehended and whether the consent is adequately voluntary. Finally, the fourth section addresses whether incompetent patients can be expected to consent and what role parents, guardians, and other surrogates can play in giving approval for medical treatments for those who are legally incompetent to do so themselves.
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Consent and the incompetent patient: Ethics, law, and medicine. London: Gaskell, 1988.

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Buchteile zum Thema "Incompetent patients"

1

Yang, Yaning. „A Family-Oriented Confucian Approach to Advance Directives in End-of-Life Decision Making for Incompetent Elderly Patients“. In Philosophy and Medicine, 257–70. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-12120-8_17.

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2

Erbel, Raimund, M. Drexler, S. Mohr-Kahaly, N. Wittlich und J. Meyer. „Diagnostic value of transesophageal echocardiography in patients with coronary artery disease and mitral insufficiency“. In Ischemic Mitral Incompetence, 89–98. Heidelberg: Steinkopff, 1991. http://dx.doi.org/10.1007/978-3-662-08027-6_8.

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Yacoub, M. H., T. M. Sundt und N. Rasmi. „Management of aortic valve incompetence in patients with Marfan syndrome“. In Cardiovascular Aspects of Marfan Syndrome, 71–81. Heidelberg: Steinkopff, 1995. http://dx.doi.org/10.1007/978-3-642-72508-1_10.

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Treese, Norbert, M. Coutinho, A. Stegmeier, S. Jungfleisch, A. Werneyer, U. Nixdorf, N. Ophoff und J. Meyer. „Influence of Rate Responsive Pacing on Aerobic Capacity in Patients with Chronotropic Incompetence“. In Computerized Cardiopulmonary Exercise Testing, 139–46. Heidelberg: Steinkopff, 1991. http://dx.doi.org/10.1007/978-3-642-85404-0_14.

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5

Klyscz, Thomas, Irmgard Jünger, Ulrich Jeggle, Martin Hahn und Michael Jünger. „Clinical Improvement of Skin Microcirculation in Patients with Chronic Venous Incompetence (CVI) by Physical Exercise Training“. In The Physiology and Pathophysiology of Exercise Tolerance, 311–14. Boston, MA: Springer US, 1996. http://dx.doi.org/10.1007/978-1-4615-5887-3_44.

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6

Klyscz, T., M. J�nger und G. Rassner. „Physical Therapy of the Ankle Joint in Patients with Chronic Venous Incompetence and Arthrogenic Congestive Syndrome“. In Management of Leg Ulcers, 141–47. Basel: KARGER, 1999. http://dx.doi.org/10.1159/000060639.

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7

Berg, Jessica W., Paul S. Appelbaum, Charles W. Lidz und Lisa S. Parker. „Exceptions to the Legal Requirements: Incompetence“. In Informed Consent. Oxford University Press, 2001. http://dx.doi.org/10.1093/oso/9780195126778.003.0011.

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It might seem strange to locate discussion of incompetence under the heading of “exceptions.” Although patient competence serves as a prerequisite for informed consent, surely patient incompetence cannot serve to relieve physicians of all obligations, either ethical or legal, under the doctrine of informed consent. The goals of informed consent—safeguarding patient welfare and autonomy—apply no less to incompetent patients, although they must be pursued differently. The goals of informed consent are pursued on behalf of an incompetent patient by a process of surrogate decision making. A surrogate or proxy participates in the informed consent process on behalf of the incompetent patient. Yet, from the perspective of the physician, the patient’s incompetence constitutes an exception to the usual process of informed consent. A determination of incompetence alters the legal requirements for physician disclosure and for patient consent and thus it is properly regarded as an exception in this sense. This chapter, like the previous two, focuses on the legal doctrine of informed consent and addresses the variation in the legal requirements occasioned by a patient’s incompetence. We leave to others to examine in greater detail the ethical justifications for the legal framework surrounding treatment of incompetent patients (3). It has been recognized since the earliest legal cases dealing with consent that certain individuals are incompetent to consent to treatment and that they may be treated without their consent (4,5). One alternative to treatment without the patient’s consent would be no treatment at all (6), a result that would make a fetish of consent, for it would mean that those lacking the ability to make medical decisions would be required to forgo medical care. The exception for incompetent patients is closely related to the emergency exception. In fact, many situations involve an overlap of the two exceptions, since a number of cases of genuine emergency treatment involve unconscious (and thus incompetent) patients. However, the class of incompetent patients includes more than just those who are unconscious, and situations arise involving the treatment of incompetent patients that are not emergencies.
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8

„Incompetent patients and substitute decision-making“. In The Australian Medico-Legal Handbook, 86–112. Elsevier, 2008. http://dx.doi.org/10.1016/b978-0-7295-3760-5.50008-2.

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9

„Incompetent patients and end-of-life decisions“. In The Australian Medico-Legal Handbook, 149–61. Elsevier, 2008. http://dx.doi.org/10.1016/b978-0-7295-3760-5.50011-2.

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10

Mei-che Pang, Samantha. „Ethical Challenges of Engaging Chinese in End-of-Life Talk“. In Handbook of Research on Technoethics, 316–27. IGI Global, 2009. http://dx.doi.org/10.4018/978-1-60566-022-6.ch021.

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In Hong Kong, end-of-life practice ideally adheres to values that include respect for the patient’s selfdetermination and an understanding shared by and consented to by the patient, the family and the healthcare team. However, consensus about end-of-life care is seldom reached within this trio before the patient become critically ill or mentally incompetent. This chapter examines the customary belief, protectiveness in medical care, which hinders Chinese patients and families in their discussion of lifesustaining treatment; challenges the practice in question; and discusses the possibility of engaging frail nursing home residents in dialogue by using the “Let Me Talk” advance care planning program.
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Konferenzberichte zum Thema "Incompetent patients"

1

Sova, Milan, Amjad Ghazal Asswad, Samuel Genzor und Vitezslav Kolek. „Chronotropic incompetence in patients before lung cancer surgery“. In ERS International Congress 2019 abstracts. European Respiratory Society, 2019. http://dx.doi.org/10.1183/13993003.congress-2019.pa4675.

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Camcioglu, Burcu, Meral Bosnak-Güçlü, Müserrefe Nur Karadalli, Nurdan Köktürk und Haluk Türktas. „Comparison of exercise capacity, respiratory and peripheral muscle strength and dyspnea in patients with interstitial lung disease with and without chronotropic incompetence“. In Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.pa4821.

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